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Dr.  Hanson
Dr. Hanson, Veterinarian
Category: Pet
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Experience:  D.V.M. for more than 30 years. I have experience treating all varieties of animals.
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My 12 year old Sheltie has had rapid weight loss, very ...

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My 12 year old Sheltie has had rapid weight loss, very lethargic, just lays around, minimal appetite, doesnt respond to any stimulation, is very sensitive near his back end, and lower abdomen. I am very concerned. He has another appt with the Vet, they have done blood work and now are going to do an ultra sound of his belly. Not sure what to do. I kind of feel like they are "guessing" what it could be. Prior to the weight loss, he was diagnosed with Hypo-thyroidism because of a rapid weight gain and then put on a thyroid medicine (which he is no longer on). He is now back to just under his normal weight...but with all of the other symptoms...he is not himself. It's very scary, it is almost like he is slowly dying. Please help! Tell me what you think it may be, and if there is anything I can do to get my old energetic buddy back to being himself. Thank you.

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Age: 12; Male; Breed: Sheltie

Already Tried:

From the information that you wrote in your question "12 year old, rapid weight loss, Prior to the weight loss, he was diagnosed with Hypo-thyroidism because of a rapid weight gain, very lethargic, just lays around, doesn't respond to any stimulation, very sensitive near his back end, and lower abdomen, now back to just under his normal weight...but with all of the other symptoms...he is not himself.almost like he is slowly dying" I deduce that your dog either has anal sacs that require expressing or else he has feces in his rectum that needs to be helped to be eliminated.

Constipation and impactions can cause an elderly dog to become toxic and apathetic because of the absorption of waste products from the dog's impacted rectum into his blood stream. Occasionally the stool builds up inside of the dog's colon and causes pressure on the nerves to the other organs including the dog's heart. So that impacted feces can cause a dog's heart to stop. Lack of water intake or the reluctance to defecate on a regular basis due to weakness, lack of exercise ("very lethargic, just lays around" or due to painful anorectal problems e.g. anal sacs that need expressing or possibly an enlarged prostate can cause hard, dry feces. If your dog is on any drugs then they may be causing constipation. An X-ray of your dog's abdomen can show that he has fecal retention.
Constipation is a common problem in geriatric dogs. Usually once the dog's dry feces are softened and removed then the dog will be back to his active and playful self with a normal appetite. Feces can be removed either by oral milk of magnesia, 1/2 of a pediatric glycerine suppository, a warm tap water enema, or by manual removal. The longer that feces remain in a dog's rectum then the more toxic, apathetic, and lethargic they will become. The last part of the colon is where water is re-absorbed from the feces so that the longer the feces remain in the dog's rectum then the drier the feces becomes.

Your dog's anal sacs might need expressing. When a dog's anal sacs are full, then the dog sometimes will also not evacuate his bowels leading to an obviously toxic-looking elderly dog. So by removing the waste contents of your dog's anal sacs first, then he might have a good bowel movement. Be very gentle. Your vet can also remove the contents of the anal sacs. I advise that you observe the vet or whomever does this procedure to be sure that they treat your dog with loving care as most people don't especially enjoy performing this task. This is why I advise dog owners to learn how to express their dog's anal sacs. Usually if the dog is in the hands of its loving owner then it is more likely to have a better outcome from the procedure. You can learn how to express your dog's anal sacs. Always remember that "less is more" when you are treating your geriatric dog. It's like chipping away at a rock a little bit at a time will eventually get the job done. Place a paper towel against your dog's anal glands (they're located at the 4:00 and 8:00 position of your dog's anus as if it were a clock and as you look at him from behind. His anal sac will feel like a grape under his skin near his rectum. Be careful of his prostate gland. Very gently press them to express their contents. Or, put some K Y jelly on your gloved index finger and place it inside your dog's rectum and then gently squeeze his anal gland and express its contents. Usually this will be sufficient for the dog to have a bowel movement also. You might not want to view this link because it is graphically explicit regarding anal sac removal surgery but it will at least show you where the glands are located.

