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Throwing up. Now he is diabetic and has been for 8yr. But…

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Throwing up brown. Now...

Throwing up brown. Now he is diabetic and has been for 8yr. But yesterday he stopped eating. Wont get up just lays there

Veterinarian's Assistant: I'll do all I can to help. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else important you think the Veterinarian should know about the dog?

He is 2 days shy of 13. About 85lbs get 25cc in the am & at night. Has been fine until the 24th

Submitted: 4 months ago.Category: Dog
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Answered in 2 minutes by:
12/26/2017
Dog Specialist: Dr. B., Veterinarian replied 4 months ago
Dr. B.
Dr. B., Veterinarian
Category: Dog
Satisfied Customers: 22,616
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 he been showing signs?

Is it brown like his food or like coffee grounds?

Can he keep any water down?

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

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

Could he have eaten anything harmful (ie bones, toys, plants, chemicals, human meds, etc)?

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Customer reply replied 4 months ago
He stopped eating the 24th in the Am. I hand feed him chicken on the 24th around 9:30. Now in the am he got his 25cc of insulin because for about 6mths now he will only eat after the insulin but he didn't just a treat. Then again that night chicken breast and only 12cc of insulin. Then just laying around. Did drink some water. Then the 25 nothing no eating and only a small amount of water. So reading we found he may have to much insulin and use honey to fix it. We did that and he purked up a small bit but drank more water. By night time he is just laying still not eating, last drink around 8pm. Now sometime last night after 2:30 am he threw up brown slim. He's done the throwing up before 8yrs ago when we found out he was diabetic. No blood in the urine either
Customer reply replied 4 months ago
Our vet said that being 13 if he gets sick they will lean to putting him to sleep and I'm not doing that.
Customer reply replied 4 months ago
Gums are pink but tacky
Dog Specialist: Dr. B., Veterinarian replied 4 months ago

Hello again,

First, you are right that if they get their normal dose of insulin and dont' eat the blood sugar can get low. Often they will be lethargic as you saw but for him to have vomited suggests that we have more afoot here then that alone. Vomiting and appetite loss too are both caused by nausea and that is often triggered by issues like bacterial or viral gastroenteritis, pancreatitis, parasites/protozoa infections, or dietary indiscretion. That said, given that he is older there would also be concern of nausea secondary to reduced kidney or liver function, IBD or cancer. And if this vomit looks like coffee ground material (the appearance of blood from the stomach), then a stomach bleed or ulcer would become a worry and indication for him to be seen as an emergency.

With this all in mind, we'd not just jump to euthanasia for nausea. Yes, there are some issues that cannot be cured (ie if he had a severe kidney failure) but those first differentials I noted are much more common and treatable. So, in any case, first off we can try some home supportive care. To start, if he hasn’t just vomited (since otherwise we’d need to rest his stomach for a few hours first), then you can consider treating him 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 medications you haven't mentioned. Though if he cannot keep it down due to nausea, that is usually a red flag that we need to bypass his mouth with injectable anti-vomiting medication from his vet.

Afterwards, you can try tempting him to eat. Favorites are allowed or often we use 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 he cannot be tempted but we can counter the nausea, then we could also 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

Finally, as dehydration is a risk in these situations, do keep an eye on his hydration. 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, your lad's signs do raise some concerns but at this stage we need to counter that nausea to see if we can get him eating one of the above options. If we can, he can have a half dose of his insulin and we can see how we go. Of course, given how delicate diabetics are, if he doesn’t respond to the above within 12-24 hours; then we'd want to get his vet involved to look into those issues I noted and to try treating with injectable anti-vomiting medication, fluids, appetite stimulants, +/- antibiotics to settle his stomach, and get him back feeling like himself.

Kind regards,

Dr. B.

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