Dog Veterinary

Ask a Dog Vet and Get Answers to Your Dog Health Questions

Ask a Dog Veterinarian,
Get an Answer ASAP!

Dog Veterinary

I am looking from a vet with experience in treating IBD and

Customer Question
I am looking for advice...
I am looking for advice from a vet with experience in treating IBD and oesophagitis. My dog has been diagnosed w idopathic IBD. She has post anaesthetic oesophagitis. While she drinks water she will not eat even though she seems hungry. It appears as though it is the pain of swallowing which prevents her from eating. We have been trying to force feed her but it has become impossible to continue. We have tried syringe feeding but she spits the food out. She has been on prednisone and azothiaprine for 8 days. Is there anything we can give her to assist her to swallow or is it kinder to let her go.
Submitted: 1 year ago.Category: Dog Veterinary
Show More
Show Less
Ask Your Own Dog Veterinary Question
Answered in 1 hour by:
5/24/2016
Dog Veterinarian: Jennifer Van Noy,
 replied 1 year ago
Jennifer Van Noy
Category: Dog Veterinary
Satisfied Customers: 87
Experience: Veterinarian at Riverside Animal Hospital
Verified

Hello,

I’m Dr. Jenn and I’m a licensed veterinarian with 18 years of experience. I’m here to help with your question about Song.

I’m so sorry you’re having this problem, but glad you’re looking for the information you need. You may join the conversation at any time by typing in what you want to say then clicking REPLY or SEND. Then we can chat back and forth until you’re satisfied with the information I’ve provided. I’ll do my best to ear your good rating, because that’s the only way I receive any compensation for helping you.

In order to help me help you better, I’ll need a little more information. To start with, please tell me:

  • Which Gastrointestinal signs of IBD did Song initially have? i.e. did she have vomiting and diarrhea, weight loss? Just trying to get a better picture of her history.
  • Is she still on Omeprazole?
  • I see Carafate typed out, is she still on that?
  • Is she on anything for pain control? Esophagitis is very painful.
  • How much does Song weigh and what doses of drugs is she on?

I’ll be standing by and awaiting your reply. Thank you for using our website.

Ask Your Own Dog Veterinary Question
Customer reply replied 1 year ago
Hi Jenn sorry for the delay in responding. Initially Song started vomiting we thought she had eaten something that didn't agree w her. Then it seemed to resolve. She stopped eating raw chicken drumsticks her usual meal and started eating mince instead. She has had no diarrhoea but she has dropped from 15 to 12.5 kilos. She is on 10mg of omeprazole once a day. She takes carafate twice a day. I asked about pain control and I was offered tramadol however it doesn't seem to help it just seems to sedate her. She is on azathioprine 25mg a day which she has taken for 7 days. She will now alternate that dose every second day. Prednisone is 10 mg a day. I recently read a study on VSL#3 probiotic in dogs and I am giving her 3 mg (100 billion bacteria per Gm) per day. I tried her on ondanestron however it does not appear to effect her appetite at all.
Customer reply replied 1 year ago
I should mention that prior to her IBD diagnosis she had surgery for a low grad soft tolissue spindle cell on her shoulder. She did not recover and stopped eating all together after the surgery. I raised my concerns re post anaesthetic oesophagitis and the same clinic did a barium study and told me she didn't have oesophagitis. I took her to another vet and asked him to treat her empirically for oesophagitis w prednisone and there was an immediate positive response she began self eating. After a week I thought there was something more going on and agreed to an endoscopy. This found severe oesophagitis particularly the upper oesophageal sphincter, ulcer and thickened stomach lining which resulted in the diagnosis of IBD. Greater difficulty w regards ***** ***** and a general decline in her overall well being seemed to coincide w administration of the azathioprine. She had one night a few days ago when she developed what looked like polydipsia and polyuria, she was restless and anxious. I stopped the prednisone for 36 hours and the polydyp/polyuria is still present she is not overtly anxious but seems lethargic and a little depressed.
Customer reply replied 1 year ago
In addition to clarify Song started vomiting constantly following the surgery.
Dog Veterinarian: Jennifer Van Noy,
 replied 1 year ago

I'll try to get this to flow together, but lots of info to give back and forth.

