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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16157
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 dog has been trembling hours. JA: I'll do all

Customer Question

my dog has been trembling for several hours.
JA: I'll do all I can to help. What is wrong with your dog?
Customer: she won't eat, barely drinks and is shaking almost non-stop
JA: What is the dog's name and age?
Customer: Bubbles - almost 12
JA: Is there anything else the Veterinarian should be aware of about Bubbles?
Customer: she is taking tramadol for pain due to an inflamed pancreas
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Veterinarian about your situation and then connect you two.
Submitted: 7 months ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 7 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 she been off food and water?Any retching, gagging, lip licking, drooling, or vomiting?Are her gums nice and pink (not white/pale)? Moist or sticky?If you press on her belly, does she have any tensing, tenderness, discomfort, or pain?Could she have eaten anything she should not have (ie bones, stones, socks, toys, plants, chemicals, human meds, etc)?What dose of Tramadol is she on? How often? How much does she weigh?Is she on anything else for her pancreas?
Customer: replied 7 months ago.
She drank about 60 laps of water yesterday but ate nothing since Saturday night. Her appetite has been waning slowly over the last couple of months, especially since she was placed on Chloramphenicol for a joint infection. We decided last night to quit giving it to her - she has been on it a month. A week ago Saturday we took her to the animal emergency hospital because she began throwing up. That is when we discovered the elevated pancreas & liver amounts. They told us to take her off of Previcox (for pain) to improve her appetite, she spent the night got an iv and fully hydrated then came home because she felt better.
Any retching, gagging, lip licking, drooling, or vomiting? No
Are her gums nice and pink (not white/pale)? Yes
Moist or sticky? Neither-damp
If you press on her belly, does she have any tensing, tenderness, discomfort, or pain? No
Could she have eaten anything she should not have (ie bones, stones, socks, toys, plants, chemicals, human meds, etc)? No -she is still recovering from her 3rd surgery on her left hind knee so she is watched carefully.
What dose of Tramadol is she on? How often? How much does she weigh? 50 mg. 4 x day, 25 pounds.
Is she on anything else for her pancreas?No but she takes 10 mg pepcid 2 x day; 25 mg. benedryl twice a dayso we tempted her
Expert:  Dr. B. replied 7 months ago.
Thank you, ***** ***** would note that trembling is a non-specific sign that a dog feels unwell or possibly feverish. So, it is a sign that doesn't tell us much about what is amiss. That said, if she has progressive appetite loss, this raises concerns of underlying nausea despite the Pepcid (possibly due to the ongoing pancreatitis or secondary to the Benadryl or even the Tramadol) but also could fit with oral issues (ie dental disease, rotten/sore teeth, masses, oral ulcers from kidney disease, etc). With this all in mind, we need to tread with care. To start, try tempting her with an easily digestible diet like cooked white rice with boiled chicken, boiled white fish, cottage cheese, scrambled eggs, or meat baby food (as long as its garlic/onion free). 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. Though if she refuses and since she isn't vomiting, we'd need to consider syringe feeding her at this point. We can use a calorie rich diet like Hill's A/D, Royal Canin Recovery or even canned puppy food. As well, there are also liquid diets like Clinicare Canine/Feline Liquid Diet or Dogsure. All of these are nutrient dense, so a little goes a long way nutrition-wise. And these could just help get some more calories in even if we can’t get a huge volume of food in. Finally, if you are struggling and Bubbles won't eat on her own, then we need to ring the local vet about stronger anti-nausea medication to use with the Pepcid. Her vet can treat by injection or provide oral options like Cerenia, Metoclopramide, or Zofran. As well, they can start her on an appetite stimulant to give her a "push" to eat for us. And since she is already on a very high Tramadol dose, you could speak to them about an alternative like Buprenorphine. Finally, since you noted possible liver issues too, we may need to think about an ultrasound to see what is going on with that organ and just make sure her pancreatitis isn't being caused by an enlarged liver or mass on the liver compressing the pancreas. Depending on the findings there, we may need to also start liver supplements to help get her settled and feeling better. Please take care, Dr. B. -----------------------------------------------------------------------------------------------------------------If you have any other questions, please ask me – I’ll be happy to respond. **Afterwards, I would be grateful if you would rate my service by clicking on the "Rate my Expert' button at the top of the page as this is the only way I am credited for helping you. Thank you for your feedback!: )