# Please Help. Dog has gastroenteritis.



## snowball05 (Apr 5, 2011)

Hi Everyone,

I have several questions about my dog's health. I have a 3 year old chow. I took him to the vet about 11 days ago and she did blood work, xray, clean out his ears..all while he was sedated for an hour. Turns out he had an ear infection so she gave us some ointment to put in his ear. He doesn't like going to the vet and gets really nervous/stressed so when he came home he was still shaking and breathing hard. He stopped eating but continues to drink water.

I took him back to the vet 4 days later because he was still not eating and has been vomiting and having diarrhea. Vet said he has gastroentritis which can be caused by stress or he ate something else but I think it was his vet visit that scarred him because we had to leave him for an hour. She gave us meds for vomiting and diarrhea but none of it seems to help. My dog has no appetite and does not want to eat. He does drink a lot of water and urinates a lot. He has no interest in food and I see he has lost weight. I called back to the vet and she wasn't in and the clinic wanted me to bring my dog back again for re-evaluation which I feel is another way to charge me $50 for the visit without solving my problem PLUS I don't want to stress my dog out anymore than he already is.

I called different vets around the area 5-10 different clinics. Some have told me I dog needs to be hospitalized w/IV and that will run AT LEAST $900 a night and I'm not sure how that can help when my dog is not dehydrated because he drinks a lot of water. Some just told me to bring him in for the vet to take a look which I also stated to them that my dog gets stressed out easily and I when I ask them what their treatment method for dogs with gastroenteritis..they would not not tell me..so I'm not sure if I should put that additional stress on my dog by bringing him to the vet again.

I started force feeding my dog..he vomits some times and other times he keeps it in but I don't know what else to do. I bought him the calorie booster gel that I've been putting in his mouth and he eats that up. I've laid off his regular dog food and has been feeding him chicken broth. My dog cannot eat solid food because he had a neuter surgery due to undescended testicle and has been unable to eat solid food ever since so we blend up his dog food into powder and mix it with water to make a pastey-watery food. So far he's been eating that for over 2 years and his blood test/all the works show his body is functioning normally.

Does anyone know what to do with dogs with gastroenteritis? How long do your dogs go with no appetite/not eating food? I heard of the chicken/rice diet to ween him back to eating..does anyone have any other suggestions? How long does this upset stomach last for? I checked today and his stool is still mucousy and reddish. Is hospitalization my only resort..if so will that really help dogs with the condition? I'm really trying everything I can to bring my sick pup back to normal and I do not want to lose him.


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## RedChase (Mar 13, 2011)

Your dog has Idiopathic inflammatory bowel disease, which is a name for many diseases including Gastroenteritis. It looks like you may need to go to the vets to get this cleared up. You can read for yourself, I find the Merck Vet Manual very useful when i need a refresher.

http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23312.htm&word=gastroenteritis

Treatment (from manual):

