Ollie and the Internist

[Amy, Cubbie & Ollie]

At the end of May I took Ollie to the internist to get him checked out for vomiting.  In January he started vomiting off and on but didn’t have any changes to his weight, energy, or appetite.  It didn’t seem like any big deal at first but then I started coming home to bile on the floor at least twice a week.  Then it went away for a little bit and then it returned but would often occur in the late night/early morning hours.  He would throw up 2-3 nights a week for a week or 2 and then he would be fine for a week or 2.  The blood tests run by the regular vet didn’t show anything so we went to the specialist.

 

When we met with the specialist, they felt his stomach and did a basic exam.  I was told not to feed him after 10pm the night before so they could do any necessary testing; this meant that Ollie was hungry and gave the vet the opportunity to hear how loud his stomach is when it grumbles.  You can sit across the room from him and hear his stomach making noise.  They recommended doing an ultrasound to make sure that there were no blockages and he would also look at the size of his adrenal glands.  If the glands looked small, he would recommend a blood test for Addison’s disease.  They did the ultrasound – no blockage and the glands looked normal.  The next step was to do a scope and look around and take a biopsy.  I agreed, since I wanted to find some answers.  They did the scope and saw some inflammation and corrugation in his intestine (it is supposed to be smooth).  They took a biopsy and sent it out to the lab.

 

The biopsy results came back and there were no signs of cancer.  The vet said he didn’t really think it was cancer, but having the confirmation made me feel a lot better.  He said that it was inflammation likely related to IBD or a food allergy type of response.  He said that he would like to do a diet change and start Ollie on Prednisone and that he was going to send his recommendations over to my regular vet to handle the treatment plan.  I went and saw my regular vet last Monday and spoke with him about the results of the biopsy.  I was ready for a fight about Rx food but he suggested that we start Ollie on a low dose of Prednisone (I can’t remember the dosage, the pills are at home) and that we would see if that helps him and then potentially see if we can get him off the drugs.  Well, when I went in on Monday, Ollie hadn’t thrown up for a week and a half.  I told the vet that I wanted to hold off on giving him the pills and he was fine with that.  But now it is over a week later and still no vomiting so I still don’t want to start the Prednisone.  We have a follow-up next Tuesday.  Do you agree that I’m making the right decision by holding off on the steroids until the vomiting returns.  He hasn’t been sick since May 22. 

 

I’m completely at a loss for what could’ve been causing this that would suddenly just go away.  I stopped giving him his Zyrtec before his visit to his new allergist, but I stopped those at the end of April and the vomiting still continued for the next month.  What do you think?

[Debb, Lucy & Oscar]

I'm just wondering if you took any steps to curb Ollie's vomiting before all these tests. My Lucy also would vomit bile before breakfast if I let her out of her crate 1st. Now I wait till its all ready before letting her out and she hasn't gotten sick since. A couple good-sized dog biscuits before breakfast helps too (if we want her out of her crate before breakfast). She'd also throw up bile in the evening if we didn't feed her at her usual time (meaning, later) so we have to be careful about that. I think you are doing the right thing by holding off on the steroids,, especially now that Ollie hasn't been sick.

[Debb, Lucy & Oscar]

Lucy's condition is called 'bilious vomiting syndrome'. Did your vet rule this out?

[Amy, Cubbie & Ollie]

Thanks Debb.  I've taken all kinds of steps.  Added an antacid.  Added more frequent feedings including a late night snack before bed.  These changes were (increased feedings) were the same from day to day yet the vomiting would occur some nights and not others (usually around 1-2am or between 4 and 5am).

[Karen, Jasper and Jackdoodle]

I'm really sorry to hear this, Amy. Ollie & JD must be related. JD's dermatologist feels there is a connection between his A.D. and IBD , both of course related to an overactive, screwed up immune system. 

I'm surprised that the internist didn't run a GI blood panel. An abnormal cobalamin or folate value can often help with the diagnosis. You can always still have that run. It has to be sent out and takes about a week. If it's normal, at least you'll know that he's absorbing nutrients. 

