MerlinsMum

July 9, 2013

I, too, am only seeing this now. Happy belated Birthday, Honey.

We miss you, sweetie. :cry1

July 7, 2013

I usually use doxycycline at 5-10 mg/kg twice daily, but it can also be dosed at 10 mg/kg once daily. I'm not sure if there's much difference between the different protocols. I'd ask your vet if it's ok to just give 2 capsules twice daily.

The esophageal concerns with doxycycline is mainly just irritation if the pill/contents don't go down and remain in contact with the esophageal lining for an extended period. It's really more of an issue with cats, and as long as he ate/drank after the pill, he should be fine. I always just instruct owners to make sure the doxy is followed with food or water.

Thank you so much. This really helps to assuage my concerns.

Thanks to everyone who has offered tips to better administer pills to an unwilling patient A lot of great suggestions here - I appreciate it! I feel as though I have lots of ideas and options now. :colgate

July 7, 2013

Thank you! I was alarmed and had a mini freakier tonight when I have him the Doxy, as the vet's instructions on the label said to give 4 (100mg) pills wrapped in food every 24 hours. Presumably, since a typical range for dosing (as I understand it) is between 5mg and 10mg per kg, and Sagan is 85lbs (=40kg), he was given the higher-end dosage. Giving him 4 pills at once in Pill Pockets was super stressful for me since, unlike Merlin, Sagan is unused to being given pills and tends to "clamp down" whenever I ask him to open his mouth. I freaked out because the first time I gave him 2 capsules in one Pill Pocket and although I meant to put it at the back of his throat, somehow he clamped down on it and we heard a crunch! I hope he's going to be alright :ohno :riphair My vet was very insistent that the capsule be wrapped and swallowed properly so that it reaches the stomach before dissolving... which is why I bought the Pill Pockets (which I'd never used before). As I recall, it has something to do with an increased risk of esophageal cancer in dogs that chewed it or something...? :unsure I didn't see any powder "spillage" in his mouth when I opened it after I heard the crunch. Let's hope I didn't do any damage :cry1

The thought of repeating the process for the next 24 capsules fills me with anxiety. I also find it weird that I have to give him 4 capsules at once. Why not 2 capsules twice a day? Does it target the problem faster if it's given all at once, who knows.

This is when I wish I'd gone to vet school. If I call my vet to check they might fire me :lol I feel like I pester them as it is...

July 6, 2013

So I decided to postpone the dental and get his platelets back to normal first.

He is on doxy starting tonight. We will re-test in 7 days, although of course it's likely he'll have to be on doxy longer than that.

All of your answers helped me so much. I was able to really read up on aminocaproic acid, for starters, and I feel so much more educated now. I have been reading Dr. Couto's team' studies on the subject, and I also found that I was able to order Amicar from Walgreens (tablet form) for $74 - which is way better than $186!! And they can get it for me in 1 business day. After reading your comments and experiences and reading more information online, I have decided that I will be putting the hounds on Amicar for any future surgery they require.

Thanks again so much!

July 3, 2013

Dr. Couto recommends all greyhounds be given Amicar pre surgically. I thought it was am amino acid?

Wow, really? Even when no bleeding episode has been experienced in previous surgeries? Merlin and Sagan have had several dentals between the two of them, and they have never been given it. In fact, I'd never even heard of it. There again they've never had bleeding issues.

I found this paper by Dr. Couto's team: http://issuu.com/oncologiavet/docs/aminocaproic_acid_greyhounds_amputation_osa_jvecc_ and I haven't had the time to read it all yet. Unfortunately it looks as though you have to have a subscription to the Journal of Veterinary Emergency and Critical Care in order to download it as a PDF.

If bleeding is a particularly greyhound-related issue, and vet offices don't have it on the shelf as a matter of course, I doubt that many greys are being given it pre-surgery... most vet clinics aren't tailored specifically to greys, after all..

July 3, 2013

Thank you for all your continuing input, it's all really helpful.

Just wanted to clarify that they retested his platelets three times after the first lab results. This did include a manual count, which showed just 4-7 platelets per field, and 'giant' platelets (young platelets that have just been released) running low.

Amicar is far, far more expensive in tablet form than it is in liquid form. But, as I mentioned in a previous comment, sadly the liquid form is not currently available due to manufacturing problems (although it's supposed to be available any day now).

July 3, 2013

Yup, mine cost about 50 for Lucy. I now keep a few days supply on hand because not all pharmacies carry it and it can take a few days to get it. I got mine at CVS.

I noticed that you are going to be discussing things with the vet tech -- maybe you want to talk to the vet instead. Also, find out who will be doing the dental, the tech or the vet.

