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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 32885
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My 2 year old male chihuahua Papi is small at only 1.5kg but

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My 2 year old male chihuahua Papi is small at only 1.5kg but has always been healthy until he started vomiting around a month ago. He ended up in the dick vet hospital where they placed him on a drip and gave him anti nausea medication along with an ultrasound of his stomach which didn't show anything. Their diagnosis was that he had picked up a stomach bug but he didn;t have any diarrhea. The vomiting was under control but Papi continued to be lethargic and I noticed that his poo looked like charcoal although it was formed. I also noticed that he had swelling on both sides of his neck so I took him back to my vet. She was worried about his heart so did an ECG which shows that he has arrythmia and high vagal tone. At the same time she did another ultrasound and discovered another 2 swollen lymph nodes near his stomach. She did a full blood test and discovered that his red blood cell count is low and he has to go back in 3 weeks to have more blood tests. Her finally diagnosis is inflammatory bowel but it does not ring true to me as he has not had any diarrhea. He has not lost any weight but seems to be eating/drinking/urinating more frequently. I am still very worried as he is still lethargic and has a bad smell around him which the vet also noticed. Do you think given his age that this could be lymphoma or would this have shown up somewhere else in the blood test. The vet was going to aspirate cells from the swelling in his neck but decided it might be his salivary glands so decided against it. I should also mention that he is swallowing alot more than usual. Any advice you could give me would be greatly appreciated.Thanks
Customer: replied 1 year ago.
Apologies - I forgot to mention that the latest blood tests show that he has a low red blood cell count so is slightly anaemic.

I'm sorry, I've been called away and can't continue on in this conversation. I'll opt out which will give another expert the opportunity to do so.

Customer: replied 1 year ago.
OK - thank you

I'm back. I'm sorry that your question wasn't answered in a timely manner. It's difficult for us to jump in the middle of such a complicated case that has already been attended to by specialists - in this case at the Dick Vet Small Animal Practice. I'll address your concerns as you posted them...

The very dark stool is often associated with digested bood in the stool but slowed motility of the GI tract is the more likely reason for the darkness. The bacteria in the GI tract metabolize bile into stercobilinogen which gives stool its characteristic color. When motility slows those bacteria have more time to work on the bile and so the stool becomes darker.

We can still aspirate salivary glands although I admit that such a diagnostic isn't likely to be helpful in Papi's case.

Increased vagal tone due to GI inflammation/hyperactivity can slow the heart. It isn't clear to me if that's being termed an arrhythmia or another type of arrhythmia exists in addition to that caused by increased vagal tone.

A nonregenerative anemia (Papi isn't able to efficiently replace the red blood cells he lacks) is consistent with any chronic inflammatory disorder. It doesn't clarify which disorder is present, however. The enlarged lymph nodes in his abdomen may be reactive rather than malignant as would be the case with the malignant lymphoma. In other words, draining areas of inflammation and reacting to that activity.

Vomiting may be the only symptom of inflammatory bowel disease - particularly in cats. Please note that IBD can nauseate and result in vomiting. In addition, his swallowing excessively also indicates nausea and gastroesophageal reflux (GERD, acid reflux, heartburn). This should be addressed with an over the counter antacid such as PepcidTwo dosed at at 0.25 mg/lb twice daily of the famotidine component of that antacid.

Finally, only scoping and biopsy of Papi's GI tract might reveal the etiology of his vomiting.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
Hi, thanks for getting back to me. I think you have eased my concern so will just hope for the best and I now have him on a special royal canin hypoallergenic diet which he surprisingly seems to like. He's just so tiny I hate having to put him through so many tests and our previous dog was a cavalier king Charles who had syringomelia so we lost him when he was 4. I guess I'm a little on edge but thank you - I'll get back to you if I need another second opinion.

You're quite welcome. I'm thrilled that he's eating so well. That's certainly not consistent with lymphoma. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Thank you for your kind accept. I appreciate it.