I agree with holding off on the prednisone. 

Is his poop normal? Appetite?

IF there is a connection between the vomiting and the A.D., it might account for the sudden starting and stopping, if the trigger for the IBD is one of Ollie's seasonal allergens. Nobody knows for sure if that happens or not, but there is some evidence that it can. Many of the dogs in my IBD group have seasonal flares, and JD did, too. 

I'm sorry you & Ollie have something else to worry about and deal with. 

[Amy, Cubbie & Ollie]

his appetite is as big as ever (he is one of those dogs that would eat himself sick if he were given the opportunity) and his stool is normal too. 

 

It seems like Ollie has been itchier the past week and a half which is the exact opposite of what you mentioned (of course it is, why would something with him follow the "norm"? lol).  I even noticed him chewing on his paw this morning which he hadn't done in a couple of months, but I'll post that discussion in the AD group.

[Karen, Jasper and Jackdoodle]

Start the Zyrtec again, I don't think it has anything to do with the vomiting. And if it does, that can only help you figure things out. 

This really doesn't sound like IBD. Maybe some kind of acute gastritis, I just don't know. But I can't see putting him on pred if he doesn't need it. 

[Amy, Cubbie & Ollie]

I guess I'll try the Zyrtec again because I don't want him chewing up his paws like he did before.  Though I'm not sure how much it really helped.

[Ginny Nightingale]

I have had this issue with one of my dogs in the early morning hours maybe two times a week--if she has not vomited by the time I get up she runs outside to eat grass so she can vomit, then runs in to eagerly eat her breakfast--I think it is from an empty stomach and I try to remember to give her a handful of kibble at night and that soothes her tummy until her next meal.

[Amy, Cubbie & Ollie]

Thanks Ginny.  He gets his dinner around 5:30 and then a snack (1/4 cup of kibble) around 9pm but there was still vomiting on random nights and I've maintained the same schedule and now the vomiting has stopped which is why I'm so confused.  I spent 2 months with blankets and towels left on the floor of my bedroom because I never knew when he was going to be sick and there is nothing like having to clean up vomit from the carpet in the middle of the night  :)

[Debb, Lucy & Oscar]

2 things come to mind. Maybe instead of giving 1/4 cup of food at 9pm, give equal meals several times a day, ending with the 9pm feeding. That would be assuming he'd get more than 1/4 cup of food at 9.

Is Ollie crate trained? Keeping him in a crate at night would really help to ease your mind about his messing up your carpet in the middle of the night. Just a thought.

From what I've learned about bilious vomiting syndrome, its not necessarily consistent in it's onset. Lucy eats the same amount at the same times every day, and yet some days she would have it and other days she would not. All things considered, I do hope it is just bilious vomiting syndrome. Ask your vet about it. I know there are certain drugs that can help, too.

[Amy, Cubbie & Ollie]

He gets 1/2c in the am, 1/2c at dinner, and then 1/4c before bed.  Unfortunately I can't do any more than that because I'm at work all day. 

 

He was crate trained when I adopted him, but he hasn't been in a crate for 2 years.  Both of my guys have beds in my room.  I'd rather just put the towels back on the floor than try to get him back into a crate (we had some issues with him guarding his crate).

 

I'll have to look up that syndrome.  It isn't one that I've heard of before.  thanks!

[Nancy, Ned, Clancy, and Charlie]

Amy, I am so sorry you and Ollie are going through all this, but at least some serious diagnoses have been ruled out, which is awesome.  I am so glad that he is on a vomiting remission.  I think you are right to hold off on the Prednisone if he is doing okay right now.  I know that you said that you had discontinued the Zyrtec for a month and he still had some vomiting, but I wonder if it took that long for his stomach to settle from taking the medication on a continuous basis.  I know that when my Springer was ill and given Prednisone (and is apparently is highly allergic to it), we were to wait an unbelievably long time for his system to clear before we could do some tests.