If the platelets are low, I would not be contemplating any surgery - way too risky. As someone mentioned, you can take care of an infection with antibiotics until you get a better handle on this.

The vet also didn't seem to know that this is given afterwards and not before the surgery, I'm not so sure I would be comfortable with that.

Of course the vet does the surgery. She has done dentals for Merlin and Sagan before and they have gone swimmingly. She is an extremely competent vet. I have no qualms about that. I think I have gaps in my understanding here though, for sure, and you're right, it's possibly from talking to the vet tech this afternoon rather than directly with the vet (who was in surgery). However, the vet tech in question specifically mentioned a few times that she did not have as much knowledge as she'd like about Amicar, and she checks in with the vet before and after every conversation and reports back. So maybe I'll talk with her again and ask if I can speak directly to my vet, if she is in tomorrow.

But at this moment in time, I think you and others are right, I think I am currently inclined to hold off on surgery for now, even if it's just to have a clearer and more comprehensive discussion with my vet over this matter. This whole drug drama and people in this country getting fleeced by greedy pharmaceutical companies makes my head spin. I don't get it, but that's a rant for another day :lol

July 3, 2013

I asked my vet to have Amicar on hand for Gracie's dental. She was glad to learn of the product. Fortunately it wasn't needed and we were not billed just for having the clinic have it in stock.

That's nice to hear. I don't really understand why I would need to be charged for it if they ordered the injectable form. Surely they need to have some on hand at the clinic at all times, in case of a bleeding issue during surgery? So really I would assume that they would want to order some anyway, to have there, once it's available again... regardless of whether they know for a fact that they will need it for a patient. Sounds to me like one of those "just in case, better safe than sorry" type drugs you should have available at all times if you're a vet... :dunno

I agree the low platelets are worrisome. Though they *can* vary from time to time. If a tick panel has come back negative, I might be talking to my vet about a week or so of doxycicline, just in case - TBD cans be notoriously tricky and sneaky. If other bloodwork is OK, there's not much else to go on without more expensive testing. You might need to make a choice of whether to go ahead or not, without knowing *why* his platelets are/were low.

I too would do some online checking/calling in your area before you give up on the amicar. Don't take your vet's word as final in this matter - they make money selling drugs to customers. Amicar is used for people and it isn't that expensive. The pharmacy may have to special order it, but should be able to get it, one way or another. Have your vet write you a scrip, or call one in to where you can find it. It is VERY new for use in greyhounds for bleeding, and most vets don't even know about it, or know how to administer it properly.

Places like Walgreen's, Walmart and Costco usually have pretty good prices and will even give a vet/pet discount. (You don't have to be a member to use the Costco pharmacy.)

Amicar is not expensive-you have been given some poor quotes. It most certainly is available in tablet form--you need to give 500mgs three times day for 5 days--start the evening of the procedure (it strengthens clots-doesn't help form them so no need to start the day before--per Dr Couto). I have some here--think it was $30ish dollars for 15 tablets-got mine from Walgreens. It took them a couple of days to order it for me but, it was no big deal.

As far as the platelet count-how low is low? Did you run tick borne panel? A clotting profile??

If your vet is comfortable with proceeding I would perform the dental prophy ASAP--his teeth are only going to get worse.

If you can not find the Amicar pm me.

I have been looking online and everyone it's expensive or you have to buy it in large quantities, which ends up being expensive :huh ....

If you have trouble getting it try SBH Veterinary Compounding Pharmacy in Ohio. They show it as one of the drugs they carry. Their pricing also has consistently been the best for various drugs I've gotten through them.

Here's their number,: 866-724-6333

Thank you very much. :thumbs-up

How low are his platelets?

Are you or is the vet expecting extractions? If it's just a teeth cleaning, you won't need the Amicar. If it's more than that, you might not need it either -- I'd see if your vet can talk with a canine dentistry specialist about some of the newer techniques and materials for minimizing bleeding after extractions.

That's the problem... the vet says that she can't say for sure whether he needs extractions or not, although at this time they are not anticipating it. But his back teeth are very bad and his breath is nasty. She told me that if it's just a cleaning the Amicar won't be necessary. So I'm not sure why the vet tech mentioned that he would need to be given some before surgery too. What if there are no extractions after all? Is it given ahead of surgery "just in case" when it's available?

July 3, 2013

Kerry...for what it is worth, medicine or not....cost of drugs not even considered, I would not take the chance. Bad teeth that have to wait until you can get funds for extractions will not kill him, but a platelet issue could. Worse case, if one of those teeth gets infected in the meantime, a round of clyndamiacin does wonders and it is not hugely expensive. EZs teeth need to all come out....half were removed five years ago...but he is too old and has a major heart murmur. We treat as needed. I realize he is older than Sagan so you may not want to ride those teeth out for a lifetime, but the risks seem too high.

