A 9-year old female spayed dog vomits some time after eating for more than 2 weeks. Why? HISTORY: 9-year-old female spayed Miniature Schnauzer. Vomiting for some 2 weeks or more. No diarrhoea. Not eating anymore. Usually vomits some minutes after eating but now avoided eating. What is the cause? FINDINGS: Thin. Very painful throat. Periodontal disease Stage 4 (tartar covered teeth). I advised dental work to resolve the severe gum infections around 7 days later. Lungs and heart sounds normal on auscultation. No abdominal pain or lumps on palpation. BLOOD TEST: Red cell count and haemoglobin are normal. No anaemia. White cell count is normal. No bacteraemia. Kidney disorder as evident by an increase in urea and creatinine. Urea 42 mmol/L (Reference range: 4.20 - 6.30) Creatinine 280 umol/L (Reference range: 89 - 177) X-RAYS No abnormal findings in the abdomen. No gastric tumours or foreign bodies visible. No stools in the intestines indicating that the dog had not eaten for some days. INPATIENT FOR 3 DAYS. IV drips with antibiotic and painkillers for 2 days. Day 1. No food. Vomited fluid overnight and vomited canned Hills ID in the morning of Day 2 Day 2 - 3. Ate all Hills ID food. Passed normal stools. Day 3. Owner took the dog home for observation. Hills ID food. TIPS AND ADVICES: 1. Persistent Vomiting in old dogs may be a sign of kidney disease, as in this case. 2. A blood test is needed. 3. X-rays are advised. 4. IV drips to prevent dehydration and to clear toxins are standard treatments. 5. Pancreatitis will be checked if there is still vomiting. The tests add up to the medical costs. 6. Dental work to extract dead and loose teeth causing pain and bacterial infection and ulcerations in the gums is advised.
7. A misdiagnosis of gastroenteritis due to food poisoning or foreign bodies in the stomach is possible. Prescribing medication and sending the dog home after consultation will not resolve the problem of vomiting.
FOLLOW UP ON 19 Nov 2020. The dog vomits once a day, unlike before treatment. He needed to be spoon fed the Hills ID. He does not drink water and is weak. I phoned the owner to tell him to put the dog on dialysis under the skin - Hartmans and dextrose saline for the next 14 days as blood tests showed high urea and creatinine. Kidney disease can cause vomiting.
UPDATES WILL BE AT: https://2010vets.blogspot.com/2020/11/3899-old-dog-has-been-vomiting-for.html (this webpage)
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DRAFT SCRIPT
A 9-year old female spayed dog vomits some time after eating for more than 2 weeks. Why?
HISTORY: 9-year-old female spayed Miniature Schnauzer. Vomiting for some 2 weeks or more. No diarrhoea. Not eating anymore. Usually vomits some minutes after eating but now avoided eating. What is the cause? FINDINGS: Thin. Very painful throat. Periodontal disease Stage 4 (tartar covered teeth). I advised dental work to resolve the severe gum infections around 7 days later. Lungs and heart sounds normal on auscultation. No abdominal pain or lumps on palpation. BLOOD TEST: Red cell count and haemoglobin are normal. No anaemia. White cell count is normal. No bacteraemia. Kidney disorder as evident by an increase in urea and creatinine. Urea 42 mmol/L (Reference range: 4.20 - 6.30) Creatinine 280 umol/L (Reference range: 89 - 177) X-RAYS No abnormal findings in the abdomen. No gastric tumours or foreign bodies visible. No stools in the intestines indicating that the dog had not eaten for some days.
INPATIENT FOR 3 DAYS. IV drips with antibiotic and painkillers for 2 days.
Day 1. No food. Vomited fluid overnight and vomited canned Hills ID in the morning of Day 2 Day 2 - 3. Ate all Hills ID food. Passed normal stools. Day 3. Owner took the dog home for observation. Hills ID food. TIPS AND ADVICES: 1. Persistent Vomiting in old dogs may be a sign of kidney disease, as in this case. 2. A blood test is needed. 3. X-rays are advised. 4. IV drips to prevent dehydration and to clear toxins are standard treatments. 5. Pancreatitis will be checked if there is still vomiting. The tests add up to the medical costs. 6. Dental work to extract dead and loose teeth causing pain and bacterial infection and ulcerations in the gums is advised.
7. A misdiagnosis of gastroenteritis due to food poisoning or foreign bodies in the stomach is possible. Prescribing medication and sending the dog home after consultation will not resolve the problem of vomiting.
FOLLOW UP ON 19 Nov 2020. I phoned the owner today. The dog vomits once a day, unlike before treatment. He needed to be spoon fed the Hills ID. He does not drink water and is weak. I phoned the owner to tell him to put the dog on dialysis under the skin - Hartmans and dextrose saline for the next 14 days as blood tests showed high urea and creatinine. Kidney disease can cause vomiting. Loose and dead teeth will need to be extracted once the dog no longer vomits.
UPDATES WILL BE AT: https://2010vets.blogspot.com/2020/11/3899-old-dog-has-been-vomiting-for.html (this webpage)
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PERSISTENT VOMITING IN OLD DOGS
An old dog has vomiting for more than 2 weeks. Not eating now.
My top differential diagnosis will be kidney disease and/or gastric tumours.
I took a blood test. It confirms kidney disease.
X-rays appear to show a firm rounded mass in the stomach? Gastric tumour?
X-ray shows an empty stomach with no gas.
It is not possible to confirm gastric tumours in this X-ray
Consultation Day 1. Inpatient. IV drips with medication and anti-spasmodic.
Vomited food on Day 1 morning.
Day 2 - 3.
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See a previous case study: A 13-year-old Westie has a large gastric tumour.
https://2010vets.blogspot.com/2019/06/3349-13-year-old-westie-has-large.html
Hard firm mass - gastric tumour
A 4-month-old pug has a screw in the stomach
https://2010vets.blogspot.com/2015/11/2362-follow-up-4-month-old-pug-has.html
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Rotten teeth may be a cause as bacteria goes to the blood stream to the kidneys over a period of weeks.
The dog is on IV drip for the past 2 days as a form of dialysis and to prevent or treat dehydration.
This old dog had bad gum disease with thick tartar enveloping all teeth. The bacteria in the gums spread via the blood to the kidneys causing kidney disorders --- persistent vomiting. Yearly dental check up would have been best.
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Consultation at Day 1
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