greyhndz

The trick of the month around here is thin slices of deli roast beef. Galgo Dandi will take his pills wrapped in slices of American cheese, but iggies Lexi and Bailey can sort through cheese, turkey slices, peanut butter -- you name it, they'll ptui the pill onto the floor. For the last couple of weeks a roll of roast beef wrapped around the pills has worked magic. Other option is to hide it in a spoonful of soft, stinky canned food. Lexi didn't fall for the liverwurst -- must be the only dog on the planet who doesn't like it.

Propranolol was literally a lifesaver for Kody, who had the worst case of storm phobia I've yet to hear of. In the mid-90's I brought him to Nicholas Dodman at Tufts - we tried Prozac, xanax, valium, desensitization, conditioning, and nothing would keep him from trying to break through windows or burst through a 6' stockade fence. What finally proved to be the winning combination was propranolol an hour (if possible) before a storm, together with melatonin. He fared much better being in an enclosed area without windows and with some type of "white noise", like the bathroom vent or a clothes dryer. I've never heard from anyone else who's used propranolol and I'm kind of surprised. In human medicine, it's used for performance anxiety or stage fright. It didn't take away Kody's fear response, but it did moderate his "fight or flight", escape compulsion, and that's what threatened to kill him.

Aw, Beau looks wonderful! Life is good for all of you -- finally!

Sweet Misty, and loving mom Claudia, who is always there for everyone needing support or a shoulder. You both are surrounded by caring friends now, who wish you peace, the comfort of knowing that you're doing what is right for your baby, and a gentle journey for Misty.

Roberta, it's so great that you posted. Sara is the poster girl for GME, and I hope her successful remission will give Anne hope that Kylie, too, can get there. Anne, try to not be overwhelmed by everything you read and hear. Yes, GME is a complex disease, but it can often be controllable. Asking your vet about whether he plans to start Kylie on some type of chemotherapy or immune modulating medication (so Kylie can eventually be tapered off prednisone) would be a good thing to do, when your brain clears from the roller coaster it's been on the past few weeks. And if Kylie is started on one of these medications, there are pharmacies (like Costco online) selling many of these drugs for far less than the veterinary hospital would charge. I'd be happy to help you find a good price if needed. Hang in there, and just take it one day at a time. And if you feel discouraged, think about Roberta and Sara.

You and Kylie are in our hearts. She's in the best place possible, and they'll keep her sedated and comfortable. Try to take the time tonight to recharge your batteries, because you've got to be running on empty right now. No second-guessing allowed... you've done, all along, what you truly believed was right for Kylie and followed the advice you were given. What's important is that you've had the fortune to find someone who can help, and Kylie is in his hands.

My heart goes out to you and Kylie and I do so hope there will be an answer for you, and more importantly, reason to hope for a cure. I was hesitant to bring up the possibility of GME -and to complicate matters, an MRI and lumbar puncture (spinal tap) are usually needed for this diagnosis. If the neurologist does believe this might be GME, try PM'ing 3greys2cats as Roberta has a GH who is now in remission after treatment for GME. I also know of a very well-known neurologist here in Boston who is one of the GME guru's and has developed a successful treatment protocol - PM me if you'd like this info. Will be anxious to hear an update when you're up to it. Warmest hugs and continued positive thoughts coming out to you and your sweet baby girl. Jordan

Joslin, I brought Susie to see one of the ophthalmologists at Mass Vet. Referral Hosp. in Woburn. Dr. Welch - really nice guy, very thorough. They do require a referral from the primary care vet, but my vet took care of that without needing to evaluate Susie first. I hope Harley's eyes turn out to be normal - I thought Susie had visual impairment much as you describe with Harley, but luckily Dr. Welch did not find anything to suggest this was the case.

Oooo my ears were burning! Interesting that you asked about LFTs, because I spent a good portion of the day researching this. My iggy, who has renal disease and immune mediated polyarthritis, developed an elevated ALT (another liver enzyme; the typical liver function tests include ALT, ASP, ALP (alkaline phosphotase), bilirubin, albumin, and GGT. An elevated AST by itself (and your pup's AST is only slightly elevated) isn't specific to the liver - it can also reflect skeletal muscle breakdown, such as occurs with injury or hard exercise. Researching the veterinary literature today, the recommendation for evaluating elevated liver function tests is measuring both the ALT and a fasting bile acids; an elevated ALT together with a fasting bile acid of > 25 correlates with liver disease. This can also be confirmed by adding on a postprandial (2 hrs after meal) bile acids. I can't recall offhand the increase in the PPBA that's considered diagnostic of liver disease. Suzanne Stack explains the meaning of the various liver function tests here I come from the school of medicine (I'm a PA) which advocates looking at the patient, not the numbers. If your pup has been healthy, without any symptoms of illness such as jaundice or lack of appetite, I, personally, would repeat the labs in a couple of months to see if they've normalized. If they're still elevated, the vet may want to pursue this further by repeating the bile acids both fasting and after a meal, and if abnormal, possibly obtaining an ultrasound, with or without a liver biopsy. Some medications can also cause elevated LFTs and your vet should talk with you to find out if this is the case. There are also infections (such as lepto) which can affect the liver. My iggy's internal medicine vet told my regular vet that her ALT is elevated because of progression of her chronic renal disease - this is called a "reactive hepatitis". She's also been on steroids for over a year, which can increase enzymes. Treatment for this is Sam-E, liver support, and control of her chronic renal disease. Lexi has been acting like a sick dog this past week, but as of one week ago, her ALT was normal. Bottom line: if your pup has been acting sick, if her bilirubin is elevated resulting in jaundice, etc. the labs should be rechecked and additional workup done if indicated. If this was just an incidental finding and she's been healthy, I'd probably just repeat the labs to see where they're headed. I hope this helps without being too technical! ETA: Batmom, you are a WEALTH of knowledge of anything greyhound, including health issues!

