greyhndz
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Posts posted by greyhndz
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Thinkin' about Cuffy and you today!
I believe Joslin heard from Dr. Sisson and was told an appointment was available today, but she was waiting to confirm. Hopefully Cuffy will be having his neuro evaluation sometime today.
Be sure to update us, Joslin! I'm confident Dr. Sisson will figure it out, and
that he'll be able to get Cuffy pain-free and feeling well again. -
Jenny, we have to stop meeting like this!
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Iggy Lexi responded within 48 hrs of starting prednisone, and this happened every time she went onto steroids before she was properly diagnosed. She may be 11 but she's always been a little ball of fire, and a jumper. For months she didn't jump, barely stood up on her hind legs, and walked very slowly down the stairs. We were so convinced it was Lyme, especially when she developed what looked to be a meningitis/meningoencephalitis.
But once she was diagnosed and started on high-dose prednisone (she began on 40mg/day, and has gradually tapered since February) she very quickly became herself again. She's still doing well, and is on methylprednisolone 4mg every other day. My vet (neurologist, as we thought she had GME) started Imuran a few months ago, as he felt her kidney disease and liver enzymes might improve if she were tapered off pred sooner than planned, but she became very ill within a week - drug-induced (Imuran) hepatitis. So we'll finish the 6 months of steroids and hope for the best. 50% of dogs will relapse after completing their steroid taper, and if this happens, she'll go back onto steroids and also a different immunosuppressant.
Please keep us posted on how things are going - and if possible, try to get in to see an internal medicine specialist.
Jordan
ETA: Oops, you can't PM yet. Feel free to e-mail me at greyhndz at comcast dot net!
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I think Shanti's mom and I can fill a book...
Hopefully your vets are running a complete tick panel, including anaplasma. But usually, with tickborne disease, you start to see clinical improvement around 48 hrs after starting on doxycycline, and it doesn't sound as if that's happened.
I can share my experience with Lexi, my 11.5 year old iggy. She became progressively more ill between November and January last year - appeared "owie" but it seemed to vary in location and severity. Ran fevers intermittently, depressed, lethargic, had an episode of severe neck pain - and her vet and I were treating it as if it were Lyme. She'd go onto antibiotics and steroids, and bounce back in 2 days. Did this 3 times with same results, but she'd relapse within a few weeks. We thought it might be GME, so went to neurologist in Boston. He immediately diagnosed her with autoimmune (or immune-mediated) polyarthritis, by aspirating her joints and examining the fluid, and also by ruling out virtually any infectious disease you can think of.
She's currently on a 6-month gradual taper of steroids - initially prednisone, then switched to methylprednisolone due to elevated liver enzymes and renal issues. And she's returned pretty much to her baseline iggy self.
She did not have the problem with thrombocytopenia (low platelets).
She did develop proteinuria and renal insufficiency - felt to be a part of her autoimmune syndrome, or a result of "circulating immune complexes" that can cause damage to the kidneys.
This is where you really want to get in to see an internal medicine specialist ASAP. You've got to get a solid diagnosis and if necessary get her onto steroids, and probably onto a long-term immunomodulating drug like Imuran, Cyclosporin, Leflunimide, etc.
Feel free to PM anytime
Jordan
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Hi Joslin
I hope you get this figured out - I know that when Cuffy is hurtin', mom is hurtin' even more. It certainly could be a herniated disk or some time of nerve root impingement.
If you need a good neuro, go to see Dr. Sisson at Angell. He's brilliant. If you need contact info, let me know.
Jordan
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Jenny, you can try a Bite-Not collar (if you can get one quickly - I've only seen them sold online). I used this successfully with Teo, but I understand that it may not work that well for tail or extremity injuries.
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I used...and I'm not kidding...a can of instant iced tea mix that I cut the ends off of. It was thick cardboard and worked just as well - cost me about $5. It looked hilarious. I'm sure I have a photo somewhere.
