Chronic inexplicable diarreah (with blood) and vomiting
 

I know this is going to sound like just another post about another sick yorkie. After 10 years of dealing with this problem, I think I can safely say this is out-of-the-ordinary. I'm finally going to make a stand and figure out what is wrong with my little guy.

Some background: 10 years ago, I picked up Armaneo from what--in retrospect--was probably a puppy-mill in Southern Illinois (not sure). Not long thereafter, I learned he had a congenital defect (Legg Perthes), which required major surgery. He got the surgery and, though there were complications with the operation, he is doing well now.

He's also otherwise in pretty decent health. I brush his teeth every night and he is up to date on his shots and flea medication in the warmer months. He goes outside at least three times a day on a harness leash in a very clean neighborhood environment in Chicago. His feet are wiped with baby-wipes every time he comes back into the house.

The only issue that I deal with on a daily basis is his gastro-intestinal issues. He has an remarkably sensitive stomach. Early in his years, he rejected lots of food. After experimenting with countless brands and formulations, he finally settled on California Naturals (lamb) and 100% real lamb jerky treats. If he eats anything else, he has diarrhea or vomiting. He gets no other treats, no human food, no nothing. I actually feel so sorry for him that he never gets to enjoy anything else.

The slightest stimuli will make his stomach upset. If there is thunder, the next day he has diarrhea. If he is left alone for more than 5 hours, he gets diarrhea. If he eats anything that is not his food, he has diarrhea. And, this is the worst part: sometimes, he just gets sick for no reason.

Each time he has diarrhea, it is very soft, pudding like consistency with blood (mostly dark, with some medium colored blood, as well). Usually, it lasts for 2 days.

2 weeks ago, we left him with neighbors for 4 days and when we got back, he was sick. He's been having diarrhea and vomiting (on and off) now for ten days. I've been feeding him only pedialyte and pumpkin paste lately, but he's still sick. 1 or 2 days during the last 10 days, he seemed fine, and had a normal bm, but he's still definitely sick.

These types of episodes have happened in the past several times, almost always coinciding with cold weather. When I take him to the vet, they ask me to bring in a stool sample. They run some tests, sometimes take blood, and then they tell me nothing is wrong.

But, my intuition is telling me this is something worse than simple stomach upset. Is it possible he has a congenital defect that is affecting his stomach and intestines? Is it possible that he has stomach cancer? Am I doing something wrong? Is there something I should be aware of? Tests I can run?

What could be causing such persistent issues? I really need help getting to the bottom of this. I can't see him suffering like this anymore, especially in his older years.

If your vet does not know what this is, perhaps you need to do a consult with a veterinary internal med specialist.

Have you tried another vet?

Intestinal issues helped by certain diets are not uncommon in yorkies. My first thought about the bloody stool after stressful events is colitis. It might be worth trying a small dose of Prozac. If it is happening or no reason now, you may need an internist. If all blod is normal, somebody will eventually want to biopsy. some general vets are comfortable doing this.

You could always continue to try and manage with food, but maybe switch to an rx diet.

Thank you both. I will set up an appointment with an internist asap.

Good advice I was thinking colitis too. I would also add probiotics to his food.

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I am the type that needs an answer to the problem...it has never done me any good at all, to be placed in a position where I can see abnormalities, blood from places where there should not be blood, etc, and be told "there is nothing wrong". THERE IS SOMETHING WRONG, YOU JUST HAVE NOT FOUND IT, DOC!!! So, I will work with my regular vet up to a point....if it ever reaches the point where I am seeing what I KNOW is NOT right, and my vet is not able to diagnose the problem, I head for specialists....I personally head for "my" vet school, A&M. I would recommend you do likewise. I know you are in great distress over your baby....and he isnt feeling on top of the world either....you need a specialist.

Thank you for your understanding. You know exactly how I'm feeling.

As for the colitis diagnosis, I think that's pretty darn spot-on. Just reading about it here on this forum seems to support that theory. For example, the post here (http://www.yorkietalk.com/forums/1021141-post8.html) identifies nearly all of the symptoms that my guy has. Would it be irresponsible of me to get him on Tylan even before I can schedule the specialist?

If he's ten years old, I think you need to schedule an appointment first, he's gone far too long with this problem.

Nope. Not irresponsible at all! As long as the vet okays it, it is fine.

My yorkie has similar issues. No blood in stool, but it used to get gray/green liquidy. She was very sick with it. I did ot go to an IMS bc we had been therenot long gefore for a liver issue, the only thing left to do was biopsy and my vet is more than capable of doing that, and I didn't feel like paying for an ultrasound bc they are of limited value for intestines.

My girl's trigger is just about every ingredient. She does well on hydrolyzed food. We were fairly certain it wasn't cancer bc the symptoms were present for awhile. Her protein levels were normal. bloodwork did indicate SIBO. Tylan did nothing for her. Metro only worked at first. By the time I started justifying a biopsy we found a food that works.

Diarrhea is definitely not normal. Sometimes no cause will be found though. IBD...

BTW - the vet has done Spec cPL, TLI, folate/cobolamin, and all that good stuff, right?
Ultrasound can't hurt. It just may not help.

This doesn't sound like colitis if there's DARK blood in his stool. Colitis is inflammation of the colon & will only produce red blood @ the end of the stool. It's also very easily managed w/diet & keeping a stress free environment (no household cleaners, insecticides, etc.) If there's any sign of dark blood, it originates from the stomach...please see an internist for this condition.

