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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 24467
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Treatmant for Yorkshire Terrier

Customer Question

Our Yorkie has been prescribed asprin 0.3ml every day , steroids & anti-biotics twice a day, is symtems are very loose poo, inflated tummy and slight loss of hair,he is now on a special diet high in protein, can you please tell me what the prognosis could be ?. The Vat has also said Jamis needs an endoscopy. 

Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry for the delay in responding to you. There are discrepancies in the history that need to be addressed.

1) Aspirin and steroids are a dangerous mix. We avoid a nonsteroidal antiinflammatory drug (NSAID) such as aspirin when steroids are also on board. When the two of them are given concurrently, gastrointestinal ulceration is a significant risk.

2) Diets high in protein are useful for puppies and performance dogs but are rarely prescribed for dogs with internal medical disorders. We might limit the protein but make sure that the protein we do offer is high quality.

I need to know why Jamie's tummy is inflated. Has an abdominal effusion (collection of fluid) been identified on an X-ray, ultrasound, or by tapping his abdomen with a needle?

If an endoscopy has been recommended, I can conjecture that Jamie suffers from a protein-losing enteropathy. The most common cause of this is lymphangectasia - an abnormality of intestinal lacteals (lymphatic channels). Dietary therapy is essential. Ultra-low fat, easily digestible diets such as cottage cheese (1% fat) and cooked white rice or commercially available highly digestible diets containing <3g/100kcal metabolizable fat.

Inflammatory bowel disease and adverse food reaction need to be considered as well; hence, the recommendation for endoscopy. Please respond with further questions or concerns if you wish.
Customer: replied 3 years ago.

Thank you for your response Dr Salkin, which confirms basically what we have been told, I can tell you that Jamie had an x-ray and water was shown to be the problem however over the last 2 days the swelling has gone down, his appetite is not effected at all and he is eating boiled chicken carrots & rice like it is going out of fashion !!!. The cost of the endoscopy is not cheap and we have been informed that the operation is dangerous and that there is a risk he may not come not come through it, we live our dog deeply and do not want to be told he died on the operating table.

Customer: replied 3 years ago.

Thank you for your response Dr Salkin, which confirms basically what we have been told, I can tell you that Jamie had an x-ray and water was shown to be the problem however over the last 2 days the swelling has gone down, his appetite is not effected at all and he is eating boiled chicken carrots & rice like it is going out of fashion !!!. The cost of the endoscopy is not cheap and we have been informed that the operation is dangerous and that there is a risk he may not come not come through it, we live our dog deeply and do not want to be told he died on the operating table.

Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for the additional information. The accumulation of fluid in his abdomen, then, is due to a lack of albumin in his bloodstream. Albumin is a protein necessary to keep fluid inside vessels and out of "third spaces" such as the abdominal cavity. He's likely to be losing albumin through his GI tract although I can't rule out a poorly functioning liver that can't produce enough albumin.

Scoping and biopsy isn't considered a dangerous procedure. There's always a risk with general anesthesia, however. You can always presumptively treat for a lymphangectasia and see how Jamie does. I've discussed the diet needed above. In addition to dietary therapy we supplement with vitamin B12, folate, and general vitamins/minerals paying particular attention to the fat soluble vitamins D, E, and K. Calcium and magnesium supplementation should be considered as well. Corticosteroids such as prednisone may be helpful and antibiotic therapy with metronidazole may help control secondary bacterial disturbances and provide some antiinflammatory effects. Thromboembolism prophylaxis is warranted (e.g., aspirin).

Please continue our conversation if you wish.
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 24467
Experience: University of California at Davis graduate veterinarian with 44 years of experience.
Dr. Michael Salkin and other Vet Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a week for an update. Please feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.

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