OK, I have to laugh because I envision you using something like this:
That must be one skinny-necked dog!
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What a HUGE relief! I'm so happy to hear this! Please do keep us posted, and give that brave girl a big hug from us!
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Sometimes the Bite-Not doesn't work too well for the extremities, as the dog can turn his head just enough to reach his legs.
Some alternatives: a long-legged jammie, a very good vet-wrapping job (sometimes just not possible) or even a tube sock covered with vet wrap from thigh level all the way down to the paw.
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Thinking about you and Cassidy, and (whenever you're up to it) anxious to hear how Cassidy's cardiology visit went.
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Hi Ellen
You've obviously been doing lots of research, and learning as much as you can about what Cassidy may be facing. But I can share with you that, as a medical professional (I'm a PA), when it came to Kody's symptoms and his diagnosis, I was a blathering fool. As you said, there's so much emotion involved, and helplessness that you can't make them healthy again -- it's very hard to be levelheaded and make objective decisions.
The cardiologist will give you information tomorrow that you will need to decide what path to take, but remember that both Cassidy and you also play a big role in the greater picture. You know her best. You'll look in her eyes and she'll tell you what she wants, and you love her enough to listen.
Jordan
Some veterinary literature, if you wish:
Prognosis of heart base tumors
PubMed - In the "search" box, enter "pericardial effusion, dog", and you'll see a long list of abstracts.
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GREAT idea on the compounding -- that hadn't even occurred to me. I will investigate this immediately.
The guy who owns Center Vet Pharmacy was really great about getting right on Lexi's prescriptions, as I'd told him her story and the urgency of getting the meds. He's kind of an odd bird (
) who apparently invented the whole flavoring system and admits to tasting the flavoring before using it. But he had the compounding done immediately and the meds arrived in 2 days. We didn't do the MRI b/c of cost and that it wouldn't change our treatment, in the neurosurgeon's opinion. We have had numerous x-rays, and they show nothing but maybe a slight narrowing of the lumbosacral joint where you'd expect the stenosis to be. No other abnormalities.Ah, I'm relieved to hear that. I feel the same way about the MRI, or myelography, or anything else invasive; if you're not planning to proceed with surgery, there's no reason to do any of those studies.
The other thing suggested to me about disguising pills in yummy treats: never put medication in their supper, or they'll start avoiding eating their meals. Also, if you hide the pills in a treat, give him a couple of treats without the pills both before and after the "spiked" one, and he'll be less likely to avoid taking the treats in the future. Will Duke eat a little canned food? When I got the compounded meds, I'd squirt them into a large tbs of canned food, cover it up with a little more canned food (something stinky - strained baby meats also works), and Lexi would chow right down.
Desperate times call for desperate measures!!
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I agree with Ruth about the melatonin, although you'll find that each individual hound will have its own individual response to any type of treatment.
Jenn, do you have a bathroom with an exhaust fan or a laundry room? What finally worked for Kody (stormphobic extraordinaire) was a combination of:
being in a closed-in environment with background noise - either a bathroom with an exhaust fan, or even better, a laundry room with the washer/dryer running.
Inderal 40mg (propranolol) given preferably at least an hour before a storm.
and Melatonin 3mg about 1/2 hr before the storm is due. (Also, and don't laugh, classical music!)
I tried him on xanax 2mg, valium 10mg, prozac - you name it. None of that helped, but other dogs have done well on those meds.
Good luck!
Jordan
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As far as pilling, have you tried having his meds compounded? There are many veterinary compounding pharmacies around the country, and they will compound almost any med into a liquid, or a transdermal gel, or a chewable treat that can be easily administered.
They can flavor the liquids almost anything imaginable. I used a pharmacy I found online called Center Pet Pharmacy in Washington DC (I live in NH). They'll take the prescription order by phone or fax, and work with you to compound the meds into a formulation that will work. (The transdermal gel, which you apply to the skin on his ear, might work well for Dune.)
