Gastric Disorders Cases

This is my dog Ruby she’s a 9 & 1/2 year old female spayed pit bull and  I’m a veterinary technician at an integrative practice. Ruby has been struggling with acid reflux as you can see in this first video. She has episodes of swallowing and licking. She gets so scared and swallows air and struggles to breathe when this happens. I’ve tried a series of GI foods and she’s currently eating Dr. Harvey’s canine health and then I cook the protein. Either turkey or chicken. I’ve done several bloodwork panels , barium study, ultrasound , and even an endoscopy. We can not get down to the cause. On endoscopy her stomach lining was very irritated, biopsy came back inconclusive. The barium study revealed that her gi tract was moving slower than it should so they recommended Reglan for a little while. All this started after Ruby was prescribed an antibiotic , Clarithromycin ( recommended by my human GI specialist when I was sick with H pylori, and then she and my other dog tested positive as well ) I think it really damaged her gut. before that she was completely healthy and was even my clinics donor for fecal transplants ! We have been dealing with this for almost 2 years. I currently give her visbiome probiotic and she takes omeprazole and Dasaquin advanced. I discontinued her galliprant just in case but no difference. Whether she’s on the omeprazole or not she has episodes so I don’t think it’s helping. I tried kefir but she breaks out in rashes. I did a food allergy test and she’s allergic to milk and a few other things. I’m convinced she has leaky gut. How would you recommend I approach this? I am open to any and all recommendations you have. Eastern and Western. Thank you!!

P.S - she never has diarrhea and she also doesn’t vomit. Just these weird episodes .

Dr. Steve's Advice - the good news is that there are many things that may help. The bad news is that there might be some trial and error, but since you're a trained professional, you're in a good position to go through that process. Hopefully the first choice will be the right one. 

The more that the one thing we try captures all salient features of Ruby, the more likely it will work. I think Halscion  (https://goldstandardherbs.com/products/Original-Halscion-85g-p647327436)   by Gold Standard Herbs does that for her. Here's why:
- I agree that Ruby must have a leaky gut, given the allergy to keffir. Leaky gut and associated allergic tendencies are addressed well by Minor Bupleuurm, which is at the core of Halscion
- The slow peristalsis is also likely to be improved by Minor Bupleurum, since evidence suggests it is commonly due to low-grade IBD (e.g., from the leaky gut). In worst case scenarios, that peristaltic disruption appears able to provoke GDV
- The worsening from antibiotics for Helicobacter suggests the leaky gut is due to dysbiosis, which normally could be remedied by a probiotic, but in practice appears to need a local immune stimulant given at the same time for the probiotic to be reliably effective. Halscion has that effect through its content of Minor Bupleurum. Note that long term use of omeprazole, although I see why you felt it was necessary, fosters continued both dysbiosis and Helicobacter infection. Specifically, it promotes stomach and small intestinal bacterial overgrowth (SIBO) since stomach acid is one of the key ways that the GI protects itself from bacterial pathogens
- Helicobacter is an opportunist, taking advantage of not just low stomach acid but poor stomach mucosal circulation. The same condition can cause chronic unresolved gastritis, which can occasionally be reflected in the very pink muzzle that you're seeing in Ruby. My favourite formula to address this condition is Yi Guan Jian (Glenhia and Rehmannia), which is a component of Halscion

All things considered then, Halscion is what I'd start with. 

As well, if you can find a local vet acupuncturist, have them test whether your dog's pulse softens in response to acupuncture at GB 34. If it does, it pretty much proves the Halscion will work, but in the meantime, will help improve gastric emptying and reduce the tendency to what is essentially the equivalent of GERDs. If you see that change, you may be able to start weaning off the omeprazole. If it never helped to begin with, perhaps just discontinue it, but then watch to ensure the condition doesn't worsen. If it does, try something like TUMS or Zantac, which is not quite so wholly suppressive of stomach acid production as to foster SIBO and Helicobacter infection.

Hope that helps!

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I have many of your suppliments already. What would you advise for a dog who burps a bunch after eating and a little bit of food comes up every time with every single meal. It is damaging his teeth which are brushed daily!  He is a quite rare Russian toy (779 registered in the United States) he’s also a registered therapy dog. He is 3 years old and 3 lbs. He eats raw food and it appears chicken beef and Turkey all Still cause the burping. Here’s a recent X-ray of his stomach. It doesn’t show hernia they say. He was hospitalized for an episode in which he aspirated and got pnemonia after we believe he was going to vomit from pain in his abdomen. They did many X-ray and a scope and found nothing in the stomach. Blood work was normal. On the third day in the hospital his stomach filled with fluid 3x the size it should be.  Our vet believed he would die.

The vet waited to long to scope him that day and he sugar crashed to a 25 and almost died.  The video is of him jumping in pain after an odd episode that almost looked like a seizure. That’s why he aspirated.

