Gut Health Matters: Understanding Gastroenteritis in Dogs
Imagine this: your furry friend is lethargic, vomiting, and experiencing frequent diarrhea. You're left feeling helpless, wondering what's causing their discomfort. If this sounds familiar, your dog may be suffering from gastroenteritis. This condition is a common digestive issue that affects dogs and can cause serious discomfort. In this episode, we're going to uncover the mysteries of gastroenteritis and help you understand everything you need to know as a dog owner.
Listen in to learn about the different causes of gastroenteritis in dogs, and the signs to look out for, so you can spot the problem early. We'll also talk about the role of diet, hydration, and medication in managing this condition, and share tips and tricks to keep your pup happy and healthy. This episode is a must-listen for all dog owners, so grab your furry friend, sit back, and get ready to become a gastroenteritis expert.
What You’ll Learn:
What gastroenteritis is.
When you should take your dog to the emergency room.
What you can do to treat gastroenteritis at home.
Common signs to look out for that your pet has gastroenteritis.
Causes of gastroenteritis.
The importance of knowing what you’re feeding your dog.
How veterinarians diagnose and treat gastroenteritis.
Ideas Worth Sharing:
“Chicken and beef are two of the most common allergens for dogs.” - Tyler Sugerman
“Our goal with gastroenteritis is to see what could be causing the discomfort, and if not, we start treating symptomatically.” - Tyler Sugerman
“If your dog has an upset stomach, we often suggest feeding them plain rice and boiled chicken.” - Tyler Sugerman
Resources Mentioned:
ASPCA 888-426-4435 or pet poison helpline 855-764-7661
Read The Transcript:
Welcome to Vetsplanation. I'm Tyler, or you can call me Suggs. I love being able to educate my pet parents on what's going on with their furry little loved one. But as an emergency veterinarian, I'm usually running around from critical case to critical case and don't always have the time to be able to tell you what I've learned in 25 years of experience in just those short two minutes.
I'm hoping with this podcast, I'm going to be able to help you guys understand what your veterinarian is trying to tell you. So, let's jump into this week's episode.
Tyler Sugerman: Hey everybody, welcome back to the podcast. So, for anybody who does know me, you know that I work overnights and so I usually do this when I'm staying up at night, and the room is really dark, and it's really cold and it's dark outside. Today, I'm actually doing it in the daylight, there's like nice trees and sunshine, it's great.
So, today, we are going to talk about Gastroenteritis. So, gastroenteritis, if you go to your own human doctor and you went in for vomiting and diarrhea, they're going to tell you that you have something like a stomach bug or the stomach flu.
So, a stomach flu does not have anything to do with influenza, it's just what they called it at some point. And then the same thing with a stomach bug, it's not like a bug that's causing it, it's not like a parasite or anything.
It actually just means that you have gastroenteritis. “Gastro” means stomach, “enter” is the intestines and then “it is” just means inflammation, so gastroenteritis.
And the symptoms are going to be very similar to what you would call the stomach bug, but it just basically means that you’ll have sometimes vomiting, sometimes diarrhea, sometimes you have both, not really wanting to eat.
All of those are symptoms of gastroenteritis. And if there's blood in the vomit or the diarrhea, it could also mean that the pet has something called HGE or hemorrhagic gastroenteritis. The other name for that is acute hemorrhagic diarrhea syndrome (will shorten that to AHDS), but again still means that we have inflammation of the stomach and the small intestines.
There's usually two types of these. So, it could be something that's very acute, meaning that it's something that comes on very quickly and goes way very quickly as well.
It also can just go away quickly on its own. It doesn't always mean that you have to have some sort of medical intervention. Same thing with you when you have the stomach flu or the stomach bug, you don't always go into urgent care because you're having vomiting. It just something happened and you start vomiting, and usually, you deal with it when you're at home. Same thing with the dogs.
The other side of that is the more chronic gastroenteritis. So, that can occur over weeks or months or even years. And there's different things that cause both the acute and the chronic one. We'll talk about those in just a minute.
But the most common signs you're going to see is usually going to be watery diarrhea, mucousy diarrhea, maybe some tarry black stools. Those are not good, you need to come in immediately when you see that. They might have blood in the feces, they might be really lethargic, just really tired and don't really want to do anything.
