Aquitane At Er After Grapehounds - Severe Legs Spasms

[RaineysMom]

continuing to send more prayers your way!!!! :hope

 

and Happy Birthday

[tbhounds]

PLN= protein losing neuropathy--basically losing protein through the kidneys into the urine. To determine the extent of the protein a UPC should be run (urine protein creatinine ratio).

PLE=protein losing enteropathy--basically losing protein through the GI tract. The blood proteins would be low--total protein, albumin are key values to check. FYI, ghs have lower blood protein values than other breeds.

[seeh2o]

So glad to read it may be a nasty booboo rather than something more serious. How could she be a self respecting Greyhound living in New York City without boots???!

 

I hope you enjoyed your Tiki drink, I'm toasting you now with an adult beverage, happy birthday, Carron! (It's still your birthday here in the City of Angels)

Edited August 1, 2012 by seeh2o

[carronstar]

Unless I am being unrealistic, it looks like the blue liquid soak and the antibiotics have already started working. She was putting weight on her leg more consistently this morning. She hates the boot but will walk on it. Now I just want to be able to wean her off the Tramadol so her appetite comes back. She will eat cookies with peanut butter but how many cookies can she live on. She turned her nose up at her bowl yesterday and this morning. I even warmed it up for her and it has scrambled egg and some potato in it. I am bringing home grilled chicken from the cafeteria today.

 

From her tests in Ithaca:

 

Urine and Sediment results from IDEXX VetLab In-clinic

LaboratoryRequisition ID: 0 Posted Final

Test Result Reference Range

COLLECTION = Free catch

COLOR = darkish yellow

CLARITY = slightly cloudy

SG = 1.030

GLUCOSE = Neg mg/dl Negative - Negative

BILIRUBIN = Neg Negative - Negative

KETONE = neg mg/dl Negative - Negative

BLOOD = Neg Negative - Negative

PH = 6.5

PROTEIN = 300 +++ g/L negative - 4+

WBC = 0-2 # per HPF 0 - 5

RBC = 0 # per HPF 0 - 3

RODS = 0 # per HPF 0 - 0

COCCI = 0 # per HPF 0 - 0

CASTS = 0 # per HPF 0 - 0

CRYSTALS = Rare amorphous # per HPF 0 - 0

EPI CELLS = 0-1 #per HPF 1-2 - 3-4

 

Chemistry results from IDEXX VetLab In-clinic

LaboratoryRequisition ID: 17535 Posted Final

Test Result Reference Range

ALB = 2.1 g/dL L 2.2 - 3.9

ALKP = 80 U/L 23 - 212

ALT = 28 U/L 10 - 100

AMYL = 1433 U/L 500 - 1500

BUN/UREA = 20 mg/dL 7 - 27

Ca = 8.6 mg/dL 7.9 - 12

CHOL = 218 mg/dL 110 - 320

CREA = 3.3 mg/dL H 0.5 - 1.8

GGT < 0 U/L 0 - 7

GLU = 110 mg/dL 70 - 143

PHOS = 4.3 mg/dL 2.5 - 6.8

TBIL = 0.3 mg/dL 0 - 0.9

TP = 5.1 g/dL L 5.2 - 8.2

GLOB = 3 g/dL 2.5 - 4.5

 

 

Chemistry results from IDEXX VetLab In-clinic

LaboratoryRequisition ID: 17535 Posted Final

Test Result Reference Range

Chloride = 118 mmol/L 109 - 122

LIPA = 1430 U/L 200 - 1800

Potassium = 4.5 mmol/L 3.5 - 5.8

Sodium = 152 mmol/L 144 - 160

ALB/GLOB = 0.7

BUN/CREA = 6

Na/K = 34

[JJNg]

Urine and Sediment results from IDEXX VetLab In-clinic

PROTEIN = 300 +++ g/L negative - 4+

 

Chemistry results from IDEXX VetLab In-clinic

ALB = 2.1 g/dL L 2.2 - 3.9

BUN/UREA = 20 mg/dL 7 - 27

CREA = 3.3 mg/dL H 0.5 - 1.8

 

Did the vets who saw Aquitane's bloodwork not comment on his high creatinine (CREA)? I'd be concerned about a creatinine of 3.3, although it's unusual for the BUN to be normal with a high creatinine. What kind of food does he eat? Along with the protein in his urine and the low blood albumin, I'd be thinking PLN and not PLE.

