Long Term Pain Meds

[Guest SusanP]

greytlucy, what is included in Lucy's CHF treatment besides Enalapril?

[greytlucy]

greytlucy, what is included in Lucy's CHF treatment besides Enalapril?

 

 

Vetmedin, Lasix, Diltiazem and we just added Digoxin. We're trying to treat both a-fib and CHF, though from what I understand they often are associated with each other.

Edited May 31, 2010 by greytlucy

[Guest Greytluv]

Ryan

 

Lots of good advice here. It seems you're doing everything you can. I have no experience with any to this.

[Anne]

The first thing that came to my mind was CHF. Does he cough at all?

I remember all that he's been through and know that it's really an amazing thing that he's still alive!

Big hugs to your old man, he's always been one of my favorites here on the board, cause he's a survivor!

[Trudy]

No coughing. His heart was included in the ultrasound 3 years ago, but no real check other than normal listen to it each vet visit since then.

The Enalapril was/is for his kidneys - basically to get what we can to keep him from heading into kidney failure from his other issues. I guess kidney support is the main reason.

 

I think he really is only panting when he's just plain hot. With all the rain yesterday, it cooled down a bit and the AC didn't even need to kick on during the evening and he was not panting - unless he went outside and he'd be panting when he came back in.

We also went for a stroll, in the rain, to the mail box at the end of the driveway. Jet and Tavarish would have said "that's it?" if I took them with us, but it was just me and Ryan and he was more than content with that 'walk'. Already too hot outside for him to do that again, so we'll try to do that tonight if it cools off a bit.

[Guest LindsaySF]

I was thinking CHF also, with the fluid retention and history of clotting.

 

This may or may not help, but my mom has CHF and is on tons of meds for them. She has great difficulty with heat and humidity, it causes breathing troubles and fluid retention, moreso than normal. She's almost asymptomatic in the winter time. Maybe it's from stress? I don't know. But the heat definitely causes flare-ups for her and they need to increase her Lasix. She stays in the A/C as much as possible or she can't breathe.

 

I hope you can figure out Ryan's troubles soon.

 

 

 

~Lindsay~

[krissn333]

Hey Trudy... Fluid retention can be indicative of lots of things, including Kidney Failure and Cardiac related issues.

 

 

Those two things were my first thoughts...actually a cardiac issue was my VERY first thought. I hope that you will be able to pinpoint something soon

[jenn8]

Wow, Trudy, how familiar all of this sounds. You are describing my first grey, Bullet. Panting, drinking, peeing, blood values always good, kidney values creeping up, fluid retention in back legs.

 

Extreme panting was what brought us into the vet. A highly respected vet in the greyhound community BTW. Took x-rays and blood tests which all looked normal but found something way back in his throat that he thought might be cancer but surgery would be tricky and require a specialist. We decided to try Prednisone in the meantime to see if it might clear the problem.

 

2 weeks later, Bullet’s panting suddenly got worse so I took him to ER. That vet recommended more x-rays, EKG and Echocardiogram (Ultrasound examination of the heart) which showed that he had Dialated Cardiomyopathy (Enlarged heart).

 

The first vet felt very bad that he missed the possibility of heart problem. But I am thinking it might not be as easy to tell since grey’s hearts are already bigger anyway. He also mentioned that Prednisone might have made matters worse and should not be given to dogs with heart conditions.

 

Oh yeah, Bullet never slowed down either and was walking/playing up until the very last day.

 

We aren’t vets here on GT but I have to say this is the first time I have ever been this confident with my guess. Greytlucy explained the possibilities very well. Definitely revisit this with your vet and see if he thinks the other tests might be indicated.You would need them to find out for sure.

 

A side note: There are a variety of heart medications that can effectively manage CHF but it is very important to find the right combinations and adjust them whenever necessary. Vets only look at the blood values to determine, for example, how the liver is holding up with the current dosage. You need to observe your dog’s well being while on those drugs and notify your vet when things don’t seem right. Depression, restlessness, vocalizing, discomfort, etc. If any of this starts, it is probably due to the meds and can be resolved by adjusting them. Digoxin is an especially tricky one but you can’t go entirely without. Anyway, don’t be afraid to make suggestions to your vet as often as you want. He needs your input. Sorry to hijack.

 

Good luck, Trudy.

 

Jenn

[Guest Fasave]

If he has PLN it is possible he is retaining fluid because his blood proteins are too low. I would get him in for a chem panel. They might even want to do a quick u/s just to make sure he doesn't have abdomial ascites.

 

 

My guys had PLE/PLN/IBD and had a couple incidents of leg swelling and abdominal ascites. I second the chem panel.

[greytlucy]

 

 

A side note: There are a variety of heart medications that can effectively manage CHF but it is very important to find the right combinations and adjust them whenever necessary. Vets only look at the blood values to determine, for example, how the liver is holding up with the current dosage. You need to observe your dog’s well being while on those drugs and notify your vet when things don’t seem right. Depression, restlessness, vocalizing, discomfort, etc. If any of this starts, it is probably due to the meds and can be resolved by adjusting them. Digoxin is an especially tricky one but you can’t go entirely without. Anyway, don’t be afraid to make suggestions to your vet as often as you want. He needs your input. Sorry to hijack.

