# Help! Vomiting maltese no solution :(



## LOWBLiz (Jun 21, 2011)

Hello all - I'm new to this and I'm sorry this is going to be a long essay. I need some help with 4 year old male maltese named jack. He is approximately 7.5lbs, and has not been losing any weight through this ordeal. 

Background: Has been fine living with me since he was a puppy. I have moved about 3 times since then and he often stays with my parents and their two dogs. In October 2010 I broke my leg and left Jack home with my parents until January. Once getting him back he was fine for about a month and then started having weekly fits of vomiting. I thought maybe his food i had kept had turned and bought a new bag (Royal Canin) These episodes happened at about 4am (he eats at around 7pm) when he'd start crying, jump off the bed, and crawl into a corner before wretching and throwing up lots of undigested food and bile. These have progressed into defecation and urination along with the vomiting, still at 4am, and increased to every 3-4 days. We considered food allergy and I switched his food to Wellness simple formula. After this did not help, I dropped him at my parents as they live closer to my vet. 

Vet history: He went through multiple blood tests, h pylori labs, had an endoscopy, and an ultrasound. They found a slight (albeit not significant) inflammation around the duodenum as well as some erosions of the stomach they said seemed indicative of food allergy. We again switched his food, placing him on plain rice, plain chicken, as well as a specially treated formula the vet recommended (which name I cannot remember at the moment). Through all food changes his condition did not improve (yes, we did give him some time between changes to let his system adjust). He was also put on multiple antibiotics, and reglin injections and unfortunately did not react well to them (lost appetite, was very lethargic and produced a yellowish discharge from his nose and mouth). He also was placed on injectable and oral steroids which decreased the frequency of his episodes to approximately every 7-10 days. There is one more antibiotic the GI doctor wants to try but based on his prior intolerance I'm hesitant, especially because the approach seems very nonspecific. My parents are both doctors and i am in medical school, so their tests and various treatments have not been idly accepted.

In between problems, he is a happy, energetic dog. His appetite is healthy (he loves dinner time), and he plays with my parents two dogs (a maltese and an english cocker) constantly. A few times he has had these episodes during the day but most of the time it is in the middle of the night, hours after he has eaten.

I would appreciate any help, insight, or ideas as frankly I am stumped.


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## dntdelay (May 27, 2011)

Could it still be the food? Maybe you should change the time in which he eats. I am so clueless.:huh:


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## edelweiss (Apr 23, 2010)

I am sorry to hear about Jack's sickness. I know how frustrating it is to NOT know what to do to help because a proper diagnosis is absent.
Did the vet do a BAT (Bile Acid test)---this is NOT done in regular blood work! On what was the ultrasound done?
Maltese are prone to liver issues also and many vets who do not treat mainly small dogs don't know this.
Your baby is obviously suffering. Let's keep asking questions & try to find answers here.


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## maggieh (Dec 16, 2007)

Have you tried a protein other than chicken? Sometimes dogs can have a sensitivity to that. Something "novel" like venison or rabbit may help. Good luck!


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## LOWBLiz (Jun 21, 2011)

Thanks for all the replies! We spoke to the vet again this am (he is now on my speed dial) and am trying one more round with the abx, this time to fight intracellular infection. Edelweiss: we did do a bat - totally normal. we also tested his urine to rule out kidney issues and everything came back ok. The ultrasound looked at his stomach and intestines. Again, aside from a slight thickening of the duodenum, there were no apparent abnormalities.

Maggieh: we have given him plain rice (no protein) during which time he was still sick. We tried a salmon based formula but he hated it and refused to eat it. The food he is on now is a duck formula as well.
I could change the time at which he eats to the morning and might try it just because I'm running out of options. 

I feel so badly for him and fear that he's doing some harm to himself with all this vomiting, but between these episodes he's completely fine, LOVES eating, and is so energetic and loses no weight so nutritionally I hope he's staying healthy. Thanks for all the ideas and keep em coming!' I'll send updates as soon as we run more tests or figure something out


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## edelweiss (Apr 23, 2010)

It sounds like this appeared suddenly? as in when you got him back from your parents? Was he completely ok before that? Did he exhibit it when at your parents house?
Does he eat more than once a day? How much does he consume at one time.
Defecation and urination along with the vomiting? Does this ALWAYS happen? It sounds like a seizure w/out the actual seizure?
Still chewing on this!


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## spookiesmom (Mar 28, 2010)

Have you tried feeding him x 2 daily? That may help him digest it better, possibly a small treat between meals to prevent him from being totaly empty, cut down on the bile coming up. I do this with my dogs.


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## LOWBLiz (Jun 21, 2011)

Was completely fine before January, appeared very suddenly which is why I initially thought something was wrong with his food supply. He absolutely does it at my parents' place now.