The goals of therapy are to reduce diarrhea, promote weight gain, and decrease intestinal inflammation. If a cause can be identified (eg, dietary, parasitic, bacterial overgrowth, drug reaction, etc), it should be eliminated. Dietary manipulation by itself may be effective in some cases (eg, in chronic colitis); in other cases, it can enhance the efficacy of concurrent medical therapy allowing for the drug dosage to be reduced or for drug therapy to be discontinued once clinical signs are in remission. Corticosteroids, azathioprine, sulfasalazine, tylosin, and metronidazole are among the drugs most often used in the management of IBD.
Dietary modification generally involves feeding a hypoallergenic or elimination diet, ie, feeding a source of protein that the animal has not been previously exposed to such as homemade diets of lamb and rice or venison and rice or commercial diets. This diet should be the sole source of food for a minimum of 4-6 wk, and no treats of any kind should be fed. Novel protein diets alone are effective in controlling clinical signs in cats with IBD, but not in cats with food sensitivity or food allergy. Dogs with large-intestinal diarrhea may benefit from diets high in insoluble fiber content. Supplementation of dietary fiber alone is rarely effective in cases with severe inflammatory cell infiltrate.
Corticosteroids may be useful for small- as well as large-intestinal disease. Initial dosages recommended are 2.2 mg/kg/day for prednisone or prednisolone and 0.22 mg/kg/day for dexamethasone. Budesonide (dogs: 2 mg/dog/day, PO; cats: 1 mg/cat/day, PO) has a high topical glucocorticoid activity and a substantial first-pass elimination. The drug is rapidly inactivated in the liver, resulting in lower systemic bioavailablility and reduced effects on the hypothalamic-pituitary-adrenal axis, making iatrogenic hyperadrenocorticism less common. In cats with mild to moderate IBD or relapse of clinical signs, and in those in which administration of oral medication is difficult, methylprednisolone at a dose of 20 mg, SC or IM, every 2 wk for 2-3 doses, then every 2-4 wk, may be effective as the sole treatment or as an adjunct to prednisone and metronidazole. Dosages should be gradually reduced every 7-10 days to the lowest possible dose required to control clinical signs and, if possible, discontinued altogether. Animals in which this is not possible should be closely monitored for adverse effects associated with longterm or high-dose corticosteroid therapy. Prednisone alone or in combination with another drug is effective in controlling clinical signs in most cats with lymphocytic-plasmacytic enterocolitis. When combination therapy is indicated in cats, prednisone is often combined with metronidazole.
Azathioprine is commonly used in the management of IBD in dogs and cats. However, because of the potential adverse effects (eg, hepatotoxicity, myelosuppression, pancreatitis), it should be used only in cases refractory to dietary manipulation and corticosteroid therapy. Recommended dosages of azathioprine are 2.2 mg/kg, PO, sid, for dogs, and 0.3 mg/kg, every other day, PO, for cats. Cats are especially prone to bone marrow toxicity, and the dosage is decreased accordingly. Clinical signs typically improve in 3-5 wk. A CBC should be completed at 2-wk intervals to monitor for evidence of myelosuppression.
Sulfasalazine is used in the management of colitis in dogs. In the colon, this drug is split to release 5-aminosalicylic acid, which exerts its anti-inflammatory activity in the mucosa. The principal adverse effects noted in dogs are keratoconjunctivitis sicca and vasculitis. A dosage of 3-4.5 mg/kg, bid-tid for 7-10 days, is recommended in cats. Other newer aminosalicylic drugs without some of the adverse effects of sulfasalazine are available, eg, olsalazine (10-20 mg/kg, PO, tid in dogs) and mesalamine (10 mg/kg, PO, tid in dogs).
Metronidazole (10-20 mg/kg, PO, bid-tid) is also commonly used for the treatment of IBD in dogs and cats. Management for gastric ulcer or erosion may include misoprostol, omeprazole, cimetidine or ranitidine, or sucralfate. Cyclosporine has been recommended in people with severe, unresponsive IBD.
Ursodeoxycholic acid (10-15 mg/kg/day, PO), an agent used to treat chronic inflammatory cholestatic liver disease, primary biliary cirrhosis, chronic persistent hepatitis, cirrhosis, and biliary atresia, promotes biliary flow, has anti-inflammatory properties and may also have a role in reducing inflammation associated with IBD in cats.
The prognosis for feline IBD is good for adequate control but poor for cure. It has been reported that 79% of cats with IBD treated with a combination of diet and prednisone had a positive clinical response. A more guarded prognosis is reported in cases with severe histologic lesions, mucosal fibrosis, eosinophilic enteritis, or hypereosinophilic syndrome. Relapses occur and are most often precipitated by dietary indiscretion.


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## winniec777 (Apr 20, 2008)

Sorry, too much denseness above for tired eyes at the end of the day, so maybe the above says this, but don't you need a biopsy to diagnose IBD? 

I agree about getting the dog back to the vet. Our vet believes our dog has IBD and has put her on a low dose of Tylan 2x a day + prescription diet. She does pretty well on it. Stress like you described can make her ill, so when I see the early signs (lack of appetite for more than 12 hours, lethargy), I double her Tylan dose and start feeding a bland diet of boiled chicken and rice in small amounts (usually after she has not had any food for 12-24 hours). If she starts vomiting or has diarrhea I take her to the vet. She is usually put on a round of metronydazole and another drug I can't remember. Giving her stomach a break with the bland food and the meds usually helps perk her up within a day or so and she's back to her usual self within a few days. I keep feeding the chicken and rice for 4-5 days and then slowly start blending it with her regular food so that she's back on it in another 2-3 days. 

Once she had to be put on IV for fluid loss but since we started reacting at the first sign of stomach upset, we haven't had to take her to the e-vet.

I don't know anything about why a neuter surgery would result in a need to change diet, so can't comment on that. I can tell you that very few vets I've known will diagnose over the phone, especially a patient they've never seen. 

Time to go back in. Force feeding could be doing a lot more harm than good.

Good luck and let us know how it goes.

P.S. I can understand your reluctance to take the dog into the vet when it's a source of stress (my dog is highly stressed at the vet), but you need to weigh risk/benefits here. Not getting your dog proper treatment is WAY more risky than a potentially stressful visit to the vet. The benefits of going in far outweigh the risks.


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## snowball05 (Apr 5, 2011)

Got a call back from the vet this morning and I explained to her the situation with my dog. I told her the medication doesn't seem to be working and we've been force feeding him but still see bloody diarrhea. At this point, she told me my dog needs to see a specialist as we have previously talked about because of my dog's inability to eat solid food (esophagus stricture). She recommended the procedures of an endoscopy and balloon dilation to resolve the issue. At this point she said we need to take him to the specialist to find out what is wrong because if we do not he could possibly die. So, I think I will take my dog to the specialist.

Has anyone had the balloon dilation done on their pets? 

Does anyone know anything about pet insurance? I called the specialist place and the consultation is $150 and the balloon dilation could be from $1000-couple of thousands depending on how bad it is.


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