I have a 2-year-old Shih Tzu. He started vomiting about four months ago. We took him to the vet, where they kept him for two nights and gave him IVs. They said he was dehydrated and probably ate something that made him sick. We have done lots of blood tests and everything is normal, and an ultrasound was normal. The vet has him taking Pepsid and Predisone. He is eating better, but i think it hurts him when he eats. He just stands and shakes all over, like he is in pain. He weighs 11 lbs. What do you think we should do next?
Gastrointestinal problems in a young dog like yours are usually something infectious or due to something they ate that they shouldn’t have (like a foreign object). Gastrointestinal ulcers are often the result of both of these conditions and can be very painful as well.
If a diagnosis is not clear based on the bloodwork and ultrasound, other tests that can be performed include X-rays and an upper GI (also called a barium study), where barium is administered orally and X-rays are taken in series throughout the day to evaluate the passage and motility of the intestine. If the barium stops at a certain point and will not continue, it could be an indication of an intestinal obstruction. In addition, the barium is often therapeutic as well as diagnostic, since it coats the lining of the intestine and can soothe an irritated bowel.
There are also specialized blood and fecal tests that check for intestinal function and for the presence of potentially damaging bacterial and viral infections. Endoscopy and/or surgical exploration with biopsy of the intestine is the gold standard for diagnosing primary gastrointestinal diseases. With endoscopy, a fiber-optic camera is passed into the intestine to examine the gut wall and to retrieve foreign objects lodged in the upper intestine. With surgical exploration, the entire abdomen can be explored and examined, which has the added benefit of allowing any major problems to be corrected. However, it also requires invasive surgery.
Because of the prolonged nature of his illness and lack of response, your dog may also benefit from referral to a board certified internal medicine veterinarian who has a special interest in gastroenterology. Although this is often more expensive, specialists can often look at a case from a different perspective and have access to more specialized equipment that can help obtain a diagnosis.