He only eats once per day, consumes about a cup of food and eats all of it. We've considered that he was eating too fast but the wellness pieces are large and he takes his time eating and chewing and this is still persisting.

The defecation and urination with the vomiting is a newer development (in the last 2 months or so), prior to that it was just vomiting. Now it always happens paired. Stool is soft but no diarrhea. We've brought this up to the vet and he thinks that jack is getting upset and doing it out of stress/discomfort rather than an actual need to defecate/urinate.

I'm starting to lean towards neurological problems but don't even know where to start with those, it seems that there has to be something wrong with his stomach due to that mild duodenal thickening but at this point myself, my parents, and our vets are stumped. My best friend is at UPenn vet and has given his labs to one of her professors with no successful treatment, so far the common suggestion is put him on chicken/rice diet and abx but we've tried that unsuccessfully.

Thanks so much for all the feedback!


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## Cosy (Feb 9, 2006)

I would eliminate chicken, rice and white potatos for a period of time to see how he does. It may take time for his system to heal from the sensitivity(s).


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## edelweiss (Apr 23, 2010)

This is an interesting article, but it seems an endoscopy would have revealed this problem:
Pyloric Obstruction/Stenosis - Page 1


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## jodublin (Sep 27, 2006)

have you tried brown rice and turkey ..most maltese are sesitive to chicken


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## Bonnie's Mommie (Mar 2, 2006)

Bonnie used to vomit sometimes in the middle of the night. I changed her routine by feeding her just a little extra food a few hours before bedtime and the vomiting stopped.

I hope you get an answer, it's so frustrating and sad to see them go through something without knowing what the root cause is.


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## Snowbody (Jan 3, 2009)

I'm so sorry this is going on. I see below your avatar that you're in New York. Don't know if the city or upstate but if you're upstate you might want to try Cornell University. I know they are supposed to be amazing and it sounds like you need vets who think out of the box. 
I do however totally agree that I would split his meals. Half in the morning; half in the evening about 6pm and see what happens. That's a lot to digest when he's lying around sleeping.


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## vjw (Dec 20, 2006)

Cornell is a wonderful suggestion!

I also totally agree that I would try more frequent meals. Everything I've ever read about feeding smaller dogs mentions they should be feed at a minimum twice a day. 

If you're in medical school, you may be familiar with the Merck Manual. There's a veterinary version and here's what it says about canine vomiting:

Merck Veterinary Manual





Joy


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## Hunter's Mom (Dec 8, 2008)

I might suggest, along with cutting his meal into 2 portions a few hours apart, to feed him sweet potato or turnip as your starch and a different protein such as pork. When our dog was sick we started doing this along with a veggies like peas and after few weeks of this we slowly starting adding some other foods in to gauge what he might be having a reaction to. Turns out he has issues with protein in some foods but not others and too much grain was bad for him. 

If you are thinking its neurological then I would highly suggest you take him to Cornell.


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## LOWBLiz (Jun 21, 2011)

that is interesting and i'll definitely propose it to the vet, Though you're right, you'd think the endoscopy wouldve revealed it. Right now we're doing the abx and continuing the steroids orally for this week to see if he improves...fingers crossed!


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## LOWBLiz (Jun 21, 2011)

We've tried feeding him 2x a day but he doesnt really like eating in the am and tends to just ignore it till our other dogs start eating at night - Between his walk and me leaving for school and all there's just too many other exciting things going on!

Because of the abx effects on his stomach we are actually feeding him 2 smaller meals a day right now. our other dogs think that he's getting sooooo much extra food and look very sad haha. I hope this new round of abx helps but again, not optimistic. We have seen two GI people and none suggested switching out the grains (just the proteins) so I will try turnips/potatoes something more varied to see if it helps. And while i'm sure he'd LOVE the turkey suggestion (his favorite food) he still throws up the turkey so I'm assuming its not a chicken specific issue (for the record, he has had issues on turkey, chicken, lamb, and duck. never tried exclusively beef but it doesn't seem that that's the source of the issue)

I also live in the city but my next stop is my boyfriends vet in brooklyn and then I'll try cornell. Our vets have been great with some difficult dogs (our Jack Russell had lupus) but they are just as stumped as we are by now.

Again, thank you all for the suggestions and I'll definitely try to implement some. It's horrible watching him go through this so randomly, and he's such a happy little nut when he's not throwing up (currently chasing a bug around my yard in the sun...i never said he was smart)!


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## aprilb (Jul 9, 2010)

I agree about feeding smaller meals twice a day. Also, ask your vet about giving Pepcid AC before bed time. Just a thought..


