# Cashmere's tummy problems - advice on diagnosis?



## kilodzul (Oct 7, 2013)

Hello dear SM friends! I need your advice on how to diagnose the root of Cashmere's gastrological problems.

She's been having gag reflex after eating something for the last 2 months. No vomiting, just gagging. It's always directly after eating and drinking, but sometimes it also lasts for few hours afterwards. Her tummy is often tense, and she eats a lot of grass. Last Thursday she scared me to death, because I thought she was having neurogical attack - she started to walk stiffly, with her back haunched, and she was twisting her head to the sides, shivering. After seeing video of this behaviour, the Vet was convinced that it was only the attack of acute stomach ache. 

We did blood tests, but her ALT, AST, Urea, Creatinine etc are all within normal range. There are no parasites in her stool. USG of abdominal cavity didn't show any pathological changes (except by accident we found out she had bladder infection and we found crystals in her urine - which we're treating now).

The next tests Vets are proposing are RTG and gastroscopy, but it needs to be done on general anesthesia, and I'm really afraid of doing it.

Right now (since the attack on Thursday) we're treating her symptoms with controling acitity of stomach acid, and with linseed and probiotics (I can't really experiment with her diet right now, since she has to be on kibble to dissolve cristals in her urine. It seems to lesser the symptoms, her abdomen is less tense and the weird attack didn't happen again, but we still need diagnosis.

Other than gag reflex, she's acting totally fine, is full of energy, has good appetite, normal stools etc

I know many of you have dealt with tummy problems of your pups, maybe you can share what other tests can be run, before we'll decide to do more invasive tests?


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## socalyte (Nov 15, 2010)

I can only tell you that Cozette has GI issues too, with GERD and IBS. The hunched over position is a classic pain pose. It sounds like you're going down the right road with the antacid treatment. Perhaps there is a motility issue as well. Perhaps working on sympomatic treatment first will help you avoid the anesthesia required for the testing. Cozette is on Pepcid and Reglan, which have been just short if miraculous for her. Good luck...I really feel for you and your precious furbaby.


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## pippersmom (May 21, 2012)

Just want to say I'm sorry Cashmere isn't feeling well and I hope you find the problem soon and it's an easy fix.


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## mdbflorida (Feb 28, 2013)

I have to give anti acid to Zach and it works. Wheatens are prone to what we call the gulpies. You might want to try a dog food for sensitive tummies with limited ingredients too. 

Any chance Cashmere is eating and drinking too fast? I would also switch to a water bottle instead of a bowl.


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## sherry (Jan 4, 2013)

I have no advice to give on this topic but am really sorry Cashmere is having these problems. Sounds like you have a good vet.


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## Chardy (Oct 30, 2008)

The tests that I would have done would be an ATCH stim test to rule out that there isn't any pancreatitis going on. Standard Chem Profile won't pick it up. It also could be inflammation due to allergy in the diet. A suggestion would be to feed a single protein (low fat) and a single carb that maybe Cashmere has never had before. For example, bison and quinoa or white fish and sweet pot. As a rule it takes many weeks for the inflammation to resolve on it's own, usually the routine is a steroid if they suspect IBD but it has to be confirmed from a endoscopy. My Chardy had IBD and I was able to get her off of steroids after diagnosis with a home cooked diet but the type of IBD she had was mild. Her symptoms were hunched back, acid reflux, loud stomach noises. She did not have vomiting or diarrhea as a rule. Hope this helps.


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## maggieh (Dec 16, 2007)

It certainly sounds like an IBD/IBS issue, although mild pancreatitis might also be a problem here. Antacids and probiotics are great for all of this; instead of a "medical" antacid Tessa gets ginger-mint tonic which does the same thing without the risk of side effects. 

I know you are on the prescription diet, but my Sweetness had both types of crystals and has been "crystal free" since switching to a grain-free food with moderate protein (19 - 21%), slightly higher in fat and, since it's a dehydrated raw, reconstituting it with 2x water to 1x food. Actually, it's the water that is the most important thing as our little ones often don't get enough to keep the urinary tract bacteria from building up and causing UTIs or crystals. And, since the proteins are kangaroo, brushtail and venison, the novel protein keeps Tessa's tummy problems in check so they can both eat the same thing.


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## wkomorow (Aug 26, 2011)

So sorry Cashmere is having GI issues. It is a common problem. As Maggie mentioned, make sure it is not pancreatic. inflamation. I think there is a simple blood test to rule pancreatitis in and out.


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## Fee (Oct 26, 2013)

Julia, I am so sorry poor Cashmere is going through this. I have been through h... and back the last month with Boycie. First anal sack and eye problems then babesia and then tummy trouble (recurring). 

I have done several tests but at the end of the day he got anti vomiting and anti-diarrhea injections and was put on a diet. After a few days, it cleared up. I made him extra watery rice and chicken, almost like soup! I am sorry I can't be of more help, hope everything will be fine soon, keep us posted! :heart:


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## jmm (Nov 23, 2004)

Incorrect information in the post I'm quoting:
An ACTH Stim tests for adrenal function - Addison's disease in particular. 
Pancreatitis is diagnosed with a cPLI test.