I like the idea of the probiotic. That won't hurt, may help.

When the biopsy came back as IBD, was she started on both the Prednisone and Azathioprine at the same time? Or was the Pred started, then azathioprine added on? Was she ever on Metronidazole (antibiotic)? If yes, what dose and length of administration? How about a novel protein source?

The surgery for the spindle cell tumor- how long ago was that? Did she recover fully from that or is that how the vomiting got started? I'm not sure of timeline.

Is she doing any vomiting now?

Do you have the actual histopathology report that you could share? Or tell me how severe and what type of IBD she has?

I used to use a fair bit of Tramadol, but further recent absorption studies show dogs barely absorb the drug and it's about useless. Most of the esophagitis (I'm in the US, so no "o" for me) I've treated has needed IV Fluids and IV pain control initially since it is so painful- for me most often a combination of an opioid ( morphine or hydromorphone), ketamine, and lidocaine (MLK or HLK Constant rate infusion) to get them over the hump of being so painful.

Have you used Metoclopramide? Or Cisapride (harder to get now at least in US, but could still get it compounded as of last year)

I like she's on omeprazole and carafate. Is the carfate 1 gm? There is likely room to go up in dosing frequency. This may be helpful.

What are you a currently trying to feeding?

Sorry for all of the questions, this is going to take some time to sort through and come up with a good plan.

Ask Your Own Dog Veterinary Question
Dog Veterinarian: Jennifer Van Noy,
 replied 1 year ago

One further question- For the spindle cell tumor. Were they able to get clean margins? What grade was it? Where her chest x-rays clear at that time? How long ago was that?

Ask Your Own Dog Veterinary Question
Customer reply replied 1 year ago
Thks Jenn Prednisone was started before the biopsy then azathioprine later. No metronidazole. Started feeding kangaroo 2 days ago but can't manage to force feed her safely after tonight she just doesn't seem to swallow.Surgery was 8-9 weeks ago following surgery she was vomiting frequently and wouldn't eat except occasional liver treat then increasingly less then nothing at all. Oesophagitis came on after the surgery. I have the histology report form tumour margins were clear.I asked about cisapride and it was prescribed however after the endoscopy it was recommended to stop giving it to her as it would increase ulcer pain.Carafate is 1 Gm tablet. Thks for the info re pain management for the oesophagitis. I think it has been very poorly managed she has been in a lot of pain. Would morphine subcutaneously have the same effect or is Iv necessary to maintain constant dose?I have been feeding pork and veal mince w duck fat to help emulsify when she swallows. We switched to kangaroo but she just won't swallow at all now. How long does omeprazole take to resolve the oesophagitis and an ulcer? I am not sure way to do next w feeding for her now that she is not cooperating at all. I am concerned about the risk of aspirational pneumonia ....
Dog Veterinarian: Jennifer Van Noy,
 replied 1 year ago

Was the azathioprine started because she was still vomiting? Or why was it started?

Discounting the esophagitis for the moment- when I have an IBD case, typically I'll start them on novel protein source diet, Metronidazole, Pred, and Colbalamin if needed. Were her Cobalamin levels tested?

She has both ulcers in stomach and esophagus?

Metoclopromide only works on esophageal sphincter, so that may be the better choice.

Morphine SQ works okay, but not as well as IV. Fentanyl patch may be worth looking at. Honestly, it sounds like hospitalization for at least a little bit is likely indicated, then back to home care once she's doing a bit better.

I'm going to be away from my computer for a bit. Let me know these answers and we'll go from there.

Ask Your Own Dog Veterinary Question
Dog Veterinarian: Jennifer Van Noy,
 replied 1 year ago

I just want to make sure I get the timeline correct, as it does matter to what my response will be.

