Jasper (12 yr old Mini Schnauzer) is now at peace

Hi Everyone,
Well I have been trying to get an update together about all that is going on with Jasper, and things keep happening that I have to add. :(

So the report from last weekend when Jasper was hospitalized I feel shows that he had a bit of an Addison's crisis again. I don't have any of the lab reports yet, but from what I wrote in my notes, here is what my vet said verbally:

• The CBC was WNL but showed that he was a little dehydrated
• The chemistry panel showed that the kidney values were ok. But I wrote that she said the BUN was 30, and when I look at the normal range from one of my other reports, it lists the normal range as 10-28 mg/dL so that would be a little high according to that. Also, on his last chem panel, the BUN was 8, so that is quite an increase. Maybe that is due to dehydration? I will have to ask her about that. She did say the creatinine was WNL. So, I will be anxious to get the actual lab report to see what's what. It was run on the in house lab, so maybe the reference ranges are different than what I have here at home.
• Sodium was low at 123, this was confirmed by a secondary test that showed it as 120 (138-154 mmol/L) :eek:
• Potassium high normal at 5.2
• ALP higher than 2400 (the machine in the office only goes up to 2400) - this is significantly higher than on the last check where it was 1719 (<95 IU/L)
• ALT high at 1280. This was 66 on the last check which was normal (<100). I think one time in the past this has shown a mild elevation, but it has been WNL for the most part.

He was given subq fluids, injectable anti nausea medication, injectable dexamethasone, antibiotic injection. He also got an injection of Percorten to help stabilize the electrolytes. (I am forcing myself to not think about how many jabs that is, in addition to the blood draws :eek: ). I know it was all more than necessary so I just have to put it out of my mind.

So other than the Addison's getting out of control again, my vet's main concern seemed to be the big elevation in the ALT. She said this is usually due to an acute insult to the liver. We talked about this, and I know Jasper could not have gotten in to anything toxic, I am with him all the time when he is outside, I monitor everything. Other than when I am at work, he is not out of my sight. While I am working he is barricaded in the kitchen, and there is nothing in there for him to get into. She is feeling that the increased ALT is most likely caused by an inflamed pancreas. There can be other causes such as bacterial hepatitis or a tumor, both of which she feels are less likely. She did say she is not sure what is causing what. That makes me a little nervous. She mentioned that we may need to get an ultrasound of the liver if the values don't go back down quickly with treatment. I am thinking positive that the treatment will be effective.

So here is the treatment and plan:

• Cerenia 24 mg once daily x 3 days (finished 9/10)
• Amoxicillin 250 mg twice a day x 10 days
• Zeniquin 25 mg 1 1/2 tabs once daily x 10 days (my vet said the Amoxicillin and Zeniquin are the combination of choice for liver inflammation/infections)
• Dexamethasone 0.5 mg 1/4 tab daily (usually he gets this every other day so this is a temporary boost)
• Start Denamarin 225/24mg one tab daily x 30 days
• Resume Enalapril 5 mg 1/2 tab twice a day
• Resume Welactin 1/2 spoonful with food twice a day
• Percorten injection (not sure what the dose will be now, but I imagine he will be back on this every 26 days)
• Feed hamburger/rice mixture and transition back to Royal Canin Renal MP diet as tolerated
• Recheck liver profile in 7-10 days (appt on 9/16)
• Consult again with our IMS in town, including discussing possible prolonged action of Percorten since Jasper's electrolytes have stayed WNL for an extended period of time after we discontinued the monthly injections.

Current report:

He had been doing pretty well since being hospitalized. He was eating, keeping meds down, finally had a small formed poop after 3 days with no poop :eek: (Guess he was pretty cleaned out from all the vomiting and diarrhea). I had been slowly advancing his food to get him back on his prescription renal kibble. I had it down to mixing in only 1/4 cup of the hamburger/rice mixture, and then Friday morning 9/13 he acted like he didn't want to eat. I managed to get him to eat most of it so I could get his meds down him, but it was a struggle.

