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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 24468
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog is a mixed breed dachshund and schnauzer with

Customer Question

My dog is a mixed breed dachshund and schnauzer with Cushings. He has not been eating much for a month. Today he woke up vomiting a dark orange. I could not tell if was blood or had blood. He is on Vetoryl. He was checked 2 weeks ago by our vet and his blood test were normal. What should I do. This is the first time his vomit has been this unusual color.
JA: I'm sorry to hear that. Hopefully it didn't make a mess. Did your dachshund eat anything unusual?
Customer: Not to my knowledge.
JA: OK. The Veterinarian will know what to do. What is the dachshund's name?
Customer: Simon.
JA: Is there anything else the Veterinarian should be aware of about Simon?
Customer: That is has not been eating much. And the meds he is currently on which I mentioned earlier. But he is taking a supplement for his bladder stones. He has had 4 surgeries to remove stones over the last 3 years.
Submitted: 3 months ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 3 months ago.

I'm sorry to hear of this with Simon. I would discontinue trilostane in any cushingoid dog who has been inappetent for as little as a few days much less a month. His vomiting with blood (?)(hematemesis) or bile (the dark orange?) can indicate a glucocorticoid deficiency (iatrogenic Addison's) that wasn't detected by his blood tests 2 weeks ago or any number of disorders outside his GI tract (pancreatitis, chronic hepatic or renal failure, e.g.) or primary gastrointestinal disorders that might require ultrasound or even scoping and biopsy of his gastrointestinal tract to identify. What has Simon's vet had to say about Simon's inappetence? It's important to recognize that any cushingoid patient - patients who rarely let food dropped reach the floor - who become inappetent need to be invetigated for the cause of that inappetence.

Customer: replied 3 months ago.
The vet performed the ACTH. Beliw are the results:
The pre ACTH was 3.19 and the post ACTH was 5.05. This is a good report. Both in normal range.
Customer: replied 3 months ago.
Vet did not show much concern regarding his appetite since his bloodwork was normal.
Expert:  Dr. Michael Salkin replied 3 months ago.

Sorry for the delay. Your question was mistakenly closed. Thank you for the additional information. It's good to see that his cortisols are nicely controlled. Inappetence in spite of normal bloodwork suggests a primary gastrointestinal disorder which is poorly represented by basic blood and urine tests. Pancreatitis is an important rule-out in cushingoid dogs and so a specCPL blood test which is most sensitive for detecting the presence of pancreatitis plus an abdominal ultrasound which is most sensitive for detecting changes in the gastrointestinal tract itself would be my next diagnostics of choice. Please continue our conversation if you wish.

Expert:  Dr. Michael Salkin replied 3 months ago.
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin

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