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I'm sorry your pooch is not feeling well. An echocardiogram (ultradound) will show if there is flid around the heart which is CHF.
I hope this is not the case. Having a sick dog is heartbreaking. We are going through issues with our beagle as well and have not been told everything by our vet.
Keep us updated as to your girl's health. They stopped Vetoryl on our dog as well.
Sharlene, could you weigh in here? I am supposed to take her for an ultrasound tomorrow and I don't want to have them perform another test if it is not one that is needed or will tell me what is wrong....I think I may not give her the Vetoryl tomorrow.
If the blood work from 12/5 showed that she might have been in congestive heart failure or kidney failure, then shouldn't that have been addressed before the Vetoryl???
Or is what might be going on now, Congestive Heart Failure of Kidney Failure.
I am very confused and upset right now. I have my grandsons here and I am ready to lose it!
These are both better than I thought they would be so that's good news. My layperson's opinion of what the lab abnormalities look like are just that, a layperson's opinion based on my own experience with both kidney disease and congestive heart failure. As I mentioned, your vet would be the appropriate person to discuss these abnormalities with you. I will say this, however, if this blood chemistry is what your vet used to pursue a cushing's diagnosis, I personally would be concerned because this is not what we are accustomed to seeing on blood chemistry. I think having an ultrasound at this point is a very good idea.Quote:
Originally Posted by Joan2517
Glynda
Hi Joan, I'm not Sharlene, but it sounds to me as though the ultrasound has been ordered to check to see whether or not the "crackling" is related to fluid overload in the lungs or around the heart. Ultrasounds can be focused on different areas of the body, but an ultrasound of the area around the heart can be used to check for fluid that is associated with congestive heart failure.
It is a good thing that Lena's creatinine and urine specific gravity are both within normal range. So it appears as though Lena's BUN is the only abnormal renal marker in the bloodwork, and that elevation was perhaps caused by something as simple as dehydration.
I did notice that her urine was cloudy and had both blood and protein in it back in December. This would be consistent with a urinary tract infection. I can't remember whether this was noted at the time and whether or not she received any treatment for a UTI?
At the moment, I don't think there is any cause to skip Lena's trilostane unless the vet has told you to do so. It sounds like a good plan to go forward tomorrow with the ultrasound, however, and let's see whether it reveals anything of interest.
Marianne
They did an ultrasound on 12/7 and found an adrenal tumor, which was where the final diagnosis came from. The 12/5 blood work was looking for diabetes, but after it came back they suspected Cushing's.Quote:
Originally Posted by lulusmom
They never said she had a UTI and was never treated for any...this was all back in December...could she have had one all this time?Quote:
Originally Posted by labblab
She hasn't had any bloodwork, except for the ACTH tests, since December 5.Quote:
Originally Posted by Joan2517
This is the result I'm looking at. If I'm correctly seeing cloudy urine with a protein level of 3+ and a Red Blood Count of 4-10, then yup, this could definitely signal a bad UTI that may still be persisting. Without doubt, I would bring this to the vet's attention tomorrow and ask, "What's up with this???"Quote:
Test Requested Results Ref Range
Urinalysis
Appearance cloudy *clear
Protein 3+ Neg
RBC 4 – 10 (HIGH) 0 - 3
Maybe that's why she hasn't felt so good all along? Her tummy has been hot all along, would that be from a UTI? Would the antibiotics she's been taking for the possible abscess clear a UTI up as well? Maybe I should bring a sample with me tomorrow and have them test it...her first urine of the morning is usually 5:00 or 5:30. Does it have to be the first?
What if it is congestive heart failure, Marianne? I feel so sick now, like I should've know this, and what if I put my faith in a vet who hasn't done what he should have for Lena? I will never forgive myself if this is the case....
Duh! Yes, I'd forgotten she's on antibiotics right now. They might indeed clear a lingering UTI, as well. It would just depend on whether the UTI bug is sensitive to that particular drug. How long will she be taking this course of med? You may want to hold off on the urine sample until she finishes the antibiotic, in hopes that her urine will be cleared up at the end of the course. But I would still point out that urinalysis result tomorrow so as to have a gameplan in place.
