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Posted: 3/22/2015 1:34:48 PM EDT
[Last Edit: 4/2/2015 12:08:42 PM EDT by aa777888-2]
15 month old male Akita. Well exercised and entertained. He's always been a difficult eater (there's an archived thread in this forum somewhere). We've been through innumerable foods and jumped through many hoops of fire to make it palatable, adding beef, chicken, various broths, liver, you name it. Any normal dog would be wolfing down this stuff. Our other Akita certainly does. He grudgingly eats. Throughput was good with good stools.

Over the last week he's gone from difficult to impossible, and the last two days he's eaten almost nothing at all, just a few treats but even those in a disinterested way. He's always been skinny because of this and he's dropped an additional 4 lbs in this past week. His energy and attitude are obviously down. Stool output is near zero, of course.

No other signs or symptoms. He's always had an occasional cough, and once in a while vomited up a little something, but nothing regular and nothing specific to this past week.

We took him to the vet today. I was thinking worms even though he's on Heartguard. The vet suspected Addisons. However vital signs, blood, urine, stool and X-ray are all completely normal, although the vet said the urine was a little "concentrated". The vet brought out a combination of canned food and baby food he called "ambrosia for dogs". The vet was flabbergasted when he turned his nose up at it, especially after a two day fast. The vet literally said "I have no idea what is wrong with your dog." The X-rays are going out to radiology for an additional read and we have an appointment with a canine internist on Tuesday.

The vet prescribed 40mg Pepcid AC once a day and 120mg Cerenia once a day on speculation that it's some sort of stomach upset.

To say that I'm worried is beyond understatement. He is going to starve himself to death. Any ideas would be most appreciated.
Link Posted: 3/22/2015 4:04:04 PM EDT
It's hard to offer much advice/input without doing a physical on the dog but concentrated urine doesn't really concern me; especially if he isn't drinking alot (it should be concentrated). Bloodwork should reflect a sodium/potassium ratio that is abnormal in order for me to think addisons. Is he outdoors much? Is there anything he could have eaten on or around the property? Was his temp normal? I guess in this case where it is a young dog i would be taking abdominal radiographs to evaluate his internal organs, stomach, intestines, and to rule out the possibility of a foreign body. I know that none of this gives you an answer but if youre in an area where you have multiple options for veterinarians then i would consider a second opinion. It takes alot for a dog to starve "to death" but water intake and hydration are the most important thing. Keep us updated.

Cschelk2 DVM
Link Posted: 3/22/2015 6:03:40 PM EDT
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Originally Posted By cschelk2:
Bloodwork should reflect a sodium/potassium ratio that is abnormal in order for me to think addisons.
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Originally Posted By cschelk2:
Bloodwork should reflect a sodium/potassium ratio that is abnormal in order for me to think addisons.

Doc--thanks so much for your reply. Blood work was normal.

Is he outdoors much? Is there anything he could have eaten on or around the property?

All the time. We have 150 acres. He could have eaten anything, really.

Was his temp normal?

Yes, temp and other vitals were normal. Doc said "Wow, he's got an incredibly strong heart."

I guess in this case where it is a young dog i would be taking abdominal radiographs to evaluate his internal organs, stomach, intestines, and to rule out the possibility of a foreign body.

As noted above, they did the radiography and the vet read it as normal. However it is going out for a radiologist consult.

I know that none of this gives you an answer but if youre in an area where you have multiple options for veterinarians then i would consider a second opinion. It takes alot for a dog to starve "to death" but water intake and hydration are the most important thing. Keep us updated.

We are already set up to see an internist on Tuesday. We are all over the poor guy, encouraging drinking and eating. He did eat some bland, boiled chicken so far this afternoon. Maybe the problem will resolve spontaneously, but no way we're going to treat this lightly.

