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nekovet
nekovet, Veterinarian
Category: Dog
Satisfied Customers: 21464
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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My is seriously vet averse and always requires sedation to

Resolved Question:

My ***** ***** is seriously vet averse and always requires sedation to be examined. For that reason I avoid taking her unless absolutely necessary, because of the distress it causes her. This is why I am asking for advice in advance of making a decision.
Yesterday she vomited three times and had diarrhoea tinged with a little blood. She has not vomited for the past 24 hours and has shown interest in some boiled chicken but still has diarrhoea. In case it's relevant, she has been on Apoquel for allergy the past two weeks but is otherwise healthy and lively. She is 10 years old. All vaccinations, flea treatment and worming are up to date.
Submitted: 1 month ago.
Category: Dog
Customer: replied 1 month ago.
Just wondering if a vet is looking at my question?
Customer: replied 1 month ago.
Is anybody there?
Expert:  nekovet replied 1 month ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

What did the vomit look like?

What color was the diarrhea (besides bloody)?

Can she keep water down?

Are her gums pink or white/pale? Moist or sticky?

If you press on her belly, any tensing, tenderness, discomfort, or pain?

Could she have eaten anything harmful (ie bones, toys, plants, chemicals, human meds, etc)?

Customer: replied 1 month ago.
Hello.
Vomit was unremarkable in appearance, just partly digested food.
Diarrhoea pale brown plus blood.
Gums pink as normal for her.
Have felt, rubbed, tickled abdomen. No sign that it's painful.
I believe she may have scavenged a bone while out walking a couple of days ago.
She is eager for food but still obvious blood in diarrhoea.
Expert:  nekovet replied 1 month ago.

Hello again,

Now I am glad Cuko hasn't those other signs I asked about. Though given her signs, this does mean we need to consider include bacterial or viral gastroenteritis, pancreatitis, parasites/protozoa infections, or dietary indiscretion. And just to note her Apoquel isn't likely to have caused what we are seeing since it usually does so days after starting if it doesn't agree with them.

With this all in mind, before we have to decide if she hasn't to be seen, we can try some home supportive care to try to settle her stomach. To start, if she hasn’t just vomited (since otherwise we’d need to rest her stomach for a few hours first), then you can consider treating her with a OTC pet safe antacid. [ie Milk of Magnesia (0.25tsp every 12 hours), Zantac (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/ranitidine-hcl-zantac), Tagamet (More Info/Dose Here @ http://www.petplace.com/article/drug-library/library/over-the-counter/cimetidine-hcl-tagamet)]. Whichever you choose, we’d give this 20 minutes before food to allow absorption. Of course, do double check with your vet if she has a known health issues or is on any medications you haven't mentioned. Though if you give this and she cannot keep it down due to nausea that is usually a red flag that we need to bypass her mouth with injectable anti-vomiting medication from her vet.

Afterwards, you can consider starting her on an easily digestible diet like cooked white rice with boiled chicken, boiled white fish, cottage cheese, scrambled eggs, or meat baby food (as long as its garlic/onion free). There are also OTC vet diets that can be used (ie Hill’s I/D or Royal Canin’s sensitivity) too. The aim of these diets is that they will be better tolerated/absorbed by the compromised gut. Therefore, it should get more nutrients in and result in less GI upset. As long as improvement is being seen, I usually advise continuing this until the signs are settled, and then weaning her slowly back to her normal diet.

Since dehydration is a risk here, we need to keep an eye on her hydration. To check that she isn't dehydrated, there are a few things you can test. Further to checking for gum moisture, do make sure she doesn’t have sunken eyes and that she doesn’t have a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a good video HERE (http://www.ehow.com/video_12232503_dog-dehydrated.html). If you are seeing any signs of dehydration already, then that would be our cue to have her seen before this becomes an additional issue for her (especially as it is often dehydration that makes them feel unwell).

