Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

Why use stomach medication for mast cell tumors?

Updated: December 11th, 2018

Many dog lovers are coping with a diagnosis of canine mast cell tumor.  Just yesterday afternoon I was removing a very large one from the body wall of Big, a 10 year old, 105 pound, much-loved mixed breed.

The day before his surgery, Big started to throw up.  He became quite sick, and would not eat.  His tumor, which was about 5 inches in diameter, had started getting very painful, red and inflamed.

Luckily, tumor is now out and Big is on his way to happier days.


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One of our strategies is to help Big with his nausea.  I was explaining to his owner last night that the mast cells in the tumor secrete a substance called histamine, which is the same stuff that causes a bee sting to become red, swollen and painful.

These high histamine levels now in Big’s bloodstream cause the lining of the stomach to produce excess acid.  When you have a belly full of acid, it feels awful and you may start vomiting.

So in dogs with any signs of decreased appetite, nausea (licking lips a lot, salivation), vomiting, or loss of energy with mast cell tumors, we always want to address this acid issue.

There are several approaches.  We definitely want an antacid.  Cimetidine (Tagamet) is a good choice, as this drug has not only antacid effects but also some nice, documented anti-cancer effects.  Tagamet is available over the counter at most locations where non-prescription human medications are sold.  Like many drugs we use in veterinary medicine, it is labeled for human use.

Fresh ginger is always a nice supplement to use in dogs with nausea, and has been shown in papers to help in human medicine with both anti-cancer effects and helping nausea. Many big-box grocery stores will carry ginger root, and some health food stores do as well.


For more information on Mast Cell Tumors, get a copy of the Dog Cancer Survival Guide


Many clinicians advise famotidine (Pepcid), which has a good antacid effect, but no anticancer effects.  You can get Pepcid AC over the counter at most places where non-prescription medications for people are sold.

In cases where there is no other option and the vomiting is very severe, a drug called Zofran (odansetron) can be used.  It is rather expensive, and its use is on the new side.  It does help though for cases where the stomach upset is really bad.  It is a prescription medication.

If there is diarrhea, which reflects inflammation of the intestine (lower down the digestive tract than the stomach), misoprostel (Cytotec) should be considered.  This drug stimulates the protective lining of the intestine and decreases inflammation of the intestinal wall. This is a prescription medication.

Slippery elm, which is from bark of the slippery elm tree, is a good supplement that can be added for diarrhea as well.  It acts as a natural bandage, coating the lining of the intestine and helping soothe and heal.  Slippery elm is available on-line and at health food stores.

Branched chain amino acids can also be added as a part of the arsenal.  These supplement the other approaches by providing the building blocks to rebuild the lining of the intestine.  Branched chain amino acids are available in health food stores and supplement outlets.

Probiotics can always be added to help a bit with diarrhea.  A probiotic is a bacteria which helps restore the normal amounts of healthy bacteria in the intestine.  We need these bacteria, and so do our dogs. These can be purchased at supplement outlets and health food stores.

Lastly, plain old liquid Pepto Bismol helps a lot with diarrhea as well, and is available over the counter too.

For more information and specifics on these items, you can find more details on dosage and use in The Dog Cancer Survival Guide and through discussions with your vet or oncologist.

All my best,

Dr D



 

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  1. Tarun Grag on June 17, 2014 at 1:30 am

    Thank you for sharing your valuable information.this information very useful for online learners

    medication for cancer

  2. Betty Hamilton on February 15, 2012 at 5:51 am

    Dear Dr. D.
    My 9 yr. old pug has 4 mast cell tumors. These were tested in Aug. when he had surgery for bladder stones. He had already had surgery on both back legs earlier. I have your book and it is wonderful. After much soul searching we decided against surgery. He is on benadryl and and anacid. I have him on Apocaps and K9. His stool is now semi loose and soft but not watery and gold or yellow in color. I have just this week taken him off Apocaps and K9 to see if this helps. His feed has to be Hills U/D because of the stones.He has not lost weight and has no other noticible symtoms. What can I do to firm his stools. My vet is very kind and sympathize but has admitted she knows nothing about pet nutrition. Thanks for you book and guidance. B

