Kelly was having a terrible problem with constant little refluxes that would become mini-regurgitations that she would usually re-swallow. This happened at all hours of day. Her abdomen would seem to make a little twitch and then she would start licking the air, trying to recapture what came up into her mouth. If she was resting at the time, she would jump up when it happened, and take a while to re-settle, like she felt uncomfortable. When it escaped from her mouth, was clearly stomach-acidy in smell, so no doubt was refluxed stuff, not just food that didn’t go down that moved up into her mouth. Kelly has had ME for about 8 years, but I can’t tell you if this was a newly developed issue of if it “always” existed, since I only found this group and all it’s suggestions, about a year ago, and only recently did I get her on-the-floor regurgitations under control enough that I started focusing on the “littler stuff” and trying to correct that, too. (Actually, I think now that the tiny in-the-mouth reflux regurgitations may actually be more dangerous than the on-the floor ones, since she seemed to suck in and inspire during her attempts to recapture the tiny amounts of refluxed food, whereas with the larger amounts, she just put her head down and let it out..) I tried so many different things, never arriving to a solution to the reflux issue. I found the answer for Kelly by accident, trying to cure other issues that developed recently, and it was an answer that I never would have associated with the reflux issue (although it does make sense). After a period in which the little, usually re-swallowed reflux regurgitations seemed to be Kelly’s major remaining problem, (but also mixed with occasional fairly small on-the-floor regurgitations that by the smell were clearly refluxed stuff) Kelly had a worsening in her situation, and very frequently seemed to have some additional problem, only in the mornings, sometimes vomit, sometimes large regurgitation, sometimes just not wanting to eat, (occasionally all went well for a few days, leading me to think I’d found the solution to all that…) Finally, as an attempt to resolve those issues, I tried the ARG treament of Metronidazole, and Amoxicillin (plus clavulanic acid) and continued omeprazole (which I had switched to from ranitidine a month before) and sucralfate. This not only resolved the vomiting, mucus and on-the-floor regurge issues, but SHE NEARLY STOPPED DOING THE TINY REFLUX REGURGES INTO HER MOUTH!!!!!!!!!!!!!!!!!!! (The very few that she does do now, seem to be of a completely different character and likely of different origin – seem truly like an occasional burp that pushes some food up — I usually hear the burp noise.) It has now been a month and a half and she is continuing on the good path! (Actually, I kind of hate to say this on group to not provoke the bad sense of humor of the “regurge gods”) Thinking about it, I can now imagine a variety of reasons why a gastritis could lead to increased reflux issues (don’t know how many of those are just my imagination…)

For the record, here are some of the things I tried before the ARG treatment, that did NOT resolve Kelly’s repeated reflux issues:
1) Stopping coconut milk (this did greatly reduce her on-the-floor regurgitations but did nothing to stop the in-the-mouth reflux regurgs)
2) Reduced fat content of her food by mixing a very low fat fish variety with her turkey variety food. Final fat content of food is now 13.5% of dry weight. ( I read that fat content over 20% of dry weight is considered high fat, 10 to 16% is considered moderate fat, and under 10% low fat)
3) Added Vitamin B complex to food
4) Even smaller meals than was already giving
5) Thicker consistency food (I give milkshake style)
6) Changing to a “sensitive digestion” variety of the same brand (and meat) canned food (BTW, the problem existed also when I was using a different brand of food)
7) Adding plant digestive enzymes to food .- I tried a few different brands, and also different amounts (Actually, now that I realize she likely had gastritis, I realize that the enzymes were a BIG MISTAKE since they can aggravate the lesions of gastritis
8) Added probiotics
9) More compulsive “burping” during meals (I was pretty fixated on the idea that it was burps that was pushing the reflux up…)
10) Taking great care to make sure that all bubbles were removed from food before feeding
11) Feeding from spatula instead of spoon, hoping she’d take in less air that way
12) Introduced Metoclopramide. (Most of you are surely thinking “IT’S ABOUT TIME!!”) I tried various doses, (changed to liquid form to titrate dose better) with absolutely no change in the reflux issue
13) Simethicone drops (gas-X) in food
14) Taking care to lift her vertical for a while every time she did a re-swallow, so she wouldn’t then keep mini-regurging the same reflux over and over
15) Making sure she rests on slanted bed (not flat on ground) also during daytime
16) Altering slant of bed and modifying bed to insure she stayed always in correct direction
17) Leash walks at various moments before and after eating
18) Switching from Ranitidine (Zantac) to Omeprazole (Prilosec)

WHAT WORKED WAS THE ARG TREATMENT!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Now, I don’t think I’d try to convince someone else to try that as a first approach to the reflux problem. Can be due to so many different things!!!!!!! But now that I know my Kelly better and know that HER reflux is enormously increased by something that responds to the “ARG treatment” (presumably gastritis), if she starts doing that again, (even without the additional symptoms of mucus, vomit, on the-floor regurge) it will certainly be the first thing I try!

(By the way we have now stopped the Omeprazole (prilosec), that I used only temporarily, and gone to using famotidine (pepcid). (My vet is quite contrary to using prilosec chronically and so for now, as long as this works for us, I am just switching to it temporarily if issues arise. I continue to use the sucralfate all the time)