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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 30338
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My 9 month old cocker spaniel has a heart rate of 70, he

Customer Question

my 9 month old cocker spaniel has a heart rate of 70, he won't eat much and has had terrible GI issues. Could they be related and would the low heart rate indicate something that might help us resolve his GI issue?
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.

My initial thought was that undiagnosed Addison's underlies Charlie's GI issues and bradycardia. An EKG should be considered looking for increased T-wave amplitude, decreased P-wave amplitude, and bradycardia. These changes are consistent with hyperkalemia, however, and an atypical Addisonian may not be hyperkalemic. If an ACTH-stim test has already ruled out Addison's, scoping and biopsy of Charlie's GI tract would seem to be the next diagnostic of choice. Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thanks. My vet and specialist feel they've ruled out Addisons and he passed a slim test with no sign of Addisons. He had an endoscopy and while he had a thickening of the wall, the only thing found was hyplobacter (sp?) and he was on 2 courses of antibiotics for it. He just isn't getting better and I'm desperate to help him. I've spent over 8k on vet and hospitals, but I dont have anything to show for it. Any other ideas or would you treat for Addisons even if he doesn't test for it?
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the additional information. No, if the ACTH stim test results ruled out Addison's there's no reason to treat. Once a specialist has been involved as I expect was the case when Charlie was scoped, I become superfluous and can only recommend further consultation with that specialist. I don't know which presumptive therapies you've tried. A trial of an immunosuppressive dose of a glucocorticoid such as prednisone and/or a hypoallergenic diet trial should always be considered in such a patient in which testing hasn't been productive. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Charlie's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time. Pardon me if I've been redundant. I can't imagine that these presumptive therapies haven't been discussed with you but I'm at a loss to recommend anything further at this time.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Thanks again. He's been on 20mg of prednisone a day and hills z/dand now on the royal canin ultra protein hypo diet with no improvement. He also hates it. As iImentioned, I'm desperate and worried we will lose him
Expert:  Dr. Michael Salkin replied 1 year ago.

I understand. I'll opt out which will give other experts the opportunity to enter our conversation.