Dog still vomiting on elimination diet?

[CarinaMarina]

My border terrier is 12 months old. 4 weeks ago, he was vomiting badly and was unwell - he eventually threw up what looked like little beads of clotted blood the size of sesame seeds. Vet found he had lost 0.4kg since his last check up (he was 7.2kg in November and had dropped to 6.8kg), diagnosed a possible food intolerance or IBD, and put him on a 6 week elimination diet. I was weaning him onto Hills ZD when I let him have some roast chicken (because I'm an idiot and assumed chicken would be fine), and that made him very ill - he spent a night in the hospital on fluids. He recovered but hated the Hills, so I tried to transition him to Royal Canin Hypoallergenic, but that gave him terrible yellow diarrhoea and he dropped a little more weight.

He's been back on 4 meals a day of pure Hills ZD (dry mixed with wet) for 10 days, he's filled out a bit and stools are back to normal, but he's still vomiting and shows signs of cramping (praying/posturing after a gurgly stomach) - he repeatedly vomits up a large volume of food early evening, but is otherwise fine and seems to still want to eat. He is occasionally nauseous in the mornings and throws up froth.

Tonight he's just done it again - thrown up what he's eaten today, but seems hungry and otherwise well.

It can't be a food allergy if he's still vomiting on the hydrolysed diet can it? The vets have made noises about doing blood tests for vit B12 and folates to start the process of investigating inflammatory bowel disease, but they seem fairly casual about it and wanted to give him more time on the diet. He does 2 - 3 firm stools a day, no blood (and no blood in vomit since the first time).

I'm at a loss, they are reluctant to do more than blood tests and leave him eating hydrolysed protein, but he's vomiting every other day virtually?

Any experiences of IBD effecting the stomach rather than lower intestine?

[Leonberger]

Has he had any other diagnostics? X-ray or ultrasound?

I would push for a referral for a scan personally to rule out other causes. Ultrasound with a specialist would also confirm IBD as a diagnosis at which point you can at least be sure your on the right path.

Hope he feels better soon.

[CarinaMarina]

Hi, no nothing...he was absolutely fine up until 4 weeks ago so I guess we're only at early stages.

I just don't like the idea of him feeling rotten and sick constantly while seeing out the elimination diet, it's obviously not an allergy so I'd like to be doing more to find out what's happening and get him right sooner. He has excellent insurance, there's no reason he can't be referred.

Should I just ask for one, or let my vet go through the usual channels first?

[Leonberger]

Yes, you can ask for a referral or second opinion from another vet in your area if you wish.

Personally after 4 weeks I would want to start going down the route of xrays, bloods and scans to get to the root of the problem. I don’t think it’s fair to leave a young dog like this for any length of time, it’s certainly not normal even with IBS.
We use a referral level ultrasonographer who can usually pick up changes that would point to IBS, but it would depend on what sort of facilities your vet has to hand.

I think if the dog had improved significantly on a diet trial then great, but as he hasn’t I would be trying to get to the bottom of it ASAP.

[CarinaMarina]

Thank you. Yes he seems to improve for a day or two, then he's vomiting or got some pain again. It seems to effect his stomach more than the other end, but although he's generally pretty perky I hate seeing him feeling rubbish even if it's not for very long.

I've been feeding 4 or even 5 small meals a day, but it's as if they all just sit in his stomach during the day and he brings them up just after meal #3. And, incidentally, he will find somewhere outside to do it in private then he eats it again. I've busted him doing it twice, grim.

I don't think that's a symptom in itself though is it? Dogs are a bit gross and he obviously feels well enough to want to eat...maybe his stomach is irritated and he's just regurgitating.

[Leonberger]

Is he a scavenger? Worth getting him checked for a foreign body also. I’ve seen plenty of dogs with something random lodged in the stomach for a period of time. Usually they do become very unwell but I have seen a few that aren’t actually that I’ll, presumably because it’s more of a partial than a full blockage.

