Victor

Thank you, RaineysMom. I'm sorry to hear that Larry is having similar symptoms. Hopefully it's nothing, but to be safe I'd ask for an abdominal ultrasound. That should allow them to see if there are any abnormalities in blood flow to organs that could affect the GI, such as the spleen. They should also be able to check Larry's portal vein using ultrasound. They weren't able to see Duke's portal vein using ultrasound because too much fluid had accumulated in his abdomen. (Duke had to have a CT scan, which requires anesthesia.) I assume they also x-rayed Larry's leg and shoulder to rule out osteo? I don't want to scare you, but Lana also did the fly biting thing before we discovered she had osteo in the leg she would bite at. They say fly biting is a type of seizure, but I think it can also indicate a source of pain. Here's a video of Duke that shows his gait when walking uphill. At times it was more pronounced, but this is the only video I have: http://www.youtube.com/watch?v=WAJH3D9anzc

Thank you, Batmom. It means a lot to hear you say that. Thank you, Debbie.

Thank you all for your condolences. We still can't believe that Duke is no longer with us. As I am sure is the case with many of you, our dogs are our children. We adopted Lana in January 2010 when she was 4 years old and then Duke in July 2010 when he was 3.5. After Lana lost her battle to osteosarcoma in January 2014, we were devastated. Now with Duke gone, the pain is almost too much to bear. We're trying to stay strong for Joy, though. (We adopted Joy in March. She's 5 days younger than Duke. Duke was so happy to have a "younger" sister! He loved showing her around, and she followed him everywhere. She would even try to lie next to him on his bed, although Duke wasn't too keen about that!) I wanted to post something about the time leading up to Duke's illness, in case it's of help to anyone else. I'll also post the results of Duke's autopsy when we receive the report. From what I've read, portal vein thrombosis was once thought to be rare in dogs, but it's being recognized more often now. You can read more about it here: http://sites.tufts.edu/progressnotes/2011/09/current-concepts-4/ http://www.ncbi.nlm.nih.gov/m/pubmed/22369249/ Usually there is some underlying condition that leads to the development of a clot. Unfortunately, there are many possible causes, even just being too sedentary. (We still don't know why Duke developed a clot, but maybe the autopsy will shed some light on this.) If the clot is detected before it gets too big it can be treated on an outpatient basis with anticoagulant therapy such as warfarin. Unfortunately, clots in the portal vein are often not detected until the dog is in critical condition. This was this case for Duke. In retrospect, there are three things I wish I'd paid more attention to prior to the day Duke became obviously ill: (1) The first was a gradual behavioral change. Over the past few months Duke had started going outside less often. Whereas he used to go out whenever he had the chance, he started declining to go out (or just going out to pee) when asked. He also started stopping in the middle of walks, at first on longer walks and then on relatively short walks, refusing to move for several minutes, either to go forward or to go back. There was also a change in his gait. When walking uphill he would favor his right leg. It wasn't a pronounced limp so much as a bobbing of his head. The vet x-rayed his leg and shoulder to rule out osteosarcoma and the orthopedist suspected bicipital tenosynovitis. I wish we would've pursued this more aggressively and followed up sooner. (2) The second was an unexplained bout of nausea and vomiting that occurred several months ago. Blood tests at the time didn't indicate anything unusual, other than a decrease in platelets (91,000 compared to 104,000 in July 2012, 116,000 in August 2011, and 133,000 in July 2010). When we rechecked platelets 3 weeks later they were at 99,000 and his 4DX came back negative, so we assumed the nausea/vomiting was due to something he ate. (We live in the country and I had observed him eating frozen feces of some wild animal.) I wish we had also done an abdominal ultrasound at the time; that might have shown something was amiss. (3) The third was an incident that occurred a day or two before Duke became seriously ill. One evening when he was lying on his bed he started licking the base of his chest. I scratched the area for him several times but he kept licking at it, almost obsessively. We had applied Advantix II for the first time on July 1st so I attributed it to skin irritation. In retrospect I should've taken him in to get checked. I'll also never forgive myself for ignoring important signs on July 4th. When Duke vomited at 5:30am, I shouldn't have been so quick to dismiss it as tummy upset. I should have sat with him to see how he was doing. Instead I cleaned up the vomit, reassured him, and went back to bed. Later, after I had eaten my breakfast, I offered Duke and Joy some milk, as I always do. Duke took several laps of milk and then refused to drink any more. This is a dog who lives for food and drink! Right then and there I should've taken him to the ER. It wasn't until after breakfast and a short walk that I realized how uncomfortable he was and that his abdomen was distended. Finally, I'm sorry we let Duke fight so long. I was so sure he would beat the odds that I failed to see that, despite the occasional improvement, his overall condition was getting worse, not better. If I had acknowledged this we could've saved him from some of his suffering, and we could have been with him when he passed. Thankfully we were with him near the end, but it kills me that this beautiful, sweet, gentle, loving boy, who spent nearly every hour of his four years with us and wanted nothing more than to be with us, had to leave this world without us by his side. Words cannot express the pain, sorrow, and guilt I feel. Here's another photo of our happy boy:

