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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24357
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog, Dempsey, has had vomiting almost every day

Customer Question

My dog, Dempsey, has had vomiting almost every day for about 2 weeks. The first time 2 weeks ago he was shaking all day and very lethargic. Then, the next day he vomited again and began to collapse. He is a 67 lb Labradoodle, 5 yr old male. Fortunately I caught him. We took him to his vet, and she diagnosed him with an intestinal infection due to bacterial overgrowth in his stool sample. He also had a high fever 107 degrees. We gave him antibiotic for 7 days and he seemed to improve. Now, about 1 week after the end of the antibiotic he has been vomiting again every day the past 4 days. Yesterday he vomited about 3 hours after eating, and he collapsed and hit his head on a bed post. We called the vet, who was booked until this coming Tuesday but said to feed him a bland diet. We checked his temperature yesterday and it was normal 101.5, His gums are pink, and he is still drinking water well. He is urinating and defecating but his stool has seemed smaller than normal the past 2 weeks. My concerns are he may have a blockage as he is a gulper and about 3-4 weeks ago he swallowed an entire knotted end of a large raw hide bone. He's also been known to swallow food bones whole in the past. 1. Can a blockage persist for weeks with these types of symptoms? 2. Twice he has begun to pass out and collapse following vomiting. My vet seems to think it is because he is woozy from vomiting, but I've never seen this before and it makes me wonder if there is some other underlying problem. We gave him rice the past 24 hours, and then 1 cup of kibble tonight to test. He threw up all the kibble right away and I found a lot of rice from earlier in the day undigested with the kibble. Again, he is drinking water and seems hydrated, but I am worried. Thanks for your help.
Submitted: 7 months ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 7 months ago.
Dempsey needs to have his abdomen X-rayed or ultrasounded at your earliest convenience. Considering his ingestion of the knot of raw hide bone, an obstruction in his gastrointestinal tract is a very real possibility. His collapsing when vomiting can be a vagal response but also suggests Addison's disease (hypoadrenocorticism) which in standard poodles (he's half standard poodle) is over-represented. Make sure that Dempsey's electrolytes are checked when his diagnostics in for the form of blood and urine tests are performed. An elevated serum potassium level and decreased serum sodium suggests Addison's.You mustn't wait until Tuesday. Feeding a vomiting and collapsing dog a bland diet and not performing these diagnostics doesn't constitute the standard of care. Please respond with further questions or concerns if you wish.
Expert:  Dr. Michael Salkin replied 6 months ago.
Hi,
I'm just following up on our conversation about Dempsey. How is everything going?
Dr. Michael Salkin
Customer: replied 6 months ago.
A couple of things to note. Nothing against you personally, but when I originally submitted the question the site said "Dr Dan is online now to answer your question." With that in mind I agreed to the terms. Unfortunately we didn't hear from him right away, but you responded later,valbeit with very good advice. The problem is your message didn't get to us for a few hours, and actually was after we ended up seeing a vet at a local animal ER. So, although I valued your advice, it wasn't within the time frame I was expecting. I ended up paying $440 for no diagnosis. CBC, abdomen x ray, and they did an ultrasound to check for free liquid (based on possible heart issue due to the two collapses post vomiting). No free liquid seen. They did say there may or may not be something suspicious in his stomach, but they said it was inconclusive. She thought a partial blockage in the stomach may explain his on and off again vomiting as it may be acting like a valve to the small intestine. His blood work showed slightly low potassium and elevated GGT, and slightly high rb, total protein, mch, pcv, rbc and hgb. The vet didn't seem to think there was cause for concern because they were just a point or two beyond normal range. However she did say she could not rule out Addisons or heart disease without further testing. She suggested bland diet and if he vomited to fast him for 12 hours and recheck the stomach with another x ray. That was Friday, and he seemed to be doing better until today when he had a massive vomiting incident about two hours after eating. We have an appointment tomorrow afternoon with his regular vet and I am just giving him water with a little gatorade until then. He hasn't collapsed since the last incident last week, but he has been somewhat lethargic probably because he's been sick. I appreciate you checking in, just give me a week or so to pay you as the bills are mounting, and we're not done yet.
Expert:  Dr. Michael Salkin replied 6 months ago.
I understand. I'm not privy to your side of the site and so I can't comment on the Dr. Dan business nor why another expert didn't answer your question before I did. I agree that the blood work wasn't diagnostic. Addison's will usually cause an elevated rather than decreased potassium but vomiting can cause loss of both sodium and potassium and skew the electrolyte values and there are atypical Addisonians that have normal serum electrolyte values. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience.