Last update | @April 12, 2022 |
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Author | Patryk Kabaj |
Hi,
this is a story of my 11 months old German Shorthaired Pointer — Wally — who at the age of 5 months began to bloat and has not stopped bloating since. It all began in October last year (2021) and since then we are trying to figure out what is going on and why. So far, no success.
I wrote this piece in English to seek help outside of the borders of Poland where we are based. We need all the advice and insight that’s out there. When I write “we” I mean myself, the group of vets working together to help him and Wally himself.
If you know an amazing vet — please share a URL of this page with them. If you are a vet yourself please reach out to me at bloatingwally@gmail.com.
We have already shared this story with Polish veterinary groups on Facebook and discussed it there. The group of vets leading the diagnosis and treatments is open to feedback, tips, advice, critique and insights. For the sake of vets’ privacy and not to jeopardise their professionalism by a possible incorrect representation of their practices — I won’t be using names throughout the story. Though, if you reach me at bloatingwally@gmail.com, I’ll be happy to connect us together.
Patryk & Wally
If you speak Polish: Jeżeli szukasz polskiej wersji, mam podobną w PDF, proszę napisz na bloatingwally@gmail.com — podeślę podsumowanie po polsku.
Table of Content
- 1 — Introduction
- 2 — Wally
- 2.1 — Quick Introduction
- 2.2 — Pre-illness Wally
- 2.2 — Wally’s Environment and Companions
- 3 — Symptoms
- 3.1 — Symptoms Today (@April 9, 2022)
- 3.2 — What Lead us to the First ER Visit
- 3.3 — Symptoms from October till January
- 3.4 — Symptoms from February till April (@April 9, 2022)
- 4 — Diagnosis & Treatment
- 4.1 — What we know
- 4.2 — Treatment
- 4.2.1 — Diet
- 4.2.1 — Meds
- 4.2.1 — Exams & Tests
- 5 — Summary
1 — Introduction
The goal of this document is to provide a detailed overview of what we did and what we know in order to find help (outside of Poland). If you have an idea, tip, or advice or you had a case like this — even if it means that it’s likely I’ll need to put Wally down — please reach out to me at bloatingwally@gmail.com.
The last thing I want for Wally is to suffer from pain, and discomfort and die due to malnutrition, in hunger, while eating himself from inside. Therefore, I value honesty and being clear on what the situation is. Sure, I don’t want it to end in a tragic way, therefore I am putting everything we know on paper and sharing with the world.
I am going to divide this piece into 4 sections:
- Who’s Wally — A fast intro to the dog
- Symptoms — What the symptoms are and how they evolve.
- Diagnosis & Treatment — A high-level overview of what we’ve already done and when.
- Data Sheets — a more detailed overview of the diet, med and exams we’ve had.
Let’s dive into this.
2 — Wally
2.1 — Quick Introduction
This is Wally, an 11 months old German Shorthaired Pointer.
Putting together a semi-pedigree overview.
Name | Wally |
Breed | German Shorthaired Pointer |
Sex | Male |
FCI | Yes. Well known, widely suggested FCI breeder. |
Born | @April 28, 2021 |
Age | 11 months (@April 9, 2022) |
Height | 68 cm / 27.5 inches |
Weight | 17.5 kg / 38.6 lbs (@April 9, 2022) |
2.2 — Pre-illness Wally
Wally was born on @April 25, 2021, making him today an 11 months old boy. He was the biggest pup and keen on approaching people. He would eat the most from the litter and had a huge appetite ever since.
Until he began to bloat (mid-October), we had few problems but nothing too strange or similar to what he’s experienced since falling ill. These problems were:
- Diarrhoea — resulting in antibiotics being applied in his 10th week, accompanied by probiotics and him quickly recovering from this. No problems after this.
- Hairless Tail Gland — we received him with a hairless spot on his tail gland, it’s still there today though less visible than when he was a pup.
2.2 — Wally’s Environment and Companions
Wally lives in a house with a garden. He lives with a 2 years old Whippet — Blue. Blue is healthy.
3 — Symptoms
Here’s a structured overview of what Wally has been experiencing. I begin with what we experience today, followed by a historical overview of how these symptoms changed (slightly) over time.
