Printable View
Leslie -
So glad to hear Squirt is doing well. Such an adjustment in the pack I'm sure without dear Ruby, but Squirt's vibrance, spirit, and spunk endures - what a wonderful thing for all of you. Continued good wishes to all! :)
Tammy, Crash, & Darby
...an extra "woof woof" to Squirt from Crash & Darby!
Hi ya'll,
Well, it's been a while and it's time to share some things with ya'll.
Squirt continues to do well with her Cushing's...she hasn't been tested recently but still has no signs and the blood work she has had done supports that as well.
But she is facing another issue...her knees. Actually it is her right knee. We went to see her old vet yesterday who thinks it is the "tendon" they put in originally that has stretched and needs tightening. Since we are looking for a new Gp vet anyway, I went ahead and made her 2 more appts. to get a second/third opinion. (Some of you may recall my strong reluctance to having this surgery inflicted on any other pet again.) They didn't take any pics and sent us home with Tramadol and Rimadyl, to return in a week if not improved. :( They did do a mini-panel to check her liver and kidney values before giving her the Rimadyl and I was very pleased with the results. Will post them tomorrow. The only thing that caught my attention was a slight elevation in total protein.
Today the vet we saw seconded my fears, via radiographs...a pin has worked its way up out of the bone and is sticking up about 3/16". He is waiting for her records from TN to arrive and then he will contact the same surgeon that I wanted to do Crys' surgery...he is the only board-certified surgeon in ARK. Dr. Nelson, the GP today, has worked with Dr. Dew (the surgeon) and feels that Squirt is a prime candidate for stem cell therapy. The pin would be removed and then the therapy would begin as soon as the correct cells are growing and can be injected. I am not at all familiar with stem cell therapies but if this can help her and be less invasive than redoing the knee, it is certainly worth talking about.
For tonite, Squirt remained at the vets. She was sedated for the radiographs and once they saw the pin realized the amount of pain she must be in, plus they want to keep her as quiet and still as possible. Every time she moves, that pin is moving as well and causing more damage.
I had put her on conservative management the last few days trying to limit her movements and had debated giving that measure a few more days before taking her in. I am so glad I didn't. What this will mean for her in the coming days, I'm not sure. I hate the thought of the pain she much be experiencing and hate the thought of her going under the knife again...for any reason. But she has given no indication that she is tired of this old world and until she does, I will do everything I can to help her have the best life possible.
Tonite will be a long, lonely one...she is supposed to be here but I have to believe she is at less risk of injury where she is. (Otherwise, I would be banging on someones door yelling, "GIVE ME MY BABY!!!") I will keep you informed of her situation as I can.
Say a prayer for my Sweet Bebe...
Hugs,
Leslie and Squirt
Leslie,
We do what we have to to help our babies. I have you and Squirt in my thoughts and prayers. Stay strong.
Jenny
Dear Leslie,
Keeping you and your bebe in my thoughts and prayers. I'm sure she would rather be home with you too. Give her a hug from us when you see her tomorrow.
Dear sweet Leslie,
You and Squirt are definitely in my thoughts and prayers. I know that when Corky started having problems with one of his hind legs that has a pin in it, his vet and surgeon thought they would have to remove the pin as it kept popping out. I'm hoping and praying that Squirt will improve without having to have this done.
Bless your heart, we're here for you, as you've always been for us.
Luv ya bunches,
Dear Leslie,
I am so sorry to hear about Squirt's knee problem, but very reliefed she is in capable hands. I know, it's tremendously hard to give them into the care of someone else cause noone does a better job then we do, right? :) I'll be anxiously awaiting the news of how they will proceed with Squirt's knee...
Keeping you and Squirt close,
Saskia and Yunah :)
Hi Leslie,
Thinking of you and Squirt and hoping she's home again soon.
Linda and Spicey
Hi Leslie,
Keeping you and Squirt in my thoughts and prayers. Give precious Squirt some hugs and kisses from Harley and me when you see her. Please let us know anything as soon as you can.
Love and (((hugs)))
Lori
Leslie, Will pray for you and Squirt. Do keep us updated. Sounds like Squirt is in great hands. Keep the faith. Kim
Hi Leslie,
We are all hoping and praying things turn out well for Squirt.
Hugs,
Addy and Zoe
Leslie, I'm sure it was a very LONG night for you without Squirty...:(
But it sounds as though she's right where she needs to be, and we'll be waiting right here to find out what the gameplan is gonna be.
