I don't want Daisy to have an 18hr fasting blood test

[MattB]

Daisy is nearly 13. She has kidney disease, initially diagnosed nearly 6 months and my understanding was it was stage 3, but given greyhounds' higher creatinine levels more like stage 2. She did well on renal food and her tests 4 months later showed creatinine back to normal. However eating has become a struggle, I don't think this is new, she's always been very picky. I think this is sometimes linked to how nervous she is; she would always literally run away from a bowl of unfamiliar food e.g. scrambled eggs. We've been through all of the big brands and she eats them for a while then goes off then. I've been homecooking but again she's gone off anything I make.

 

Anyway, this wasn't about eating difficulties, while Daisy's blood was generally normal, she had high lipase levels indicating pancreas inflammation so I reduced fat by going to exclusively home cooked meals with grilled meats and low fat versions of recipes to hopefully reduce the pancreatitis - which it did. We repeated the bloods 2 weeks later after 12 hrs of fasting which was difficult for Daisy as she eats most of her food quite late (this could be morning nausea which hopefully is being managed now). Her lipase was now normal but her cholesterol and triglycerides were still high. The vet then wanted an 18hr fast to retest but I've heard from other owners that after pancreatitis it can take these levels weeks to return to normal so I felt like these levels were probably to be expected.

 

The vet wondered if it could be a thyroid issue but I said, rather than another test could we hang on a few weeks to tag it on to her routine bloods but she still suggested an 18hr fast.

 

I've gone along with everything the vet has suggested but I really feel strongly about the fasting, partly because I don't want to put her through the discomfort but mainly because I don't think there's anything wrong. She has some intermittent incontinence but other than that she is really really well. We went on 3 walks yesterday and she could have continued. She's sleepy when she's not walking but I've found some new food brands and she's really enjoying her food at the moment. I don't want to be ignorant and if she was 7 years old and/or poorly I wouldn't hesitate, but the bloods seem to fit with the pancreatitis which we can look at again in the next routine bloods, just with no fasting.

 

Or am I am idiot?

[macoduck]

You are not an idiot.

At an age of 13 I'd want my dog to be as happy and comfortable as possible. None of my dogs would like a long fasting period.

Have you consulted Dr Couto? I don't recall what his fee is, but you or your vet can send him all Daisy's lab tests, xrays, ulatrsounds and history.

I'd suggested you making the contact first. What I've learned after reaching out to him for a couple of my greyhounds is this:

- put your dog's history and your questions in a numbered, bullet-point format
- he sometimes didn't answer all my questions, so I'd write asking to response to question number whatever
- it may take a few days to hear back from him because he is often traveling
- he may suggest other tests
- I didn't have to pay an additional fee any time I had a few more questions about the same dog for the same problem
- he has a vast knowledge of quirky greyhound information. One of my dogs had a rare condition that Dr Couto had only encountered in 2 other greyhounds in his career
- you may not get an answer you want to hear, but you will know you've had an expert review Daisy's case
- my vets were happy to communicate with him when they were stumped
https://www.coutovetconsultants.com/

[ramonaghan]

Just chiming in to say the consult fee is $150. Worth every penny. Dr. C has been such a help with Sweep.

Best of luck with Daisy. You're not an idiot. Quite the contrary: you're keeping your girl's best interests in mind because you love her and want to do right by her.

[MattB]

Thanks for this Both.

Dr Couto is a good idea - I will hang fire until Daisy's next bloods as this will no doubt be helpful.

I really like my vet but sometimes feel they are too enthusiastic about tests - a recent example a vet (different from normal but same practice) suggested a kidney scan, I asked if the outcome would impact anything at all and they said 'No', I've also been sent for a horrendously expensive cardiology appointment who said there was nothing to report (very very tiny aortic valve leak) but said she was so nervous she was very difficult to deal with and she'd had a traumatic few hours. 

Daisy has had a great life but things that would seem minor to other dogs I've had, such as a quick visit to the vet, really take a toll on her. Part of me wants to just keep her at home on as good a renal diet as she will eat and forget about the vet unless she has symptoms - I'm aware this may be burying my head in the sand and that blood tests give me a heads up on how I can help her with a modified diet, but the balance needs to be right. 

Thank you for your perspectives :) 

[EllenEveBaz]

I don't think you're burying your head in the sand.  I think you are being realistic.  She is 13 with a history of health issues, which you seem to be managing well.  

But if we could explain the situation to the dog and get their opinion about what they want to do, it would lift such a burden, wouldn't it?  

[Jerilyn]

You know Daisy better than anyone. Do what you feel is best for her. You're taking very good care of her and it sounds like she's doing fine for her age.

[Remolacha]

I think it is just in the nature of vets (and people doctors) to want to find out everything and fix everything. I once had a vet (not our regular one) who suggested I take my 18 yr old cat for an MRI to see if he had a tumor in his sinus/nasal cavities. Why? We weren’t going to do head surgery on an 18 yr old cat! (He lived to 21, btw)

I agree with you that quality of Daisy’s life is the most important thing. You want to do what you can to help her feel better and live as long as she comfortably can, but a bunch of expensive tests and such is probably not in her best interest. I surely would hesitate to put a 13 yr old dog through an 18 hr fast. Listen to your instincts, you are doing what’s best for Daisy.

[greysmom]

She's thirteen and doing reasonably well.  Will the results of any testing have a significant impact on how you're treating/maintaining her?  Probably not.  There really isn't anything to treat, other than old age, which, no matter how much we wish it, we can't do anything to hold back.

My vet and I have a good, collaborative working relationship that I really appreciate.  She'll listen to my opinion and give me hers, and we can decide together if a particular test or medication will change anything going forward.  I have had several dogs through the years where the testing is definitely worse for them than the problem, so sometimes we just don't.

You know your girl.  You do you!  Not every issue has to be resolved completely for good quality of life.

[zimsmom]

My motto when they become teenagers less is more.   As some stated you know your dog best. 

 

[MattB]

Thank you so much everyone. As many of you know, caring for an elderly hound can be emotionally draining. Your support means an awful lot. Mx