Thanks again, and I'll post an update when I have anything significant to report.

aa
Link Posted: 3/22/2015 8:11:51 PM EDT
[Last Edit: 3/22/2015 8:13:17 PM EDT by heron163]
teeth/gums OK?

a friends husky had a bad tooth - dog would not eat.

kind of dealing with the same thing right now but know it is the meds - cyclosporine - that is messing him up...

hope he gets well
Link Posted: 3/22/2015 8:53:19 PM EDT
Just sharing my experience for what its worth.

My Akita had food allergies and would hardly eat. Would sometimes vomit bile in the morning when his stomach was empty.

Had a scope put in his stomach and biopsies done. Steroids and special diet fixed him up. Took time though.

Good luck,

IR
Link Posted: 3/23/2015 10:39:17 AM EDT
Teeth and gums appear OK. Again, physical exam was unremarkable.

Irwin--that's interesting. Can you share any more details on how they figured that out? He doesn't have any allergic type responses to any food he's ever eaten.
Link Posted: 3/23/2015 10:48:50 AM EDT
My dog wouldn't eat. I guess she couldn't cause she swallowed a golf ball. Another reason to hate golfers. 870$ later she was good.
Link Posted: 3/23/2015 4:57:46 PM EDT
Update:

Gave Pepcid and Cerenity this AM, waited an hour, and he still wanted nothing to do with food. He'd salivate, but they told me that is a nausea reaction since he's not eating. He is hydrating, though.

Went for a follow-up visit. The radiological consult came back negative, with a recommendation to do ultrasound. The regular duty vet seems much smarter. Drew more blood for a baseline cortisol (Addison's disease) and cPL (pancreatitis). We are also going to try to collect more stool to rule out parasites but that's tough because he's not eating (idiots didn't process the sample from yesterday and lost it). Plan is to confirm or rule out those. If they rule out, then consider endoscopy to diagnose IBD.

Got home and he had about a cup of boiled chicken and drank some water. We can give Pepcid BID now, Cerenity still Qd.

Go back tomorrow for ultrasound and results of the cortisol and cPL labs.
Link Posted: 3/23/2015 8:49:41 PM EDT
Link Posted: 3/23/2015 9:01:09 PM EDT
Had a Boxer act like this until he pushed out the 3 socks he ate....

Hope your pup comes out OK.
Link Posted: 3/23/2015 9:09:45 PM EDT
Weim did this for a while. Still don't know if he had a grain allergy to his food - or if it was the plastic bag I found all twisted up in a big pile of poo in the back yard.


Hope your pup is ok.
Link Posted: 3/24/2015 6:47:24 PM EDT
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Originally Posted By aa777888-2:
Update:

Gave Pepcid and Cerenity this AM, waited an hour, and he still wanted nothing to do with food. He'd salivate, but they told me that is a nausea reaction since he's not eating. He is hydrating, though.

Went for a follow-up visit. The radiological consult came back negative, with a recommendation to do ultrasound. The regular duty vet seems much smarter. Drew more blood for a baseline cortisol (Addison's disease) and cPL (pancreatitis). We are also going to try to collect more stool to rule out parasites but that's tough because he's not eating (idiots didn't process the sample from yesterday and lost it). Plan is to confirm or rule out those. If they rule out, then consider endoscopy to diagnose IBD.

Got home and he had about a cup of boiled chicken and drank some water. We can give Pepcid BID now, Cerenity still Qd.

Go back tomorrow for ultrasound and results of the cortisol and cPL labs.
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Update #2:

All tests negative. Stool negative for Giardia. Still don't have the worm tests back. Ultrasound almost unremarkable. Here's the written narrative we got from the vet:

"There is a small lymph node near part of the pancreas that has a cystic appearance (irregular). This may actually be part of his pancreas as well and he may have some early pancreas inflammation. At this time I recommend treated Magnus supportively for early inflammation of his pancreas (low fat diet and anti-nausea medication), possible stomach ulcers (if he has chronic acid reflux, a stomach ulcer will make him suddenly feel much sicker), and the diarrhea. All of his signs may be related to mild inflammatory bowel disease. I would recommend biopsies of his stomach and intestines prior to treatment such as steroids."

