I will skip ahead now, but summarize the last few months...
Catcher's insulin dose was increased to 7 units in July. At his one week recheck his BG was 83 so we decreased the insulin back to 6 units twice daily. His weight was up to 41.4 pounds.
Catcher seemed to do well for the next few months. I ordered a glucometer so I could test him at home, though I was still uneducated and did not test him as regularly as I should have been.
At the end of October he was tanking on water again. I tested his blood and it was in the upper 300 range. I was advised to do a glucose curve on him. (Take readings every two hours post injection)
He had his insulin at 7:20.
7 am: 345
9 am: 187
11 am: 220
1 pm: 333
3 pm: High (high on the glucometer means it is over 500)
5 pm: High
Okay so the way it is supposed to work is that the insulin is metabolized at a rate that 6 hours post injection the BG will be at it's lowest point. Catcher was now metabolizing it within 2 hours of his injection. So we switched him to Vetsulin (a porcine insulin). Ideally vetsulin is metabolized slower and only needed every 24 hours, however we were giving it every 12 for Catcher.
Catcher was not responding to the vetsulin at all. I spent the first half of November with him reading over 500. I was getting cranky and worried that nothing was going to be able to help him. After doubling his dose, and still not working, we discovered that Vetsulin is a different concentration (40 units/mL rather than human insulin being 100 units/mL). (I also discovered that human pharmacies are useless). So because I was using the human syringes he was not receiving the correct dose. We promptly changed the syringes and began to see a difference. He still did not react to 6 units however, so we increased his dose to 10 units twice daily.
His peak with 10 units was 73 so we decreased to 9 units.
Monday, November 24, 2008
Friday, July 11, 2008
More Blood work
I was very overwhelmed at first. We started Catcher on pancreazyme mixed in his food. It was a nightmare getting him to be hungry enough to eat it, but eventually he warmed up to the idea.
We ran another pre-anesthetic profile on him just to monitor his progress.
His BG was 351. It was recommended to increase his dose to 7 units twice a day and recheck in one week.
We ran another pre-anesthetic profile on him just to monitor his progress.
His BG was 351. It was recommended to increase his dose to 7 units twice a day and recheck in one week.
Monday, June 23, 2008
EPI - We Learn More
Over the past few weeks I have learned a lot about Catcher's issues. Simply put Exocrine Pancreatic Insufficiency means that he cannot absorb the nutrients he is digesting. Which explains his wasting over the last few weeks.
From an online article:
"The pancreas has two functional parts. The endocrine part secretes insulin and glucagon, which are essential for the metabolism of carbohydrates. The exocrine part consists of units called acini that produce and secrete enzymes essential for the digestion of protein, into the small intestine. With EPI, there is a gradual wasting away (atrophy) of the acini. Clinical signs do not develop until most of the acini are gone. As dogs lose the ability to digest protein, they progressively lose weight despite a voracious appetite.
Affected dogs lose weight despite voracious appetites, and usually pass large amounts of semi-formed feces. They often eat their own stools, or other inappropriate substances. Some dogs with this condition do not show these typical signs, and may experience intermittent watery diarrhea or vomiting.
Although this disorder cannot be cured, management is generally fairly straightforward. Powdered pancreatic enzyme extract is mixed in with each meal. Within a few days, your dog's appetite and stools should become more normal, and s/he will begin to gain weight. Enzyme supplementation of your dog's food will be necessary for life." 1998 Canine Inherited Disorders Database.
From the Cornell website:
Description: EPI is characterized by inadequate production of digestive enzymes from pancreatic acinar cells. This might be a result of chronic pancreatitis, juvenile pancreatic atrophy, decreased function in severe protein-calorie malnutrition, or rarely following acute hemorrhagic pancreatitis. The lack of digestive enzymes and bicarbonate secretion results in acidification of the gut, malnutrition and weight loss, with voluminous stools containing undigested fat, muscle fibers and protein.