Big healing hugs being beamed to your baby girl,
Marianne
Hi Leslie... know just how you feel at moment , will be thinking of you ...fingers crossed for good outcome .
Catherine..
Mornin',
Just got back from taking Squirt her breakfast and visiting with her and Dr. Nelson. She is READY to come home! :p
I saw the X-rays and the pin has moved 3/16" and about 1/2 that has come thru. That portion is bent...which means it has been going on for a while. :( She has whimpered from time to time recently when walking but there has always been an immediate cause...bee sting, ant hill, thorns, crossed nails...so once that was attended to, my mind stopped looking for a further cause. :mad::(:mad:
We have an appt. in Russellville, AR with Dr. Dew Wed. morning for the consultation. Squirt will prepare for surgery "as if"...no food after midnight Tues. Dr. Dew and I will discuss the options and go from there Wed. morning.
Squirt is still at the vets for a bit longer today; they will do the CBC and some additional pre-surgery work-ups. Her records are being faxed from TN to Dr. Dew hopefully today. Until, we see him Wed. she will remain under conservative management to try to protect that leg as much as possible.
I have to say that everything else on the radiographs looked really good for a pup her age. There is some minor arthritic change in the hips but nothing major. The knees, of course, have some changes as well but not near what Dr. Nelson expected. Everything else visible was unremarkable! He was impressed...I hope the blood work impresses him just as much! ;)
Thanks to you all for you support. Don't know what we would do without ya'll!
Hugs,
Leslie and Squirt
Leslie -- so glad to read that Squirt will be back home with you soon. Even if our pups are feeling well, I am convinced they do better at home in familiar surrounding with their people. Will be sending lots of prayers your way as next Wednesday approaches!
Leslie, you know you and Squirt are in my prayers.
{[BIG HUGS!!}} Love too!
Shelba and Suni
Hi Leslie,
I'm keeping you in my thoughts and prayers. Corky and I are keeping everything crossed that everything goes well.
Leslie -
What a ride you've had the last couple of days. Poor Squirt. I bet she is more than ready to be home as much as you are ready to have her home. We're thinking and praying for you all here. Hugs!!
Tammy, Crash, & Darby
Hi Leslie,
I'm glad there is a game plan for Squirt and that she will be home with you soon. Hope you have a quiet weekend and will be waiting to hear next week how it all goes for the both of you,
HUGS and prayers for a smooth and successful surgery and recovery...take care,
Jo-Ann & my Dollydog angel & Victoria :)
Tons of prayers and positive thoughts being sent your way.
Love and hugs,
Lori
Hi Leslie,
Sending out healing thoughts and prayers for you and Squirt.
You are always close to my heart.
Luv & Hugs
~Mary Ann
Thinking of you and Squirt!!! Kim and Annie
Hi Leslie,
Sending good thoughts for you and Squirt!!:):)
Tight hugs for you and your little squirt.
Luv ya bunches. Xo Jeanette
Licks, Princess
Well, my elation over the first lab report was short-lived...it was what they called a "mini in-house panel" and it's results were vastly different from those Dr. Nelson got when he ran a CBC.
Here are the results (all) from the first panel:
July 7, 4:40pm
ALKP 184 U/L 23-212
AKT 101 U/L 10-100
BUN 19 mg/dL 7-27
CREA 1.1 mg/dL 0.5-1.8
GLU 112 mg/dL 70-143
TP 8.5 g/dL 5.2-8.2
These are the results on the same values from the second panel:
July 9, 9:59am
ALKP *** 339 U/L 20-150
ALT*** 140 U/L 10-118
BUN 14 MG/DL 7-25
CREA 0.8 MG/DL 0.3-1.4
GLU 97 MG/DL 60-110
TP 7.8 G/DL 5.4-8.2
Not sure what would cause such a difference in less than 48 hrs, but there it is. Based on the second panel, her liver values have risen from her last CBC, not returned to normal as I had thought based on the first panel. geez.....
There are other values that are out of whack but these are the ones that I can compare across the two panels so I posted them first. I will try to get the rest soon. Her calcium is quite high, as are retics (?), grans (?), and neut (?).
They also ran a "Buffy Coat Profile" (?); that profile along with the hematology results concluded "Borderline Thrombocytosis"...:eek::eek::eek: BLOOD CLOTS!!!! :eek::eek::eek:
I am running out of time at the moment so will briefly say that Dr. Nelson sees Cushing's indications where I haven't...(so perhaps I am more than the Queen of Guilt...perhaps I have become the Monarch of Dumbassity as well)...will discuss these with you later!
