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Old July 31st, 2013, 12:09 PM
zoeymaicaboo zoeymaicaboo is offline
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need 2nd opinion - no proper diagnosis from vet - vomitting & LBM w/ hints of blood

Hi! I hope you can help me out. One of my dogs is sick. I’ve already bought her to the vet twice this week, and so far she’s had a stool exam , blood test, and x-ray (thoracic and abdominal) . The diagnosis was inconclusive and the vet didn’t really know the exact cause of my dog’s LBM and vomiting (note that the episodes are infrequent and a few hours apart, and other than that my dog seems fine, energetic and alert).
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The vomiting started Saturday a.m. and I figured it was because she ate hair from the floor ( I trimmed my bangs that night and wasn’t able to clean all the hair off the floor – totally my fault ). I’m sure she ate hair because it showed up in her vomit. After that I she vomited 3-4 times that day and it was yellow and goopy, so I gave her some honey and a bit of probiotic drink and thought her tummy will settle after a while.
The next day, she still had LBM and also vomited 2-3 times (with a few hours interval in between) . I noticed that twice she tried to vomit but nothing came out. Her stool started looking normal after I gave her some boiled chicken but after a few hours, I started seeing little blobs of jelly like stool again. I kept an eye on her the whole night until early a.m. and I noticed that she tried to go potty a little more than usual (3-4 times). a bit of the gooppy stool did come out but it seemed to me like she wanted to get something out of her system.
I didn’t give her any food for at least 12 hours but I regularly gave her water, probiotics, and yogurt in small amounts using a syringe. This whole time, she seemed fine, and even until now she isn’t weak or lethargic and she hasn’t lost her appetite. The only other thing that worries me is that her breathing is sometimes a little quicker than usual even when she’s resting – well, it has always been that way since she as a puppy but I didn’t really see it as a cause for concern until now. She has always been more rambunctious and faster on her feet compared to my other dogs, which I figured was the reason why she couldn’t keep her weight up as well as the others, even w/ her enormous appetite.
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I brought her to the vet the on Monday , and she had a stool exam (no major findings, just higher levels of bacteria – but nothing too abnormal according to the vet - , and that she also lost a noticeable amount of weight in a span of 6 days since her last vet visit (she just had her annual booster shots ).
The vet prescribed the ff. meds:
- Colymoxin (which is colistin+amoxicillin+attapulgite+neomycin+electrol ites)
2.1ml once a day for 5 days
- Metronidazole (amoebicide/antiprotozoal)
4.2ml 2 x a day for 7 days
Everything went fine on Tuesday and I thought she had recovered. She went back to her usual diet of steamed squash, meat, and rice (no salt, no oil, just a bit of water- note that sometimes we do add a bit of salt – to maintain sodium level, and garlic – as tic repellent, but I skipped that this time). I gradually adjusted her diet starting with just liquids and then moved on to pureed chicken and rice, then to chicken strips and soft rice, and finally to her usual diet. (note: I haven’t fed my dogs commercial dog food for the past two years and they’re much healthier now – no more rashes and frequent vet visits) . One mistake I made was that I allowed her to have a few tiny bits of freshly baked bread last night as a treat. I’m also worried that I transitioned her diet a little too quickly. She’s now back to liquids – water and Gatorade for tonight + a bit of nutriplus gel. I will slowly start giving her pureed steamed squash tomorrow in small amounts as suggested by the vet – she also advised me not to give her any meat just yet.

Here’s a few more info that could help you out it coming up with a possible diagnosis:
- My dog is a shihtzu/poodle/minpin mix, and is 3 years old
- Her parents have a history of ehrlichia
- Her brother had severe parvo-like symptoms once (sudden onset vomiting and pooping of blood) when he was still a puppy but he recovered from that
- it was not properly diagnosed because our vet was out of the country at that time and my only recourse was the local city vet. They did not have proper diagnostic equipment. We basically had to rely on the meds, IV fluids, 24/7 tlc, and prayers


- Another thing that really concerned me was that just 6 days ago all my 4 dogs had their yearly vaccine/booster shots. The vet gave the 4-in-1 and rabbies vaccines at the same time along with the dewormer! I asked her about it and she said it was fine as long as the dog is healthy (very skeptical and very worried about this. I recently read an article on the risks of vaccines and Im totally make sure that this doesn’t happen the next time ).

