Do Not Know What To Do

[Guest apm519]

I need advise on what to do with my 10 1/2 year old greyhound name Jazz.

 

Jazz has kidney disease, diagnose last October.

 

She was diagnosed with mrsa on her toe last Thanksgiving been on antibiotics for all of this time. Did culture a few weeks ago and the mrsa is finally gone however her toe is swollen and red. I still soak it in a antibiotic wash and keep it covered so she does not lick it. Last week she was not feeling good and my vet told me to bring her into the hospital so he could try and figure out what is going on.

 

They did an ultrasound of her abdomen and found a growth on the top part of her spleen, the vet thinks it is cancer because of the shape of the tumor.

 

The vet wanted me to do another urine analysis to check if the levels are increasing and if so Jazz could not go through surgery, I would have to put her down sometime in the near future. He does not want the spleen to rupture.

 

If the analysis comes back stable he said I could do the surgery and remove the toe and spleen or I can do another ultrasound( I have an appointment in 3 weeks) to check the spleen and make my decision after that. After reading and talking to people about Jazz there are mixed thoughts on what I should do. I want what is best for Jazz, quality of life. On the good side her heart and lungs sound great.

 

Any thoughts would be appreciated.

[Guest FordRacingRon]

Well I have absolutely no experience with this in an animal,,what I do have is experience of this as a human and what I do have is an again dog (11 3/4) that is not doing to well so I would draw on those two experiences.

 

As a person who is 11 years out from surviving kidney cancer my first thought when I hear "tumor" is removal ASAP. If the cancer has not spread, reducing the tumor load is the number one way to prevent it form spreading. with my type of cancer biopsy to determine malignancy vs benign was not an option as 95% of tumors on kidneys are malignant so I wanted that kidney out ASAP.

 

As an owner with an aging dog my thoughts with my girl was , do what I can to get her better. But I am handcuffed with something as a human I am not handcuffed with,,,the costs. If my 11 3/4 year old came down with cancer, would I remove the tumor and subjecting her to a procedure she may not live through but if I do it, she may live longer. And can I afford the surgery. And how much time would I buy her and would it really just make her feel worse.

 

If I could afford it, if my dog would survive the surgery and if it would increase her quality of life then in a heartbeat I would schedule the surgery. If we are looking at prolonging her life to make me happy or prolonging her life for 3 months I dunno if I would do it or not. Would should have a great life for those 3 months, or would she be miserable.

 

We love them so much and they really can't tell us anything as far as their feelings so we just pray we do the right thing for our loved ones,,as I am sure you will do.

[macoduck]

How is Jazz feeling? Happy, sad, eating/not eating? Any behavioral changes?

 

Do you have any of them lab values that diagnosed the kidney disease? Can you post them so we can review them for you? Is your vet greyhound-savvy when it comes to the difference in test values?

 

Toe amputation are easy. Hopefully you won't have to deal with mrsa again.

 

A spleen rupture will make her crash quickly. I would repeat the blood and urine tests and ultrasound again. If not showing signs of improvement I don't think I would proceed with surgery.

 

[tbhounds]

I guess my question to you is to what degree of renal disease does she have-does she require a renal friendly diet, how's her appetite, attitude...???

Often splenic tumors are benign hemangioma's however, benign tumors can cause troubles too-they grow to a point and ruture causing an acute hemoabdomen (blood in the abdominal cavity). This could cause collapse, shock and even death--they essentially can be ticking timebombs.A splenectomy is a rather straight forward procedure but, not without risks. At times an irregular heartbeat (vpc's) will be noted post surgery (72 hrs) requiring a lidocaine drip). I would have chest rads done just to rule out mets (heaven forbid your dealing with hemangiosarcoma). Regarding the toe-I would continue what your doing-daily soaks, topical treatments and perform rads to rule out any boney involvement and make the spleen your priority.

So, I imagine your veterinarian is going to check your hounds renal values again and will check the urine specific gravity to make sure your Jazz can concentrate her urine (helps to determine renal function).

