10yr Sheltie with CHF is having diarrhea

[barryku]

My dog, Jimmy is having CHF and pulmonary hypertension. He doesn't eat by himself and started having diarrhea two days ago. I am very concerned how I can keep him up till his cardiologist appointment 9 days away.

Jimmy was diagnosed with congestive heart failure and pulmonary hypertension on Tuesday, and he is on Lasix and Benazepril for CHF and Viagra for pulmonary hypertension. He stayed overnight at the hospital for O2 therapy and got back Wed. night. The internist didn't feel comfortable with Jimmy's case due to the complexity of his illness especially pulmonary hypertension, and urge us to see a cardiologist. I had booked an appointment with the only cardiologist available in the entire SF bay area, but it won't happen until 8/6 as the cardiologist is out of office.

He started having diarrhea early Thr monring and last till Fri monring. I was fasting him with vegetable broth from Thr to Fri night. Since Jimmy had only one diarrhea early Fri morning, I gave him a few pieces of boiled chicken last night. Early this morning, his diarrhea came back again. Jimmy started to have dry cough about a month and half ago, and his appetite was declining. We took him to the family Vet two weeks ago when he stopped eating his dry food completely. He got a chest x-rays and blood test. The x-ray shows that he has dilated heart, and his heart rate reached 200. He is breathing a bit heavily. Our family vet put him on Lasix, Benazepril, and Hills dry k/d, but his condition didn't get much better after a week. That's when we were referred to the internist for a thorough checkup. Since Jimmy stopped eating his dry food two weeks ago, I tried cooking ground chicken/beef with white rice and it worked for about two days. I then had to force feed him with a syringe of liquified k/d which I blended with some water. It lasted for 4 days until we took him to see the internist. His stool was fine for the first 3 days of feeding k/d, and I noticed a bid diarrhea that morning before we went to the internist. I force fed him k/d Wed. night after he was back from the hospital, and next morning was when I found the serious diarrhea problem. He is drinking and urinating a lot due to Lasix, so I hope that wee keep him away from dehydration.

[mummummum]

I'm so sorry you dawg is so ill. Just an out-side-the-box question ... has your dog eaten chicken before for any period of time without digestive problems ? Hills k/d is not a kibble brand I would use regardless of what a Vet might indicate. Are you using any supplements or digestive aids, any holistic medicines along with the prescribed ones ? Does you Sheltie take any meds other than those you've listed ?

[crazydays]

Sorry to hear about the problems Jimmy is having. He is a medically complex dog and you must be exhausted with the stress of trying to keep things together. My only advice to you is that he needs to see a vet before 9 days. I would be very worried about dehydration, chemical imbalances related to diuretics, others meds and diarrhea. I am thinking he may need his electrolytes taken and possibly started on IV fluids. You are giving him complex care at home but, with the diarrhea and decreased food intake plus the diuretics, cardiac meds I think he needs to see the ER room asap.

[barryku]

Originally Posted by crazydays

Sorry to hear about the problems Jimmy is having. He is a medically complex dog and you must be exhausted with the stress of trying to keep things together. My only advice to you is that he needs to see a vet before 9 days. I would be very worried about dehydration, chemical imbalances related to diuretics, others meds and diarrhea. I am thinking he may need his electrolytes taken and possibly started on IV fluids. You are giving him complex care at home but, with the diarrhea and decreased food intake plus the diuretics, cardiac meds I think he needs to see the ER room asap.

Thanks for your reply. My family vet suggested the same when I contacted him regarding Jimmy's diarrhea Thursday morning . Jimmy was pretty stressed out from the hospital stay, and I wasn't too happy about the treatment he got there either. Since it's Sat already, so most likely I will have to send him to the same hospital which opens 7 days. I don't really want to send him back to the same place if possible. They gave Jimmy twice the dose of diuretic to clear the fluid in his lungs, but he didn't urinate much. I called the next morning to inform them that Jimmy will only relieve himself on lawn or grassy area, and the assured me that they would take him out to relive himself. Jimmy urinated for like half minute right after I got him out of the hospital.

Anyway, I will definitely get him to my family vet or other vet if he is not getting better this weekend.

[Dr Lee]

barryku,

Can you contact your regular veterinarian? Can she/he prescribe some antidiarrheal medications? Sometimes cardiac problems can manifest as gastrointestinal problems so I would at the very least call your regular vet and discuss the new clinical signs. A physical examination by your vet can help establish his hydration status.

As far as cardiologist in the SF Bay area - what about U.C.Davis VMTH (veterinary medical teaching hospital) - they have several cardiologists and residents there. They are one hour away from SF. Their main phone number is (530) 752 -1393. (That is where I went to veterinary school).

