Signalment

• Age: 16 years
• Sex: female spayed
• Breed: American Eskimo
• Species: dog

Disease Notes

• Certainty: tentative
• Comments: Sarah is a sweet happy little dog with a history of repeated episodes of severe gastroenteritis, bloody diarrhea with vomiting and pancreatitis.
  
  Was spayed at age 15. Did well.
  
  Had surgery one year ago for removal of small mass, partial tail amputation and dental, started having trouble after that. Got HGE, then became constipated on medications and alternated diarrhea and constipation.
  
  US 6 months ago showed cholestasis.
  
  I had recommended a homemade diet most of her life - raw meat and cooked vegetables ,and she did well. Over the past year one caretaker has been trying an all raw diet, mostly meat.
  
  They came to me after all her troubles after the surgery, in an acute HGE event. I changed the diet to cooked single protein (turkey) diet with cooked vegetables and she has done much better since then - only two episodes of HGE - both associated with eating things - something strange in the park and one time with too many treats.
  
  When I saw her back then in feb of 2014, her tongue was pink, slightly reddish, no coat and her pulses were very thin and deep and weak.
  
  We did arsenicum album 30C sid x 7 days and changed the diet to cooked.
  
  In march I gave yi guan jian and she was on that until august when she had an episode of HGE. We stopped for about a month and resumed it
  
  Today she had a nice pink tongue but the pulse is still very thin and weak.. She is stable, good stools, no vomiting, good appetite, prefers cool, mild tear staining, normal thirst and urination, good energy.
  
  About 8 times a month she "spits up" about a tablespoon of food - no abdominal heaving, just urps it up, like reflux. Pepcid did not help.
  
  One of the caretakers adamantly wants to go to an all raw diet alternating proteins. The other two caretakers don't want to take a chance and feel that she is stable. I feel that she does better with the lightly cooked pureed meat and chopped lightly cooked vegetables - sort of predigested. I think the yi guan jian has helped, but we need to do more to help the reflux.
  
  What are your suggestions on herbs? On the diet?
  
  Thank you
  P
• Final Status:

Treatment and Outcome