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DrChristineM, Veterinarian
Category: Dog Veterinary
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Experience:  6 years in small animal medicine treating dogs and cats.
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My dog is a 9-year-old Sheltie, male, fixed. He wont eat -

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My dog is a 9-year-old Sheltie, male, fixed. He won't eat - appears interested, sometimes tries and drops the food. Has been to the vet - kidneys, blood work, liver, etc. are OK. Had an x-ray of abdomen - looked good, and very empty. Inspection of mouth does not indicate a problem (a cracked tooth, but vet not thinking it is the problem since Skyler still chomps on ice). Asked vet to do thyroid panel (previous sheltie had unusual case that ended up responding to thyroid treatment). Got results on Wednesday - some numbers are low, so Skyler was started on a thyroid medication.

Might eat lunchmeat, not eating hamburger; will eat a few bits of cheese curd; used to lick out yogurt container, but not interested anymore. Tried baby-food and baby-food meat sticks which he ate when chopped into tiny pieces. Eventually stopped eating them. Looks at food bowl (dry food), thinks about it, and walks away. Got him to eat bits of tuna, but eventually refused. No longer interested in peanut butter. He was drinking a lot of water, but not so much anymore. Couldn't get him to drink Pedialite. He's still interested in eating - he'll beg, but when the food is offered he'll either put it in his mouth and then drop it, or refuse it. Tonight he finally walked away from his favorite treat - ice cubes. Ate them earlier this evening, but now - although he's interested, walked away.

It's going on a month. The vet had him on antibiotics and something to calm his stomach (had vomited a couple times). Then on carafate in case there might be an ulcer and reglin (?) to help move food from his stomach. Some days he was better - wanted to play, perky; then others he was worse - pacing, looked depressed. After about two weeks, finally managed to get him to eat enough to poop - sort of tarball like. Then didn't pass anything for several days; finally had a runny movement twice. Yesterday it wasn't quite so runny. It's been going on for so long now we are really fearful it's going to become a spiral. We lost his half-sister a year ago to kidney failure.
Sorry to hear that you are having such trouble figuring out what is going on with Skyler.

So the only blood work that has come back at all abnormal has been the low thyroid, correct? Everything else, (CBC, liver, kidneys, urine, etc) have all been normal? Has your vet tested for pancreatitis?

You say he sometimes tries and "drops the food"--does it seem like he is having any trouble actually picking up and eating the food, or is he more dropping the food because he decides he doesn't want it?
Customer: replied 6 years ago.
Hello Christine,

He drops the food because he doesn't want it. Today he is refusing water and food. My husband is scooping water into his hand to get Skyler to drink - he will still lick our hands. He is retreating to cubby holes to be out of reach.

How do I know if he was tested for pancreatitis? I have a print-out of all his numbers. What do I look for? Should we do an ultrasound, some kind of IV parenteral fluids? He ate some lunch meat and cheese bits yesterday evening, but after midnight he threw it up. His stomach is most likely completely empty.

Thank you,
Could you give me all the numbers? That would help immensely. I do think we are in for an abdominal ultrasound and possibly some IV fluids, but if I could review the lab tests, I may be able to see if there is anything we may have missed. Can you get him to drink some pedialyte?
Customer: replied 6 years ago.
To be fair, I'd like to provide an accurate history of his numbers for you. Is there a way to attach an excel file?
I don't think there is a way to attach an excel file--the only options are the icons just above here in the tool bar of the text box. You can paste a word doc, insert a link, etc. You may be able to copy the information from excel into word and paste into here. They don't give us a lot of options for things like this!
Customer: replied 6 years ago.
OK - working on getting the info input. BTW - Sklyer went outside and hung out a bit, barked at things and seemed engaged. Came in, couldn't get him to drink. Got him to lick a few fingertips of yogurt, then he went back into hiding.
Has he had any more vomiting?
Customer: replied 6 years ago.
Last night he threw up everything he ate - no sign of digestion. Refused food all day today, but did lick the yogurt from my fingertips. Waiting to see if it stays down. Following are his numbers - hopefully they come through OK:

