Have I finally found my friends? (Palmer has crossed over the Bridge)

Good Morning.

Palmer had another round of diarrhea around 2AM....outside :D

After that we were able to give him about an ounce or so, if that, of sandwich turkey. He turned up his nose at bread.

This AM he got up and had a good amount of water. I just tried to get him to go for a walk and he is not interested.

Sent my fax off to the vet and have not heard back yet.........she'd just be getting in about now. I know she will call when she can.

He has become more needing of closeness.... of which I am happy to oblige :)

More news as it becomes available.

Thanks to all of you for being so supportive.

-Susan

Just curious as to what those 'outstanding' ACTH results were? Sounds like it's been 3 or so weeks since the test was done. Do you have the specific results or can you get them and post???? Because I know from experience with Zoe, that one time her numbers fell dramatically - to .7 and 1.6 when she'd always been difficult to get below 5. Don't know to this day why it happened. But it's possible so I wouldn't rule out an unexpected drop in the last couple weeks. Sue

PS - then again, if it is something like that, by stopping the trilo, you might see improvement. Electrolyte testing could shed some light.

Hi Gang-

Saw the vet late afternoon. She okays the stopping the Trilostane.
We are running three different "tests."
Fecal test which will include parasite testing and Giardia test.
Complete blood panel.
B12/Folate test

I am also going to make an appointment to see the internist for a consult and for abdominal ultrasound. If the aforementioned tests give us an answer, I can cancel the Ultrasound.

Palmer had his last bout of diarrhea at 2AM. His total intake today has included some water and two 1" length pieces of a Snausage.
He is more sedate today.

I asked the vet if at some point we would administer nutrition and she says if he doesn't get better, we can do that.

Palmer will go in early tomorrow AM to have his blood drawn and so the vet can get another "look" at him. The fecal results should be back tomorrow.

The vet is perplexed, so far, as to what is causing all this. We did have a lawn treatment one week ago, today. Palmer often chews on grass. I don't know if that occurred before we could get the stuff watered in. The vet said one week later is entirely possible to be continuing to have a reaction to that, if he did it.

Okay - here are the test results from 7/8/10.
(You will find a number of earlier results posted earlier.)
Pre ACTH 3.7 Range 2-6
Post ACTH 4.8 Range 60-018.
We had high results in the following;
Alk./phosphatase 567 Range 10-150
GGT 18 0 - 14
Bun 57 7 - 27
B/c ratio 35.6 no range shown
Anion gap 25 12 - 24
Neutrophil Seg 82 60 - 77%
Auto Platelet 799 164 - 510 Thous/ul
Absolute neutrophil Seg 13694 3000 - 11500/ul
WBC 16.7 5.7 - 16.3 Thous/ul
He was low in the following;
MCHC 31.8 32 - 36 g/ul
Lymphocytes 8 12 - 30%

If it comes down to needing a liver biopsy, we are not going to put Palmer through that. That was raised when we first tested w/UTK and at that time we agreed we would not put him through that.

So that's today's events. He is sluggish and not drinking much water-but drinking some. We have tried a gazillion different foods and he has interest, but then turns away. He's crashing on his bean bag bed now and we'll go cuddle up in our bed soon.

As always-thanks for the support and the suggestions.

Susan & Palmer

Susan, I don't know if you know what Palmer's normal water intake is per day but I would measure out water and start tracking it. While food is important - water is critical. Annie went as low as 1/4 cup one day.

You have probably tried all foods known to man but just to be safe... when their tummies are upset they always say to try the simplest easiest things to digest. Homemade chicken broth, white rice, chicken breast are my standbys. There were days when broth was all I could get her to take.

Heating food makes it more attractive. Try giving him things that are easy to digest to see if that helps. I assume you tried canned food - have you tried totally new food groups like venison, buffalo etc? You can find them at most pet stores. Usually combined with sweet potato. I also cooked sweet potatos. Annie did eat those. Boil eggs and give only the white part - it is a protein source.

Try sneaking some pedialyte into his water for extra nourishment. Babyfood (chicken, sweet potatos)

I didn't realise you had just done a blood panel. There are enough things elevated in the last one to perhaps point to something. Maybe Deb has some thoughts.