There might be a compounding pharmacy near you, or you can google veterinary pharmacies to find other accredited pharmacies in the area. I used compounding for my iggie's methylprednisolone and enalapril. You can either shoot it into his mouth, or put it on his food, and he won't taste anything bitter.
ETA: Have any imaging studies been done? I ask because that degree of pain and debilitation makes me wonder about tumor, having gone this route with my 12 yo Mini who developed wasting of her R hind leg, and was diagnosed with spinal osteo.
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We'll be thinking of you and Cassidy, greymomof2. I hope she has a restful day and night, and will be anxious to hear about your visit to the cardiologist tomorrow. It's so fortunate that you live near great veterinary resources, and that they can see her so quickly.
Hugs to both of you.
Jordan
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Unfortunately, when I asked my vet if they carried them, he had never heard of them before
I showed them what they are, so now they know, but they still aren't planning on carrying them, so I'm on my own. I ordered the 6" collar and I'm sure it will be fine.Yep, I had the same problem. No one in my area carried them, so I mail ordered from the Handicapped Pet store in Amherst, NH. And I wound up paying an addl. $20+ for overnight delivery.
I think you'll be happy with your decision, though. Teo, who is usually afraid of his own shadow, wore the collar without any stress, and was able to go in/out of the dog door, eat, sleep, etc. very normally. But definitely use the strap, because that helps keep the collar in position and prevents him from turning his head far enough to bite at the wound. good luck, and let us know how it works out!
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Is the vet very experienced?
Altho' I'm not a vet,I'm not really understanding how Lasix can or will address the pericardial effusion. It's a different physiological occurance then for ex.,congestive heart failure.
I'm sorry if I'm incorrect on that,but I'll do my best.
Is Cassidy symptomatic at this time?
Actually Lasix is frequently used in humans for a few reasons: because the way she presented is suggestive of cardiac tamponade, which results in heart failure (usually right-sided when you see jugular venous distension), the lasix may be helpful in relieving the fluid overload. It may also, to some degree, decrease the effusion, especially if it resulted *from* congestive heart failure. And if she has a peritoneal effusion (I'm assuming they mean ascites - fluid in the abdominal cavity), the lasix would be appropriate to try to decrease the fluid.
If they did wind up doing pericardiocentesis, I hope they sent the fluid for cytology (cell analysis) to see if there were any cells suspicious for cancer.
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Hi and welcome!
What the cardiac echo seems to indicate may unfortunately be a cardiac tumor, most often a hemangiosarcoma, but could also be fibrosarcoma, lymphoma, or even metastasis from another location.
This article actually shows a photo of a dog with neck swelling due to distension of the jugular vein -- this occurs when the fluid in the pericardial sac (around the heart) becomes restrictive and the heart cannot pump adequately, leading to heart failure. Click for article
This scenario is all too familiar to me. New Years weekend 2001, my first greyhound, Kody, suddenly developed panting, and stopped eating, even his favorite strained baby meat, so I knew there was a major problem. Chest xray at the vet's showed an enlarged pericardiac sac and pericardial effusion (a fluid collection within the sac). The next day, an echocardiogram was done which showed a right atrial tumor and confirmed the effusion.
I discussed with my vet the options available: drain the fluid from the pericardial sac with a needle, knowing it would reaccumulate in short order. Put Kody through surgery to create a pericardial "window", in which an opening is created in the pericardium, which would prevent fluid from reaccumulating, but would not solve the problem of an inevitably enlarging (and fatal) atrial tumor. Because Kody was already very symptomatic (and, as in Cassidy's case, this was a very abrupt occurrence), and had stopped eating, I did not want him to suffer, or become increasingly short of breath, because I needed a few more days with him. He went to the Bridge that day, and I still can't talk or think about it because he was my absolute heart dog.
I wish I did not have to paint such a bleak picture for you, and I so hope to be proven wrong, but from the veterinary literature I've read, and my own experience, Cassidy's condition is very worrisome.
