# Dog wasting away -- what to ask vet?



## Megora (Jun 7, 2010)

Can I ask what you are feeding him? 

Sometimes for whatever reason dogs don't do as well on food as they used to. Could be formula changes or - who knows. 

I switched my guys off Nutrisource to something else because of coats not being as good as they should be. Especially my older boy whose coat really looked bad after about 1-2 years on Nutrisiource.

My guys are now eating Nutro Ultra and the old boy's coat has come back really nice again. 

I do firmly believe that what the dogs eat does make a difference. I think some vets over diagnose allergies vs getting down to actually what is going on with the dogs.


About the vet -

I'd do a full blood test, checking all the numbers to make sure he's not fighting anything, urinalysis, and then the full thyroid panel.


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## Tahnee GR (Aug 26, 2006)

Sounds very much like my girl, Suva. She did great until she was about 3 or so. Then, her coat started getting ratty, it was dry feeling, she lost most of her feathering, she would bite at her flanks sometimes and just did not look good. Her stools were generally normal but sometimes would be soft and more voluminous. We did the test for EPI and it came back negative. She did test low for cobalamin, so I gave a series of injections for that. The injections did not seem to help unfortunately.

Then, my vet found an abcessed tooth, so we scheduled her for a dental. She turned out to have 14 abcessesed teeth, which had to be removed! She loved to catch balls and frisbees, and apparently some of them were too heavy and broke her teeth.

My vet thinks that the constant infection caused GI issues, which did fit with her test results. In addition to pulling her teeth, we put her on a constant low level dose of Tylan. It has been like a miracle! She is happier, more energetic and her coat is coming in beautifully. She is only allowed to catch chuck it balls too 

Keep looking, sometimes the answer is unexpected.


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## hotel4dogs (Sep 29, 2008)

Has he been checked for diabetes?


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## Altairss (Sep 7, 2012)

I would ask for a full panel to see what his organ functions is and ask for another thyroid to retest his thyroid its been two plus years and he could have changed that happens quite often so don't assume one normal means he is good forever. My friends golden due to family history was checked yearly and the third time his thyroid function had seriously declined. Also has had a fecal to check for issues? parasites, worms etc can cause some serious issues. Check teeth also agree to check for diabetes or Cushing's


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## Prism Goldens (May 27, 2011)

Isn't EPI primarily a GSD disease?

I believe for them there is a supplement that costs for a month about what the test costs (this is only rumor) and it is a definitive test in itself, that most vets believe if the supplement 'fixes' it, that tells you if the dog has EPI. I can ask a GSD friend if you like.


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## jennretz (Jul 24, 2013)

There is now a camera available that is inserted into the stomach and takes pictures as it goes through the system. That is how we were able to get to Duke's IBD diagnosis; confirmed with malabsorbtion (?sp) issues. He's now on B12 injections. They noticed a thickening of Duke's stomach lining first which led to the additional tests. They also did a colonoscopy and endoscopy with biopsies. We did full panels as well and are now on the path towards changing diet and adding Rx's to his diet. Hope you get some answers soon. It's no fun when you're not sure what's going on, but you know something isn't right. Trust your gut.


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## FosterGolden (Mar 10, 2014)

Megora said:


> Can I ask what you are feeding him?
> 
> Sometimes for whatever reason dogs don't do as well on food as they used to. Could be formula changes or - who knows.
> 
> ...


His last blood panel, with the full thyroid, and included a urinalysis, all came back perfect two years ago. I know it's been two years and symptoms are worse, but they started before the blood panel. I'd like to try something new, so I'm going for the GI panel and if it also comes back perfect, we'll re-check the rest. 

Over the past few years I have fed him: 

Raw - whole mackerel, pork, beef, goat, turkey, rabbit, eggs and veggies. I do sometimes still feed raw meals. Dogs also get raw knuckle bones a few times per month. 

Homecooked - was always in addition to kibble because I did not work on balancing the homecooked food. I've always given them veggies from the garden or leftovers. Sometimes I used rice, sometimes lentils, sometimes oat meal to bind it all together. 