 

I'd suggest checking his blood pressure and doing a urine protein:creatinine ratio. Might need to consider starting an ACE-inhibitor like benazepril or enalapril as well as a low-phosphorus diet, like Hill's k/d or Purina NF. If you're interesting in pursuing it further, I'd suggest consulting with an internist and having an abdominal ultrasound done to look at his kidneys.

[kudzu]

Are you going to do a UPC, urine protein:creatinine ratio test? Am not up on PLE but her albumin & total protein don't look in a range where I would suspect it. However, I would suspect PLN.

 

Since getting the residing senior lurcher on treatmet for PLN she has easily gained way. Actually gained a bit too much before I cut her food back enough to compensate. She's only eating 2/3 what she was on arrival but is on the verge of needing to be on lower rations. Though she remained the biggest drinker in the house her bloodwork shows things back in the normal range again. She's 13 yo & acts like she's 3. Girl might outlive us.

 

Hope you can get things nailed down for you pup & a good treatment plan started. Best wishes.

[carronstar]

 

Urine and Sediment results from IDEXX VetLab In-clinic

PROTEIN = 300 +++ g/L negative - 4+

 

Chemistry results from IDEXX VetLab In-clinic

ALB = 2.1 g/dL L 2.2 - 3.9

BUN/UREA = 20 mg/dL 7 - 27

CREA = 3.3 mg/dL H 0.5 - 1.8

 

Did the vets who saw Aquitane's bloodwork not comment on his high creatinine (CREA)? I'd be concerned about a creatinine of 3.3, although it's unusual for the BUN to be normal with a high creatinine. What kind of food does he eat? Along with the protein in his urine and the low blood albumin, I'd be thinking PLN and not PLE.

 

I'd suggest checking his blood pressure and doing a urine protein:creatinine ratio. Might need to consider starting an ACE-inhibitor like benazepril or enalapril as well as a low-phosphorus diet, like Hill's k/d or Purina NF. If you're interesting in pursuing it further, I'd suggest consulting with an internist and having an abdominal ultrasound done to look at his kidneys.

 

 

Yes, the creatinine was mentioned, and I spoke to the Ithaca vet this morning who will be sending the final lab results later today. She indicated that her UPC is now 1.5 and it was over 3 when she had her surgery in December .

 

She is on 10 mg of Enalapril and 15 of Amlodipine daily. She is also eating a mix of kidney diet kibble and senior kibble along with Hills KD canned.

 

Her weight is good.

 

There were more results that I didn't copy because there were almost 4 pages.

Edited August 2, 2012 by carronstar

[JJNg]

Sounds like she's already being treated for PLN, and since her UPC has decreased, that indicates the meds are helping. My apologies for getting her gender wrong in my response from last night.

[carronstar]

She has been on the Amlodipine and Enalapril since her emergency splenectomy in December when my vet felt her BP was too high.

 

My vet referred me to a Dr. Palma at Animal Medical Center here in the city. He says he is the best internal meds doc in the country. I think he has a little vet crush on him! My vet wants Dr. Palma to do the consult and then make the plan for us and then he will manage it with me.

 

I got the final results today for the labs and they came with graphs which is very helpful. Much easier for me to read!

[juliemac]

How's Aquitane doing today? Is she putting any more weight on the leg?

 

Also, if the boot is too uncomfortable, you may be able to get away with a baby sock & a bit of vetwrap.

 

Gentle hugs!

[carronstar]

The antibiotic and blue rinse seem to be working on the foot with the cut. The swelling is down and she is putting more weight on her foot/leg. She is used to wearing those boots on her feet at night because she has ripped through so many covers for her couch. Once she starts walking (and has let me know how much she hates the boot) she is fine. It only has to be on when we are outside walking and her walks are short for at least this week. Thankfully, there have been no more spasms so we are just dealing with the cut.

[krissy]

First of all greyhounds do often have higher creatinine levels than other breeds. A slightly elevated creat would not get me very excited. Besides that creatinine is usually fairly markedly elevated and is generally accompanied by an elevation in urea.

 

Protein shouldn't show up in the urine even in greyhounds. However,Summit had an elevated UPC last fall. Everyone got very excited about PLN. I rested him and rechecked 4 days later... totally normal. It seems that sometimes INTENSE exercise can cause a transient increase in urine protein in greyhounds. Summit had been bombing around at the dog park for over an hour the night before. So sometimes apparently it can happen in a greyhound. But I'd be more excited about the UPC if it was elevated on multiple tests.

