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Ullaluv

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    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    Where to start?

     

    I just got home from having the leak in the tire fixed, so I can get to OSU safely. And just got off the phone from my most recent call from OSU.

     

    Bottom line is: No one has been able to figure out what's going on with Princess. They had a big conference this morning with Surgery, Pathology and Internal Medicine. Her bilirubin has continued to rise (0.2 0n 12/23, 6 on 1/2, 11 on 1/7, over 17 last night.) Her liver enzymes continue to be sky high, and her cholesterol is still falling - all signs of liver failure. But all the biopsies that they did on Monday have only mild, non-specific changes. Liver biopsy does not look like liver failure, and no sign of fatty liver. Her pancreas appeared normal when they did the surgery, and biopsy unremarkable. The duodenal and jejunal biopsies came back with only non-specific inflammatory changes, not lymphoma and not diagnostic for IBD. When they put the esophageal feeding tube in yesterday, they went back and looked at the duodenum again, and the stent in the bile duct is draining.

     

    We've ruled out anything infectious that we could think of. Tick titers, fungal titers, etc all negative, and she's been on antibiotics since 12/19, when she first stopped eating. She has not had any vomiting, and her stools have been consistently normal consistency and color. And she doesn't act anywhere near as sick as her labs make her look. As the Internist said earlier today, no one has told this girl she's sick.

     

    They've started feeding her, small amounts through her feeding tube and are switching her meds to oral. She's tolerating the feedings much better than they expected, given her extreme wasting. I think they'll start steroids today. If there's no change for the worse between now and tomorrow morning, I'll drive to Columbus and bring her home to continue her feedings and meds, and probably take her back sometime next week.

     

    We seem to be all out of ideas about what's causing all of this. Maybe the best I can hope for is that she'll somehow recover without a diagnosis. If she recovers, that's what really counts.

     

    Thanks for your continued prayers for my soul mate, my precious Princess.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    I've been trying to do this update for almost two hours. I talked to Dr. Townsend, Princess' pathologist. My girls blood tests are getting worse. Her liver values are continuing to go up, her bilirubin is now over 17, and her cholesterol is going down, so it looks like she is in liver failure. She obviously won't be coming home tomorrow.

     

    When they put in her esophageal feeding tube this morning, they went ahead and looked farther down. The biliary stint is open and bile is draining into the intestine. They're going back to take a closer look at the liver biopsy, and her case will be taken over by Internal Medicine. Final intestinal biopsy results look more like non-specific inflammation than IBD. I guess we're back to not really knowing what's going on, except that it does not look good.

     

    OK, I put it in words, so I guess it must be real. Please continue your prayers and good thoughts for my girl.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    Dr. Townsend just called. The final path report isn't in yet, but the preliminary report doe NOT show lymphoma. They're thinking IBD.

     

    After eating a little today, she is refusing to eat again. They are tube feeding her. Tomorrow they will put in a feeding tube so we can start getting maximum calorie food into her. She is so cachectic and wasted that we have to get food into her. Then they will transfer her care to Internal Medicine, where they're more used to dealing with IBD. I'm sure they'll start Pred, but they can't do that until the full thickness biopsy sites have healed more.

     

    She may be able to come home on Friday afternoon! and then go back for followup with Internal Medicine.

     

    It seems that the gall bladder really was a separate issue.

     

    I'm so relieved that it's seeming that this is something that can be managed. I know that my girl has a very strong will and a very strong spirit.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    I just had a quick call from Princess' vet student. They don't have the pathology report back yet, but Princess seems to be feeling better today. She actually ate a bowl of food! He'll try to call me again before he leaves this evening.

     

    Jane, we're sending all our prayers and good wishes Joey's visit tomorrow. Fingers, toes and everything else crossed for a good report.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    I haven't heard from OSU this evening. It's probably late enough that I won't hear anything tonight. I'm assuming no news is good news and will call them in the morning. I'm really anxious for the biopsy results to be back

     

    Oil light on the old SUV resolved. I checked the dip stick, and the oil registered only at the very bottom, just below the minimum fill line. I call the place that services it (a small German, family owned mechanic, best place ever,) and Chris assured me that I could safely drive it there. Took it in, they serviced it, changed the oil and all. So I'm good to go again in bad weather.

     

    I'll update again as soon as I talk to OSU. Thank you all!

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    I just got off the phone with Princess' vet student. She's doing well. He says she's about the same as she was before the surgery, which sounds greyt to me. Said she bounced back really quick for a Greyhound, and no bruising or anything. She really perks up when he takes her outside and wants to check everything out. He's managed to tube feed her a little, since she still does not want to eat. (It's only 20 hours since she came out of surgery, so I guess that doesn't sound too bad.)

     

    He'll call and update me again before he leaves this morning. Now to figure out what's going on the the oil light on the 4=wheel drive, so I'm not snow bound since the snow came in.

     

    More later, and thank you all so much for your continued thought and prayers for my girl.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    Hope left OSU around 6 pm so won't be home until about 10 tonight. After taking care of all her other furkids she is going to be just exhausted. So I hope it is okay with her if I post some details.

     

    The biopsy done via endoscope was not conclusive. Dr. Couto and several other docs took a look and no-one could say one way or another for sure. The bile duct was definitely distended, indicating that bile was not flowing properly. The duodenal biopsy showed what looked to be some lymphatic cells but they weren't clearly lymphatic cells. So the recommendation was to continue on with surgery.

