Bilious Vomiting Syndrome in Dogs

 

Bile serves important functions in the digestion of food and removal of waste materials from the body. Bile is created in the liver and stored in the gallbladder until food has been ingested. It is then released into the small intestine to aid in digestion of food and to emulsify the food so that it can be used appropriately by the body.

 

Bilious vomiting syndrome occurs when bile abnormally enters the stomach from the intestine, causing irritation and vomiting. The presence of bile is indicated by a watery, yellow-green substance in the vomit contents. If vomiting does not occur and the bile remains in the stomach, the irritation to the stomach can lead to gastric reflux.

 

Vomiting is usually seen in the morning or late night just before eating, especially in dogs that are fed once daily. This might be due to prolonged periods between meals, or to related stomach inactivity, which aggravates the bile reflux.

 

This condition is commonly seen in older dogs but can occur at any age. Both genders are equally affected.

 

Symptoms and Types

 

• Chronic intermittent vomiting containing bile
• Usually takes place in the morning or late night
• Abdominal discomfort
• Nausea
• Lack of appetite
• Weight loss

 

Causes

 

• The exact cause is still unknown
• Diseases causing gastritis or inflammation of intestine, modifying gastrointestinal motility
• It is presumed to be caused by stomach and intestinal reflux, which often occurs when a dog’s stomach has remained empty for a long period of time

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, a background history of symptoms, possible incidents that might have led to this condition, and recent activities. As much as you can, you will need to tell your veterinarian when the symptoms began, and how frequently the vomiting occurs.

 

Your veterinarian will then perform a thorough physical exam on your dog, with a complete blood profile, a chemical blood profile, a complete blood count, and a urinalysis.

 

A history of intermittent vomiting with bile contents is usually enough for a preliminary diagnosis. In the course of diagnosing this disease, laboratory testing is not of much help as the results are usually within normal ranges. Specific radiographic and ultrasound imaging studies of the abdomen may reveal delayed stomach motility. Endoscopic examination often returns normal in these patients.

 

Fading Syndrome (Neonatal Mortality) in Puppies

 

Newborn puppies are born with an immature immune system that needs to be built up over time, starting with their mother’s milk. Because of their immature body organs and systems, puppies are prone to various insults, including infections and environmental, nutritional, and metabolic factors. Also, young animals do not yet have strong body temperature regulation, and their body temperature can fluctuate profoundly in response to changing environmental temperatures and humidity. Glucose control may also be poor, and blood glucose levels may fall below normal ranges in cases of nutritional disturbances, leading to a state of hypoglycemia. Neonatal mortality, or fading syndrome, involves the death of puppies from birth to two weeks of age. This syndrome is more common in pedigree puppies.

 

Symptoms and Types

 

• Weakness
• Low birth weight
• Loss of weight
• Failure to gain weight
• Decreased activity
• Poor appetite
• Constant vocalizations and restless in early phase, but puppy may become inactive and quiet in later stages
• Straying away from the dam and rest of the litter
• Diarrhea
• Low body temperature

 

Causes

 

Dam (mother)-related

• Difficult birth or prolonged labor
• Problems with milk letdown
• Injury
• Inadequate nutrition

 

Environmental

• Temperature and humidity extremes
• Poor sanitation

 

Pup related

• Congenital defects
• Infections

 

Diagnosis

 

You will need to give a thorough history of your puppy’s health, including a background history of symptoms and any background information you have regarding your puppy’s parentage. After taking a complete history, your veterinarian will conduct a complete physical examination. Laboratory tests will include a complete blood count (CBC), biochemistry profile, and urinalysis.

 

Blood testing may reveal anemia, changes in leukocyte (white blood cells, WBC) counts, including an abnormally low number of platelets (the cells responsible for blood clotting) and an increase in the number of white blood cells, which is what is usually seen in infections. A biochemistry profile may indicate abnormally low levels of glucose (hypoglycemia) along with other changes, depending on which organs are being the most affected. The urinalysis may indicate the presence of hemoglobin, the oxygen carrying component of red blood cells, in the urine. It may also show bacteria present in the urine, indicating an infection of the urinary tract. More specific testing would include isolating the virus or bacteria from various body fluids. Your veterinarian will also conduct a fecal examination to test for the presence of parasites.