Well Friday night, he wouldn't eat any kibble at all, even out of my hand or with rice mixed in. So I put him back on full hamburger and rice. I have to get him to eat something so he can take his meds. I don't want him to miss a dose of either of the antibiotics. So that is what he has been getting all weekend. I have been sneaking in about 1/4 cup of his kibble, which he manages to eat around and leaves about half the kibble in the bowl. Sometimes he will go back and finish it later. So he is not keen on getting back on his food. I will talk to my vet about that tomorrow. I am not sure that he will ever want to eat it again. It seems like it doesn't appeal to him anymore. I don't understand that because he was eating it just fine before.

I will ask my vet about trying the canned version. He has to be on a kidney diet, so there aren't a lot of options. So frustrating! But I am thankful that he will eat the rice and hamburger, at least he will eat that. He still seems a bit mopey and low energy, and is very short tempered with his sister. Hopefully that will all continue to improve. I keep wondering if his poor appetite and low energy are related to his liver issues now. So hard to know for sure.

So that is where we are at. We will see the vet tomorrow after work. I have to get my list of questions/concerns together, and also need to remember to get copies of all the most recent labwork. The bill from everything last weekend is still pending. :eek: I have dusted off my Care Credit card so it will be ready for tomorrow. :rolleyes:

Thank you everyone for the ongoing support and good wishes. It took me a while to get all of a this information together, thanks for checking back on my boy. It sure helps to get all of it in a post so now it will be easy to reference for the future. As always, any feedback or suggestions are most welcome. Thanks for reading, I know this is so long. :o

Love and hugs,
Tina and Jasper xo 💜

So, a couple of concerns, the ALT/ALKP and BUN. You might have to recheck that a couple times as it always seems to take longer for liver issues to come down than it takes for them to go. But if they are making a move in the right direction on 09/16, then it is possible that it might have been an bit of an Addison crisis, but possibly brought on by a pancrease bout.

Jasper might associate his kibble with his feeling so sick. Baby steps on that one and maybe a bit of the canned till you can get him back on the kibble. Do you have can kidney diet at home? If not maybe pick up one can or two, and trying blending that in with the hamburger/rice.

You know we say it all the time, but really does feel better to Have a plan. :)

hugs,
Sharlene and Molly Muffin

Hi Tina,
Sounds like Jasper is getting back on track. Is he still saying no to his kibble? I hope he's been feeling better each day and getting his schnauzer spunk back. :)

Barbara

Hi Tina,

You might try soaking the kibble before adding it to the hamburger mix so he can't pick it out, plus help get him used to the taste again. He may simply not want that taste compared to that good burger. ;) If he sticks with the hamburger and rice, you may want to add either a good canine vitamin/mineral or something like NutriCal so he is getting more of a balanced diet.

Let us know what the vet had to say and if the plan has changed....and certainly how our sweet boy is doing.

Hugs,
Leslie and the gang

Hi Everyone,
I just wanted to check in real quick. I have had a tough week with Jasper. Lots of trouble getting him to eat, and labwork from Monday 9/16 was not as good as we had hoped. The ALT had shown some improvement, but was still way elevated. His electrolytes were still way out of whack. Sodium was still critically low and now the potassium was elevated. :eek: :( I will post values later. I ran him in on Tues 9/17 for another Percorten injection. He is still very subdued and mopey but I was able to get him to eat some of his kibble last night and this morning. He is just not bouncing back very quickly. Hoping we are turning the corner now. Thanks for checking in on us, I will post more tonight.

Love and hugs,
Tina and Jasper xo

Tina, Still following your story and sending out strength, love and prayers friend. Kim

Tina,
sorry ya'll have had a rough week. Keep us posted on Jasper. I hope he continues to gain his strength & you have a good weekend.

You so did not need another rough week. I hope Jasper starts to feel better soon and those electrolytes can be stabilized real soon too. I think if those get better, then other things will start to fall into place too. He's just going to be feeling really yuck with those out of sync. :(

Here's hoping for a really, really good weekend!

hugs,
Sharlene and Molly Muffin

i have found putting kibble in blender, it will turn to near powder, consistency of sugar. mix that in with the hamburger and rice. No way it can be picked out. and if you add water to the ground kibble its like canned food. Excellent hydration too.

Sending love to you both, and hoping Jasper feels better real soon.