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Dr. Gary
Dr. Gary, Veterinarian
Category: Veterinary
Satisfied Customers: 19798
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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Hello. Our 7 year old rescue coonhound has been treated on

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Hello. Our 7 year old rescue coonhound has been treated on & off for 5years for symptoms of gastritis. The past 6 wks have seen his condition gradually deteriorate with severe anaemia, but his Hb has since improved & stabilized following 1 unit of plasma, 2 of packed cells & meds listed below. However, he remains extremely weak, barely on his feet & thin despite now tempted to eat, taking fresh meat, fish, cheese in fair amounts. His recordings & blood tests show up 'normal' & the vets at our local practice cannot understand why he is not picking up & on his feet. He has had xrays but no ultra-sound as they fear this could exacerbate probable ulcer/s. His current meds = cimetidine bd, omeprazole, antepsin qds & tramadol tds & he has also had 2 courses of antibiotics. We are very grateful for any help/suggestions as we cannot bear to see him suffer but don't want to give up on him unnecessarily & are at our wit's end. Sincere thanks.
Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

I'm sorry to hear about your dog. I think I would try to get an upper GI endoscopy done on him. That is going to be your best way to visualize ulcers using a non-invasive technique. You can also have biopsy samples taken at the same time to determine what is going on in the stomach.

I think we have to assume that it's GI bleeding causing the anemia. Typically that is the cause if we have blood loss (low red cells, low protein) and we can't find where the blood went.

If the medication alone doesn't resolve this, then I would go in surgically and remove the ulcer that is bleeding. It's possible that this is a tumor on the stomch that is ulcerated and bleeding. In that case, the prognosis would be poor. If it's just an ulcer, we can cure it with surgical removal.

The one other med I'd add here would be Sucralfate (Carafate). This is a coating medication. It's a tablet that we dissolve in water and give as a slurry 2-3 times daily. This is nice to help ulcers heal up faster.

I hope this helps, let me know if you have any other questions.

Dr. Gary, Veterinarian
Category: Veterinary
Satisfied Customers: 19798
Experience: DVM, Emergency Veterinarian, BS (Physiology)
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Customer: replied 4 years ago.

Thank you for your reply.

If he did have a tumour, wouldn't this show an abnormality in his blood test results?

Customer: replied 4 years ago.
Relist: Other.
If he had a stomach tumour, wouldn't there have been indications of this in any of the full range of blood tests he has undergone?

I'm sorry Dr. Gary went off line and hasn't been able to get back to you. I have read the conversation up to this point. Unfortunately, a tumor in the stomach (or intestinal tract in general) doesn't have to have any alterations in the blood tests that Irwyn has had to this point. I've seen cases where stomach and intestinal cancers had perfectly normal blood work except for low red blood cell counts and albumin due to the constant bleeding they had. One thing that I'd look for to indicate stomach bleeding is very dark, tarry feces. If this much blood is being lost into the stomach, then I would expect his stools to look like tar being passed. If they are a normal brown color, then I would question where the blood was being lost (or not not produced) elsewhere. Could he have an immune issue or infectious issue causing these low counts?
Customer: replied 4 years ago.

Thank you for your reply.

Yes, his red cell count has now stabilized at an acceptable level following the transfusion 1 week ago &, apart from a few episodes of vomiting fresh blood clots prior to this, there has been little evidence of blood loss from elsewhere - his stools have been darker on occasion but certainly not tarry, as you would expect. Irwyn would not eat unless we put tempting foods under his nose on his blanket, where he would lay all day if we didn't encourage him to stand outside at intervals for comfort breaks. We are giving all the medication as prescribed but the vets here said that they would have expected his condition to have improved by now.

May I also add that he has been vomiting bile every morning on waking for the past 18months, but has appeared very happy & healthy otherwise.

Customer: replied 4 years ago.
Relist: Other.
Please may I have a response from anyone available now, thank you
Hi, I am online now and I can help you with your questions. Let me know what exactly you want to know. Thank you.
Customer: replied 4 years ago.

Basically, i am wondering whether he should appear better by now, or could this take more time, making his general malaise acceptable under the circumstances?

Thank you

I agree with the previous comments made by the other experts. Medications are only to relieve systoms, blood transfusions only replenish blood cells temporarily, but what they are all doing is called symptomatic treatment, it is temporary. Once the underlying condition is found and treated all the symptoms such as ulcerations, anemia, nausea would improve in time. I think the first and best thing to do is discuss the availability of an edoscopy at your veterinarian's office. It would provide better understanding of his stomach problem and the first step towards finding the underlying disease. Let me know if this was helpful.

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