Signs: Abdominal distention, Abnormal behavior, aggression, changing habits, anorexia, diarrhea, dullness, flatulence, increased borborygmi, internal abdominal mass, lack of growth or weight gain, pale, pica, polydipsia, polyphagia, rough hair coat, steatorrhea (fatty stools, feces), Tachycardia, underweight (poor condition, thin, emaciated, unthriftness, ill thrift), unusual or foul odor (stools, feces), vomiting or regurgitation, weight loss
After reading several different articles, and talking with my friend Jenn whose collie is suspected to have EPI, I realized that Catcher had certainly been showing most of the symptoms. The problem was that they were intermittent, and any of those symptoms could be evidence of something else. For a long time we suspected that his off and on again diarrhea was due to a parasite problem (he had picked up whipworms at daycare as a puppy and we'd been treating with panacur regularly to break the cycle). It was only when looking at everything as a whole did the pieces of the puzzle begin to fit together.
I was still left with asking how and why. How did an adolescent dog who was perfectly healthy (as proven by multiple blood workups) develop all of these conditions (KCS, EPI, Diabetes) within 2 months of each other. What had changed? Did his neuter have any effect on this? The unfortunate problem was that no one had any answers. All 3 conditions are fairly rare in Border Collies, especially ones under the age of two. EPI and Diabetes are both pancreatic and if untreated EPI can lead to Diabetes. However, the KCS was a totally unrelated issue.
From an online article:
"The pancreas has two functional parts. The endocrine part secretes insulin and glucagon, which are essential for the metabolism of carbohydrates. The exocrine part consists of units called acini that produce and secrete enzymes essential for the digestion of protein, into the small intestine. With EPI, there is a gradual wasting away (atrophy) of the acini. Clinical signs do not develop until most of the acini are gone. As dogs lose the ability to digest protein, they progressively lose weight despite a voracious appetite.
Affected dogs lose weight despite voracious appetites, and usually pass large amounts of semi-formed feces. They often eat their own stools, or other inappropriate substances. Some dogs with this condition do not show these typical signs, and may experience intermittent watery diarrhea or vomiting.
Although this disorder cannot be cured, management is generally fairly straightforward. Powdered pancreatic enzyme extract is mixed in with each meal. Within a few days, your dog's appetite and stools should become more normal, and s/he will begin to gain weight. Enzyme supplementation of your dog's food will be necessary for life." 1998 Canine Inherited Disorders Database.
From the Cornell website:
Description: EPI is characterized by inadequate production of digestive enzymes from pancreatic acinar cells. This might be a result of chronic pancreatitis, juvenile pancreatic atrophy, decreased function in severe protein-calorie malnutrition, or rarely following acute hemorrhagic pancreatitis. The lack of digestive enzymes and bicarbonate secretion results in acidification of the gut, malnutrition and weight loss, with voluminous stools containing undigested fat, muscle fibers and protein.
Signs: Abdominal distention, Abnormal behavior, aggression, changing habits, anorexia, diarrhea, dullness, flatulence, increased borborygmi, internal abdominal mass, lack of growth or weight gain, pale, pica, polydipsia, polyphagia, rough hair coat, steatorrhea (fatty stools, feces), Tachycardia, underweight (poor condition, thin, emaciated, unthriftness, ill thrift), unusual or foul odor (stools, feces), vomiting or regurgitation, weight loss
After reading several different articles, and talking with my friend Jenn whose collie is suspected to have EPI, I realized that Catcher had certainly been showing most of the symptoms. The problem was that they were intermittent, and any of those symptoms could be evidence of something else. For a long time we suspected that his off and on again diarrhea was due to a parasite problem (he had picked up whipworms at daycare as a puppy and we'd been treating with panacur regularly to break the cycle). It was only when looking at everything as a whole did the pieces of the puzzle begin to fit together.
I was still left with asking how and why. How did an adolescent dog who was perfectly healthy (as proven by multiple blood workups) develop all of these conditions (KCS, EPI, Diabetes) within 2 months of each other. What had changed? Did his neuter have any effect on this? The unfortunate problem was that no one had any answers. All 3 conditions are fairly rare in Border Collies, especially ones under the age of two. EPI and Diabetes are both pancreatic and if untreated EPI can lead to Diabetes. However, the KCS was a totally unrelated issue.
Thursday, June 19, 2008
Another Re-Check
Today Catcher had a re-check for his eyes, which getting a bit better during this whole fiasco. He was up to getting the Tacrolimus 3x daily, BNP 2x daily, plus artificial tears and saline flushing as often as possible.