They can be really restless because they're one, they have to have diarrhea constantly, so they're constantly moving around. But also, sometimes it's painful. Like when they lay down, think about like where they're laying down: they're laying down like their belly is pressing on the ground and that's going to be really uncomfortable for them. So, sometimes they just pace a lot.
They might have abdominal pain so if you push on their belly, it might be really painful for them. They could have nausea. So, usually, signs of nausea are drooling, licking at the lips or even just swallowing very frequently. They could have vomiting and then again not wanting to eat, so inappetence.
Some of the potential causes, there are lots of causes for these things. So, the interesting thing about when you go into the human doctor and they say you just have a stomach bug, there's no — like everybody just takes it as a face value. Like oh it's just a stomach bug, then I'm okay.
But there's actually thousands of things that can cause gastroenteritis. And the interesting thing when you compare humans versus veterinary medicine is if you bring your dog or cat in, a lot of people want to know what the answer is, what is it that caused this?
But if you go into your human doctor, nobody really asks like what caused this? Was it something that I ate? Was it some … this very particular virus that could have caused it. A lot of times you just want to feel better.
And so, sometimes that doesn't quite happen with dogs. Like everybody wants to know exactly what it is that caused that. Now, that's the hard thing about these is we can't know unfortunately what the cause of this always is.
We always do or we want to do testing for it, so we can try to determine what it could or could not be. Because we want to make sure that if it's something really serious that we are dealing with that really serious problem, versus it maybe being a very mild case that might go away on its own.
So, some of the things that it could be are going to be like if they ingest some raw foods that they're not used to or spoiled food or things that are not food items. So, objects like let's say, rocks. I definitely had my lab ate rocks at one point and she had an upset stomach, but I'm pretty sure they’ve passed.
You could also have toxins that they can ingest. So, mushrooms is a common one in Washington out here. And again, it causes them to just be nauseous. There's other toxins we have to worry about as well, if it could be like grape toxicity or if it's raisins or if it's lilies. Unfortunately, there's no way for us to know which toxin it's going to be besides hopefully you seeing that they ingested that toxin.
It could be from a virus. So, parvovirus is a very common one, distemper is one, could be Coronavirus. Not the same Coronavirus that we have. In people, this is a different type of Coronavirus, but it affects their stomach and their intestines, which can cause them to have the vomiting and diarrhea.
It could be from parasites. So, things like giardia, coccidia, round worms, those are the most common ones that cause it. But that parasite is basically eating all of their nutrients, it's filling up their intestines and it makes them really nauseous. It could be that there's some change in their intestinal flora, meaning that we always have bacteria in our GI system.
Dogs, cats, us, doesn't matter, there's always going to be bacteria in there. The goal is that we have more good bacteria than bad bacteria that's in there. So, when the bad bacteria starts to overgrow, then we start having problems.
So, when we change foods, like if we change the dog's food, suddenly, we don't do it over a slow period of time — that changes their gut flora to all that good bacteria very quickly as well. And then that bad bacteria starts to overgrow the good bacteria, and it'll cause them to have things like mostly diarrhea but can cause vomiting as well.
So, really sudden changes in food. It could also be from just giving them different types of food. So, let's say, they get steak every day. There's a lot of fat sometimes on the steak and if you're constantly giving that to them, that is going to almost accumulate, basically it makes the pancreas really upset.
And I did a whole episode on pancreatitis that you can go back and listen to, but it makes the pancreas really upset and that can cause changes in that gut flora as well. Food allergies or food sensitivities. Some dogs are just really sensitive to things like chicken or beef. Those are the two most common allergens is chicken and beef and anything related to it.
So, any sort of foul, so ducks and even turkey or with beef, it could also be bison. They definitely can have allergies to other foods as well but those tend to be the most common ones, is those two proteins.
It could be that they have some sort of ulcer. So, a stomach ulcer or an ulcer in the intestines. Remember, I was talking before about that dark tarry stool, that usually means that there is an ulcer usually somewhere in the upper GI tract.
So, meaning the stomach or the very first part of the small intestines that is blood that's been digested and moved down the GI tract into the colon. So, if you see that black tarry stool, that is definitely an indicator to come in immediately because we need to address that.
Some of those ulcers can be so bad that they'll actually perforate the stomach or basically open the stomach up and all that stuff in the stomach now spills out into the abdomen, which is not good. Other things can be liver and kidney disease. So, the liver is there to help filter toxins throughout the bloodstream. Same thing for the kidneys.