Also, food for thought-unless your vet clinic is 24/7 I would have the surgery done at a referral/university hospital. As I already mentioned-the surgery is not horribly difficult however, if things became complicated I would want my dog in a clinic that has blood products available also, one that is staffed overnight and one that is able to perform CRI's (constant rate infusions) and continue IV fluids (esp if she requires extra fluids because of her renal diease).

Hope this helped and not confused. Hugs to Jazz (and you might need one too!)

Edited to add-yikes-almost forget to mention that Jazz should take Amicar to prevent gh post operative bleeding.

Edited January 18, 2015 by tbhounds

[greysmom]

Both the toe amp and splenectomy are relatively straightforward surgeries, and easily survivable by a healthy senior dog. What you and your vet need to determine is if your dog is healthy *enough.* The cost will also be a factor. I also second having the surgery done in a 24/7 hospital inc ase of complications, and the use of Amicar (aminocarproaic acid) to prevent post-operative bleeding.

 

Good luck.

[Houndtime]

I feel the key to this whole discussion is the age and health of the dog. I have had two dogs pass from a tumor burst on or in the spleen. They both passed in one day. Fine in the morning and gone by the end of the day.

 

If you could only determine the quality of life post surgery. Your decision will be made by the desire to do the best that you can to help her be free of pain and discomfort. I wish you and your girl all the best.

[Guest normaandburrell]

I second hound time. Just as with an older person, with an older animal it is a quality of life issue. Prayers for you and your girl.

[MP_the4pack]

If the spleen has not ruptured yet, the survival rate of splenic cancer is very high. But once it ruptures you have only weeks. I've lost three to this horrible disease. But in all three cases it was already too late.

But if you caught it in time, she will feel terrific. Good luck.

[silverfish]

Providing Jazz is healthy enough and a generally happy, reasonably active dog (bearing in mind her age and kidney problems) I'd do the surgery ASAP. As your vet has mentioned and others have noted, tumours on the spleen tend to be bloody and can rupture. Often that means that the dog simply drops dead on the spot due to blood loss and shock. You don't know if or when that is going to happen, so mostly, once this type of tumour is diagnosed, the vet wants them as soon as possible. When Sid was diagnosed with a large tumour on his spleen, he went in for surgery the very next day. His recovery, after the initial period of hypovolemic shock (due to removal of a very large volume of blood, his spleen weighing in at around 5lb) was rapid and easy. He is now fine. In fact one of the kennel guys from his trainer's kennel came round today and was marvelling at how good he looked.

 

Good luck with your decision and with Jazz's bloods. I hope that she will be a good candidate for the surgery. At least the MRSA is gone, so you won't have to worry about that after surgery. Whether they remove that toe .. I'd leave that up to the vet. If he thinks that would be a good solution, do it.

[Guest apm519]

Thank you for all of your comments. Jazz is on a bland diet right now because of diarrhea. She is happy and looks great you would not know anything is wrong with her.

 

Jazz had chest x rays when she was in the hospital and they looked fine.

 

My vet knows greyhounds inside and out; his hospital is a 24/7. I don't know the renal values; I'm calling tomorrow to get the October results so when my internal medicine doctor calls me I can ask her more questions. I already lost two greyhounds kidney failure and cancer.

 

I will post again after I talked to doctor; hopefully tomorrow.

[tbhounds]

Keeping my eyes peeled for an update ;-)

[Guest IrskasMom]

Waiting for an Update !

[Guest apm519]

The urinalysis from October; I do not know how to upload the results so I'll type everything. The bold is everything that is high. Last week urinalysis is not in as of this morning.