Weight: 39.2# (we've gained some, that's good)
Schirmer Tear Test: Left Eye: 18 Right eye: 15 (at least there is some tear production)
However, the stain did have some uptake. (Damn.) Another mild abrasion. Other than that he's doing well.
We rechecked his pre-anesthetic profile today as well. I don't have the results, but I think everything seemed fine.
Weight: 39.2# (we've gained some, that's good)
Schirmer Tear Test: Left Eye: 18 Right eye: 15 (at least there is some tear production)
However, the stain did have some uptake. (Damn.) Another mild abrasion. Other than that he's doing well.
We rechecked his pre-anesthetic profile today as well. I don't have the results, but I think everything seemed fine.
Thursday, June 12, 2008
Second Birthday
It's been one week since Catcher's diagnosis and today is his 2nd birthday. One week ago I didn't think that I would be able to celebrate today with him.
Tuesday, June 10, 2008
Blood Tests Offer a Diagnosis
Catcher returned to the vet today for a recheck of his glucose levels.
At 1:00pm BG: 139 (yay!)
Our plan: to recheck a preanesthetic profile on Thursday.
and here is where it begins to get interesting...
Results are in from the Tick Panel, TLI, and Immune panels...
Lyme - Positive 1:400*
Antinuclear Antibody (ANA): Positive 1:25
Rheumatoid factor: Negative
Ehrlichia Canis: Negative
Rocky Mountain Spotted Fever: Negative
Trypsin-Like Immunoreactivity: 2.1**
Coombs Test: Negative
Platelet Count: 238 (within normal limits of 164-510 thous/uL)
* Now remember that Catcher had an all around negative 4DX test in February. We decided to rerun a 3DX and see what it said. Negative all around. Hmmm. Notes from lab report: "A positive titer indicates exposure to the Borrelia Burgdorferi or similar antigen but does not confirm the presence of the disease. Titers may be affected by vaccination or disease." So we decided it was a false positive due to vaccine history.
** Reference range for TLI is 5-35ug/L. Catcher read 2.1. Anything <2.5 is consistent with Exocrine Pancreatic Insufficiency.
(There is also a note regarding the ANA about age or inflammatory disease but I can't decipher it)
At 1:00pm BG: 139 (yay!)
Our plan: to recheck a preanesthetic profile on Thursday.
and here is where it begins to get interesting...
Results are in from the Tick Panel, TLI, and Immune panels...
Lyme - Positive 1:400*
Antinuclear Antibody (ANA): Positive 1:25
Rheumatoid factor: Negative
Ehrlichia Canis: Negative
Rocky Mountain Spotted Fever: Negative
Trypsin-Like Immunoreactivity: 2.1**
Coombs Test: Negative
Platelet Count: 238 (within normal limits of 164-510 thous/uL)
* Now remember that Catcher had an all around negative 4DX test in February. We decided to rerun a 3DX and see what it said. Negative all around. Hmmm. Notes from lab report: "A positive titer indicates exposure to the Borrelia Burgdorferi or similar antigen but does not confirm the presence of the disease. Titers may be affected by vaccination or disease." So we decided it was a false positive due to vaccine history.
** Reference range for TLI is 5-35ug/L. Catcher read 2.1. Anything <2.5 is consistent with Exocrine Pancreatic Insufficiency.
(There is also a note regarding the ANA about age or inflammatory disease but I can't decipher it)
Friday, June 06, 2008
D-Day + 1
I brought Catcher back to the vets to be admitted for the day. He seemed much happier. The techs all praised how good he had been the day before. I warned them to watch out because he was feeling better and I could see him eyeing the quick pace of the techs as they rushed around the back rooms.
Observations from the chart:
owner gave insulin @ 11:30pm. Chem profile run @ 7:30am. Restarted fluids @ 84ml/hr. 2 cc Cerenia in fluid bubble. owner says he ate a 1/2 cup of food last night. Ate well for us. Restarted Lactated Ringers with Dextrose.
Blood Glucose @ 11:40: 364 (off glucose drip 30 min prior to BG) gave 6 units NPH
2:15 - Disconnect IV fluids. Remove IV catheter. BG: 393 @ 2:45
Write script for NPH insulin - 6 units twice daily
Re-check Mon or Tues ~6 hours post injection
We were sent home with a box of syringes, bottle of insulin, and the instructions to give him 6 units twice daily, making sure that he had eaten before giving it to him. We were to bring him back Mon or Tues to test his blood. We were still awaiting the results of the bloodwork sent to Idexx.