Good luck

[barryku]

Originally Posted by Dr Lee

barryku,

Can you contact your regular veterinarian? Can she/he prescribe some antidiarrheal medications? Sometimes cardiac problems can manifest as gastrointestinal problems so I would at the very least call your regular vet and discuss the new clinical signs. A physical examination by your vet can help establish his hydration status.

As far as cardiologist in the SF Bay area - what about U.C.Davis VMTH (veterinary medical teaching hospital) - they have several cardiologists and residents there. They are one hour away from SF. Their main phone number is (530) 752 -1393. (That is where I went to veterinary school).

Good luck

Thank you. I will try antidiarrheal to see if that works. I did call UC Davis small animal clinics before making appointment with Dr. Kienle, and their earliest appointment is 8/22. It's so unbelievable that there are so few cardiologists available here.

[barryku]

Originally Posted by mummummum

I'm so sorry you dawg is so ill. Just an out-side-the-box question ... has your dog eaten chicken before for any period of time without digestive problems ? Hills k/d is not a kibble brand I would use regardless of what a Vet might indicate. Are you using any supplements or digestive aids, any holistic medicines along with the prescribed ones ? Does you Sheltie take any meds other than those you've listed ?

He had chicken occasionally in the past, and never had diarrhea after having it. Since his appetite is quite poor, I tried boiled chicken which is on the list of food the internist suggest to get him start eating. My feeling is that his diarrhea started two days ago has not recovered yet. He hasn't eaten much in the last two weeks and he has lost a lot of weight. I really want him to start eating something, so I think I need to get the diarrhea situation under control soon. He is not on any other holistic medicines since it's already hard for me to give them the other medication now.

[barryku]

Does anyone know any good pet hospital opens weekend in south bay area other than the one on Thornwood? I may need to take Jimmy to an ER for IV fluid today or tomorrow.

[mummummum]

Sorry barryku can't help you with a Vet recommendation.

Have you tried a prebiotic like real yoghurt (I use a product called Bio-K) ? This will help settle his digestive tract and aloow him to gain more nutritive value from the food he is eating. If you can get him to eat, you might also want to add some pure pumpkin (the canned type but not the "pie filling") and psyllium (metamucil) to some broth along with shredded chicken (if you are going to boil it, do so in the broth so you retain a little more of it's nutritive value). Florazyme LP is another digestive enzyme which supports pancreatic function ~ you might also find this helpful.

In terms of rehydrating I use Pedialyte in similar circumstances. I know it's time for rehydration when I "pinch" my dog's skin and it retains the pinch for more than a few seconds or when I press on their gums and it stays white for more than a few seconds. If your dog is still interested in drinking on it's own, you can boil up a clove of garlic, with some ground meat or a meaty bone ~ he may prefer that to regular water.

Slippery Elm is an herb which I find helps with diarrhea but, I've also used products like Fowlers and Kaopectate.

When you are providing him with food and liquids I find it's best to keep the portions small and give them frequently rather than freely. When you fasted your dog, you helped to slow down his digestive enzymes ~ which was what he needed. When you fed him, his system likely became flooded with enzymes and his digestive tract revolted. But as Dr. Lee and crazydays have mentioned ~ your dog is in a complex health situation. And I agree, waiting that long for a cardio consult is insane ~ keepus posted !

[barryku]

Thanks mummummum, Dr Lee, and crazydays, Jimmy seems to be doing better except for the diarrhea. We just got back from the ER, Jimmy's hydration is good, and his kidney function is ok and wasn't affected by the medication. His heart rate and breathing actually improved. I am very happy that he didn't need an IV and can come home with us after the examination.

We got some anti-diarrhea medication for him, so hopefully we will see his diarrhea stop soon. The vet also suggested to give him easy digested food starting now since he is literally skin and bones. He weights 13.6lb from 14.2 since Wed. and he was around 18 before the illness. I will try mummummum's suggestion and give him som white rice and pumpkin later. I also got a bottle of Nature's Bounty's probiotic acidophilus. Hope it's close enough to bio-k. The doctor said I can give him half capsule a day.

The past two weeks have been really emotional, and I was worried sick yesterday. Although his illness is complicated and his condition is not stablized yet, at least we are seeing some light at the end of the tunnel:love: .

[mummummum]

barryku ~ you're a good Daddy who is doing his best.

[crazydays]

Hi barryku
What great news it is to hear that jimmy is feeling better than he was. Good for you for nursing him through this weekend!! Lets hope jimmy can stabilize with his weight. I would love it it you keep us updated.

You are doing a fabulous job big daddy!!!! Also, I would love to see a photo off him.