     

    The surgeons put a stent in the bile duct and removed the gall bladder. The fluid in the gall bladder was viscous but there didn't appear to be a blockage. The surgeon commented that perhaps it was just too thick to pass through the duct properly but didn't say what would cause it to be this thick (at least not that I can remember). They took a full thickness sample of the duodenum (where they suspect there might be cancer if there is any cancer at all). While they were there they also took samples from the jejunum, the liver and I think the pancreas (not sure on the fourth sample). Normally it takes 3 to 5 days for pathology but Princess's surgeon is married to one of the pathologists at OSU. She says that her husband will likely put a rush on it for her and we might hear as soon as Wednesday. If it is lymphoma in the duodenum, Dr. Couto says he has only seen this three times in his entire career -- all of them were greyhounds. So given the rarity of this, I am hoping that everything is okay cancer-wise.

     

    Meanwhile, Princess is staying at OSU where they can monitor her closely. She is currently in the ICU -- most dogs go to the ICU after any fairly major surgery so this was expected. They are administering Amicar and following Dr. Couto's protocol. Dr. Couto is in all week so he will be keeping tabs on her.

     

    If needed, I will make up some home cooked food and take it in for Princess. I will be back at OSU on Thursday anyway, so if she is still there and Hope wants me to, I will ask to see her. On Thursday, my Joey is going in for a chest x-ray and monthly blood work. It will be almost 6 months since his amputation (osteo) on July 28. So I will either be very happy or very, very sad on Thursday.

     

    I'm sure Hope will correct anything I've gotten wrong once she gets the chance.

     

    Jane

     

     

    You got it all right! Thanks for updating for me. And many, many thanks for being there with me through the whole long day.

     

    I will add one thing: Just before I left we were talking to the family of the Grey in the run next to princess. They told us how she made them all laugh yesterday when they brought the cart for their girl (who can't walk right now.) Princess decided that she did NOT want to go in her bed, and proceeded to try to climb into her neighbor's cart instead. That's my girl, still having a good time and not about to give up!

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    Update: I spent about an hour and a half sitting on the couch in a visitor's room with Princess. She seems tireder and weaker, though she had no trouble jumping up on the couch. Maybe it's just because she doesn't have the adrenaline going from the excitement and fun of going somewhere and meeting new friends. We just sat quietly, and I stroked her and talked to her off and on.

     

    I think they are going to scope her first, instead of starting out with more invasive surgery. They'll stop with the scope if it looks inoperable.

     

    As I was leaving, the vet looked at me and said, I think you know this is something bad and that's why you want to be here before they put her under.

     

    Instead of waiting for the surgeon to call in the morning, I'm heading there shortly after 6:00 so I can be there by the time they would have called to talk about what time to start surgery. My heart is breaking at the thought of loosing her, but if they scope her and say there's nothing to be done, I will say goodby to her there. So far, she hasn't been in pain or distress, and I wouldn't want what's left of her life to be lived in pain.

     

    Again, I thank you all for your thought and prayers.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    OSU called a while ago. Princess is doing well. She's rehydrated and actually ate for them last night. Her numbers are a little better (probably because she's rehydrated,) and they think the surgery can be scheduled for Monday, rather than being done this weekend on emergency basis, which I think is a good thing all around.

     

    I can't see her today (and she's having a ball there without me around.) The vet has to be there to arrange a visit, and he was leaving shortly. So I'll spend the day resting up and catching up on a few things here. I have a visit scheduled for 11:00 tomorrow morning, and they'll schedule her surgery on Monday at a time that I can get there before they start.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    I'm back home, and Princess is at OSU. Her bilirubin has gone from 6 to over 11. There's sure there's an obstruction, though they were unable to visualize the far end of the common bile duct where it empties into the duodenum. She's staying there so that they can monitor her blood work and keep her better hydrated than I can here. They'll talk to the surgeons again in the morning. Don't know if the surgery will wait until Monday, or if they'll do it Sat or Sun, either way, I'll be going back, probably tomorrow.

     

    Princess, true to her self, is more than making the best of it. She has absolutely won everyone over, as the sweetest Greyhound and the one with the most personality they've ever met. She will have her favorite dog bed there, in a run, not a kennel. When I left, she was making up to both the staff vet and the senior vet student, and telling them she wanted to go in back again to be fussed over. At least I don't have to worry about her being stressed by staying there. Sick as she is, she's having a ball!

     

    Now her Mom needs to feed her brothers and sisters and try to get some sleep.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    I'm definitely considering at least a surgical consult. Someone else suggested an internist. We are doing ongoing flushing, about a liter a day, with IV fluids rather than sub-Q. She well may be nauseated, but neither the Pepcid, nor the Cerenia (for central mediated nausea) has made any difference. Ohio State is taking a look at her labs, and I'm waiting to hear back about that. Also waiting for a call from my vet.

     

    Her weight this morning is down to 41 pounds, from 42.2 yesterday morningid

    Please keep the ideas and prayers coming for my girl!

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    Oh Hope, no advice here. You and Princess are in our prayers and thoughts. :bighug

     

    Have you tried really stinky stuff on her food (i.e. Tuna fish or canned salmon, or cheap canned dog food) which might entice her to eat? Mine prefer raw chicken/beef, etc to cooked.

     

    Gremlin seems to think frozen poopsicles are the cure for mouth cancer. I pray it works.

    :bighug

     

    Thanks, Pat

     

    She ate sardines once - only one - then turned her nose up at them.

     

    She's never been a poop eater before, and still has no interest in fresh poop, just checks it out and rejects it.

    Princess, My Soulmate

    in Health and Medical discussion

    Posted

    Does this mean anything to anyone? Princess went outside to pee. She didn't come right back in, so I looked and found her searching among the poop. She found an old, hard, dried up piece and brought it inside to her bed to eat. No interest in fresh poop, just the old dried up piece. But then she turned her nose up at both Arby's roast beef and a freshly cooked ground turkey patty with a slice of cheese on top. What would entice her about the hard, dried up poop?

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