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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 14832
Experience:  Over 20 years of experience as a veterinarian.
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I have a 3 year old small springer who had a operation in

Customer Question

I have a 3 year old small springer bitch who had a operation in June due to an obstruction in her bowel
JA: I'll do all I can to help. What is the matter with the dog?
Customer: it was successful and ever since she's been a puppy her tummy grumbles so loud and every now and then she's sick with water she takes charcoal tablets but nothing helps
JA: What is the dog's name?
Customer: Holly
JA: Is there anything else important you think the Veterinarian should know about Holly?
Customer: What sort of things?
Submitted: 2 months ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 2 months ago.

Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

Expert:  Dr. Kara replied 2 months ago.

I'm sorry to hear about Holly's chronic issues with increased gastrointestinal noise and upset.

When you say she's " sick with water " does that mean her stools are very watery or that she vomits a watery substance?

If she vomits a watery substance does she also have diarrhea? If so what do her stools look like?

When she's not feeling well is she reluctant to eat or is her appetite still very good?

Do you find that she is more likely to eat things she shouldn't or eat grass/plant material during these episodes when her stomach grumbles more?

Expert:  Dr. Kara replied 2 months ago.

I see that you are offline now. I will give you some general information about dogs with increased gastrointestinal noise and obvious discomfort and you can ask questions or give me more information that you may feel is important.

The noises that you are hearing are the result of ingesta moving through the gastrointestinal tract and gas bubbles. In most cases they are completely normal and seem to cause the dog no distress. But in cases where the dog acts uncomfortable it is likely that the pup is experiencing some reflux or abnormal motility, or painful intestinal spasms that are more than the usual. In severe cases this can be linked to pancreatitis which is a painful inflammation of the pancreas leading to increased enzyme leakage.

Possible causes for these symptoms include a change in diet, dietary sensitivities or allergies, or eating things that she should not have like too many fatty table scraps or garbage, bones etc. Metabolic organ failures (kidney or liver disease), Addison's disease (hypoadrenocortisim), pancreatitis, inflammatory bowel disease or even infiltrative cancers (less likely because this started at a young age and has been going on for a while) are other possible causes.

I would recommend checking basic blood tests on her including a complete blood count, biochemistry panel and a blood test for pancreatitis called can spec PL (canine specific pancreatic lipase) which is highly specific for pancreatitis.

If her electrolyte levels seem unbalanced (high potassium and low sodium) then testing for Addison's disease with a test called an ACTH response test would be reasonable.

If those things are normal then the next step diagnostically would be an abdominal ultrasound and endoscopy to collect intestinal biopsies.

But for now here are some suggestions to help her when she seems uncomfortable.

For now to help with gastrointestinal upset and reflux you can give either:

1) Pepcid ac (famotidine) at a dose of one 10mg tablet per 10-20 kilos of body weight every 12 hours

OR

2) Prilosec (omeprazole) at a dose of one 20mg tablet per 20 to 40 kilos of body weight every 24 hours

These are acid reducers and should help her feel more comfortable. They are quite safe and can be used for a few days if needed. In some cases dogs remain on them long term if this is a repeated problem.

I would pick up all food for now and water for a couple hours to allow her stomach to settle after the acid reducers. In a couple hours you give her water or low salt clear broths like low salt beef or chicken broth to drink, but make sure it is in small amounts only.

If she seems to feel better in 8-12 hours offer a bland diet mix of 1/3 boiled, minced, white, skinless chicken or boiled, lean hamburger, all fats drained off the meat after cooking, and 2/3 boiled, plain, white rice, mashed potatoes or pasta mixed with some low salt chicken or beef broth to make it easy to lap up and swallow as well as increase her fluid intake. If she refuses that you can offer a little meat baby food. If she refuses both then don't push it she likely needs to be seen by your family veterinarian.

Probiotics such as Fortiflora, Proviable, or Benebac can be added to the bland diet mix to help replace appropriate bacteria.

If things go well and she eats and seems more comfortable feed her the bland diet for 2 to 3 days then slowly start to mix back in her regular food, a little more at each meal. It should take about 5 to 7 days to slowly convert her back to her regular diet.