  3. Kimberly on February 13, 2012 at 8:54 am

    Hi Dr. D,
    My 8 year old mix breed just had two mast cells (grade 2) removed last week and since the operation has steadily had severe bouts of diarrhea. He has been put on Pepcid and we have been feeding him boiled chicken and rice only for his meals. It doesn’t seem to be getting any better. We have an appointment with his new oncologist on Thursday but his regular vet told us it was likely from the anesthesia and the pain killer used, as well as stress. Is it more likely, however, to be the result of histamines released during the procedure? Thank you for all of your great information.
    K

  4. margaret on June 15, 2011 at 3:21 am

    Hello,
    I just came upon your web-site.. It does seem to have very useful info.
    My dog does have the mast cell tumors. I’ll talk more about that @ a lster date.
    till–then.. Margaret………………

  5. Lindsay on April 26, 2011 at 1:07 pm

    Hi Dr. D,

    I just found your very informational blog today and a week after our family’s 14 year old labrador was diagnosed with very aggressive mast cell cancer. I wish I had found this site longer ago because his prognosis is not good and the battle is day to day at this point.

    However, I also have a 4 year old boxer. After reading the many posts by you and others it has made me think about all of her issues over the past 4 years. I can’t tell you the amount of pepcid, benadryl, and pepto she has had since a pup. She has always had a sensitive GI with bouts of vomiting and diarrhea. We have had a few vets and even a holistic vet and all attribute her sensitivities to some type of allergic reaction (I feel it’s environmental, as does my current vet but the allergy tests did not come back strong in any environmental area). I have even noticed other reactions in her such as being more “down,” quiet, whiny, urine accidents in her crate, vomiting, etc when she seems to be having a reaction.

    Is there a higher chance of mast cell tumors in dogs with allergy issues? She has been fairly stable lately but has bouts of allergic reactions and most recently has had irritations on the skin folds of her face which she itches to death and causes them to bleed, and has had to have antihistamines and sometimes antibiotics for infections. Her bowels have been stable for a good 2 years since switching to the proper food for her needs- California Natural Herring and Sweet Potato. The throwing up has been minimal and pepcid usually fixes it but I definitely want to try Tagamet based on your suggestion of anticancer properties.

    I guess what I’m getting at is that she has allergy issues(to what?- we aren’t exactly sure)- bottom line and they creep up every so often- some more severe than others. I hate medicating her but is it better to put her on an antihistamine as needed to calm her body from worse harm? Is there any way to prevent mast cell cancer and what do you think about her issues or is she just a “sensitive” dog with typical “boxer issues”?

    Also, have you heard of Moducare? She has been on it daily for 2 years or so as prescribed by her holistic vet we see occasionally for alternative meds. This was suggested as an immune system booster for her when she was about 1 1/2 years old and having many digestive issues to help support her immune system.

    Looking forward to what you suggest/think. Your blog is wonderful and so informative. I am thinking about getting your book just to be educated as I am such an animal lover and always wanted to be a vet as a kid!

    Thanks for your time,
    Lindsay

    • DemianDressler on April 27, 2011 at 10:19 pm

      Dear Lindsay,
      there seems to be a bit of a link, although a soft one, between allergies and mast cell tumor. You might consider allergy testing and a true hypoallergenic food trial and possibly immunotherapy. And if you are a dog lover and a boxer guardian, the Guide would be a smart idea…
      Best,
      D

  6. Nick P on April 25, 2011 at 9:34 am

    My daughter’s Chihuahua was diagnosed with a singular mast cell tumor. Her vet put him on cimetidine only and after two months the tumor is gone according to the vet. Can this be? She to reduce and then eliminate the cimetidine and then that’s it. I cannot believe this cured the pup. Is it possible?

    • DemianDressler on April 27, 2011 at 10:20 pm

      Dear Nick
      well, i believe that it may have shrank to be imperceptible…but I wonder how the diagnosis was reached…and also we need to understand that mast cell tumors can indeed come and go based on the histamine release waxing and waning and thus the swelling going up or down…time will tell!
      D

  7. jess on February 1, 2011 at 12:08 am

    Dr Dressler:

    My Boxer Scarlet is not doing very well but, I am trying to be patient. After getting your guide and trying to have a better care plan for her. I am using the apocaps and I am following your guide. She is taking benedryl and tagemet, 1 pedisone a day and currently she is on an antibiotic because the ulcerated mass on her front paw seems to get infected on and off. I am going to the oncologist wednesday, I am going to ask her about predsolone being injected into the mass cell on her paw to see if it will shrink. There is also a lymp in her shoulder, I mentioned in my last e-mail that is the size of an egg. It has started to ulcerate. Is it safe to also inject with predsolone in this mass also or is that impossible? I Thank You for the wonderfull guide that has helped me to relax a little and try to understand how to help my best friend!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
    Any information you could suggest would be greatly appreciated.