Kibble - currently am feeding Fromm and rotating between all of the grain free options. Sometimes add NutriSource to the rotation, also grain free. No chicken in his diet. Often add boiled eggs, yogurt, cooked meat, sardines, homemade bone broth, but not always/consistently. 

Supplements - was also, at one point, feeding the following - Answers Fermented Raw Goat Milk, coconut oil (organic virgin, etc.), enzymes, pro biotics, grizzley fish oil. 

Everything I've done, I've stuck with for a couple of months before making changes again.


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## FosterGolden (Mar 10, 2014)

Tahnee GR said:


> Sounds very much like my girl, Suva. She did great until she was about 3 or so. Then, her coat started getting ratty, it was dry feeling, she lost most of her feathering, she would bite at her flanks sometimes and just did not look good. Her stools were generally normal but sometimes would be soft and more voluminous. We did the test for EPI and it came back negative. She did test low for cobalamin, so I gave a series of injections for that. The injections did not seem to help unfortunately.
> 
> Then, my vet found an abcessed tooth, so we scheduled her for a dental. She turned out to have 14 abcessesed teeth, which had to be removed! She loved to catch balls and frisbees, and apparently some of them were too heavy and broke her teeth.
> 
> ...


That's really interesting! Thanks for the info.


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## FosterGolden (Mar 10, 2014)

hotel4dogs said:


> Has he been checked for diabetes?


I'm not sure, but I'll ask. We did a full blood panel and urinalysis. I'll check when I go in.


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## FosterGolden (Mar 10, 2014)

Altairss said:


> I would ask for a full panel to see what his organ functions is and ask for another thyroid to retest his thyroid its been two plus years and he could have changed that happens quite often so don't assume one normal means he is good forever. My friends golden due to family history was checked yearly and the third time his thyroid function had seriously declined. Also has had a fecal to check for issues? parasites, worms etc can cause some serious issues. Check teeth also agree to check for diabetes or Cushing's


I'll probably have a GI panel and then go back for a full blood panel if that comes back clean. He had a fecal last year; it was clean. I am planning on another one this time around. I'll ask about Cushings, but he doesn't fit the bill. His coat is not a thyroid coat and he has only a couple of the symptoms. Same with diabetes, but it's worth asking about. She'll check teeth along with his annual.


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## hotel4dogs (Sep 29, 2008)

The only reason I mentioned diabetes is I saw this exact pattern in a lab and his only symptom was weight loss.
I hope you get to the bottom of this frustrating problem quickly.


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## FosterGolden (Mar 10, 2014)

Went to the vet today (last appointment was rescheduled due to the flu going around the clinic) and when the vet saw Oakley her first thought was EPI based on what I told her. We ended up running a full blood panel, the full GI (includes B12 and folate) test and a "super-fecal" that looks for bacteria as well as parasites. I should have all of the tests back in 3-5 days. If all comes back normal, we'll look at an ultrasound of his gut to see if there are any issues. She felt pretty strongly that based on his symptoms as well as what I have already tried, this is EPI or at the very least, some other malabsorption issue that we should be able to see in his tests. Fingers crossed that we get some answers. He has lost ten lbs over the past 24 months and he's just bordering underweight. He weighs five lbs less than Wyatt, my other dog, and they are the same height and similar bone. Wyatt eats a little less in his meals, but gets more in the way of training treats, so it's about the same amount but Wyatt is more active (he's an easy keeper). She is treating a few other confirmed EPI cases currently and seems pretty educated on the condition.


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## Neeko13 (Jul 10, 2010)

I hope you get your answers soon, and able to get him on the right track..poor thing, I'm sure he hasn't felt good through all this .... good luck....


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## nolefan (Nov 6, 2009)

Fingers crossed that you all get to the bottom of this. It must be so hard worrying and not knowing. Thank you for updating us.


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## Yaichi's Mom (Jul 21, 2012)

I wish I had some suggestions for you with what you are dealing with, however I don't.

