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Dr. B.
Dr. B., Veterinarian
Category: Dog
Satisfied Customers: 16265
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 2 year old shihtzu has been vomiting on and off days,

Customer Question

My 2 year old shihtzu has been vomiting on and off for three days, she's stopped eating for a day and now will have small pieces of chicken nut nothing else, she keeps having ammo smelling watery diorrhea with specks of blood in it. She's cry quiet and not her normal self.
Submitted: 4 months ago.
Category: Dog
Customer: replied 4 months ago.
Due to autocorrect some words aren't cotreat is should say ammonia smelling diorrhea and is quiet and sleeping a lot. She will not eat her dog food which is james wellbeloved. The sickness has stope but the watery poo with bits of blood in it is still happening
Expert:  Dr. B. replied 4 months ago.

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

Can she keep water down?

Are her gums pink or pale/white? Moist or sticky?

If you press on her belly, does she have any discomfort, tenderness, or tensing?

Could she have eaten something she should not have (ie bones, toys, rocks, plants, chemicals, etc)?

Customer: replied 4 months ago.
she's drinking loads, her gums are pink and moist
she doesn't seem to mind me pressing her stomach. I can't think of anything she might of eaten as she's quite a fussy eater in general and won't eat anything she shouldn't usually
Expert:  Dr. B. replied 4 months ago.

Thank you,

Now I am quite concerned about Cleo. It’s good that vomiting has settled, but her poor appetite suggests that she is still nauseous. In regards ***** ***** for these upper and lower GI signs, we’d be most wary of a potential bacterial or viral gastroenteritis, pancreatitis, or parasites/protozoa infections.

With this all in mind, as long as she can keep that water down, we can try some home supportive care to see if we can settle her stomach. To start, if she hasn’t just vomited (since otherwise we’d need to rest her stomach for a few hours first), then you can consider treating her with an antacid. Common pet safe OTC ones we can use include Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac), or Milk of Magnesia (0.25trsp every 8 hours). Whichever you choose, we’d give this 20 minutes before offering food to allow absorption. Of course, do check with her vet before use if she has any known health issues or is on any medications you didn’t mention. As well, if you try this and find her nausea too severe to keep it down, then that is usually a red flag that we need her vet to bypass her mouth with injectable anti-vomiting medication.

Once that has had time to absorb and she is steadier on her stomach, you can consider starting her on a light/easily digestible diet. Start with a small volume (a spoonful). Examples you can use are 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. When you offer that spoonful, give her 30 minutes to settle. If she keeps the food down, you can give a bit more and so on. As her stomach stabilizes, you can offer more. 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 her diarrhea. You can even add Weetabix or 0.25tsp of Benefiber to a bit of canned food (so its mixed) to help bulk up her stools for her. As long as improvement is being seen, I usually advise that the diet be continued until her signs are settled, and that they are then slowly weaned back to their normal diet.

Since dehydration is a risk despite her good drinking (since they can rarely keep up with losses from both ends), we need to keep an eye on her hydration. To check this and ensure she’s not becoming dehydrated, there are a few things you can test. Further to checking for gum moisture, you will want to make sure her eyes are not looking sunken and that she doesn’t have a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a good video HERE (http://www.ehow.com/video_12232503_dog-dehydrated.html). If you are seeing any signs of dehydration already, then that would be our cue to have her seen before this becomes an additional issue for her (especially as it is often dehydration that makes them feel unwell).

Finally, you can consider trying a pet safe anti-diarrheal. As I am sure you appreciate, these would not be a cure if the cause were infectious; but it can still be of benefit. It will reduce diarrhea load, allow the body to absorb more water/nutrients, and soothe the upset gut. In regards ***** ***** options for your wee one, the one we most commonly use is Kaolin/Kaopectate (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/kaolin-and-pectin-kapectolin-k-p). This is available OTC at most pharmacies. Otherwise, Propectalin, Canikur, Fast Balance, and Protexin Pro-Fiber (which is available OTC at vets, pet stores, and even Amazon) would be another option. All will slow diarrhea and those last ones have the added bonus of providing support to the delicate good GI bacteria. So, these can be used as a short-term means of soothing this upset GI and if we can reduce the diarrhea then the blood will likely stop as well (as it sounds gut irritation related).

Overall, a wide range of agents could trigger the GI upset we are seeing. Therefore, in her case, we’d want to start supportive care to settle her stomach. If she cannot keep that or water down, appears dehydrated already, or doesn’t respond to the above within 12-24 hours (since this has already been going on longer then ideal); then we'd want to get her vet involved. They can assess her hydration, rule out fever, make sure there is nothing in her stomach that shouldn't be there or any sinister viruses present. Depending on their findings, her vet can treat her with injectable anti-nausea medication, fluids, +/- antibiotics to settle her stomach, and get her back feeling like herself.

Please take care,

Dr. B.

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