    Thanks,
    Jess

    • DemianDressler on March 8, 2011 at 9:49 pm

      Dear Jess,
      so sorry to hear about Scarlet. I wonder why no removal of the growths? Surgery is still one of the main ways we get rid of tumors in dogs and it seems like this would be a good idea, along with biopsies, after some initial tests.
      I hope the oncologist consult went well
      Best
      Dr D

  8. margaret on January 7, 2011 at 5:10 pm

    I’m so sorry for you heartbreak. I went thru this last oct. with my 10 year old Shih Tzu, Tommy. It was a long and hard road and ended in sorrow for all involved. I think you have covered all possible options looking for cure or at the least some more time. Tommy started with the mast cell tumor on his front paw. We had the surgery and then in Jan started with radiation. During this process the mast cell tumor moved from the paw site to the lymph system and developed a large growth in the side of his neck. We had three drs. working on the problem including a holistic dr. Tommy had 14 months before he passed.. most of it good some bad. Would I do it again?? you bet.. I miss him everyday.. margaret.

  9. jess on January 7, 2011 at 12:57 pm

    Dear Dr. Dressler:

    As with alot of the other dog owners, I am a Boxer/dog lover whose dog Scarlet has a Mass Cell tumor on the front paw along with lymp spread in upper shoulder the size of a large egg. This is not the 1st Boxer of mine this has happend to, this is the 3rd one in less than 2 1/2 years.(2 other females died of different types of cancer it has been quite life changing). She is currently being treated with benedryl, predisone, cycblastin (spelled this chemo wrong hope you can identify), pepcid and recently the growth looks to be spreading but, it is hard to tell if it is inflammed because it changes drastically from day to day. We are treating her also with hollistic, flax oil, mushroom, shark cartilage so much it would be hard to list she is 6 yrs old and blood tests say she is tolerating well, she is grade III. Would it help to change the pepcid to tagemet ? These growths I was told by 2 onclogists could not be removed but, I am hopeful she might be a fighter and if I do everything possible there might be something I missed or could try. If you have any suggestions please HELP, I am running out of money and information. I have read your helpful advice and any would be greatly
    appreciated

    Thanks, Jessica

    • DemianDressler on January 13, 2011 at 10:35 am

      Dear Jessica,
      so sorry to hear of these hard days. One thing that I notice is that the supplement selection appears to be less than ideal. Have you read The Guide? It is an easy read and will answer questions about diet (very important), proper supplementation, immune support, and ways to modify brain chemistry to shift to a cancer-fighting state. Are you not using Apocaps (the apoptogen supplement I use for my patients)? Beta glucans? Doxycycline/cimetidine? These are some of the ideas right off the bat.
      Best,
      D

  10. Diana on September 13, 2010 at 3:10 pm

    I had to make the devastating decision to euthanize my dog Mickey this past January after he had surgery to remove a bladder stone. He was 11 yrs. and 10 months old and had diabetes. He had just been switched from Vetsulin (which was no longer available) to NPH insulin just 3 days prior to having his surgery. He developed ketoacidosis and was very sick for 5 days. The vet gave him barium to try and soothe his esophogus and stomach which was full of ulcers because he said he had found in the past that the barium could actually help stop the vomiting and ease the pain he was experiencing. When he was still vomiting the next day the vet took some x-rays and discovered a “filling defect” in the stomach where the barium could not pass through. He told me that Mickey had stomach cancer and that there was nothing we could do for him. Mickey did not have any signs or symptoms of stomach cancer before his bladder surgery, just occasional vomiting. The vet later told me that he was not sure if Mickey had cancer because he did not do an autopsy. I am devastated and feeling so guilty for putting him down!! Could this really have been cancer or do you think he developed some kind of blockage after his surgery? I miss him soooo much!!