They do different ones, but it's basically they help filter out toxins and it doesn't necessarily mean a toxin that they eat. That could even just be things that they would normally ingest. It's there to help filter all of those things out.
So, if they have liver disease or kidney disease, that can definitely make them very nauseous. It can be cancers. So, you can have cancer in the stomach or in the small intestines that can cause a blockage, or it could just make them really nauseous. So, again, we want to try to rule those things out, like can we see any potential masses in there that's causing this.
Foreign bodies is another one, so if they eat an object. If they eat an object, it can cause them to have just a backup of all the rest of their food if it gets stuck somewhere causing an obstruction. Other things are going to be like genetic diseases.
There are some dogs that will have issues just with their GI system in general: boxers are really common one. They get boxer colitis, which just means an inflammation of their colon, but it will also sometimes, affect their intestines as well.
It could even be that they have some sort of stricture, so like some scar tissue of their intestines that makes it to where they can't move things through very well.
I've even had a dog that unfortunately had a disease that made it to his nerves in the stomach and the small intestine stop working, and so nothing can pass through. All not really good things, so we want to try to make sure that we've done diagnostics to try to evaluate for them for those things.
Typically, if you bring them into the vet for vomiting and diarrhea, like for me, I usually talk to you about like try to figure out in the history, is there potentially some sort of dietary change that might have caused this or did you see them vomit up a worm or how long has this been going on for?
So, we're going to take a pretty extensive history because we want to know like what are the causes that could have been to try to figure out what's causing this gastroenteritis.
So, I know that usually the technician gets a history but we'll also as a doctor, be asking some more extensive questions as well. Another one that I haven't mentioned yet is going to be salmon toxicity. I've already talked about salmon toxicity in another episode, but it's basically if they eat any freshwater fish, that will cause a gastroenteritis as well, inflammation of the stomach and the intestines.
So, if we go through the history and figure out that there wasn't really anything that we know of that they could have gotten into. Like I do have a lot of dogs that are in an apartment, they're walked on a leash, somebody's home with them every day. Nobody feeds them any table scraps, and it's kind of a mystery then. So, we need to start figuring out like what this could be and more importantly, what is it that it's not.
So, usually, doing diagnostics meaning we're going to do usually x-rays and blood work to try to figure out if we can find something that's causing this.
Sometimes an ultrasound will be used as well, it just kind of depends on the doctor. But in blood work, we're looking to see like are their kidney levels okay, are their liver levels okay? Do they look like they have a really high white blood cell count and potentially, have some infection somewhere?
Or do they look like they have a really high red blood cell count and maybe have something called HGE, or hemorrhagic gastroenteritis, meaning that's the blood that we see in the stool and also, in the vomit. There may even be further blood testing that needs to be done.
Sometimes, we're doing extra blood work to look for something called Addison's disease, which I'll do on another episode, but it's basically where the adrenal glands do not work as well. And we use our adrenal glands to make a steroid which every part of our body needs. So, we're looking for extra testing on those things.
We'll also maybe be doing a fecal. So, we're looking at a fecal sample which hopefully, if you can remember, bring a fecal sample in to us. It's much easier for us to do a fecal on a sample that's much bigger than what we might get when we're doing it on our exams. So, bring a fecal sample in so that we can check for any sort of parasite that might be in there.
Sometimes, we'll do it in-house, so we'll look at it right there and see if we can find anything, or sometimes, they get sent out so that that way they do have some better testing. So, they're doing like some PCR-type testing. Basically, they're looking for the DNA of the parasite rather than us just looking for the actual eggs themselves.
But we might be doing that so that we can try to see if we have any parasites that might be causing this as well. On x-rays, we're going to look for any obvious foreign bodies. Is there like a rock in there? Do we see cloth in there? There are some things that we cannot see on an x-ray, especially if there's something called a partial obstruction.
So, if you have something that's only like partially blocking the intestines, stuff can still move through, and then we're not going to see those signs of a full obstruction. We're not going to necessarily always see those signs of a gastroenteritis.
More advanced imaging might be doing that we look on ultrasound. I often like to look on ultrasound to see if I see any masses that could be in there that could be causing it. Or if I see something like the intestines aren't really moving very well or if I see that there's a lot of gas in some area. So, we usually are using quite a few tests to look for things.