Of course, you know my history....so my fears may be a bit extreme....but it just my perspective.

And it is a perfectly reasonable perspective, Robin :nod :grouphug In fact, I have felt more and more inclined to agree with those suggesting I wait. DH has made it clear that he thinks we should just wait and sort out the platelets and not buy these expensive meds that we may or may not need. Even if I could get them cheaply - in which case I wouldn't be averse to buying them just in case I might need them anyway - I am not sure I want him to go into surgery in a condition in which we have to give him certain meds to force his blood to clot because it's not doing it on its own. I mean, to me that's kind of scary. So many things can go wrong. And then there's the fact that, as greysmom said, it's only very recently been used for greys -- and like any meds there can be side effects. I don't know. I will discuss this a bit more with the vet tech tomorrow, and I don't deny that I'm very concerned about avoiding extractions, but tbh I'm more concerned about not having him bleed out on a table.

Please keep the advice coming, I so appreciate it and it's really helping me get a sense of the pros and cons. I am open to changing my mind 10 times over if necessary. It's easy to say that I want to go with my gut; but really, I don't. My gut has got things wrong before. There is no margin for error here, I have to get this right, yet there are so many question marks and IFs here, it's not easy.

July 3, 2013

LuvEarsies, where did you get it so cheap? I have been looking online and even if you buy it more cheaply from a Canadian store, it seems you have to buy it in large quantities. I don't need 100 tablets.

The vet tech I spoke to this afternoon spent ages calling pharmacies around here and no one carried it. They could special order it but the cheapest price quoted to her for the amount I would need was $186 at Rite Aid.

July 2, 2013

I haven't been around much at all, and I'm sorry. Too much craziness in my life at the moment, it's been going on for a while and will continue at least until the end of summer. But I really need your advice, if you have any to give.

Sagan was supposed to get dental surgery today, and we rescheduled out of concern that he might otherwise be at risk for post-operative bleeding, due to his platelets being unusually low (yes, even for a greyhound). I am so glad I requested pre-dental labwork. Anyway, without getting into it all, which would lengthen this post considerably, the point is that my vet mentioned that there is medication (aminocaproic acid) that can be administered just before surgery - and then following surgery for a few days - that will prevent bleeding, so if his platelets were still low next week, the dental could still be carried out. The problem is that they don't have this drug in injectable form (apparently it's been off the shelf in that form for some time, and no one locally seems to have it in tablet form either, so it would have to be special ordered. It is a very expensive drug - $200 for five pills. I am now faced with a decision as to whether to spend an extra $200 on medication that I may not even need to use, because it is not refundable. $200 is a LOT of money for me. Merlin's chronic health issues, apart from putting years on us in terms of stress and anxiety, have depleted our savings and we literally can only just barely afford to pay our bills at the moment.

The vet tech I spoke to asked me if I wanted to look into possibly obtaining the meds from a Canadian online pharmacy to see if I could get them more cheaply that way. I wonder, has anyone done this before and can maybe recommend a good website that ships fast?

You might be asking, Why the rush? Why not wait to see if his platelet count improves before a dental? It's a good point. There are two problems:

1. If we don't do his dental now, we're going to have to wait for quite some time. My vet is not going to be around until possibly well into August. If things don't go as planned, it might be even later.
2. If we wait that long, I may end up spending even more money because he may well require extractions at that point. His teeth are horrible and his breath is awful.

The point here, though, is that we really can't afford to spend $200 for "just in case" medication. I also feel that this whole discussion overlooks the main issue, which is that his platelets are low and we need to find out why that is. And if we do, then the whole discussion about bleeding is redundant anyway. Although this all begs the question... what do vet offices do if a dog's labwork is fine and the surgery goes ahead and then all of a sudden the dog starts bleeding out? Do they seriously have to resign themselves to thinking "oh well, we're out of that particular medication that could stop the bleeding, tough luck"? :ohno I mean, I can't make sense of that at all.

Am I missing something?

What would you do?

June 5, 2013

Keeping Passion and you in my thoughts today! :goodluck

May 22, 2013

On Monday I found out on Facebook that Spud didn't have osteo after all -- I had missed that post completely. I was overjoyed, thrilled at the thought that you would have so much more time with your Spud.

On Tuesday morning I woke up to the devastating news that you had to let him go. I know I've never met you or Spud, Mary Jo, but I cried and cried, and I cannot tell you how devastated I am for you. I know how incredibly close you two were, how much love there was between you... how much love there still is and will always be. :brokenheart

I can't believe that we won't see his beautiful, quirky, ridiculous Spudzilla ears anymore... :cry1 :weep His goofy faces... the photos of the two of you together... There was a recent one you posted to Facebook of the two of you together, both smiling, that makes me cry everytime I think of it. So much love. You can't even begin to quantify the loss when love is so great.