My suggestion:
I would be pursuing an endoscopy with biopsies and maybe a barium swallow or fluoroscopy to address the swallowing issues. 




Chardy said:


> The tests that I would have done would be an ATCH stim test to rule out that there isn't any pancreatitis going on. Standard Chem Profile won't pick it up. It also could be inflammation due to allergy in the diet. A suggestion would be to feed a single protein (low fat) and a single carb that maybe Cashmere has never had before. For example, bison and quinoa or white fish and sweet pot. As a rule it takes many weeks for the inflammation to resolve on it's own, usually the routine is a steroid if they suspect IBD but it has to be confirmed from a endoscopy. My Chardy had IBD and I was able to get her off of steroids after diagnosis with a home cooked diet but the type of IBD she had was mild. Her symptoms were hunched back, acid reflux, loud stomach noises. She did not have vomiting or diarrhea as a rule. Hope this helps.


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## Chardy (Oct 30, 2008)

jmm said:


> Incorrect information in the post I'm quoting:
> An ACTH Stim tests for adrenal function - Addison's disease in particular.
> Pancreatitis is diagnosed with a cPLI test.
> 
> ...


Brain **** Spec Cpl !!!! Thank you!!! Too much on my mind!!!!


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## Robynn (Mar 1, 2014)

I had trouble with my lil bit. She had grumbling tummy, diarrhea and mucus. They wanted to do endoscopy but we said no. She is only 4 pounds on a really good day. Now she's on answers goats milk twice a day and royal canin an allergic and is the healthiest she's ever been. She's like a new dog. Definitely give t a try. Good luck.


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## Matilda's mommy (Jun 1, 2005)

Julia your such a good mommy, I'll be praying for Cashmere, and I'll keep praying until she is better. Hugs to you:wub:


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## kilodzul (Oct 7, 2013)

Thank you for all words of support and for all pieces of advice. I knew I can count on you, so many great ideas!



socalyte said:


> I can only tell you that Cozette has GI issues too, with GERD and IBS. The hunched over position is a classic pain pose. It sounds like you're going down the right road with the antacid treatment. Perhaps there is a motility issue as well. Perhaps working on sympomatic treatment first will help you avoid the anesthesia required for the testing. Cozette is on Pepcid and Reglan, which have been just short if miraculous for her. Good luck...I really feel for you and your precious furbaby.


Thank you. This is kind of what Vet said - to first wait 2-3 weeks to see if the symptomatic treatment works and then think what to do next. I only wonder if those meds are ok to give for long period of time? Do you give something to protect Cozette's liver?



mdbflorida said:


> I have to give anti acid to Zach and it works. Wheatens are prone to what we call the gulpies. You might want to try a dog food for sensitive tummies with limited ingredients too.
> 
> Any chance Cashmere is eating and drinking too fast? I would also switch to a water bottle instead of a bowl.


I honestly don't think it matters what Cashmere eats at this point. I always feed her food with one meat protein source, without grains or poultry, but it's the action of eating that causes problems, not what she eats. And yes, she has tendency to eat very fast, and after each meal she has silliness attack, and starts to jump, run and do zoomies around the home. Which I also don't think is helping. I ordered the bowl to slow down her eating and I try to teach her to relax after eating.



Chardy said:


> It also could be inflammation due to allergy in the diet. A suggestion would be to feed a single protein (low fat) and a single carb that maybe Cashmere has never had before. For example, bison and quinoa or white fish and sweet pot. As a rule it takes many weeks for the inflammation to resolve on it's own, usually the routine is a steroid if they suspect IBD but it has to be confirmed from a endoscopy. My Chardy had IBD and I was able to get her off of steroids after diagnosis with a home cooked diet but the type of IBD she had was mild. Her symptoms were hunched back, acid reflux, loud stomach noises. She did not have vomiting or diarrhea as a rule. Hope this helps.


Yes, it's very helpful, thank you. She was on single carbon and protein diet, since she was 6 months old. Well I think I'll have to check her pancreas, although I think there's usually vomiting and diarrhea involved when there's issue with it? But it's also worth a try.



maggieh said:


> It certainly sounds like an IBD/IBS issue, although mild pancreatitis might also be a problem here. Antacids and probiotics are great for all of this; instead of a "medical" antacid Tessa gets ginger-mint tonic which does the same thing without the risk of side effects.
> 
> I know you are on the prescription diet, but my Sweetness had both types of crystals and has been "crystal free" since switching to a grain-free food with moderate protein (19 - 21%), slightly higher in fat and, since it's a dehydrated raw, reconstituting it with 2x water to 1x food. Actually, it's the water that is the most important thing as our little ones often don't get enough to keep the urinary tract bacteria from building up and causing UTIs or crystals. And, since the proteins are kangaroo, brushtail and venison, the novel protein keeps Tessa's tummy problems in check so they can both eat the same thing.