  11. Anne on October 20, 2009 at 3:39 am

    Thanks again Dr. D,
    We are seeing the vet tomorrow, and I will ask. She crashed again last night, exactly a week after her last crash, so your cyclic histamine theory must be right on the mark. I appreciate your input. Even with two excellent vets in the mix, you’re still offering new ideas when they seem to be running out of them.

  12. Anne on October 19, 2009 at 6:33 am

    Thanks Dr. D,
    I appreciate your reply, and hope you can clarify about the antacid component. She was on Pepcid, but was switched to Prilosec by the oncologist. How does that fit with the Tagamet? Does it act with Benadryl? Does it make sense to mix and match antacids, or should we pick one? She also has Ondansetron for nausea, a drug (Sulfa-something)for ulcers, a small dose of Prednisone and Cipro. She is on Hesperiden, which I think gives her the luteolin you recommend, Milk Thistle for her liver, and now Benadryl. Tramadol and Gas-X as needed.

    • Dr. Dressler on October 19, 2009 at 11:14 pm

      Anne, I would discuss doxepin with your oncologist. This is the real deal for histamine receptor (very potent H1 and H2) blockade. If they don’t know about it have them research it. Known a little in behavioral circles as an “anti-depressant” but there is way more to it..
      D

  13. Anne on October 15, 2009 at 7:53 am

    Has anybody had this experience? My 11-year old dalmation has been battling mast cell disease since last winter. She’s had surgery, chemo and even Palladia, but it still spread. A month ago, her white count was way down, the disease showed up in her liver, and they told me it was time to let her go. Three days later, she rebounded so well that I began to doubt the test results. Now it’s just a roller coaster. She crashes, she bounces back. She’s curled up in a ball shivering, she’s bouncing around like a puppy. She’s on all these stomach medications, plus antibiotics, Benadryl, herbal supplements and Metro-something for a nasty bout of diarrhea that hit a few days ago. She recovered in less than 24 hours. The oncologist doesn’t seem to know what to do with a dog that’s past her expiration date, and her holistic vet is stumped too. Is this this just the way the disease progresses? I am beyond grateful for any extra time with my girl, but I could really use some advice on stabilizing her. I appreciate any feedback. Also wondering the same thing as Lu Ann re: anti-histimines. Thanks!

    • Dr. Dressler on October 17, 2009 at 9:58 pm

      Anne, I would bet the cycles are related to cyclic histamine secretion and gastric (stomach acid) secretion. Definitely talk to your vet folks about increasing the antihistamines and cimetidine/famotidine, and possibly some pain medication for those episodes. Consider luteolin too, which in humans has been shown to stabilize mast cells and inhibit histamine secretion.
      d

  14. Lu Ann on October 9, 2009 at 12:44 pm

    Reading through all the information, I didn’t see anything about using an antihistamine on the mast turmors. Your article said the tumors produce histamine and that’s what causes them to become so large. Is it likely that an antihistmine will help? I am giving my Pepto Bismol right now and will start her on Pepcid in the morning, but wanted to know if we could use the antihistimine. I’m hoping to shrink the tumors enough that she can start eating again and have surgery to remove them.

    • Dr. Dressler on October 17, 2009 at 9:54 pm

      Lu Ann, the treatment for mast cell tumors involves a lot more than this single post about digestive upset and mast cell tumors. Yes, benadryl is commonly used to deal with histamine secreted by mast cell tumors. Interestingly,the cimetidine in this post is a specific type of antihistamine, but works on a different receptor type than does benadryl..and deals with stomach acid, unlike benadryl.
      Best, D

  15. Gayla Stone on October 6, 2009 at 7:30 am

    I have heard that mast cell tumors typically can spread to other areas of the body. My golden had a mast cell and it was surgerically removed and we were led to believe she would be ok because the vet said he got the entire cancer. The cancer spread to other areas of her body and she died of the disease. Should we always do surgery and hope for the best or are we just kidding ourselves?