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## Deborah (Jan 8, 2006)

Rylee is free fed so she eats anytime she wants to. This works only if you have one dog. Rylee has been on Chicken Soup bites her entire life. I have never switched food on her. Sweet Potato and lamb are a pretty good combo. When I had Marshmallow she would throw up bile if her tummy was empty for too long. I also think you should get the smaller bites food. Just because he chews you do not know how much is chewed.
Pumpkin is excellent to help with upset tummies. NOT Pumpkin pie just plain pumpkin. I bought a can froze it in little dollops then wrapped each one. I give that to Rylee when her tummy seems to be upset. Hope some of this helps.


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## LOWBLiz (Jun 21, 2011)

We did try pepcid before bed, as well as with meals and it didnt do anything. i'm not fully convinced the issue is localized to his GI tract, even if thats where his symptoms are exhibiting. I can't free feed because we have 3 dogs, all on different foods, etc etc. Jack was on smaller pieces and would eat them very very quickly, the larger bites are actually good for him as they slow down his eating and he doesnt throw up solely from the rapid eating. Additionally, when he first started vomiting he was on the smaller pieces and the bits in the vomit were of similar size to the bits in it now.

I will definitely try the pumpkin, just in case it really is just a stomach issue. The oddest part is that he was on the same food his whole life (minus his puppy formula) and other than one or two issues with car sickness (which was resolved by buying him a sleepypod, which he now falls asleep in and is the most amazing invention for small dog travel, imo) never had any issues with vomiting or stomach sensitivity. The sudden onset of the whole thing makes me feel that its not just indigestion or eating habits.

Unfortunately after 10 days vomit free he had 2 severe episodes the last two days, one at 3am last night and another tonight. He will be at the vet tomorrow morning :/ Fingers are crossed


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## KAG (Jun 1, 2006)

Aww, so sorry you and your baby are going through this. Lots of prayers and good luck wishes are headed your way.
xoxoxoxoxoox


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## edelweiss (Apr 23, 2010)

The thing that has me most concerned is the defecation and urination along with the vomiting. To me that shows that something other than just a digestive, or allergic issue is going on here. It has become progressive since the vomiting started. Also, from what you stated it seems he knows it is coming & jumps off the bed---so it is more than simple regurgitation. Has your vet tried to explain that to you? 
As I understand you he is now getting 2 smaller meals & is still having episodes? The funny thing is that it doesn't affect his weight! Puzzling for sure!.


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## kathym (Aug 5, 2006)

I'm sorry you are going through this with your fluff. If it were me i would want a second opinion from another Vet...I live in the city if you would like another Vet mine has been on the best Vets list in NYC..


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## aprilb (Jul 9, 2010)

Oh my, this is a perplexing case. Have you ruled out a liver or kidney problem? I would definitely get a second opinion. If there are no issues with the liver or kidneys, I am beginning to wonder if the problem is neurological.(?) You poor thing. You must be so frustrated. I hope your baby gets better soon.


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## poochie2 (Jan 14, 2010)

I would have to agree that feeding once a day is not a good idea especially for a 7.5 pound maltese. Maybe u could break down the 1 cup thoughout the day. Try giving canned food in the morning if he refuses to eat kibble in the am.
Another sugestion which I highly reccommend and I do this myself is to give a a dog cookie/biscuit before bed so his tummy will not be empty.


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## edelweiss (Apr 23, 2010)

Do a search on this title:
Episodes of stumbling, vomiting, urination/defecation


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## LOWBLiz (Jun 21, 2011)

Thanks for all the good thoughts and ideas - we're still baffled. Spoke to the vet this am, he's going to check stool for giardiasis, which doesn't seem like it would fit as he has had no diarrhea throughout this experience.

We ruled out liver through a BAT last month and kidney through urine analysis at the same time. They did tests before and after eating too so I'm pretty sure the liver/kidney are functioning normally.

Edelweiss: Yes, he ALWAYS gets off the bed and circles around my room for a few seconds before throwing up. A few times he has gotten extremely upset, and claws at my face (this is a dog that always sleeps at the foot of my bed so him coming up by my head is abnormal) as if to wake me up like "mom im going to be sick now, get up!" The defecation and urination have become paired with the vomiting more recently but now they always happen paired. I'm still leaning toward neurological but the vets dont seem to agree with me, saying if it was the symptoms would be much more consistently timed and that the abnormal thickening in his duodenum wouldn't persist.

We have spoken to 2 GI specialists as well as our normal vet. They're all great vets but this is just too perplexing - We are going to get through this week with them and if they don't have any more answers my next stop is my boyfriends vet in brooklyn then I'm going to call cornell and ask their opinion. 

As for his feeding schedule, when Jack was a puppy we had multiple larger dogs that only got one meal and didnt want to feed the dogs at staggered times as the others would get upset. We spoke to our vet about this and he said that one meal a day is ok as long as he tolerated it and didn't loose weight or get sick. For 4 years he tolerated, and seemed to prefer, the one larger (albeit not huge) meal per day - when i moved i started feeding him 2x per day and he basically ignored the morning meal, lost some weight, and i went back to a larger night time meal. I don't like canned food as much, I've had many dogs that dont tolerate it, but i was advised to mix in some baby food, or fresh chicken which i keep around for him. He gets plenty of cookies (though now not as much as we wanted to rule out food allergies to them, now he gets pieces of chicken as "cookies") so his tummy is never really empty.