Was Palmer eating when that panel was done? Annies lymphocytes were off as well due to her bacteria infection.

Other than diarrhea - do you hear his stomach growling/gurgling? Can you feel it churning? I know this is tough because I just went thru it and you feel so helpless. I send my very very best wishes your way. Kim

Susan, the couple of things I see are the elevate WBC, & absolute neutrophil count. The elevations are not extreme, but they are an indication that there is probably an infection somewhere. That BUN is pretty high, but was Palmer's creatinine normal. Dehydration will elevate a BUN, but as long as the creatinine is normal, this may not be a kidney issue. I don't have time tonight to recheck the past couple of days posts, but were the result of the stim you posted at the beginning of the month before or after Palmer got sick? If they were before, I think it's imperative that you run a stim ASAP. Even though trilo should clear the system in about 12 hours, if Palmer's adrenal glands have suffered any damage, this may be the actual problem. What has the vet said about trying some prednisone to see if it might help?

Debbie

PS- Concerning the pred, it won't hurt Palmer. The several times that Harley has had a severe round of vomiting for unknown reasons, my vet has always wanted me to try the pred, first. When he showed no improvement with the pred, we started looking at something else besides Cush related problems. Actually, I just went back & checked those results, the BUN /creatinine ratio appears to elevated. The normal range that I found looking around is 4-27. Granted it's not elevated a lot, but it's enough that I think it might be worthwhile to ask the vet about the possibility of early renal failure. I don't think renal failure is the core problem, I think there is something else going on that is increasing the stress on the kidneys.

Well-I may have at least a little bit of good news. First-the fecal reports came back and were negative for parasites and Giardia.
Today's events are-Palmer was shaking this morning. :( That's not like him. I covered him up and cuddled him. He went to the vet and when he returned, we watched tv together on the bed. Palmer was not eating and not drinking. Mid afternoon he took a good bit of water. I tried everything I could think of, once again, and he turned his head away at all of it. Kim-thank you for mentioning the chicken. It's been discussed before and I tried it last week and had no luck. With him not drinking and not eating and this being day #9, I was very concerned. In addition, the vet's office is closed Saturday and Sunday. The vet saw Palmer this morning, and took the blood sample, and (I could not go) did not tell my husband anything new or different. I was figuring we'd need to get nutrition in him by other means before the end of tomorrow.

I was getting back to being really upset and had to go out for an hour. On my way back, thanks to the reminder about the chicken, I stopped and picked up a cooked chicken breast. (And it was $2 off because it was cooked @11:30 and the meat guy wanted it to go!)(This was 3pm.) (It had been kept very warm.) I came back home and let Palmer sniff the grocery bag. It looked like he had interest. I started slicing and chopping away and put down about 1/4+ cup. HE ATE IT!!!!!!!! :D:D:D:D He did not finish the bowl, but went back several minutes later and then did finish it off. I cut up some more, another 1/4 cup, and he ate that as well. The only "bad" thing about it is about 3/4 hour later he was heaving, but what came out was like a few spit balls. The chicken stayed down. I didn't want to give him any more than what I had because he hasn't eaten for so long and I didn't want the stomach reacting to too much food. We got him right outside and he just kind of sat around staring off into space. When he came back in he went and retrieved this huge squeaky, fluffy duck he has. It's as big as he is! That is his Linus blanket. Whenever he gets uneasy, he heads for the duck. He plays with it at other times. (As a matter of fact, he "uses" it to stimulate himself. He doesn't always achieve his goal, but he still keeps trying.);)

A little later I took him outside while I watered some plants. He went to the end of the driveway and I told him to stay out of the street. (We live on a cul de sac. I mostly didn't want him going over to a neighbor who doesn't like Palmer. ) So he sat at the end of the driveway.....just as if we had an invisible fence! We went around back to water a couple more plants and he saw a gal friend of his. He went over to greet her, as she was heading toward him and they visited. Buffy, the friend of his, is about five years younger. They have always gotten along and even played and romped, but his age is beginning to show. He doesn't romp much anymore. So we hung around as the dogs visited and I visited with the owner. We came back inside and watched tv together. So far (this is 11pm) everything is staying down. His water intake seems to have gone back to normal. He was looking, kind of, for more food, but I wanted to "reenter" eating at a slow pace.