 

 

Dogs are known for eating things when they are not supposed to. This is especially true of puppies. Also, dogs have an excellent sense of smell, making it fairly easy to find any secret hiding spots for the chocolate. This can be a dangerous combination when there is chocolate around the house.

 

Chocolate is derived from the roasted seeds of Theobroma cacao, which contains certain properties that can be toxic to animals: caffeine and theobromine. If ingested, these two ingredients can also lead to various medical complications and may even prove fatal for your dog.

 

If you would like to learn how chocolate poisoning can affect cats, please visit this page in the petMD Health Library. Also, go to our Chocolate Toxicity Meter for more information on the dangers of chocolate poisoning and its effects.

 

Symptoms and Types

 

• Vomiting
• Diarrhea
• Increased body temperature
• Increased reflex responses
• Muscle rigidity
• Rapid breathing
• Increased heart rate
• Low blood pressure
• Seizures
• Advanced signs (cardiac failure, weakness, and coma)

 

The amount and type of chocolate ingested is also important, as they are the determining factors for the severity of the toxicity. The three types of chocolate that you must be aware of are:

 

1. Milk Chocolate – Mild signs of toxicity can occur when 0.7 ounces per pound of body weight is ingested; severe toxicity occurs when two ounces per pound of body weight is ingested (or as little as one pound of milk chocolate for a 20-pound dog).
2. Semi-Sweet Chocolate – Mild signs of toxicity can occur when 0.3 ounce per pound of body weight is ingested; severe toxicity occurs when one ounce per pound of body weight is ingested (or as little as six ounces of semi-sweet chocolate for a 20-pound dog).
3. Baking Chocolate – This type of chocolate has the highest concentration of caffeine and theobromine. Therefore, as little as two small one-ounce squares of baking chocolate can be toxic to a 20-pound dog (or 0.1 ounce per pound of body weight).

 

Causes

 

In the right quantities chocolate can become toxic for any dog. So be wary of feeding your pet anything that might contain chocolate and always keep it out of reach.

 

Diagnosis

 

Your veterinarian will perform a complete physical exam, including a chemical blood profile, electrolyte panel and a urinalysis. These tests will help determine if there is a chocolate/caffeine overdose.
 

Blood can also be taken to test for theobromine concentrations, while an ECG is performed to help determine if the heart is showing any abnormalities in rhythm or conduction of heart beats.

 

 

Amitraz Toxicosis in Dogs 

 

Amitraz toxicosis (or poisoning) occurs when a dog is overexposed to the pharmaceutical drug Amitraz (formamidine acaricide), which is commonly used in dog collars and in topical solutions for the prevention and eradication of ticks and to control demodex mite infections.

 

Toxic levels of this drug will affect the dog’s nervous, endocrine/metabolic, and gastrointestinal systems. Amitraz topical solutions usually contain 19.9 percent of the pharmaceutical in 10.6 ml bottles, while impregnated collars contain 9 percent of it in a 25-inch, 27.5 gram collar.

 

Symptoms and Types

 

The symptoms of Amitraz toxicosis develop acutely after the overexposure occurs — usually within two to six hours after the incidence. The most common symptoms include:

 

• Vomiting
• Diarrhea
• Lethargy
• Weakness
• Staggering
• Disorientation
• Hypothermia
• Abdominal pain
• Light or severe depression

 

In severe cases where the correct treatment is not administered, Amitraz toxicosis may result in a comatose state or death.

 

Causes

 

Amitraz toxicosis can be caused in a number of ways. The most common cause of the condition is when a dog chews or ingests its own tick collar. It may also occur if an inadequately diluted Amitraz-containing solution is topically applied on the dog’s skin, or if the dog ingests the undiluted solution directly. If a diluted solution is topically applied in the proper way, Amitraz toxicosis occurs quite rarely.