Hugs,
Leslie and Squirt
I'm thinking the rise in her ALP and ALT was stress...don't know if the Rimadyl would of raised the liver enzymes, but I am sure stress would have...Squirt missed her mommy and with them poking and prodding her for the Xrays, well, up goes the stress hormone...cortisol!!
This article is pretty informative about ALP and it says:http://www.vetconnect.com.au/5min/data/01880189.htmQuote:
ALP is found in many tissues, including the liver, bone, intestine, placenta, and kidneys.
The serum activity of ALP is much lower in cats than in dogs. The half-life is much shorter in cats (6 hours in cats versus 3 days in dogs),
So, I'm thinking in another 3-4 days her liver enzymes will fall back to the normal ranges.
Love and hugs,
Lori
Thanks, Lori. Dr. Nelson has me really concerned about the Cushing's now...I have felt really good about it as I have seen no changes in signs or behavior. Well, her behavior has changed since April, but our whole lives have been in chaos since then so changes were not unexpected nor in my mind unexplained. The mention of thrombocytosis scared the crap outta me, tho. :eek::(
For today, she is still on restricted movement, being carried everywhere, which she sees as no more than her due as Queen of Dogdom. :D;) Dr. Nelson also wants her to have 15-20cc of Pedialyte 4X a day until we see Dr. Dew. She was a bit dehydrated plus he said the Pedialyte will help flush the liver and kidneys. She must recognize her need for it because she drinks her water with it in it with no problems. But I can see where that will get old for her and I will need to encourage her to drink it after a day or so. :p
I am doing my best to take it one minute at a time and try to focus on the leg right now. Once that is over, we can start addressing these other problems...if they still present as they are now.
So far, I still like Dr. Nelson and he seems to have a fair grasp on Cushing's, including Atypical, tho he isn't very supportive of my Holistic views. :rolleyes::p One of the things we will "talk about later"! ;) He is in for a surprise with the diet he was talking about tho... LOL
Hugs,
Leslie and Squirt
OH! about the Rimadyl...I didn't give it to her...just couldn't do it even in light of the first liver values. When Dr. Nelson asked what meds she had already been given and I told him I hadn't started the Rimadyl, and had no plans to, his response was, "Oh, good! I was going to tell you to throw those away. Your baby does not need NSAIDS." :D
Ok...here are all the results from Dr. Nelson yesterday; CBC and Hematology results....
Vetscan VS2
Comprehensive Diagnostic
ALB 4.4 2.5-4.4 G/DL
ALP 339 20-150 U/L
ALT 140 10-118 U/L
AMY 917 200-1200 U/L
TBIL 0.3 0.1-0.6 MG/DL
BUN 14 7-25 MG/Dl
CA 12.3 8.6-11.8 MG/DL
PHOS 3.8 2.9-6.6 MG/DL
CRE 0.8 0.3-1.4 MG/DL
GLU 97 60-110 MG/DL
NA+ 148 138-160 MMOL/L
K+ 4.6 3.7-5.8 MMOL/L
TP 7.8 5.4-8.2 G/DL
GLOB 3.4 2.3-5.2 G/DL
QC “OK”
HEM 0 LIP 1+ ICT 0
Hematology Results
HCT = 45.8% 37.0-55.0
HGB = 14.1 g/dl 12.0-18.0
MCHC = 30.8 g/dl 30.0-36.9
WBC = 14.2 x10(9)/L 6.0-16.9
GRANS = 11.6 x10(9)/L 3.3-12.0
%GRANS = 82%
NEUT – 10.7 x10(9)/L 2.8-10.5
EOS – 0.9 x10(9)/L 0.5-1.5
L/M = 2.6 x10(9)/L 1.1-6.3
%L/M = 18%
PLT = 745 x10(9)/L 175-500
Retics – 0.3%
GENERAL HEMATOLOGIC REMINDERS:
Borderline Thrombocytosis
I typed these up just as they appeared so there is no uniformity between the two...sorry. Any help in interpretation will be most appreciated!
Hugs,
Leslie and Squirt
Hi Leslie
With an IMHA pup I should be able to interpret your results but I will leave these up to Debbie as she is way more qualified than me!!!
What I will say ... is that we placed Flynn on low dose aspirin to pre-empt the possibility of blood clots as this appears to the number one reason why IMHA dogs do not survive. Flynn (who is now about 22- 23kg) takes 1/8 low dose asprin tablet (tablet is 75mg). There are other medical products that can be taken to thin the blood as well which may be more suitable for Squirt's weight (I would not want to try and cut a tablet smaller than an eigth as the tablets we use are so small!).