Dr. Steve's Advice - if he was a larger dog, I'd almost say he has gastric issues reminiscent of GDV, which always makes me reach for Minor Bupleurum derivatives like Adoptrex      (https://goldstandardherbs.com/products/Original-Adoptrex-85g-p647327433) from Gold Standard Herbs. If that's one of the ones you have on hand, I'd give it a try.

Adoptrex pairs well with Glehnia and Rehmannia to heal stomach ulcers as well. I know they saw no ulcers, suggesting it is more of a motility disorder, which makes Adoptrex my top pick. Still, to hedge your bets and ensure acid production is truly normal, you could use it with Kan Essentials' Glehnia and Rehmania

Hope that helps!

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Hello Dr Steve my Dog (3 yrs old on raw) went into emergency operation for bloat Sunday night and was released today. They recommended a bland chicken and rice diet for the next 3 day and transition to regular diet (raw) on day 4. My question is do you think i should be feeding him rice or can Imyou suggest something else? He was also prescribed Gabapentin for pain and Clavamox for nasal discharge I know sometimes pain meds are necessary put should I give him the Clavamox? I want to avoid any further damage to his microbiome which I’m sure I’m gonna have to look into. Thank you for your time

Dr. Steve's Advice - GDV or bloat pretty much exclusively happens in so-called Shao Yang disharmony animals - that is, in animals who benefit from Minor Bupleurum. These animals also need more soluble fiber and fermentable carbs in their diet for normal GI function. The rice, therefore, seems fine for now as a source of simple carbs. Make sure your dog takes a Lactobacillus and/or Bacteroides probiotics from now on. 

I have also never seen a dog bloat when given Minor Bupleurum. Minor Bupleurum is a main component of Adoptrex by Gold Standard Herbs   (https://goldstandardherbs.com/products/Original-Adoptrex-85g-p647327433) The other component is a formula called Wei Ling Tang which helps to regulate peristalsis. If this were my dog, I would make Adoptrex a standard dietary inclusion, unless the veterinarian is sure there is no risk of GDV in the future. If they did a gastropexy, abdominal discomfort can still occur, which Adoptrex will eliminate.

As for the Clavamox, I can't really comment, since I don't know how bad the nasal discharge was. If your dog had major abdominal surgery, then a few days of antibiotics is probably not a bad idea, especially if they couldn't keep the operating field as sterile as they wanted it.

Hope that helps!

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We would really appreciate your help.
We have a 6 yr old cocker spaniel. He is suffering from what we have been told is GERD. He has been diagnosed with dysmotility of the esophagus after barium swallow. 

After 2 years of trying many medications, supplements, medical tests, food trials, changes to routine and elimination processes we cannot find something to help him. What could we try to help him please? 

He possibly has IBD.
He has had 6 seizures in 2 years.
Only abnormal blood test findings - low folate June 2021, back to normal Feb 2022
He had 3 deep ulcers in his duodenum in Oct 2021, healed now. 

Thank you

Dr. Steve's Advice - I don't know what supplements you've tried, so I can't promise this won't be a retread of advice someone else gave you. There are three basic Chinese medical diagnoses that can give rise to the licking symptoms you're seeing there: Shao Yang disharmony, Dampness, and Stomach Yin deficiency. Shao Yang can be associated with either of the other two, but the other two are somewhat mutually exclusive. So it probably will boil down to a process of elimination. The first thing I would try (since it is usually what works) is Yi Guan Jian (One Linking Combination), sold by Kan Essentials as Glehnia and Rehammnia Combination. It is probably the world's oldest treatment for GERDs and the tendency to gastric ulceration. I've cured my own dog with it, and many human patients, too. You should be able to find the Kan version easily on Amazon. Dose according to the table at https://nphc.ca/using/dosage

If the GERDs gets worse on the formula, even that is good news, because it at least tells us your dog is Damp. I don't think that will happen, though. I would give it a try.

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We’ve been working with Rodney Habib for about 3 months now for our dogs excessive swallowing issues.
Tonight he suggested I reach out to you for help.

Hazel has been excessively swallowing before and after waking up from sleeping for about 4 months.
It’s to the point where when she wakes up from her sleep it seems although she has an excessive amount of saliva in her mouth.
It’s typically when she lays down before her nap/sleep and worse when she wakes.
Her nose is also super congested so we thought it may be some sort of post nasal drip issue, we’ve tried allergy relief options and have had no relief 

We’ve done the GERD protocol by Rodney and we’ve tried a million natural supplements, herbs, etc. None have made a difference at all over the past 4 months.

She’s been on raw and now we do the honest kitchen and add our cooked protein which she loves and seems to be great. 

She’s had chiropractic work done once since because she did run into me when she was off leash pretty hard and the symptoms happened shortly after, but the chiro didn’t seem to help at all. 

We are unsure what steps to take next, if we should get an X-ray or try to find another chiropractor etc.
any help would be great

Thanks!