There are even more advanced imaging. You can have like a radiologist that looks at them on an ultrasound. A radiologist is somebody who is board certified, meaning that they went to school specifically so that they can read x-rays and ultrasounds.
You can also have an MRI or a CT scan that's performed as well. Sometimes for these chronic cases, we end up using CT scans to look for any foreign body so we may not be able to see or any masses that we may not be able to see.
You can even do things like endoscopy or colonoscopy for some of these more chronic cases as well. So, that's basically where they stick a camera for an endoscopy, stick a camera down into the stomach, sometimes into the small intestines a little bit but it really depends. It's not very easy.
But looking at the stomach to see do we have anything like stomach ulcers or foreign bodies that are in there. Doing a colonoscopy so sticking a camera up into the rectum, into the colon to look for anything there as well. Again, usually like ulcers is what we're looking for there. But there are definitely more advanced things for things that are chronic conditions.
So, I know we just talked about so many things that can cause this. And there's tons and tons and tons more that can cause gastroenteritis as well. So, our goals like I said, are usually that we just want to try to see if we can figure out what could be caused by and if not we start treating symptomatically.
So, my most common question I think I get is “When should I take them into the vet?”
Because like I said, with you as a person you go into a human doctor when you've been vomiting for quite a while, it's usually not like you've vomited for a day or 24 hours and you're fine. Or you're having diarrhea, you're usually not going into the hospital or into urgent care at that point.
So, usually, when I say like for small puppies and kittens, things that can get really dehydrated, it's usually best to go in pretty immediately. For anybody who's been vomiting for more than 24 hours, I usually think that they should come in. Any old dogs should come in as well.
The old dogs and old cats, because typically, those are not the guys that are going to get into just food or an object — those are usually the cats and dogs that are going to have some more chronic problem that we need to deal with, some kidney problem or liver problem.
If there's blood in the vomit or blood in the stool, then again, I do think you should come in at that point. We need to assess like how bad it is and make sure this isn't something that's more like a toxin that can cause a bleeding problem or some autoimmune disorder. So, something that their own body attacks themselves that's causing this, because those could become life-threatening things.
If you think that you know that your dog had eaten an object or your cat had eaten an object, definitely, they should come in as well because we worry that there's something that's stuck in there. The sooner we get into surgery to remove it, the better. The less chance that we have that it's going to cause that perforation or that hole in the intestines or stomach or a hole into the stomach as well.
And then what are things that you can do at home? Let's say that they were just having diarrhea, you can actually try just a bland diet at home. I know I kind of covered this in pancreatitis, but basically, just doing chicken and rice.
So, when you do chicken, you want to make sure it is bland, boiled chicken breast: no skin, no bones, no seasoning, no oil, no butter, and boil it. Don't bake it because it still has quite a bit of fat when it sits in the baking area.
Even with the barbecuing unless you are like my friend who he like scrubs his barbecue with a toothbrush every single time he uses it, ideally you don't want to use the barbecue because it's still going to have a lot of seasonings and stuff that are going to be on that barbecue.
With the rice it just needs to be boiled as well. Very bland, no seasonings again, and it can be white rice or brown rice. It doesn't really matter which one, just basically chicken and rice.
Some people will ask can I add chicken broth? I'm usually pretty hesitant about adding chicken broth because it usually has a lot of sodium in it, which is going to make the pet have a lot more water retention. Not really ideal. So, I usually say try not to do chicken broth if possible.
I also have the question of like for people who have dogs who have a lot of food allergies, what to do. Unfortunately, for those guys if they have so many food allergies that they can't use certain types of proteins, then I usually just tell them just to keep them on their same diet and then we just have to kind of do medications instead.
But let's say, like maybe they're only allergic to chicken. So, I just said use chicken and rice. You can use other things, like you could use ground beef. Again, boil it because that way all that fat will come out in the boiling process. You can use ground pork. Same thing, boil it to just also make sure it is thoroughly cooked through. So, we don't have things like Salmonella.
Or it could even be that you can use boiled lamb, as well, and ground lamb is fine. It doesn't have to be like a lamb chop or anything, just ground lamb is okay too.
And if you don't want to cook or you don't really like cooking, there's two other alternatives. For chicken, you can even use just canned chicken. If you go to the tuna aisle at the grocery store, they'll usually have canned chicken in water, not the one in oil, again, too much fat, but the canned chicken in water — you can use that instead.
