Ascites in dogs

What is ascites?
Ascites is the abnormal fluid accumulation in the peritoneum, that is, the serous membrane that forms the lining of the abdominal cavity. There may compression of the diaphragm due to enlarged abdomen and thus interfere with breathing. It is common in dogs and endangers the dogs life in extreme cases, when large amount of fluid is produced or rapidly produced. In dog the ascitic fluid may go up to 20 litres.

What are causes of ascites in dogs?
(a) Severe liver diseases like hepatitis and liver cirrhosis leads to
decreased albumin production or by increased resistance to blood
flow within the liver.
(b) Congestive cardiac failure, cardiac insufficiency.
(c) Peritonitis- inflammation of peritoneum which causes leakage of
intestinal contents.
(d) Compression of mesenteric vein and lymphatic vessels by large
tumor and cyst
(e) Infestation of dog by heart worms causing cardiac failure.
(f) Bleeding disorder which might be inherited or due to ingestion of
poison.
(g) Malabsorption of protein and excessive loss of protein through
faeces.
(h) Retention of sodium due to renal insufficiency.

What are the signs and symptoms of ascites in dogs?
Swollen abdomen or abdominal distention will be seen in dog and it may assume a pear shaped appearance. Abdominal discomfort, diarrhea, vomiting, lethargy is seen.The dog is anemic, pale, weak with sunken eyes and the ribs are visible very prominently. Dog refuses to eat food. There is increase heart rate and accelerated respiration rate . Temperature may remain within the normal range. Coughing is seen which may be due to heart disease. Breathing difficulty is seen in the dog and the dog is inclined to lie down.

How is ascites diagnosed in dogs?
Ascites is diagnosed by
(a) Clinical findings like enlarged abdomen, etc
(b) Urinalysis
(c) Blood test
(d) X-rays
(e) Biochemical profile.


How is ascites treated in dogs?
The lines of treatment for ascites are as follows
(a) Diuretics such as thiazide or lasix
(b) Spironolactone – potassium sparing diuretics
(c) Corticosteroid as supportive therapy
(d) Blood transfusion in case of ascites due to trauma
(e) Antibiotic is given in case of infection
(f) Vitamins and minerals to restore vitality
The dog should be fed with high protein and low sodium diet. Routine deworming of the dog. In serious cases, ascites is treated by “paracentesis abdominalis” where a needle or trocar and canula is inserted in the site between the umbilicus and pubis close to the linea alba. This is done to drain out the excessive fluids from the peritoneum.

58 comments:

  1. This information has been very helpful to understand what is happening to my dog.

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  2. good.informative

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  3. Thanks for taking the time to discuss this,I really feel strongly about it and really like knowing far more on this topic.

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  4. My beloved dog developed ascites, dyspnea, anemia, vomiting, coughing and lost her appetite - but sadly my vet believed she had late stage lung cancer - she had a mammary mass which had not been biopsied and no blood tests had been carried out to confirm it - when in fact it was brought about following a severe reaction to her treatment for lungworm - the vet recommended euthanasia - I was devastated to subsequently learn that the condition could have been treated - I have been beating myself up about it - I miss her terribly.

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    1. my beautifull yorkie had it and she had to be put to sleep she was 10 and very beautifull i miss her so very very much heart broken

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    2. I am at lost I have a yorkie also and the doctor say he has this . He is 5 soon to b6 in april , can you please give me some advice on what to do. For the past 3 months the doctor has drained his stomach ,change his meds but a few days later he is swollen again. Some helpful advice for someone who has been through this will guide me on what to do..thanks you..

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    3. Having the exact same reaction, draining the ascitis but then few days later she is swollen again! Doctor says we can do nothing to help but as my dogs appetite is good, I cannot believe him! Anyone had experience with healing ascitis??

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    4. I have a yorkie mix, she was diagnosed with a liver shunt. It was repaired at UT in Knoxville. Ascitis goes along with liver problems. Watermelon is a natural diuretic and liver dogs seem to love it!

