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My dog just finished a round of antibiotics (citrofloxacin…

Customer Question
My dog just finished...

My dog just finished a round of antibiotics (citrofloxacin 260 m twice a day with meals) for a bladder infection. Vet says blood tests are now good. Now she will not eat or drink. Very lethargic. We are giving her yogurt but she is worse today. The vet said all her organs look good. Vet did CBC and abaxis comp diag profile. She was given fluids yesterday. Uneven gait. Dr. Gave her tramadol which could explain the gait issue. She has fight or flight syndrome which makes her difficult when you just touch her. Not us but the vet?

Veterinarian's Assistant: I'll do all I can to help. Could be a lot of things that cause lethargy. The Expert will know how to help your dog. What is the dog's name and age?

Lola, 9 years she has always been extremely healthy except for bladder issues since she was fixed years ago.

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

Mixed breed. Got her and her sister at the same time when they were rescued after a hurricane. They were approximately 10 weeks old.

Submitted: 4 months ago.Category: Dog Veterinary
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Customer reply replied 4 months ago
It is a Saturday and Dr. is not available
Answered in 7 minutes by:
1/7/2018
Dog Veterinarian: Dr. B., Veterinarian replied 4 months ago
Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 22,824
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

How long has she been off food/water?

How long since she finished her antibiotics? Was she off food when on them?

What dose of Tramadol is she on and what does she weigh?

Any retching, gagging, lip licking, drooling, or vomiting?

Are her gums pink or white/pale? Moist or sticky?

If you press on her belly, any tensing, tenderness, discomfort, or pain?

Can you take a breathing rate for me (just count her breaths for 10 seconds + multiply by 6)?

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Customer reply replied 4 months ago
I can get her to eat the yogurt. We can also get her to drink sips. She was given fluids yesterday. Since last Thursday 3,days.
Gums are pink.
Tramadol 50 mg 2 every 12 hours
No vomiting, wretching or licking
18-24 breathes
She will yelp no matter whether she is in pain or no
Dog Veterinarian: Dr. B., Veterinarian replied 4 months ago

And what is Lola's weight, so I can check that dose?

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Customer reply replied 4 months ago
78
Dog Veterinarian: Dr. B., Veterinarian replied 4 months ago

Now I am glad her gums and breathing rate is normal here, as that does allow me to exclude respiratory causes for this anorexia. With that aside, underlying nausea (even without vomiting)would be out top concern here. And that is something we often see with a lot of antibiotics but also Tramadol. So, those would be suspect here. Plus her unsteady gait could be related to the Tramadol but also could be a side effect of a low blood sugar from her not eating.

With this all in mind, her Tramadol dose one is a mid range dose but if we can it may be worth dropping it down 50-70mg every 12-24 hours to just see if her appetite picks up and her gait steadies. Else we can pre-treat with an OTC pet safe antacid. [ie Pepcid (More Info/Dose @http://www.petplace.com/article/drug-library/library/over-the-counter/famotidine-pepcid), Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac))]. Whichever you choose, we’d give this 20 minutes before food to allow absorption. Of course, do double check with your vet if she has a known health issues or is on any other medications you haven't mentioned.

Afterwards, we'd hope to get her more settled so we can get her eating. So, we can try favorites or you can consider starting her on an easily digestible diet like cooked white rice with boiled chicken, boiled white fish, cottage cheese, scrambled eggs, or meat baby food (as long as its garlic/onion free). There are also OTC vet diets that can be used (ie Hill’s I/D or Royal Canin’s sensitivity) too. Else if she cannot be tempted and since we haven't active vomiting, we can offer or syringe feed watered down canned puppy food, Hill's A/D, Royal Canin Recovery, or Clinicare Canine/Feline Liquid Diet. All of these are critical care diets that are calorically dense, so a little goes a long way nutrition-wise. And that will get fluids in too, but we can also supplement with Pedialyte (aim for 1.7L per day for her size as that's her daily requirement) by syringe as well. Or we can tempt her to drink with low salt broths or lactose free milk. And just since she has that yelping, make sure she isn't refusing to eat/drink because she cannot lower her head comfortably to her bowl (hand feeding or raising it may help).

Overall, I don't like hearing that she yelps without reason as sometimes that can be a sign of spinal pain but I'd have expected her vet to have mentioned that if it was a worry. Still we can try the above to see if we can get her a bit more steady and eating for us. Of course, once her vet is open, it sounds like we'd want her back to potentially try a different pain relief (ie anti-inflammatory) but also may need her on an appetite stimulant here as we work to narrow down the cause for her other signs.

Kind regards,

Dr. B.

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Dog Veterinarian: Dr. B., Veterinarian replied 4 months ago
Hi,

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

Dr. B.
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