Violet's Dental - Update: U/a Results Post #83

[NeylasMom]

TBhounds- the place she's at is a shared specialist/Evet place, so yes, they do have overnight staffing (I'm guessing they'd move her over to that side). It's a really good hospital. God knows I've been there enough.

Jen - we were posting at the same time. Sorry you don't have more answers, but your approach is prudent. Let me know if I can do anything for you. Also, thank god for insurance!

So grateful I have insurance. Of course the insurance covers no part of the dental & extractions, but I did call Healthy Paws to make sure that an illness that was separate but resulted from the procedure indirectly would be covered and they told me it would as long as they could identify which charges were non-dental related.

 

And thank you - I may take you up on that!

[Remolacha]

Just catching up, I am so sorry things did not go as smoothly as we hoped! I know it is hard to leave her, but it is the best thing for her. Hopefully they will have some answers, or at least a good update in the morning and she can go home.

[MaryJane]

Oh yeah, we're at an emergency/specialty hospital. This is the place that treated her for her rhabdo so they have staff 24/7 and she'll be monitored constantly.

 

MaryJane, would it make a difference diagnostically at this point? The vet said they saw blood clots when she urinated, but I can't imagine they picked up a clot to examine closely so it's possible it was mucous (but why would there be mucous in her urine). The clots seem more likely to me - from what I can tell, she had a lot of blood in the urine. But I can ask if you think it would help with diagnosis.

 

I did give them the okay to keep her overnight. They are setting up a room for me to meet with the ER doctor who will be supervising her case overnight and then I will be able to spend some time with Violet in the room. They have to take her off of fluids to bring her in though so it will probably only be for a half hr or so.

 

 

Good news that they will let you spend some time with her and the ER vet. It sounds like the best place for her is at the hospital overnight - I assume Violet will be in the ICU or being checked on hourly. Maybe you can take her out and see if she will pee for you ....

 

As to blood clots or not blood clots - a detail but, I'm a person that is all about details (character trait). As noted, I would not expect blood clots except in certain acute situations like trauma (car accident). If the urine was just dark (without clots) it would be supporting the rhabdo as an initial issue. Although, you could have a trauma (accident) initially and then as a result of that, the rhabdo as a secondary. Does it matter in the diagnosis? Hard to say at this point but, when formulating a theory, you want to base that on facts. I suggest that you discuss this with the ER vet and maybe he/she could elaborate on whether that could potentially change the treatment plan that would be followed with Violet.

[Riverhound]

Well, hell. I was out all afternoon and just saw the updates. Jen, I'm sorry this crazyness is happening to your girl.

[Jenbo]

I'm sorry I said don't panic. I would have totally panicked. I'm sure they will take good care of her for you.

[lothianjavert]

I don't have any useful knowledge or advice Jen... but lots of hugs to you both and I hope things get sorted out quickly. The clinic sounds like a good place and she's getting good care. :grouphug

[krissn333]

Came over to look for updates...sorry to find she's got to stay overnight, but, I suppose it's for the best. Hopefully she has a restful night and everything looks good in the morning

[NeylasMom]

Thanks all. I just got home about a half an hour ago after picking up Amicar and then Zuri and then finding poop on my bedroom floor that I got to clean up, yay me.

 

Anyway, I reviewed everything with the ER vet before I left and then I got to spend about 30 minutes with Violet. Her mouth is pretty swollen and she was definitely stressed when they brought her in. She had been lounging with the staff in the dental room, but she had to be moved to a cage in the ER side and apparently that freaked her out. But after I left they got more Dexdomitor on board and she was resting quietly when I called for the update.

The good (very good) news is that I took her out to potty when I had her. They had been taking her out, but she wasn't going. She went immediately for me and her urine did not have blood in it!! :yay So I really really hope she is on the mend and I will be able to pick her up in the morning. We discussed whether she still needed to stay overnight and agreed it was the safe thing to do provided they could keep her from getting anxious, but a big part of me really wanted to just bring her home because I know she would be happier here. Anyway, I really don't think this was rhabdo and don't know if we'll ever know what it was. They are going to run a urine culture (tbhounds, she said they have a special culture they can do when ABs have already been given) and we'll see if any bruises pop up tomorrow. I decided to cancel sending urine out to test for myoglobin in light of hte yellow pee since the vet said she would have to do some digging to see where to even send it.

 

One question - how many days after a dental do you typically give Amicar? I went to pick up a 7 day supply and it was $200!!! So I took 2 days worth and I'm going to see if I can get the rest cheaper from Costco tomorrow.

[tbhounds]

Amicar is given three times a day for 5 days so you need 15 500mg tablets. I'm sure she'll be ready to go home in the a.m. Get some sleep!

Edited December 18, 2014 by tbhounds

[NeylasMom]

Amicar is given three times a day for 5 days so you need 15 500mg tablets. I'm sure she'll be ready to go home in the a.m. Get some sleep!

Thanks, that seems in line with what I did for Zuri. Would that change if they've already given injections? She got one this afternoon and I am pretty sure they were planning to give another one either tonight or tomorrow morning.