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  5. I'm totally with you who commented on Feb. 12.
    I lost my beloved dog 3 weeks ago. She developed ascites caused by a mass between liver and spleen. I was panicked and did what the vet suggested, which was euthanasia. Reading these treatment makes me greatly regreat the decision I made and I feel awful.

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  6. thank you very much Doctor - very helpful

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  7. How soon after treatment starts will you see improvement?

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    1. There is no specific time. Improvement depends on what stage of ascites treatment is done and also the underlying cause.

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  8. My friend has a dog suffering from ascites. The dog is having most of the symptoms mentioned above. We are in Chennai. Please let me know if there is any doctor who has seen and cured such cases.

    Thanks

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    1. I have treated dogs suffering from ascites.Take the dog for treatment to a veterinary doctor at the earliest.

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  9. Hello, I have a yorkie suffering from ascites for3 months . Dr. Naroaier do u have any advice , the dogs has been pumped 3 times to remove fliud , change of meds cause after being pumped 3days later he is swollen again. I don't know what else to do for him. Can u be very open with me on this case I would appreciate it. Thank you.

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    1. I just learned my adopted sheltie (12 yrs old) has liver cancer which is causing the distended abdomen (fluid accumulation). About 1 cup of fluid was drained from his stomach area but he is now swollen worse. I suspect that the swelling is making his already low appetite worse. No coughing, vomiting or diarrhea but obvious discomfort and lack of appetite. I read that the draining procedure hastens the decline by causing the fluid build up to speed up, increase fluid retention volume and add more stress on other organs (heart, lungs, kidneys, etc.). So, if you have the choice, avoid the draining at all. I regret letting the draining be done without my permission. Now, I know that in a few days/weeks, I will have to euthanize my dog.

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    2. Sorry about your dog!! Thank you for your advice. I will not let them drain him again and I have came to that I will not let him suffer .... It's hard when you love them like your own kid. I feel for you I had a dog pass away 3 yrs ago with cancer its not easy... It's just hard on us with my YORKIE cause he was healthy no signs of nothing and all in one month he went down hill. Thanks again appreciate the honesty cause no one is willing to give it to,me.

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  10. I have a dog with chronic heart failure and ascitis, been removing the fluid almost weekly by now and she keeps deteriorating. I have no trust to any vet anymore because the medications especially the diuretics-lasix are doing absolutely nothing for her. Can it be heart worms??? Is it possible?? I am asking because no medication seems to be making her feel better, her appetite is good and she only has the ascitis problem.
    Any ideas? I will certainly not euthanize our dog if I am not convinced that there is no way of making her feel better.

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    1. My whippet has congenital heart failure (cardiomyopathy). A vet suggested euthanasia 3 1/2 years ago but I was sure he had a lot more life in him. His heart is great according his new vet however the ascites is a big problem. Does he need to have a general anaesthetic to have it drained?

      Does anybody know if any traditional medicines or techniques can help this? I was thinking of trying cupping with some moxy.

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  11. Dear doctor,
    I have a 12 yrs old beautiful cocker spaniel that has been diagnosed liver failure a month ago. My vet is treating him with carduus compositum and other medicines. He has been drained 3 times, last time on january 7th, but my vet decided to stop this procedure because albumine levels are really low and he didn't want to mess with the oncotic pressure the dog has reached. Now my dog has troubles breathing due to the severe pression of the abdomen on the diaphragm. Is there anything else I can do to help him? He isn't in pain, he's still wagging its tail.. thank you for your help

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  12. I have just viewed about 7 articles and this is by far the best. Concise and included critical information.

