Need help diagnosing sick Sheltie - low protein / weight loss

[aaronb]

Hey there,

Was doing some research about our sick Sheltie Kirin, and came across this forum. Seems like people are really helpful on here so I thought I'd give it a shot. There are a lot of people with a lot of experience, and hopefully someone can give me some advice.

Kirin is our 10 year old Shetland Sheepdog. She has lost about 10lbs (18lbs, down from 28), has had diarrhea for the past month, has fluid accumulating near her stomach, and was tested to have very low protein levels.

We have had her to the vet multiple times during the last month, and despite multiple tests have little to go on. Initially they thought it might be colitis, but that was before the low protein levels found. Then it was thought it might be an infection of some sort when we noticed the fluid, although when it was extracted the fluid was clear signifying that it wasn't bacterial. An x-ray was then done to check for tumors or other "bodies" but it turned up nothing. Finally we did a blood test for malignant cancer cells which also came up negative.

The vet is stumped, and we don't know where to go from here. Exploratory surgery is where they would normally go from here, but in her condition it is unlikely that she would make it through. Not something we're considering.

We prepared for the worst while waiting for the cancer blood test, but have been taking a "wait and see approach" after that was negative. She appeared to be doing quite a bit better so far this week. She's been eating very well, the diarrhea was becoming less frequent, and she was still running around, barking, and wanting to go outside.

We're monitoring her quite closely, but unsure where to go next. On the forum I found the "Quality of Life Scale" which was quite helpful. Part of my nature I guess to want something to help with a very hard decision. I don't want to wait until things get unbearable to put her down, but her progress for the week left us cautiously optimistic.

Today seems to be more of a "bad day" for her. Her stomach seems to be more tender when she's lying down, and she's been walking around with her tail halfway up which is rather abnormal. Stool was also looser than it has been lately...

Thoughts?
Thanks for your help... sorry about the long post.

Aaron

[sugarcatmom]

Has liver disease been ruled out? What about doing an ultrasound?
http://www.canine-epilepsy.com/liverdisease.htm

[sugarcatmom]

Forgot: what does Kirin eat? Could this be lymphocytic-plasmacytic gastroenteritis (aka IBD): http://www.addl.purdue.edu/newslette...Fall/clpg.html

Chronic small bowel diarrhea is the most common clinical sign of lymphocytic-plasmacytic gastroenteritis. If only the stomach is involved, vomiting might be the most common sign in dogs. Initially, the chronic diarrhea and vomiting is intermittent, but eventually increases in frequency over time. Additionally, weight loss with a waxing and waning appetite is usually reported. On physical exam, poor BCS, dehydration, ascites (abdominal fluid accumulation), thickened bowel loops, fluid filled intestines, or abdominal pain may be noted. Initial diagnostic findings may include a neutrophilic leukocytosis with a left shift, microcytic anemia, hypoproteinemia, hypoalbuminemia, and hypocholesterolemia.

[Karin]

You may want to ask your vet about hemangio sarcoma. It is usually a large/old dog cancer but can happen in any breed at any age.
I have lost one to this and have seen many others (clients) go.

[aaronb]

I've been looking over everything that has been submitted... but I'm just not sure still. There has been no vomiting so far, and x-rays were inconclusive.

Tonight she's been having problems going up and down the stairs. It seems like her mind is convinced nothing is wrong but the legs just won't seem to keep up.

Could be something to do with the pain in the abdomen... not sure. Once she's up the stairs she's running around looking for a treat, barking and have a great old time.

Just don't know...

We'll call the vet tomorrow, see where they suggest we go from there.

[aaronb]

Although the liver problems could be something...
They had talked about doing the ultrasound with the vet, but they were unsure if they would see much with all the fluid.

It's one of those things that may come to it at a last resort, but might not be worth putting her through something like that again.

[aaronb]

Originally Posted by sugarcatmom

Forgot: what does Kirin eat? Could this be lymphocytic-plasmacytic gastroenteritis (aka IBD): http://www.addl.purdue.edu/newslette...Fall/clpg.html

Oh, and she's been on the same diet for the last 2 years. Dry food with some wet food at dinner time. Treats have been limited, and no people food for months.

We do live on a field... so there is a chance that she could have gotten something out there.

[hazelrunpack]

Here's a link to the Merck Veterinary Manual discussion of low protein/malabsorption/weight loss:

http://www.merckvetmanual.com/mvm/in...m/bc/23313.htm

It's not an easy read, but maybe if you print it and bring it in it will give your vet some ideas of where to go next. Another option would be a referral to a Teaching Hospital if you have any Veterinary Schools near you.

Good luck with Kirin, aaronb. I hope you find some answers!