  16. Leslie D Ufford on September 28, 2009 at 7:40 am

    I couldn’t attend the Webinar but I just finished listing to it. You addressed my question (Leslie Parker for some reason you got my first name and town name). Clear margins were not obtained because of the location. His tumor was in the axillary region and there were so many vital structures in that area. There is no evidence of spread at this time. My gut feeling was the same as yours, use everything, but I think that the holistic vet is concerned about long term effects of the Cytoxin. Do you think we should try again with surgery even though the location is risky. The original surgery was not done by the oncologist but in a large, progressive hospital. I just don’t know if the were conservative because they did not know what the tumor was or if the structures were truly the issue. The fine needle aspirate done presurgically was mostly blood with no definative diagnosis. The surgeon actually expected the tumor to be a different type. My dog currently shows no evidence of disease. He had had xray, ultrasounds, bloodwork and physical (palpation of area) exams.

  17. christina on September 28, 2009 at 1:52 am

    Dear Dr dressler,
    unfortunately I have a second Italian greyhound with mast cell cancer. While Donny was going through radiation, I found a tiny lump on marcelino’s side (under the shoulder) We had it taken out (it was too tiny to aspirate) My vet was concerned about the chance for it to ba a mast cell cancer because the lump rose and fell over and over for about a week.He told me about the Histamine they give off. He removed it and it turned out to be a mast cell grade 2. He got good clean margins but wanted to go back in a few days later and make even more of cleaned area because of what my other IG went through with him
    needing radiation. We did the stain kit (he was the one who took it upon himself to send out for the stain :)) it came back that the reocurrence of the mast cell was very low (sorry, don’t remember the terminology or #s) Based on the kit, the lab gave marcelino about 70 months before we would have to worry about cancer. No radiation was given and no chemo. NOW marcey has a second growth about 3 inches from the center of the first. It was so tiny, you could hardly see it but then it would grow to the size of a golf ball within an hour and then after a dose of benadryl, it would shrink again. This has been going on for 2 weeks and his surgery to remove it is set for tomorrow. We have not had it aspirated and now it is so tiny. I am opting for radical surgery and do not want to put marcey through 2 surgeries again because I know it has to be a mast cell again. Am i wrong? Should I just have it popped out, tested and THEN do the radical surgery given his history??? The last surgery was only a few months ago. i know my vet is aware of doeing with the benadryl during mast cell removal….but maybe some cells slipped by, causing this second tumor so quickly???
    This dog also had oral resorptive lesions that took away ALL but one tooth before he was 3 years old. He is now 5 and only has one upper canine left. He is a rescued dog so i do not know his breeding history. He is a strong and healthy dog and is fed Dr Harvey diet since he was 5 months old. His teeth (when he had them) were brushed every day– that is why i noticed his teeth turning pink and caught the mouth disease so early. (I am teeth obsessed) He had 4 surgeries in 2 years as the teeth succumbed to the lesions.

    I am petrified that my IG is full of cancer cells due to his immune issues…I do not vaccinate either.

    http://www.flickr.com/photos/louies/3879092024/
    this was his last tooth surgery——and his mast cell tumor is also on this same site.
    christina

  18. christina on September 27, 2009 at 12:45 pm
    • Dr. Dressler on September 27, 2009 at 1:04 pm

      Yay!!!!!
      Thanks for the useful input Christina. Good for Donny boy!
      Best
      Dr D

    • hundetrainer saarland on September 13, 2012 at 3:15 am

      I’m still learning from you, as I’m improving myself.

      I certainly liked reading everything that is posted on your site.

      Keep the stories coming. I enjoyed it!

  19. christina on September 27, 2009 at 12:44 pm

    thank you Dr Dressler for such a fine book. I purchased it while my Italian greyhound, Donny, was going through radiation treatment…boy I wish I could have read it BEFORE I decided so lightly to go through with the radiation! Your book explains everything so easily…my top oncologist did not 🙁
    http://www.flickr.com/photos/louies/sets/72157616287244159/

    my poor donny took over 4 months to heal from the horrible burns he received from the radiation. He had a delayed reaction to the treatment. Went through 17 rounds with no issues, no pain, no hairloss…………THEN bam! he was basically writhing in pain with burned skin UNDER his coat! the photos are horrific. The radiation doctors told me that what he had was a very rare reaction.

