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.
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