It could really be any number of things but I would push investigations. It’s probably that your vet has a plan in mind but I would consider stressing how unwell your dog is and that you want it dealt with now rather than over weeks.

Also remember, you are paying for a service and are free to go somewhere else if you want!

[whattodo2019]

i would seem a second opinion.
My JR terrier has always been sick. just before christmas o moved him to a raw diet and he has t been sick since. He has gained weight, his teeth are gleaming and his poos are tiny!!

[CarinaMarina]

Well, yes he sort of is - I've seen him pick up all sorts including stones, but he usually spits them out and he hadn't done it in the period leading up to this. And as you say I'd assume he'd be much sicker - but I didn't know it could be partial! Worth considering, it would explain a lot.

I think I will just push for more action a bit sooner. I last spoke to them on Friday morning about transitioning him to a single protein food a week early due to the shortage of canned hydrolysed food, and I said he'd been much improved in the previous 5 days - now he's going to make me look an idiot as he's vomited 6 times since then!

[Boppers4]

Hi, we went through something similar with our dog. He had no problems up to the age of 6 and then out of he blue horrific diarrhea and vomiting. First occasion put it down to eating something that didn't agree. Then it happened again 1 month later. Given 1 week of antibiotics. Then 4 weeks later same again. And again 4 weeks later.
After much googling I put it down to a bacterial overgrowth and persuaded vet he needed 1 month of antibiotics. He was then fine for about 15 months.
Then it started all over again at 1 month intervals. He would have horrible uncontrollable diarrhea along with vomiting until he had got ebery last trace of food out of his stomach. Each episode only lasts about 24 hours. Anyway, asked vet for 1 month of antibiotics but this time they had no effect.
I then cut out all treats ( absolutely everything) and put him on Royal Canin hypoallergic and within 24 hours, his poohs were very solid.
He has been on this diet for he last 10 months and he has been fine. Not had any antibiotics. I have started to give him the Fish4dogs fish skins as a treat and all ok so far.
The good thing about your dog is that because he is vomiting and diarrhea every day, you can easily monitor the effects of any treatment.
You could try Anallergenic Royal Canin instead. Even more expensive but that is made with hydrolysed feathers. Might be worth a try? If you don't see a change within a week to 10 days I would be insisting on antibiotics as a start.

[CarinaMarina]

That sounds pretty horrific @Boppers4. Your poor dog! Glad he's settled down now.

Mine has never had antibiotics, my vet has suspected IBD from day 1 - presumably because of the seed-type bits of blood (tissue?) he brought up at the beginning, combined with his weight loss. A puppy of his age should never be losing weight.

He's been on a 100% hypoallergenic diet - Hills ZD, dry kibble plus a bit of canned, which is all hydrolysed - for 4 weeks. Nothing else, no treats other than those I can bake from the Hills kibble (bizarre but if I blend the biscuits to a powder, add a pinch of parsley and some water, and bake into biscuit shapes, he loves it - rarely touches the kibble on its own though).

Yet he's still vomiting and lost more weight initially - I think it's levelled off now. The diarrhoea has stopped almost completely, he does the occasional soft yellow one in the evening but not often. He's still getting outrageous stomach noises, feeling nauseous and getting stomach pain.

I called the surgery today and they were very willing to get him in for blood tests and an ultrasound - the vet who has dealt with him the most is calling me tomorrow to discuss next steps.

He's booked for laparoscopic castration on 1st Feb (he has a retained testicle), but I'm tempted to cancel that until this has been sorted.

In the meantime, he's been OK today after being off colour first thing - no vomit for 24 hrs.

[Boppers4]

Just to note about the antibiotics.. they have a very good anti inflammatory effect. I think that is the way they have helped my dog and not for reducing the bacteria in his intestines.

[CarinaMarina]

I know my neighbours dog has colitis and takes antibiotics permanently. But we don't have a diagnosis yet, so I guess we'll see!