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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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My dog olly had to have forign body removal surgery, he then

Customer Question

My dog olly had to have forign body removal surgery, he then got peritonitis but has recovered well from both operations... the problem is he cant stop being sick despite meds all been changed we are still at a loss to why he is still being sick, if he is sitting down in his cage he is fine but as soon as he gets up he cant stop being sick. He has lost alot of weight and struggle to keep food down ( he is on a liquid diets 5ml a hour) today i have to make the dicission how long we go like this for as he is getting weaker due to not eating but he is only 4 and i cant forgive myself for giving up on him, if we can get the sickness to stop he would be fine but we are at a loss to why this is happening. can someone please help me?
Submitted: 1 year ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 1 year ago.
I'm sorry that your question wasn't answered in a timely manner. This is a complicated and difficult case for me to jump into the middle but I can tell you that when post-operative vomiting persists after gastrointestinal manipulation - enterotomy (opening) or resection (removal) of the GI tract - a stricture in the GI tract should be considered and investigated by ultrasound imaging. If imaging suggests stricture, he'll need to be opened up once again. The sequelae of peritonitis include adhesions and scar tissue that can alter the motility of the GI tract as well. Once again, another surgery would be necessary to remove such sequelae. Please respond with further questions or concerns if you wish.
Customer: replied 1 year ago.
Hi thank you for your reply. Can you please explain what a stricture is?? thank you
Expert:  Dr. Michael Salkin replied 1 year ago.
You're quite welcome. Certainly. An intestinal stricture (also called a stenosis) is a narrowing of the intestine. It can be caused by inflammation or a foreign body inside the intestine or by scarring/adhesions outside of the intestine - picture squeezing the cardboard roll inside a toilet paper role within your fist. Please continue our conversation if you wish.
Customer: replied 1 year ago.
No one has discussed any of this with me and am £3000 down within one week. They asked me today if i want toput him to sleep but he is only 4 and i just cant stop feeling there must be something they can do about this sickness. I had him home last night for 12 hours but his sickness was that bad i had to return him to the vets this morning. I love my wee dog so much this is completely tearing my family apart. My vet even called Edinburgh and Glasgow veterinary school today and was given no advise really just to carry on with the drip and the liquid diet that he keeps bringing back up. He is now 7 days post operation and this sickness has not improved in any way even tho they have changed all his medication thinking the antibiotics could be the cause of the sickness. I am waiting on my vet calling me back to discuss your reply to them. Are you hopeful this can be the case and if so what is the chances of survival? Thank you i really do appreciate your help.x
Customer: replied 1 year ago.
My dog has lost a great amount of weight due to this, his weight is now dangerously low.
Expert:  Dr. Michael Salkin replied 1 year ago.
Ouch!If there were a stricture he would need to be re-opened and yet more surgery performed. He could certainly survive surgery with excellent monitoring and ancillary care but I can't prognosticate accurately without directly visualizing what's going on inside his abdomen at this time. I agree that all drugs should be stopped in case any one of them is causing the vomiting. I would very much like to hear what his vets have to say.
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Customer: replied 1 year ago.
I have spoke to the vet and they cant rule out what you suggested but they dont feel that the sickness is due to scarring or strictures. They want to say they think its ileus??? He was opened up to flush out the infection and everything was look as it should and all scars where healing and no leakages either. He has also not had a poo. And the sickness is like yellowish so they do think he is keeping down a bit of this liquid diet but he is still in a cage at the vets, its as soon as he gets up is when the sickness starts.
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for the additional information. Ileus describes paralysis of the GI tract. Post-operative ileus is common and usually lasts no more than 2-3 days. Ileus that persists for more than 3 days following surgery is termed postoperative adynamic ileus or paralytic ileus. An underlying disorder such as intussusception (the GI tract invaginating upon itself /a sock turning inside out on itself), or persistent infection needs to be identified and by the principle of Occam's Razor, his peritonitis should be the etiology. My next diagnostic of choice would be an ultrasound of his abdomen in an attempt to better understand what's going on in there. There's a good chance that peritonitis remains. I'm pleased to hear that healing appeared normal. Thank you for your kind accept. I appreciate it. I can't set a follow up in this venue and so would appreciate your returning to our conversation with an update at your convenience.
Customer: replied 1 year ago.
Thank you Dr Michael Salkin, I will keep you informed to what the vets say to your suggestion. But i strongly agree an ultrasound would be the best next step to help my dog get a proper diagnosis. Thanks again.
Expert:  Dr. Michael Salkin replied 1 year ago.
I appreciate it! I'll watch for your next post.

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