3.1 — Symptoms Today (@April 9, 2022)
Here’s a recap of what’s going on with him today.
Bloating | Wally gets bloated multiples times every day. It never ends up in GDV. First, the stomach gets bloated, quickly followed by the duodenum. Typically in the morning, his small intestines rarely get bloated, however, this changes in the afternoon when small intestines also get bloated. He looks like a balloon and when it happened for the first time - vets didn’t want to let us out of the clinic. It is very dramatic and looks way worse than what dogs qualifying for gastropexy look like. What’s associated with bloating are very loud noises from his intestines of fluids and bubbles moving around. Since he’s got little muscles, you can actually see intestines moving through his skin. He can bloat even 10 hours after eating. Bloating is typically triggered by him seeing, sniffing or thinking of food. His intestines begin to move (you can hear and feel) and within 3-5 minutes, he becomes a bloated cow. |
Burping | Burps when bloated but it’s hard to trigger or make him do that on purpose. Struggles to depressurise his stomach. There is no smell to his burps. |
Farting | Typically at the end of the day. Very long farts. They rarely smell (or we got used to but I don’t think we did). |
Vomiting | Rare (once a month). Typically from hunger (yellow fluid). |
Weight | 17.5 kg and going down 📉 (-0.4 kg per week atm). |
Abdominal pain | A quite recent new symptom (about 6 weeks old). Wally, typically in the afternoon and evenings, way before or straight after meals, gets these like cramps |
Rehydration | High fluctuation here. Sometimes his gums are wet and pink, sometimes they are grey and when pressed stay white for a long time (6 seconds and more). He rarely drinks water. |
Urine | Normal, fairly often but this might be due to the pressure on the bladder exerted by a bloated stomach and intestines. |
Faeces | If the meat he gets is fatty — the faeces is surrounded by a silky, gelly-like substance. Switching to the light meat of turkey breast helped avoid that. Unfortunately, he seems to have real issues digesting semolina. Sometimes it comes out literally untouched. |
Bodily | He’s got undeveloped testicles (but everything is hanging outside). It seemed they were too small when he got ill. He’s got a hairless, clean spot on his tail gland. |
Heart beat | Some of the docs checking him in the clinic suggested he might have bradycardia. |
Energy | Wally is a very calm GSP (unlike his breed...) but he has never-ending energy exactly like his breed. No losses here, ever. |
Neurological | None at the moment. |
Psychological | His humour and energy seem to be related 1:1 to his pain moments. He’s down when he’s in pain. He closes his eyes and has a shrimp-like shape with his tail in the forward direction. |
Temperature | Normal. |
Meals / Diet | 4 meals per day, at least 1200 kcal, made of turkey breast and semolina. Read on to learn what else we tried. |
Let’s talk about bloating in more detail.
- When does Wally bloat?
- A couple of times a day (6-7) with a varying degree of intensity.
- Mornings — are typically mild. As I prepare the food (cook, cut) Wally impatiently walks around the kitchen and sometimes his stomach gets dilated. This takes place around 7 am. Next, around 10 am he gets his second meal, and sometimes he gets full, dramatic bloat and sometimes he gets just stomach bloat.
- Afternoons — Sometimes between 1-4 pm he gets bloated on his own. Around 4-6 pm he typically gets his 3rd meal of the day and, very often, he gets bloated as I prepare the meal. Sometimes dramatically. From that moment onwards — bloating is going to last longer and tends to be more dramatic.
- How long does it last?
- 2-4 hours unless he goes to sleep or we take him to run at the fields which are 20 mins away via a car. He typically releases all the gases as we drive there, he typically sleeps during that time.
- What are ways in which bloating gets reduced?
- Sleep — is the best way to have him depressurise. He typically comes for help, cuddles and goes to sleep. It’s his best medicine to get rid of the bloat.
- Driving to the fields (typically asleep) and while he’s running on the fields — Dynamic walks are best for him to depressurise. Unfortunately, he gets bloated once we get back home.
- Not eating for at least 22 hours — we failed two USG checks because after 12h and 18h he’d still bloat during or before the check.
- What does not work?
- Simethicone — does not work at all. We tested giving him loads of it and little — it has literally no influence on his condition.
