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Dr. B.
Dr. B., Veterinarian
Category: Dog
Satisfied Customers: 16144
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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Our 4 year old Maltese is panting, pacing, throwing up,

Customer Question

Our 4 year old Maltese is panting , pacing, throwing up , blood in her diarist I, can t even keep water down
JA: I'm sorry to hear that. Hopefully it didn't make a mess. Did the dog eat anything unusual?
Customer: Not that we know of
JA: What is the dog's name?
Customer: Ruby
JA: Is there anything else the Veterinarian should be aware of about Ruby?
Customer: No
Submitted: 2 months ago.
Category: Dog
Expert:  Dr. B. replied 2 months ago.

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

How long has she has these signs?

What does her vomit look like?

How much blood have you seen? A spoonful, cupful, etc?

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)?

Is she up to date on vaccines?

Customer: replied 2 months ago.
Vomit was chocolate colored now it is clear
Pinkish diaria
Gums are pink
Expert:  Dr. B. replied 2 months ago.

Thank you,

First, I am glad to hear that her gums are pink despite the blood tinge to her diarrhea and concerns of blood in the vomit (as digested blood will often look like coffee ground type material). Though we need to monitor that closely. Otherwise, if Ruby cannot even keep water down, then we need to tread with care. Dogs this nauseous often are high risk for dehydration and require us to bypass their mouths with injectable anti-nausea medication to break their vomiting cycle.

Just to note, signs of this nature do raise worries of bacterial gut infections (ie Salmonella, Campylobacter), viral agents (ie Parvo, hemorrhagic gastroenteritis), stomach ulcers, severe parasites/protozoa infections, and ingestion of harmful items (ie toxins, plants, non-edible items).

With this all in mind, I would note that while I suspect she will need injectable anti-nausea treatment with the severity of signs you reported, you can try her with an OTC pet safe antacid like Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid), or Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac) if you wish to. Whichever you choose, we’d give this 20 minutes before offering food to allow absorption. Of course, do check with your vet before use if she has any known health issues or is on any medications you didn’t mention. Though if she fails to keep this down or settle, then we’d again need her seen at this stage.

After that has had time to absorb, we can start small meals of a light/easily digestible diet. 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). When you offer these meals, give her 30 minutes after to settle. If she keeps the food down, you can give a bit more and so on. 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 her diarrhea. Furthermore, you can add fiber (ie canned pumpkin, all bran) +/- a canine specific OTC probiotic (ie Benebac, Fortiflora) to help bulk up her stools and support her good gut bacteria that should be helping counter this diarrhea. 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 here for Ruby, we need to keep a close 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 do find these dehydration signs, then that would be our cue to have her seen before this becomes an additional issue (especially as it is often dehydration that makes them feel unwell).

Overall, a wide range of agents could trigger the signs we are seeing for poor Ruby. Therefore, we’d want to start supportive care to settle her stomach. If she cannot keep anything down, appears dehydrated already, or doesn’t respond to the above within a few hours; 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, your vet can treat her with injectable anti-vomiting medication, fluids, +/- antibiotics to settle this for her.

Please take care,

Dr. B.

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