  20. Katie on September 25, 2009 at 9:46 am

    Ron, I’m sorry for your loss, but I can’t imagine that it’s Dr. Dressler actually deserves the treatment you describe. Do you really think it’s his fault that your Bichon passed? I have read his book, implemented his recommendations, and while my Sweetie is not out of the woods, I can see that she is really helped. I also attend Dr. Dressler’s monthly teleseminar and get all of my questions asked. I don’t think it’s fair for you to assume that if you post on a blog where hundreds of others post, too, that Dr. Dressler can answer every question personally. Again, I’m sorry for your loss, because I know exactly how it feels (my Dusty passed last year from Mast Cell), but I think you’re letting your anger get in the way. I for one am thankful that Dr. Dressler’s information is here, now, to help my dog. The fact that I didn’t know about him last year doesn’t mean that he’s to blame for Dusty dying. I hope that eventually you find comfort, because I know how hard it is to lose a great dog.

  21. Ron on September 25, 2009 at 8:06 am

    I asked for this information several months ago when I had a Bichon with stomach cancer and didn’t get a reply. Thanks for nothing. My dog is dead and your information is 4 months to late. If you caught on fire I wouldn’t piss on you to put the fire out. Now you know how I really feel.

  22. Katie on September 24, 2009 at 2:12 pm

    Since my dog is raw fed he dosent seem to be affected with the over production of acid when histamine releases with mass cell. Since Dannon is eating Raw foods I believe this helps to disperse the excess amounts of HCL that may be produced and the body uses it for digestion the way dogs are supposed. There food is digested in the stomach instead of the small intestine like canned and kibles are not the way nature intended it to be. Even with Neoplasene. NO vomitng no diarrhea no loss of appetite. So far so good. Next is angiostop, myomine and revivin for cancer apoptosis. This is the next rotation for treatment as well as DMSO mixed with sodium bicabonate as a poltis to rid the body of the external tumors. And yes it really works. Or it can be injected directly into the tumor especially if the sodium bicarb mixture is injected corectly. The tumor shrinks and disapears completly, typically in 6-9 days. These are alternative therapies that can help and rid the body of cancers.

    • Keven Bonner on September 24, 2009 at 2:18 pm

      Hello Dr. Dressler,
      Our doggie had squammous cell carcinoma of the nasal septum. Dr Alice Villalobos, Oncologist, prescribed Reglan before each intra lessional treatment. Do you use this medication in your practice?

      • Dr. Dressler on September 27, 2009 at 7:27 am

        Kevin,
        Reglan (metaclopramide) is a common medication used to control vomiting. Yes, I have used it. I will talk more about the treatments for nausea on the webinar this week (www.mydogvet.com), which will be recorded if you want to listen later. Thanks,
        Dr D

  23. Carmen on September 24, 2009 at 7:06 am

    Dear Dr. Dressler,
    Thank you for this very informative and helpful information. I was treating my Boxer with an antiangiogenesis protocol that was very upsetting to his stomach. At the time, I used a generic form of Pepcid AC but am very thankful to know that cimetadine has anti-cancer benefits. Since Boxers seem to have sensitve stomachs from time to time, I will defiantely use this instead when needed.

    Thanks again!

    • Dr. Dressler on September 27, 2009 at 7:39 am

      Thanks Carmen. Best of luck to you and your Boxer. You may be interested in this month’s webinar on mast cell tumors (www.mydogvet.com), which will be recorded.
      Warm regards,
      Dr D

  24. Janet on September 24, 2009 at 4:34 am

    Hello Dr. Dressler,
    We have a boxer the we have been giving our dog Pepcid for awhile now because he will occasionally vomit when he drink a lot of water at once and he seems to get an upset stomach easily. He has had four mast cell tumors all which have been removed. They were all send off to Michigan State for c-kit testing. Three came back with a Kit staining pattern 1 and one came back as a Kit pattern 2. All were PCR negative. Now we are being told he needs to have chemo which I am fine with if it is necessary but he is only 4 years old and we can’t seem to get a really good reason as to why we should do the chemo. He is healthy now that the mast cell tumors are gone. I was just wondering what your thoughts would be. We give him krill oil and feed him Orijen 6 fresh fish with sea vegetables which seems like a good food. Do you have any syggestions for us that might help?

  25. Kate on September 22, 2009 at 4:45 pm

    Hello Dr. D,

    Thanks for all the useful information. I didn’t know that fresh ginger can be a nice supplement that can be used to ease dogs in nausea.