I've even seen the instant rice, you can use that for the rice too. Or if you don't want to do the rice, even just do the canned chicken for a couple of days. It usually needs to be for about three to five days. Just making sure that the diarrhea has gone away, the vomiting has cleared up, they are eating and then you can slowly switch them back over to their normal diet.
So, usually, I say just do it as a very slow as in if you take three quarters of chicken and rice to a quarter of your regular dog food for one day. The next day, just do half and half. And then the third day, do a quarter of the chicken and rice and three quarters of the dog food. Even if you feel like that's too soon, you can even just extend that over two or three days as well.
For people who don't want to cook also, usually you can find a veterinary bland diet as well. So, the common ones are going to be Royal Canin gastrointestinal, Hills i/d and then also PRO PLAN sensitive digestion. So, the next question I usually have is “Can I just use the sensitive stomach from over the counter?”
So, sometimes, those still have a lot of fat in them, so I usually don't recommend them. There are certain ones that I will try, so like just food for dogs like I'll usually use their gastroenteritis ones. So, there's one that's called like Balanced Remedy, I believe it is. And it’s turkey and rice basically. It has other nutrients and stuff as well to make sure it's a balanced diet, but that's usually a good one. They usually do pretty well on that one.
And then the other thing is that you can use probiotics. You can pick these up at pretty much any pet store. You can walk into a vet hospital, and usually, they'll have some for sale there as well. But usually like just PetSmart, Petco, that's fine. You could just pick up probiotics there too, and you just sprinkle it on their food so that way, you can try to help give back nutrients to the good bacteria that we want to overgrow that bad bacteria.
If you bring them in and we do do diagnostics or maybe we don't do diagnostics and you're just like, “Well, I want to see how they do just with medication” because sometimes we'll just give medication and see if it improves. If this is some sort of virus that caused this or some sort of bacteria, they should improve within a couple of days. So, if you're going to do that, then most typically, you'll see veterinarians give something to help stop the vomiting called an antiemetic.
So, we talked about how in our other Valentine's podcast and some of the other ones that emesis means to make vomit. So, we want to do an antiemetic to help stop the vomiting.
Most commonly, that's going to be Cerenia that we use for that. There are other ones as well like Zofran, which is used in human medicine. Kind of stings so and we have to give it kind of a lot, so we don't usually use that very often. Or Reglan is another one I've seen used or Metoclopramide is the other name for that.
And those don't necessarily stop vomiting, it just makes the intestines move faster so that it moves stuff out of the stomach. But the other ones like Cerenia does help stop vomiting and does help stop nausea. Sometimes we'll prescribe a probiotic. So, again, something to try to help make sure that the good bacteria grows over that bad bacteria.
Sometimes if there's worms, we're going to do a dewormer. And then, also, this one is a little bit controversial, giving Metronidazole. So, Metronidazole is an antibiotic, and they feel that if it's given in cases that are really mild, that's really unnecessary.
If you can do just a bland diet that's more likely to help with the GI flora. So, an antibiotic is going to kill bacteria. We cannot make it kill only the bad bacteria, it's going to kill some of the good bacteria as well.
So, if you can get rid of the diarrhea just with a bland diet, that is going to be the more preferential way. But if you can't and this diarrhea is still continuing, then usually Metronidazole is going to be given if that's the case.
And this is something we've always given. So, this is something we've done for a very long time is giving Metronidazole. This is kind of a newer thing that we've discovered that it may be a little bit detrimental to give Metronidazole to everybody. So, we try not to give much Metronidazole as much as possible anymore.
Sometimes we'll also give fluids under the skin called subq fluids or subcutaneous fluids. Just means that we're doing fluids underneath the skin. They look almost like a camel hump between their shoulders, and eventually, over about 24 hours, that fluid just kind of helps reabsorb into the body to keep them hydrated.
It will kind of sometimes fall as well. So, just to warn you with gravity, like it'll fall onto their shoulders, or it might fall onto their chest, and look like they have a large lump that's there but it's just gravity pulling that fluid down. That's all. But it tries to help keep them really hydrated. There are certain dogs we cannot give fluids to. Typically, it's going to be dogs or cats that have a heart problem that we don't do that with.
