chronic vomiting -- any vets out there?

[Caleb'sMom]

forgive me, this is VERY long.

At the beginning of November, my dog started vomiting after chugging down water, and after eating.

There were two things of any consequence that occured around that time. One, I started jogging with my dog, 3 miles, cool air that got progressively cooler as the days went on. I then fed him within about a half hour of coming home. Two, he got hold of a plastic toy in the middle of the night, did damage to it, and threw up the pieces.

We let it go for a month. He didn't throw up every meal. But it was enough that we didn't let him stick his face in the water bowl and chug it all down.

At the end of November, I called the vet's office. Its a pretty high volume place, so they have a "pet liaison" that you leave your concerns and questions with. The liaison called me back and told me to do rice and burger for two weeks. I called again to speak personally because I believed that rice and burger is the cure all, and I wanted to have more discussion on the issue. When she heard about the excercise and eating thing, she agreed that it could be something else. I never knew that the excercise and meal time had to be very far apart. So, she told me to get his food off the ground (we were doing this anyway because he seemed to be taking in more air of late), soak his food, monitor his water intake, and not exercise him for one hour before or after eating.

Three weeks went by. Still pretty regular vomiting, but better. AT this point, if he ate snow he lost his lunch. It was hard to monitor his water, for fear of dehydration. So I called and asked for the vet this time. (The vet checked to see if I talked to the liaison before initiating conversation.) She told me to continue what we were doing, and bring him in.

His coat remained great, eyes clear, energy high, blood came back normal, xrays normal, urine normal but with a high water content: 25/10 when it should be 15/10, so he was not returning enough water from his kidneys back into his system.

So, the vet presented two possibilities. One was a motility disorder, and the other an inflammatory problem. She prescribed reglan, for the motility, which would move the food into his stomach faster. I am not a vet, obviously, but I wondered how slow motility could actually cause instantaneous vomiting? It seems an odd connection. She said that if this didn't work, we'd then try the other route.

After a week, he was still doing better. (The vomiting was already down, jsut this week with the meds there was none.) So we tried it for another week. This past week. And, he threw up from the pill wrapped in cheese twice, a piece of tuna steak once, and from one bite of snow once.

So, we're up to today. Last night after the snow I'm cleaning my rug at midnight. I've had it.

The vet calls me back today, after I left a message yesterday with an update and a query as to what we do now. And honestly, I'm SO frustrated. When I relayed the information about the returned vomiting, she said the cheese was because it was cheese, the tuna because it was tuna, and the snow was because his stomach had had too much and couldn't take any more--but he only had *one bite.*

She wants me to continue on the reglan. So I asked about the inflammatory issue, was there something we could pursue there. She got frustrated with me then. But I'm not going to jsut medicate my dog for the rest of his life, and still live with the problem! Especially when she herself mentioned in the beginning that there was another route to try!

Now, I know vets know more than lay people, that's why we go to them. But in my opinion, there's an issue here, and I want to knwo what it is. It seems that the cold air/exercise/dinner thing caused a condition. And he's improved. But I'm trying to determine what the continued issue is, and how to help him. When I expressed this to the vet, she told me that quite often people ask her to guess, and that's what she's trying to do for me.

I forgot to mention, that instead of the drug for inflammation, that she originally mentioned, she said the other way to go next is to do floroscopy (sp?). But, she says, its very expensive, 5 or 6 hundred dollars. She reminded me that my pet health might not cover it.

I told her that I need to think about all this and get back to her.

Today, I talked with a coworker whose cocker spaniel just developed this chronic problem one day too. He said I'm wasting my time and that the vet will keep me forever as a customer of her pharmacy. That two weeks on rice and burger, limited water, no snow, one meal a day, and Caleb will be fine. I am *so* wanting to believe him.

Caleb is 3 in May, 100 lbs., great attitude.

Pls help?

Amy

[spidey]

I'm not a vet, but I can offer you a couple of thoughts:

I wondered how slow motility could actually cause instantaneous vomiting?

The food may not even be getting to the stomach, if the motility in his esophagus is slow the food will either build up in his esophagus until it's distended enough to cause vomiting, or not go anywhere and come right back.

I am usually a pretty staunch defender of vets, but I really feel you need to find another vet, and sooner rather than later. The fact that the vet hasn't recommended a barium series (especially before talking about fluoroscopy), with the history of the dog eating plastic, and the fact that GI inflammation usually clears up pretty quickly with a bland diet and meds, is pretty surprising to say the least. At very least you'd want visible proof that the GI tract is patent, and that there's no megaesophagus before you started talking fluoroscopy, IMO. The dog has been vomiting for three months, there's no excuse for leaving an animal in that state while you guess at what could be wrong over the phone. I also don't like that you have to speak to a "liaison" - I don't see that you can have a close relationship with a vet if your calls are screened to that extent.

Another reason to see another vet is that you, yourself, pretty clearly feel that this vet has hung you out to dry. Get to another vet before you make any changes, you may get some good advice here, but the more changes you make to things like diet and supplements, the harder it will be for a vet to sort out what's causing what.

IMO, you need to get your dog to another vet, perferably tomorrow. Good luck, and please let us know what happens.

[Caleb'sMom]

Thank you so much for the support. The esophagus issue, and your suggestion of other methods are great.

I live in the Boston area, I was thinking of calling Angel Memorial tomorrow. They have an outstanding reputation.

On another note, I read some of the other past thread on 'vomiting'. Its kind of helpful, but nothing seems to fit, exactly.

Thanks again.

