Jimmy Continues To Struggle

[lovinggreysslp]

Some of you may remember our eleven year old Jimmy having both endoscopy and abdominal surgery three weeks ago to remove four dog boots from his stomach. He did quite well during the week following the surgery but has been declining the past two weeks. I really could use some insight into what could be wrong with our poor boy.

Problems: Jimmy has been running a low grade fever (102.6 - 103.8) the past two or three days. Jimmy's appetite has been declining this past weekend and he is now refusing most of what he is offered (he usually would eat anything offered). Jimmy has moments of "shivering" and breathing faster than normal. Jimmy has gained less than a pound since his surgery. While he is not eating much now, he was eating at least 2,000 calories per day. His stool has never returned to normal. Jimmy's energy level has declined and he is struggling to get up from lying down now.

labs today: urine sample showed blood and protein in the urine, some white blood cells and cast cells. With this information, our vet thinks Jimmy may have glomerular nephritis. The good news is that he is not showing signs of renal failure.

blood work: almost everything looked fine except that his usual low white blood cell count is now 7,000. Our vet saw a rise in monocytes (28% post surgery, 6% pre op). There was a slight decrease in albumin and a slight increase in globulins but these were still in the ok range.

Our vet is very concerned that Jimmy has histomycosis or blastomycosis based on the yet unexplained fever. Urine will be sent to test for these as we had one hound two years ago die from blasto and one other hound treated for blasto as well.

We came home today with baytril to try to knock out whatever is causing the change in Jimmy's urine/kidney funtion. He will continue pepcid, tramadol (50 mg twice daily) and propectalin.

The frustrating part of this is except for the boots being present in Jimmy's stomach, every tissue sample, blood work, radiograph, abdominal exploratory etc from the surgical procedure found that Jimmy was really in good shape. Our vet is really unsure right now as to what the problem is. Any thoughts or ideas (and positive prayers) would be greatly appreciated. We really would like to see our spunky senior return to his lively, love to eat anything, self.

Edited February 5, 2012 by lovinggreysslp

[tbhounds]

Perhaps it's time to see an internal medicine Dr for another opinion. As for the GN- common condition with GHs-- do you have a baseline u/a prior to the surgery? Have you run a UPC? Urine culture??

[lovinggreysslp]

Oddly enough, many tests were run prior to surgery but not a urine analysis. We have only had Jimmy since this summer when he was returned to our group. We had never had a reason to run a urine analysis before now. We did run a urine culture today which is how our vet found the protein and blood in his urine. Sorry but I do not know what a UPC is. This is my first time to have a hound with kidney/urinary issues so I know very little about this area. I need to do some reading.

[Time4ANap]

Sending lots of good thoughts to our friend Jimmy (and his Mom.)

[tbhounds]

Sorry- a UPC is a urine protein creatinine ratio. My guess is your hound has had GN prior to the surgery. Unlike other breeds Ghs can have GN chronically. Low dose aspirin is given to prevent clots. Clots may form because when your hound loses protein in the urine he is also losing antithrombin 3--- anti clotting factor.

I don't think GN the problem of the day for you.

Are the Drs absolutely sure that the gastronomy /enteronomy healed well?? Sutures didn't break down??

[Greydawg]

Sending good thoughts to Jimmy for a positive outcome and speedy recovery.

[lovinggreysslp]

Our vet does not think this is a surgery related problem. She says that it has been too long a period of time and that he is not spiking a high fever. She thinks that the surgery was rough on Jimmy's system and that something else that was "brewing" emerged while he was in his weakened recovery period.

Thanks for the good thoughts Rocket and Don.

[sabrina]

Sorry no suggestions just wishing Jimmy the best

[jamngrey]

No help here but want o send prayers

[JJNg]

Are the Drs absolutely sure that the gastronomy /enteronomy healed well?? Sutures didn't break down??

I was thinking the same thing. While the time frame is a little long, you also mentioned that he started declining about a week after surgery, which is closer to the time you can start to see post-op complications from GI surgery. Not all dogs spike a fever. My mixed breed Corey had septic peritonitis from a ruptured cecal (appendix) tumor, and he never had a fever at all. Before doing all kinds of testing to search for a different, unrelated problem, I'd want to have an abdominal ultrasound done to make sure everything's ok from the abdominal surgery.

[4My2Greys]

I'm certainly no expert, but my thoughts were something related to the surgery or complications from having eaten those booties. I think it would be a good time as has already been mentioned to take him to a specialist. I'm sending lots of white light to your boy for a quick turnaround and speedy healing.

