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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16526
Experience:  Over 20 years of experience as a veterinarian.
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19 lb-->16lb JRT female approx. 4 yrs Got from shelter late JAN, be

Customer Question

19 lb-->16lb JRT female approx. 4 yrs
Got from shelter late JAN, began Fromm’s Beef Frittata Premium Food (v
Began vomiting (and wanting/eating grass) MAR/APR, usually vomits just her food and just 1x typically middle of night or early evening. Appears fine afterwards and in general — somewhat diminished energy especially after BM; stools primaily yellow and soft, occasional diarrhea.
3/31/15: CBC/Vet Report: Negative for pancreatitis test, fecal showed bacterial overgrowth, with sporulated rods predominating, slightly elevated HCT and LIPA upper normal ALT, heartworm negative; began probiotic and 2wk course of Metronidazole
Transitioned to Acana Regionals Wild Prairie Food in APR after bland diet post vomiting
Mid APR:Vomited again over 4 days, 1x a day; began Cerenia for 4 days and another (4 wk) course of Metronizadole; began Purina HA food
Has vomited x since mid April, both times in last week (SUN nite and FRI nite) Still appears fine/happy, very hungry, less energy post w
Submitted: 2 years ago.
Category: Dog Veterinary
Customer: replied 2 years ago.
PLEASE NOTE: There were a lot of formatting issues once my question was submitted and part was cut off so I am resubmitting here for clarity:
19 lb-->16lb JRT female approx. 4 yrs (vet said overweight when first saw her in FEB, is down to 16 now)
Late JAN 2015: Got "Georgia" from shelter, began Fromm’s Beef Frittata Premium Dog Food
MAR/APR: Began vomiting (and wanting/eating grass), usually vomits just her food and usually just 1x typically middle of night or early evening. Appears fine afterwards and in general — somewhat diminished energy especially after BM; stools were always primarily yellow and soft, occasional diarrhea.
3/31/15: CBC/Vet Report: Negative for pancreatitis test, fecal showed "bacterial overgrowth, with sporulated rods predominating", slightly elevated HCT and LIPA upper normal ALT, heartworm negative; began probiotic and 2 week course of Metronidazole; Transitioned to Acana Regionals Wild Prairie Food in APR after bland diet post vomiting.
Mid APR: Vomiting again over 4 days once a day; began Cerenia for 4 days and another (4 week) course of Metronizadole; began Purina HA food
LAST WEEK: Has vomited 2x since mid April, both times in last week (SUN nite and FRI nite)
Still appears fine/happy girl, very hungry and somewhat diminished energy post walk/BM.
We are following vet's instructions but have real concerns about the Purina HA food and the antibiotic course(s). We like to pursue a holistic route but were at a loss what was happening (thought allergies, then too much fat, possible overfeeding and tried to adjust accordingly but vomiting always restarts.
Food note: we started her on Fromm's Beef Fritata-->Acana Regionals Wild Prairie before vet insisted on Purina HA. We have both a limited ingredient hypoalergenic food (Acana Singles Pork) and Lowfat Annamet Lean that we were going to try but have stuck with the Purina HA for now.
Since 3/27/15 she has vomited 10x, 1-2 heaves and then up with primarily food (in beginning there was some clear mucus and bile, but now mostly her food and just once usually at either 1AM or 3AM and then she's fine, always hungry (and happy) next day.) Note she was also xray'd w/ and w/out barium and "best she could tell no definite obstructions".
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I'm sorry to see that Georgia is having so much trouble with vomiting, and loose, yellow stools. I know that you have been waiting a while for an answer and that is likely because this is not an easy question.Dogs that are losing weight and repeatedly vomiting and suffering with loose stools are having trouble digesting and/or absorbing the food that they are taking in.Vomiting and diarrhea can be due to parasites, inflammatory bowel disease or even a food allergy. But it can also be related to metabolic organ disease (such kidney or liver disease) due to organ wastes irritating the gut, pancreatic insufficiency or Addison's disease. It makes sense to change the diet because that is fairly easy to do and can make a huge difference. A hypoallergenic diet makes sense too to try and clear the allergens. HA is excellent, and so is Hills z/d. I understand that she's been on HA, but it's only been a week, and sometimes it can take a few weeks to see improvement. It also makes sense to test for parasites and treat presumptively for them, even should stool samples come back negatively. Parasites eggs/cysts aren't found in every sample. I see that she's had metronidazole, so I recommend pyrantel and then fenbendazole (Panacur). Pancreatic insufficiency is another possibility for dogs not to gain weight, vomit and have loose stools. These dogs have a pancreas that produces a decreased amount of digestive enzymes, and the amount produced can wax and wane in some cases, especially early in the disease process. Testing is by running a blood test called a TLI which checks for digestive enzymes. Treatment is replacement of digestive enzymes at each meal. An easier to digest food would be expected to create less problems with digestion and as such less diarrhea. You mention a pancreatic test but don't say which one. A spec PL or canine specific pancreatic lipase is a test for pancreatitis, which can cause vomiting. Is that what was done? Kidney and liver disease can cause diarrhea too, but I would expect that she has had a blood panel to look for those. Addison's disease, which is a poorly functioning adrenal gland, can lead to chronic diarrhea and vomiting. These dogs cannot handle stress at all because their adrenal gland doesn't produce cortisone when stressed and their electrolytes can be off too if their adrenal gland isn't controlling that normally either. We see vomiting, diarrhea and sometimes physical collapse in severely affected dogs. Testing is an ACTH response test to check adrenal gland function and checking electrolyte levels. Treatment is steroid replacement therapy and electrolyte replacement. Checking blood levels of cobamalate and folate can pinpoint primary intestinal disease depending upon if they are low or elevated. If we suspect primary intestinal disease then small intestine biopsies are the best way to get a definitive diagnosis and guide treatment. Different types of primary intestinal disease react better to a hypoallergenic food, high fiber or easily digestible foods.I understand your frustration, but I think that more testing needs to be done.Please let me know if you have any further questions.The
Expert:  Dr. Kara replied 2 years ago.
Hi Cj,

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

Dr. Kara