My only thought is, if you don't get the answers to what is manifesting, you may want to consider contacting a homeopathic DVM.

Anything and everything we give/allow to be administered to our dogs leaves an inprint that can cause the whole body to be "out of whack" for lack of a better way to verbalize.

I am sure you are very distressed. I am hoping that you find some answers and that your pup is on the way to better health. Best wishes.


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## Alaska7133 (May 26, 2011)

Going back to the tick panel. Just because it was negative doesn't mean he doesn't have tick disease. You could try a round of doxy and see if he doesn't get better. I've known dogs that didn't have a positive tick test, yet once they were on doxy for a week or so, they were back to normal. Doxy is an inexpensive antibiotic.


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## CAROLINA MOM (May 12, 2009)

Hope the test results will provide the answers so your boy will be able to get the treatment he needs and feeling better soon.


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## FosterGolden (Mar 10, 2014)

Alaska7133 said:


> Going back to the tick panel. Just because it was negative doesn't mean he doesn't have tick disease. You could try a round of doxy and see if he doesn't get better. I've known dogs that didn't have a positive tick test, yet once they were on doxy for a week or so, they were back to normal. Doxy is an inexpensive antibiotic.


Tick disease is very rare around these parts. He was not tested for it and vets around here don't even carry lyme vaccines. I don't think a tick disease would explain most of what is going on with him. What is it about his symptoms makes you think tick disease? Zero pain, depression, swelling or such issues. Poop eating, massive volumes of poop compared to input, poor coat, weight loss and gas are his general symptoms.


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## FosterGolden (Mar 10, 2014)

Yaichi's Mom said:


> I wish I had some suggestions for you with what you are dealing with, however I don't.
> 
> My only thought is, if you don't get the answers to what is manifesting, you may want to consider contacting a homeopathic DVM.
> 
> ...



Thanks. I'm definitely open to a homeopathic vet, especially if it is EPI. I'd rather feed for the disease than give any type of medication or synthetic supplement for life, and I understand that people have had luck doing just that. This vet is pretty progressive in her treatment and supplies the happy medium I like in vet care -- not too much. We'll see what the results are...one step at a time!


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## Swampcollie (Sep 6, 2007)

Did they check for Degenerative Myelopathy? It does occur in Labradors.


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## FosterGolden (Mar 10, 2014)

Swampcollie said:


> Did they check for Degenerative Myelopathy? It does occur in Labradors.



No. He has zero symptoms of this.


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## Peri29 (Aug 5, 2017)

Just a quick note. I do not know if you redid the thyroid test which shall be repeated every year under suspicious circumstances.Very important. 

However, I would not only check for Lyme, but would also check on Ehrlichiosis, Babessia, Anaplasma even *Leishmania* which I suspect due to the skin symptoms you mentioned earlier.
However, please do not trust the kits but have an IFAtest which works via titration.I know they are expensive than kits ( But it will help you a lot . You shall check BOTH IGG/past and IGM / current. 
Sometimes dogs do not show any symptoms but some do show , especially with Leishmania.Both skin & visceral.However, it recurrs. And if it recurrs, it is fatal.
You may say that you are not living in an endemic area however just one bite is enough. And please do not forget they are transmitted via sandflies, fleas, ticks which can roam km s jumping on someones clothes and sandflies can fly. Or an animal infected may have moved to your zone. It does not necessarily be a dog& cat, the vector can be any animal.
In Turkey or in Europe, those are the first tests we do .Reason is South Italy, Spain are very endemic areas.And people travel with their pets between the countries. Noone would suspect a Leishmania case in Switzerland, but it does occur .Most probably , a family travelled to Spain / South Italy with their pets. Their dogs were bitten by an infectious sandfly. They went back to Zurich.A sand fly bit their infected dog not showing any symptoms , and the same sandfly bit than other dog on the street/day care any time. So, a second dog got infected. I know it sounds crazy. But it does happen a lot(


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## Siandvm (Jun 22, 2016)

If I were a betting woman, which I’m generally not, I would place good money on EPI, based on your description. The one dog I have diagnosed with it based on symptoms alone (yes, I tested, but I mean it was just so clear cut that the test was just a confirmation) was not a German Shepherd, but Prism is right, they are the poster child for EPI. I think my patient was a Shar Pei, so not being a GSD does not preclude EPI.


