Please diagnose my pup.
January 4, 2017 7:56 PM   Subscribe

My dog has vague symptoms (lethargy, weight loss) and normal blood work. Help me figure out whether we should continue testing, or I'm being an overprotective pup mom.

Our dog Penny (obligatory photos here) who is 8 years old, has been seemingly not feeling well for the past several months. She had been staying with my parents until last January, when we moved her to Denver with us. She was doing okay, but in February she had a bout of diarrhea that turned into hemmoragic gastroenteritis (HGE). She was treated with antibiotics and fluids, and it resolved itself after a couple days.

After that scare, she had intermittent diarrhea and loose stools every few weeks or so. She also frequently had mucus in her stool, and would occasionally have accidents inside the house. Additionally, she lost about 2 lbs over the year (on a 12 lb dog, that's a significant amount). We took her to the vet a few times since then. She had bloodwork done in July for a teeth cleaning, which revealed no concerns.

We talked to the vet about the ongoing issues she'd been having, and the vet came up with a plan of attack. We changed her diet to a limited ingredient diet excluding chicken, as the vet felt Penny may have developed a chicken allergy over time. We implemented this change in the beginning of December. We did see a change in Penny's gastro symptoms; no more loose stools, and we haven't seen an incident of D since then. However, Penny still seems lethargic and hasn't gained weight. It seems to wax and wane, where some days she clearly isn't feeling well (following us around the house, tail down, won't eat) and others she seems generally okay, if low energy. She also seems like she might have some weakness in her legs (she seems hesitant to jump on the sofa, where she did not have issues before.) Yesterday, the vet re-did the basic bloodwork and ran an ACTH stimulation test, in hopes of diagnosing Addison's disease. The bloodwork was clear and the ACTH was negative. The vet has suggested an abdominal ultrasound as the next diagnostic step, with the idea that it could diagnose inflammatory bowel disease, tumors or pancreatitis.

What I need at this point is opinions on whether to continue with diagnostic testing at this point. I can't tell if I'm seeing symptoms where there are none; the diet change did help with the gastro symptoms, and the rest seem so vague that they could be in my head. But I'm also scared that she has a tumor or a degenerative disease that could be treated in its early stages. The recent round of testing was $450, and the abdominal ultrasound would be another $500, which is a significant amount of money for us. Please help us get some perspective on this situation, and help us decide whether we should continue pursuing tests for our sweet pup.
posted by bluloo to Pets & Animals (10 answers total) 2 users marked this as a favorite
 
Did you give her canine probiotics after the antibiotics? I've had so many dogs develop skin problems or other issues after antibiotics that I always do this now. Also if you think she might be deficient in something or not absorbing her nutrients Nupro is an excellent additive for dogs.
posted by fshgrl at 8:09 PM on January 4, 2017 [3 favorites]


If you're not already grain-free I'd go there next in terms of food, especially if she's got any history of or tendency to skin concerns like being excessively oily/stinky. Some animals do not do well with grain. Have parasites been ruled out?
posted by Medieval Maven at 9:01 PM on January 4, 2017


To answer the first couple questions, yes we've had her on a daily probiotic for the last several months. The limited ingredient diet is a duck and sweet potato formula, so it is grain free. Also, parasites have been ruled out via fecal testing.
posted by bluloo at 9:09 PM on January 4, 2017


before you scare yourself, this is fairly rare and my experience is with a cat.

it sounds a little like when my 15 year old cat eventually caught and succumbed to feline infectious peritonitis which wasn't diagnosed until the very end since it's kinda hard to establish.

it's caused by a coronavirus and there's a dog version as well that is equally difficult to establish but has a vaccine and looks more treatable.
posted by noloveforned at 9:49 PM on January 4, 2017


If it were me, I'd go ahead with the testing.

We used to have a cowboy corgi who (among other things) had chronic, intermittent HGE. When it flared up, we'd take her to the vet and treat the symptoms. She wound up dying after a horrible, unrelated foreign body ingestion event, and when it was all over, the emergency surgeon told us it looked like she'd had significant gut inflammation for a long time.

She was a really tough little dog, and she didn't act like she was in hurting, at least not in a way that we could parse-- but she did exhibit a variety of odd behaviors that may have been ways of dealing with constant pain. (At the time, we just chalked it up to her being a rescued herding dog who was from circumstances and who was a little too bright for her own good.)

I loved that dog beyond reason, and I absolutely hate that she may have been suffering every day, while we spent years laughing at her quirks and failing to help her. If I could pay $500.00 to go back and change that, I absolutely would, with no hesitation, and I'd call it a bargain.
posted by palmcorder_yajna at 11:51 PM on January 4, 2017 [3 favorites]


I have two questions. Are you taking your dog to a regular vet or have you actually seen a boarded internal medicine specialist? I would be taking her to the specialist. Some vets will keep running tests, others know when to throw in the towel and refer to the specialists. It's also the most bang for your buck. And if you are going to spend $ for the US, have either an internal med specialist or a radiologist do it.

second, has she had a fecal done? Two things that come to mind (even though her signs have resolved for now) are giardia and whipworms, both persistent buggers. If I were treating the dog, I'd probably do a course of fenbendazole and repeat at 3 weeks and 3 months just in case it was whipworms (which are not only persistent but sneaky).

Just my 2 cents.
posted by bolognius maximus at 12:53 AM on January 5, 2017 [4 favorites]


The vet has suggested an abdominal ultrasound as the next diagnostic step, with the idea that it could diagnose inflammatory bowel disease, tumors or pancreatitis.

I would go ahead with this step. I went through a long period with a cat who was diagnosed with IBD instead of the pancreatic cancer he had. I really wish I'd just done the ultrasound instead of putting him through a bunch of other tests and diet changes.
posted by gladly at 7:09 AM on January 5, 2017


I also came here to ask if there was a fecal. I'd be especially suspicious if you live near an agricultural area... diseases from cattle and soil are prevalent. I'd do the fecal first...but I would also probably do the ultrasound as well. Coronavirus, erlichia, and a host of parasites can also have wasting as a sympton, though erlichia would have been suspected if there was a low platlet count, which the bloodwork would catch. But I've had a foster who was lethargic, with low platlets, who tested negative for everything, but responded to doxycycline, so she had some kind of tick disease
posted by answergrape at 7:10 AM on January 5, 2017


Have you seen a veterinarian who is boarded in internal medicine or just your general practitioner? If you haven't seen a diplomat of the American College of Veterinary Internal Medicine I would and I'd have them do the ultrasound at their practice if they think it's warranted. You can ask your GP for a recommendation.

I've always gone for the ultrasound when it's been suggested and unfortunately for my pet family it's always revealed something that needed either further medical or surgical treatment - but I've also had the benefit of a hefty employee discount (I am licensed veterinary technician) and I have great pet health insurance so my out of pocket expense is low.

Good luck!
posted by OsoMeaty at 10:46 AM on January 5, 2017 [2 favorites]


Firstly, Penny is beautiful!

Secondly, it's tough to tell from the photos you've posted but she also looks like she might have some sighthound breeds in her make-up. Thankfully I've never had to know too much about the specifics but I'm vaguely aware that blood test levels for sighthounds can be different to most other breeds, and to make sure I use a vet who is aware of this and accounts for it in their analysis/diagnosis.
posted by A Robot Ninja at 5:22 AM on January 6, 2017


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