Yes, this is very much the case. I lost my Arielle suddenly when she was given Deramaxx for scapular osteo. She took one dose, and was violently ill from a GI bleed within a day. She was literally groaning in pain, and despite the best attempts of the E-clinic and my vet, had to be euthanized. One dose. I'll never allow it to be given to my dogs again.

I'm so terribly sorry. What a devastating day this has been for you and your family. Know that you're surrounded by so many of us who truly understand... Godspeed sweet Alan - you were and always will be adored.

Here's the link to Carol's Assistance Harness.

Kind of - but his are discrete little areas, not so widespread (yet). Do you think I should bring him to a veterinary dematologist? Is discoid lupus something a plain ol' general vet would recognize right off the bat without a biopsy? I think I may be getting ahead of myself a little here... I think it's definitely worth having your own vet evaluate it first. My vet was pretty certain it was DL. We did confirm it with a bx (which my vet did herself). If you can save yourself an expensive trip to a dermatologist, that's all good.

My Robyn was incontinent of poop due to lumbosacral stenosis. Robbie was completely unaware of it and just kept on doing what she was doing. This happened primarily when she was sleeping but occasionally when she was walking. Do you have access to "incontinence pads"? These are used on beds for people who are incontinent. They have quilted absorbent fabric on one side, and waterproof lining on the other side to keep the bed dry. You can put these pads on Ivy's bed, and also on the floor where he walks, and instead of having to constantly wash blankets and beds, you just wash and change the pads. SO much easier!!! If you go to Valethics website and click on "used pads", you'll see what I mean. If you can't get these in Europe, I'd be more than happy to help get them to you from the US. Hugs to sweet Ivy Jordan

Is this what it looks like? My Ruby lived with DL for > 14 yrs. It only affected his nose for most of his life, but he did develop it on his pads late in life. It never bothered him. It's very rare that DL would progress to systemic lupus, so I wouldn't stress about that. The diagnosis can be confirmed with biopsy although many dermatologists can make the diagnosis just by examining him. I found it helpful to use bag balm or calendula to keep his noise well-moisturized, and sunscreen to prevent sunburn.

Feel free to PM me with any questions, or if you just need an ear. My iggy was diagnosed with IMPA over a year ago, and I'm happy to share our trials and tribulations! Jordan

I'm not clear on what basis the vet has started steroids. He's not exhibited a specific pain pattern, though some of his behaviors may actually be his way of manifesting pain. He hasn't had swollen joints, just, if I understand correctly, depression, new fearfulness, poor appetite.... these symptoms make me think of something metabolic -- i.e., Addison's, Cushing's, thyroid disease, a problem with the pituitary gland or hypothalamus in the brain.... Prednisone is "the great imposter" and cause give you a false sense of security because the dog may initially become more animated, eat better, engage better, but this may just be side effects of pred. I would be very hesitant to put a dog onto steroids until I had clear, objective evidence of an inflamatory or autoimmune disease; if I were sure there was no chance of undiagnosed underlying infection; if I had ruled out any other possible metabolic cause for his behavioral changes. I'd even give thought to this being a neurologic issue. But IMHO, the correct sequence would be to narrow down the diagnosis before putting a dog on steroids, which could easily mask symptoms and potentially set fire to any underlying "smoldering" infection. In human medicine, persistent "fever of unknown origin" is a very challenging diagnostic workup, but basically you think about infection, autoimmune or inflammatory process, or neoplasm (cancer). OR - something metabolic (such as hyperthyroidism). I think a wise move to make, ASAP, would be to consult an internal medicine vet for a comprehensive workup. And unless there's a specific reason for doing so, I'd ask your vet to stop the pred before it interferes with the IM workup and masks symptoms. Pred will likely mask fever and may skew cultures and other labwork. This is what I'd tell my human patients, and what I'd expect from my vet were this one of my pups (and indeed it was, a year ago, with the ultimate diagnosis of immune mediated polyarthritis). Hugs to both of you, and I'll be anxious to hear pupdates. Feel free to PM anytime. Jordan