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  13. I have a 12 year old Border Collie that had normal blood work at the end of November. Currently his liver profile is quite elevated, has some anemia, and ascites. We suspected Leptospirosis, but the test had very small elevations. He is not jaundiced, is not eating, barely drinking. we are trying to decide the next step. My father in law is a retired vet and recommends stopping all treatment.(He has not seen the dog) I am not convinced that we are done. It could be denial on my part, any ideas, suggestions? We have not done an ultra sound. The expense so far has been high. Thank you

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  14. our dog just got diagnosed with liver cancer. so sad. she is very bloated and did get an ultra sound. we were given days...weeks at best. :(

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  15. Our 4 year old labrador has haemalytic anaemia and has now developed ascites. We're measuring his stomach to monitor him and it's grown to 82 cm, having started at 65 cm and he's fairly uncomfortable. He's been given two different diuretics to reduce the fluid retention. Is there any benefit in draining the fluid to improve the effectiveness of the drugs? Your advice would be greatly appreciated.

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  16. We live in Malawi and have no vet. Our German Shepherd (18 months old) has developed ascites and is very thin, ribs and backbone prominent. She eats well and is always hungry. We have been treating her with furosemide (one tab/day) to reduce the fluid and this has gone down, but she is still thin as a rake. She also has low energy levels and has diarrhia although not frequent as she lasts the night. we did manage to get a blood test done which showed a problem with her liver but we are not able to go further as we have no expert help here.
    We feed her four small meals a day, with good protein, (dried fish/meat/egg) sweet or ordinary potato and greens. I read that papaya leaves are good for digestion, so we have started giving her some raw chopped into her meals - but she is STILL so very very thin.
    Does anyone have any idea of what on earth our lovely doggy can be suffering from?
    Many thanks, C

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    1. My daughters St Bernard has same symptoms. He had heart failure 8 months ago, and was always breathless since. He went off his doggy food, and lost weight, but has a renewed appetite for cooked chicken, ham, susages etc. He is looking boney, and just recently his stomach distended. the vet has diagnosed fluid accumulation due to the heart failure. I am not so sure. There are so many causes of stomach dilation in dogs, and also of apparent heart failure, such as 'Bloat'. I also think he may have suffered a bout of rheumatic fever prior to his 'heart failure' . Not sure about this though. However, reading the above article, there are several things that can be done to treat 'Ascites' , if that is what he is suffering from. His distended stomach feels taut, and not what I would expect to feel if full of fluid. Hope this helps. Keep trying, and get a second opinion!

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  17. i have a 5 yr old lab who is happy, eats, sleeps, drinks, plays and poops great. No s/s of breathing difficulties. he has developed ascities and the vet took an xray and determined a tumor about the size of a grapefruit...he sees it but does not look well defined to me. stated that the outlook is not good and does not recommend treatment. recommend to put him down as soon as any s/s of SOB noted. it's hard d/t he is so happy and doing great except for the gradual increase of the ascities.

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  18. My 8 year old Italian Greyhound was prescribed Prednisone after surgery in June and it caused his liver to fail, which caused severe ascites in the abdomen and back legs after being on the steroid for only 5 days. I took him in to see the same surgeon and he immediately took him into surgery and drained my dog of about 700ml of liquid. Four days later, he swelled up again and I brought him to the surgeon to see what was wrong. The surgeon said the only way to find the cause of the problem was to conduct an exploratory surgery, but because of my dogs health condition, he would probably not survive. I thought that was crazy and he told me that the only other option was to put him down. I said no way and took him to an internal medicine doctor. She looked him over and said he could definitely recover. She said the steroid had caused the liver to shut down and the body was dumping fluid into the body, that should have been pumped through the veins and organs. He was skinny, lost his appetite, was severely dehydrated and was so depressed. Because he was so sick, we had to leave him with the doctor for three days on IVs, just to see if his body would balance out. He wasn’t getting better after a day on IVs and the internist was considering doing a biopsy or putting him down. We decided to give him more time and he thankfully made it out alive, but it was a close call. We took him home and the liquid remained in his body. About every 3-4 days we would have to drain him (300-500ml at a time) because he was so uncomfortable and was unable to lay down. As a last resort, I took him to see a Chinese herbalist that had seen him before years ago, for a skin condition. She advised to take him off all medications (diuretics, pepsid, antibiotics, etc.) because they were not helping the liver, but destroying his frail system, which I did immediately. The herbalist gave him three types of drops (essence (to restore all damage done by medications and stress), ginseng A (a mood booster) and zhen wu tang (to restore liver)) and advised to feed him a cooked diet (nothing crunchy or dry). I also did some research and found out that papaya, parsley and Mexican squash chayote are all great foods for the liver. After just a couple of weeks of taking the drops, my iggy looked healthy and the ascites was completely gone! We took him in a final time to have blood work done with the internist and everything came back normal. Please, always seek a second opinion, even if it seems out of the ordinary. Veterinarians and surgeons don't always see the problem or know how to cure our animals. I have so much faith in alternative medicine after all this nightmare began. In my case, the surgeon wanted to kill my dog, the internist kept him alive and the herbalist is curing him. I hope my experience can shed some light or offer a alternative to euthanasia