Observations from the chart:
owner gave insulin @ 11:30pm. Chem profile run @ 7:30am. Restarted fluids @ 84ml/hr. 2 cc Cerenia in fluid bubble. owner says he ate a 1/2 cup of food last night. Ate well for us. Restarted Lactated Ringers with Dextrose.
Blood Glucose @ 11:40: 364 (off glucose drip 30 min prior to BG) gave 6 units NPH
2:15 - Disconnect IV fluids. Remove IV catheter. BG: 393 @ 2:45
Write script for NPH insulin - 6 units twice daily
Re-check Mon or Tues ~6 hours post injection
We were sent home with a box of syringes, bottle of insulin, and the instructions to give him 6 units twice daily, making sure that he had eaten before giving it to him. We were to bring him back Mon or Tues to test his blood. We were still awaiting the results of the bloodwork sent to Idexx.
Thursday, June 05, 2008
D-Day
Today was one of the hardest days of my life. When I woke up this morning Catcher was extremely lethargic. He's not been eating well the past few days. Over the weekend I was at a seminar in Methuen and he began tanking water and urinating frequently. The poor guy had several accidents in his crate during the day and at night he would scream to wake me up and let him out. I feared I knew what was causing it, but clung to the hope that it was a displacement behavior due to stress. He got better Monday and had a good day. Tuesday he started seeming lethargic again. He has been unable to keep any food down for the last 2 days. Last night his temperature was 102.8. I called my vet first thing this morning. Of course they were closed for a staff meeting until 10:00 but I left a message saying it was urgent.
When they re-opened for appointments they called me back and we rushed him in. His temp was 102.0. We ran a urinalysis and blood work. While waiting for the results I took what I thought may be the last picture I would have of him.
Here are the notes from his chart:
Findings:
Weight: 37 pounds (he lost close to six pounds in 3 weeks)
weight loss, decreased appetite
started Tacrolimus yesterday, clinical signs of pu/pd (increased water consumption and urination) began prior
run full urinalysis, CBC, chem profile, radiograph thorax/abdomen (suspect blockage)
Urinalysis:
Glucose ++++ Ketones ++
Cloudy, dark
negative for: Leukocytes, nitrite, protein, blood
Normal for Urobilinogen
Specific Gravity 1.020 - 1.033 (two different numbers on two different spots)
Ketones 40
Glucose >2000
At this point I'm sitting on the floor with him in my lap wondering if we're going to survive the morning.
Radiographs: 2 views, lateral thorax and abdomen. Normal findings, no blockage (damn, that would have been the better hope)
They tested his blood glucose it was 448. His ALP - 339. ALT - 132. Na - 135. K - 5.2 (N)
We decided the best course of action (and really only course) was to admit Catcher for the day. They would give him an IV and start him on insulin. He was so sick he could barely move. I left him there and headed to work (as I wasn't being allowed to take the day off). I spent the rest of the day trying to hold back hysterical tears while awaiting news from Mom. I told her that I couldn't lose him one week before his 2nd birthday. That after the 12th I would make any decision needed, but he was having a 2nd birthday.
Treatments for the rest of the day:
IV catheter: 84 ml/hour
0.04 ml (4 u) reg insulin IM & 2 cc Cerenia SQ @ 1pm
Blood glucose @ 2:30: 422
Gave 2 units insulin @ 2:40pm
Notes/Suspected Diagnosis:
Treating for Diabetic Ketoacidosis (frightening words to me). Given recent diagnosis of KCS suspicious of underlying autoimmune disorder. Sent tick panel, TLI, and Immune Profile to Idexx. Currently treating with more aggressive protocol of hourly reg. Insulin IM injections and will switch to SQ reg insulin or Humilin N insulin accordingly. Tentative plan of stabilizing, sending home for the night, then arrange drop off again in AM to continue treatment.
Continued Treatments:
3pm: Brighter. BG @ 2:30: 422 - begin hourly 2 units reg. insulin IM
3:30 - 2 units
4:30 - 2 units
5:30 - Blood Glucose 188
Catcher was sent home with the instructions to give him some dinner at 10:30. I believe we were sent home with I/D but cannot be positive. Then to wait one hour to make sure he held it down and give him insulin at 11:30 pm. He did seem brighter when he got home that night. I kept him with me in the living room. I slept on the couch, and he slept next to me on the floor.