Also, try not to panic about the possible CHF. It may be newly developing since the "crackling" wasn't heard before, and therefore nobody's fault that anything has been overlooked. Plus, depending on the severity of the condition if it even exists, it may be managed satisfactorily with medication. You've got to keep in mind that Lena is 15, and body parts just wear out over time. We are very lucky that we live in a time when veterinary medicine has advanced so far and even parallels human medicine in many ways. Let's just see what the ultrasound shows us and then go from there.
Marianne
Okay, thanks Marianne. I'll try to calm down.....Quote:
Originally Posted by labblab
Sorry I wasn't a round much the last couple days and all this went down for Lena. Goodness.
Okay you said they did an in house test in Nov and the glucose was a bit high right (i see that) I see that did a Fructosamine test in December and it was also high.
I do think I'd have the glucose rechecked. It might explain some of the abnormalities in the blood work like the electrolytes being off.
The main thing right now is to get rid of the fluid build up. That can build up rather quickly. Hopefully the antitibiotics and lasix shot will help with that.
Baby steps and one thing at a time here okay. :)
Thanks, Sharlene...the in-house was just to make sure they could put her out for the dental work on Nov. 16 and the December one was when I first noticed how much she was drinking and we were thinking diabetes. That's the one that came back so bad that my vet was shocked and wanted the ultrasound done the next day where they were looking at the adrenal glands...and the rest is history.
We are having the ultrasound done tomorrow afternoon. I thought they could also check the adrenal tumor, but that is considered another scan and will cost more, so that will have to wait, especially since the ACTH test will need to be done at the end of this week because we are at the 30 day mark on 30mg.
I am trying to stay calm but I am ready to jump out of my skin!
Wait. What ultrasound are they doing tomorrow that they can't check the adrenal tumor?
I just don't ant you to waste money if it isn't going to tell you anything. I have N vet heard of a different scan needed to be done to check an adrenal tumor compared to any other ultrasound. Do they mean a high definiti N? In which case I don't know the value of doing a low res ultrasound. Wouldn't it be better to have one high res that can check everything than two separate? Less something else is meant. Do they mean a MRI or ct to look at the adrenal glands?
I'm not sure how we got from thinking diabetes to checking the adrenal glands.
If the glucose is high and signifies diabetes that still has to be treated regardless of if there is or isn't a problem with adrenal glands. Did they in fact rule out diabetes?
Just want to make sue we have all the facts straight especially in light of this new dvelopment with the fluid.
Sharlene, Joan can correct me if I'm wrong, but as Sophie's mom has said, it sounds as though they are planning to do an echocardiogram tomorrow, which is an ultrasound of the heart. They are wanting to evaluate the possibility of congestive heart failure. So the adrenals will not be part of this chest imaging -- another abdominal ultrasound will probably be done later on.
Agh okay that make snse to me know Marrianne! Thanks. An EKG is dfinitely a priority. I've been getting internal organ ultrasounds too long obviously. Didn't even make the connection. D'oh
You are right, Marianne, they are just checking the heart. And the initial blood work on 12/5 was because of the excessive drinking which he said could be diabetes. If it wasn't, we were going to do other testing. But the test came back so bad that I think he knew then that it would be Cushing's, which is why we went for the ultrasound and found the tumor then the 8 hour test to make sure it was adrenal and not pituitary. There was no more talk of diabetes after that. And besides the ACTH testing, there has been no other blood tests done.
Should there be? They didn't even check her mouth after her dental work until I asked them to on Jan. 30 because I was worried about the fact that Cushing's dogs don't heal as fast.
I have used them for about 15 years, but I am not sure all of them are as knowledgeable about this as I need them to be. They keep telling me that she looks great for her age and I don't think they are taking my concerns seriously.
But they have been very good with other issues with the other cats and dogs....so I am conflicted.
I guess I will see what happens tomorrow...I'm so tired of being so worried and second guessing myself and them. I just want to make sure that Lena is getting the best care.
Thanks for all of your responses/suggestions/help. I don't know what I would do without you.
Joan, when they draw blood for the ACTH this week, I would ask them to also run a basic blood chemistry panel so as to monitor Lena's glucose, liver and kidney markers, and potassium/sodium balance. It will be interesting to see whether Lena's glucose has dropped back into normal range now that her cortisol is under better control. Although even as I write that, I realize this cannot be a fasted test since she needs to take her trilostane along with her breakfast. So her glucose may still hang a little bit higher on the testing. But you also want to keep an eye on the kidney, liver, and potassium/sodium level for a dog taking trilostane. So I think it would be good to have a chemistry panel run this week.
