Complex Symptons in Dog

by Jamie Nettrour

Dr. Schonbeck,
I will try my best to cover all the details of our much loved "Nellie". She is a 2 1/2 year old yellow lab who has been in great health.
About 3 months ago, she started to have diarrhea, vomiting (some vomiting in morning yellow bile) & turned her nose up at her food. We took her to the vet who ran blood work (all normal), no fever, but dehydrated. They gave her some fluids under her skin. With held food for 24 hours, continued to have same symptoms. Took her back to vet, they did xrays (found nothing) & kept her for the day for observation/fluids. They also gave her other medication. She eventually worked her way out of this and was back to her normal food gobbling self.
Now...about 3 weeks ago, the same exact symptoms appeared, same vet did all the same things. This time it progressed to a more lethargic Nellie that looked bad. The vet kept her & progressed to a barium and several xrays. We decided to do surgery & the vet found small bit of bark, dog hair and small piece of cord. Took her home afterwards and the next day she looked good. Wagging tail, drinking water, no pain. She was taking an antibiotic, and pain meds. Then, she slowly started to decline. I took her back to the vet for 3 more mornings for the vet to check - she was concerned. On Tuesday morning, I called the vet in tears b/c I felt she was deteriorating. My vet asked me to take her to the critical care hospital.
She was admitted & I was told they would do an exam & hopefully she just needed additional supportive care. They also did an ultrasound which showed one area of stomach thickening. All her blood work normal. Wednesday (yesterday) night we went in to visit her & we all left in tears over her condition. I called the hospital and asked to speak to the attending Dr. She agreed Nellies mood was more down than night before. They were doing a screening for Addison's disease which came back 1.4 so they did a more conclusive test - results in the morning. Now her case has been moved to the internal medicine specialist. They would like to do surgery and a biopsy if the Addison's test is negative (just as you talked about in your article). My father is a surgeon and came with me today to consult with the Dr. Nellie looked much better today, but she still has diarrhea and vomiting. My father feels another surgery would be invasive and very expensive and that we should just bring her home since she appears to be on the up-swing. IBD was talked about along with gastritis. All blood work still normal. My father feels we could put her on steroids and see how she does. My concern is eating, drinking, medication & what is best for our girl.
Any insight you can give me is greatly appreciated.
Thank you so very much,
Jamie Nettrour

My Comment:

Hi Jamie

Its sound puzzling.

I guess IBD is a possible diagnosis. It should be possible to take a biopsy from the stomach and intestinal lining by the uses of an endoscope. So the need for her to be "opened" - being more traumatic - could for now at least be avoided.

I have to careful as I believe a lot has been done and have been tested. The whole story is almost unknown to me and is sounds that you are receiving care by a super specialist. Treatment and so on is hopefully the best you can get.

Some of the signs of Addison apart from testing from it can be seen in the Na and Cl as well. Hart rate is often very low and the patient can be depressed as well. In general the signs ca vary a great deal.

IBD can give some deficits in the vitamin B values and might give some indications of it being possible diagnosis or not.

About testing cortisone without an definitive diagnosis......can be an option. But of cause you have to weight the advantages and disadvantages against each other. As your father know the use of cortisone can influence the blood values.

If you should do it or not is impossible for me to say. But in general I would consider it an option but only after discussing this with the owner several times. Absolutely being sure that the owner understands all the pitfalls doing this.......and of cause the dog doesn't suffer from doing it (obvious).

It is always the vet in charge who should take this discussion. It might not be all vets accepting this approach neither as we are different as persons.

All the best

Per Schonbeck