My current understanding:

Initial surgery to remove spindle cell tumor on shoulder 8-9 weeks ago.

After that started vomiting, likely esophagitis.

Pred started

Endoscopy of esophagus and stomach. Where there biopsies taken of this or was it a presumptive diagnosis of IBD? If histopathology available- what type of IBD? How severe?

Does she have ulcers in esophagus and stomach?

Azathioprine started 1 week post Pred. Why? Still vomiting?

All the other meds added on too.

Trying to understand if Pred and Azathioprine added on because histopath came back as IBD or exactly why and when.

Thanks.

Ask Your Own Dog Veterinary Question
Customer reply replied 1 year ago
Hi Jen sorry to be away for so long I hope you get this msg. Endoscopy revealed thickened stomach lining and an ulcer in the stomach only. They found no oesoniphils but lymphocytes were found and other immune cells I believe. I was told they treat all IBD as severe although I am unaware of the different grades. She is not losing protein, elevated alkaline phosphotase, one of her liver enzymes slightly elevated ( probably the prednisone?) the azothiaprine started on advice from a specialist ie to treat as severe from the beginning. Yes she has been vomiting less - once a day now. So azathioprine added to pred following endoscopy because of IBD diagnosis. This was approx 14 days ago now. To me she seemed worse on the azathioprine w re to the vomiting. She has low sodium and potassium from the chronic vomiting. Yesterday she had a fecal microbial transplant administered orally and rectally. It's experimental so I don't know wat to expect with that. Would maropitant help her w vomiting and inflammation? Might that be an alternative to the prefer and azathioprine as they don't seem to be doing much to help her...
Dog Veterinarian: Dr Chris, Dog Veterinarian replied 1 year ago
Dr Chris
Dr Chris, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 49
Experience: Registered General Practioner
Verified

Sorry, it's a little hard to orientate myself with the photo being so close-up. Can I firstly clarify the orientation? The tail is towards the bottom left of the image, the anus is in the middle, and the lump is middle left? So the lump is above and to her right of the anus. Is this correct?

Ask Your Own Dog Veterinary Question
Dog Veterinarian: Dr Chris, Dog Veterinarian replied 1 year ago

Oops. Sorry about this interruption. I don't know how I accidentally entered this conversation. I'll be gone...!

Ask Your Own Dog Veterinary Question
Dog Veterinarian: Jennifer Van Noy,
 replied 1 year ago

Hi, I got email notification of the message. I'm glad you wrote me back with the additional info, because I didn't want to say anything potentially "negative" without understanding the full story! What I don't understand is why Song is on a steroid if she has a stomach ulcer. Yes, often w/ IBD we do use Prednisone to treat, but we don't put dogs with stomach ulcers on steroids, because it makes the ulcer worse - which causes continued pain, anorexia, vomiting, etc, etc, etc. Both steroids and NSAIDs are contraindicated in cases of stomach ulceration. Now once the ulcer is healed, if she still had clinical signs consistent w/ IBD, and wasn't responding to Metronidazole and novel protein source,then I'd add back in Pred and maybe Azathioprine (or more likely cyclosporine). I do think this needs to be nicely discussed with your vet- that's why I wanted to verify with you that Song does have an actual stomach ulcer.

I wonder how much of the vomiting at this point is due to the Azathioprine + the stomach ulcer + the Pred.

It's good she's not losing protein! Not a surprise her Na and K+ were low.

Maropitant may be useful. How much is she still currently vomiting? Also, considering Metoclopramide too.

If she were my patient -- a dog w/ stomach ulcer and esophagitis with IBD, I would initially be treating with opioid pain meds, Carafate/Sucralfate, Omeprazole, Metronidazole, and likely Maropitant, possibly Metocloparmide too. I'd do as much initially as an injectable as possible, obviously Carafate works as a coating, but want as little in the stomach as possible. I would be pretty aggressive with my treatment as esophagitis and stomach ulcers are very painful and hard to get under control.