Levels of bloat: Level 1 — Just the stomach
Levels of bloat: Level 2 — Stomach and duodenum
Levels of bloat: Level 3 — Everything: Stomach, duodenum, small intestines
Full bloat typically takes place in the evening but can happen in the morning too.
Let’s talk about the abdominal pain he’s experiencing.
- It never takes place in the morning, typically takes place from 3-9 pm.
- It attacks him just like that while chilling on a sofa, or during a walk. Typically always in the evening after eating.
- Duration — 0.5 - 1h or until he goes to sleep.
- 1 x Drotaverine 40mg every 12h doesn’t seem to relieve him of pain (Med in Poland: Nospa).
- Symptoms of the pain: he sits next to me, doesn’t want to lay down, slurps, burps and occasionally grunts. His eyes are semi-closed, his ears directed towards his back. This goes on for 10-15 mins and eventually, he lays down and goes to sleep.
- Sometimes the pain is not accompanied by sounds from his stomach. Sometimes it’s just quiet there.
And lastly hydration.
- He rarely drinks but he’s on a cooked diet.
- He seems to pee a lot.
- His hydration changes rapidly and I can’t find any correlation to external factors.
- His gums become pale and dry (instead of pink and wet), when you press them, it takes a while (6+ seconds) for the colour to come back, and his skin feels slow when grabbed.
- Many vets who see him give him drips (slow drips but also under his skin). Typically this gets his gums to return to normal the next day.
- This became less of a symptom recently as we’ve been giving him Levothyroxinum natricum (Med in PL: Forthyron).
3.2 — What Lead us to the First ER Visit
The first visit to the ER due to the first bloat took place on the late evening of @October 17, 2021. Wally was 5 months old. I was aware of the seriousness of GDV affecting deeply-chested breeds so I took no chances and I took him to the 24h vet clinic nearby. Once we got there, the bloat was gone.
Three days later, he bloated again. We got to the clinic and the bloat was gone again. As we waited in the clinic for an x-ray, he bloated again. This is what we saw.
There had been other symptoms leading to this condition that we ignored. In fact, we laughed about them slightly and I was about to switch him to a different dog food brand. These symptoms were:
- 1 Farting — 3 weeks earlier Wally began to fart a lot — he stayed with other dogs at my mum's house, a place he was familiar.
- He’s also eaten cat’s grit — As he stayed at my mum’s, he hunted the place where my mum’s cat would do his toiletry and would eat his faeces covered in the grit (made of bentonite and on a couple of occasions from some silicon).
- 2 Looking fat — 2 weeks earlier when I picked him up he looked fat. Two days later he no longer looked fat. Today I know that his intestines were full of gas at that time.
- 3 Burping — As I picked him up from my mum’s, he began to burp from time to time, something that was kind of dismissed. We laughed at it sometimes. I didn’t trust the original kibble brand he was on (Petkult) and planned on switching to some other brand (VetExpert).
- 4 Testicles — He had no other issues than this, apart from the fact that his testicles looked a little bit smaller than I expected (I raised another GSP male 3 years earlier, I compared images).
Wally weighed 19.0 kgs when it all started.
3.3 — Symptoms from October till January
Here, the symptoms were pretty much the same, despite different dog foods, diets, meds and supplements:
- Bloating — Every day bloating, number of times.
- Burping and farting — are pretty much ongoing when bloated.
- Faeces — Pretty ok, never loose, most of the time ok, didn’t smell bad.
- Height & Weight — He managed to retain 19.0 kg until February but you have to realise that his skeleton, and legs kept growing. He doubled in height while retaining his weight.
3.4 — Symptoms from February till April (@April 9, 2022)
- Weight — In February he began dramatically losing weight, as much as 1 kg per week. If we gave him more semolina instead of meat, he would lose weight quickly.
- Faeces — Oily as we switched to cooked food including fattier parts of a turkey (skin). Otherwise pretty ok.
4 — Diagnosis & Treatment
First of all, I am not a vet so please bear with me if I say something stupid or incorrect. I am doing my best here. As you can imagine, after 5 months of tests, and visits to the vet, there’s plenty to say. I’ll do my best to be precise, brief and clear. I’ll do my best.