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## FosterGolden (Mar 10, 2014)

Peri29 said:


> Just a quick note. I do not know if you redid the thyroid test which shall be repeated every year under suspicious circumstances.Very important.
> 
> However, I would not only check for Lyme, but would also check on Ehrlichiosis, Babessia, Anaplasma even *Leishmania* which I suspect due to the skin symptoms you mentioned earlier.
> However, please do not trust the kits but have an IFAtest which works via titration.I know they are expensive than kits ( But it will help you a lot . You shall check BOTH IGG/past and IGM / current.
> ...



I'm not saying this absolutely could not be the case, but typically we start with the obvious vs. just testing for anything and everything right off the bat. If those tests prove incomplete, we move onto other possible issues. Because Lyme is rare in my area and my dog has zero symptoms of Lyme, there is no reason to test for it unless we become, well, desperate. I looked up some of the other diseases and not only are those things extremely rare in my area, but my dog has maybe one symptom, which is weight loss, and weight loss occurs with so many things. His coat is not patchy, his skin is not infected or even flaky, he's not sore, depressed or having diarrhea or vomiting. No excessive thirst or urination. No weakness. No loss of appetite, no swelling anywhere.


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## Peri29 (Aug 5, 2017)

FosterGolden said:


> I'm not saying this absolutely could not be the case, but typically we start with the obvious vs. just testing for anything and everything right off the bat. If those tests prove incomplete, we move onto other possible issues. Because Lyme is rare in my area and my dog has zero symptoms of Lyme, there is no reason to test for it unless we become, well, desperate. I looked up some of the other diseases and not only are those things extremely rare in my area, but my dog has maybe one symptom, which is weight loss, and weight loss occurs with so many things. His coat is not patchy, his skin is not infected or even flaky, he's not sore, depressed or having diarrhea or vomiting. No excessive thirst or urination. No weakness. No loss of appetite, no swelling anywhere.


Dear Foster Golden, I totally understand but sometimes they do not show any signs & symptoms. I have rescued dogs which seem to be totally fine from outside but came out Ehrlichia / or Leishmania positive. I am sure it can be due to other reasons but I would first rule those out at least to shrink the possibilities. It must be really stressing for you not being able to find the underlying reason since 2 years:frown2:


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## FosterGolden (Mar 10, 2014)

Interestingly, Peri29, you might be right about something. Preliminary results suggest that I should get a tick profile done on him. That's all I know from a voicemail and the vet is gone for the day. Dang! Not going to jump to conclusions, but so weird if it is a tick disease since that is incredibly rare here and he shows no symptoms of anything related to ticks. I mean, he has symptoms of something, but not that and in many cases, he has opposite symptoms (loss of appetite, for example). So weird... Should know more tomorrow.


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## FosterGolden (Mar 10, 2014)

I also received this email:


Hi Julie,
 I called and left a message and wanted to quick touch base with you regarding Oakley's diagnostic and treatment plan.
His blood report findings that were significant were a low white blood cell count and evidence of bacterial overgrowth in his small intestine. (His cobalamin is below the standard and his folate is high) 
The neutropenia can be caused by exposure to estrogen creams (dogs licking humans on estrogen cream), anti-convulsants and a few other odd ball toxins. It can be from sepsis (not in his case) or bone marrow disease. Another cause is tick borne disease. 
I spoke with an internal med specialist, and they recommended the following:
1. Tylosin treatment
2. A low fat hydrolyzed diet like Purina HA 
3. B12 supplementation
4. Instead of a fecal pathogen screen, we perform a tick panel.
5. Recheck the white count in about 2 weeks.