Marianne
Okay,Marianne....that's what I will do. Hopefully nothing terrible shows up on the test today.Quote:
Originally Posted by labblab
Joan. How did the test today go? What did it show?
Okay, they did an echo cardiogram and it didn't show CHF, but apparently she has a murmur and the walls of the heart are a little thick? When the head vet came out to tell me, I asked about the crackle because that is why I thought I was there, and he said that he was told that there was a murmur...I told him I was very confused. The cute one never said murmur, he said crackle and admitted to reading the wrong chart (our chihuahua has a heart murmur). So he did xrays for free to check on that (it was the least he could do after all the $ I have spent there in the last few months, not to mention years with all the pets that we have!). They heard a little something so they changed the antibiotic she was on to Clavamox.
He also said we should keep an eye on her blood pressure, at which point I reminded him that we just did on January 30. He looked at her eye and said it looked fine.
I questioned the urinalysis on Dec. 10 and he said the blood was probably from the way they got the urine.
So, all in all, if I can believe they know what they are doing, she is doing well.
After we got back, I made a fire and put the big dog bed on the floor in front of it (Lee was sleeping on another one next to me, the poor little girl was so pooped!). I laid down on the dog bed and woke up to her licking my face and rolling on her side like she used to for kisses and belly farts. I think if I didn't have to work and could stay home with her, she would feel much better.
I asked for and got a copy of the echo. Tomorrow I am going to try to scan it to a JPEG and upload it. It may or may not work...if not what do you want me to post?
I felt good asking pertinent questions today and I think my vet was a little surprised!
LOL!
Oh this Is good news! Did he say anything specifically about the fluid. What might have cause it and if that is now decreasing? Just curious since she is feeling so much better of that isn't getting better too.
So I think that just the ACTH and a blood draw to check the other values and see if they are more in line now that she is being treated with trilostane. Don't freak though if liver values remain high. They don't always go down. Some do some don't so no panic. I don't think that I would get a follow up internal ultrasound yet then. Just me personally. I tend to do those every 6 months or sometimes only once a year unless something comes up. I do it to keep an eye on the nodule in Mollys adrenal that it hasn't enlarged and to check liver kidneys etc. So depending on how Lena is doing and if you feel and the vets feel she needs one. You can make that decision.
It is good to feel that your vets have a ha ladle in what is going in with her and on track to take care of her. Less worrying for you.
That is so cute her wanting belly farts. I do that to Molly too. Lol
Over all good report! Thanks for letting us know.
Thanks, Sharlene...he never really said much about the fluid, just put her on the Clavamox to stop whatever might be there or beginning. I don't care as long as she starts feeling better.Quote:
Originally Posted by molly muffin
It was so weird to wake up to her doing all that last night. At first I thought I was dreaming. She's loved the belly farts since she was a baby! The more she does what she used to do, the more I realize how much I missed it...but again, as in the symptoms, it was gradual. I just hope she doesn't get upset now because my 3-day weekend is over and I have to go back to work.
We got up at our usual time 5:15ish, quick potty break, then on the couch to go back to sleep for an hour...but I just lay there enjoying having her sleeping next to me. I'll be a zombie all day at work, but who cares!
I just put Lena's echocardiogram report in her album (my scanner at work can make a JPEG!). It's hard to read, I don't know what the abbreviations/terms are, but it looks like everything the vet said.
Hopefully she is sleeping soundly waiting for me to come home....I hate having to work for a living!
Gads, I don't know if I could read that just looking at the paper itself. Scribbly LOL. It sort of looks like a recheck isn't needed for 9 months? if so then it doesn't seem like anything dire or worrisome was seen.
It is very good to see them doing the things they always loved to do all over again.
That's the part I could read too! lol.
Finally finished reading your whole thread. Lol So happy Lena is doing so well! The eye thing rang a bell so I wanted to out my 2 cents in. (Finally feel like I can give back!) Right before the Cushings diagnosis, the same thing happened to Maggie. Her eye actually looked like it was popping out. For a Boston, that's pretty bad! Turned out she had an infection in her tooth and the swelling was pulling the skin down. A round of antibiotics cleared it up. So there wasnt anything ever wrong with the eye. Hopefully, it was something like that. :)
That's what the vet thought when she saw her Thursday (even though she wouldn't have noticed it if I hadn't said it was larger...I know my girl)....she is on antibiotics and it does look better. She did have 8 teeth pulled just a couple of weeks before the Cushing's diagnosis, so an infection wouldn't be a surprise.