I am thinking of you, MJ. I am so, so sorry. :grouphug

Rest well, Spudzie. We will miss you forever. :gh_run2

May 14, 2013

Poor Thunder!

:goodluck Sending lots of good thoughts!

May 12, 2013

I'm so terribly sorry for your loss, Robin :cry1 You have been very much in my thoughts. :grouphug

Rest in peace, sweet Treasure. I never met you, but I will always remember you as the girl with the pretty little front toofers... :wub: :brokenheart

:gh_run2

... Merlin.

May 9, 2013

I did ask about why we were using pred rather then budesonide. There are very specific reasons why she is using pred, and they certainly made sense to me. She said that perhaps down the road that drug might be an option, but right now it is not. Since she is the board certified internal medicine specialist I think that she knows best!

This is what my vet told me too. She said that even if we ever did try budesonide it would only be after first trying pred.

I am so glad that Lady seems better! :yay

April 26, 2013

:angry:

My vet just told me that they aren't making Sentinel anymore! :dunno :headwall Aaargh! They are selling Tri-heart now. Grrr. I'd rather buy Sentinel since it agreed with Merlin's extra sensitive tummy better than Tri-heart...

:riphair

April 26, 2013

Tears of joy streaming down my face! :weep :colgate I am so happy for you and for Aidan and Cinco and the whole gang.

Welcome home, boys!!!!! :confetti

April 23, 2013

:cry1 :cry1 :cry1 Rest well, Sadie. I'm so glad that you found Deb and John and a pack / family to call your own. And what a family. :beatheart

Deb and John :grouphug :grouphug

April 21, 2013

That seems strange. :unsure When I used to give Merlin FortiFlora, it worked great to firm up his poos :dunno It would work within a couple of days. Have you checked for worms?

April 20, 2013

I'd seen your post on FB but I'm only now seeing this touching tribute and pictures so beautiful that they almost made my heart stop. SO much love. And with great love, now, I"m sure, comes a great sense of loss. I know how much you loved your sweet little man. I am so terribly sorry you had to be parted. I hope you're okay.

Thinking of you :beatheart :grouphug

April 7, 2013

So very sorry you had to be parted. :grouphug :cry1

Sleep well, Spencer... :gh_run2

April 2, 2013

Oh no :ohno :cry1 What a shock for you. I am so, so sorry!

:grouphug :f_white

March 28, 2013

I have no experience with this, I just wanted to say how very, very sorry I am. :cry1 :grouphug I hope you have a lot of quality time left together. :heart

March 23, 2013

Rachael, I'm sorry for your co-worker. Having been through HGE (and later a diagnosis of IBD) with Merlin for the last two years, and dealing with periodic flare-ups, expensive prescription food and meds, and the stress or hearinghis stomach gurgle and not wanting to eat the only food he is able to take.... it's all exhausting and worrying, so I sympathize. We spent over $2000 when he was first diagnosed between specialists and tests and hospitalization... it builds up quickly. Luckily he is insured so we got some of that back.

I was a bit puzzled at the mention of a blood transfusion, but I don't know all the details in that case. Merlin was hospitalized and started on Sucralfate, Metronidazole (Flagyl) and sub-q IV fluids. After 24 hours he came home but we continued the IV fluids. He has been on Pepcid and Metronidazole DAILY for the last two years. It took us several months to figure out what dose was needed for him, in order to avoid frequent flare-ups. He had two bad episodes of HGE but hasn't (fingers crossed) had one since, as we've been managing the condition with the Metro. It sounds to me as though Tyke needs to be on Metronidazole (at a minimum) on a constant basis at this point. Or Tylosan (Tylan powder), if that works better for him. Tylosan didn't work for Merlin, his "magic number" seems to be 500mg of Metronidazole TWICE a day, so 1000mg daily. I also feed him three times a day instead of two, and that has helped as well. I just spread out the same food over three meals. If course actually GETTING him to eat is like trying to get blood out of a stone... but that's a separate issue. He doesn't like his prescription food much (I/D) but I have tried SO many other things and this is the only food that keeps his flare-ups under control with the Metro. He also takes Pepcid in the evening.

Good luck... It DID get a lot better and more manageable, the expense has drained our savings and we've had to tighten our belts considerably to accommodate the expense of meds and prescription food, but I'd rather go without other things to pay for the vet bills. On the other hand I also don't have the expense of kids, so I am sure that helps...

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