- The vet also told me to stop giving probiotics and yogurt for the meantime as it will interfere with the meds. I didn't argue, but from what i know probiotics replenish the good bacteria in the tummy.

- I know it sound gross but I’d like to give you an idea of the consistency of her stool and vomit since Saturday:
- Most of the time its medium- dark brown, jelly/mucus-like and smells slightly fishy/metallic; it started looking normal on tueday, and at one time it looked black/tar-like (which I assume is blood), and this a.m. her stool was back to the gloppy jelly texture with specs of fresh blood.
- Frequency of vomiting - around 3x a day or less with about 3-5 hoursinterval
- usually it was yellowish/jelly-like , but one time I saw very tiny hints of pink/red
- yesterday she did not vomit at all and seemed fine
- today she vomited once this morning and I was told it was small and foamy and had bits of food in it – this was after she ate her breakfast.
- She also pooped once today and it was goopy and had hints of red blood
-
- Today’s blood test was normal except for the high wbc count (25.5 x 10^9/L Ref range : 6.0 – 17.0).
The x-ray also looked fine since there were no visible bowel obstructions. The vet did notice that the small intestines looked empty but there is still some stool in the large intestines. She informed me she will have to show the slides to her colleagues just in case she missed something.

- FYI: She’s not our regular veterinarian by the way. She’s the niece of our trusted vet (who again, is currently out of the country). I’m worried that she’s not as experienced as her uncle but I don’t really have other options since they are the only trusted and properly equipped private clinic in our area. I’ll have to board a plane if I want to go to other clinics, and I just don’t have the finances to afford the transportation cost + the exorbitant vet fees.

- These are a few things I discussed with the vet regarding the possible causes for my dog’s symptoms:

.Ehrlichia, and other similar diseases ? - the vet ruled this our since her blood test levels are normal except for the wbc count

.vaccine side effect? – she didn’t give me a conclusive answer on this

. bacterial infection or food poisoning? – most likely because of the stool sample findings and the high wbc. But we can’t pinpoint the cause

. bowel obstruction? – partially ruled out because of the x-ray results; she told me she will email the slides to other vets to get a second opinion.

. heart or lung problems? – I mentioned this to her since I’ve noticed that her breathing/heartbeat is more rapid compared to my other dogs ever since she was a puppy.

. heartworm? - I really hope not. I don’t give them heartworm meds after reading a lot of horror stories about dogs getting severe reactions from the meds. My dogs usually stay inside the house and prefer to nap and play inside my room so they’re not often exposed to mosquitos. I occasionally walk and let them play at the nearby park but not that often anymore due to a recent incident where an off-leash pitbull suddenly attacked one of my dogs (thankfully he didn’t sustain injuries but it scared the living daylights out of me and my dogs).

- IBD, asthma, lime disease?... etc. etc.…

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That’s all the info I can think of right now. Sorry for the uber long / rambling jumbled-up post, and do excuse the gazzillion typos – I haven’t had much sleep the past few days, lol.

Anyway, I’m just really hoping someone can give me a second opinion so I can relay the info to my vet and she can narrow down the possibilities and I’ll hopefully get a proper/conclusive diagnosis.

Thanks so much and I really hope to hear from you guys soon!

Last edited by zoeymaicaboo; July 31st, 2013 at 08:12 PM.
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  #2  
Old August 4th, 2013, 03:02 AM
MaxaLisa MaxaLisa is offline
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"Today’s blood test was normal except for the high wbc count (25.5 x 10^9/L Ref range : 6.0 – 17.0). "

Sounds like an infection and you haven't found the right antibiotic, or used it long enough.

