Although we are a small animal practice, one of our patients is Emma, a 130-pound Mastiff, with a cornucopia of problems. We first saw Emma when she was 3 years old, with a history of episodes of not eating and vomiting. These episodes could last for 3-4 days and then she would be fine for a few months and the cycle would start all over again. This had been going on for 2 years.

She had been treated elsewhere but nothing stopped the cycle. Dr. J prescribed a new diet and medication, but Emma’s stools then turned bloody. With things getting worse, we recommended endoscopy. However, Emma was 130 pounds, so the question became, “Would the endoscope reach far enough into the small intestine to get the necessary information?” Emma’s endoscopy (esophageal gastroduodenoscopy) was a success. The endoscope was passed into the small intestine and we obtained good biopsies. Now all we had to do was wait for the pathologist to tell us what the biopsies revealed.

We sent Emma home with medications and instructions. The pathology report came back with IBD (inflammatory bowel disease), a disease that has a variable response to treatment, but no cure. We set out to try to “control” Emma’s problem by changing to a hypoallergenic food. Then we sat back and waited for Emma to make the next move. At her 1 month check we found the IBD was under control.

This story should happily end here, but almost a year later Emma developed a second problem: She started to strain while urinating. A routine urinalysis showed Emma had a urinary tract infection (UTI). We started her on antibiotics and the infection resolved. However, these infections kept recurring over the next ten months -- apparently, due to Emma’s inability to completely empty her bladder.

A surgeon felt surgery would solve the problem. However, one month after surgery, Emma had another infection. Dr. J gave injections designed to give Emma’s immune system a boost without success. Dr. J had read an article about using estrogen to help fight recurrent UTIs in menopausal women, and decided to try this novel treatment. We never saw another infection and concluded this treatment works in thousands of menopausal women and in one 130-pound mastiff.

Emma’s story doesn’t end here. Emma was soon fighting for her life. One day, her owners noticed she was a little sluggish and not acting right. An exam showed Emma’s gums were pale, not a good sign. Dr. J performed an ultrasound to check for internal bleeding but didn’t find anything problematic. Next, blood tests were ordered. Warning bells sounded when the test results returned. Emma was very anemic. She had an autoimmune disease with her immune system destroying her own red blood cells. Emma was now fighting a disease that only 30% of patients survive. Her owners asked if we should continue or put Emma to sleep. As Emma was such a Not just little patients have big problems. great dog, we agreed to continue the fight.

Red meat is one of the better sources to supply nutrients for making red blood cells. However, with Emma’s IBD problem, she was on a restricted diet. It was time to bite the bullet with red meat and cottage cheese. Emma began to improve but she was losing weight. Her owner was feeding the regular amount but it just wasn’t enough. Emma lost a lot of weight and became very skinny at 118 pounds. Emma’s quantity of food needed to be increased to 9 cups of dry food and 1/4 cup of beef plus cottage cheese, all divided into 3 feedings daily. Emma was eating the owners out of house and home, but this quantity was enough for Emma to put on a few pounds.

Emma showed us what she was made of from the beginning. Days after starting treatment, her anemia improved and her activity level increased. Dr. J was impressed with Emma’s progress, but she hit a plateau after 5 months and stayed mildly anemic. Dr. J. was concerned that again normal therapy was not doing the job. After consulting with another internist, they concluded that Emma didn’t absorb vitamins and iron normally with her IBD, so they decided to supplement Emma’s diet with vitamins and iron. Now these were not just ordinary vitamins. They were horse vitamins and were ordered by the gallon. Because of her size, Emma needed vitamins meant for the big guys. Once more, Emma responded to a simple treatment option. The vitamins did wonders for Emma.

After Emma’s recovery, we heard that a senior member of the family started to take these ‘wonder’ vitamins because they worked so well for Emma. He was later told by his doctor that taking ‘horse’ vitamins probably wasn’t a good idea. With three major problems, and two of these potentially life threatening, Emma is still here to talk about it. Back to her normal weight of 130 pounds, she has been doing well for 6 months. We all know a cat has 9 lives but we don’t know how many a dog has. In Emma’s case, we may never find out.