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    1. hi pal, I feel so happy for you and your boy, its really crazy how easy vets throw the 'putting down' card over the table...so, I´m in a situation just like your´s with my little guy, but there´s no herbalist I can take him for a consult in my city (I live in Brazil), so I´m learning all I can through the web so I can come up with the correct tcm diagnosis, and then buy the appropriate formulas from an online store to start his treatment. so first question is, do you remember the diagnosis the herbalist gave to your guy? I mean, yang defficiency, yin defficiency, damp-heat, and so on? about this essence you mentioned, can you remember what was it made of? and if its not asking too much, I know you already answered it here, but how many drops or ml/kg of each medicine you had to give him at a time? thank you so much for the help, and I hope you have many healthy happy years with your guy ahead! all the best

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    2. Hello! I just saw your message and I'm glad you read my post! I am going to go home tonight and find all the info I can (I kept all the records) and pass it along to you. And just so you know, Chinese herbalists treat humans and animals in the exact same way.

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    4. I really hope this helps your little guy! OK so this is what his records show. He was first prescribed Essence a 1/2 inch dropper 4 x day. He was also given Ginseng + prepared antidote 1/4 inch dropper, as needed. This was more of a mood booster. He was on a strict diet of moist cooked foods. I started with chicken broth, white rice, Mexican squash, parsley and papaya. Heavy on the papaya. I really had to baby him for a week, but little by little he got stronger. Brought him in again 2 weeks later (drained him twice I think), we went back and she also gave him Zhen Wu Tang ++ 1/2 inch dropper 2 x a day until finished. This is what really kicked his recovery into high gear. If you can't find a Chinese herbalist, a homeopath might be able to point you in the right direction. If you want to maybe take this further, I can put you in contact with the herbalist and see if there is something she could do for you. I am in the US, but that doesn't mean we can't try to help from afar :) I said a prayer for your little guy and I'll keep checking on here for a response.

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    6. I can't get a hold of the doctor, but I did a little research and found there are some Chinese doctors in Brazil. I actually found some on yelp.com, because it sounds like he needs the actual medicine, right?