When they re-opened for appointments they called me back and we rushed him in. His temp was 102.0. We ran a urinalysis and blood work. While waiting for the results I took what I thought may be the last picture I would have of him.
Here are the notes from his chart:
Findings:
Weight: 37 pounds (he lost close to six pounds in 3 weeks)
weight loss, decreased appetite
started Tacrolimus yesterday, clinical signs of pu/pd (increased water consumption and urination) began prior
run full urinalysis, CBC, chem profile, radiograph thorax/abdomen (suspect blockage)
Urinalysis:
Glucose ++++ Ketones ++
Cloudy, dark
negative for: Leukocytes, nitrite, protein, blood
Normal for Urobilinogen
Specific Gravity 1.020 - 1.033 (two different numbers on two different spots)
Ketones 40
Glucose >2000
At this point I'm sitting on the floor with him in my lap wondering if we're going to survive the morning.
Radiographs: 2 views, lateral thorax and abdomen. Normal findings, no blockage (damn, that would have been the better hope)
They tested his blood glucose it was 448. His ALP - 339. ALT - 132. Na - 135. K - 5.2 (N)
We decided the best course of action (and really only course) was to admit Catcher for the day. They would give him an IV and start him on insulin. He was so sick he could barely move. I left him there and headed to work (as I wasn't being allowed to take the day off). I spent the rest of the day trying to hold back hysterical tears while awaiting news from Mom. I told her that I couldn't lose him one week before his 2nd birthday. That after the 12th I would make any decision needed, but he was having a 2nd birthday.
Treatments for the rest of the day:
IV catheter: 84 ml/hour
0.04 ml (4 u) reg insulin IM & 2 cc Cerenia SQ @ 1pm
Blood glucose @ 2:30: 422
Gave 2 units insulin @ 2:40pm
Notes/Suspected Diagnosis:
Treating for Diabetic Ketoacidosis (frightening words to me). Given recent diagnosis of KCS suspicious of underlying autoimmune disorder. Sent tick panel, TLI, and Immune Profile to Idexx. Currently treating with more aggressive protocol of hourly reg. Insulin IM injections and will switch to SQ reg insulin or Humilin N insulin accordingly. Tentative plan of stabilizing, sending home for the night, then arrange drop off again in AM to continue treatment.
Continued Treatments:
3pm: Brighter. BG @ 2:30: 422 - begin hourly 2 units reg. insulin IM
3:30 - 2 units
4:30 - 2 units
5:30 - Blood Glucose 188
Catcher was sent home with the instructions to give him some dinner at 10:30. I believe we were sent home with I/D but cannot be positive. Then to wait one hour to make sure he held it down and give him insulin at 11:30 pm. He did seem brighter when he got home that night. I kept him with me in the living room. I slept on the couch, and he slept next to me on the floor.
Thursday, May 29, 2008
Specialist
I could tell that Catcher was not feeling well. With the discharge from his eyes he was becoming more and more lethargic. He didn't want to play. He didn't really want to eat. I was extremely concerned at this point. One other observation was that I no longer needed a muzzle at the vet because he was too sick to be scared. He would just sit there and let them do anything to him.
I took him to see Dr. Marion at Essex County Vet Specialists. She was wonderful. Very pleasant to speak with, and handled Catcher great.
Her findings:
Absolute (that's a scary word in a diagnosis) KCS in both eyes.
Superficial corneal ulceration right eye, central location (told ya)
Medication directions:
Saline irrigation after outdoor activities and prior to applying any ointments
Tacrolimus ophthalmic ointment applied to both eyes three times daily long term
BNP ointment applied to both eyes three times daily until recheck
Recheck with either Dr. Marion or normal vet in 7-14 days.
Bilateral KCS is uncommon. She explained that it would take about 12 weeks to 6 months to see the tacrolimus helping. If this plan did not work the next option would be surgery.
I took him to see Dr. Marion at Essex County Vet Specialists. She was wonderful. Very pleasant to speak with, and handled Catcher great.
Her findings:
Absolute (that's a scary word in a diagnosis) KCS in both eyes.
