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My English Setter,, ;is, listless, has finicky appetite, her…

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My English Setter, bitch...

My English Setter, bitch , ;is, listless, has finicky appetite , her coat has an odd disheveled , appearance, and she has had a limp, which could be un related, ..she is always licking her paws and other parts of her body, ..she is 4yrs old, ..

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?

Amber

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Amber?

She has been taken to a vet in the course of a whole month, has had, blood tests , x-rays, put on medication, for possible, ailments, with no real success.

Submitted: 2 months ago.Category: Dog Veterinary
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Answered in 6 hours by:
5/30/2018
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 2 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 35,503
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 2 months ago

I'm sorry that your question wasn't answered in a timely manner. I'm sorry to hear of this with Amber. I'll address your concerns as you posted them...

1) Listless: non specific clinical sign of illness or laziness

2) Finicky appetite: This is one of the least specific clinical signs and will not in itself direct the clinical evaluation. It's 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.

3. Disheveled coat/appearance: There are quite a few metabolic disorders that can affect the skin/haircoat and there are quite a few primary skin disorders that do so as well.

4. Limp: Musculoskeletal and neurologic disorders

5. Licking her paws and other parts of the body: Most often seen with an allergic dermatitis - flea saliva allergy, atopy (allergies to environmental allergens such as pollens, molds, dust, dust mites, etc.), food intolerance; ectoparasites - fleas, mites, lice; bacterial, yeast (Malassezia), fungal infection

Regretfully, you can see that it's impossible for me to be as specific for you as I would like. Something has been missed by Amber's vet. I would pleased to review Amber's test results for you. Perhaps I can find something that has been overlooked. Can you upload a copy of her test results to our conversation? I understand that you might not have a copy at home but Amber's 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.

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