Check your dog's teeth because sometimes elderly dogs have loose teeth that are painful so that they don't eat because they can't chew.   

Offer your dog Hill's prescription diet a/d anorexic diet mixed with slightly boiled (for a few seconds) calve's liver or calve's kidney that's been chopped so your geriatric dog can gum his food if his teeth are painful. The fresh liver or kidney will stimulate his appetite. Also you can mix in 1-4 Tbsp of coarse wheat bran so that he has fiber. Increase the amount of fiber in your dog's diet. Dogs like vegetables. Give your dog a fresh carrot to chew on.

Give your dog Pedialyte because he is dehydrated. Dehydration occurs rapidly in elderly dogs that have lost their appetite. Some signs of dehydration are depression and loss of appetite. Place some Pedialyte in a bowl next to his regular water bowl. Sometimes a dog will not drink anything if they are offered a new source of hydration so it's wise to offer him both.

Common safe laxatives for a constipated dog are: milk of magnesia (magnesiuim hydroxide) is an osmotic laxative. Give your geriatric dog 1 teaspoonful of Milk of magnesia every day by mouth or Mineral Oil 1 teaspoonful every day by mouth which is a lubricant to help his bowels move.

You can give him 1/2 of a pediatric Glycerin suppository if you can't get him to take the milk of magnesia or the mineral oil. If he doesn't have a bowel movement after the 1/2 suppository then give him another 1/2 pediatric glycerin suppository in 8 hours. If still no bowel movement then you can give him an enema to moisten and soften feces making them easier to pass. Warm isotonic saline or tap water (5-10 mL/kg) will help to loosen the feces. If the impaction isn't relieved then you or the vet will have to use a gloved index finger to very gently remove any dry feces from his rectum. Apply KY jelly to your gloved index finger and be very gentle. Complete removal of all feces might take 2-3 days. Remember that a little at a time is much better than removing too much and causing your dog any pain in his rectum. Also, most of the time when you remove a little bit then the dog is able to eat better and he is stronger and can usually move the rest of the feces from his bowels on his own.

Sometimes pets tend to lie around waiting for you to motivate them and join them in some activity that is appropriate. Your Sheltie might be just bored. I know this sounds overly simplistic, however, Shelties are bred to work. They need to feel useful by participating in an appropriate stimulating activity (within their capability of course) so they will have an appetite for life and an appetite to eat.   Spend some time appropriately exercising your sheltie and massaging his body (especially his abdominal area) to help him move his bowels.   

Since he is a working breed he might feel like eating if he is encouraged to spend at least a few minutes outside everyday to stimulate his appetite for life and food. It might be enough just to sit outside with him in the fresh air for a few minutes every day to perk up his bored geriatric canine appetite. Maybe just play an easy gentle game of fetching a soft tennis ball inside the house if he is not able to go outside. Since your dog is geriatric that doesn't mean that he should be relegated to his doggie bed. Take his doggie bed outside if the weather is permitting and allow him to smell the stimulating fresh air and hear the sounds of the birds. If he can't go outside because of the weather being too cold then put him in the car with the heater on and then both of you go for a ride so that he can look out of the window.

Keep your dog warm so that he doesn't have to use up his energy maintaining his body heat. We keep our home at a constant temperature of 80 degrees because of our older pets.

Older dogs don't require much food to maintain their health like when they were younger. It's normal for an older dog's metabolism and appetite to gradually slow down because their heart muscle is not as strong and can't pump as efficiently as when they were younger but that doesn't mean they're going to die soon. Older dogs require more sleep to restore the myelin sheaths on their nerves and to restore their heart muscle fibers. Provide your dog with a quiet and dark place that he can go to get out of the glare of lights. Glaring lights are painful for older dogs.

Well, I hope this information is helpful for your dog. If you have additional questions I will gladly answer them, otherwise please click"ACCEPT". "POSITIVE FEEDBACK" and a "BONUS" would be greatly appreciated.