This is a quick summary. I am happy to talk with you further. I am out the rest of today and will be in again tomorrow morning.


Please feel free to email or call at your convenience. 


Best, 
Dr. Conradi


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## FosterGolden (Mar 10, 2014)

I replied to her email. I'm thinking that the SIBO and low white blood cells are related though she is not sure. I mean, why wouldn't they be? 


Sorry I missed you. He’d have to be exposed to estrogen daily for a while so that’s off the list. 


His maldigestion profile test came back as consistent with small intestinal bacterial overgrowth and not EPI. The TLI test was normal, ruling out EPI but his cobalamin and folate levels were off which is characteristic of a small intestinal absorption problem. 


The low white count is believed to be a separate problem. Neutrophil levels below 1500 increase risk of infection for him. He is at 1480. Normal is 2500 to 8500. I’m not sure if the low count could be the reason he has GI bacterial overgrowth. The specialist thought the two findings were unrelated.


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## SandyK (Mar 20, 2011)

I was shocked to see the results you received. I have had dogs with tick born diseases and they did not have symptoms like Oakley. Hope treatments go well and you see improvements soon.


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## Gleepers (Apr 20, 2016)

FosterGolden said:


> Interestingly, Peri29, you might be right about something. Preliminary results suggest that I should get a tick profile done on him. That's all I know from a voicemail and the vet is gone for the day. Dang! Not going to jump to conclusions, but so weird if it is a tick disease since that is incredibly rare here and he shows no symptoms of anything related to ticks. I mean, he has symptoms of something, but not that and in many cases, he has opposite symptoms (loss of appetite, for example). So weird... Should know more tomorrow.


Talking with my vet and some others the past couple years. Some of these transmitted diseases are finding their way to places that they weren’t common before. 
Warmer climate might Be contributing but also rescues are transporting dogs across country much more often. 
These days just because it shouldn’t be, doesn’t mean it isn’t. 

Hope you find your answer.


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## Sweet Girl (Jun 10, 2010)

FosterGolden said:


> Interestingly, Peri29, you might be right about something. Preliminary results suggest that I should get a tick profile done on him. That's all I know from a voicemail and the vet is gone for the day. Dang! Not going to jump to conclusions, but so weird if it is a tick disease since that is incredibly rare here and he shows no symptoms of anything related to ticks. I mean, he has symptoms of something, but not that and in many cases, he has opposite symptoms (loss of appetite, for example). So weird... Should know more tomorrow.


Did you travel anywhere with Oakley in the past year or two? If you don't have ticks in your area, and he's not on prevention, it could have happened someplace you passed through? 

It sounds like you're making some progress. Hope the treatments show some good results.


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## Goldhill (Jul 3, 2016)

Lyme disease and other tick-borne diseases are highly underdiagnosed and even though they are less common on the West coast than the East, I am convinced that many, many people (and pets) get these diseases and suffer terribly from them because the doctors around here don't think of them as a possibility. Nearly my entire family got Lyme living on the East coast so I am extra cautious about it, but I do have a friend living in Eastern WA that got it without having traveled anywhere. She was the first case on the map for the entirety of Eastern WA. 

Lyme maps: https://www.cdc.gov/lyme/stats/maps.html


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## FosterGolden (Mar 10, 2014)

I challenged the vet on the tick panel. The whole reason the specialist suggested it was because of the low white blood cells. There is a tick disease called ehrlichia and that is one cause for the low white blood cells. While the dog has had a tick or two throughout his life, if he has had SIBO for two years, doesn't it stand to reason that his white blood cell count could be low as his body fights the bacterial infection? Another cause of low white blood cells is "prolonged or overwhelming infection". I'm not sure that the specialist that she talked to had access to or read his files before making that suggestion. 


While I am not against a tick profile, it does not make the most sense to me, and she agreed. Short term plan is, we are going to treat the SIBO with meds and B12 plus a special diet, then re-check white blood cell count in 2-4 weeks to see if there is a change. If there is, we'll know it's the SIBO, if not, there is something else. That said, knowing that SIBO can be a secondary issue, unless it turns out to be a one-off situation, as long as the white blood cell issue is improved, we'll look at an further research and hopefully a diagnosis. 