4.1 — What we know
No foreign objects | We did upper GI tract radiography twice (barium as contrast material). No visible signs of foreign objects. |
Accelerated peristalsis | The upper GI x-rays revealed that food moves to the duodenum faster than it should. Consecutive ultrasound checks confirmed accelerated peristalsis. It was suggested that it looks like a functional disorder of the gastric tract. |
Trichuris vulpis | In November we discovered eggs of Trichuris vulpis in his faeces. We gave him anti-parasitic Fenbendazole over 5 days (along with Prednisolone, he behaved neurologically weird in the 3rd and 4th day of curation). Next, we repeated this a month later. We are checking his faeces every month. No come-back so far. |
Gastroscopy | We took pieces of the stomach for the histopathological examination. We were not able to get further than the stomach (to the duodenum), unfortunately as the pylorus wasn’t visible due to the enlarged mucosa (or the area around the pylorus). |
Histopathological examination of the gastric mucous membrane | (via Google Translate): Multifocal fibrosis of the lamina propria of the mucosa. Minimal severity of Helicobacter sp. Numerous in the pits of the stomach. |
Intestine stimulants | We tried Trimebutine, Metoclopramide, Maropitant, Opipramol — without any effect apart from not being able to hold his pee. |
Antibiotics | We tried Metronidazole, then Tylosin, then Amoxycyllin/Azithromycin/Omeprazole. With the latter combination, Wally, after two days on these drugs, Wally experienced 3 days completely free of bloating, followed by regression, despite increasing the amount of Azithromycin. |
Steroids | We tried Prednisolone and after 2 weeks it (seemingly) worsened bloating. |
Simethicone | Makes no difference to him whatsoever in any quantity. |
Testosterone | His testicles are inactive. Blue had heat at home and Wally (9 months old) didn’t notice or seemed to care. We did a blood test and the test showed 0 testosterone (below ability to detect). We gave him 3 x Omnadren injections (Testosterone propionate/testosterone phenylpropionate/testosterone isocaproate/testosterone caproate) and he gained 2 kg. Otherwise, not much has changed. |
Pancreas | Ultrasound checks don’t reveal that much is happening there. The TLI on @November 4, 2021 was ok. TLI 13,40 µg/l (range 5-35) |
Thyroid | Seemed just above the minimums in November but has fallen down below minimums in March (possibly due to the Prednisolone given to Wally but some claim his Thyroid should be way more active back than already). He’s now getting Forthyron (Levothyroxinum natricum) but after 2 weeks of receiving it, he began to lose weight (0.4 kg per week). |
4.2 — Treatment
4.2.1 — Diet
Whenever we switched his food we would replace 10% of his food with the new food each day.
Main food
Name | When | Comment |
June - October | Dry feed he was on since a pup (from the breeder). | |
October - December | Switched once he began bloating. Likely a mistake on my side but I suspected the unknown brand to me. | |
Switch to cooked Rice & Turkey | In November | Super bloating, you could smell fermented food |
December - January | Similar to VetExpert and other dry food. No smell but no improvement. | |
Attempt in January | Skin rash on his ears. It’s likely he is allergic to sweet potatoes. | |
January | Similar to other dry ones, no improvements. On it for 3 weeks. | |
Cooked, minced turkey with skin | January - February | This is when Wally is given Amoxycyllin/Azithromycin/Omerpazole combination and experiences 3 bloat-free days, followed by regression. It’s during this regression that he drops weight and we add semolina. |
Cooked, minced turkey with skin + semolina | February | He would get parts of the turkey that had little but still some fat. His faeces would be oily. This is why I switched to the lighter breast. |
Cooked, minced turkey breast (light) + semolina | March - now | This is what he’s on now. He gets cooked meat in the morning and semolina in the evening. |
Supplements
Name | When | Comment |
Kreon (Pancreatic Enzymes) | October | No effect |
Fibre (Fibor) | October - December | No effect |
B12 Injections | December - January | No effect |
October - January | No effect | |
Probiotics (Fortiflora) | October - January | No effect |
Probiotics (Nature Science Mycobiotic NS) | January - Now | Can’t attribute effects to it but these seem to be of higher quality (we keep them in the fridge). |
January - April | We give him some vitamins to supplement his lack of nutrients. |
4.2.1 — Meds
October 22 - November 12
Active subst. | Name of the med | Amount per day |
Metronidazole | Metrovis | 2 x (not sure of the mgs) |
Vit B12, B9, Prebiotics | 1 x | |
Trimebutine maleate | 2 x 1/4 of 100 mg pill; later 3 x 1/4 of 100 mg pill | |
Weight | 19.0 kg |
Comment: No reaction here.
