Strange episode of discomfort and difficult breathing

[kudzu]

My girl, Sunita, is 12 years old now. She has been the healthiest dog I've ever had. Now though, we are facing a still to be diagnosed problem. She recently had an emergency that involved lost of shaking, panting, and clear signs of pain/discomfort. It was bad enough that I took her to ER. Once there she quickly went downhill. We do not know what triggered it the problems, but the result was an episode that looked very much like a dog with serious laryngeal paralysis that then caused collapsed esophogus. They found a lot of inflammation in the larynx/esophogus areas. (Suddenly I can't remember which.) She had to be put on oxygen and they came very close to intubating her. They had me signed papers, twice, stating my desire for or against resuscitation. It was a real horror show! The emergency vet really thought they'd lose her. However, with meds and oxygen they got her through it. In the midst of all that the vet mentioned an enlarged heart. I asked, "Even for a Greyhound?" She said Greyhounds have large hearts but Su's looks enlarged beyound that. So perhaps some chronic heart failure is involved.

When releasing her to me the next morning, the emergency vet said, "I cannot really tell you she is any better than when you brought her in last night." While riding in the car, the sedatives won out and Su was relatively calm on the trip to her regular vet. However, as soon as the car stopped, she got excited, stood up and started with another episode. And the regular vet really thought they were going to be dealing with the same problems again. This vet used a different sedative, Valium, than the ER vet chose. That might have worked better for Su. They got her calm and slowly her breathing went back to normal. They released her that evening with a serious med schedule of valium, gabapentin for pain and prednisone on a tapering dose. Su has been home ever since. We had a couple scares in the first days home, but now she seems mostly normal. Once the pred is out of her system we will discuss NSAIDs with the vet because we all feel there is underlying neck pain that may or may not have trigger the incident. Also, regular vet is not sure the heart is enlarged beyond normal Greyhound parameters. We'd need to send rads to a radiologist. At her recheck next week we will discuss that more and also discuss possible LP.

Su's bloodwork is normal for a Greyhound. She has had an issue with appetite, always been a picky eater. Now she is dropping weight quickly. It is likely not directly related to the episode, but is certainly a complicating factor. Any stress can put her off food and this has been very stressful.

Does anyone have ideas on this? Am looking for suggestions on what I need to ask/discuss with the vet now that Su seems stable.

[Time4ANap]

If your vet has the rads and the treatment records in digital form, maybe a consult with Dr. Cuoto would get you a little more info than just sending them to a radiologist for reading. 

Hope she's feeling better soon. 

[FiveRoooooers]

How frightening for both of you   Don's suggestion of a consult with Dr Couto is a good one. You mentioned possible underlying neck pain and I wondered if any xrays have yet been done. If as a senior Su is beginning to show signs of anxiety, you might discuss with your vet giving Su some low dose Trazadone to help with that.

Please keep us posted.

[kudzu]

Well, I'd forgotten about Couto. He's helped with a couple of mine. Will gather the info at our appt next week.

I do have copies of the rads from the e-vet and they supplied Idexx weblink to view bloodwork. Regular vet did rads also to compare to those at e-vet. The inflammation was greatly reduced. Both vets noticed some narrowing between cervical vertebrae and think there is arthritis. It is quite possible there is some neurogenic pain from disks. That is one reason for the gabapentin. Both vets did chest x-rays to look for pulmonary embolism. They didn't see anything, but didn't completely rule it out. That's kept us on eggshells for the past week.

Su is a sensitive girl but had not previously shown anxiety under normal circumstances. She shows stress the first few days when we travel. That only expresses itself with anorexia. After a few days, she settles into the traveling routine and goes back to normal. However, what she displayed last week was definitely anxiety. Did something trigger anxiety and then that anxiety started the episode? Or had the start of the episode triggered the anxiety, magnifying the episode?  We don't know.

[Remolacha]

I have no suggestions, but how scary that must have been! 

[cleptogrey]

i am so sorry to hear this. it sounds like LP, aging, pain from arthritis, maybe a tad of dimentia thrown in to confuse her. she is 12. personally i would try to really come up with a plan with your regular vet. does she need a sedative type drug to cut the edge on her anxiety? as per LP it's a cool environment that helps. LP can be devastating in an older dog, my welsh terrier had it and his bad episodes were not fun. ac cranked up high and a fan blowing on him as he just couldn't catch his breath. a friend from obedience classes is struggling with her 13 year old golden- here in the winter she is on the coldest surface possible(her choice) and laboring.  you mentioned using gabapentin for nerve pain- if her pain level and anxiety level can be relieved then maybe some prednisone to increase her appetite and make her feel good in general. i did that with felix when he really aged. my vet thought he would just feel better in general and it did & stimulated his appetite as well. so, there are lots of options out there to keep her comfortable- which is what my policy is with an older dog. 12 to us does not seem that old. 12 to a large dog is- lucky you she has made it to 12. my females passed at 8.5 and 10.

[greysmom]

If the pred is not making her hungry it's more than likely the cause of her increased weight loss, along with the non-eating.

LP is an option, but also, some sort of heart failure fits all those symptoms.  Talk with your vet about scheduling an echocardiogram asap.  A competent echo tech can check for heart enlargement, along with functional parameters.  And it's an easy test - no sedation, just some Trazadone to help keep them quiet.  Takes about 30 minutes.

I second the Trazadone to help with her general anxiety also.

Edited January 22, 2021 by greysmom

[cleptogrey]

bred will increase appetite- urination as well. but we used it partially as a general relief for all the ills that felix felt(one does feel euphoric on the stuff and it sends signals to cells to cut out the craziness) and as an appetite stimulant.

[kudzu]

The good news is that she's not shown had any panting for days and only a few, brief shaking episodes. She is down to pred every other day. And yes, the appetite was better at first and then declining. The switch from canned food to homemade got her eating again. For now, it continues to tempt her enough that she may actually slowly gain back some weight. Praying that continues without pred.    After having a Cushing's dog, I am not going to pred as a first choice or second or third or... However, I am not totally opposed. It has it's place and a low dose for a senior dog can be beneficial in some circumstances. At this point in the weaning off process, the excess urination has slacked off a lot. It's 24 hours since I've had to wash her bedding. The cat who likes to steal her bed is relieved as well.

So the list for our Tues. visit includes verifying the ECG/EKG was done and normal, asking about LP, weakness in hind legs (that's mild & I'd previously chalked it up to age), esophagitis, NSAID for arthritis, possibility of anxiety and treatment for that.

Am just remembering I think I have leftover trazadone prescribed for another dog. Heck, I could have used that for me over this past crazy year!

 

[kudzu]

Okay, recheck was this morning. Vet says ECG was done at e-vet & normal. She really doesn’t think enlarged heart is an issue but no problem consulting Couto if I want. Plan right now is:

1) Switch from Valium to CBD oil. I’m sure my expression was priceless when she suggested it but it’s fine by me. Worth a try. 
2) Continue with gabapentin long term.  
3) A few days after last dose of pred will switch to galiprant.  
4) Appetite is slacking off. If needed, we’ll add Entice. 
5) No help with diet. (Not a surprise.) So I’ll just do the best I can there. 
6) We’re still unsure as to cause of discomfort/pain. [sigh]

[EllenEveBaz]

On 1/26/2021 at 2:16 PM, kudzu said:

We’re still unsure as to cause of discomfort/pain.

No experience here, just sending our best wishes to your girl named Su.

On 1/24/2021 at 9:27 AM, kudzu said:

The cat who likes to steal her bed is relieved as well.