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My shih tzu 3 yrs old not eating well. my vet did labs, xray…

Customer Question
Hello my shih tzu...

Hello my shih tzu 3 yrs old not eating well. my vet did labs, xray and acth test ehich is negative. How can I get him to eat? entyce only work for 4 days that we gave it to him

Veterinarian's Assistant: I'll do all I can to help. What is the dog's name?

Max

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Max?

We used to hand feed or force feed him before the vet did all these. today he does not eat anything nor drink.

Submitted: 7 months ago.Category: Dog Veterinary
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Answered in 9 hours by:
12/26/2017
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 35,548
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

I'm sorry that your question wasn't answered in a timely manner. Please let me know if you still need help. May I have an update on Max, please? Regretfully, there are far too many causes of anorexia for me to tell you how you might get him to eat. Please see below**.

Can you upload a copy of Max's latest test results to our conversation? I understand that you might not have a copy at home but his vet can give you one which you can scan into your computer and then give me the file link or you can photograph the pages and upload them by using the paperclip icon (if you can see that icon) or by using an external app such as dropbox.com/

I not only review the test results but also note which tests should have been performed but weren't.

**I can understand your frustration. Anorexia is one of the least specific clinical signs and will not in itself direct the clinical evaluation. Anorexia is purely an indication of underlying disease. For the truly anorexic patient, the causes may be legion. It's vital to differentiate between a patient disinterested in eating and one who experiences difficulty or discomfort while eating. Thereafter, routine laboratory tests and diagnostic imaging complement the history and physical exam for elucidating the cause of anorexia.

Here is a synopsis of the differential diagnosis for anorexia:

Disinterested in food altogether (true anorexia): systemic disease, infection/inflammation, neoplasia, food aversion

Reluctance to eat (pseudoanorexia)

Associated with pain/discomfort

Painful prehension or mastication, odynophagia (repeated attempts at swallowing) as seen with: retrobulbar abscesses from apical/tooth root abscesses, e.g., intraoral masses/foreign bodies, mandibular fractures/temporomandibular joint disease, masticatory myositis (inflammation of the muscles of chewing), periodontal disease, salivary gland disorders, oropharyngeal dysphagia, esophageal disease (masses, foreign bodies), nasal disease affecting sense of smell.

Associated with nausea

Gastrointestinal inflammatory disease Ileus (paralysis of the GI tract), delayed gastric emptying, vestibular disease, side effect of medications; many drugs have GI tract side effects.

The initial database for pseudoanorexia is a neurologic examination, oral, dental, and cranial examination (sedation or general anesthesia); radiographs of the teeth, mandible, or nasal cavity may be required. Thoracic radiographs and/or endoscopy to evaluate the esophagus and gastroesophageal sphincter for any obstruction (e.g., strictures, masses, foreign bodies) or mobility problems. The initial database for true anorexia involves laboratory testing and imaging as suggested by history and physical exam findings.

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