Finally, you can consider trying a pet safe anti-diarrheal. As I am sure you appreciate, these would not be a cure for infectious issues; but it can still be of benefit. It will reduce diarrhea load, allow the body to absorb more water/nutrients, and soothe the upset gut. In regards ***** ***** options, the one we most commonly use is Kaolin/Kaopectate (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/kaolin-and-pectin-kapectolin-k-p)). This is available OTC at most pharmacies. Otherwise, Propectalin, Canikur, Fast Balance, and Protexin Pro-Fiber (all OTC at vets, pet stores, and even Amazon) would be another option. All will slow diarrhea and those last ones have the added bonus of probiotics added in. So, these can be used as a short-term means of soothing her upset GI.

Overall, Cuko's signs do raise a few concerns here. Therefore, we’d want to start supportive care to settle her stomach and hopefully that is all we need to do. Though if she cannot keep that or water down at any point, appears dehydrated already, or doesn’t respond to the above within 12-24 hours; then we'd want to get her vet involved. They can assess her hydration, rule out fever, make sure there is nothing in her stomach that shouldn't be there or any sinister viruses present. Depending on their findings, her vet can treat her with injectable anti-vomiting medication +/- antibiotics to settle her stomach, and get her back feeling like herself.

Kind regards,

Dr. B.

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I aim to provide best care for you just as I do for my own clients & their pets. If you have any other questions, please ask – I’m happy to help but please rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as this is the only way I am credited for my work by the site & this allows me to continue to help here. This is included in your question fee. Once you rate, your question will not close & you can still ask follow-up questions. Thank you. : )**

Customer: replied 1 month ago.
She has eaten a meal of boiled chicken this afternoon. Wanted more but I thought it best to start small. This was about 4 hours ago. No vomiting but a further burst of bloody diarrhoea. She is asking for more food.
Expert:  nekovet replied 1 month ago.

Hello again,

No you were right to be strict, as we don't want her to overdo things and then vomit again. So, stick to small volumes every hour to two and we can use the above for her to soothe her gut and see if we can get her settled here.

Best wishes,

Dr. B.

******************************************************************************

I aim to provide best care for you just as I do for my own clients & their pets. If you have any other questions, please ask – I’m happy to help but please rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as this is the only way I am credited for my work by the site & this allows me to continue to help here. This is included in your question fee. Once you rate, your question will not close & you can still ask follow-up questions. Thank you. : )**

Customer: replied 1 month ago.
Do you have view on the likely cause of the bleeding?
Expert:  nekovet replied 1 month ago.

Hi again,

As its slight, it just sounds like the colon is becoming inflamed by the diarrhea. So, we'd expect that to settle as we reduce that diarrhea for her.

All the best,

Dr. B.

******************************************************************************

I aim to provide best care for you just as I do for my own clients & their pets. If you have any other questions, please ask – I’m happy to help but please rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as this is the only way I am credited for my work by the site & this allows me to continue to help here. This is included in your question fee. Once you rate, your question will not close & you can still ask follow-up questions. Thank you. : )**

Customer: replied 1 month ago.
Could it be trauma from a jagged bone?
Expert:  nekovet replied 1 month ago.

Hi again,

Bones can cause gut bleeding but usually we see vomiting and blood from the stomach not the lower GI. Though if she ate shards of bones it could cause this but usually they will have pain when passing stool as well. So, it cannot be excluded if she had a bone but less likely from what you have reported.

Dr. B.

******************************************************************************

I aim to provide best care for you just as I do for my own clients & their pets. If you have any other questions, please ask – I’m happy to help but please rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as this is the only way I am credited for my work by the site & this allows me to continue to help here. This is included in your question fee. Once you rate, your question will not close & you can still ask follow-up questions. Thank you. : )**

Customer: replied 1 month ago.
Thank you.
Expert:  nekovet replied 1 month ago.

You are very welcome, my dear. :)

Have a lovely day,

Dr. B.

********************************************************

Please rate me with the **STARS** (or leave a written rating of 1-5; 5 being great) as this is the only way I am credited for my work by the site & this allows me to continue to help here. This is included in your question fee. Once you rate, your question will not close & you can still ask follow-up questions. Thank you. : )**

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