Argolola, I just caught up with this thread. I agree with confirming that a thorough TBD evaluation has been done. This not only includes the usual suspects, but often one of the TBD lab gurus will be able to test for specific strains endemic to the areas where Rudy has lived. Running appropriate PCRs at NCSU is also crucial, as is re-testing to see if the titres are going up (indicating acute infection). Unless this proves to be babesia, I'd have expected Lyme, anaplasma, many of the ehrlichia strains, to have responded early on. I get the sense from your post that he may not appear to be improving significantly, meaning he's never returned to his baseline. Or are his symptoms waxing and waning, meaning improving, and then relapsing? As far as testing for autoimmune disease, labwork can be notoriously unreliable: a positive ANA, canine rheumatoid factor and/or elevated sedimentation rate may raise suspicions. Elevated ESR is non-specific, however, and can be found with any type of systemic inflammation or infection. However, normal labwork does NOT exclude an underlying autoimmune disease. Besides the fever, can you elaborate more on his symptoms? Does he show signs of joint pain? Does it always involve the same joint, or does it migrate to various joints at different times? Do the joints visibly swell? Has your vet ever been able to get a sample of the joint fluid to send for testing? Jordan

I got a PM from Robin tonight (I'm sure she'll catch up and post herself) - said Beau is doing really well, and that the specialist she consulted reviewed Beau's records and did NOT see anything in the results of the joint tap that indicated autoimmune polyarthritis! So, a tentative "yay"... *** film at 11 ***

I think it's great that Beau is feeling good now, after a horrendous couple of weeks. You can catch your breath (and start thinking about your new moo-girl) and not feel pressured into making decisions under fire. It gives you all a little down time, and just as important, time to do your research, and learn about the different types of treatment being used for IBD and IMPA (and the reasoning behind them). See, Robin, the thing about many autoimmune diseases is that they can be unpredictable, and flares can come down fast and furious. The theory behind managing autoimmune diseases has changed over the years from the "stomping out fires" approach (usually involving high doses of steroids when flares occur) to taking a proactive stance, and moderating the immune system to try to prevent flares altogether, and thus avoid the need for steroids (dirty little beasts that they are). I'd not only be interested in hearing the IM vet's recommendations, if I felt she were knowledgeable and her recommendations correlated with what I'd read in the veterinary literature, I'd thank my lucky stars that I'd found a great vet to manage his very complex conditions. And I'd jump on whatever she suggested. Managing autoimmune diseases is a challenging subspecialty, and I to those who do it well. And I've been humbled into not second-guessing them. So although I risk sounding like a stick-in-the-mud, I'd not sit-back-and-wait; if the IM vet reviews Beau's chart and confirms the diagnosis, I'd let her "drive the bus" and tell you how best to prevent any future flares. Just to throw in a personal note (and the reason I'm so passionate about this subject), were it not for my having connected with the right specialists at the right time in 2006, I would likely have lost most or all of my vision in one eye. I would probably have been kept on steroid drops indefinitely, and/or been on oral steroids for a very long time, if not for life. (Yup, an autoimmune disease.) Steroid eye drops generally cause cataracts and/or glaucoma with prolonged use. And long-term oral steroids? Oy. Instead, my care was managed by someone whose goal is "durable remission off all steroids". I went onto methotrexate for 2 years, remained in remission that entire time, and was able to come off it just a few months ago. All without any steroids. No cataracts, no glaucoma, and no loss of vision. You want someone who knows how to get Beau into remission, and keep him there. If this IM vet knows how to do that, give her the keys to the bus. J

Me, too -- no one can come close to matching their price. Robin, I'm so glad Beau is better. Everyone in your house could use a little respite right now! i'll be interested to hear what the specialist has to suggest.

but I don't think anyone else does! I can get a little too medicaleesey sometimes. Luckily, this is counteracted by my true personality: Lindsay, don't you bring Becky to Angell for her care? (I seem to remember your saying that at some point.) I don't hear of leflumonide being used that often, except for Dr. Sisson (for GME and other inflammatory brain disorders) and the other Angell staff. And Lexi's IM vet in Woburn is also comfortable using it. It seems that Imuran and cyclosporin are the first "go-to" drugs, but Lexi didn't tolerate Imuran, and cyclosporin is not an option because of her renal disease, so leflumonide it was. you're absolutely right about it taking quite a bit of time to find a "cocktail" that will work for an individual dog. It's a fine line between a therapeutic dose and a toxic one, and sometimes a dog will have an idiosyncratic reaction to a drug that most dogs can handle without problem. You just go with the flow, and find an experienced specialist whom you can trust to manage this for you. Update us on Beau when you can....

this news could only be topped by finding out that Shanti is VF-free! I'm so glad to hear this, Jenny! Now about that upcoming VF titre.... positive vibes for a negative test! And skritches to your brave and beautiful girl.

NCSU - Idexx Snap-3, 4 This article gets quite technical, but it's a very good overview by Ed Breidtschwert of NCSU's TBD lab, describing what the IDEXX snap-3 and snap-4 actually test for, and how to interpret the results, and also ways of identifying false positives. There are TBD's which are not covered by the IDEXX Snap-3 or 4. I've found it very helpful to talk personally with either Ed. Breidtschwert or Cindy Holland of Protatek, explain the dog's clinical symptoms, where the dog has lived, and let them guide me as to which TBD's to test for. They're also great resources for helping you understand what the test results mean, and advise of any repeat testing indicated in the coming weeks/months.