Dr. Steve's Advice - there are a lot of options that can help your dog. I guess the first thing is to check out the carb content on a DM basis of the Honest Kitchen. If it is above 30%, that may be the problem (unless this was happening on raw - was it?). If so, you could try to source Three Seeds Combination from Kan Essentials (e.g., from Aamzon in the US). It can decongest the nose and help reduce or resolve the GERDs.

If it was happening on low carb raw, then get a hold of some Adoptrex      (https://goldstandardherbs.com/products/Original-Adoptrex-85g-p647327433)  by Gold Standard Herbs and give it a try.

Lastly, it's possible that a Kan Essentials formula called Glehnia and Rehmannia might help, but use it only after you've tried the above.

One rule out is megaesophagus with a secondary nasopharyngeal infection. X-rays may help disclose that. Note that Three Seeds and Adoptrex are two good treatments for megaesophagus, so trying them first might be a good idea. They can even be used together if you want to hedge your bets.

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I'd like to start by saying that Gaby is being actively managed by a veterinarian but so far we haven't been able to find a clear answer to what is happening so I am praying you have seen this before. 

Gaby is a distemper survivor (neutered male) of unknown age. He was already an adult (at least 3 or 4) when i rescued him and he was a former street dog who was actively battling distemper so to say his teeth were bad would be an understatement. He and I both fought like hell for months and he finally beat distemper roughly 4 years ago and has lived a really cushy life in Southern California ever since. 

He does have tics (his head bobs) and had a few seizures early on but those have been managed well with a very low dose of phenobarb. It has now been 1+ years since his last breakthrough seizure and his tics have actually softened so much that they are almost gone now. 

In the last month or two, his health has started deteriorating and no one can figure out why. He has always been a picky eater but he has recently grown so much worse. He acts like he is hungry (runs up to the food bowl eagerly) but as soon as he sees/tries to eat the food, he smacks his mouth and walks away. Two different vets have checked his mouth and seen no reason there, so thought maybe nausea and put him on cerenia but that hasn't helped. His appetite has waned to the point that we are about to put a feeding tube in so he can get adequate nutrition while we look for answers. 

He has also started displaying weird behavior: pacing endlessly in circles, making weird/random vocalizations (sometimes grumbling, sometimes crying). His bloodwork has been great: kidneys/liver/WBC/RBC/etc. with the exception of somewhat low cortisol. His cortisol is .9. We ran the Addisons test and it was negative. We have also done an abdominal ultrasound and it looked normal except some inflammation in his small intestine and a small nodule that the vet believes he was born with on his pancreas. Next we ran a micronutrient panel and it showed he had low B12 so we are now supplementing that and awaiting a low dose steroid to take care of the inflammation.

Tomorrow he is being sedated and will have a more thorough exam (to include x rays) of his head/mouth/neck. If that comes back normal, the next step will be a CT scan of his head/neck. 

I am at a complete loss here and, in spite of the measures we are taking to help him, he doesn't seem to be improving. I can't justify giving up on him because we don't know what is causing his issues and, without that answer, we don't know if this is fixable or not. 

My fear is that he is entering the early (or advanced) stages of dementia and that it may be happening earlier in life because of the neurological damage from distemper. But that wouldn't explain his low b12 and cortisol so there has to be SOMETHING else....

Thank you for reading this far and for any advice you can give on additional tests, protocols, etc. This little boy brings so much joy to the lives of myself and others and I am terrified that I am losing him. Please help.

Dr. Steve's Advice - you may need a trained chiropractor to palpate his neck or jaw, to be sure there are no fixations there that could be contributing to jaw pain and refusal to eat despite hunger. If they don't find anything on his exam today, keep that in mind.

My suspicion, though, is that he might have a mild ulcer. He gets hungry, but then as soon as gastric juices start flowing at the sight of food, he experiences abdominal pain and backs away. Gastric ulcers are hard to detect with routine X-rays and lab work, unless they are quite severe.

The cognitive issues would appear to be separate from a conventional perspective, but in Chinese medicine commonly arise from one of the most common causes of ulcers, namely Shao Yang disharmony. 

Chinese medicine understands the body as made up of Yin and Yang. These two substances - matter and energy - move around the body over the course of a day, powering different organs as they go. If they don't move smoothly, problems arise, particularly if it is Yang that is getting stuck somewhere. It is the job of the Shao Yang to prevent that from happening.

Yang is supposed to internalize at night. If it doesn't, all that energy in the brain creates insomnia, pacing and vocalizing. Seizure tendencies are common as well. If, during the day, the same Shao Yang dysfunction has Yang trapped in the interior, then it concentrates in the Stomach producing problems like ulcers and GI inflammation (which can lead to low B12 levels). 

If that analysis is correct, your dog should respond pretty promptly to Halscion      (https://goldstandardherbs.com/products/Original-Halscion-85g-p647327436) by Gold Standard Herbs. It contains two sub-formulas. One of them, called Chai Hu Jia Long Gu Mu Li Tang, has been used for two thousand years to deal with those cognitive issues. Another one, Yi Guan Jian, is the top formula for healing gastric ulcers. If this were my dog, I would be giving it a try right away

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