Tootsie unable to keep water down...
 

I have been meaning to post about my sweet foster, Tootsie, to see if anyone had any ideas other than what I was thinking....just never got around to it.

I took her to the specialist today for testing and am now sharing this because it is extremely rare and we never know who might come along with a similar condition.

Tootsie has been regurgitating water (not vomiting...it just comes up with no gagging or retching). She is able to keep food down. I had noticed that she was drinking a lot of water when she did drink but only a small amount was coming up. My vet had done x-rays and sent them to the specialist who then suggested Tootsie have a barium swallow with a fluoroscopy. She went there today and had that done. They also found her cortisol level to be low so they did the ACTH test to rule out Addison's. I don't have the results of that yet.

Easier for me to copy/paste this information...kind of fascinating but I hate that it is in my house. Seems every pup that lands here gets some weird thing. I keep joking about God teaching me but this is really getting crazy...I told Him the joke needs to stop.

From her discharge summary:

Results: 3-Phase Esophagram: Liquid is unable to easily move past the upper esophageal sphincter into the esophagus without 10-15 swallowing motions. Food is able to move normally, whether canned food or kibble.

DISCUSSION: Tootsie's history suggested issues with swallowing and regurgitating liquids like water, and this has been confirmed by fluoroscopy. Her upper esophageal sphincter will not open properly to allow water to enter. However, food readily enters the upper esophageal sphincter. Since swallowing is a reflex of the nervous system, this implies that water is not stimulating the nerves in the upper esophageal sphincter to activate and trigger the swallowing reflex. This decreased sensation of the nerves is what
leads to conditions like mega-esophagus, otherwise known as esophageal ectasia. So, we can tentatively say Tootsie has ectasia of her upper esophageal sphincter. Again, this is due to the nerves not reacting to a liquid stimulas to swallow. This condition is very rare and it may progress or may stay stable overtime. If it does progress, treatment options would be injecting the upper esophageal sphincter with botox or other substances to bulk it up and hopefully make nervous stimulation easier. However, Tootsie's signs are no where near severe enough to warrant that. For now, after she drinks, just hold her up for 15-30 seconds to help gravity push liquid against the sphincter to better trigger swallowing.

Monitor Tootsie closely for worsening of her regurgitation or difficulty breathing. Difficulty breathing may indicate she has aspirated some fluid or food, leading to aspiration pneumonia.

Here is darling Tootsie! :)

Attachment 394038

Oh, Linda, how I hate to read that. I know she's in good hands with you and I'm hoping it doesn't get any worse.

Thanks Karen...I feel so bad for her. I hope that this does not get in the way of her finding a home. She is the sweetest pup ever!

I know she is a sweetie. I could see that when you got her.

What a sweet face. I hope all works out for this little one.

Tootsie is a darling, I hope her condition doesn't get worse. She is in good hands with you.

Oh, I am so sorry about Tootsie. I have never heard of this condition and appreciate you teaching us Linda. Hopefully, this will continue to stay mild and this will not stop someone from giving her a wonderful forever home.

Love the picture and her name. She is a cutie.

Linda, they have stuff called "Thickn-It" or something like that....we use it in the hospital for stroke patients that have issues with swallowing liquids like water....when you thicken the thin liquid up so, it is much easier for them to swallow.....since she can swallow kibble or wet dogfood without any problems, maybe this stuff added to her water, would help her with this issue? Poor baby girl.....

I have been thinking about this little girl. I would definitely ask the vet about the "thickening" water. Sounds like a possible answer.

One of my friends told me last night about it but she did not know the name. She did say that people complain that it tastes icky??? I am definitely going to ask the specialist about it...thanks so much!!

The thing is, I have multiple pups and not sure all would be happy with this...or that it would be ok for them. I don't know. I am also thinking maybe I should give her canned food mixed with her kibble...or all canned. That would give her more water and maybe she would not feel thirsty as much and have to stand at the water bowl for so long to get it down.

She is the sweetest little thing...it bothers me so much that she has this...I just hope it does not get worse. :(

So happy you appreciate it. :p I swear it's crazy the things that my fosters and my own pups get. Someone who works at the specialist told me yesterday that the word is out on the streets about me and the yorkies know where to go. :eek:

Great idea Judi. My Dad had to have that towards the end of his days.

Linda I was also thinking about wetting her food more. Adding some water to her every kibble meal.

How old is she now?

A couple of other thoughts, if elevation is helpful to the swallowing reflex, how about elevating her water bowl. I have two ideas, purchase a water bottle for doggies and install at appropriate height for her. Just above head level so she needs to stretch up to lick the water out. Razzle has stopped drinking from his water bowl (for some reason) and now has taken to stretching up on his hind legs to drink out of the big boys dish. Magic has taken over his small water bowl... Sigh....

Another idea, if you know of a good dog acupuncturist, I would explore with them the feasibility of using acupuncture to stimulate the nerves for swallowing. I have one here in Toronto I have used effectively for a quite different condition.

Lastly again I know this maybe out there for you, explore treatment options with a cranial/sacral therapist. These treatment can be very very effective and are of a very gentle technique.