From what you've told me, it seems like the initial esophagitis and ulcer was secondary to her lumpectomy surgery/anesthetic event. That's when all the vomiting, etc started. She wasn't having GI issues prior to that. My personal opinion, is the ulcer and esophagitis has to be healed first.

I'm more than happy to continue to communicate with you. I want to hear she's feeling better!!!

I hope this information was helpful to you.

You may return to this page at any time to review this information and/or post more. You may do so even after you’ve rated my response. I’ll be notified of your response via email and will do my best to help you. If you are satisfied with the information I’ve provided, please take a moment to rate my response. I’ve done my best to provide you the most accurate, thorough, and up-to-date information that is available, and your positive feedback is important to me. Without it, I receive no compensation for helping you. If you are not satisfied, please let me know how else I may be of assistance. Thank you for using our website.

Ask Your Own Dog Veterinary Question
Ask Jennifer Van Noy Your Own Question
Jennifer Van Noy
Jennifer Van Noy
Jennifer Van Noy
Category: Dog Veterinary
Satisfied Customers: 87
87 Satisfied Customers
Experience: Veterinarian at Riverside Animal Hospital

Jennifer Van Noy is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete!

Bev & GeorgeBoca Raton, FL

Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help.

Mary C.Freshfield, Liverpool, UK

This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!!

AlexLos Angeles, CA

Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult.

GPHesperia, CA

I couldn't be more satisfied! This is the site I will always come to when I need a second opinion.

JustinKernersville, NC

Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around.

EstherWoodstock, NY

Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know.

RobinElkton, Maryland

< Previous | Next >

Meet the Experts:

Dr. Debbie

Dr. Debbie

Dog Veterinarian

902 satisfied customers

Companion animal veterinarian practicing for over 10 years.

Dr. Andy

Dr. Andy

Medical Director

16,087 satisfied customers

UC Davis graduate, emphasis in dermatology, internal medicine, pain management

Dr. Gary

Dr. Gary

Dog Veterinarian

9,949 satisfied customers

DVM, Emergency Veterinarian, BS (Physiology)

Dr Scott Nimmo

Dr Scott Nimmo

Dog Veterinarian

9,704 satisfied customers

BVMS, MRCVS. { Glasgow UK }

Dr. Scott

Dr. Scott

Veterinarian

9,615 satisfied customers

15 years of small animal, equine and pocket pet medicine and surgery.

Dr. Bruce

Dr. Bruce

Veterinarian

8,945 satisfied customers

15 years of experience as a small animal veterinarian

Rebecca

Rebecca

Dog Veterinarian

7,442 satisfied customers

More than 30 years of companion animal practice.

