My dog is very sick, multiple vets have no diagnosis. What's next?

That duration of inappetance is very concerning. Did you family vet prescribe some therapy, anti nausea medication? It sounds like your kid needs to see a specialist. For a case like this an internal medicine specialist would be the best person to see. A full abdominal ultrasound with an experienced ultrasonographer (either a radiologist or internist) is likely the first step if blood work and xrays are normal. Unfortunately some pets cases are complex and some disease processes require more advanced testing then what family vets can provide. Likely your family vet has ruled out some common things but an internist will look for the uncommon things. Unfortunately decreased appetite is a very non specific symptom because in animals when they do not feel good for any reason they can stop eating. Your family vet should be able to provide a referral for you if you are interested in this option. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Hello, I'm sorry to hear that Riley is having this problem. I suggest you take him for a second opinion with a board certified veterinary internal medicine specialist. An MRI is not a bad idea but I think there are other less expensive tests that may be more applicable to run first like more extensive bloodwork to check for endocrine diseases, tick borne diseases, etc. Also, if he only had plain film X-rays, a contrast study might be a good idea. I suggest you ask your vet for a referral to a specialist in your area. Hope this helps. Best wishes.

Thank you for submitting your question regarding Harrison. Your veterinarian ruling out parasites and instituting a diet change were great first steps. This will give an answer or resolve the diarrhea in 75% of cases. Unfortunately, it seems that Harrison is still suffering from intermittent diarrhea. I would recommend bloodwork next. Low cholesterol and/or low albumin levels can indicate serious GI disease. In this case, I typically perform an abdominal ultrasound (by a board certified radiologist) and run blood to check pancreatic function as well as cobalamin and folate levels (vitamins used in digestion). This will guide my treatment protocol as far as diet (I may consider a hydrolyzed diet which can have anti-inflammatory properties), medications (chronic antibiotics, steroids or other immunosuppressive drugs) and supplements (probiotics, vitamin B12, etc). There are lots of options to resolve his diarrhea, but will take a further work up since he has not fully responded to the common causes and treatment. I hope this information helps and I am available for a consultation if you want to discuss Harrison further. Good luck!

There is not enough information here for me to properly help you. If a vet, in person, has not been able to help you I don't think us, over the internet without examining the dog or knowing the history, will be able to help you. My recommendation would be to get a second opinion from another vet if your current vet is unable to help you. If he is unresponsive to antibiotic therapy the type of antibiotic may need to be changed or he may need to be on a couple antibiotics at the same time. Not to scare you but cancer is VERY common in Boxers and being that he is older and he is not responding to therapy I would have this a differential diagnosis. I don't know what diagnostic testing has been done (if any) but that is often important. If you don't allow any testing to be done the vet is only doing his/her best to guess what might help. Some things cannot be fixed without testing. Regardless of all that, it sounds like his condition is very serious and that he may be suffering. If nothing can be figured out then you may need to consider humane euthanasia if his quality of life is not good. Of course, you know him best and I am just speculating but you should have that in the back of your mind if treatment is failing to cure him. I am sorry you are going through this. I hope this was helpful. If you have more questions please feel free to ask again. Best wishes.

I'm so sorry that you are having this problem with Rocky. It sounds like Rocky has something going on internally that just isn't getting completely resolved. Often when I have chronic GI problems (vomiting and diarrhea), I will recommend going to an internal medicine specialist for additional specialized testing such as abdominal ultrasound and specialized blood testing. Although most specialists listed here are in in the US, hopefully you can find an internal medicine specialist near you at the website below that can help Rocky. http://find.vetspecialists.com/ Good luck! I hope that was helpful and that you can figure out what is going on with Rocky. Thanks for using PetCoach.

With a normal stool sample and blood panel, the next steps are experimenting with diet - specifically a hypoallergenic prescription diet (such as Royal Canin Ultamino, which is definitely the most expensive option, but also the one that seems to work best in diagnosing food allergies. It takes eating ONLY the prescription food for about a month to see if it helps, and then if it does help you can certainly experiment with less expensive foods. If you she would having signs of food allergy you'd need to do a full 3 months, but for intestinal issues, you should see a response in just a couple weeks) OR a high fiber/easily digestible diet (such as Hills Fiber Response EN). Some dogs need continual probiotics to keep normal stool. Treating any underlying anxiety (if present) can also help. Finally, a gut biopsy, which is much more invasive and costly can be done. Since she isn't yet spayed, I would consider doing a gut biopsy when/if she is spayed because that would be minimal additional expense or trauma for her while she's already have an abdominal surgery. I hope that helps! Wishing you the best with this difficult issue - It can take a long long time to get to the bottom of things

Thank you for submitting your question regarding Remi. In the bloodwork that was run, did it include GI specific testing such as cobalamin, folate, PLI and TLI levels. These are values that will give information such as the location of GI disease (small intestine vs pancreas) and treatment options. I typically do this planel in conjunction with an abdominal ultrasound. This information with the ultrasound can give insight into conditions such as inflammatory bowel disease, pancreatitis, exocrine pancreatic insufficiency, food sensitivities or as you mentioned cancer. The anti-inflammatory properties of the antibiotic she was on could help even with a tumor in GI tract, but there are so many other causes of diarrhea that would respond as well. I think it is worth pursuing further bloodwork and the ultrasound. If you can get a diagnosis, then a treatment plan can be developed. I hope this information helps!