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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 16308
Experience:  Over 20 years of experience as a veterinarian.
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My dog is a 16yo female spayed schnoodle. She has

Customer Question

Hello. My dog is a 16yo female spayed schnoodle.
She has had stomach issues for the past 2 years. Approx once a week, her stomach gurgles and she is extremely tired and will not eat or drink. Between Jan and April 2015, we were feeding her KD Hills diet and she seemed to be doing extremely well. We recently changed her to the KD dry food and that's when the problems started again.
I changed her back to the canned food for the past 3 days and she's had this gurgling stomach on Thursday and now again today. She recently had a blood panel done and the doctor said that everything looks normal. She was recently diagnosed with Cushing's disease and we gave her 2 doses of Trilostane (Monday night and Tuesday morning). We brought her into emergency on Tuesday evening because of severe back pain and the doctor gave us rimadyl and tramedol. Since the back, stomach issues, we have stopped all meds.
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your poor little one is having so much trouble with stomach upset and pain. I think that she may have several issues going on.
Expert:  Dr. Kara replied 2 years ago.
The stomach upset when going from canned k/d to dry is likely explained by slightly different formulations between the two foods. There is likely something in dry k/d that her gastrointestinal tract is irritated by, she likely has a food allergy or sensitivity. Even with a switch back to canned k/d due to the effects of the different diet (dry k/d), and then a switch in diets, her symptoms won't go immediately go away. Her gastrointestinal tract needs to heal from the insult.Was she put on k/d because she has a history of kidney disease?How was she diagnosed with Cushing's disease?Was she eating a tremendous amount and drinking a lot? Did she have muscle weakness and elevated liver enzymes and a pot bellied appearance?I don't tend to treat dogs just based on blood results, I only treat dogs that are symptomatic. The reason for that is that the drugs we use to control Cushing's disease can have significant side effects too. Trilostane can make dogs nauseous, cause poor appetite, vomiting, lethargy, diarrhea, and weakness. Rarely we can see more serious reactions, including severe lethargy, bloody diarrhea, collapse, hypoadrenocortical crisis (hypoadrenocorticism) or adrenal necrosis/rupture which may result in death.We have found that many dogs need lower than recommended doses, so I tend to start them low to see how they tolerate it.I cannot say why she appeared to have back pain but it may be due to the Trilostane, so I think that you were wise to stop it.It may also be unrelated to Trilostane and could indicate a kidney infection or intervertebral disc disease.Was she given any Rimadyl or Tramadol? If so did that help? The chain of events seem to be she was diagnosed with Cushing's and given two doses of trilostane. At that point she was eating dry k/d. Then Tuesday she seemed very painful and was taken to emergency and prescribed Rimadyl and Tramadol. Stomach issues returned Thursday so switched back to canned k/d and stopped all meds. Is that correct?At this point I would not give medications either, especially not Trilostane, as that seems to precede much of her symptoms.To try and settle her stomach today you can give either:1) Pepcid-ac (famotidine) at one half of a 10mg tablet per 10 to 20 pounds of body weight every 12 hours.OR 2) Prilosec (omeprazole) at one half of a 10mg tablet per 10 to 20 pounds of body weight every 24 hours.These will reduce stomach acid and should help if this is related to simple nausea and gastrointestinal irritation from the medications and a diet sensitivity.I would not feed her any food for 12 hours after the acid reducers are started. This should help stop gut spasms and restore normal gut motility. Small amounts of water or ice cubes given frequently are fine as she needs fluids. You can give her pedialyte or low salt chicken or beef broth to replace electrolytes tooAfter her food fast start a bland diet of 1/3 boiled, lean hamburger (or boiled, white, skinless chicken), all fats and juices drained off the meat, mixed with 2/3 boiled, plain white rice. Feed several small meals a day. Once she feels better (no noise for 48 hours and eating well) start mixing in canned k/d dog food very slowly, less bland more k/d with each day. It should take a week or so to convert her back.I highly recommend rechecking with her veterinarian, getting her urine cultured to look for an infection and if they have an ultrasound machine checking her abdomen, looking closely at her kidneys and adrenal glands. She should be checked for any changes in adrenal gland architecture before considering restarting Trilostane. And if Trilostane is restarted I would cut her dose back significantly to start.Please let me know if you have any further questions.
Expert:  Dr. Kara replied 2 years ago.
Hi Goldine,
I'm just following up on our conversation about Pepper. How is everything going?
Dr. Kara
Customer: replied 2 years ago.
Not well Dr. Kara. Pepper had an ultrasound on Monday and they found a mass on her lower small intestines plus some nodules on her liver. We had surgery on Tuesday for a biopsy. They could not remove the mass as it was in a very dangerous position (I believe near the colon). Anyway, we're waiting for the results but the doctors both believe it is cancer. We have an oncologist appointment next week and we're waiting for the best route (chemo, holistic meds, etc).
Expert:  Dr. Kara replied 2 years ago.
Thank you for the update on Pepper. I am sorry to hear that the news is not good for her. I understand that there are multiple masses in her abdomen, involving her intestine and her liver. I suspect that her primary tumor originated in her intestine and those in the liver are metastatic (spread from the primary tumor). That alone bodes poorly for her as once cancer has spread it is very difficult to fight, but the inability to remove her intestinal tumor is a huge concern as well. No wonder your poor little one was having some many intestinal troubles.I hope that she has the sort of cancer (like lymphoma) that is responsive to chemotherapy since removal of the primary tumor is impossible.Please let me know what the biopsy result is, thank you, ***** *****
Customer: replied 2 years ago.
Dr Kara, how is chemo administered to dogs?
Expert:  Dr. Kara replied 2 years ago.
It depends upon the drug(s) used, which of course will depend upon the type of cancer and the stage it is in.Some is given slowly intravenously, so it must be given in a hospital setting, some comes in pill form which can be given at home.Once you have a diagnosis then her oncologist can give you a plan of action, and there are often a few options depending upon the type of cancer and your wishes. I highly recommend asking lots of questions from the oncologist as they have the most experience and expertise. It's what they do every day.