RANGE

SPECIFIC GRAVITY - 1039 1015-1050

PH - 7.5 5.5-7.0

PROTEIN -3+ NEG

GLUCOSE - NEG NEG

KETONE - NEG NEG

BILIRUBIN - 1+ NEG - 1+

BLOOD - 3+ NEG

WBC - 2-3 0-3

RBC - 11-20 0-3

CASTS - NONE SEEN

BACTERIA - NONE SEEN

SQUAMOUS EPITHELIA - 0-1 0-3

CRYSTALS - NONE SEEN

OVAL FAT BODY - >50 NONE

RATIO - 3.3 <=0.5-

[tbhounds]

I assume she was treated for a uti? Did you happen to culture the urine? Also wanted to note that her USG (urine specific gravity) is good-1.039. Do you remember of this was a first a.m. catch or a midday sample? Either way I would be less worried about renal disease with a USG of 1.039

[Guest apm519]

She was on antibiotics, I don't think it was culture. There was another urine test done the week after but I didn't get the results. For some reason the vet tech could not get that one to fax. When I go to the vet I am going to get a copy. The vet took her urine in the afternoon, they did a clean catch.

 

Still waiting for vet to call from last Friday's urine test.

[tbhounds]

Can you post her blood work results too?

[Guest apm519]

I'll have to see when she had blood work done. Jazz was getting her toe cultured every two weeks since mid October, I don't know about the blood work. Let you know tomorrow.

[Guest apm519]

This is last weeks blood and urine when she was in the hospital.

 

TOTAL PROTEIN - 5.5 5.0-7.4 SPECIFIC GRAVITY - 1032

ALBUMIN - 2.8 2.7-4.4 PH - 7 (5.5-7)

GLOBULIN - 2.7 1.6-3.6 PROTEIN 3+

ALB/GLOB RATIO - 1 0.8-2.0 GLUCOSE - NEG

UREA NITROGEN - 20 6-31 KETONE - NEG

CREATININE - 1.7 .5-1.6 BILIRUBIN - 1+

BUN/CREA RATIO 12 4-27 BLOOD 1+

PH - 1.9 2.5-6 WBC - NONE HPF

CALCIUM - 9.3 8.9-11.4 RBC - 4-10 (0-3)

CORRECTED CALCIUM -10 CASTS, CRYSTALS, BACTERIA - NONE SEEN

SODIUM - 149 139-154 SQUAMOUS EPITHELIAL - 0-1

POTASSIUM 3.8 3.5-5.5

NA/K RATIO - 39

CBC - PENDING

[tbhounds]

I'm not seeing renal disease. Is your vet aware that ghs creatinine runs higher than other breeds? The BUN and the specific gravity are normal. Looking at this your dog does not have renal disease. The protein found in the urine is mostly likely because blood was present.

http://www.greyhoundadoptionofoh.org/Greyhound_Health_Packet_08.pdf

Edited January 20, 2015 by tbhounds

[Guest apm519]

I will ask him. Thanks for your input. Will let you know.

[GeorgeofNE]

Doesn't look like renal disease to me either.

 

George's creatinine was higher than that all the time, and he was just fine.

[MaryJane]

You mentioned you are feeding a bland diet - how much are you giving and of what. The reason that I mention this is that there could be some protein spilling off into the urine and sometimes that happens when the diet is too protein heavy. The red cells could cause some of the protein showing up in the urine, but that level of protein in the urine is pretty high, more so than what I would expect with some blood.

[tbhounds]

You mentioned you are feeding a bland diet - how much are you giving and of what. The reason that I mention this is that there could be some protein spilling off into the urine and sometimes that happens when the diet is too protein heavy. The red cells could cause some of the protein showing up in the urine, but that level of protein in the urine is pretty high, more so than what I would expect with some blood.

The protein could also be from contamination -we don't know how clean the catch was.

[MaryJane]

The protein could also be from contamination -we don't know how clean the catch was.

 

 

I've personally never seen contamination that causes the protein to spike like this but, anything is possible. Have you seen a particular case that caused this and if so, I'm curious - what was the contamination?

[tbhounds]

Often it's from owners using contaminated containers. Slightly of topic but, thought I would share. Had a client submit a urine sample in a used jelly jar---hummm, not knowing what container was used one would have feared diabetes :-)