So basically we don't have a definitive diagnosis and are just getting speculative treatment and hoping for the best, which sucks. They are shotgunning him with Omeprazole 40mg Qd, Sucralfate BID, Cerenia Qd, Metronidazole Q12h and start Mirtazapine Qd in two days. Low fat diet as above.

If we can get him eating and put 5 or 10lbs back on him I'll feel better and this will buy us time to obtain a definitive diagnosis.

And his belly itches him where they shaved it for the ultrasound
Link Posted: 3/24/2015 6:53:55 PM EDT
[Last Edit: 3/24/2015 6:59:36 PM EDT by squirrelslayer1]
Is he interested in raw red meat?

Throw a raw t-bone in front of him and see what he does.
Link Posted: 3/24/2015 7:20:14 PM EDT
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Originally Posted By squirrelslayer1:
Is he interested in raw red meat?

Throw a raw t-bone in front of him and see what he does.
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The answers are "no" and "does nothing". Right now the only thing he will eat is bland, boiled chicken and only late in the day after med's have been on board for a while. We'll see how he does with the new regimen.

None of my Akitas has ever liked raw, as strange as that may seem. And red meat, cooked or not, is now off the list because he's got to be on a low fat diet for the possible pancreatitis.
Link Posted: 3/26/2015 9:24:18 AM EDT
Update: he's still got no appetite so we have to pill him, and it's a lot of pills per day. In other words hiding pills in treats doesn't work. We are starting to have to chase him down for pilling as he's learning to hate it. We're keeping his physical activity low so he's not burning calories. Weight is holding at 95 down from 101 originally. That doesn't read badly in this post but you have to understand that 101 was very skinny to start with. Nausea and diarrhea seem to be resolving and his spirits are somewhat better. But he's still not eating except for a little bit, maybe a cup and a half in the evening and we've had to rotate food again as he's "done" with chicken. Today we start the Mirtazapine to increase his appetite. And we still don't know what's wrong with him.
Link Posted: 3/26/2015 12:54:01 PM EDT
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Originally Posted By aa777888-2:
Update: he's still got no appetite so we have to pill him, and it's a lot of pills per day. In other words hiding pills in treats doesn't work. We are starting to have to chase him down for pilling as he's learning to hate it. We're keeping his physical activity low so he's not burning calories. Weight is holding at 95 down from 101 originally. That doesn't read badly in this post but you have to understand that 101 was very skinny to start with. Nausea and diarrhea seem to be resolving and his spirits are somewhat better. But he's still not eating except for a little bit, maybe a cup and a half in the evening and we've had to rotate food again as he's "done" with chicken. Today we start the Mirtazapine to increase his appetite. And we still don't know what's wrong with him.
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I was just reading up on your post and was going to mention mirtazapine; i've seen it do some great things for canine appetite stimulation. I hate to say it but maybe (in regards to his physical health) nothing is wrong.
Link Posted: 3/27/2015 5:55:46 PM EDT
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Originally Posted By cschelk2:
I was just reading up on your post and was going to mention mirtazapine; i've seen it do some great things for canine appetite stimulation. I hate to say it but maybe (in regards to his physical health) nothing is wrong.
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Thanks for keeping up on this thread, Doc, much appreciated.

So would a dog just starve himself to death? For no reason? The Mirtazapine is helping, but he's still picky as hell. We know we're going to have to wean him off of the wonderful stuff, chicken, hamburger, treats, etc., back onto regular dog food, but at least he's starting to eat again.

I've never heard of a dog just not eating
Link Posted: 3/29/2015 3:09:16 PM EDT
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Originally Posted By aa777888-2:
Teeth and gums appear OK. Again, physical exam was unremarkable.