 

I tried to call while at the pharmacy, but Dr. Stiles (our dentist) was gone and the tech gave me crap about she could ask the ER vet, but Dr. Stiles was "the captain of the ship" and the ER doc was just carrying out her overnight care and I was too tired to argue with her so I just bought the 6 pills and figured I'd figure it out in the morning. Which I will do so I suppose you don't really need to answer me, but I like to have your input.

 

Ah yes, sleep. I should try that. I was thinking I'd just pass out, but now that I'm home and sitting again I start worrying that I'm too relaxed and I better worry lest I be caught off guard with a phone call in the middle of the night that things went downhill. A couple of times of that happening and you learn your lesson I guess.

[tbhounds]

I guess to have to take into consideration of how many doses she'll have while admitted. She should had had two today and I suppose one in the a.m. So you'll need 12 tabs. -so you'll need to get 6 more tabs.

Put a boring movie on and pour a glass of wine for yourself--she's napping right now-you should try it too.

[EllenEveBaz]

[NeylasMom]

Put a boring movie on and pour a glass of wine for yourself--she's napping right now-you should try it too.

Yes ma'am. Making myself turn off my computer right now.

[KF_in_Georgia]

Jen, be sure to check GoodRx.com for Amicar prices in your area. Here in my neighborhood, GoodRx has a coupon that cuts Walgreen's price nearly in half: six 500mg tablets (assuming you've got six from your vet and she already has some on-board): $44 at Walgreen's, $23.75 at Walgreen's with the GoodRx coupon. If you've already got six from the vet, you're good for 48 hours after she comes home.

[tbhounds]

Jen, be sure to check GoodRx.com for Amicar prices in your area. Here in my neighborhood, GoodRx has a coupon that cuts Walgreen's price nearly in half: six 500mg tablets (assuming you've got six from your vet and she already has some on-board): $44 at Walgreen's, $23.75 at Walgreen's with the GoodRx coupon. If you've already got six from the vet, you're good for 48 hours after she comes home.

Have you actually used GoodRx?? I tried at my local Walgreens in the past (I was actually price shopping for a good client)--the pharmacist told me that they don't honor the GoodRx prices--she said that you'll save a few dollars but, nothing like GoodRx claims.

[Charlies_Dad]

Good thoughts for Violet. I hope this morning finds her doing well and that she can come home.

[galgrey]

[NeylasMom]

She can come home! I'm supposed to be there at 10 to get her. There is apparently still blood in her urine, but its not visible, just showing up on analysis. We don't know when we'll get the urine culture back, but now he's saying there was some bacteria in her urine yesterday (that somehow got lost in translation I think). Not a lot, but we'll see if the culture shows anything. Also mentioned an elevated liver value that I don't recall hearing about yesterday, but said its coming back down. CK has gone up a little bit more from 1300 to I think 1900, but according to him that's consistent with post surgical stress.

 

So still no clear answers, but no reason to keep her there longer, which makes me very happy.

[Riverhound]

Yay!!!

[robinw]

Great news!!!!!!

[NeylasMom]

Great news!!!!!!

Robin, totally random, but you were in my dream this morning. We were at a beach of some sort though nothing like Dewey. I've forgotten most of the other details. No clue why I'm dreaming about you.

[lothianjavert]

Glad she's coming home!

[KF_in_Georgia]

Have you actually used GoodRx?? I tried at my local Walgreens in the past (I was actually price shopping for a good client)--the pharmacist told me that they don't honor the GoodRx prices--she said that you'll save a few dollars but, nothing like GoodRx claims.

 

Yes, I've used them and gotten exactly the price on the coupon for amicar at Walgreen's and clomipramine at CVS (before even the coupon price for that got so high that we switched to fluoxetine). The coupon has a FAQ page that says this:

 

 

What if my pharmacy cannot process this coupon?

If your pharmacy is unable or unwilling to process your coupon, please call 1-888-277-3911. Most issues can be resolved quickly.

 

It also has a note to the pharmacist that says this:

 

 

For the Pharmacist

This coupon displays a contracted rate based on agreements between your pharmacy or purchasing group and a Pharmacy Benefit Manager (PBM).

 

If a listed pharmacy is refusing to honor the coupon price, they're violating their contract with GoodRx.com and I wouldn't hesitate to blow the whistle on them. After all, the price advertised by GoodRx may be what got me into that particular store in the first place.

 

Having said that--if the pharmacy has it's own price program, you may get a better price with that than with the coupon. (Tigger's prozac is cheaper on the CVS plan than with the coupon.) I've also shown the prices quoted to my vet, and he's tailored his prescription to match the GoodRx requirement for a script for something long-term.

Meanwhile, I'm delighted Violet is going home.

Edited December 18, 2014 by KF_in_Georgia

[4My2Greys]

Jen, I'm sorry to hear about the problems Violet is having. I found this website, while it is discussing hematuria in humans, to be very informative nevertheless.

It says that clots are usually indicative of urological problems, but have they checked for proteinuria to test for glomerular infiltration to help rule out nephrotic issues?

 

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/evaluation-of-hematuria/#cesec5

[Remolacha]

So glad she is home! Whatever the problem, and sometimes we never know, I hope she well from now on.