Again, the sudden onset after 4 years of problem free living is what scares me the most. luckily we've ruled out masses through the scoping and ultrasound but i'm going to start focusing on the neurological possibilities after this round of abx and steriods... fingers crossed and again, thank you so much for all the well wishes and ideas!


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## edelweiss (Apr 23, 2010)

edelweiss said:


> Do a search on this title:
> Episodes of stumbling, vomiting, urination/defecation


Sorry this wasn't clear---I meant here on the SM site.


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## bellaratamaltese (May 24, 2006)

I can certainly appreciate how many diagnostics you've done (and how much you've probably spent!) and I sure wish you can get some answers soon.


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## silverhaven (Sep 6, 2009)

So sorry to hear of all the problems, sounds awful. I know Lola can sometimes throw up undigested food too. This sounds more serious though. I am also wondering quantity. Have you tried feeding less? Of only kibble Lola only eats about a 1/4 to 1/3 cup a day........ and she is 8 1/2 lbs. and not skinny. Homecooked about 3 oz for dinner plus about 1/8 cup kibble for bfst. I am wondering if that is just too much food to handle.


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## mss (Mar 1, 2006)

Did they do the blood test specific for pancreatitis? X-ray or ultrasound for gall bladder problem? (I've had experience with those in my little pack over the years)

In case it might be either of those, I might suggest a very low fat food for a while. My current schnauzer is on a Royal Canin prescription low fat formula. There are some other prescription "weight diet" foods that are very low fat. Or you could try a low fat home-made menu.

I might also suggest feeding him his food wet--soak the kibble well with water until it is very mushy. Or instead of rice, use rice baby cereal. It mixes up quickly with hot tap water.

A friend who's a RN, and also had a little dog with pancreatitis, recommended the rice baby food with some scrambled or very finely chopped boiled egg. 

Brainstorming other possible causes--have you used any different chemicals in your home--floor cleaning products, carpet cleaner, air freshener, bug spray, different flea control products on/in your dog, different shampoo or conditioners, dog toothpaste? Any signs of a spider or bug bite or bee sting?

Vertigo from ear infections?

Fear reaction to something happening late at night?


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## mss (Mar 1, 2006)

Also, I think that the intense retching and vomiting might actually be able to cause the defecation/urination, just from the muscular contractions. One of my dogs once coughed very hard and lost everything else ... on the bed. And then there's my carsick schnauzer who does that....

I hope you and your vets find a course of treatment and diet that help your dog! {{{{}}}}


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## Deborah (Jan 8, 2006)

I hope you find an answer soon.


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## Barb and the boys (Oct 26, 2007)

Is there something in the new house that is new. Is the carpet new or recently cleaned? Maybe something is leaching out of the floor, carpet or paint that is giving a reaction that hasn't been there before.......

Keeping you in our prayers to get better soon.


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## Maidto2Maltese (Oct 19, 2004)

Praying for your little guy and that they can come to a conclusion as to what is causing it. I assume full blood panels have been done?


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## LOWBLiz (Jun 21, 2011)

Thanks for all the feedback! We have nothing new in my/my parents house that I can ID - maybe just the pin in my broken ankle but i surely hope he's not allergic to that  we've done all the blood panels/xrays and those were all normal. He does love baby food (we often use it as a mix for pills since it keeps longer than cheese) so i will definitely try mixing that in. As for the soaking the food, he just doesnt like wet food in general - i think he's very into that satisfying crunch from kibble haha (but the wet food he basically licks for a few minutes before looking at me like an orphan or something asking for more)

So far nothing new - no vomiting since tuesday though he was a little lethargic today. Am attributing this to the new abx and hopefully he'll snap out of it...

Fingers crossed and thanks for the love and support - L+jack


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## vjw (Dec 20, 2006)

Make sure the baby food you are feeding doesn't have onion powder in it (See number four on slide show):


Dangerous Foods That Dogs Should Never Eat - WebMD Slideshow



Joy


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## uniquelovdolce (Mar 10, 2010)

wow , im just praying ur little guy gets better soon !


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## mss (Mar 1, 2006)

Just to clarify, the test for pancreatitis that I was thinking of is not on my vet's usual blood panels. It's a test they ordered separately. I think it's the Spec-CPL -- but I'm sure your specialists know about it. 

http://idexx.com/pubwebresources/pd...ratories/testmenu/cpl-fpl-research-update.pdf

We will keep hoping and praying for the best for your little pal! {{{{}}}}


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