I was home for the holiday weekend and I think she really missed me because she must've gotten up looking for me a lot of times...could tell from all the pee on the wee wee pads. She usually sleeps all day when I'm at work and probably forgot the routine. Problem is my Puggle marks wherever someone else pees, so came home to a huge mess! And my big guy Gable gets so upset whenever the Puggle pees (because he would NEVER do anything like that) that when I let them out he won't come back in until I beg him to.
I really need to win the lotto so I can stay home!
Lena was in respiratory distress tonight and I had to rush her to the Emergency Room. They think she has a thrombosis clot...I think that's what they said. Her heart is enlarged and something is going on in her lungs. She is in an oxygen tank and they are keeping her. They did blood work, xrays and have her hooked up to an IV. She was so upset when I kissed her goodbye. She has never stayed overnight in a hospital in the 14 1/2 years we've had her. My heart is breaking and I can't stand the thought that she is there.
I was just getting ready to go the the ER when I finally got my vet on the phone, he told me to keep her calm and watch her. I did that for about 1 minute and then took off. It's a good thing I didn't listen to him. I am so afraid she is going to die all alone in the hospital.
Oh Joan, sending prayers your way for Lena to pull through this hurdle. I'm so sorry for what Lena and you are going through tonight.
Be strong for Lena as she needs you when she wakes up tomorrow. Many hugs. Song
I am so sorry Joan. :o Lena is right where she needs to be right now. Yes, it is very hard to leave them. :o
Sending healing thoughts and prayers your way.
Paws up Lena! We are pulling for you!
Hugs,
Kathy
Oh my gosh Joan. How absolutely terrifying for you and Lena. Do let us know how she is doing. You will both be in my thoughts and prayers.
Oh, I am here too!! Hoping so much for some good news this morning!
Thank you all...she made it through the night. They said she slept, but they might just be saying that. She was barking to go out, so they took her out of the oxygen tank to pee and seemed okay, but started panting again. That could be her nerves....the doctors do rounds around 9 and then they will call our vet for the results of the tests the other day, they've given her Lasix. She must be terrified and wondering why I'm not there.
I can hardly see, my eyes are swollen shut and I can't stop crying....
Whew! Our girl made it through the night OK!!!
Will they let you visit with Lena today, or do they think that will get her too agitated? Either way, can you maybe drop off a shirt or a towel or something that carries your scent on it? That might be comforting to Lena -- something familiar to her that links her to her mom.
Marianne
I'm so glad she made it through the night! Come on Lena sweetie. You can beat this. Sending you big hugs Joan. something with scent on it is a good idea. Good thought Marrianne!
They told me to come around noon, by then they will have gotten her imaging from our vet and be able to go over everything with me. I'm so afraid...if I had listened to my vet she would probably have died...not that I had any intention of listening to him. I was already almost out the door when he called back. And if she had been in his hospital, there's no one there to check on them at night.
One of the vets in this Emergency Hospital specializes in Cushing's. I think I picked up her card, but they are just ER doctors and I'm not sure if they do regular office visits. But I think my days with my vet might be over. I'm not sure he has been concerned enough...but I could just be too upset right now to think clearly.
I did manage to get the Credit Care or whatever it is called. I was approved for $3400, which will probably be used up just for this. The bill as of last night was $2100 or something like that and that was just 75% of the high estimate.
I don't know how I am going to be able to go to work and leave her when she gets home.
My prayers and positive thoughts are with you... Lena is so lucky to have you...!!! I am sure she will recover quickly and be back home soon.
God, I hope so...just thinking about how she kept reaching for me and putting her face up to the plastic to kiss me last night is killing me. If she didn't have to be in the oxygen tank, I would stay and hold her, but it will only upset her if she sees me and can't get to me...and that goes both ways....and then she'll see that I'm crying and it will only make it worse...I can't stop crying.
My prayers and healing thoughts are going out to you and Lena! Since you have some time before you go to meet with the doctors, try to write down your questions for them. My Abbie is in the hospital now and I just finished my list for her doctor. Take care!