 

Elderly, sick, diabetic or debilitated dogs and toy breeds are particularly vulnerable to this condition. Curious puppies are probably the most frequently affected victims.

 

Diagnosis

 

If there has been a recent incidence of access or exposure to an Amitraz-containing solution or tick collar and your dog is displaying any of the symptoms of an overdose, your veterinarian will base the diagnosis on a physical exam.

 

An abdominal X-ray will typically show that there is a collar buckle in the gastrointestinal tract. The results of an exam may reveal traces of Amitraz on the hair or in the gastrointestinal contents, and a biochemical and urine analysis will often reveal hyperglycaemia (high blood sugar).

 

Additionally, these tests may reveal an elevated level of liver enzymes when Amitraz toxicosis has occurred, although only rarely.

 

 

 

Cholangitis-Cholangiohepatitis Syndrome in Dogs

 

Inflammation of the bile ducts and intrahepatic ducts — the ducts that carry bile out of the liver — is medically referred to as Cholangitis. Bile, an essential component in the digestive process, begins in the liver and is then stored in the gallbladder until a meal is taken. The bitter fluid is then released into the dog’s small intestine, where it emulsifies fats in the food to be used as energy by the rest of the body.

 

Cholangiohepatitis, meanwhile, describes inflammation of the bile ducts and liver. Together, these diseases are referred to as Cholangitis-Cholangiohepatitis Syndrome (CCHS). This disease is rare in dogs, but is well documented in the cat population. 

 

Symptoms and Types

 

Certain conditions often occur prior to or simultaneous to CCHS: inflammation or clogging of  the liver ducts running outside the liver (EHBDO), inflammation of the pancreas, inflammatory bowel disease (IBD), fatty liver disease, or long-term inflammation of kidney tissue. Symptoms may be sudden, intermittent, or long-term.

 

However, there are currently only three types of CCHS are recognized: suppurative, which has a discharge of fluid within the biliary canal and is often sudden onset, but generally has a good outcome; nonsuppurative, which is reoccurring and has a guarded to poor prognosis; and lymphocytic/lymphoplasmacytic, where lymphocytes and plasma cells invade and surround the liver’s portal vein or portal triad (the portal vein, bile duct and artery of the liver), and which has a poor outcome due to its longer lasting chronic nature and tendency to progress to cirrhosis of the liver.

 

Suppurative CCHS

• Fever
• Swollen painful abdomen – due to fluid crossing over into the abdomen (ascites)
• Yellow skin and yellow whites of eyes
• Dehydration
• Shock

 

Nonsuppurative CCHS

• Enlarged liver (hepatomegaly)
• Lack of energy
• Lack of appetite (anorexia)
• Vomiting

 

Causes

 

Suppurative CCHS

• Infectious:
• Non-infectious:
  • Happens after EHBDO (extra-hepatic bile duct obstruction)
  • Happens after gall bladder blockage

 

Nonsuppurative CCHS

• May not be directly causal, but concurrent with:
  • EHBDO
  • Inflammation of gallbladder
  • Gallstones
  • Inflammation of the pancreas
  • Inflammatory Bowel Disease
  • Long-term swelling of kidney tissue

 

Diagnosis

 

Your veterinarian will perform a thorough physical exam on your dog, taking into account the background history of health, onset of symptoms, and possible incidents or illnesses that might have led to this condition. Some of the factors that place a dog at risk for developing CCHS are inflammatory bowel disease, pancreatitis, or obstruction of the bile ducts outside of the liver.

 

A chemical blood profile, complete blood count and urinalysis will be taken. These may reflect anemia, high liver enzymes, bilirubinuria (bilirubin in the urine), and/or lymphocytosis. They might also reflect cancer if it is causing the swelling of the liver and/or gallbladder. Often, sludged bile is found, which may be the cause of blocked bile ducts.

 

If your veterinarian suspects swelling of the pancreas, a TLI blood test (trypsin-like immunoreactivity – a pancreatic digestive enzyme) can be taken to test for pancreatic sufficiency. Vitamin B12 levels will be tested; low values indicate absorption problems in the small intestine, or pancreatic problems. Coagulation tests will also be performed to verify whether the blood is clotting normally. And thyroxine, a thyroid gland, may be tested to rule out a thyroid tumor.