Irwin--that's interesting. Can you share any more details on how they figured that out? He doesn't have any allergic type responses to any food he's ever eaten.
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Really sorry I didn't reply sooner with you having a sick dog.

The choice to scope him and do biopsies was based on symptoms only. Would have to add different stuff to his food all the time to get him to eat. Venison would do it the best.

The vomiting on an empty stomach to the point of bloody foam from wrenching so hard.

Biopsies showed inflamed cells from contact allergy. No external response otherwise that would let you know what was going on.

Months of steroids and special diet fixed him up, venison and potato. At the time of the tests he was under 100 pounds and looked bad. Healthy 120 after about six months.

He lived to 12 1/2, I thought the massive amounts of steroids he was on for so long would have hurt him but it did not seem to.

Wish you the best of luck,

IR
Link Posted: 3/29/2015 3:17:29 PM EDT
no reason to make a dog eat dog food, that crap can kill them.

our golden only gets human food, or raw diet. no dog food
Link Posted: 3/29/2015 8:41:32 PM EDT
IR--thanks for the reply. No worries on being late and all that. Thankfully there's no evidence of an ulcer or allergy. However lately he has been rubbing his snout on the snow. But only the snow, so I'm thinking he just likes snow!

coldair--the pup won't eat raw, absolutely refuses it. Right now we've got him on a rotation of ground pork, beef, chicken, and turkey. He has eaten a little honest to goodness dog food today, which was somewhat miraculous, but it's still a major struggle to get calories in him.

Without the Mirtazapine I think we'd be in dire straights right now.

I've spoken to a number of people. Without a formal diagnosis the best guess is still pancreatitis. There was a slight abnormality of the pancreas on the ultrasound, but there are no other supporting signs and symptoms other than depression and lack of appetite. There appears to be no real treatment for this problem, although if anyone has any suggestions I'd be very interested.

Link Posted: 4/2/2015 12:08:07 PM EDT
UPDATE:

Liver panel negative. No changes over the past week. Put med's in him everyday, beg, plead and feed all kinds of stuff to get calories in him. He's barely touched any dog food. Mostly he eats cooked turkey or chicken. He's down another 1.5 lbs. All other signs remain negative, no vomiting, no diarrhea, etc. Just no appetite at all, and his spirits are down, of course.

More blood was drawn today for an absorption panel.

The vet is convinced it is IBD. She wants to do full-on surgery to explore his intestines and obtain biopsies from along it's length because he's too big for endoscopy to get far enough into his intestines and it's the only way to obtain a definitive diagnosis. They'll scope his esophagus and stomach at the same time.

This is major surgery with a hospital stay. We are currently gathering info to see if it's worth the definitive diagnosis or to just try him on steroids and see how it goes. Cost is not a factor in this decision, only the exposure to the risks of surgery.

If anyone has any guidance here it would be most appreciated.
Link Posted: 4/2/2015 3:01:10 PM EDT
IF it were me I'd try the meds (steroids) to treat IBS and see if they reduced symptoms without splitting my dog open. Cheap, relatively safe and possibly diagnostic.
Link Posted: 4/2/2015 3:51:08 PM EDT
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Originally Posted By aa777888-2:
UPDATE:

Liver panel negative. No changes over the past week. Put med's in him everyday, beg, plead and feed all kinds of stuff to get calories in him. He's barely touched any dog food. Mostly he eats cooked turkey or chicken. He's down another 1.5 lbs. All other signs remain negative, no vomiting, no diarrhea, etc. Just no appetite at all, and his spirits are down, of course.

More blood was drawn today for an absorption panel.

The vet is convinced it is IBD. She wants to do full-on surgery to explore his intestines and obtain biopsies from along it's length because he's too big for endoscopy to get far enough into his intestines and it's the only way to obtain a definitive diagnosis. They'll scope his esophagus and stomach at the same time.

This is major surgery with a hospital stay. We are currently gathering info to see if it's worth the definitive diagnosis or to just try him on steroids and see how it goes. Cost is not a factor in this decision, only the exposure to the risks of surgery.