< Previous | Next >

Related Dog Veterinary Questions
My dog ate some raw meat out in the field yesterday. His
My dog ate some raw meat out in the field yesterday. His belly is very bloated. He has been groaning continuously. He hasn't pooped since. He is lathargic and lacks appetite. What can I give him? … read more
Dr. Gabby
Dr. Gabby
Veterinarian
Doctoral Degree
4,408 satisfied customers
Dog at raw bread dough, she's a 75 lb dog and ate some raw
no she's young 2 yrs old 75 lb lab hound great dane mix… read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
My dog got into my fridge and ate a whole pack of raw bacon
My dog got into my fridge and ate a whole pack of raw bacon and two raw pork chops … read more
Dr. Peter
Dr. Peter
Doctors Degree
14,316 satisfied customers
She will not eat anything -did not eat chicken this morning.
She will not eat anything -did not eat chicken this morning. just tried to give her cheese or broth. No go. Not even water. Belly is not bloated. Ears are cool. Nose is cool and wet. I suspect kitty l… read more
Pet Doc
Pet Doc
Senior Small Animal Veterinarian
BVSc
2,782 satisfied customers
My 4 year old puggle ate raw chicken I was getting ready to.
My 4 year old puggle ate raw chicken I was getting ready to cook. About 2 lbs of it. I think my daughter missed her last two months of heart worm. Is she going to be ok? … read more
Dr. Kara
Dr. Kara
Doctoral Degree
5,376 satisfied customers
My dog ate a Costco chicken carcass.....the entire
My dog ate a Costco chicken carcass.....the entire thing....it has been 1.5 days..he seems fine, is still eating and has pooped. Will he pass all the bones? We have not seen them yet. … read more
Dr Scott Nimmo
Dr Scott Nimmo
Dog Veterinarian
9,704 satisfied customers
I need to know if organic skinless and boneless chicken
I need to know if organic skinless and boneless chicken breast is good for my 8 pound poodle? … read more
Dr. Meghan Denney
Dr. Meghan Denney
Doctor of Veterinary Medicine
Doctorate of Veterinary Medicine
1,484 satisfied customers
Dog ate chicken wings anytime between 7hrs ago to now. What
Dog ate chicken wings anytime between 7hrs ago to now. What should I do? Should I be worried? He is a 60 lb standard poodle.… read more
Dr. Deb
Dr. Deb
Associate Veterinarian
Doctoral Degree
556 satisfied customers
My dog had diarrhea and after feeding him chicken and rice
my dog had diarrhea and after feeding him chicken and rice for a week, he will not go back to his regular feeding schedule and it's been three weeks. He eats sometimes but not always. … read more
Scott Perry
Scott Perry
Veterinarian
Doctor of Veterinary Medicine
1,252 satisfied customers
She is a 50lb Pyrenese/Aussie Shepherd mix who ate three raw
She is a 50lb Pyrenese/Aussie Shepherd mix who ate three raw Pilsbury Crescent rolls about 20min ago. … read more
Dr. Kara
Dr. Kara
Doctoral Degree
5,376 satisfied customers
Under a vets care for a very raw looking rectum. No
Under a vets care for a very raw looking rectum. No diarrhea, notchewing, Vet put 10 month old pug on stool softener, told me to use baby suppositories to lubricant. Did this for 5 Days 4 x a day. Res… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
8,629 satisfied customers
I have been feed feeding duke chicken and rice for 1.5 days
I have been feed feeding duke chicken and rice for 1.5 days he passed the meat pad, but tonight I have been up every 2 hrs b.c he is having diharrea does the chicken and rice cause diharrea that bad ?… read more
Dr. Christina
Dr. Christina
Small Animal Veterinary Internist
277 satisfied customers
I have a schnauzer and am thinking of feeding a raw food
I have a schnauzer and am thinking of feeding a raw food diet from … read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
She licked her hind quarter nearly raw- and had raw spots in
She licked her hind quarter nearly raw- and had raw spots in her "arm pits" from allergies. The area around her eyes was red. Anyway they checked for mites --I knew she had none, and they shaved and c… read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
8,629 satisfied customers
My dog ate around 3 pounds of raw chicken I had out for
My dog ate around 3 pounds of raw chicken I had out for dinner. Is there anything i should do? … read more
Dr. Peter
Dr. Peter
Doctors Degree
14,316 satisfied customers
Two days ago, I fed my small dog a half of a raw chicken
Two days ago, I fed my small dog a half of a raw chicken wing (cage-fed, no hormones, etc) as I read up on vets who say it's healthy to sometimes supplement their diets, and that the raw bones help cl… read more
Dr. B.
Dr. B.
Veterinary Degree (BVMS)
3,439 satisfied customers
My dog licked raw chicken blood yesterday and today he won't
My dog licked raw chicken blood yesterday and today he won't eat, play or move. He vomited once and had diarrhea which was runny with mucus and blood in it. … read more
Dr. B.
Dr. B.
Veterinary Degree (BVMS)
3,439 satisfied customers
Switched food. Akita puppy was on raw chicken diet,vet told
switched food. Akita puppy was on raw chicken diet,vet told me to put on science diet large breed puppy foodbut he's vomiting it up and its not chewed up … read more
Jess K
Jess K
Doctor of Veterinary Medicine
1,514 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x