 

Chest X-rays, abdominal X-rays and an abdominal ultrasound can be used to check for cancer and to visualize the liver, pancreas and kidneys. For a closer visual exam, a laparotomy may also be performed. This method uses a diagnostic tool called a laparoscope, a small, flexible instrument that is passed into the body through a small incision. The laparoscope is equipped with a small camera and biopsy forceps, so that you doctor can visually inspect the walls and ducts of the liver and pancreas, and take a sample for biopsy. For further laboratory analysis, abdominal fluid and cell samples may sometimes be taken.

 

 

Clostridial Enterotoxicosis in Dogs

 

Clostridial enterotoxicosis is an intestinal syndrome brought on by abnormally high levels of Clostridium perfringens bacterium, a bacteria found commonly inhabiting decaying vegetation and marine sediment. It can also be acquired from raw or improperly cooked meats and poultry, and meats that have been left out in the open. There is also evidence that dogs can acquire this infection from being with other dogs, such as when boarded at a kennel.

 

Generally, the implications of the clostridial enterotoxicosis are limited to infections of the intestinal tract and do not progress to systemic disease conditions. Symptoms typically last a week in acute cases and include diarrhea, abdominal pain, and nausea. Long-term (chronic) cases of clostridial enterotoxicosis, meanwhile, involve recurrences of diarrhea, which may repeat every two to four weeks, and may continue for months to years. In fact, clostridial enterotoxicosis in dogs is suspected to occur in up to 20 percent of large bowel diarrhea cases.

 

Although it is more common in dogs as opposed to cats — perhaps because dog spend more time amongst vegetation, or eating found meat (such as in refuse) — most animals have antibodies that will effectively fight the bacteria and clear it from the body.

 

Symptoms and Types

 

• Diarrhea with shiny mucus on its surface
• Small amounts of fresh blood in diarrhea
• Small, meager stools
• May have large volume of watery stools
• Straining to defecate
• Increased frequency of defecation
• Vomiting (on occasion)
• Abdominal discomfort – characterized by standing with lowered front and raised back end, or curling up to cover abdomen, resistant to being touched in abdominal area
• Abnormal amount of flatulence (i.e, passing gas)
• Fever (uncommon)

 

Causes

 

Clostridial enterotoxicosis is caused by an overgrowth of the bacteria Clostridium perfringens in the intestine. Often, the bacteria is acquired from the environment (e.g., flora) or as the result of eating raw, undercooked, or old meat. Other risk factors include:

 

• Dietary changes
• Abnormally high pH level in the intestine
• Deficiency of antibodies
• Exposure to other dogs at a hospital or kennel
• Stress to the digestive system due to concurrent disease (e.g., parvovirus, gastroenteritis, and inflammatory bowel disease)

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have precipitated/preceded this condition, such as time spent outdoors, rummaging through garbage or getting hold of old or uncooked meat, or being boarded at a kennel.

 

Your veterinarian will conduct a thorough physical exam on your dog as well as standard blood work, including a complete blood count, chemical blood profile, and urinalysis. Most of these tests will return normal. Because this infection has obvious intestinal symptoms, a fecal sample will need to be taken for microscopic analysis.

 

This intestinal disease is sometimes difficult to identify because there is no one good test for it. Often, false positive results will return as the result of interfering substances in the feces. Your veterinarian may also want to use an endoscope to visualize the interior of your dog’s intestines, and possibly take a tissue sample.

 

 

Coral Snake Venom Toxicosis in Dogs

 

There are two clinically important subspecies of coral snake in North America: the eastern coral snake, Micrurus fulvius fulvius, in North Carolina, southern Florida, and west of the Mississippi River; and the Texas coral snake, M. fulvius tenere, found west of Mississippi, in Arkansas, Louisiana, and Texas.