Dr. H
Dr. Hanson and 3 other Pet Specialists are ready to help you
Customer: replied 11 years ago.
Reply to XXXXX XXXXXson's Post: I appreciate your initial answer, but I forgot to mention that all of the above seemed to just happen "overnight". He went from being himself to practically lifeless. Do you still think it could be constipation or impaction? Also, he is wobbley (kind of walks sideways). And the tip of his nose is peeling (but is not warm) it is just cold and dry. His weight is 22 lbs.
#1---"Prior to the weight loss, he was diagnosed with Hypo-thyroidism because of a rapid weight gain and then put on a thyroid medicine (which he is no longer on)".

Your dog was gaining weight before your vet diagnosed him and treated him for hypothyroid. The classic hematology findings in canine hypothyroidism are anemia and
hypercholesterolemia. The diagnosis of hypothyroidism is made by measuring free T4 concentration not bound to plasma proteins (normally 0.1% of total T4). What was your dog's free T4? hemoglobin and hematocrit? cholesterol level?

When a dog is diagnosed with hypothyroidism then thyroxine replacement therapy is necessary for the remainder of the dog’s life this is why it is important for a vet to make an accurate diagnosis. Once the dog is taking Thyroid medication if the medication is discontinued then the dog's thyroid might not be capable of producing its own natural thyroxine. A thyroid replacement medication replaced your dog's natural thyroid hormone. A normal dog (euthyroid) that is given thyroid medication will have a decreased natural output of his own thyroid hormone if the thyroid replacement medication is discontinued (while on the re-placement thyroid medication he "had rapid weight loss" then the thyroid replacement medication was discontinued and "He is now back to just under his normal weight." It will take your dog some time to return to his previous normal thyroid state since he was administered a thyroid replacement drug and then had the drug discontinued. Your vet should re-test your dog's lab values to see if your dog is producing his own normal amount of free T4.

#2----"the tip of his nose is peeling (but is not warm) it is just cold and dry."

Your dog has a form of canine discoid lupus. The dog's immune system attacks the end of the nose causing it to peel. Canine discoid lupus is an immune-mediated disorder that affects the dog's nose and face. It is usually nothing to worry about. It is exacerbated by exposure to ultraviolet light. Keeping your dog inside while the sun is the brightest (around noon) can help to prevent further drying and peeling of his nose. Treatment of your dog's nose includes topical steroids, Vitamin E, and sunscreen ointment. Mild topical steroids: Hydrocortisone 0.1% or 1% (Dioderm, Efcortelan). Moderate topical steroids: Clobestasone butyrate 0.05% (Eumovate, Trimovate). Potent topical steroids: Betamethasone valerate 0.1% (Betnovate), Fluocinolone acetonide 0.025% (Synalar Hydrocortisone butyrate 0.1% (Locoid). Very potent topical steroids: Clobetasol propionate 0.05% (Dermovate).

#3---"he is wobbley (kind of walks sideways)"

The most common cause of a 12 year old Sheltie having difficulty walking is hip dysplasia. An elderly medium-sized dog (Sheltie) with hip dysplasia will walk awkwardly and throw its hip out to the side ("he is wobbley kind of walks sideways). Supplement his diet with Drs. Foster and Smith Joint Care and Gluco-C. Glucosamine with chondroitin 500mg twice a day, along with a Fatty Acid will improve your dog's joints. After he takes the glucosamine and fatty acid supplements for awhile, then he will walk more normally and have less pain in his hips. It will take at least six weeks for the glucosamine and chondroitin to begin to heal your dog's cartilage and then it should be continued even after his joints improve.
A natural sulfur kelp product called MSM (methyl-sulfonyl-methane) can help strengthen connective tissue, reduce scar tissue, reduce inflammation, and alleviate pain in dogs with osteoarthritis.

If your dog's osteoarthritis isn't treated then it will progress and then he might lose his muscle tone. An older dog with un-treated osteoarthritic hip dysplsia often needs help to stand up. Of course, any activities that apply force to your dog's hip joints are contraindicated e.g. jumping off of a high surface onto the floor or up in the air to catch a ball, etc.