Duke passed away this morning at 6am. At 4:10am they called because his heart rate was over 200 and they thought he might go into cardiac arrest. We went over and sat with him for about half an hour while they administered more plasma. He seemed to be doing better so they had us go home. The plan was to meet again at 8am. Shortly before 6am Duke started having trouble breathing again and then his heart rate slowed and stopped. We rushed over but we were too late to be with him. Thank you again for all your support and prayers. I cannot describe how much we miss Duke. He was the happiest boy you can imagine. He loved to sing and talk, and he spent nearly every waking moment with his mommy. They were inseparable. We had four precious years with him. Please hug your greys for us. Victor, Shihmei, and Joy

What a day. When we went to see Duke around 1pm we were devastated, thinking we were going to have to say goodbye. Then he surprised everyone and started doing a little better again. This afternoon he even got up on his own several times. He's not out of the woods yet, but there's still fight in his eyes. We're going to stay the course until he or his body tells us otherwise. Thanks again for all your support and prayers. We're pretty much running on empty (emotionally and physically), so I may not post as many updates these next few days. Please continue to think good thoughts for Duke!

Maybe. I don't know. I guess we'll see when we go visit him.

Just heard from the vet. Duke is overall worse than he was yesterday. His oxygenation was low last night so they started giving him supplemental oxygen again. There's fluid around his lungs, which they're going to remove now. They're also going to do a chest x-ray to see if there might be fluid in his lungs. His protein is still low, so he'll need more plasma today. He's also less responsive, which could be due to the oxygenation or due to bleeding or clotting in the brain. They're also going to start him on either a feeding tube or a different kind of IV to get some calories into him. He hasn't vomited since yesterday, but he still has bloody diarrhea. The vet says Duke's prognosis is poor. They're going to call us when we can go see him, probably around 11am or noon.

Everyone there has been so kind and helpful. You can tell that they really care about him.

Thank you all for your continued prayers and support! tbhounds, they weren't able to see the clot on ultrasound due to all the fluid. If he's well enough tomorrow they may repeat the CT scan. They didn't want to risk moving him today in case he was bleeding internally. I sure hope the clot is starting to dissolve. It seems so unfair that greys are so good at dissolving clots after surgery but not when you need them to!

The vet just called. The plasma seems to be helping. Duke's breathing is still labored, but he's able to get enough oxygen on his own now, so they stopped the supplemental oxygen. She said that after we left Duke had a bowel movement and then he seemed more calm. So part of his distress might have been due to needing to go to the bathroom. She's still worried that his lungs are injured, though, so they're going to hold off on more heparin until they have a chance to re-evaluate tomorrow morning.

We just saw Duke. He's not doing so well. He's having trouble breathing, so they had to put him on oxygen. The vet is worried that he may be bleeding into his lungs. She's giving him plasma right now to counteract any possible internal bleeding. The other possibility is that part of the clot has moved to his lungs, but the fact that he responded to the oxygen makes her think that's not the case. His breathing started to get worse while we were there, so they asked us to leave. They were worried that he might be getting too excited from our visit. He cried when we left. They're going to call if the situation changes. We're praying that the plasma will help. We lost our first grey Lana to osteosarcoma in January. We just can't bear to lose Duke too.

Thanks, everyone. Sorry for the delay in posting an update today. The vet didn't call until 11:15am, and then we went right over to see Duke. He's still fighting for his life. His abdomen is very swollen, and he was feeling quite nauseous. He vomited mucus and blood while we were there. They added another antiemetic, so hopefully that will help with the nausea. He's still having bloody diarrhea, and his protein levels are low. They're continuing to give him fluids. There's also been an increase in bile in his bloodstream, so they're keeping a close eye on that. The good news is that his platelet count is up to 47,000 (from 38,000 yesterday). Here's a photo of our poor puppy:

Thank you so much for all your support! When we saw Duke this evening we told him how everyone is rooting for him. The vet says Duke is stable but still has a long way to go. The biggest challenge is trying to achieve fluid balance while he has the clot. He still has fluid accumulating in his abdomen, and it may need to be drained again tomorrow morning. The diarrhea seems to have subsided some, so that's encouraging, although he vomited some blood this afternoon. The heparin therapy isn't as far along as they'd like. His clotting time was too short again, so they're going to try increasing the heparin dosage. We're praying that he'll make it through the night okay. Here's a photo my wife took of our poor boy in the ICU this afternoon:

We just got back from visiting Duke. He's in pretty rough shape. They had to drain a liter of fluid from his abdomen this afternoon because he was having trouble breathing. They're giving him another 2 units of plasma to counteract his low protein levels. The downside of the plasma is that it offsets the anticoagulation of the heparin, so they have to keep adjusting the dose to keep Duke's clotting time where it needs to be. On the plus side the blood test they did earlier showed that his kidneys and liver are still functioning normally.

