Vomiting dog

Dr. Marie replied:

Hi Brian,

I'm sorry to hear that NuNu is not doing well. I'm sure it is frustrating to see him sick and not have an answer as to why he is vomiting.

There are a great number of things that can cause a dog to have the symptoms that he has. I don't like the fact that he is vomiting everything that he eats.

Has he had any blood tests done? I'm wondering if he perhaps has pancreatitis. While most dogs with pancreatitis are sore in their abdomen, some can be really good at hiding this discomfort. If this is pancreatitis most dogs need to be treated with IV fluids and injectable pain medications which both would be given in a veterinary hospital.

Another possibility would be something affecting his kidneys. Dogs with kidney failure will be extremely nauseous and vomit. They often are very thirsty because the kidneys are failing to retain enough fluid in the body. Dogs can get kidney failure from eating something toxic or from exposure to something called leptospirosis which is a bacteria that can be caught from drinking water contaminated with wildlife urine.

There is some suspicion in Canada right now that some dogs are getting Fanconi syndrome because of treats that are made in China. Fanconi causes kidney problems and we usually see glucose in the urine and normal blood glucose levels. Has he had any urine tests done? You can read more about this issue here: Are treats from China causing Fanconi syndrome in dogs?

An obstruction still is possible even with normal xrays. Some types of material don't turn up well on xrays. If this was my case and I was worried about an obstruction then I would be doing a barium series of xrays. This is where we give a white liquid that turns up really well on xrays and then we take multiple xrays over a period of several hours. We can watch and see if the liquid travels through the intestinal tract without a problem. If it doesn't then this is really suspicious for an obstruction. Hopefully that's not it though because if it is, he may need surgery.

This doesn't sound like an infection to me. Plus, Noriclav (called Clavisceptin or Clavamox in Canada and the US) can cause stomach upset, so I'm not sure if it's the best idea here, unless it was suggested by the vet.

I wish I could give you more help here. Is there any way he can get to a vet that is able to do some better testing? I have no idea what vet care is like in China.

Feel free to reply if I can be of any help. I'll be online till about 10 pm EST tonight and I'll check in on your question in the morning as well.

Dr. Marie.


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Dr. Marie replied:

Hi Brian. Yes, that is quite a high ALT level.

Do you know what other blood tests were done? Specifically I'd love to know if an ALP level or any of PLI, AMYL or LIPA were done.

ALT can be high because of pancreatitis, but we would expect to see some of the other levels high as well.

If all of the blood tests were done and were normal and just the ALT is elevated then this is really suspicious for a toxin. There can be some parasites that can affect the liver as well. In my area this is really uncommon. I would think that if this is common in your area then one of the vets would have suggested treatment for parasites.

The good news is that if this is a liver toxin then the liver is quite good at repairing itself.

Does NuNu have any access to food with the sweetener xylitol in it? (i.e. sugarfree gum). This ingredient is really toxic to a dog's liver.

It's also possible though that this is something like a liver tumor but he is quite young for this.

I'm not familiar with inosine but I see (from some quick research) that it is a liver protectant so it sounds like a good idea. (I can't see any reference to use in dogs though so I can't say 100% for sure if it is safe.)

To answer your questions about food, a single dose of onions would not cause him to get sick. Chronic use of onions can cause anemia (low red blood cells) but not his current symptoms. Some foods can be contaminated with aflatoxins which could cause liver toxicity so it's possible that his food was contaminated.

I'll let you know what my treatment would be for an animal with suspected liver toxicity but keep in mind that I don't know all of the facts for NuNu's case and this is just a generalization:

• IV fluids for 2-3 days to flush out toxin from his system.


• Anti nausea medication


• A liver protectant such as sam-E (adenosyl)

I hope he continues to improve! Dr. Marie.

Dr. Marie replied:

Unfortunately the numbers don't mean a lot to me without the reference ranges. Some of the units are different than what I'm used to. If you have normal values along with those values I may be able to see if I can help more, but I don't think it's going to put us too much further ahead.

Dr. Marie replied:

You're very welcome. Keep me updated. I wish I could do more to help the little guy!

Dr. Marie replied:

Wow! That's great news!