He looks brighter. He's hangin' with me now. So hopefully we have turned a corner. He is scheduled for an ultra sound next Wednesday, but if he continues to improve, I am going to cancel that. I still look forward to the remaining test results and will post them when I get them. I should have at least one tomorrow, if not both. The vet says she'll call us Saturday if they come in that day. Our son is going to come visit for the weekend and that should be very positive for Palmer (and for my son.)

So-all in all, it turned out to be a positive day. :D:D Nothing has come out the back door since the diarrhea almost 48 hours ago. There can't be much left to come out........before the chicken. We will hope for a good night's rest and an even better day tomorrow.

I'll check back in tomorrow and let you know if this continues.

Susan

Wonderful news Susan!! Maybe you could try some mushy cooked rice, mixed with cooked chicken and I cook some sweet potato and green beans and add that too. I have never seen a dog turn away from my homemade dog food and its easy on their stomach.

I was thinking about you tonight when I went through Casey not wanting to eat today. Its very scary so it must have been extremely hard watching that for 8 days.

Love and hugs,

Glad to help! I would keep anything else you want to add to the mix separate vs adding them into the chicken because that way if he doesn't eat the new items you don't have to throw away the whole batch. Plus you can test one item at a time - like we do with drugs. Do it slowly so you can tell what is working and what is not.

I could not figure out annie's pattern until after the dx I realised that she could only eat foods that were soft and didn't hurt that nasty throat and her ulcers!

Annie had the shivering! Full body shivering. She had it for quite a while and it came and went. I am convinced that is pain. (or was in Annie's case)

Have you noticed any tummy growling or gurgling? Gotta be if you had diarrhea right?

Anyway.... glad to hear some great news. Keep it up Palmer!

So you stopped the trilostane a couple days ago and things began to improve, right? Like Debbie, I'm suspicious that maybe his cortisol did take an unexpected nosedive for whatever reason. Palmer's numbers on July 8 were good, but could have fallen in the two weeks after that. Did the vet suggest how long to withhold the trilo? Sue

Hi-
The trilostane is being discontinued for "a few days."

Today is not so good. The vet called and said his Kidney enzymes are elevated and she thinks he is dehydrated again. She wants him to receive fluids intravenously for 48 - 72 hours....and of course, we're coming up quickly to another weekend and those nasty "emergency" rates. Her office can do it, but there is not 24 hour monitoring there. They will be closed as of 5PM tonight. She would have someone come on in and check Palmer...maybe it would be her. The Emergency ER will have 24 hour monitoring over the weekend, but neither Palmer nor we have ever been there. Then the vet suggested we take him to Annapolis where he is scheduled for the ultrasound on Wednesday. If he went in today, we'd get the ultrasound done on Monday but by a different DR. We are trying to get an idea of the cost for any of these. So far I know the Ultra sound, consult and weekend emergency rates will be a minimum of $786. That doesn't include any fluids nor the boarding rate. The Annapolis place won't give me any idea-they say the vet will have to call. So we are now waiting for the vet to call us back so I can tell her that. Then we'll be waiting for the vet to call back with the #. Bob wonders if we can wait to take him until Monday. Then he'd be there already for the consult on Wednesday. I asked her what would happen if we just did not do this and she says she cannot answer that-since we don't really know what the problem is.

Today-he is back to not eating. He seems ok, but he has seemed ok pretty much all along. He never has looked seriously ill. So now the discussion revolves around how much are we willing to spend to continue on this path. If he is having renal failure or if they find a tumor with the ultrasound, we would not be pursuing further action. We are not going to subject Palmer to surgery. So we could go through a lot of expense (they're talking over $2000) just to find out we can't do anything.

That's where it sits. This just is not a pretty picture. I am also wondering if we should just get back to treating the Cushing's and not pursue this....but then we still have the issue of him not eating. I'm not willing to watch him starve himself to death.

I don't know....I just don't know. I can't promise real regular updates, but I will try my best to get in here at least once every 24 hours. Please pray for Palmer.

-S