November 10-14 — fighting Trichuris vulpis
Active subst. | Name of the med | Amount per day |
Fenbendazole | Fenbenat Plus | 2 x |
Prednisolone | Prednicortone | 1 x |
Slow drips | Once a day | |
Weight | 19.0 kg |
Comment: Neurological reactions on the 3rd and 4th day. Wally got weird, running around the house as if he was chasing something, with sharp, rapid moves. It let it go on the 5th day. No effect on bloating.
November 23 - December 8
Active subst. | Name of the med | Amount per day |
Tylosin | Tylofort | 2 x 400 mg |
Weight | 19.0 kg |
Comment: No reaction here.
December 8 - January 6
Active subst. | Name of the med | Amount |
Maropitant | I think once a day | |
Kibble change | Royal Canin Annallergenic | |
B12 Injections | 6 x injections, one per week | |
Weight | 18.7 kg @January 4, 2022 |
Comment: No reaction here.
January 6-20
Active subst. | Name of the med | Amount |
Opipramol | Pramolan | |
Metoclopramide | Metoclopramid | |
Kibble change attempt | Skin rash reaction (possibly due to sweet potatoes) | |
Kibble change | Hill’s Z/D | |
Weigth | 18.6 kg @January 26, 2022 |
Comment: No reaction here. After 20th we didn’t give any meds until February 7th.
February 7-22
Active subst. | Name of the med | Amount per day |
Omperazole | Polprazol | 1 x 20 mg |
Amoxicillin and Clavulanic Acid | Clavudale | 2 x 400 mg |
Azithromicin | - | |
Kibble change to cooked food | Cooked turkey meat | |
Weight | 18.1 kg @February 7, 2022 |
Comment: After he received the antibiotics, after two days he had his first three bloat-free days, followed by a regression to the previous state. After he began to fall back to the original state we increased Azithromicin but with no effect.
February 22 - March 4
Active subst. | Name of the med | Amount per day |
Omperazole | Polprazol | 1 x 20 mg |
Amoxicillin and Clavulanic Acid | Clavudale | 2 x 400 mg |
Prednisolone | Prednicortone | 2 x 1/2 20 mg pill |
Weight | 18.2 kg @February 22, 2022 |
Comment: This is when we decided to try Prednisolone. By the 5th of March — Wally began to significantly bloat and his condition worsened. He would not hold his pee while on Prednisole (got better over time).
March 5-21
Active subst. | Name of the med | Amount per day |
Omperazole | Polprazol | 1 x 20 mg |
Amoxicillin and Clavulanic Acid | Clavudale | 2 x 400 mg |
Prednisolone | Prednicortone | Progressive reduction to 1/8th of a pill 20mg etc. |
Weight | 16.3 kg (worst weight) |
Comment: Progressive reduction of Prednisolone while still on antibiotics and Omeprazole.
Next on March 14, we begin 3 weeks long Testosterone boost therapy.
Active subst. | Name of the med | Amount |
Testosterone propionate/testosterone phenylpropionate/testosterone isocaproate/testosterone caproate | Omnadren | Injection of 125mg once a week |
Comment: Two weeks after he got Omnadren, he gained 2 kg.
March 22 - @April 12, 2022
Active subst. | Name of the med | Amount |
Levothyroxinum natricum | Forthyron | 2 x 400 μg |
Weight | 17.0 → 18.1 (@March 28, 2022) → 16.9 kg (@April 12, 2022) |
Comment: An interesting period where:
- Initially, Wally gains 2 kg after testosterone boost (reaches 18.1 kg)
- Next, in the 2nd week of Forthyron (Levothyroxinum natricum), he stops gaining weight and begins losing.
- @April 12, 2022 he is 16.9 kg, he’s lost 1.2 kg over the last two weeks
4.2.1 — Exams & Tests
5 — Summary
That’s it. That’s all we know, so far.
If you are keen on helping out, please reach out to me at bloatingwally@gmail.com .
Patryk Kabaj