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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23826
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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He has not eaten for 2 days, is currently on medication for

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He has not eaten for 2 days, is currently on medication for Valley Fever, but is now gagging, coughing up slime and in his stool this morning there was slime/mucus with a streak of blood, plus a few drops of bloody fecal matter at the end.
JA: I'll do all I can to help. The Expert will know if the dog will be able to digest that. What is the dog's name?
Customer: Zeus, 5 yrs old - Black Lad/Australian Shepherd mix
JA: Is there anything else the Veterinarian should be aware of about Zeus?
Customer: He was prescribed fluconazole and prednizone. We have weaned him off the prednizone this past week, but told he is to remain on the fluconazole for long term - up to a yr.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner, but I wanted to touch base with you about Zeus.

If he has developed signs of colitis (the mucus/blood in stool) this may be inflammatory, in reaction to his medications, or a secondary bacterial infection. And as colitis can cause nausea (likely what is behind the gagging, appetite loss, and slime he is bringing up), we do need to tread with care. Now give that he is already struggling with Valley fever, we are best to ring his vet as soon as they are open to get him onto treatment (antibiotics, injectable anti-nausea medication, appetite stimulants) +/- check a stool sample to ensure we get these signs settled as quick as we can.

In the meantime, we can try supportive care. To start, to counter nausea, we can try him 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 offering food to allow absorption. Of course, do double check with your vet if he has a known health issues or is on any other medications you haven't mentioned.

Afterwards, you can try 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. The aim of these diets is that they will be better tolerated/absorbed by the compromised gut. Therefore, it should get more nutrients in and result in less GI upset. If his stools are quite loose, fiber (ie canned pumpkin) and OTC probiotics (ie Benebac, Fortiflora) can be added to these meals to firm those loose stools quicker and support digestion.

Finally, as dehydration is a risk in these situations, do keep an eye on his hydration. To check that, there are a few things you can look for. Besides gum moisture, make sure his eyes aren't sunken and that he doesn’t have a "skin tent" when you lift the skin. To see how to check those dehydration signs, here is a good video ( http://www.ehow.com/video_12232503_dog-dehydrated.html ) to look at. If you do see any signs of dehydration already, that's our cue to have him seen before this becomes an additional issue (especially as it is often dehydration that makes them feel unwell).

Overall, Zeus's signs do raise some concerns here. Therefore, we’d want to start the above supportive care now. If he doesn’t respond to the above within 12-24 hours; then we'd want to get his vet involved. They can assess his hydration, check for the above and start appetite stimulants, injectable anti-vomiting medication +/- antibiotics to get him eating for us.

Kind regards,

Dr. B.

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Customer: replied 7 months ago.
Your information was helpful and allowed us to ask better questions of our Vet. We called for an appt. but didn't get to talk to or see the actual vet - only the tech. They put him back on the prednisone and continue with the fluconase for another 30 days. I am not pleased with the level of care received and am considering taking him elsewhere. After 6 months of dealing with this issue I would think the actual Vet would see him and re-evaluate. Seems the current program is not working.. Thank You

Good afternoon,

I agree that is odd that they've not seen Zeus to reassess him given the time frame and his appetite decline. Especially as Prednisone on any empty stomach could upset it or even cause a stomach ulcer. So, I do agree that a second local opinion to just make sure we are on top of everything for him would be best, ***** ***** we would want to be making some positive progress by this stage not taking steps back here.

Best wishes for you both,

Dr. B.

Customer: replied 7 months ago.
Thank you for the message and advice.

You are very welcome, my dear.

Best wishes,

Dr. B.

Customer: replied 7 months ago.
Zeus is responding favorably to the prednisone and has been eating some foods. We’ll try once again to get him back to the point of weaning him off the prednisone and fluconase. The vets office called today to follow up. I have expressed my feelings with regard to the lack of hands on evaluation.