 

The coral snake is from the Elapidae family of venomous snakes. Elapids have fixed front fangs that are used to inject venom into their victims. The coral snake is tri-colored and can be recognized by the bands of red, yellow, and black that fully encircle the body. The coral snake can be distinguished from the similar colored but harmless tri-colored kingsnake by the arrangement of the bands: if the yellow and red color bands touch, then it is the venomous coral snake; if the red and black color bands touch, it is the non-venomous kingsnake (this rule only applies to North American coral snakes – coral snakes in other parts of the world have different patterns). In addition, the coral snake has a relatively small head, with a black snout, and round pupils.

 

Bites are relatively uncommon because of the snake’s reclusive and non-aggressive behavior and nocturnal habits. When injuries do occur, they often occur on the lip because an animal has gotten too close. Onset of clinical signs may be delayed several hours (up to 18 hours) after your pet was bitten. Victims develop paralysis, including paralysis of the breathing muscles. The primary cause of death is respiratory collapse.

 

Symptoms and Types

 

• Paralysis
• Salivation/drooling
• Shortness of breath
• Altered voice production (inability to bark)
• Reduced spinal reflexes
• Diarrhea
• Convulsions
• Shock

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, recent activities, and onset of symptoms. Your veterinarian will need to rule out several other explanations for the symptoms before arriving at a diagnosis.

 

If you are sure that your dog has been bitten by a coral snake, your veterinarian will look for the fang marks so that the bite can be treated immediately and so that antivenom drugs can be given.

 

 

Pit Viper Snake Venom Toxicosis in Dogs

 

Pit vipers are of the family Crotalinae, and are known by several species: Crotalus (rattlesnakes), Sistrurus (pigmy rattlesnakes and massassauga), and Agkistrodon (copperheads and cottonmouth water moccasins). These snakes have retractable fangs and can be distinguished by the heat-seeking pit located between the nostril and eye on their triangle-shaped heads. Their range is throughout the continental U.S. Bites most often occur in rural areas where these types of snakes are most frequent.

 

Toxicity of the venom is considered hematoxic, which means that it causes blood poisoning in the victim. Several species have subpopulations with lethal neurotoxic venoms, meaning that the venom attacks the nervous system (e.g., Mojave rattlesnake). The general ranking of severity is: (1) rattlesnakes, (2) moccasins, (3) copperheads.

 

The venom causes local tissue injury and interferes with coagulation of the blood. It also affects the cardiovascular and respiratory systems. Eighty-five percent of bite victims have altered laboratory values and clinically important swelling, with severely low blood pressure from the pooling of blood within the nervous system or pulmonary (lung) vessels. Fluid loss is secondary to severe swelling.

 

Symptoms and Types

 

In most dogs, there are puncture wounds on the head and forelimbs. In addition, symptoms may be delayed for 8 hours after bite, including:

 

• Local tissue swelling and pain surrounding bite site
• Bruising, with possible dead tissue and sloughing at bite site
• Red patches and spots on tissues and mucous membranes
• Rapid heart beat
• Shallow respiration
• Depression and lethargy
• Nausea
• Excessive salivation 
• Low blood pressure and shock

 

Causes

 

Victim-associated

• Bite site – bites to tongue and torso are of major concern
• Size of victim may affect severity of the reaction
• Elapsed time between bite and initiation of treatment will result in increased severity of symptoms
• Activity level of victim after the bite – activity increases absorption of venom in the system
• Owner may see bite marks, or heard the snake nearby at the time of injury (such as with rattlers)

Snake-associated

• Venom toxicity is higher in spring, lower in fall; highest in very young snakes.
• Aggressiveness and motivation of snake can increase venom value

 

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, recent activities and onset of symptoms. Unless you saw the snake bite your pet, the diagnosis may be complicated by the fact that many other things can cause the same symptoms. For example, insect bite, blunt trauma, penetrating wound, animal bite, penetration of foreign body, or a draining abscess can bring about many of the same symptoms of snakebite. 

 

A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, and a urinalysis. Your veterinarian will obtain important information from the blood test and urinalysis. Clotting tests can also indicate the origin of the symptoms, as clotting disorders are often a symptom of snakebite. Your doctor may also conduct an electrocardiogram to evaluate the functioning of your dog’s heart.

