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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Veterinary
Satisfied Customers: 29709
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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I have a 2-year old Toy Pomeranian. She's not spayed, weighs

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I have a 2-year old Toy Pomeranian. She's not spayed, weighs about 4lbs (maybe more but certainly less than 5... she's a small dog). We have had issues with her before with vomiting and diarreah. About a month ago she was puking almost all day and came out with blood. Took her to the emergency and they fixed her up. She did fine afterwards. We withheld food and water and got her on a rice/chicken breast diet after 24 hrs and she did fine. A few weeks after that she cane down with diarreah, there were small spots everywhere. The stool varied from light brown mucus stool, to almost transparent, and yes there was blood - not on all of them but on most. Talked to the vet, told us to put her on a bland diet of chicken and rice after 12 hours of not feeding her, and so we did. She didnt poop for three days. When she finally did, it was like two poops in one (a darker brown and a light brown swired). She continued to deficate fine after that. Another few weeks later (today)... she pooped large poops for her size yesterday and today. Poop was perfect in color and texture, but when she deficated again it was mucusy and runny, no blood. I noticed yesterday after we came back from church a big pile of normal poop and a small watery mucus poo near by. Today she was deficating fine and it happened again around noon today; a nice pile of normal poo, and then about an hour later runny brown and mucusy, no blood. She has since deficated four times with mucusy stool, no blood so far. She's on a vet prescribed RX: "MR X Hills Canine I/D". She has been on that for about a year now. She eats nothing else other than the ocasional rice and chicken breast. She eats no human food and no treats. I have kept her from treats for almost a year because of her delicate stomach. Worthy to mention we recently got another toy pom from a breeder. He weighs more than her, and has been vaccinated and everything. They get along for the most part but at one point the female will fight him off. We try not to keave them unsupervised when they are together because the make can be quite rough on her. On a few times I have cought them leaking each others privates. But I have noticed a pattern that when we get them together she has runny stool as described. They were allowed play yesterday and a bit of today after 3 to 5 days when we had her under observation due to her diarreah that since fixed except for today. She just deficated again and it was watery mucusy and clear, no bood (thats a good thing), but I am concern that something is wrong. We have taken her to the vet twice and the pet ER once in the last 2 to 3 months and they say she is fine, blood work and fecal mater came back fine (about 2 months ago). I need help, I feel like she needs help and I dont know what to do. She is playful and active and moves around. She gets lethargic when she has gas like she has now. She gets on her pounce pose and stays like that, and I've read somewhere that it releaves gas pressure or cramps. I can hear her stomach like growling and gasses passing through, normal noises as with human diarreah I guess, but what is causing this?
JA: I'm sorry to hear that. 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 Pomeranian?
Customer: Nothing else that I can remember, she has always been a bit delicate, so we just need to know uf there us any serious underlining conditions.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

I'm sorry to hear of this with your Pom. You're correct to be concerned that an underlying problem exists and which hasn't been identified. Please note that diagnostics in the form of blood, urine, and fecal tests may not reflect that underlying problem. Imaging in the form of ultrasound of her gastrointestinal tract and, most important, scoping and biopsy of her GI tract can be definitive. Her current behavior indicates colitis as the colon is rich in mucous glands and the presence of red blood indicates bleeding from the distal portion of her GI tract - the colon, rectum, or anus. Here's how I address these patients:

1) Presumptively treat for gastrointestinal parasites with 7 consecutive days of fenbendazole. Fenbendazole is effective against all of the common nematodes (roundworms, hookworms, whipworms) as well as the protozoan Giardia. It's available over the counter in pet/feed stores as well as at your Pom's vet's hospital. Routine fecal ova and parasite exams are too often falsely negative; hence, the need for presumptive treatment. If a positive change isn't seen...

