Very Sick Grey...advice Needed Not Sure How To Proceed Or If To Procee

[Guest alannamac]

Hi, I haven't posted here in a few years since my old boy Bandit passed and didn't expect to need to so soon after adopting such a young new greyhound, but here I am and Red's in a lifethreatening crisis and I need advice please....

 

Red is 5 yrs old and I've had him for 2 years. He's a high anxiety guy and I've always striven to keep things calm and quiet for him as stress seemed to make him feel poorly.

 

A little over a week ago I took a 1 week trip out of the country and left him in the care of another grey savvy family...very quiet household, only one other grey, and someone home all the time. We even tried a 3 day weekend test first to see how he would do, and he seemed to do fine. Well this one week trip has triggered something awful, not sure what but he's one sick fellow and may not pull through....Symptoms, I came home to a lethargic dog with poor appetite and looking quite frail. I fed him chicken and rice and gave him Pepcid....diarrhea ensued...on to Immodium...not effective....on to metronidazole...effective and he seemed to eat slightly more, (still no meals just nibbles) and have

pudding poop rather than diarrhea. But he looked strange and wasn't improving so I took him to the vet yesterday and she said he was very sick...his albumin levels are appalingly low in his blood and his electrolytes were all over the place. He had begun vomiting uncontrollably that morning as well. His belly, heart and lungs were full of fluid.

So many treatments ensued with a course along the lines of an Addisonian crisis because that's what it looks like. IV fluids were difficult to give as his blood values and protein levels are so low but an ACTH test and dexamethazone were given, metronidazole, attempts to get him to eat to reverse the protein loss etc. His liver function is fine if that's important. Very labored breathing because of the fluids.

So long story short they hospitalized and took excellent care of him all day yesterday and I took him home last night trying to feed every hour and a half what I could with the thought that stress levels would be much lower at home. I got him to eat about a cup of turkey and 50 ml of liquid diet More metronidazole and Pepcid as well. But after returning for hospitalization this morning learn that his blood protein levels and sodium levels have plummeted even further and this thing isn't turning around.

We still don't know what's causing it but it is being treated as an Addisonian crisis until the results come back as that's what it looks like this is. He is bad and on plasma and oxygen right now. My vet is recommending transfer to intensive care in another city and I'm not sure what to do. She said they do not have any magic bullets their either and she's not sure he's going to make it but that 24 hour care was going to be required if I continue treatment.....

 

I'd appreciate thoughts from anyone who's seen something like this before. I'm out of my depth here. I don't want my pup to suffer but I also don't want to give up too soon.

 

Thanks for your help.

Edited May 29, 2014 by alannamac

[Batmom]

Oh my word. Can't help much but in your place, I would continue the supportive treatment if possible, until the vets can figure out what's wrong. Are you sure he couldn't've gotten into something like Ibuprofen? Sending prayers.

[Guest alannamac]

I checked with the sitter and she said nothing unusual happened. He definitely didn't get into anything at my home but thanks for the thought and prayers.

[MaryJane]

I'm so sorry that this has happened to you ...

 

I would think that he might have gotten into something at the other house. How long was he not eating before you picked him up?

 

I would probably continue the care until at least I found out what the issue was but, a factor in this is going to be the cost. Is there a teaching hospital or a large practice near you that might have more experience with cases like this - if yes, I would recommend going there and getting their opinion.

 

Did they take x-rays at all to see if he has an obstruction?

[NeylasMom]

You might consider having your vet consult with Dr. Couto. I don't have any suggestions about what could be going on, but sending good thoughts that your boy pulls through.

[kudzu]

My personal opinion is to get him to specialty intensive care ASAP. He's young and deserves a chance. Having that be in another city is rough but that's what many of us have had to do. At the very least try to continue helping until the ACTH stim test results come back. I've had pups in ER multiple times and the younger ones all pulled through even though they were close to death. (Actually the older ones pulled through in the short run but turned out to have terminal illnesses.) I am definitely not one to make an animal suffer when there's little to no hope of recovery but if you don't know what's wrong and there is no irreparable organ damage so far then it seems worth a try. That's just me.

 

I am far from an expert on Addisonian crisis but it is the first thing that came to mind when you mention a dog collapsing under stress and electrolytes being out of balance. Not knowledgeable about the low albumin levels. In my limited experience that has related to GI or kidney issues but there are certainly other causes.

[Guest alannamac]

Yes xrays were taken...no obstruction and things flowing smoothly in the intestines...I think she said no inflammation either....BUT a ton of fluid around them. The nearest teaching hospital is about 5 hrs away I think...VA Tech.

[kudzu]

 

Sending good thoughts on finding the cause.

[Guest alannamac]

Thank you for your good thoughts. My poor fella.

 

Should also note no blood in vomit or stool and his RBC and WBC counts are fine so far.

[NeylasMom]

Where in VA are you? There are a lot of really good specialty hospitals in NoVA, which if you're in the southeasternmost part of VA would be about 3 hours from you I believe. I agree that if you don't have a high quality specialty hospital where you are then it's worth transporting him if you can do so safely.

 

ETA: VA Tech is also a good option and may be less costly if the drive isn't a factor.

