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My dog, Buddy is 5 yo male lab mix who has had gastric

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My dog, Buddy is...

My dog, Buddy is 5 yo male lab mix who has had gastric problems off and on since he was about 10 months old. The first episode was frank blood stools. It was severe enough to hospitalize him for 2 days. About every 6 months he has an episode of vomiting (usually thick mucus without blood) and diahrea stools. I take him to his vet and he's started Prednisone, Metronidazole and Fortiflora. Within a day, he's feeling and acting better.

Veterinarian's Assistant: I'll do all I can to help. Hopefully it didn't make a mess. Did Buddy eat anything unusual?

No. He is on a prescription diet of Hills I/D 3 cans a day. I know it's alot of food, but he usually eats it well and if I cut back, he acts like I'm staving him. We have no other pets. He cannot get into the garbage (and he doesn't try). My husband and I take him to work every day, so we watch him closely. We live in Elko, Nv, a small isolated town. Buddy's vet always gives him the best of attention. I wonder if I should take him to Salt Lake or Reno for diagnostic tests. Any ideas will be appreciated. Thank you. *****: OK. The Expert will know what to do. Is there anything else the Veterinarian should be aware of about Buddy?

I think that's the broad overview about Buddy..

Submitted: 1 month ago.Category: Dog Veterinary
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Answered in 43 minutes by:
12/30/2017
Dog Veterinarian: Dr Linda, Dog Veterinarian replied 1 month ago
Dr Linda
Dr Linda, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,556
Experience: I am a practicing veterinarian with over 20 years experience in a mixed animal practice.
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Hello, this is Dr. Linda. I hope I can help with your concerns about Buddy today.

Could you tell me if, or when your veterinarian last did a full blood panel on him?

Thank you.

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Customer reply replied 1 month ago
He had blood draw in July, but I don't know the exact results. His vet said everything looked good.
Dog Veterinarian: Dr Linda, Dog Veterinarian replied 1 month ago

Hello again.

Although this may be a bit of a stretch, if your veterinarian has not suggested an ACTH stimulation test, this would be my next step. Intermittant, but regular bouts of vomiting & diarrhea that responds to steroids sounds like Addison's Disease. However, it does not sound like he has the full blown spectrum. He may be an atypical Addisonian dog, & much more difficult to diagnose. If your veterinarian does not offer ultrasound, then it might be a good idea to consult with a larger or more specialized referral clinic. I would like to see an ultrasound of his abdomen, including his adrenal glands. Then the next step is some further endocrine testing. Sometimes the results of these test are a bit tricky to interpret, so talking with a board certified veterinary internist might be a good move.

Please let me now if you have any further questions or concerns.

Thank you.

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Customer reply replied 1 month ago
Dr Linda:
Thank you for your comments about Buddy's condition. Although I'm not an expert, I am an RN and have some awareness of adrenal and pituitary problems. Please explain to me why you associate Buddy's gastric symptoms with adrenal insufficiency. I suspect he responded to the Prednisone because of an inflamed bowel, He may have additional problems but I would have guessed you'd recommend a more thorough gastric evaluation. Do adrenal problems come with significant vomiting and diarrhea?I'm sure you have your reasons, and I'd like to share them with Buddy's veterinarian. He has had so many bouts that he is not bouncing back as quickly as he did as a younger dog. Please don't think I am challenging your advice. I really want to understand and help Buddy feel better.Thank you.
Dog Veterinarian: Dr Linda, Dog Veterinarian replied 1 month ago

Addison's, or hypoadrenocortism is a condition where not enough cortisol is produced. Intermittent, but chronic bouts of vomiting & diarrhea are one of the hallmarks of the condition, so I would want to rule this out before deciding to do something invasive like a gastric biopsy. His symptoms do not fit well with much else, except for a possible food allergy, but I would expect more regular & consistent effects, along with weight loss.

There are gastrointestinal/pancreatic (exocrine ) function tests, along with diarrhea PCR panels to look for unusual fecal ova & parasites, but I would still want to at least rule out the Addison's. The sign's of Addison's are nonspecific & are seen in other, more common medical disorders, particularly renal diseases ( which would have shown in his last blood work). The fact that Buddy has such severe attacks twice a year that responds to hospitalization & I assume fluids, & then the steroids, although not pathognomonic, should alert any veterinarian to consider the diagnosis.

So since the extent of involvement varies from case to case, & symptoms can range from mild & few to severe & life-threatening, & this condition can mimic so many others, it is a good one just to rule it out so you can concentrate on what else may be causing his problems. And because this condition causes veterinarians so much grief trying to understand the results, sometimes using a referral practice is better. But your veterinarian should have no problems doing an ACTH stimulation test . I cannot tell you if this is the answer to Buddy's recurrent bouts, but at this point I would want to rule this out.

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