Caturday quickie: Pupdate

Crash puppydog

What Nuala spends most of her time doing these days 😦

It’s been a while since I’ve had to offer a proper pupdate of this nature.

All was going well with our Nuala until a week ago last Friday. Previous to that day, our dear little pup (DLP) was handling her medication well, without apparent incident. She would snarf down her food in thirty seconds, consume carrots, apples, and cheese with wagging abandon.

In short, she behaved like the pup that she, at ten years of age, no longer is.

Then, on Friday, she stopped eating.

It started with her carrots, her mid-day and evening snacks. As a dog with food allergies, it was the snack (outside the hypoallergenic treats) recommended by our vet. Nu left a carrot uneaten.

As the weekend progressed, she ate less and less of her food.

Come Monday, she puked and wouldn’t eat any of her food at all.

Tuesday, we took her in to the vet and he examined her, performed blood tests, urinalysis, and took x-rays.

That evening, we were given the news: the only obvious issue was a urinary tract infection. We would be getting antibiotics for that.

Her blood work was troublesome, though.

Her kidney and liver enzymes were both elevated, indicating potential failure of either or both organs in the future.

There’s nothing that can be done for kidney or liver disease in dogs.

They’re starting dialysis trials at the veterinary college at the Univerity of Guelph, but it’s an ordeal for the animal and a great expense for the owners. At this point, our vet did not recommend it.

So we’d continue with the Fortekor, get Nuala back on the kidney support diet, and see how things went.

She left most of her food Tuesday evening and didn’t eat at all Wednesday (Canada Day). This is not a good thing for a dog on insulin. She needs food to process the drug. And she continued to vomit.

On Thursday, I resorted to canned salmon and plain rice. She ate. I was relived.

On Friday, Phil picked up an appetite stimulant and another medication to prevent ulcers from the vet.

When he returned, Nuala licked at her empty food dish and Phil gave her a serving of rice and salmon. She ate. He filled her bowl a second time and she ate again. Friday evening, she ate a full can of the kidney diet without being prompted.

Better days

Better days

This morning, she picked at her food and we tried the appetite stimulant. It didn’t appear to work, but then, at noon, she ate her food. And vomited it up two hours later.

The weird thing is that the UTI shouldn’t put her off her food. No obstruction was apparent in the x-rays. Her kidney and liver situations were not far enough advanced to depress her appetite.

So we’re all at a loss (even the vet) and Phil and I have the vet emergency service number in case something dire happens over the weekend.

It’s so distressing to have a sick pet. You just wish they could talk.

So that’s the latest health crisis for our DLP.

I’ll keep you posted.

Caturday Quickie

Sundog snippets: Pupdate, July 2013

So here’s a quick pupdate for you.

First, the story so far:

In January, Nuala had an ACL repair. On the heels of that, she contracted a UTI. We administered antibiotics. She somehow scratched herself an aural haematoma. Rather than having it drained, the vet recommended letting her body metabolize the blood. We agreed.

The follow up urine sample, however showed extra protein, which is usually a sign of a problem with the kidneys. Blood tests showed that Nu’s kidney enzymes were in perfect balance. An x-ray revealed no stones in either kidney or bladder, but an enlarged liver and spleen.

The vet recommended an ultrasound. This would require a journey of several hours for which Nuala would have to be sedated (she doesn’t travel well) and several days off work for Phil and me. The ultrasound may or may not have found anything and may or may not have resulted in a laparoscopic biopsy, which may or may not have proven clinically definitive. We declined.

We changed her food to a kindey health diet, and started her on a regimen of ACE inhibitors. Nuala subsequently redeveloped a UTI and this time we have the urine sample cultured. It turned out to be a massive e-coli infection. Uber-doses of antibiotics later, she was once again clear of infection, but the high protein in her urine remains a concern.

Where we are now

The vet is again encouraging us to consider the ultrasound. We’ve discussed things at length and here are the ultimate reasons Phil and I are not going to follow through with it:

  1. Nuala is behaving well, she’s feeling better than she has in a long time. Her residual limp from the ACL surgery is almost unnoticeable. By all accounts, she’s happy.
  2. What will the ultrasound reveal? The existence (or the lack of existence) of a growth of some sort.
  3. If the growth is benign, will it be removed? No (unless its negative impact on Nu’s health is severe).
  4. If the growth is malignant, what can we do? Not much. Cancer in dogs is notoriously fast-growing and often has metastasized before an operation can remove it. Though they do have canine chemo and radiation, the course of treatment would again involve travel and its effectiveness is not as good as human therapies.

While it may result in a better diagnosis and possible prognosis, we may not be able to act on it quickly enough to make a difference.

So we’ve decided to stay the course with her current medication and see how things go.  If Nuala’s health worsens, we may have to revisit and reconsider our decisions, but I honestly don’t think this will happen.

Our last dog, Zoe, had cancer, and we did what we could, but the cancer was aggressive and ultimately fatal. The operation to remove the cancer wasn’t effective, was very hard on her, and it may have bought her two weeks, but they weren’t a good two weeks. Her death broke our hearts and it was two years before we thought about adopting another dog.