Edited May 29, 2014 by NeylasMom

[MaryJane]

There could be a chance that if the dog was starving itself and not drinking that it would be reflected in the albumin and the electrolytes.

 

edited to add a link --- this is a long article about albumin in people http://www.nursingcenter.com/lnc/static?pageid=720126

Edited May 29, 2014 by MaryJane

[Guest alannamac]

It is quite possible he did not eat and drink enough. Pet sitter sent me home with most of the chicken and Nutro I had provided. Thank you for the article I will read it. I hope this is a recoverable condition.

[Guest alannamac]

I am in Tidewater VA. The closest specialty groups are in Richmond which is about an hour's drive...not bad if Red is stabilized this evening...it's a matter of what the heck is causing this and is it recoverable...should I put him through it all if the probability is poor etc....Just trying to do the best I can for my boy knowing so little about this...it's very complex with no known cause : (

[NeylasMom]

If you are unsure, you could ask your vet to consult with the hospital you would take him to. They may be able to tell your vet what they would do that your vet can't, or alternatively suggest tests your vet should run before transporting, give input on whether it is safe to transport him, what his chances of recovery are or whether those chances are improved if you move him, etc.

 

I am a big fan of seeking specialty care as soon as things move outside the realm of your standard every day stuff, which this case clearly has so if it were me, I would just do it and get him in the care of a good internist who can really lay out what your options are, etc., but obviously that's just my opinion.

[EZHARRY]

I am in Tidewater VA. The closest specialty groups are in Richmond which is about an hour's drive...not bad if Red is stabilized this evening...it's a matter of what the heck is causing this and is it recoverable...should I put him through it all if the probability is poor etc....Just trying to do the best I can for my boy knowing so little about this...it's very complex with no known cause : (

Can you drive ~3hours to come to Fairfax, VA? If so, there is South paws Veterinary Specialists & Emergency Center.

They are the best vets in Northern Virginia.

 

http://www.vcaspecialtyvets.com/southpaws.

 

Good luck.

[carronstar]

No advice, just lots of good thoughts and prayers. I would second the Dr. Couto consult.

[Remolacha]

All I can tell you is what I would do if it were my dog. I would transfer him to a specialist and give him a chance, at least until you know what is causing this. If it it something treatable, he is young enough to have a good chance of recovery.

[kudzu]

....Just trying to do the best I can for my boy knowing so little about this...it's very complex with no known cause : (

We know. Hang in there.

[wendell]

I'll be thinking of your guy. These are such hard decisions to have to make.

[Guest alannamac]

Thank you all for your thoughts. My vet is on the same track as you and is trying to consult with Dr Couto...unfortunately theres a lot of red tape so she has another expert in mind to consult if she can't get through.

In the meantime, Red's RBC count is starting to drop and no idea why or where it's going.......

 

should add the ACTH test came back negative...this is not an Addison's crisis...so not even a clue what's started this....

Edited May 29, 2014 by alannamac

[MaryJane]

If a dog (or person) is very dehydrated, once they start putting fluids into the blood, the solid part of the blood (RBC) will be less of a percentage to the whole. So what might have been an HCT of 55% drops depending on the amount of fluid put in.

 

Talk to the pet sitter and find out exactly how much the dog ate and drank. The vets should also check the platelet count.

[Guest alannamac]

Pet sitter said Red ate less than usual. With all of the food she sent back, I don't think he ate much at all.

Good point about the RBC dilution, but I think my vet is accounting for this factor.

Tons of tests have been run, EKGs, tick disease tests...the gammut

 

Do you think this is a simple reaction to not eating? Would all of this occur in a week? (not doubting your thoughts, just amazed such a reaction could happen)

Edited May 29, 2014 by alannamac

[Guest OPointyDog]

I'm so sorry you're going through this. What a terrible feeling to not have any answers. Fingers and toes crossed for a quick turn-around.

 

Healthy dogs can go quite awhile without eating and not suffer damage, from what I understand. Cats, on the other hand, can suffer liver damage within a few days if they don't eat. It does beg the question of why he stopped eating in the first place.

 

We went through something somewhat analogous with our cat - very sick and lethargic, and her electrolytes were all over the place, stopped eating and had fluid build-up. All the usual tests negative. She was in emergency care and it took many days to determine what was going on. Eventually the vet's best guess was that she'd had a stroke and thrown a blood clot that splintered, and part of it lodged in the part of the brain that controls electrolyte balance (unfortunately confirmed via autopsy). He did try several things to try to "reset" her system but she was elderly and had a heart condition and she didn't make it. Apparently extremely rare in cats, but sometimes seen in dogs.

[Houndtime]

No thoughts, just good wishes for your boy.

[MaryJane]

Pet sitter said Red ate less than usual. With all of the food she sent back, I don't think he ate much at all.

Good point about the RBC dilution, but I think my vet is accounting for this factor.

Tons of tests have been run, EKGs, tick disease tests...the gammut

 

Do you think this is a simple reaction to not eating? Would all of this occur in a week? (not doubting your thoughts, just amazed such a reaction could happen)

 

 

I think that you should consider calling the pet sitter and asking how much your dog drank. After 3 days of not having water - a person would be in a bad way .. for food, it is about 14 days. It gets serious very fast.