My Sheltie is 13 y.o. (~21 lbs). She began having periodic vomiting, usually in late evening or early morning hours, mostly mucus/bile, about 7 months ago. At that time, it became more frequent (including late afternoon) and my vet felt it was bilious vomiting. My dog was started on famotidine
. When it continued over the next month, another vet in the practice added metoclopramide 2.5 mg q. 8 hrs, thinking that gastric stasis might be a factor. Also about 7 months ago when the vomiting began, my dog had been eating Science Diet Nature's Best Lamb and Rice (she was on that for about 2 yrs -- prior to that, was on a different brand of Lamb and Rice). When I realized the Science Diet brand contained soy, I switched to Natural Balance Lamb and Rice in case a soy allergy was a problem.
Since that time, my dog was improved, with an episode of vomiting (mucus, bile) ranging about every 4-5 days to every 2-3 weeks. Her medications continued to be famotidine and metoclopramide. About 6 weeks ago, the vomiting seemed to be ~1-2 x a week so she was switched from famotidine to omeprazole. My dog also started "dry heaving" more frequently, with nothing vomited. She would have episodes of this in which once she vomited, it would stop instantly.
About 3-4 weeks ago, my dog began this "dry heaving" -- abdominal muscles
move (the vet observed an episode and said it appeared to her that it was more upper GI) -- almost constantly for 20 minutes or so at a time with breaks inbetween. Giving her a meal will cause this to stop. I talked to my vet about the possibility of helicobacter and after consulting with a specialist at Virginia Tech, we tried a 3 week course of amoxicillin
, metronidazole, and omeprazole. My dog also started taking a sucralfate slurry q 8 hrs. My dog finishes the helicobacter regimen today.
Overall, the vomiting has improved (larger time intervals inbetween, small amount of vomit). But, while she seemed much improved this past weekend (no "dry heaves"), she vomited early Tues morning and over the past day since then, has frequent "dry heaving" again. As before, the dry heaving usually stops as soon as she eats (I feed her 3 meals per day; she was switched to Hills Prescription Diet i/d when she started the helicobacter regimen).
At this point, my vet and I appear to be at a loss as to what is going on. She had abdominal x-rays and an abdominal ultrasound that did not show any problems. Her blood work 3 weeks ago showed and increased WBC ct and neutrophils, with slight anemia (which is another reason we tried the helicobacter regimen). The other blood work was normal
I plan to bring her in next Monday for upper GI/lung x-rays and to repeat the wbc and blood work.
Does anyone have any ideas as to what my dog's problem is likely to be? After the end of today, her drug regimen is: metoclopramide, sucralfate, and omeprazole.
Could a food allergy be responsible? She was switched to lamb and rice food many years ago due to skin allergies (biting
feet, hot spots
) -- I'm guessing from chicken
containing food -- and I'm concerned that the i/d diet with chicken could be contributing to the problem. If so, what would be a better option?
Would cisapride be a better drug than the metoclopramide?
Thanks very much.