[JJNg]

Glad you'll be consulting with in internist. While this is something most general practitioners can manage, having a specialist on the team helps ensure optimal care.

 

Krissy, I'd consider a creatinine of 3.3 to be pretty significant, even for a greyhound. The values vary slightly depending on the lab, but with a reference range of 0.5-1.8, anything over 2.0 would at least get my attention, although a greyhound might be normal up to 2.3-2.4. You're right that the BUN (blood urea nitrogen) is usually also elevated, so her normal BUN is odd given how high the creatinine is. But BUN can be lower due to a low protein diet, and Aquitane is on a mixture of kidney and senior diet which would be fairly low in protein. From the info provided, it sounds like her UPC has been high at least a couple times.

 

ETA: Just wanted to add that if the creatinine is borderline, and you're trying to decide if it's just greyhound normal or actually high, a good way to check is to look at urine specific gravity (USG) from a sample collected first thing in the morning. A well-concentrated sample with a USG over 1.030 usually means the kidney are functioning fine.

Edited August 4, 2012 by JJNg

[tbhounds]

JJNg-you stole my thunder! :-)

I was going to mention to check the USG---first voided catch of the morning :-)

[RaineysMom]

glad she seems to be doing better! sending more good thoughts and prayers! :hope

[seeh2o]

I have no experience or advice, I'm just glad that she is doing better. Sending continued healing thoughts from the west coast!

[carronstar]

First of all greyhounds do often have higher creatinine levels than other breeds. A slightly elevated creat would not get me very excited. Besides that creatinine is usually fairly markedly elevated and is generally accompanied by an elevation in urea. Protein shouldn't show up in the urine even in greyhounds. However,Summit had an elevated UPC last fall. Everyone got very excited about PLN. I rested him and rechecked 4 days later... totally normal. It seems that sometimes INTENSE exercise can cause a transient increase in urine protein in greyhounds. Summit had been bombing around at the dog park for over an hour the night before. So sometimes apparently it can happen in a greyhound. But I'd be more excited about the UPC if it was elevated on multiple tests.

Glad you'll be consulting with in internist. While this is something most general practitioners can manage, having a specialist on the team helps ensure optimal care. Krissy, I'd consider a creatinine of 3.3 to be pretty significant, even for a greyhound. The values vary slightly depending on the lab, but with a reference range of 0.5-1.8, anything over 2.0 would at least get my attention, although a greyhound might be normal up to 2.3-2.4. You're right that the BUN (blood urea nitrogen) is usually also elevated, so her normal BUN is odd given how high the creatinine is. But BUN can be lower due to a low protein diet, and Aquitane is on a mixture of kidney and senior diet which would be fairly low in protein. From the info provided, it sounds like her UPC has been high at least a couple times. ETA: Just wanted to add that if the creatinine is borderline, and you're trying to decide if it's just greyhound normal or actually high, a good way to check is to look at urine specific gravity (USG) from a sample collected first thing in the morning. A well-concentrated sample with a USG over 1.030 usually means the kidney are functioning fine.

 

Thanks for all the good thoughts and advice. The plan is to have this internal med vet create the plan, and my regular vet to manage the plan. Now, since the specialist is very highly thought of, I just have actually get an appointment. I've already sent the recent blood and urine tests. He called to say that if I can't get an appointment this week through the main desk, he will help me to book an appointment.

Edited August 6, 2012 by carronstar

[RaineysMom]

continuing to send many prayers!!!! :hope

[EllenEveBaz]

Sending a gentle hug to Aquitane.

[seeh2o]

Carron, how is my favorite NYC greyhound, Aquitaine, doing? Any new news? How's her foot?

[Guest OurIndy]

Wow am I late to the game...I'm just seeing this. I hope miss Aquitaine's doing well and that her foot and legs are back to normal. Indy and Piper say they hope their sister from another mother is feeling better!

[carronstar]

Thanks for the good wishes. The foot soaks have now stopped, she is weight bearing on the leg again with no limping for the last few days. We see the specialist about her kidney issues next week. My vet says he feels good that with the right plan we could have 4 more years together. I will take that!

 

I just love that signature picture of Indy and Piper! So cute.

[Rickiesmom]

Very encouraging update, so good to see.

[seeh2o]

I'm so glad she is able to walk well again! Please keep us posted with her kidney results.

[RaineysMom]

glad to hear the good update! sending more good thoughts and hugs to your girl!