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    7. something I didnt tell you is that I did found a doctor in my city to consult him, but he was an acupcunturist, not a herbalist. he diagnosed him and wanted to treat him with acupuncture which I declined because it was too stressful for him with the cushing´s and all that cortisol going through his liver, so I asked him if he could prescribe the drops for his pattern, which he did. the tinctures would take more than a week to get to me, so he said I could use one formula I bought one month before (for liver disease, but never used, waiting for the correct diagnosis) untill the right ones arrived. so I did, I used long dan xie gan tang for 3 days with him, a thrid of the prescription (for the sake of precaution) and it seems this thing just destroyed his kidneys. his creatinine, bun, urea levels went from absolutely normal to stage 4 failure in one freaking week. then I typed long dan xie gan tang kidney toxicity and found out its got two nephrotoxic herbs, and that it´s related to several cases of acute kidney failure deaths around the world. yesterday it was too much for my little boy and he left us... we are devastated, I can barely open my eyes, but I wanted to come here to say that I cant be 100% sure this is what happened, but I can say that I learned the worst way possible that google search finds what you type, not what you need. I was stupid enough not to look for the bad things that could happen before the good ones, and kept looking for long dan + liver disease, jaundice, etc, and almost all I got said it could be the way to go. now all its left for me is to pray there´s really a puppy heaven, and that all his pain and suffering have turned in to unending joy and happiness for him... thanks again, amigo. we will not forget there was a good soul out there willing to do what you did, first sharing your story, and then being there for someone like me who maybe could be in need of a helping hand.

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    8. What a brave little soul to for trying to hold on and fight, after everything that went on. I am so sorry for your loss and I can't imagine what you are going through. My thoughts and prayers are with you and I strongly believe he is also in puppy heaven too. Hope these quote eases your mind:

      If there are no dogs in Heaven, then when I die I want to go where they went. ~Will Rogers

      At one time a synod of the Catholic Church was held in which the question of whether or not animals had a soul was discussed very seriously: would good dogs go to paradise and bad ones, who stole slices of lamb, burn in hell eternally. The denial of the soul was voted: it is enough for the honor of the species that the question was posed. ~Alfred Barbou

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  19. To Anonymous w/the 8 yo Italian Greyhound, how much of the drops did you give your dog?

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  20. Essence 4 x day (he is still on it, onlt 3 x day) ginseng was only for a week 3 x day and wu tang 3 x day

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    1. FYI Italian Greyhound is completely cured! 2 months later and he's good as new...like nothing ever happened. Cannot stress enough how important it is to seek help from a Chinese Herbalist. They have the solution vet's don't.

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  21. Please please please help if u can. My gorgeous puggle puppy who is only 14 weeks old won't be with us much longer unless I can sort out his acities.He has had x-rays, ultra sounds, blood tests and liver function tests. The vets are so baffled by him because his liver function tests have all come back fine. After a few days off his food and losing so much weight,amazingly he is now happy and has a healthy appetite he's putting weight on and seems almost back to his normal puppy self.HOWEVER !!! his acities is getting worse day by day and now interfering with his mobility,His abdomen has grown 6cm over nite and now measures 60cm.From tests all we know for definite is that the excess fluid in his peritoneum that is causing his acities is full of white blood sells which is very unusual, the vets are so reluctant to drain him because of the white blood cells in the fluid.They can't find the cause of his acitis and have told us to fear the worst !! Please advise because my instinct is just to get him drained but I am going against expert advice.

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  22. We took our 3 yr. old male dog into the vet for not eating and throwing up about 3 weeks ago; we originally thought he had swallowed something foreign. The vet took him into surgery, called us to let us know his spleen was in enlarged and needed to be removed. We agreed to the recomendation. Since the surgery our dogs abdomen has filled with fluid to the point of having a drain for a week. Each day he goes to the vet to have the drain cleaned and more fluid removed. 3 days ago the drain was removed, today we returned to the vet for more fluid build up. We are being told protein levels are good, as well as everything else. He is now eating well, vomiting on occasion and still the abdomen is filling with fluid. In reading about Ascites and the different blogs; my dog is the very same way. The doctor is stumped and we continue to watch our dog suffer, any thoughts or suggestions would help. Thanks

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    1. My dog developed ascites after a laproscope and my vets are stumped too. I found published articles by human laproscopic surgeons who have documented ascites of unknown origin after surgery in people. When I've asked vets about it they say they have never heard of it happening with a dog. Sounds like it's happened to our dogs. Please let me know how your dog is and if you get any answers. I'll do the same. ANYONE ELSE???? I posted about my Mini Schnauzer below.