The pain of the osteoarthritic hip dysplasia is worse in cold and damp weather. Keep your dog warm and comfortable. We keep our home thermostat set at 80 degrees in the winter for the comfort of our elderly pets. A doggie sweater might help to keep your dog's joints warm. An orthopedic-type of firm foam dog bed is beneficial for your dog to distribute his weight evenly and reduce the pressure on his hip joints.

Very gently massage your dog and do range of motion physical therapy exercises on your dog's joints. Your doctor can prescribe a safe anti-inflammatory medication for your dog to take before you do the physical therapy on his joints. This is beneficial for your dog to gradually loosen up his tight ligaments and keep his joints from becoming stiff. One of the best therapies for canine osteoarthritic hip dysplasia is swimming. Our 14 year old dog loves it. The warm water in our jacuzzi is therapeutic for his hip because, of course, it takes the weight off of his hip when he floats and swims in the jacuzzi and the warmth loosens up his muscles and joints.

NOTE: Carprofen (Rimadyl Rx) can be effective for controlling pain so that dogs with arthritis can move comfortably again. It
causes less ulcers in dogs than the other non-steroidal anti-inflammatory (NSAID) drugs; however, it can cause toxic liver reactions in some dogs.

In Summary:

Apply sunscreen to your dog's nose, keep him warm, give him glucosamine with chondroitin and a safe NSAID drug, physical therapy, high fiber appetizing appropriate meals (perhaps offer him more frequent smaller meals throughout the day rather than one or two large meals), give him lots of your loving attention, and monitor his bowel movements, anal sacs, and urinary output. If he is having normal bowel movements, his anal sacs are not impacted, and he has a normal amount of urinary output, then you have nothing to worry about.

I hope this information is helpful for your dog. If you have additional questions I will gladly answer them, otherwise please click
"ACCEPT". "POSITIVE FEEDBACK" and a "BONUS" would be greatly appreciated.

Dr. H
Customer: replied 11 years ago.
Reply to XXXXX XXXXXson's Post: As he is 22 lbs., I did give him the 1 Tsp of Milk of Magnesia, but it still has not worked.. (administered 8 hrs ago). How often can I give him this and is a tsp the right dosage for his weight?

By, the way...I promise the above is my last question.

You are awesome, and your knowledge and advice are VERY much appreciated.
Whenever giving an elderly dog a medication, always remember that "less is best". They cannot metabolize chemicals as predictably and as thoroughly because their heart is not as strong and capable of pumping their blood through their circulation, specifically through their kidneys and liver. The villi of an older dog's intestines are not as capable of performing their duties of absorption and consequently the older dog might have trouble absorbing certain drugs. Certain drugs might become toxic since an older dog can't eliminate them as well. That is why you must be cautious when administering medications to your 12 year old dog.

As far as milk of magnesia it is usually safe to give an elderly dog 1 teaspoonful to 2 Tablespoonfuls (equals 6 teaspoonfuls) every 12 to 24 hours. This is 1 tsp to 2 Tbsp per dog and not per pound of weight of the dog. So that your 12 year old Sheltie can be given 2 tablespoonfuls per day---maxium. Milk of Magnesia generally produces a bowel movement in 1/2 to 6 hours; however, in a constipated elderly dog it can take sometimes 3 days of giving the dog 1 or 2 tablespoonfuls per day. I would not give him 2 tablespoonfuls at one time or he may vomit. Remember, less is best. Check his anal sacs because usually once an elderly dog's anal sacs are expressed then the dog feels much better and he can have a bowel movement without having to take any medications.

I recommend that you give him 1 tablespoonful of milk of magnesia tomorrow. Then, if he doesn't have a bowel movement, give him another 1 Tablespoonful the next day. If he still has no bowel movement you can give him another 1 Tablespoonful in 12 hours. Have your vet show you how to express your dog's anal sacs and how to give your dog an enema.

If you have any questions about anything (e.g. anal sacs, etc.) then please don't hesitate to ask me. I am here to help you and your dog.

Dr. H