[MaryJane]

It all sounds like an infection and since the surgery was relatively recent that would be my first thought that here is an infection inside - as someone mentioned, maybe the sutures breaking down or something was not closed well ....

 

The blood and protein in the urine also needs to be addressed but, not sure whether this is the cause for his current problems.

 

I suggest seeing a specialist or getting a second opinion about whether this could be from the surgery.

[carronstar]

No advice, just lots of good thoughts and prayers for Jimmy.

[MyCutie]

Thinking of you. Is there anyone at vet med consulting on this?

[lovinggreysslp]

Thank you all for your kind words and wisdom. I am trying to reach the surgeon who operated on Jimmy to talk to her about the possibility that this is stemming from the surgery. Our vet was certain that Jimmy was not showing any signs that sutures had ruptured but you are all right, I need to make sure. On a slightly positive note, I have discovered that while Jimmy will no longer eat the canned food, yummy chicken thighs or usual dog food, he will eat one of the other hounds fishy dry dog food out of my hand and loves to gobble down any dry treat offered. This morning, he does seem more energetic and yesterday his temp stayed in the 102 range.

Thanks again for all the positive thoughts for our Jimmy as he works to get his spunky-ness back.

[greytpups]

Hope he continues to feel better, but more importantly, you find out what's wrong.

[lovinggreysslp]

I spoke to the head of the soft tissue team involved in Jimmy's surgery. The surgeon does not think his current issues are related to the surgery. They told me that Jimmy would be vomiting and running a much higher body temperature. They also said that they see suture ruptures within the first three days post surgery. They advised that we see what the current tests show (results hopefully Friday or Saturday) and then do xrays or ultrasound if those tests are not conclusive.

It is at times like this that I truly wish our hounds could talk. His tail wagging every time I came home today did speak volumes but at the same time I can see he is getting weaker.

Thanks again for the positive thoughts.

[sweetdogs]

I think I'd be scheduling the ultrasound now instead of waiting for test results. Especially if he's fading. Best wishes for your Jimmy - he sounds like a sweetheart.

[mychip1]

Just kind of hard to fathom that it is all coincidence. One week post-op for onset of symptoms just rings to me as something surgical.....

 

I wish you all the best....

 

 

[lovinggreysslp]

I just got a call from our vet that Jimmy's labs came back negative for histomycosis and blastomycosis. That was good news but we still have a sick dog. So, he will go into our vet for abdominal and chest xrays as well as a clean catch urine analysis tomorrow morning. If this does not tell us why Jimmy continues to run a low grade fever despite current antibiotics, then ultrasound will be our next step.

[tbhounds]

I just got a call from our vet that Jimmy's labs came back negative for histomycosis and blastomycosis. That was good news but we still have a sick dog. So, he will go into our vet for abdominal and chest xrays as well as a clean catch urine analysis tomorrow morning. If this does not tell us why Jimmy continues to run a low grade fever despite current antibiotics, then ultrasound will be our next step.

He may indeed need an explore at this point. Fingers crossed.

[Remolacha]

I hope the x-rays give you some answers!

[lovinggreysslp]

Our vet's xrays of Jimmy's lungs and abdomen were absolutely clean. I asked our vet to refer us for another ultrasound (at the university that did Jimmy's surgery). I got a call that we could bring Jimmy in at five today. I am still getting over the shock of what the ultrasound found. After an hour of ultrasound work, the vet brought Jimmy back and said that everything looks fine!! They did not see anything that could be causing the fever, loss of appetite, and decline in mobility and energy level. When I asked the vet what could possibly be wrong, as we have already ruled out many other possible causes of Jimmy's symptoms, the vet said that she thinks he has pancreatitis. She explained that pancreatitis can occur following abdominal surgery. Looking online, many of Jimmy's symptoms do fit pancreatitis. I have already started trying to make the foods I offer him low fat.

I know I should feel relieved that Jimmy is not facing another surgery as both our vet and I were very concerned that he would not survive a second surgery. I know that we are not out of the woods yet though.

[tbhounds]

There are very specific blood tests to check for pancreatitis.

Spec Cpl is one (idexx). I'm assuming, however, the ultrasound showed an angry pancreas and that's how the Drs made their diagnoses. Fat is the enemy here-- you might want to feed I/D-- low fat and easy to digest.

Glad Jimmy can avoid surgery. For what it's worth- my boy had abdominal surgery and his pancreas became cranky too post surgery- he did do well with the bland diet (I/D).

[PrairieProf]

Beth had near-pancreatitis (not acute, but right near the border of it -- the test that showed it on her was the TLI) and has done wonderfully on I/D since then. She was also on a course of metronidazole for about 4-6 weeks, for its anti-inflammatory effect.