Most long time readers will remember Alice; the luckiest dog in the world, from previous posts. She's the only child of my good friends Phil and Martha and I tend to think of her in the niece category. Phil and I have spent lots of time in the back country with Alice along as our hiking and bear first alert system.
I'm sad to report that Alice's luck has changed for the worse, at least for now. Almost a month ago Alice started vomiting fairly regularly. At first we thought, along with her vet, that it was an intestinal virus that had been going around town.
Her veterinarian prescribed the appropriate therapy and Martha, a second year nursing student, dutifully provided the medication at home. Not much changed and the vomiting continued.
We tried holding her off food for short periods of time and gave her medication to try to soothe her obviously irritated stomach. Nothing much changed after that either, except that Alice started to lose weight.
I had been out of town for over a week, first at PurinaCareHQ down in San Antonio and then for a weekend of camping in the Chiraquawa Mountains of southeast Arizona, and when I got home I had a voice mail from Phil.
Alice was still not any better and they were starting to get very worried about her. My suggestion was to hold her off all food for 24 hours and provide her water in the form of a few ice cubes in her water bowl. She was to eat nothing and only be allowed to drink whatever melted from the ice cubes.
Last night was the end of the 24 hour fast and I decided to go over and check on Alice, myself. Two things struck me as I walked through the door. First of all, Alice was alert and happy to see me with her typical tail wagging greeting. The other thing I noticed was the very obvious weight loss. Alice has always been in really good condition. Phil and Martha don't go a day without a three to four mile hike up on Boston Hill with Alice leading the way. But it was obvious that Alice had lost close to 20% of her normal body weight.
Martha confirmed that she was down to 48 lbs from her usual 58-60lbs. Even with the weight loss she appeared alert and attentive and I noticed she still has a sheen to her coat.
We decided to see if she could tolerate any food after her fast and we prepared maybe two tablespoons of a highly digestible canned chicken and rice therapeutic diet, designed specifically for the task.
Alice snarfed it right down and licked her ice cubes. Her appetite was obviously good and she appeared to enjoy this tidbit. I was encouraged by this fact and by her general demeanor but at the same time, I was concerned over the magnitude of her weight loss.
Phil and I settled in to watch the first part of The Daily Show. We were less than five minutes into the show when Alice deposited her "meal" on the carpet in front of us. So much for the 24 hour fast, her stomach was obviously not ready for prime time.
So what could be the problem with Alice? Chronic vomiting anywhere from 10 minutes to four hours after a meal can have a variety of causes. Certainly an intestinal infection and resulting gastritis as originally diagnosed can be one cause. An intestinal foreign body (something she swallowed) can be another, but during my absence Phil and Martha's vet had done a series of contrast radiographs that seemingly ruled this out.
Contrast radiographs of the GI tract involves swallowing a contrast medium; in this case barium, which shows up on the x-ray as it moves through the GI tract. The barium series did show that the stomach was not completely blocked as some of the barium moved through the pylorus and into the upper small intestine.
So where are we now? Given her attitude, Alice is alert and hungry, I seriously doubt she has an intestinal infection or something like chronic pancreatitis. She'd be depressed and her upper abdomen would be very painful, if this was the case. She could have a tumor in her stomach but that would be kind of unusual in a young dog.
After consulting with some of my colleagues, like Dr Bill Craig at PurinaCare, we are back to thinking it's a primary GI problem with severe gastritis. Translation; we think there is something in her stomach partially obstructing or delaying gastric emptying and causing significant inflammation or gastritis.
Even though it has been almost a month there could still be something there that she is unable to pass. It could even be a tumor but we hope it is not. So what is the next step?
Endoscopy. You have to actually look into the stomach either through an endoscope or via surgery. Fortunately, we have a local veterinarian here in Silver City that has an endoscope and Martha has scheduled an appointment for this afternoon. I spoke to the the Technician at the hospital at length about the history and they'll do their own diagnostic work up asap.
Hopefully, it is some type of foreign body. There is a peach tree in Alice's back yard and she has a history of eating them, pit and all. A stomach full of peach pits could be a logical answer. They could be partially obstructing the outflow to the small intestine and causing a great deal of stomach inflammation or gastritis. As soon as anything; food or water, hits that inflamed stomach lining - up it comes.
We'll know soon. If it is an obstruction the surgery is pretty straight forward. A gastrotomy is performed and the inciting object is removed. With a little time to heal, she should be back to normal. The lining of the stomach may take a week or so to get back to normal. I'd imagine parenteral nutrition via an intravenous route would be indicated post surgically. After the lining of the stomach and the incision had had time to heal a special diet fed in small amounts several times a day would be very helpful and allow the healing to continue.
In any event, I'll report back later this week. Hopefully Alice's luck will change for the better.