I hope this sweetie stabilizes and goes onto living a great life.

Thanks for thinking of her. :) I will definitely be trying to find stuff to help her...it is weird though...not much information out there. They told me it is so rare that a lot of this is just unknown.

ROFL You are certainly the "goto" lady! Did you know the old time hobos had this secret sign language that directed other hobos to good spots, to for example catch a nap, or find a good meal hand-out? Maybe doggies have their own secret signal language too:D

:thumbup::thumbup::thumbup:
Great Ideas!! I love that reaching up to lick the water from the water bottle....that seems like a real effective solution? If you want an accupuncturist, my vet, Julie Wickel, is great with this....she teaches it all over the country, to other vets, at vet schools, seminars, etc. If you would be interested in this, pm me!

I like the thick-it idea. What about something like a bottle that hamsters drink from mounted just high enough she has to reach up to drink? She is adorable!!

What a little sweetie. I hope you are able to find a good solution for her drinking issues. Good thing she has you looking out for her.

She is about 3 years old.

I can try the water bottle thing but not sure she would use it. Funny thing I have noticed is that when she drinks she actually positions herself even with the bowl. So, I think she is trying to figure it all out herself.

I spoke with him about adding water to her kibble and that is something I plan to do but it can only be a small amount or we are going to perhaps have issues with her food. I am wondering if it might be better to just put her on canned food. Maybe she would be less thirsty...I know my pups who eat canned don't seem to drink as much as others.

Thanks for the ideas! She really will be ok as long as this does not progress...I wish they had more knowledge about it.

It is really getting to be very weird...seems that every pup in my house ends up with something odd. I am honestly beginning to wonder.

What a sweet little thing!! I am sure there is a perfect home out there for her, even with this little issue!!


I give my boys both canned and dry food, but I also put water in it as well. You could try adding water to her food.

Does she like ice cubes?? I know some dogs like to eat them...and I know some people use broth to make the cubes a a yummy frozen treat. It probably wouldn't be a way for her to get all of her liquid, but I am sure every little bit helps!!

How about adding a bit of applesauce to her water, just enough to thicken it up a bit & add a bit of weight to it. Also maybe an anti depressant as they help jumpstart nerves & help straighten out nerves that for what ever reason have just gone haywire . Yrs ago I had a Chicken that DH & I rescued as a bald chick & he developed this problem at around 8 mo & we put either apple or corn in the blender with the water & it worked well. Praying you find a way to make it work for this little angel.

Wow Linda, I know the YHR pups are special, but this makes them xtra special! Hope you'll find a solution for sweet Tootsie, I know you will!

I am always moistening Momo's kibble...bc he doesn't chew it anymore. Started moistening it when he had struvite crystals, needed to liquefy his diet. He's clear now, but he swallows the hard kibble whole! What would be the down side/ issues to that (moistening kibble)?

Lots of great ideas....the issue here is that I have multiple pups and cannot just add stuff to the water.

For now, I am going to moisten her kibble and put some canned in as well. That will give her some extra water.

I am also going to get the bottle that hangs and see if she likes that and if it helps. I missed the call from the specialist last night ... I may call him this week. BUT...the good news is that the ACTH stim test was normal so no Addison's! She is ok for now..she is not dehydrating or anything....the main concern is whether this could progress or not.

I am confident that Tootsie will thrive under your care, but I'm so sorry that you have had to cope with so many medical problems.

Thanks, Lisa. :) I had a chuckle over the last part of the sentence...was simply going to reply "me too" :D;):p I really don't get it....I think I am supposed to be learning something???

I think it's not what YOU are supposed to be learning but rather what you are teaching others, Compassion. This is simply how to treat a living being.

I'm starting to think this, too! The bonus for us is that you get the answers all figured out then can teach everyone else! :D
I like the water bottle idea as well as the thick-it. The problem with thick-it is that the longer it sits, the thicker it gets, until it turns into solid gelatin...yuk! It would not work to leave out in a bowl but would only be for immediate use times, like after eating kibble, then discard. In use like that, the other dogs wouldn't get into it. I like the idea of wet foods and the hamster bottle to get fluid intake up. Hope all goes well and that the condition doesn't progress.

Linda you are not going to believe this, but at our CYTA meeting today and discussing rescues et al, guess what came up? Laryngeal Partial or full Paralysis! Can you fathom the syncronicity of this?

Alright apparently there is a chiropractor vet here in the GTA that has some success with this condition. I can get more details if you like.

It is not the same condition. This is a reflex thing. I am not a fan of chiropractors but thank you for the suggestion.

Very happy to hear that Tootsie tested negative for Addisons. That is a relief.

Do you remember the video, you probably posted it, of a dog who was trained to jump into the homemade "high chair" like contraption to eat and drink? The contraption enabled the dog to stand up and have his head at the right angle to eat and drink. The dog was amazing the way he would go in and flip the bar down that acted like a counter for him to put his paws on.

I think he had to stay in it for awhile to make sure his food and water went down.