 

Good luck, Trudy.

 

Jenn

 

Yes, Digoxin isn't typically the first drug of choice. We just added that one to try and lower heart rate. The vet didn't want to increase the Diltiazem if this would work though. It's only been a week so still early but a follow up last friday showed a decrease in heart rate from 180 to 120 and so far no side effects. Each dog is of course different so one regime definitely doesn't fit all. You bring up an important point about observing. Subtle differences can point to dramatic changes...particularly with panting. Before the visit to the cardio vet, we'd always assumed panting meant heat intolerance(we live in the AZ desert and it got much worse with arrival of summer) or pain. Turned out to be ultimately driven by heart and fluid.

 

As for pain meds, we use meloxicam. When everything else is balanced and stabilized we can use a half dose of the meloxicam. We've been using this for at least 2 1/2 years now...we give it with pepcid as it can be tough on the tummy and without the pepcid our dog goes off her food.

 

It's a lot of drugs we give daily....so far, no real change in the kidneys. We do some homeopathic and accupuncture to support kidneys, heart and the spinal/hip issues. Don't know exactly how much it helps, but figure it can't hurt...

 

Hope things go well at the vet today and you can find some answers, Trudy!

[Guest MZH]

It sounds like maybe he has clots in his femorals. Are his femoral pulses there and are they the same both sides? Once of Dr C's suggestions at a semimar was to give aspirin to help with those clots, IIRC. I don't know the dose. Have you checked this article ? Might be something useful for you in there.

[Trudy]

It sounds like maybe he has clots in his femorals. Are his femoral pulses there and are they the same both sides? Once of Dr C's suggestions at a semimar was to give aspirin to help with those clots, IIRC.

 

Ryan can't have asprin.

Giving a dog with clotting issues like Ryan has had in the past is like playing Russian roulette.

 

vet apt at 1:45 for him today to see if we can figure some of this out.

[Guest MZH]

Sounds like you're d%%%%d if you do, d%%%%d if you don't.

 

We had a dog with clots and he took an enteric adult dose aspirin a day. It was scary but I did it. This was in the late 90s-early 20s. It also was supposed to help his kidneys. He didn't make it to 11 though.

 

I don't really understand the mechanism of why he can't have aspirin unless his blood is too thin.

[Trudy]

Because if he is full of clots like he was, aspirin can break those clots up way too fast and they will go to his lungs and/or brain. Neither place has a good outcome.

 

 

We spent 85 mins at the vet's office. We are exactly where I figured we were. No definitive reason for what is going on. Right where we were 3 years ago - lots of results yet no real answers.

He's anemic and peeing out protein faster than the water rushing past my deck. Only the anemia is new.

 

We are just doing palliative care. The vet doesn't think he'll be here when Jeff gets home either and feels he's not there yet, but will be at some point this summer Not what I wanted to hear, but I already knew that, it was just confirmed for me.

So he has a bag full of goodies to try to help him feel better until he says he's had enough

[Guest LindsaySF]

[Guest GreysAndMoreGreys]

Ryan is such a sweet little old man and I'm glad that you have some things to keep him comfy.

 

Sucks that there are no real answers as to what is going on. So frustrating.

I'm not far away if you need me. Well as long as we don't get lost again I'm not that far away

[TheFullHouse]

I'm so sorry, I was so hoping you'd get some answers. If you need anything, we're only a few hours away and always willing to help. I'm so sorry Trudy.

[Guest MZH]

Because if he is full of clots like he was, aspirin can break those clots up way too fast and they will go to his lungs and/or brain. Neither place has a good outcome.

 

 

I just remembered my reaction when I heard him say to give aspirin; it was the same as yours. I thought I had missed something, but apparently I didn't. I'm sorry about Ryan; this is tough. We went through a similar situation with our Tucker. I don't know if the aspirin hurt or helped him but he passed at 10.5 -- almost 8 years ago -- and it still hurts that we couldn't help him.

[MaryJane]

In the past Larry has two incidents of his foot swelling up to twice the normal size and both times the vet put him on antibiotics and wrapped up the leg to help the fluid get assimilated. It took quite some time for the swelling to come down.

[Guest MZH]

Wow, it was a long time ago (1997 maybe) but your post just reminded me that Tucker's kidney and "strokey" problems started with a swollen front foot! We soaked it in providine for a while and it did go down. Was probably on antibiotics but I don't remember at this point in time.

[Cully]

:bighug

[Batmom]

Bad words.

 

I'm sorry you didn't get better news.

[Guest GreyFox]

I'm sorry the news wasn't better, Trudy.

[Guest Swifthounds]

Oh, Trudy.

 

We're here if you need us.

[jenn8]

So he has a bag full of goodies to try to help him feel better until he says he's had enough

 

Aww, Ryan, you're in good hands. Try to stick around for a good long while.

 

They are so sweet when they get older.

 

Jenn