All the best
Angela and Flynn
Thrombocytosis (or thrombocythemia) is the presence of high platelet counts in the blood. Platelets are cells that form clots and are needed to prevent excessive bleeding.
http://www.broadwayvh.com/site/view/...scriptions.pmlQuote:
The platelet count is quite elevated. Platelets are cells in the blood which are responsible for forming blood clots. Non-pathological reasons for the platelets to be elevated include recent excitement or exercise causing splenic contraction, severe dehydration, or it being secondary to a pet having no spleen or during late pregnancy.
Dr. Nelson is aware that Squirt does not have a spleen, right?
Thanks for the link, Lori. I have been reading up on that and stem cell therapy the last few days. Dr. Nelson does know that she only has part of a spleen (they didn't take all of it with that tumor) but I got the impression he feels it is more connected to the Cushing's than anything else right now. But, like you, I feel recent stress has played a part in things, too.
Keep the info coming!
Hugs and love back attcha!
Hi Leslie,
I'm not quite clear on the sequence of events recently, but did Squirt have an anesthetic (for X-ray) between 7 and 9 July? If so then I'd think that the elevations in liver numbers could well have something to do with that.
My apologies in advance if I've got this totally wrong!
Alison
Hi Alison,
It wasn't anesthesia, they sedated her because she wouldn't be still. And yes, that would have been on the 8th, the day between the two panels.
She saw her old vet, who did the first mini in-house panel with the good #s on the 7th. I took her for a second opinion on the 8th and that is when they sedated her and took X-rays. They kept her that night and did the second panel, full CBC and hematology, the following day, the 9th. Would sedation and anesthesia have the same effect on the liver values? Seems logical they are related chemically....
Does that help clear things up?
Hugs,
Leslie and Squirt
Hi Leslie,
I am so sorry, my feeble mind thought that sweet Squirt had no spleen. And I should have known better in that you would have brought that up to her Dr. that she does in fact have part of her spleen, ain't? Dumb me. :( I am keeping you and Squirt in my thoughts and prayers, at least my feeble mind can do that! ;):)
With much love and big hugs,
Lori
What was used for the sedation?
Alison
I have looked at the papers I got and it doesn't say anything about it at all.... I will have to ask them Mon. what they used to sedate her. But I do know that is why Dr. Nelson recommended leaving her overnight...she was still groggy from sedation and they wanted her to remain still overnight. I hope you are on to something here...:cool:
Ok...well there has been confusion on someones part...maybe mine :p
According to the file, Dr. Nelson didn't sedate her for the xray after all...but that leaves me wondering why he said to let her stay since she was "groggy"....:confused: So, I guess that is not a factor in the liver values...darn! Just knew you had something there, Alison!
The worry over the surgery has taken full focus today; reservations are made for tomorrow thru Fri if needed, her records have arrived at Dr. Dew's office, now to get the truck ready and her things gathered up.
Squirt has been on a mini-food strike the last day & 1/2...but I believe it is because I hid the Tramadol in her food and it is REALLY bitter tasting. No meds added this morning and she ate fine...after nosing around in it and taking "sample bites" :rolleyes: Getting pills in her is becoming more and more difficult but part of that, I think, is because she doesn't have competition any more. All the girls would gather round for "pill time" tho not all got pills. The pups here will eat your hand off giving treats so she doesn't have that competitive thing going on now that helped her just gulp it down. ;) Tried every trick I know of and she still fights so we are gonna have to look into some other measures, I guess. She is still taking the Pedialyte fine. Not very happy about having to stay in a crate but loves being carried everywhere. :D
So, we are off to Russellville tomorrow and will see Dr. Dew Wed. morning. Hope to be able to keep in contact while away but if not, I will update as soon as I can.
Please keep her and Dr. Dew in your prayers and thoughts.
Hugs,
Leslie and Squirt
PS. Some links I have found on thrombocytosis:
https://www.vetconnect.com.au/5min/data/02800282.htm
http://veterinarynews.dvm360.com/dvm...e/detail/19204
Good luck and best wishes my friend! Lots of fingers and paws crossed hoping everything turns out okay for you and little Squirt.
Love and many hugs,
Keeping all of you in my thoughts and prayers and wishing you and Squirt the best of luck.
Love and hugs,
Lori
Leslie -
Best of luck to you and Squirt on this latest journey of yours. You're in our thoughts and prayers. All fingers and paws crossed here for you! :)
Tammy, Crash, & Darby