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I have a 4lb 7yr old Maltese. She is on gastrointestinal…

I have a 4lb...

I have a 4lb 7yr old Maltese. She is on gastrointestinal Royal Caniin food due to sensitive stomach. She is not eating and I can hear her belly rumbling. She keeps licking the air, and she stands with a hunched posture with her tail slightly tucked. So far there has been no vomiting or diarrhea. Is this symptomatic of an upset stomach and nausea?

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

Not to my knowledge.

Veterinarian's Assistant: OK. The Expert will know what to do. What is the Maltese's name and age?

Maya 7yrs

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Answered in 5 minutes by:
3/20/2018
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,984
Experience: Over 20 years of experience as a veterinarian.
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Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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I'm sorry to hear that your girl Maya isn't herself with lots of stomach gurgling, licking the air, hunched over posture, lack of an appetite and lethargy.

The noises that you are hearing are the result of ingesta moving through the gastrointestinal tract and gas bubbles. In most cases they are completely normal and seem to cause the dog no distress. But in cases where the dog acts uncomfortable it is likely that the pup is experiencing some reflux or abnormal motility, or painful intestinal spasms that are more than the usual. In severe cases this can be linked to pancreatitis which is a painful inflammation of the pancreas leading to increased enzyme leakage.

Possible causes for this include a quick change in diet, dietary sensitivities or allergies, or eating things that she should not have like too many fatty table scraps or garbage, bones etc. Metabolic organ failures (kidney or liver disease), Addison's disease (hypoadrenocortisim), pancreatitis, inflammatory bowel disease or even infiltrative cancers are other possible causes.

Has she gotten anything different to eat or has she gotten into anything that you know of that may have started all of this? I would be concerned that she is having a bout of pancreatitis or inflammatory bowel disease given her history of a sensitive stomach.

I can give you some suggestions but ideally if she isn't coming along quickly over the next couple of days I would recommend checking basic blood tests on her including a complete blood count, biochemistry panel and a blood test for pancreatitis called can spec PL (canine specific pancreatic lipase) which is highly specific for pancreatitis.

If her electrolyte levels seem unbalanced (high potassium and low sodium) then testing for Addison's disease with a test called an ACTH response test would be reasonable.

If those things are normal then the next step diagnostically would be an abdominal ultrasound and endoscopy to collect intestinal biopsies.

But for now here are some suggestions.

For now to help with gastrointestinal upset and reflux you can give either:

1) Pepcid ac (famotidine) at a dose of one quarter of a 10mg tablet every 12 hours

OR

2) Prilosec (omeprazole) at a dose of one quarter of 20mg tablet every 24 hours

These are acid reducers and could help her feel more comfortable. They are quite safe and can be used for a few days if needed. In some cases dogs remain on them long term if this is a repeated problem.

I would pick up all food for now and water for a couple hours to allow her stomach to settle after the acid reducers. In a couple hours you give her water or low salt clear broths like low salt beef or chicken broth to drink, but make sure it is in small amounts only.

If she seems to feel better tomorrow morning offer a bland diet mix of 1/3 boiled, minced, white, skinless chicken or boiled, lean hamburger, all fats drained off the meat after cooking, and 2/3 boiled, plain, white rice, mashed potatoes or pasta mixed with some low salt chicken or beef broth to make it easy to lap up and swallow as well as increase her fluid intake. If she refuses that then she likely needs to be seen by your family veterinarian.

Probiotics such as Fortiflora, Proviable, or Benebac can be added to the bland diet mix to help replace appropriate bacteria.

If things go well and she eats and seems more comfortable feed her the bland diet for 2 to 3 days then slowly start to mix back in her regular food, a little more at each meal. It should take about 5 to 7 days to slowly convert her back to her regular diet.

If she continues to be lethargic, begins to vomit, runs a fever (more than 103F rectally), or has a tense painful belly then she is not a candidate for home therapy and must see a veterinarian for an examination, diagnostics, injectable anti-nausea drugs intravenous fluids and supportive care.

It has been my pleasure to help you today, and I hope that I have earned my 5 star rating. Please remember to rate my service by selecting the 5 stars at the top of the screen (rating me now does not close your question). You are welcome to ask follow up questions about my response here until you are satisfied, simply use the reply box and let me know. Thank you!

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Customer reply replied 4 months ago
She has been to the vet on multiple occasions for stomach problems but all blood tests have been normal. I will keep an eye on her and hopefully her tummy troubles will resolve in a day or so. Thank you

My pleasure, glad to help.

I would give one of the acid reducers I recommended a try. One of those may help her feel much, much better.

With primary intestinal disease her bloodwork may look completely normal until the intestinal wall is very damaged, and she starts to lose protein or suffers ulcers.

Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 18,984
Experience: Over 20 years of experience as a veterinarian.
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