Superficial corneal ulceration right eye, central location (told ya)
Medication directions:
Saline irrigation after outdoor activities and prior to applying any ointments
Tacrolimus ophthalmic ointment applied to both eyes three times daily long term
BNP ointment applied to both eyes three times daily until recheck
Recheck with either Dr. Marion or normal vet in 7-14 days.
Bilateral KCS is uncommon. She explained that it would take about 12 weeks to 6 months to see the tacrolimus helping. If this plan did not work the next option would be surgery.
Tuesday, May 27, 2008
Regression
I went away for 3 days as we were decreasing his optimmune to once a day. He regressed quite rapidly.
May 19 - noticed squinting again. He was rubbing his eyes after the BNP-Dex was administered. Increased optimmune to twice daily.
May 20 - discontinued BNP-Dex for one day, green mucous returned. Continued with BNP-Dex.
By the 21st of May I was discouraged and seeking a second opinion from a veterinary ophthalmologist. Despite increasing the optimmune his eyes were no longer responding to any treatment. I called my vet in the meantime and requested an ointment without steroids as I felt it was likely that he had formed another ulcer. We decided to wait out the weekend to see if the old protocol returned him to normal. It did not.
He spent the weekend squinting. I used the artificial tears as much as possible. He had lots of white mucous discharge. I kept him indoors as much as possible so he was not getting dirt in them. Switched to the BNP to avoid steroid use due to rubbing. I also started him on Benadryl 25 mg twice daily.
I made an appointment with a specialist for May 29.
May 19 - noticed squinting again. He was rubbing his eyes after the BNP-Dex was administered. Increased optimmune to twice daily.
May 20 - discontinued BNP-Dex for one day, green mucous returned. Continued with BNP-Dex.
By the 21st of May I was discouraged and seeking a second opinion from a veterinary ophthalmologist. Despite increasing the optimmune his eyes were no longer responding to any treatment. I called my vet in the meantime and requested an ointment without steroids as I felt it was likely that he had formed another ulcer. We decided to wait out the weekend to see if the old protocol returned him to normal. It did not.
He spent the weekend squinting. I used the artificial tears as much as possible. He had lots of white mucous discharge. I kept him indoors as much as possible so he was not getting dirt in them. Switched to the BNP to avoid steroid use due to rubbing. I also started him on Benadryl 25 mg twice daily.
I made an appointment with a specialist for May 29.
Thursday, May 01, 2008
16 days later
Follow up. Catcher's eyes were doing better. He had much less discharge, and it was no longer green. His eyes actually had some life back in them. He was getting perkier.
Findings:
weight 42.8# (this will come into play a bit later)
Schirmer tear test: 22 in both eyes! Significant improvement
Treatment plan:
continue plan for 2 weeks. then decrease optimmune to once a day for 2 weeks, if still okay. then discontinue optimmune unless regresses. changed from Dexospore ointment to drops three times daily.
Findings:
weight 42.8# (this will come into play a bit later)
Schirmer tear test: 22 in both eyes! Significant improvement
Treatment plan:
continue plan for 2 weeks. then decrease optimmune to once a day for 2 weeks, if still okay. then discontinue optimmune unless regresses. changed from Dexospore ointment to drops three times daily.
Thursday, April 17, 2008
First re-check
Catcher's eyes had not improved in the two days since the first visit. Both eyes were completely covered with film. He could barely open them.
Finding this exam:
weight: 42.2 pounds
Schirmer Tear Test - no tear production in either eye
Flourescein Stain - stained only eye with worst abrasion, mild uptake
Diagnosis:
Sudden onset Bilateral Keratoconjunctivitis Sicca (KCS). Possible triggers: no recent vaccines, bloodwork within normal limits 2 months prior, thyroid panel within normal limits 8 months prior, possibly an unidentified autoimmune disorder?
Treatment:
Optimmune ointment bilaterally twice daily
Dexospore ointment bilaterally three times daily
recommend tear replacement
Re-check in 2 weeks
Finding this exam:
weight: 42.2 pounds
Schirmer Tear Test - no tear production in either eye
Flourescein Stain - stained only eye with worst abrasion, mild uptake
Diagnosis:
Sudden onset Bilateral Keratoconjunctivitis Sicca (KCS). Possible triggers: no recent vaccines, bloodwork within normal limits 2 months prior, thyroid panel within normal limits 8 months prior, possibly an unidentified autoimmune disorder?