If anyone has any guidance here it would be most appreciated.
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We don't do alot of scopes and or instestinal biopsies on younger dogs; in fact we rarely do just because its more often times IBD. True you can't diagnose IBD without those tests and in an older dog we get more concerned about intestinal neoplasia (cancer) but at this point you do have those two choices. While you've spend a small fortune already i would still consider trying steroids and dietary adjustment (when he is eating better). Hopefully they continue his cimetidine medications with the sterioids. Personally i 'd go that route but even i wouldn't spend the amount of money you have on your put (dont get me wrong, i love my dog); i just couldn't do it.
Link Posted: 4/2/2015 4:12:53 PM EDT
My GSD's pancreas wasn't working right. He would eat and still lose weight but sometime not eat and vomit for no obvious reason. He had diarrhea a lot. The first poop sample confirmed exactly what is was (can't remember the name) and he was on the pig pancreas powder mixed with his food for the last few years. He gained all the weight back too. I know apples to oranges but some of the symptoms seem the same.

Hope you figure it out.
Link Posted: 4/2/2015 4:29:57 PM EDT
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Originally Posted By cschelk2:
We don't do alot of scopes and or instestinal biopsies on younger dogs; in fact we rarely do just because its more often times IBD. True you can't diagnose IBD without those tests and in an older dog we get more concerned about intestinal neoplasia (cancer) but at this point you do have those two choices. While you've spend a small fortune already i would still consider trying steroids and dietary adjustment (when he is eating better). Hopefully they continue his cimetidine medications with the sterioids. Personally i 'd go that route but even i wouldn't spend the amount of money you have on your put (dont get me wrong, i love my dog); i just couldn't do it.
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The primary concern is that we have to know what kind of IBD it is to treat it correctly. An additional concern is that we don't get it right, wean him off the steroids to do the biopsy anyway, and then try to put him back on steroids the steroids won't work the second time around.
Link Posted: 4/2/2015 4:30:54 PM EDT
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Originally Posted By NRA2:
My GSD's pancreas wasn't working right. He would eat and still lose weight but sometime not eat and vomit for no obvious reason. He had diarrhea a lot. The first poop sample confirmed exactly what is was (can't remember the name) and he was on the pig pancreas powder mixed with his food for the last few years. He gained all the weight back too. I know apples to oranges but some of the symptoms seem the same.

Hope you figure it out.
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We've ruled out what your pup has, which is called EPI. Glad to read that your pup is doing well.
Link Posted: 4/6/2015 4:31:35 PM EDT
Absorption panel was negative. We went and got a second opinion. Doc #2 is going to do a post meal bile acid test. We are expecting that to be normal. We are not going to go forward with the surgical biopsy yet. Next steps are going to get him off of the med's and reassess. It could be behavioral. Doc #2 is basically of the opinion that's he's too healthy to have something really wrong with him.
Link Posted: 4/11/2015 10:58:14 AM EDT
So now he's off all of the med's except the Mirtazapine, he's allowed as much activity as he wants, and he's allowed only real dog food and only if he starts eating right away, i.e. old school, although not fully scheduled since we offer food fairly often. Over the last 4 days he's averaged 2.75 cups/day, which is about a cup less than he should be eating and he's lost another pound. We are hoping his consumption rate picks up.
Link Posted: 4/11/2015 11:07:57 AM EDT
keep us posted - hope it works out
Link Posted: 4/13/2015 8:13:17 PM EDT
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Originally Posted By aa777888-2:




So would a dog just starve himself to death? For no reason? The Mirtazapine is helping, but he's still picky as hell. We know we're going to have to wean him off of the wonderful stuff, chicken, hamburger, treats, etc., back onto regular dog food, but at least he's starting to eat again.

