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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 28434
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Hi, I have a 2 1/2 year old miniature poodle who been very

Customer Question

Hi, I have a 2 1/2 year old miniature poodle who been very difficult to feed since I had her. With the problem being so acute, I diarised her eating pattern for 18 months - during her heat her eating would treble and after her heat it dropped dramatically. Mid season her eating stabilised . She came on heat in mid July and ate around 350 grams of meat plus biscuits every day for three weeks and put on a Kg in weight. She stopped eating last Friday and hasn't eaten since. She is drinking. Although my vets when she was younger decided it was a behavioural problem, it isn't - They say she can go 'a long time' without eating as she is drinking. She has NEVER stopped eating altogether and as the days pass I am getting more and more stressed. Your views please ( for my sanity!)
Submitted: 2 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. I can understand a picky eater but a week's worth of anorexia simply isn't normal. I would be primarily concerned about an underlying food intolerance, chronic pancreatitis, and inflammatory bowel disease. I would initially perform a gastrointestinal diagnostic panel of blood/urine tests on such a patient. If nothing untoward were found, there are two avenues to pursue. The first is an abdominal ultrasound to better understand the health of her gastrointestinal tract - an organ that's poorly reflective in blood/urine tests. The second is a hypoallergenic food trial prior to biochemical testing.
Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Victoria's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.
Please respond with further questions or concerns if you wish.
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Customer: replied 2 years ago.

Thank you very much for your answer. Because Victoria ONLY stops or nearly stops eating after her season, can there be a physiological link between the hormone changes in her body that tell her brain that she isn't hungry? Because I have monitored her food intake so religiously and she has just had her third heat the pattern of food intake is identical over the 6 month periods - which hormone gets released after the heat? Obviously her reaction if it is hormone related is acute - is there any relationship between these hormone changes that could account for such a marked difference in her eating. I understand your suggestions - Victoria is exhibiting no signs of illness. One thing in your description of hypoallergenic foods now makes sense because Victoria will still take tiny bits of one treat, which is a 50% chicken strip which could be hydrolized to the point that Victoria is accepting of it. Sorry to go on but I have to understand if there could be the hormone link to her exceptionally worrying lack of eating which is now in its 9th day.

Thank you

Expert:  Dr. Michael Salkin replied 2 years ago.
I originally considered that the sex hormones estrogen (early in her heat) and progesterone (after she ovulates) had enough antiinflammatory activity to address an underlying inflammatory bowel disease; she would feel better, then, during her heat cycle and eat better. What doesn't make sense, however, is progesterone is the hormone that maintains pregnancy and as you can understand, the last thing the body would do is cause inappetance during pregnancy. The progestins can cause polyphagia - increased hunger and are secreted from the corpora lutea - the bodies that follicles that have ovulated become. Progesterone levels can remain high for many weeks (pseudopregnancy) after a heat period.
Please continue our conversation if you wish.
Ordinarily I would recommend spaying such a dog in which I suspected sex hormones to be causing a deleterious effect but with Victoria I'd be worried that she's starve herself to death.
Expert:  Dr. Michael Salkin replied 2 years ago.
Thank you for your kind accept. I appreciate it.
I'm going to check back with you in a few weeks 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.
Customer: replied 2 years ago.

Hi Michael

Thank you so much for all your comments regarding Victoria - I have been fighting her corner since I had her at 8 weeks and no, she didn't want to eat then either!

I have a few questions which I would be really grateful if you could help me with.

a) If her progesterone levels were abnormally high - what is happening in her body and without eating would this raise her blood sugar levels?

b) Could this lead to her being hypoglycaemic? - Is there anything other medical conditions that could result if her progesterone was too high?

c) When you discussed the possibility that Victoria has an underlying digestive problem, can something like pancreatitis have no other obvious 'ill' effects than not eating?

d) If oestrogen has an anti-inflammatory effect, when the hormone that takes over is progesterone ( and bearing in mind that the dog now considers she's pregnant) why doesn't progesterone also have an anti- inflamatory effect?

I'm so sorry I have SO little knowledge but after 2 1/2 years as you can imagine, it has been very stressful!

Expert:  Dr. Michael Salkin replied 2 years ago.
a) Progesterone levels normally increase once ovulation occurs and persist for a few weeks if a dog isn't bred; if bred, the increased levels persist throughout pregnancy; hyperglycemia isn't expected. If we supplement progesterones such as when we prescribe Ovaban/Megace (megestrol acetate) adverse effects include polyphagia, polydipsia, an increased risk of diabetes mellitus (hyperglycemia), pyometra, diarrhea, and neoplasia.
b) As mentioned above, hyperglycemia rather than hypoglycemia would be expected. There is a form of atypical Cushing's disease in which cushingoid symptoms arise due to increased progesterone levels rather than increased cortisol levels.
c) Yes, a smoldering pancreatitis may cause nothing more than inappetance. Addison's disease (hypooadrenocorisolism) is another consideration when nondescript gastrointestinal symptoms wax and wane.
d) It does. Both estrogens and progesterones have antiinflammatory effects. Actually, estrogens have both antiinflammatory and proinflammatory effects! We don't use these homrones to control inflammation choosing, instead, more potent antiiinflammatory steroids such as prednisone, prednisolone, triamcinolone, dexamethasone, etc.
Please continue our conversation if you wish.
Dr. Michael Salkin and other Vet Specialists are ready to help you
Customer: replied 2 years ago.

Michael,

I am so so grateful for your answers to my very inept questions particularly on hyper v hypoglycaemia sorry!!

I have one ( I promise just one) question

Can a smouldering pancreatitis be tested for?

Thank you

(I promised just the one question!!)

Kindest regards

Linsey

Expert:  Dr. Michael Salkin replied 2 years ago.
Yes, the specCPL blood test is the best for detecting pancreatitis in dogs. An abdominal ultrasound might be able to directly visualize a pancreatitis as well.
No worries, Linsey. Keep me posted please. I set a follow up for 09/14 in case I miss you.
Customer: replied 2 years ago.

Thank you Michael - I have never believed that Victoria had a 'behavioural' problem - it has been too acute and for far too long.

You have helped me so much and I am so so grateful to you ( here in the depths of Somerset UK)

Kindest regards ***** ***** the water!

Linsey

Expert:  Dr. Michael Salkin replied 2 years ago.
It's my pleasure, Lynsey. I'll speak to you soon. I'm currently in the depths of the island of Utila (Honduras) but will be home soon in Rancho San Diego, California.

Thank you once again.

Please disregard the info request.

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