Wally — a complex case of a bloating German Shorthaired Pointer — still to be solved
🩺

Wally — a complex case of a bloating German Shorthaired Pointer — still to be solved

Last update
@April 12, 2022
Get in touch via
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

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.

The picture was taken at his worst weight moment — 16.4 kg / 36.2 lbs.
The picture was taken at his worst weight moment — 16.4 kg / 36.2 lbs.

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.

When humans are not around and Wally is in pain, he typically finds Blue and lays on her. She’s 12 kg.
When humans are not around and Wally is in pain, he typically finds Blue and lays on her. She’s 12 kg.

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

Wally’s stomach is bloated. Typically, happens in the mornings and doesn’t go further than that.
Wally’s stomach is bloated. Typically, happens in the mornings and doesn’t go further than that.
Yep, it doesn’t look great but this is the light version of his bloat. No pain here, typically.
Yep, it doesn’t look great but this is the light version of his bloat. No pain here, typically.

Levels of bloat: Level 2 — Stomach and duodenum

His stomach gets so big that it looks as if a balloon was hidden inside.
His stomach gets so big that it looks as if a balloon was hidden inside.
From this perspective, you can see that his duodenum (or some other part) clearly goes outside of his rib cage.
From this perspective, you can see that his duodenum (or some other part) clearly goes outside of his rib cage.

Here his right side is clearly seen expanded outside of his rib cage. You can see the intestinal movements as he’s so thin.

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.

When he’s fully bloated, you can clearly see this by looking at his belly. He typically wants to pee and begins to do very long farts.
When he’s fully bloated, you can clearly see this by looking at his belly. He typically wants to pee and begins to do very long farts.
Probably one of the worst conditions I found him in. I was about to take him to the ER but he went to sleep and after 30mins the bloat was gone.

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.

Wally when the pain hits him. It’s not his normal appearance. GSPs are very lively and happy dogs. He lays on Blue (Whippet) as he typically seeks help from others when it hits him.
Wally when the pain hits him. It’s not his normal appearance. GSPs are very lively and happy dogs. He lays on Blue (Whippet) as he typically seeks help from others when it hits him.
A video of him slurping from pain. 3 hours earlier he received Drotaverine, this is 8 hours since his last meal. I was at work on calls and it hit him hard while sleeping. This has been recorded in April.
Compare this video to the previous one. This is way earlier and shows Wally who struggles with bloat after eating and the pain is clearly weaker as he’s got his eyes open and looks at everything.

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).

Taken at 11 pm.
Taken at 11 pm.
Taken at 7 am the following day.
Taken at 7 am the following day.

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.

The first ever x-ray capturing the bloat. He literally bloated from nil to this while waiting in the room for the vet to configure the equipment.
The first ever x-ray capturing the bloat. He literally bloated from nil to this while waiting in the room for the vet to configure the equipment.

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
January - Now
Can’t attribute effects to it but these seem to be of higher quality (we keep them in the fridge).
Vitamin Complexes - Vit Activ, Flawitol
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

All

2 views

All

List

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