[MARYDVM]

An endoscopic exam of the esophagus and stomach might be helpful. Although he threw up pieces of the plastic toy, it is remotely possible there are still fragments in his stomach - too big to pass or to be brought back up. A friend of mine imported an expensive dog from Germany that ended up having chronic vomiting and weight loss. They finally did an exploratory and took 3 tennis ball halves out of her stomach. Soft things like that won't show up on an x-ray.

[Caleb'sMom]

Another good idea. Thank you very much.

[spidey]

I've seen Angel Memorial on TV, I think. Huge place, almost like a human hospital, right? Let's hope they can figure this out.

Anyway, good luck with your poor boy, I hope you get him sorted out soon. I'm glad MaryDVM weighed in here with her usual good advice. Please keep us informed. :)

[Carina43]

Just an FYI on some of the advice you got - it has been determined (in the Purdue bloat study) that feeding a dog from an elevated bowl actually incresed the risk, as did adding water to kibble containing citric acid.
http://www.vet.purdue.edu/epi/dietrisk.htm
Hope you gett he vomiting issue worked out.

[Judy Chrusch]

I agree 100% with MARYDVM, though she's the vet and I am not that's exactly what I was going to say, about a blockage. After reading about the plastic bottle that's the first thing that came to mind. I can't believe your vet didn't do an X-ray. Though as MARY said not everything shows up through X-ray. Please see if their are fragments causing all this and or a blockage. I knew someone who had the same thing, later to find out a ball was lodged in the stomach but the dog sadly died bc of that. I don't want to scare you but please look into that, 3 months is waaay too long. I hope you can find what's causing all this for your poor boy. Please keep us posted.

Judy

[sugarmaginva]

From the post I read it sounds like this diagnosis was all over the phone. I would take your dog to a vet that will look at him. And I would also be leaning towards some sort of blockage.

[RottiMomCT]

Just yesterday when I was at the boarding kennel/vet exercising some of the rescue dogs that had just been vetted, I watched the vet remove a sock from the badly damaged intestine of a dog. NASTY is all I can say about what I say (although I HAD to watch...strangely fascinated...:D ).

Apparently the dog had gotten into the laundry FOUR days prior and had been throwing up meals, but peeing normally, no poop, drinking lots of water. Pieces of the sock had come up and the other sock, badly destroyed had not been ingested so the owners thought it all came up. NOPE - the dog ended up having about 3-4 ft of intestine removed and part of his stomach as well.

I was tempted to take pics of it and show my in-laws - their dogs are CONSTANTLY eating socks out of separation anxiety or just plain attempts for attention (that's another topic al-together!) and theythink nothing of it - not even when they poop them out. Their logic is, well, they always come out eventually...funny thing is...that's what the owner of this dog who was in surgery said to me!

Anyways - check into another vet. Obviously what has been prescribed is not working, and it sounds like your current vet isn't really interested in curing the problem...

Good luck and keep us posted on the progress.

[Caleb'sMom]

I'm sorry, I rambled off so much stuff it must have got lost. He had bloodwork, xray, and urine that all came back clear.

Thank you for all your advice!

I am currently waiting for contact from the head vet at the clinic I've been working with. For starters, I'm switching vets at this hospital, one whom I can communicate comfortably with, I hope.

I found out that Angel requires referrals unless its an emergency.

Also, In the meantime, I'm continuing the reglan, this will be his third week on it. When I went to pick it up today, I got to speak with a different vet, and she mentioned that trying Reglan for two weeks to a month is normal. I replied that htat would have been fine with me if that had been communicated to me.

So, when I speak with the head vet today, I will voice my concerns on Caleb, on my communication problems, and I will ask about future plans, including endoscopy, plus all the other advic epeople provided here. Thanks so much.

[k&s]

You could try Tufts University Veterinary Hospital, in North Grafton, Ma. Their small animal hospital phone number is at 508-839-5395. I do not believe you need a referral to be seen there.
Best wishes!

[moondog]

I'm wondering if you've been able to find out anything more? I hope you find out the cause and he'll be back to normal soon! :)

[Caleb'sMom]

Hi,

The other day, I spoke with the lead vet, and voiced my concerns. She pretty much ignored them. She offered endoscopy if I wanted (If I wanted?) and told me I heard wrong about flouroscopy, the the original vet must have said endoscopy. I said, do you refer to Angel memorial for endoscopies? Because that's what I was told would happen. She said no, they don't.

I got a recommendation for another vet in the area, and made an appointment with her for a second opinion. In the meantime, the original vet called me and wanted to do a bile blood test, before doing the endoscopy. I agreed.

So now, I just came from our new vet. At the very least, she *instantly* recognized that for over three months my dog has gone undiagnosed. And she wondered why there would be a need for a bile blood test before endoscopy, when his liver function had come back normal, previously, and he is maintaining his weight.

She is going to do another round of xrays, so she can see for herself, and then explore the options, probably endoscopy.

As for Caleb, he has been doing alright, pretty much. He heaved and lost his dinner tonight, about 2 minutes after eating. If I had to guess, I would say its megaesophagus, but I've heard that there is no heaving with that illness, they just regurgitate. So, I'm going to wait for our new, personable, considerate to my worries vet to figure it out. I will definately keep you all posted.

On a side note, she mentioned that a vet at a convention told her that a dog had passed a large teriyaki stick, without a puncture! How horrible would that be, for the animal to live through?

Thanks!

[spidey]

Well, it at least sounds like this new vet doesn't think it's okay for a dog to be vomiting for three months! I'd stick with her (for now, at least), she sounds as if she cares a bit more and has a plan in mind, anyway. Please keep us up to date! :)

As to the teriyaki stick, dogs can live through amazing things, there was a Staffie puppy in England who swallowed a knife almost as long as he was, and he lived. Story here .