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  23. In Feb. 2013 my 12 yr. old miniature schnauzer had elevated liver enzymes and elevated bile acids so I agreed to a laproscopic liver biopsy. 1-2 wks. after the biopsy she developed ascites (fluid in her abdomen) and has had to be drained of the fluid approx. every 2-3 wks since. The liver biopsy only showed very mild liver disease and I've been told by every vet I've taken her to that it would not cause the fluid. Since then her liver and bile acids are normal, She has had 9 ultra sounds all neg., bloodwork, neg. heartworm, heart is fine. She has never lost her appetite but is losing weight. I've even had her to a specialist who has no idea what is causing this. The 2 things I am convinced of is that the fluid was caused or triggered by the laproscope (the vets say this couldn't be it) and that she has malabsorption... but why??? Before the laproscope NO FLUID. Before the scope she did have some vomiting usually late at night so I started giving her a low dose of pepcid which completely resolved the vomiting. I wish I had never agreed to the liver biopsy. ANYONE... ANY IDEAS??? Please help or I'm going to lose her and not even know the cause or why.

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  24. Taken my pomeranian Rocky to the vet. He's had an xray & he's full of fluid. He's had an injection to try to pee it out. I've got to take him back to the vet in the morning and drop him off. They have to sedate him & take some of the fluid & take blood off him to find out where the fluid is coming from. They are confused why he is so well???? His heart & temperature are fine. Poor thing. He is only 4lb in weight. Any idea's what the best treatment is?

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  25. I am so sad there is no cure, knowing that your dog is going to die in a few months while she(your dog) has no idea whats happening. And when she smiles at you happily, and you know its the last time you'll see her, its heartbreaking.

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  26. The comment above is mine, my dog is a jack russel btw. Don't take it to heart that there is NO cure because there are possibilities of your dog surviving. Hope, love care and prayer power.

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  27. Your great information has done so much for me,my carer and most of all my dog,am so grateful

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  28. Hy Dr. T K mam.....mam it's urgent.....I am from delhi ....I hv a pug and he is having ascites...u said dt u hv treated dogs wid ascites....mam pls pls pls tell me where are u locates....Pls treat n save him...Pls mam....
    Thanks
    Regards
    Rohit
    9999475571

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    1. WTH you posted this irrelevant crap here?

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  30. My 4 month old puppy was diagnosed with a liver shunt and today we were told he has ascites and was drained.They aren't hopeful he has anything that can be corrected with surgery and putting him down will be the next step. Is there any diet that can help? He can not be on a high protein because of liver shunt. He Is just under 2 pounds started new meds today. Any and all related advice welcome. Thank you

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  32. My 9 yr old labrador was diagnosed with heartworm and ascites. We're giving him medication (furosemide, antibiotic, anti anemia, pet tabs) as prescribed by bet however his condition is getting worse (lethargy, he never eat or drink, always lying down, his tummy is still swollen.
    Please help me. Should we stop his medication? What should we do?
    We dont want to lose him. His our best pal. Please..please....i need your help....

    Thank you in advance for the comments

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  33. our 12 year dog has CHF and when we took him to the vet a month ago his liver is enlarged. He now has ascites. He is eating and going outside but with his condition I cannot tell if he is suffering, his stomach is enlarged. We give him pimobendian twice a day. Any advice?

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    1. I recommend reading the book by Cyndi Smasil called, "Hope for Healing Liver Disease In your Dog," for anyone who has a dog suffering with ascitis based on a liver problem. My dog had an ultrasound and was diagnosed with cirrhosis of the liver. 70% of her liver was scarred and dead and she was fiven 6 months to live. I researched this book and started making her a special diet based on the advice in the book and my dog is still alive after 2 1/2 years. My vet is surprised. I feed my dog a high protein, non-fat diet of shredded, cooked skinless chicken breasts with cooked macaroni, non-fat cottage cheese, and steamed vegetables-peas, carrots and green beans. I recommend this book for good answers.

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