I don't know if the metro will clear this up or not. You might try some doxycycline, though around here it is in short supply. I would also test for ehrlichia and simlar diseases, and not rely on your what your vet is seeing in the bloodwork, unless he ran specific tsts for tick disease. Even if those tests are negative, it might be a strain/species the test doesn't pick up, and if it's something he was born with, the body won't always make antibodies to it.

Long term metro can have neurological side effects, so watch for those.

Sounds like the vaccinations were the trigger for this.
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Old August 4th, 2013, 10:11 PM
zoeymaicaboo zoeymaicaboo is offline
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Thank you MaxaLisa, i was thinking the very same thing!
I suggested the doxycycline during her last visit and the vet allowed it and changed her prescription accordingly, but she only prescribed it for 5 days and we were asked to come back for another check-up after 5 days.
My dog didn't undergo any testing for ehrlichia because I was under the impression that they still didn't have the testing kit available ( this is what they told me a few years ago) and the vet didn't suggest it even after i mentioned the possibility of ehrlichia several times.
I contacted the vet just a few minutes ago and told her I would prefer to have my dog medicated with doxy for a full course (1-2 months,just like my other dogs before) just to be safe, and I also wanted to check with our main vet if this was ok (currently abroad).

She then informed me that we should test for ehrlichia first?! After all those test and multiple visits and medication wasted, she now tells me that they had the testing kit all along?
What i don't like is I could have spent a little less and my dog could have recovered more quickly if we tested her from the start.
My finances are very limited and the vet knows that (I make sure to remind her all the time) but she also knows how much I love my dogs. I can't help but feel like I'm being taken advantaged of because they know I will do anything for my dogs
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Old August 4th, 2013, 10:33 PM
zoeymaicaboo zoeymaicaboo is offline
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By the way, I will have her tested for ehrlichia next week during her next visit. Do you think I should have her tested earlier?
I'll have to save up first since a have a few bills to pay this week and I have very little in my wallet right now but I know I can find (beg/borrow/not steal) enough funds for next week.
Based on my research, the test is not really fool proof so it might come out negative even if she does have ehrlichia. Would it be ok if we don't do the test and just go on with the medication? My gut tells me to go on with the medication but I also don't want to risk any damage to my dog's liver and kidneys. I'm willing to adjust my dog's diet and have her tested twice a month to monitor her liver and kidney functions.

I'm afraid that If the test comes out negative, the vet will stop the medication and there's a possibility that doxy won't work on her the next time. I'm told the next option (Rocephin?) is much more expensive and I fear that I won't be able to afford it.
What I basically want right now is to eliminate the risk of infection and to have my dog recover as early as possible.
I also have 3 other dogs to take care of and I really don't want them to get sick as well.
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Old August 4th, 2013, 10:45 PM
zoeymaicaboo zoeymaicaboo is offline
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Join Date: Jul 2013
Location: philippines
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UPDATE:
The clinic just called back. Our primary vet is flying back next week just in time for Nairah's next check up, and he gave me the go signal to continue the doxy until next week for her test. He also prescribed supplements for the liver. Phew! I'm so relieved right now
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  #6  
Old August 5th, 2013, 02:41 PM
MaxaLisa MaxaLisa is offline
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I am glad that you are continuing with the treatment!

The limited funds thing is tough, and I've been there, I know exactly what you are dealing with! You and your vet will have to figure out what works for you guys, but it is true if the ehrlichia test is negative, that it could be something similar. If the test is positive, then at least you will know for sure. The good news is, by the time you see your vet next time, you will be able to report the response from the doxy, which can be almost as diagnostic as the test.

I think as important is the CBC, to monitor those wbcs, in addition to the tests to monitor the organs. I'm wondering if you saw any low end platelets or clumping on any of the tests. Sometimes you'll see low end albumin.
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