2) Have a diagnostic panel of blood/urine tests performed. The panel should contain a specCPL blood test which is the most specific of the blood tests for identifying the presence of pancreatitis. It should also contain a TLI blood test which is the gold standard for detecting exocrine pancreatic insufficiency - a failure of the pancreas to produce enough digestive enzymes (maldigestion). To be very complete, serum vitamin B12 and folate levels should be performed as well. Malabsorption disorders (digested food isn't being absorbed properly) are suggested by lower than normal serum levels of these micronutrients. If nothing untoward is found...

3) Consider a food intolerance. 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 her 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 her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference because it avoids the possibility of her being intolerant to even a novel protein). 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. If such a dietary trial isn't helpful...

4) Abdominal ultrasound (which is particularly sensitive in evaluating the gastrointestinal tract itself) and/or scoping and biopsy of her gastrointestinal tract is indicated. We don’t perform scoping and biopsy soon enough in too many of these patients. We're mainly looking for inflammatory bowel disease (IBD) or lymphangectasia - a protein-losing enteropathy (intestinal disorder) but need to be concerned with infiltrative malignancy such as lymphoma and solid tumors such as gastrointestinal adenocarcinoma.

Please respond with further questions or concerns if you wish.

Customer: replied 6 months ago.
Are you suggesting I talk to my Vet about switching form ID to ZD? This sort of thing has happened before and it seems to be fixed a few days later after having her on just white jasmin rice and white chicken breast meat, boiled together. We feed it to her at room temperature, and make anough for her for three days, twice a day. Is there anything I can give her (home remedy) to help with her upset stomach. She hasn't deficated since my last question, but I can tell (and hear) she has gas or cramps. What can I do to make her feel better? It's her 2nd birthday today, and we hate seeing her like that. So any home remedies for gasses for her? Should I start her back up on rice/chicken with a pinch of pink hamalayan salt? Should I use pumpkin instead? When do I start her on it? My fear has always been that I would make her worst and not better so my instict says white rice and chicken breast but I'm no expert, and if there is something out there that can make this better, I'm all ears.
Customer: replied 6 months ago.
Her eating habits are also when we are home for the most part. Her firs meal is either very early like 6am or after 12pm, like 1 or 2pm... she will eat again in the evening, and then sometimes very late at night.

Switching from i/d to z/d would make sense if you're concerned about food intolerance. Palliative care involves the use of an over the counter antacid such as famotidine (Pepcid) dosed at just 1/4 of a 10 mg tablet at 12 hour intervals as need be plus a gastrointestinal coating agent such as either Kaopectate or PeptoBismol (both contain bismuth subsalicylate) dosed at 1 mL per pound of body weight every 6-8 hours. I prefer not to continue these salicylate-containing products for more than 24 hours, however, as the salicylate can irritate an already irritated GI tract.

You can certainly see how the same diet that has been helpful for her in the past (rice/chicken) affects her this time around. Avoid pumpkin which more often acts as a bulk laxative...the last thing she needs at this time. Please continue our conversation if you wish.

Customer: replied 6 months ago.
What is the silicyclate product? Is that the I/D food I give her? Or is that the antacid? Also, when can I start feeding her again being that this started this morning? Where can I get these over the counter antacid and gi-coating agents? Anything mild a dog with a delicate stomach can tolerate? Are there any side-effects? Sorry, I'm trying to be brief, but I like to be thorough. This dog is like one of our kids.

Both PeptoBismol and Kaopectate contain bismuth subsalicylate. These and the famotidine can be found in your local drug store. As long as she isn't vomiting you can feed at any time. The chicken and rice qualifies as mild and bland.

No there aren't any side effects of note from either the coating agents or antacid. Remember, the coating agents can irritate the gastrointestinal tract if given for more than 24 hours.

Dr. Michael Salkin and 3 other Veterinary Specialists are ready to help you
Customer: replied 6 months ago.
Ok, thank you so much for taking all of my questions. I really appreaciate it. I had no idea this existed. You've been most gracious and helpful. God bless!

You're quite welcome. Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.