Please keep us posted, and know that you and Cassidy will be in our thoughts....
Jordan
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OMG...where's his head
Here it is!!
Teo likes to sleep with his head under the bed. My sweet, neurotic boy.
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Jenny, as I recall, cyclosporine hasn't proven effective with IMPA so isn't an option. I've discussed this with Dr. Sisson, as Imuran ---> severe drug-induced hepatitis after Lexi was on it only a week. I can't recall if Shanti is still on steroids, but I believe he said there were a couple of other immunomodulatory options: CCNU (Lomustine) and Leflunamide. If you want more details, I can send you his article.
I'm sorry that Imuran wasn't successful for Shanti. You've both been fighting this for a long time, and I can imagine how frustrated and sad you must feel right now.
Shanti had a joint tap to confirm IMPA, didn't she?
Hugs to you and your sweet baby
Jordan and Lexi, her partner in IMPA
ETA: I'd be curious to hear if they've done any veterinary trials of human biologic (anti-TNF) agents, such as Remicade, Enbrel, Humira, etc., or if they'd considered this for Shanti. Methotrexate is often used for rheumatoid arthritis in humans, but I don't know if it's been tested in dogs.
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I bought the 6" for Teo, who is around 70 lbs. I found the strap (which goes behind his front legs) made all the difference when it came to keeping the collar in place and preventing him from turning his head to get at the wound. I was very happy with the Bite Not! It worked well but was comfortable for him.
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I'm seeing the same thing here, Irene, on Teo, my fuzzbucket galgo. I noticed this last year. He has long, wiry hair with feathering on his thighs and toes. By the end of last summer, the feathering was gone, and he had almost no hair on his butt and sides. It was all back by mid-winter, and now I noticed he's blowing coat again, and his feathering is becoming sparse.
I wouldn't worry, unless Fuzzy and Paul's coats don't fill in by winter. I think this is the canine version of putting away your winter clothes for the season.
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I roll pills up in a little piece of deli roast turkey. Or, mix it up with a little strained baby meat.
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I am. Are you talking about Dr. Siscon (sp?)? I wish I had gone to him first but my other grey, this guys littermate, has been through two surgeries for soft tissue sarcoma in the last six weeks and I think my boss is running out of patience for all these vet visits. Instead I took him to see a neurologist at Mass Vet Referral because it was easier than driving into the city. I'm kicking myslef now. If I chooe to pursuit the neuro route, I plan to go to Angell has I don't feel I was given useful info at MVR. Is this who you were referring too?
Yes! Dr. Allen Sisson. He's a God in my eyes. Actually, I had made an appt. with one of the female neuro's at the referral hosp (not Dr. Silver, the other one), cause, coming from NH, I really wanted to avoid Boston. But I thought I might be dealing with a GME dog (iggy Lexi) and everyone on the GME board urged me to go directly to Dr. Sisson as he's the authority on GME.
If you e-mail me at greyhndz at comcast dot net I can give you the whole poop!! (and his phone number, etc.)
Jordan (and Lexi, who says "Dr. Sisson is my hero!")
ETA: Dr Sisson has Saturday hours! I'm going down 7/26.
that he'll be able to get Cuffy pain-free and feeling well again.
I showed them what they are, so now they know, but they still aren't planning on carrying them, so I'm on my own. I ordered the 6" collar and I'm sure it will be fine.
I think you'll be happy with your decision, though. Teo, who is usually afraid of his own shadow, wore the collar without any stress, and was able to go in/out of the dog door, eat, sleep, etc. very normally. But definitely use the strap, because that helps keep the collar in position and prevents him from turning his head far enough to bite at the wound. 
Cuffy's Sad Update
in Health and Medical discussion
Posted
Oh, Cuffy... Oh, Joslin... I'm so sad to hear this. I know you'll do everything in your power to keep him comfortable and happy. If there's anything at all I can do, please let me know.