 

Pneumocystosis in Dogs

 

Pneumocystosis is a fungal (Pneumocystis carinii) infection of the respiratory system. Commonly found in the environment, P. carinii only affects dogs (or humans) with compromised immune systems. This is because the weakened body defenses allows the organism to multiply and grow to critical levels in the lungs.

 

Symptoms and Types

 

Generally, the breathing difficulties will progressively worsen over a four-week period. Other signs associated with pneumocystosis include:

 

 

Causes

 

Pneumocystosis is caused by an overabundance of the P. carinii fungus in the respiratory system, typically found in immune-compromised dogs.

 

Diagnosis

 

You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well a biochemistry profile, urinalysis, and complete blood count (CBC) — the results of which are usually non-specific and may show increased number of leukocytes or white blood cells as seen in infections, increased number of eiosinophils, and increased number of red blood cells. Blood gases testing, meanwhile, may reveal decreased partial pressure of oxygen in blood (hypoxemia), and increased pressure in blood pH. Thoracic X-rays are also conducted to see the severity and stage of the infection, as related to the lungs.

 

For definitive diagnosis, however, your veterinarian will take a respiratory fluid sample or tissue sample to a pathologist to test for abnormal levels of P.carinii. Although it is the most reliable method for verifying pneumocystosis, lung biopsies are not without complications. Moreover, few diagnostic kits are available.

 

 

Ileus in Dogs

 

Ileus (functional or paralytic) is a term used to denote temporary and reversible obstruction in the intestines caused by bowel motility problems. Problems with peristalsis (or wave-like contractions that help move food along the digestive tract) results in the accumulation of intestinal contents in certain areas of the intestines. Therefore, ileus is not a primary disease, rather a result due to some other disease or condition affecting motility of intestine.

 

Symptoms and Types

 

• Loss of appetite (anorexia)
• Vomiting
• Depression
• Mild abdominal distention or discomfort due to gas accumulation due to obstruction

 

Causes

 

• After gastrointestinal surgery
• Electrolyte imbalances
• Infections and inflammatory diseases of gastrointestinal tract
• Persisting mechanical obstruction (e.g., foreign body in GI tract)
• Blockages of blood supply to intestine or part of intestine
• Septicemia (body wide illness due to presence of bacteria in blood) due to gram negative bacteria
• Shock
• Abdominal injury
• Distention of intestines due to aerophagia or excessive burping or belching
• After use of certain drugs
• Toxicity (e.g., lead)

 

Diagnosis

 

After recording a detailed history and performing a complete physical examination, routine laboratory tests will be conducted. These tests include complete blood count, biochemistry profile, and urinalysis. The main objective of the diagnostic effort is to find the underlying cause of this problem. Results of routine laboratory testing may reveal some information related to the underlying disease. Abdominal X-rays and ultrasound will help in finding various abnormalities including: presence of gas, fluid, mechanical obstruction (e.g., foreign body), tumor in abdomen, and other such conditions.

 

For confirmation, your veterinarian may use more specific testing like Barium-Impregnated Polyethylene Spheres (BIPS). Barium is a chemical used in certain radiological studies to enhance visualization of anatomical structures. BIPS are markers given orally and will demonstrate the extent of intestinal obstruction and motility disorder. Your veterinarian will assess the time it takes for these markers to move along the intestines and how much delay is involved. This test also helps in the localization of the anatomical site involved.

 

 

Endoscopy is also an option for diagnosis, especially for an assessment of mechanical obstruction. Your veterinarian will look directly into the stomach and intestine using an instrument called an endoscope. A rigid or flexible tube will be inserted into your dog’s stomach, where your veterinarian will be able to visually inspect and take pictures. In some cases, exploratory surgery may need to be performed to rule out mechanical obstruction. X-ray, computed tomography scan, magnetic imaging test, and analysis of cerebrospinal fluid (fluid circulate around brain and spinal cord) may be required in animals with suspected spinal cord injury.