Here are the symptoms of SIBO. The diarrhea part threw me off because Oakley does not have diarrhea. But in SIBO, it's small intestine diarrhea, which is different, and that is what he gets. 


*Symptoms and Identification*

Diarrhea and flatulence are the most common signs of SIBO. Chronic, intermittent diarrhea is most typical of the idiopathic form, with many dogs also suffering weight loss, stunted growth and/or generalized unthriftiness. Some dogs may appear inordinately hungry and may even engage in pica or stool consumption.


SIBO is easily identified by noting small bowel diarrhea (characterized by limited straining and its large volumes) and finding large numbers of bacteria in the fecal material. Diagnosis of the idiopathic form is aimed primarily at ruling out all potential causes of secondary SIBO. Because these are numerous, the process usually involves X-rays, serial fecal examination (not cultures, which are notoriously unreliable), and sometimes endoscopy to test the upper part of the small intestine for high bacterial counts.


Blood tests for the vitamins known as folate and cobalamine are also indicative of the process. High folate levels and decreased cobalamine typically result. That’s because folate is synthesized by the bacteria, and cobalamine is bound by them.


Here is her last email:


Hi Julie,
Excellent questions. Not in any particular order....The Royal Canin hydrolyzed diet would be fine. The key is to use a good quality low fat, hydrolyzed protein diet.


SIBO can be from any number of things such as, but not limited to, genetic predisposition and triggers, IBD, or lymphoma. An endoscopic bowel biopsy is needed to get a specific diagnosis as to why his bowel is not absorbing things properly, thus resulting in a bacterial overgrowth. Per the internist, IBD, in his case, is most likely and in dogs like this, there is very promising response to the Tylosin, B12 and hydrolyzed diet combo.


The neutropenia is unlikely to cause the SIBO. I checked on this. If a low count causes infection, it is usually respiratory tract or skin that we see problems. 


The low count could be from the SIBO though because other common causes of neutropenia are sepsis or localized bacterial infection, in this case, maybe his GI tract, esp if it's been going on for a while.
This could happen if there is translocation of bacteria through his GI wall and his white count is trying to respond to that. If this is the case, then his white count should improve with treatment and we would treat and then check it again in 2 -4 weeks.



So, for now, I think focusing on the Vit B12 injection, Tylosan, and diet is the best next step. We wait on the tick panel, and recheck his WBC and weight in 2-4 weeks.


Of course if you have additional questions or concerns, let me know. We have injectable B12 in stock and can order the Tylosan and food for you if you'd like. These items may be available on our website online pharmacy link, or we can call them into a pharmacy of your choice if applicable.


Best,
Dr. Conradi


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## Tahnee GR (Aug 26, 2006)

Sounds like my Suva  The injections didn’t do much but the Tylan has been a miracle worker! In her case the abcessed teeth were the culprit, the infection causing small bowel issues.

She is a different dog today, inside and out 

I was petting the dogs the other day and thought I was petting Selfie, because of the luxurious feel of the thick coat. When I looked down, it was Suva! 

Fingers crossed for you both!


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## Siandvm (Jun 22, 2016)

Rayder has been on Royal Canin hydrolyzed protein, tylosin, and B12 for almost a year. He is doing great! I just bit the bullet a couple of weeks ago and tried taking him off the tylosin, and he is still doing great. I would like to try him off the B12, but the blood test is so expensive that it is cheaper to just keep him on it, lol.


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## Peri29 (Aug 5, 2017)

As others said those diseases can be transmitted by different means. Please, once more I explain here that not all dogs show the symptoms, sometimes no symptoms at all. Lyme is not the only disease. Leishmania, Erhlichia, Babillosis , Anaplasma are the other ones. Vectors are fleas & sand flies. Do not limit the symptoms only to fever.


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