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Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 9141
Experience:  I have owned, bred and shown dogs for over 40 years.
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She has Immune-Mediated Anemia and has been treated for it

Customer Question

She has Immune-Mediated Anemia and has been treated for it since June. She had a blood test Friday afternoon and only small improvements noted, so prescription for prednisone was refilled. She is given Sucralfate, 1 gram, an hour before being fed, then the steriods. Today she will not eat her breakfast or hardly drink water at all. God help me, I gave her the meds on an empty stomach. She is lying on the floor next to me. Don't know what to do now if she won't eat or drink.
JA: I'm sorry to hear that. What is the dog's name and age?
Customer: Bella and she is only 5. I rescued her at the age of 3.
JA: Is there anything else the Veterinarian should be aware of about Bella?
Customer: She had a recent relapse and had to be hospitalized. Fluids were put in with IV. She was also given Metronidazone 500 mg. That prescription was not renewed after she finished it. She was hospitalized because of bloody diarehea and vomiting up of her food over the course of an entire night.
JA: Hopefully it didn't make a mess. Did Bella eat anything unusual?
Customer: Not that I know of.
Submitted: 2 months ago.
Category: Dog
Expert:  Dr. Deb replied 2 months ago.

Hello, I'm Dr. Deb and will do my best to help you today.

I'm so sorry that Bella has been diagnosed with IMHA (Immune mediated hemolytic anemia). It can often be quite a roller coaster ride with these patients, unfortunately.

I do have a few additional questions to ask about her first if you don't mind:

1. Has she taken Metronidazole before and handled it well? If so, then we can rule out a possible drug reaction as an explanation for her not eating or drinking.

2. I'm assuming she was given the Sucralfate prior to the steroids?

Thanks, Deb

Expert:  Dr. Deb replied 2 months ago.

I can't know for sure, of course, but I wonder if you're having difficulties with the site and are unable to respond to my questions? I can't see things from your end of things and I'm not responsible for site issues of this sort but my apologies if that's the case.

I'll go ahead and respond back to you in hopes that you can access my reply since I know you're terribly worried about Bella.

I can understand your concern about giving Bella steroids on an empty stomach but if you gave the Sucalfate first, then, hopefully, we won't have to worry about gastric issues. Even if you didn't, not all dogs will vomit or experience gi issues when steroids are given without a meal.

As I'm sure you realize, steroids are the gold standard for treating her condition so it's important that she continue receiving them.

If she won't eat or drink on her own, then you may need to force feed her. One method would be to mix canned food in a blender with water or low sodium chicken broth or, even better, pedialyte to the consistency of soup. Then use a small turkey baster or syringe to dribble this mixture into the side of her mouth where there's a gap. Hopefully, she'll tolerate this so that you can continue to feed her this way throughout the day.

You won't need to worry about her not drinking on her own since you'll be providing fluids in the mixture. You could supplement if you wanted by also dribbling plain liquid into her mouth.

You could also soak dry kibble in the aforementioned liquids for 20-30 minutes and then blenderize this with more liquid. Either way should pretty well.

You could also offer her human baby food but just avoid those with onion or garlic in them. She may not find this food more palatable than what she's been eating but it's worth a try.

I'm sure that your vet mentioned that the prognosis is variable in the patients and may be guarded in many cases, unfortunately:(

If she doesn't start to eat on her own, then a recheck may be prudent. Deb

Expert:  Dr. Deb replied 2 months ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Deb
Expert:  Dr. Deb replied 2 months ago.

Hello again,

I'm just following up on Bella. How are things going with her? Deb