If during these episodes she continues to be lethargic, begins to vomit, runs a fever (more than 103F rectally), or has a tense painful belly then she is not a candidate for home therapy and must see a veterinarian for an examination, diagnostics, injectable anti-nausea drugs intravenous fluids and supportive care.

If you go back to her original food and stop table food and treats and her discomfort and gastrointestinal noises return then you may wish to consider using a using a low irritant food, like Hills or Royal Canin Sensitive Stomach formulas. If those aren't enough then she may need Hills i/d or Purina Veterinary Diets EN, or Royal Canin Gastrointestinal formula.

Please let me know if you have any further questions.

Customer: replied 2 months ago.
Her stools are perfect and she's on purina gastroenteritis food
She eats well and no titbits at all
We're really careful with bins and rubbish
Her stools are picked up straight away and not left
Her vacinations are up to date and she's been wormed and has advocate flea treatment
She could be asleep and all of a sudden sits up and water comes out of her mouth
No honking to release it
It just comes up from nowhere
We've tried boiled rice and chicken and nothing makes a difference
Expert:  Dr. Kara replied 2 months ago.

Thanks very much for the further information.

This sounds like regurgitation versus actual vomiting.

Regurgitation is a passive outflow of food or liquids compared to vomiting, which is active retching with abdominal contractions.

This can be an early sign of a condition called megaesophagus.

Megaesophagus is a condition where the esophagus is dilated and has weak muscles. Food may sit in it and be passively regurgitated back up, sometimes several hours after eating. There may be mucous, which is esophageal mucous collected around the food or water when it sits in her esophagus for a period of time. The strange noises may be due to air sitting in her dilated esophagus that comes out along with the food.

Megaesophagus can be secondary to nerve damage from pulling on the collar/leash too much as well as nerve damage from a foreign body in the esophagus, it can also be due to a low functioning adrenal gland (addison's disease), hypothyroidism or a condition called Dysautonomia. Sometimes it can be caused by a mass in the chest affecting the nerves that control esophageal function.

Your veterinarian can do a test called a barium swallow to see how her esophagus works. She'll be given barium orally and then a series of radiographs can be taken to see how it passes through her esophagus and stomach.

And they will likely want to check some blood tests as well. I would want to check a biochemistry profile and thyroid profile, looking for things we can treat.

Here is a link to a very good article about megaesophagus:

http://www.marvistavet.com/megaesophagus.pml

For you can try using acid reducing medications to see if they help by decreasing esophageal burn and reflux. You can use either:

1) Pepcid ac (famotidine) at a dose of one 10mg tablet per 10-20 kilos of body weight every 12 hours

OR

2) Prilosec (omeprazole) at a dose of one 20mg tablet per 20 to 40 kilos of body weight every 24 hours

These are acid reducers and should help her feel more comfortable. They are quite safe and can be used for a few days if needed. In some cases dogs remain on them long term if this is a repeated problem.

I would also recommend feeding her in an upright position and having her stay in an upright position after eating or drinking for at least 15 minutes or so after eating and drinking.

In your girl's case this may be related to the foreign body she had removed or may be an entirely new problem.

Dogs with altered gastrointestinal motility due to a foreign body obstruction can develop gastroesophageal reflux which can damage the esophageal lining and the sphincter between the stomach and esophagus which predisposes to worsening reflux.

If that is the case we need to make sure that a stricture at the site of her surgery hasn't developed (which would place back pressure causing or contributing to reflux. If we cannot find evidence of a stricture then looking for other causes of reflux and megaesophagus is prudent. In the meantime her treating her with coating agents (sucralfate) and promotility drugs like metoclopramide as well as an acid reducer makes sense.

Best of luck with your girl, please let me know if you have any further questions.

Expert:  Dr. Kara replied 2 months ago.

Hello, I wanted to check in and see if you had any further questions after reading my response. If you do please feel free to respond with them. If not I would appreciate an update on your pet, thank you, ***** *****