Lots of problems.

Dear Dr Marie,

Here's the link to our ongoing consultation:

http://www.askavetquestion.com/display_answer.php?id=2141&cust_code=XKGE8ATI

Here's what has happened so far. (Btw, I'm thoroughly p******d off at the vets who are practising here.
They are hardly bothered and are just shooting in the dark. They are just not understanding the severity of the problem.)

* the full abdominal ultrasound showed everything to be OK

I was thinking of going in for the X-ray as well but few new things have come to light as I constantly research the web while going over his earlier treatment.

* The current vet last week prescribed a combination of two meds for him. Practin (cyproheptadine) syrup and Aristozyme syrup(digestive enzymes for humans containing diastase 50 mg & pepsin 10 mg/5 mL)

Both these syrups were to be combined and given with food (5 ml each - twice a day for five days)

Right after the first dose, Mushka's appetite increased and he started eating food. I was happy to see a sudden improvement but unfortunately once the cyproheptadine syrup was stopped after 5 days, his appetite also suddenly came down. The doctor told me not to give cyproheptadine for more than 5 days as Mushka could become addicted to the drug and become dependent on it but asked me to continue with the digestive enzymes. The digestive enzymes didn't help on their own and I stopped giving it to him after a few days.

* Going over his past medical records, I discovered that whenever Mushka's appetite had increased with antibiotics he was first given antibiotics mixed with some steroids by the earlier vet - who is very secretive about the meds he injects and doesn't clearly tell what concoction he is injecting a dog with. (I recalled a conversation I had with him once when he said he generally gives a mixture of steroids and antibiotics). The cephalexin course (oral) always followed those injections.

So we've been focusing on antibiotics (cephalexin) increasing his appetite when - I'm guessing - it was probably the steroids. Once Mushka was given steroids plus antibiotics injections for four days followed by cephalexin for 5 days - and his appetite remained strong for about a couple of months.

ALSO - Mushka has an ongoing problem with a lot of wax discharge in his ears and dark, smelly gunk regularly collects in his ears. One to two weeks after a vet cleans his ears, the issue is back. I've told the vets that this could be a problem but they have brushed it aside and said his ears just make more wax and the dirt sticks to it. My research today made me realize he could have an ear infection/ or some allergies that could be causing his loss of appetite.

Could that be the case, Dr Marie? And could a combination of steroids and cephalexin be clearing it up until it comes back again?

He also used to have a problem with discharge from his eyes as well which was resolved after medication last year.

The current vet has asked me to give Cephalexin for about 10-15 days just to see if things get better. I started yesterday morning and - after three doses - he is not eating anything at all. He's eaten nothing today except the cephalexin he took in the morning with a little icecream. His stomach is rumbling, he has vomited bile twice today (I think he feeling quite nauseous) and has tried eating grass when I took him out.

Should I stop giving him the cephalexin as it's making the situation worse? It's just been three doses so would it be detrimental to his health if I stopped now? Please advice.

Amit

Dear Dr Marie,

There is no option for a biopsy here. Although a new animal hospital in the next city might have a doctor who does endoscopy. Would endoscopy involve biopsy? or is that another procedure?

How is cyproheptadine increasing his appetite? From what I've read it increases appetite in cats, not dogs. For dogs it's used to treat allergies.

Could an allergy be causing his loss of appetite?

Dear Dr Marie,

Just so you can picture Mushka.... :)

http://goo.gl/Wy1iP

(taken some months back)

One more concern: I hope endoscopy/biopsy of dogs is a safe procedure and does not involve too many risks.

- Amit