Hm. Interesting. Well, all this talk got me acting, and I'm taking him to an internist at 2:00 PM CST today at the University of Illinois College of Veterinary Medicine.

Hope you'll find answers & a diagnosis.

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YA-BA, DA-BA, DOOOOO!!!! Be sure and let us know what is said and done!!!

I'm so sorry your little one is going thru this...SO HAPPY you got that appt today. Will check back for an update later

I wanted to provide a quick update on little guy's status.
I took him in to an internal medicine specialist, Mimi Noonan (Our Doctors - Veterinary Specialty Center). She listened intently to my story and told me she thinks it's one of three things:

Addison's disease. An issue with the adrenal gland that prevents the body from mounting an appropriate response to stresses. If there are stresses (e.g., thunder) the body is not able to cope with the stress, and physiological issues arise, often as diarrhea and/or vomiting. Treatment is extremely simple and requires a daily oral medicine.

Colitis. If I’m not mistaken, I believe the doctor said that this is also a physiological issue that manifests itself in the gastrointestinal tract. In other words, it is not a failure of the gastrointestinal tract itself, but something about body chemistry that is causing the issue.

Other gastrointestinal issue. Basically, there could be an issue in the gut itself that is creating the problems. There could be a wide range of issues that are causing the diarrhea and vomiting.

In order to test for Addisons, they needed to draw blood. They did so, and I just received a call as I was typing this. He does not have Addisons.

To test for colitis and other GI issues, they need to perform an ultrasound, and, as the doctor stated, almost always follow up with an endoscopy and biopsy under general anesthesia. I just finished scheduling him for the ultrasound, endoscopy, and biopsy for this Friday.

I’m very concerned about putting him under because he has extremely adverse reactions to anesthesia. (Almost died one time, and needed to be pumped with atropine.) But, the doctor assured me that they have two of the best anesthesiologists on staff.

I’ll report back with updates after Friday.

just reading... I hope all goes well on Friday and sending positive thoughts~~~

Will keep Armaneo and you in my thoughts and prayers. Looks like you found a great place for him!
Will be looking for your update on Friday! :)

Has anyone had their little one in for an endoscopy and gastrointestinal biopsy? Is it invasive? Did it cause lasting pain or discomfort? I just want to set my expectations correctly before going in tomorrow. These things always make me very nervous.

Oh, I dearly hope and pray that you get some kind of definitive diagnosis soon, so that your little one can start feeling better:hands: :love:

My Cookie had both done just before Christmas last year and she had no ill effects whatsoever! :) Not invasive at all with the scope.

OK. Big relief. Thank you.

You will feel better once it is all over...it really is so stressful taking them in for things like this.

My Gracie had a blockage. She is small and an example of puppy mill bad breeding so has many issues. She did really well with the surgery. I know it is very scary to have our babies go under anesthesia, have tests run and surgery. But we can't let them suffer can we, if the problem is fixable. Prayers for you and your baby. I will check for up dates.

I know I'm a bit late with this, sorry just seeing it. I totally agree with you. My baby just got diagnosed with colitis, as soon as I showed my vet a pic of a pool of bright red blood he was convinced it was colitis ( I had thought it was pancreatitis). Tests found that it was in fact colitis. So in summation OP, colitis will only be BRIGHT red, fresh blood.

OP- I'm right there with your pup- mine is 9 years old and has had chronic diarrhea/vomiting but only for the past several months. I really hope you are available to figure this out soon! I know it's tough to see them like that!

Hope the apptmt went well please keep us posted. Wishing your baby a speedy and informative recovery!

Please don't be worried. Nicky just had an ultrasound and endoscopy last week (with Barium?) to test for colitis. He was sick for days before the tests and literally came home afterwards almost completely back to his old, happy self. They put him under GA as well. I will pray for you guys! hope you get some answers soon and that he makes a full and permanent recovery! Please keep us posted.

Just as a quick update: My little guy went to the hospital at 8 AM this morning. They conducted an ultrasound and, though they found a little swelling in his spleen, they determined that the ultrasound was inconclusive.

They were supposed to move right into the endoscopy, but I guess he fell through the cracks. I called at 3, and they said they would have to call me back. At 3:15 they told me they were just getting started on the procedure and that he would not be done until about 6.

I'm a little ticked because they said he would be done by 3. It almost seems like they forgot about him. I feel terrible that he had to sit in a cage for 7 hours today, especially in light of his separation anxiety.

Will update later.

Sometimes these things happen. I am so sorry it happened ... it is very frustrating because we don't like to see them sit; but he will be fine and SO happy to see you when it is over.

Armaneo is safe and sound.

He went in for the procedure on Friday. He was attended by fantastic doctors that really knew what they were doing. He was sedated while the doctor took an ultrasound and several x-rays. In addition to the blood work that was done two days prior, none of these procedures revealed the ailment.

At that point, the doctors put Armaneo under general anesthesia and performed an endoscopy. His lower bowels were fine. His ileum (lower small intestines), however, were inflamed and raw--out of the ordinary. They took two biopsies from two different locations and sent them to the lab to be tested for a host of other ailments.

When we picked him up, he was a little disoriented, but doing well. He had very bad diarhea that night, but he is now having solid waste. He is on prednisone and metronidazole, a bland diet, and metamucil. We'll have the results from the biopsies by mid-week.

Thanks for the support, everyone.