Hello and Thank You for contacting JustAnswer
I am sorry your boy is having trouble.
I to am owned by Shih-tzus so I can tell you they often have digestive issues.
Can you tell me how often you are changing his food?
How many stool samples have been tested and have they been sent out to the lab?
Has he been placed on any medications or been dewormed?
How many times a day is he offered food?
Is he on any vitamin supplements?
Have x-rays of the abdomen been done?
I may have additional questions but this will get us started?
Thank you for the great detailed info.
I just have a few more questions.
When you put the food down and leave it what kind of bowl is it in?
Did you see both parents we they considered teacup or are they normal size?
How often do you use the Pepcid AC?
Adding fiber is one of my suggestion discussed below, I would not add to the water, this may make him not want to drink and unless he is drinking the whole bowl he is not getting enough.
Ok, Most of what you are doing is right but there are some things that need to be adjusted.
The absolute first thing I would suggest is asking your vet to test for a liver shunt. This is very common in this breed and we almost always see it is the small pups(as this effects growth). This also causing vomiting and intermittent loose stool. This can be worse after eating as this is when the toxins are highest in the body, when the eat they feel bad so they try to avoid eating. Researchers at Cornell University College of Veterinary Medicine are actually researching the gene mutation in this breed that leads to Liver Shunts.
Read more here
These dogs should be eating 4 times per day, when they go to long without food acid builds in the stomach resulting in nausea refusing to eat.At 1 year of age they can go to three times per day. I would also try using the Pepcid daily for 7 days and see if that makes a difference. Give this on an empty stomach 30 minutes before offering food. This medication needs an acidic environment to work properly.
Always use a plate most of these dogs will not eat out of a bowl. The mouth and nose form a straight line in this breed and often eating out of a bowl allows the nose to come in contact with the food.
I know you are having trouble getting him to eat but right now he is not getting a balanced diet and is not providing enough fiber in the diet to regulate the stool.
I would like to you try a good quality dry food.I highly recommend Royal Canin 24. This is a Shih-Tzu specific food (even shaped for easy pickup)
I am going to give you a link to this food scroll down to and click on the Shih-Tzu guide you will see that this company has done extensive studies into the dietary needs of this breed.They have this in puppy as well
I know you are just making sure he will eat but I can promise you the longer he eats only human foods the less likely you will ever get him to eat dog food.
Mix the dry food 1/4 day 3/4 boiled chicXXXXX XXXXXver, ground chicken or turkey. This must be boiled to remove all fat or it too will cause stomach upset and diarrhea. Over a 4 week period slowly remove the human food and add more dog food. You can always add a small amount of the meat it just needs to be mostly dog food. Adding low sodium chicken or beef broth may also make it more appealing and soften the food if he prefers it that way.
To the food you also want to add 1/8 teaspoon of metamucil once daily to add fiber to the diet. Another way to add fiber is with canned pumpkin(not pie filling) this can be frozen in an ice cube tray and given 1 cube daily as a treat.
The probiotics should also be used daily.
I would suggest discussing the possibility of a liver shunt with your vet, have x-rays of the abdomen to be sure there are no abnormalities which is also common in the tea cups. When these dogs are breed down in size it is the body that is scaled down not the internal organs and we often see digestive trouble in these dogs. Change the feeding to 4 times per day add fiber and ask about using the Pepcid daily.
I would try the above things and I really think you will see a difference. Please let me know how he is doing, please reply back if you have additional questions or concerns.
Ok, I thought from your original question that this was more often.I would still test for the liver shunt often they only have one sign and his small size, continued diarrhea and unwillingness to eat would warrant testing in our clinic. You will see the one article I sent the Shih-Tzu never had any symptoms but the problem was found when treating for bladder stones.
X-rays will allow your vet to view the liver and in some cases the liver may be smaller then normal or abnormal in shape
The liver shunt can be tested for with a simple blood test and it is better to rule it out for sure.
Your vet may want to do x rays first. You mentioned he always picks thing up I have seen a partial blockage cause the symptoms you are seeing.
I know he is not eating four times a day this is our goal. Often these dogs when they go more then 5-6 hours without food they feel nauseous. This is a vicious cycle, when they do not eat the acid builds leading to nausea making them not want to eat. Even if he only eats a spoonful or two that is great. I would definitely try to get him to eat more often, like I said feed 1-2 teaspoons at a time. If nausea is the problem you may be able to get this under control.
I have one tea cup that I cook for here is what I do if you want to try it
6 cups of the dry food
1lb of ground turkey
2 small or 1 large sweet potato
1/2 package frozen green beans
1/2 package of frozen carrot pieces
24ozs of low sodium chicken broth.
Mix all in a bowel and allow the dry food to get soft. You can freeze in meal size containers. I freeze in daily ration sizes instead of the meal sizes.
This was designed by a veterinary nutritionist for my dog. Instead of adding vitamins and supplements to the foods I use the missing link
Please let me know what the vet says.
You are very welcome. This is my favorite breed and all of my dogs are rescues with multiple heath problems so I have been through most of the typical Shih-Tzu issues.
I really think eating is making him feel bad and he is beginning to develop an aversion to food. We need to find out what is going on to help this poor boy. You may also want to ask your vet about using an appetite stimulant to get him going
Here is information on the Bile Acid test that is often done when looking for a liver shunt
Thank you so much for the update. I am glad to hear he is gaining weight and seems to be on the right track. I am glad that using the Pepcid every day seems to be helping as well. I agree that with these test results while not overly high should be retested in a few months. He really is a tiny little guy at only 6.8lbs.
I hope he continues to improve.