The vet just called with an update. Duke is hanging in there! They put him on lidocaine last night for the cardiac arrhythmia. The pressure in his abdomen is still elevated ("17cm of water"), but it's not as high as it was yesterday, so she's not as worried about organ failure. Unfortunately he's still losing fluids due to the bloody diarrhea, and his oncotic pressure is low (8). They're giving him more plasma now. They're also continuing to adjust the heparin dosage; last night his clotting time was too long so they reduced the amount of heparin, but then this morning it was too short so they had to increase it again. They're doing another blood test now to check his kidney and liver function. The vet said Duke is sedated from the pain meds, but he's conscious and responds to his name. She's going to call later with an update and to arrange a time for us to see him this afternoon.

Thanks, everyone! The ER vet hasn't called yet, so we're assuming that's good news. She said she'd call right away if Duke took a turn for the worse. Otherwise the plan is for her to call with an update after rounds this morning (around 10am).

We just heard from the ER vet. She said Duke is stable for now. He's developed a cardiac arrhythmia, but it's apparently not "electrically unstable". They're going to continue monitoring it and treat with medication if it becomes unstable. He still has fluids in the abdomen and bloody diarrhea. He's receiving 2 units of plasma right now, and he'll likely need a blood transfusion tomorrow. She said they overshot a little on the blood thinning, so they're pulling back a bit on the heparin. His temperature is thankfully normal. Thank you so much for all your thoughts and prayers! I'll post again when we know more.

Thanks, FiveRoooooers. He just had his seventh birthday in February. He's normally such a happy boy. And he LOVES to talk and sing. Here's a video of him singing. http://www.youtube.com/watch?v=klyqUR5ImoM Oh, and here he is talking with his sister, Joy, who we adopted in March: http://www.youtube.com/watch?v=JdNGl0RNM0Y

Here's a recent photo of Duke: In the photo he's waiting excitedly for his dog biscuit at the Culver's drive through.

Thanks, everyone. We really appreciate it. We're still reeling in disbelief. Duke seemed just fine yesterday. He vomited this morning at 5:30am, but otherwise he seemed okay. It wasn't until after he ate breakfast around 9am that we realized how ill he was. He was panting and his abdomen was distended, so we took him to the ER, thinking he might have bloat. An x-ray of his abdomen showed that his stomach was fine but there was fluid in his abdomen. Then they did an ultrasound and found that blood wasn't flowing through his spleen. At first they thought he might have a twisted spleen, but then he started having bloody diarrhea, and the on-call radiologist confirmed that the spleen wasn't twisted, so they suspected a clot. They weren't able to find it with ultrasound, though, so they did a CT scan, which showed the clot in his portal vein. Now all we can do is hope and pray that the heparin will give his body a chance to dissolve the clot in time.

Our boy Duke is in the intensive care unit today due to a 13cm blood clot in his portal vein. They've started him on heparin, antibiotics, and pain killers, but they said he'll be in critical condition for the next 24-48 hours. The clot is blocking blood flow from the spleen and the pancreas, causing fluids to accumulate in his abdomen. He also has bloody diarrhea. Please keep Duke in your thoughts for us. Victor

Merck announced that they've received FDA approval for their oral tick and flea medicine, BRAVECTO. From the press release: "Merck Animal Health (known as MSD Animal Health outside the United States and Canada) today announced the U.S. Food and Drug Administration’s approval of BRAVECTO™ (fluralaner) chewable tablets for dogs (112.5 mg, 250 mg, 500 mg, 1000 mg, 1400 mg). BRAVECTO is the first and only treatment that has been shown to quickly and effectively kill fleas and multiple tick species for 12 weeks in a single dose. BRAVECTO also is effective for eight weeks against Amblyomma americanum ticks. ... BRAVECTO comes in a convenient, single-dose chewable tablet and offers: * Immediate and persistent flea (Ctenocephalides felis) killing activity for 12 weeks * Immediate and persistent tick killing activity for 12 weeks (Ixodes scapularis – black-legged tick, Dermacentor variabilis – American dog tick, and Rhipicephalus sanguineus – brown dog tick) * Immediate and persistent tick killing activity for 8 weeks (Amblyomma americanum – lone star tick)" http://www.merck-animal-health-usa.com/news/2014-5-20.aspx It'll be interesting to see how it performs compared to Merial's Nexgard, which is given monthly. Nexgard has received approval from the FDA for the American dog tick and, more recently, the black-legged tick and the Lone Star tick.

Our boy Duke will sometimes choose to hold it in rather than get wet when it's raining outside. I don't know if he's ever reached 14 hours, but he's certainly gone 12 hours without peeing. When our recently adopted girl Joy suddenly started holding it in, though, it turned out she had contracted a urinary tract infection. Shortly after we started her on antibiotics she stopped holding it in. According to PetMD, if a dog is unable to urinate (due to stones, for example), it is a medical emergency that can "lead to kidney failure and/or rupture of the bladder, and can prove fatal if the obstruction is not relieved right away." I don't know how you know if he/she is unable to urinate or just choosing not to urinate.

I'm sorry to hear Jaynie's having pain in her back. I don't have any advice, but I hope her doctors can offer some good options. Thinking good thoughts for you and her, Victor

This is greyt news! Does anyone have any experience with it yet? Are your greys tolerating it okay?