Skyler, neutered male Sheltie born 6/26/01

Test 11/1/10 10/25/10 2/10/10* 6/26/08 (taken when teeth cleaned*)
RBC 7.21 M/µL 8.05 M/µL 3.00 M/µL
HCT 46.7% 53.1% 54.7%
HGB 15.5 g/dL 18.1 g/dL 18.1 g/dL
MCV 64.8 fL 65.9 fL 68.4 fL
MCH 21.5 pg 22.5 pg 22.7 pg
MCHC 33.2 g/dL 34.2 g/dL
RDW 15.7% 15.3% 19.3%
%RETIC 0.80% 0.4%
RETIC 57.3 K/µL 32.0 k/µL
WBC 10.57 K/µL 7.72 k/µL 9.7 K/µL
%NEU 51.4% 74.8% 89.5% N
%NYM 37.3% 13.8% 9.97% L
%MONO 9.7% 7.7% .082% M
%EOS 1.1% 3.5% .478% E
%BASO 0.4% 0.2% 0%
NEU 5.44 K/µL 5.78 k/µL 8.68 K/µL
LYM 3.95 K/µL 1.06 k/µL .967 K/µL
MONO 1.03 K/µL 0.60 k/µL .008 K/µL
EOS 0.12 K/µL 0.27 k/µL .046 K/µL
BASO 0.04 K/µL 0.01 k/µL 0.00 K/µL
PLT 73 K/µL 260 k/µL 309 K/µL
MPV 18.9 fL 11.6 fL
PDW 28.2% 20.0% rdw 19.3%
PCT 0.1% 0.3%
Sodium 146 mmol/L Na:K 33.2
Potassium 4.4 mmol/L
Chloride 116 mmol/L
CO2 21 mml/L

ALT 20 U/L 129 U/L 19 U/L
ALKP 353 U/L 354 U/L 229 U/L 48 U/L
TBIL 0.3 mg/dL
Ok, and this is all that was done? I am only seeing a few things from a chemistry (this is a panel that usually looks at liver/kidneys, etc) I am only seeing Sodium, Na:K, Potassium, Chloride, Co2, Alt, AlkP, Tbili.
What did they list this as on your bill?
Customer: replied 6 years ago.
Yikes - looks like the columns of info turned into a mess. I'll just list the stuff from Oct. 25 2010:
I see I missed some stuff: BUN 23 mg/dL CREA 1.0 mg/dL BUN/CREA 23 TP 5.9 g/dL ALB 2.9 g/dL GLOB 3.0 g/dL ALB/GLOB 1.0 ALT 129 U/L ALKP 354 U/L GLU 100 mg/dL pH 6.5 LEU 500 Leu/µL PRO TR GLU neg KET neg UBG 4 mg/dL BIL neg BLD 25 Ery/µL S.G. = 1.016 Don't know what all that means, hope I've transcribed it correctly.
Ok, well he's got a urinary tract infection. Did they start any antibiotics?
Customer: replied 6 years ago.
Yes - he was on amoxicilin and finished it - started it the day of the test, Oct. 25
Ok, and did the symptoms resolve at all?
Has the urinalysis or kidney function tests been repeated since that time?
Customer: replied 6 years ago.
Not sure what the symptoms are... He's not drinking or eating. I don't believe new tests were run. Don't see anything for those from Nov. 1
Ok, well the symptoms you are describing COULD be from a deep seated kidney infection/urinary tract infection. The results you provided (10/25) indicate that at that time the kidneys were functioning well (BUN and creat were normal), which is good. But since the symptoms have persisted, then a few things need to happen.
1) A repeat urinalysis needs to be done to see if the infection is still present. If it is, a culture and sensitivity needs to be done to make sure the right antibiotic is given
2) Kidney values need to be rechecked (at the very least) to make sure that no damage to the kidneys has occurred.
3) If the urinalysis is negative and the kidney and/or other bloodwork is still normal, I would suggest the following tests:
Spec CpL --this is the best test for pancreatitis, if positive, treat accordingly
Abdominal ultrasound
At this point, IV fluids may be required to prevent/correct dehydration, and there are a lot of medications that we can give IV for nausea, to increase appetite, etc. Giving these medications IV when the pet is nauseous is often very helpful as they work much more effectively this way. So hospitalization for a few days to get fluids and get Skyler eating again may not be a bad idea.
I hope this gives you some ideas of where to go from here--if you have any additional questions, please let me know.
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