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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16211
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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My 12 year old Lab/Chow mix has been lethargic, avoids food,

Customer Question

My 12 year old Lab/Chow mix has been lethargic, avoids food, has lost around 10 lbs, has loose stools and has thrown up bile recently. Any idea what the problem might be?
Submitted: 10 months ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 10 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

How long has he been showing signs?

Is he drinking normally? Can he keep any water down?

Are his gums nice and pink (not white/pale)? Moist or sticky?

If you press on his belly, does he have any tensing, tenderness, discomfort, or pain?

Could he have eaten anything he should not have (ie bones, toys, plants, chemicals, human meds, etc)?

What color has his stool been?

Customer: replied 10 months ago.
I get the impression from your web site that you specialize in cats. I asked a question about a dog. Your answer consisted of further questions. To answer those questions: No, he doesn't have any problem keeping down water. Being a chow mix, he has black gums and they seem to me to be moist. He does not seem to have any discomfort associated with his belly and in fact likes to have his belly rubbed and scratched. It is unlikely that he has ingested anything that could be the cause of the problem. His loose stool began black and is now reddish brown. As I mentioned earlier, he recently had a cortisone shot and an antibiotic regimen due to a skin allergy. However, his problems with eating and weight loss predate the recent treatment. The vet that did the recent treatment thought his weight was good but that weight (40 lbs) represents a 20% loss from what his weight has been (50 lbs) for a number of years. He is also very lethargic and is slow to get up when you want to take him out. Once out, he will go willing for a walk.
Expert:  Dr. B. replied 10 months ago.

Hello again,

I treat just as many dogs as I do cats, so I am well versed in both species as most of us small animal clinicians are. Furthermore, my post above was an information request since I needed more information about your lad. Since you have now provided that I will review that further history and post my thoughts on this case shortly.

Dr. B.

Expert:  Dr. B. replied 10 months ago.

Thank you for your patience,

First, I have to say that I am concerned to hear that you initially saw black stool. The reason is because if dogs are not eating dirt or darkly pigmented foods; this is often a sign of upper GI or stomach based bleeding. If we can rule our sharp foreign bodies, then stomach ulcers or tumors would be on our list of concerns here. And I would note that if we saw black stool after the cortisone specifically, then a stomach ulcer would be even more of a suspicion here. Furthermore, since he has enough chow heritage to darken his gums, remember that you can flip down the lower eyelid to check his mucus membrane color and make sure its not pale.

Otherwise, in regards ***** ***** question for what could induce anorexia, vomiting, loose stool, and secondary lethargy; we do have a range of concerns at his age. On top of those stomach bleed based issues, this also is consistent with bacterial or viral gastroenteritis, pancreatitis, parasites/protozoa infections, or could be secondary to underlying health issues (ie organ dysfunction, metabolic disease, cancer).

With this all in mind, I do want to note some supportive care you can try at this stage that would help allay nausea and counter any ulcer based damage. To start, you can consider treating him with an antacid. Common OTC pet safe options would be Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid) or Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac).As well, we could use Milk of Magnesia (0.5 tsp every 8 hours) since this will help with nausea but can also coat the stomach if there is an ulcer present. Whichever you choose, we’d give this 20 minutes before offering food to allow absorption. Of course, do double check with your vet if he has a known health issues or is on any medications you haven't mentioned. Though I would note that if you give this and he cannot keep it down due to nausea that is usually a red flag that we need to bypass his mouth with injectable anti-vomiting medication from his vet.

Once that has had time to absorb and he is steadier on his stomach, you can consider starting him on a light/easily digestible diet. Examples you can use are cooked white rice with boiled chicken, boiled white fish, cottage cheese, or scrambled eggs (made with water and not milk). There are also OTC vet diets that can be used (ie Hill’s I/D or Royal Canin’s sensitivity) too. The aim of these diets is that they will be better tolerated/absorbed by the compromised gut. Therefore, it should get more nutrients in and result in less GI upset and reduce diarrhea load.

That said, if he cannot be tempted, we can try syringe feeding food to break this fast. To syringe feed, we can water down calorie rich diets (ie Hills A/D, Royal Canin Recovery diet, even canned puppy food) or use a liquid diet (ie Clinicare, Dogsure). As well, there are paste supplements (ie Nutrical) that can also be used. And these will all get more in per bite even if we cannot get much in and help stop the weight loss. Of course, any vomiting from this and we’d have to discontinue syringing food.

Overall, a wide range of agents could trigger the anorexia and GI upset we are seeing. That said, if he has passed black stool we do need to tread with great care here since ulcers and bleeding gut tumors are especially a worry. Still if that has subsided, we can try the above just now. Of course, if Loki cannot keep that or water down, appears dehydrated already, or doesn’t respond to the above within 12-24 hours; then we'd want to get his vet involved. They can assess his hydration, check bloods to rule out organ issues, and determine if we have an ulcer or mass present. Depending on their findings, his vet can treat him with injectable anti-vomiting medication, appetite stimulants, +/- alternative antibiotics to settle his stomach, and get him back feeling like himself.

Please take care,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond. *Please remember to rate my service once you have all the information you need, as this is the only way I receive credit for helping you today. Thank you! : )

Customer: replied 10 months ago.
Thank you. That was helpful.
Expert:  Dr. B. replied 10 months ago.

You are very welcome, my dear.

I am glad that I could be of help and shed some light on his situation for you.

All the best for Loki,

Dr. B.

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**Please remember to rate my service once you have all the information you need, as this is the only way I receive credit for helping you today. Thank you! : )

Expert:  Dr. B. replied 10 months ago.
Hi,
I'm just following up on our conversation about Loki. How is everything going?
nekovet