Dog’s Odd Behavior Not From Inflammation

Q. My 6-year-old Maltese has an inflamed stomach and some bowel inflammation. He had been acting very standoffish, suddenly getting up and going to lie under a table, or just sitting and staring at me. After weeks of this, he vomited what looked like coffee grounds. The vet thought he had an ulcer, but because he was acting so oddly, did an endoscopy, finding only an inflamed stomach. Could this be pancreatitis? After weeks of antibiotics and Prilosec he is still having these episodes.

A. This is one of those challenging cases that we hate to see come into the ER because we can’t get a diagnosis, but love to conjecture about because it is interesting. Second and third opinions are important on cases like this because veterinarians tend to get tunnel vision occasionally.
 
Other than the one episode of vomiting, it sounds like your Maltese is displaying very vague symptoms of illness. In fact, there is no evidence that the gastrointestinal system is even involved. I would consider some neurologic disease causing back pain or discomfort, behavioral changes, cardiac disease, or an endocrine disease such as Addison’s.
 
In the meantime, continue with very basic GI drugs such as Pepcid, and possibly some Carafate to help protect the stomach. If your dog is not worsening, monitor him for any subtle clues that will help narrow down the possibilities.
 
Questions to consider:
Is his appetite improved, decreased or the same?
Is his body weight changing?
What are his bowel movements like? Water intake? Urination?
Are you seeing any other behavioral changes?
 
Let your veterinarian know of any significant changes. An abdominal ultrasound is another noninvasive test that can help rule out many abdominal diseases.