I've never heard of a dog just not eating
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Originally Posted By aa777888-2:
Originally Posted By cschelk2:
I was just reading up on your post and was going to mention mirtazapine; i've seen it do some great things for canine appetite stimulation. I hate to say it but maybe (in regards to his physical health) nothing is wrong.




So would a dog just starve himself to death? For no reason? The Mirtazapine is helping, but he's still picky as hell. We know we're going to have to wean him off of the wonderful stuff, chicken, hamburger, treats, etc., back onto regular dog food, but at least he's starting to eat again.

I've never heard of a dog just not eating


In my opinion here - Your dog is training YOU. (and that can be very normal for a smart dog)

Mine will often hold out for days when kibble is the ONLY food offered. Yesterday they both survived on a half of a peanut butter and butter sandwich each and refused the kibble entirely. Bitches 'thought' they could play me for something better and they lost that game...

If I have not mentioned it before: Your and my idea (or the 'book' number) of 'optimum' weight for a particular breed of dog is really just a ballpark figure and not something that is set in stone. Different dogs will have different metabolisms and different needs. Example: 65lbs is 'book average' for what I have breed and gender wise. One girl stays a steady 5lbs or so over this number while her sister stays a steady 10lbs under while both are fed the same exact diet and get about the same level of activity each day. Efforts to fatten the smaller girl up by feeding her more resulted in more poop and very little weight gain...

I am thinking along the same line as the vet above...

Wishing you the best of luck with all of your dogs and your training work. Always appreciate your advice and wisdom here.
Link Posted: 4/14/2015 10:11:12 AM EDT
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Originally Posted By Ar-15TechGuy:
In my opinion here - Your dog is training YOU. (and that can be very normal for a smart dog)
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Originally Posted By Ar-15TechGuy:
In my opinion here - Your dog is training YOU. (and that can be very normal for a smart dog)

Yeah, well he scared me to death there for a while! And he lost 7 lbs doing it. And he was skinny to start with, now he's even skinnier.

It's still early in this "game", it's only been a week, but he's eating the ONE and ONLY food we offer him, albeit not really on a schedule. And he is still completely indifferent to food and treats. The last couple of days have been better, though, he's eaten 4 cups each day. Holding steady in the 95lb range, down from 101 when this all started.

Wishing you the best of luck with all of your dogs and your training work. Always appreciate your advice and wisdom here.

Thanks!
Link Posted: 4/19/2015 8:09:16 PM EDT
[Last Edit: 4/20/2015 1:12:11 PM EDT by aa777888-2]
So far, so good. His consumption rate has ramped up and for the last 3 days he's averaged 5 cups/day, feeding the Royal Canin dog food. Yesterday was his last day of Mirtazapine. Now we'll see how it goes for the next few days without the appetite stimulant.

We're not even using treats for training. It's tough!
Link Posted: 4/21/2015 2:43:16 PM EDT
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Originally Posted By aa777888-2:
So far, so good. His consumption rate has ramped up and for the last 3 days he's averaged 5 cups/day, feeding the Royal Canin dog food. Yesterday was his last day of Mirtazapine. Now we'll see how it goes for the next few days without the appetite stimulant.

We're not even using treats for training. It's tough!
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Good to hear!
Link Posted: 4/29/2015 2:22:42 PM EDT
Final update on this: looks like we are in good shape. We've essentially trained him to eat what we want and a good amount, although it's still pretty much on his schedule. And we don't get to give him hardly any treats or use them for training. All that's left to do now is to move him back to one of the foods we prefer.

It's really weird, though. In order to get him to eat a decent amount we have to put a lot in the bowl. He will almost always leave exactly half, like he's saving it for something. So every time we offer him food it's 4 cups, of which he'll normally eat 2, and he tends to eat early afternoon, early evening and then after last outs. Crazy! But it's working.
Link Posted: 4/29/2015 5:55:36 PM EDT
Glad to hear it. When clients ask "why does my pet do xyz" I often jokingly reply "because they're animals, it's why we rule the world!"
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