Whatcha got there?

Nuala hoping to scam noms from Phil 🙂

You may disagree with our decision, but I hope you can respect it.

Here ends what I hope to be the last pupdate for some time. Nuala really is doing well and until we can see a reason to, we’re not going to put her through further procedures.  She’s been through enough this year already.

 

Sundog snippet

Caturday Quickies: Oh God, not another … Pupdate

My last mini-pupdate was posted March 17th.

Nuala lounging

Nu lounging on the driveway–her shaved hip is growing in well 🙂

“Let me explain.  No, there is too much.  Let me sum up.”  ~Inigo Montoya, from The Princess Bride

So when last I mentioned her health, Nuala had contracted a urinary tract infection (UTI).  That was addressed with antibiotics, and we would have to go back in 2 weeks’ time to have her urine tested again.  Also at this time, the vet wanted to take another blood sample to see how her liver was recovering after the Metacam.  Her annual exam and shots would be due then as well, so we decided to make a day of it.

While the UTI had cleared up, there was still significant protein in her pee, or proteinuria.  This is an indicator of kidney damage.  Nu’s blood was also analyzed for kidney enzymes, and they were all in perfect balance.  So on one hand, there was evidence of kidney damage, and on the other, there was none.

Nuala's aural haematoma

This shot from the back shows her injured ear. It used to be mostly upright, like the other one.

In the meantime, Nu had somehow ruptured one of the blood vessels in her right ear and had developed an aural haematoma.  We had to get some drops for her ears to treat the ongoing inflammation that likely caused her to rupture the vessel with scratching in the first place, but neither draining nor surgery was recommended (too painful).  Her body will take care of the situation on its own in a few weeks, though her wee ear will never be the same.

Other than having a ridiculously fat ear, she’s doing fine.

The vet wanted her in to test her blood pressure (hypertension in dogs can cause proteinuria) and take some abdominal x-rays to see if a growth of some sort, or kidney stones could be detected.

Nothing abnormal turned up on the x-rays.  No stones, no growths.  On her kidnies, anyway.  What the x-rays did reveal was an enlarged liver and spleen (sweet Jesus).

Nu’s blood pressure was elevated and so a course of ACE inhibitors was started.  She’ll likely be on those for the rest of her life, but we’re going back in a month to have everything checked again.  We are also transitioning her to a new food (a specialized kidney diet) and hoping that her food allergies don’t result in the mange-like fur-loss she’s experienced in the past.

More diagnostics were recommended to establish the reason for the liver and spleen enlargement, involving a trip to Newmarket, the closest town equipped to do veterinary ultrasounds.  Alternatively, our vet could perform a laparoscopic procedure and possible biopsy (if required).

Phil and I discussed it, and even though the option of sedation was offered, the travel would be more torture to Nuala than any resolution the ultrasound might reveal.  She HATES the car.  Even laparoscopic procedures are invasive, though minimally so.  We had to decide where we would draw the line.

If there is some infection or tumour causing the enlargement of her organs, there’s little that can be done in either case.  Liver and spleen are pretty important and highly vascular organs and several diseases that affect either usually result in internal bleeding, or disseminated intravascular coagulation (DIC).

We’d already gone through the heartbreak of hemangiosarcoma with our last dog, and though we authorized surgery, it did little for her other than to confirm that her condition was terminal.  Ultimately internal bleeding was the cause of her demise.

Organ failure is another possibility, but there are no transplant programs for pets.

There’s also a chance that whatever condition she has that’s causing the enlargement of her liver and spleen won’t become an issue in her lifetime.  She’s just passed her eighth birthday and most dogs don’t make it very far into their teens.

You might see this as naive optimism, or unnecessarily harsh, but Phil is Mr. Science and he used to work as a laboratory technician for humans.  He’s well-aware of the potential issues and has shared his insights.

Whatcha got there?

Nuala hoping to scam noms from Phil 🙂

Aside from which, Nu is behaving normally.  Other than a little limp, exacerbated by the leg-tugging required to get a good abdominal x-ray, she’s fine.  In this morning’s snow, she was doing her usual pup-angels and seal impression.  She was also scavenging for dirty tissues and all manner of tasty (to her) garbage.  By all accounts, she’s a happy dog.

It would be different if she was experiencing further pain, or other abnormal behaviour.

We’re going to take things a step at a time.  Use the ACE inhibitors and k/d (Hill’s Kidney Diet) for the month and see if they improve her blood pressure and proteinuria.

For us, it’s a matter of quality of life for Nuala.  The ACL injury we had to do something about.  It caused her a great deal of pain and could have caused other injuries and difficulties in the future.  When she sheared a tooth off, oral surgery was a must.  When she lost patches of fur due to a food allergy, hypoallergenic food was the fix.

Now the kidney diet and ACE inhibitors are necessary.  We’re just about at our limit with what we can reasonably do to ensure Nu’s continued, happy existence, though.

Will let you know how all of this pans out.

How are your animal muses doing these days?  I sincerely hope all is well.

Caturday Quickies