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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33336
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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We have a dog with liver and kidney disease. She is a golden

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We have a dog with liver and kidney disease. She is a golden retriever, 11 years old, and her blood tests confirmed her illness. She still wants to eat it seems and follows my wife to the food cupboard at meal times, but is refusing to eat food more than once. In other words, we will give her something on day one which she eats, and on day 2 she refuses it. This goes across the board with all types of dog food, even human biscuits she will eat once and then refuse the next day. We have tried many types of dog food, also chicken, porridge and pasta and we ae running out of ideas. Apart from this she seems quite happy, is performing poops and pees normally but I am afraid that we are now runing out of options. Any ideas on how we can get her to eat?
Aloha! You're speaking to Dr. Michael Salkin
Unfortunately, the combination of liver and kidney disease is going to nauseate our patient and irritate the gastrointestinal tract. I can be more specific for you if I could review the most current blood/urine test results. I understand that you might not have a copy of the test results at home but Angie's vet can give you a copy which you could then upload to our conversation.

Conservative care involves the use of antacids such as the over the counter PepcidTwo (famotidine), the "liquid bandage" sucralfate (Carafate) which can assist in healing of gastrointestinal ulcers, antiemetic drugs such as maropitant (Cerenia) and the appetite stimulants cyproheptadine and mirtazapine. Warming Angie's food can make it more palatable and Angie's vet is likely to carry the highly palatable convalescent food Hill's a/d into which many dgos will dive because it contains such a high percentage of fat.

It's likely that a restricted diet has been prescribed for such a patient but it's more important that Angie eat the "wrong" thing than not eat the "right" thing. As far as I'm concerned, anything goes at this time. Angie's prognosis is predicated upon what I see in her test results so please do what you can about getting those results to me.
Customer: replied 3 years ago.
Thank you! While Angie's kidney tests are abnormal, they're not altered enough to cause such inappetance. Her liver tests are significantly elevated and she's severely hypoglycemic. This is worrisome for a very poorly functioning liver and/or an insulinoma - a tumor of the pancreas that secretes insulin and drives the blood sugar down so low. Insulinomas are highly metastatic and metastasize to the liver readily.

The next diagnostic should be an abdominal ultrasound in an attempt to clarify if such a cancer is present or pri***** *****ver failure is present, instead. Please continue our conversation if you wish.
Customer: replied 3 years ago.

To be honest we had been advised of the possibility of Cancer before, and we had considered whether to go down the ultrasound route. However, it is a three hour journey from where we live to a vet, including two ferry journeys, and at age 11 we were in doubt whether we would want to put her through an operation (if it were cancer) or whether she would be strong enough to survive it. We came to the conclusion that as our own vet said that the test results were very severe, that the best course of action would be to try and help her live her life to the full until the time when she was in severe discomfort. Hence the reason that we want her to eat, but we are struggling to get something that she will actually eat for more than 1 meal.

Thank you for the additional information. I understand your pragmatic approach. Please discuss the use of those drugs I mentioned with her vet. They can be picked up at your local druggist after Angie's vet calls in a prescription. Gravol (dimenhydrinate) can substitute for the maropitant as an antiemetic/anti-nauseant.

Please continue our conversation if you wish.
Dr. Michael Salkin and other Dog Specialists are ready to help you
Customer: replied 3 years ago.

Thank you for the information, you have been most helpful.

You're quite welcome. Thank you for your kind accept. I appreciate it.

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

Please disregard the info request.