And then if, depending on how bad they are, maybe it's hospitalization. Or maybe if they have a foreign body, then it means doing surgery, which I'll do a whole another podcast just on surgery and post-op care and stuff as well.
But what are the things that we can do to help prevent gastroenteritis? So, one is getting like a trashcan that has a closed lid, something that they can't get into. You'd be surprised, just like how many dogs just stick their head into the trashcan when you're not there. So, you want to have it away somewhere.
Like I have mine under the kitchen sink, it doesn't have a lid on it but my dogs can't get into that cabinet at least. But if you have one that's out, have a lid even potentially a locking lid because some dogs are still so smart, they’ll figure out how to lift it up, lift up that lid and then still can get into the trashcan. So, trashcan, preferably, with a closed locking lid.
Switch their diet over slowly. So, if you are switching their diet, make sure to do it over a slow like one-week progression so that that way you make sure that the good bacteria still stays and can just very slowly adjust to the diet change that you're doing.
Some people change their diets constantly, they're like constantly switching their foods. Try not to do that because we're going to cause things like a pancreatitis.
No table scraps. Don't give them any foods that are going to be high in fat. So, like no meats and stuff. I know everybody is tempted to give them a bunch of steak off of the barbecue or ribs and stuff, but that could still cause them to have a gastroenteritis or worse, could cause them to have a pancreatitis as well.
Especially bones, try not to give them bones like cooked bones and whatnot. Because again, like these can cause them to have that gastroenteritis because it's a change in the flora. But also, because the middle of the bone has a lot of marrow to it and they tend to eat through that fat digests and then they get pancreatitis.
There are bones that are specifically made for them. Just again, I know I've done like a whole episode on bones as well, but making sure that it's not a bone that can get stuck in their mouth or that they can easily swallow. It needs to be something large. And then having somebody monitor them to make sure that they're not eating giant chunks of this or eat the whole thing and get it stuck. Alright. So, I think that is all for our gastroenteritis. Like I said, there are thousands of things that cause this.
Now, for our fun animal fact. So, I'm really sorry I didn't do one for the Valentine's Day edition one, but my computer was just acting all funky, couldn't get it to work, and so I was just trying to get it out quickly so that that way I would have it out for Valentine's Day for you guys.
So, today we're going to talk about just a cool thing with dolphins. So, did you know that dolphins kind of have names for each other? They're like basically the only other animal that has a name for each other.
So, like we name each other. But no other animal really like has a name for each other, but dolphins kind of do. So, we know that they make these really high-pitched squeals and all these other sounds, trilling whistles.
But what they think happens is that each dolphin has kind of their own individual whistle, and that is basically their name. It's their signature type sound so that when they go into a body of water, they'll use that whistle to kind of tell other dolphins that they're there.
So, it's basically announcing when you walk in the room you're like, “Hey, I'm Tyler” and that's basically what they're doing, is they're telling each other what their name is.
And then dolphins are so good at mimicking other sounds. Like they can mimic things like computer screens and those computer noises and stuff. So, they're so good at mimicking them that they'll then use that whistle that the other dolphin came in as you know that “I'm Tyler.’ They'll use that Tyler whistle and then now be able to call that person and be like, “Oh hi, Tyler, I’m …” and put in their whistle as maybe Jane.
So, then now, they each have kind of a name for each other and know like how to address each other. Super cool. Hopefully, they'll be able to figure out, like all the other things that they're saying. But I just thought that was very interesting that they're really kind of the only other species that has names for each other.
Alright, thank you guys and again, will you please ask me any questions? You're welcome to email me. You can go to my website at vetsplanationpodcast.com. You can find me on Facebook and Instagram at Vetsplanation or at Twitter at Vetsplanation podcast. Or I'm also trying to do TikTok; we'll see how this goes. But I'm going to try to do some TikTok videos. I'm just trying to get it all set up at this point.
So, again, if you have any questions, comments, please, please, please, email me, let me know or just leave a comment and I'm happy to get back to you. Thanks, guys.
Please remember that this podcast is for informational purposes only. This is not meant to be a diagnosis for your pet. If you have questions about diagnostics or about treatment options, please talk to your veterinarian about those things. Remember, we are all practicing veterinarian medicine and medicine is not an exact science. Your veterinarian may have different treatment options. If you like our podcast, please leave a five-star review and hit subscribe, so you'll be able to hear all the future episodes.
Thank you again and I wish you and your pet well.