Treatment:
Optimmune ointment bilaterally twice daily
Dexospore ointment bilaterally three times daily
recommend tear replacement
Re-check in 2 weeks
Tuesday, April 15, 2008
Things Begin to Change
Catcher started showing some mucousy discharge in both of his eyes a few days ago. It progressed to the point that he had a film of mucous covering each eye. I began treating it with BNP however when it wasn't getting better I decided to take him to the vet. I figured it needed steroids, however since he had been rubbing his eyes I was almost certain he had ulcerated to a degree.
Initial physical exam findings:
greenish discharge, bilateral conjunctivitis, corneal edema left side, increased ocular discharge, suspect allergies, fluorescein stain showed + Left side - Right side. Mild stain uptake on left eye, very superficial, suspect steroid would still be responsive.
Treatment:
Dexospore bilateral three times daily. optional benadryl 25-50mg twice daily
Re check in 2 days
Initial physical exam findings:
greenish discharge, bilateral conjunctivitis, corneal edema left side, increased ocular discharge, suspect allergies, fluorescein stain showed + Left side - Right side. Mild stain uptake on left eye, very superficial, suspect steroid would still be responsive.
Treatment:
Dexospore bilateral three times daily. optional benadryl 25-50mg twice daily
Re check in 2 days
Friday, February 29, 2008
Snip-Snip
I brought Catcher to the vets today for his surgery. I must commend my vet office for being so caring and professional. I had taken the time prior to the appointment to address my concerns given Catcher's temperament. I was not sure how he would act with complete strangers, especially when put in a kennel with other dogs, and being under the influence of anesthesia. I had explained that I was not only concerned about making it pleasant for him, but I did not want to put any of them in harm's way. I asked that I be able to stay with him while they sedated him and that no one touch him or try to take him outside once he was awake.
They honored my request and even let me stay until the catheter was in place and he was asleep. Then they performed his surgery first and called me as soon as he was able to stand. I brought in a urine sample as well as had them run another chem profile. Below are the results and details from the surgery:
Weight: 43.2 pounds
Urinalysis:
All normal/negative
pH 6.0
SG 1.040
Chem Profile:
All within normal limits
Sedation:
Superbag 1.9cc SQ
Ket/Val (1.0 cc each)
Catcher was groggy but happy to be home. He came through surgery well and is on Rimadyl for a few days.
They honored my request and even let me stay until the catheter was in place and he was asleep. Then they performed his surgery first and called me as soon as he was able to stand. I brought in a urine sample as well as had them run another chem profile. Below are the results and details from the surgery:
Weight: 43.2 pounds
Urinalysis:
All normal/negative
pH 6.0
SG 1.040
Chem Profile:
All within normal limits
Sedation:
Superbag 1.9cc SQ
Ket/Val (1.0 cc each)
Catcher was groggy but happy to be home. He came through surgery well and is on Rimadyl for a few days.
Saturday, February 09, 2008
Pre-Surg Work-up
Catcher had his pre-surg exam today. Everything was within normal limits. We ran a Heartworm/Lyme/Ehrlichia/Anaplasmosis test, all came back Negative. I also had them draw blood for a CBC and Chem Profile.
Blood work results:
Everything was within normal limits except the following:
MCHC High - 38.1 (30.0-37.5)
CRE High - 1.5 (0.3-1.4)
GLOB Low - 2.2 (2.3-5.2)
Will run urinalysis and chem profile before surgery day of. Neuter is scheduled for 2/29/08.
Blood work results:
Everything was within normal limits except the following:
MCHC High - 38.1 (30.0-37.5)
CRE High - 1.5 (0.3-1.4)
GLOB Low - 2.2 (2.3-5.2)
Will run urinalysis and chem profile before surgery day of. Neuter is scheduled for 2/29/08.
Friday, February 01, 2008
Decisions to be Made
I have not taken the decision to neuter Catcher lightly. However, due to his temperament and the increasing issues he is having getting along with his brothers I feel it is necessary and the correct choice. He will never, and should never, be bred. While I feel it is important to keep dogs in tact for growth and development purposes he is now 18 months old and I think it is the appropriate time for him to have the surgery. He is scheduled for pre-op bloodwork and physical exam on February 9.
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