Thank you for the advice! I'll certeinly think about special diet in near future, but firstly I need to know what's wrong and how to adjust levels of protein, fat and carbon. I don't think that her crystals were caused by lack of water - for 6 months I was home-cooking for her, so it was wet, and she doesn't have problem with drinking. Of course, I can't be sure. I guess it's just something I'll have to watch out in the future.



Fee said:


> Julia, I am so sorry poor Cashmere is going through this. I have been through h... and back the last month with Boycie. First anal sack and eye problems then babesia and then tummy trouble (recurring).
> 
> I have done several tests but at the end of the day he got anti vomiting and anti-diarrhea injections and was put on a diet. After a few days, it cleared up. I made him extra watery rice and chicken, almost like soup! I am sorry I can't be of more help, hope everything will be fine soon, keep us posted! :heart:


Thank you, I know how you feel. The last 2 months has been harsh on my poor little girl too, for more reasons than just UTI and tummy problems. *sigh* I'll write the chronological order of events in next post. I hope Boycie will not trouble you more and stay healthy!



jmm said:


> Incorrect information in the post I'm quoting:
> An ACTH Stim tests for adrenal function - Addison's disease in particular.
> Pancreatitis is diagnosed with a cPLI test.
> 
> ...


Thank you, I'll do cPLI test. And I'll think about endoscopy... just need to do more research on aneasthesia, to feel more sure about it. I'll also check what's barium swallow in Polish, to know what to ask Vets for.



Robynn said:


> I had trouble with my lil bit. She had grumbling tummy, diarrhea and mucus. They wanted to do endoscopy but we said no. She is only 4 pounds on a really good day. Now she's on answers goats milk twice a day and royal canin an allergic and is the healthiest she's ever been. She's like a new dog. Definitely give t a try. Good luck.


Thank you. My Cashmere is 7,5 lbs, so she's not that tiny... I understand why you wanted to avoid endoscopy. I don't like Royal Canin, because it makes Cashmere scratch herself, also it's mostly corn, and they don't say how many % of meat is in it... in this price you can find much better dog food. But, of course, if it works for you, then stay with it.


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## kilodzul (Oct 7, 2013)

I also wanted to add timeline because maybe I missed something... I also forgot to tell that one of Vet's theory is that Cashmere problems are related to incident with ingesting causting soda. Ok so chronological order of events that may be or may not be related to current situation:
11.03.2014 - Cashmere drinks water with caustic soda in it. I posted about it here - http://spoiledmaltese.com/forum/52-maltese-health-behavior/195346-keep-cashmere-your-thoughts-i-did-horrible-mistake-im-afraid-vet-did-too.html After this, her ALT was slightly elavated (81 was the highest), then it went back to normal.
Since then, I also started to homecook for her.
June - Cashmere lost weight without reason. ( http://spoiledmaltese.com/forum/52-maltese-health-behavior/202818-cause-weight-loss.html ) After meeting with dietician, and changing a bit her diet, and adding exercize, her weight got up to 7.5 lbs (from 6.5).
10.08.2014 - I suspected that Cashmere might have eaten her bow. I've never found it, later dismissed it after she didn't have digestive problems during following week.
20.08.2014 - Cashmere went into heat, which always lowers her immune system.
01.09.2014 - first digestive problems, whole night and day of vomiting. Cashmere gets antibiotics, anti vomiting meds, everything get back to normal.
In September, I also stop home cooking and switch her to kibble. It's also in September that she starts to have gag reflex, although it wasn't that bad at first.
17.09.2014 - Cashmere has ear infection, gets antibiotics for the second time in one month
Beginning of November - she starts to show signs of pain, I start diagnosing things seriously, we find bladder infection, another round of antibiotics, and now symptomatic treatment for tummy problems.

So... does it give you any new ideas?


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## shellbeme (Mar 1, 2011)

I know you can't change her diet right now, I just wanted to let you know, I also know how frustrating it is. Rocky kept getting sick off and on and then had that horrible episode that had us in and out of the vets for over a week. He is only able to do well on a limited diet. Dh does not want him on home cooking-we've faught enough over that.

At first he was on Royal Canin-not a company I like but he did well on it. He is currently on Natural Balance-a company I also do not like after they were bought out by Del Monte-however, when your dog is not well you learn to deal with things you don't like. 

He does even better on the NB, it is the first diet he has been on where his poops weren't mushy at all.

Good luck in finding out what was wrong. We opted not to do the biopsy either at this point but agreed with our vet that if Rocky has another episode down the line, then we will go in for a biopsy to pinpoint exactly which flavor of IBS it is.


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## jmm (Nov 23, 2004)

Have you tried something simple like chicken and rice with a Probiotic (I like Proviable DC or Fortiflora)? Perhaps the issue is the antibiotics.


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