Second opinion and dog meds

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red_slr

Original Poster:

18,034 posts

195 months

Saturday 21st October 2017
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I have a pretty good understanding of dogs, owning 3 bla bla.

Its a bit of a long story but here it is:

My 12 y/o 10kg dog saw the vet on Weds lunch time. He had wet his bed a couple of times the week before and was generally acting a bit down in the dumps. They did a urine test and for some reason I did not get a call back with the results so took him in weds for another check up and to see if the had the results. They did, he has an infection. Its not the first time, had 3 or 4 UTIs over the last few years. They put him on ABs and said take 10 days. We have done this before no issue. He had been pretty quiet all day so was happy with that. Gave 1 AB with his other meds he is on ( listed below)

Then he was taken ill that night, came on quite quickly. 7pm, started breathing short sharp breaths. 40bpm.

Called the vet he said bring him in, checked him over observed him for a bit and basically said "don't know". Gave him an injection to sedate him a little and sent us home.

He did not sleep that night and the next morning drove up to the vets and vet said he had a back injury and fluid on his lungs. Gave him pain tablets plus diarhetic (SIC!) injection. Also said he has colic and stop ABs and sent us home. This seemed strange to us because he is with us 24/7 and we have not seen him fall or anything, yes he is old so anyway carried on with that.

So Friday the vet asked to see him again and said he seemed better (he is a little) and said continue meds for now but re-start ABs on Sunday. Also asked us to up his other meds. He is a bit better but it takes him a good half an hour to settle, he gets the shakes a lot. He is sleeping a lot but shaking in his sleep.

So he currently on (daily)

Gabapentin 4 daily (was on 2 daily for back issues, vet upped to 4 for neck injury)
Tramadol 4 daily (new for neck)
Previcox 1 daily (been on this for a while for back issues)
Vetroyl 1 daily (been on this for a while - cushings)

As of sunday he will be on ABs too.

That's a lot of meds for a) me to try and get down him and b) to be sloshing around in a little 10kg dog.

Anyone got any thoughts? I have spoken to 2 vets (same practice) and one says neck injury the other says urine infection. So he is being treated for both IYSWIM.

His temp is normal though.

Once he has the tramadol he does tend to settle for a couple of hours. He has always been happy and quite mobile but now he is refusing to do pretty much anything. I wondered if it was a heart attack or something but vet says it sounds normal. Kidneys and liver are normal. Also the really weird thing was no number 2s for 3 days. He is normally like clockwork twice a day, 730am and 5pm.

Part of me wonders if its a reaction to all the meds?

He is still breathing a bit fast, IMHO, around 25bpm at rest but well over 40 when moving around. Our other dog of same age, same breed is around 12bpm at rest and only speeds up if she is really running around.

Sorry, just a bit of a rant!!

garythesign

2,237 posts

94 months

Saturday 21st October 2017
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Cannot offer a second opinion but hope it works out OK

Good luck

bexVN

14,682 posts

217 months

Saturday 21st October 2017
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Time for a referral if you can. Has he ever had an mri because I suspect he should. Personally that is what I would want to do if he were mine.

red_slr

Original Poster:

18,034 posts

195 months

Saturday 21st October 2017
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What you thinking brain issue or just whole body to see whats going on everywhere?

Don't suppose you know a rough cost of that?

Both vets are under are very well regarded and I trust both but the main issue is distance, they are about an hour drive away so the 3 visits this week have basically written off 3 days of the week. IYSWIM. So its difficult to just call in and see them. Plus they work week on week off type situation so that's why we are under the 2.

The vet who diagnosed the spinal issue is an expert in the field and sits on panels etc so pretty sure he is right on that front. That's what the gaba is for and previcox. He also spotted the cushings and vet 2 worked on that for us over a period of about 12 months. Took him for 800 ish to 100 ish.

This new issue is a bit of a mystery and vet 2 just found the neck injury but I really am not sure myself he is shaking on and off and sometimes his legs are splaying at the front which I have never seen before.

His breathing does seem a bit better this afternoon much fuller and nice and slow on the exhale.

He seems to have more control. He has also been up the stairs a couple of times where yesterday he was just sitting at the bottom.

We work from home (well Mrs mostly) but I was working from home on Weds when this started and he was not out of my sight from very early doors to when he started to come down with the problem around 7pm so we just don't know how he injured himself, if it is an injury..

He is slept in a crate overnight so no chance of a problem there.

He is due to restart the ABs tomorrow then another urine sample mid week to see where its at.

red_slr

Original Poster:

18,034 posts

195 months

Saturday 21st October 2017
quotequote all
garythesign said:
Cannot offer a second opinion but hope it works out OK

Good luck
Cheers!

bexVN

14,682 posts

217 months

Saturday 21st October 2017
quotequote all
red_slr said:
What you thinking brain issue or just whole body to see whats going on everywhere?

Don't suppose you know a rough cost of that?

Both vets are under are very well regarded and I trust both but the main issue is distance, they are about an hour drive away so the 3 visits this week have basically written off 3 days of the week. IYSWIM. So its difficult to just call in and see them. Plus they work week on week off type situation so that's why we are under the 2.

The vet who diagnosed the spinal issue is an expert in the field and sits on panels etc so pretty sure he is right on that front. That's what the gaba is for and previcox. He also spotted the cushings and vet 2 worked on that for us over a period of about 12 months. Took him for 800 ish to 100 ish.

This new issue is a bit of a mystery and vet 2 just found the neck injury but I really am not sure myself he is shaking on and off and sometimes his legs are splaying at the front which I have never seen before.

His breathing does seem a bit better this afternoon much fuller and nice and slow on the exhale.

He seems to have more control. He has also been up the stairs a couple of times where yesterday he was just sitting at the bottom.

We work from home (well Mrs mostly) but I was working from home on Weds when this started and he was not out of my sight from very early doors to when he started to come down with the problem around 7pm so we just don't know how he injured himself, if it is an injury..

He is slept in a crate overnight so no chance of a problem there.

He is due to restart the ABs tomorrow then another urine sample mid week to see where its at.
Hi, sorry been at work all day.

I just feel then when neurological issues are flaring and you have several concerns and already on a concoction of meds an MRI can be a very useful tool to use. I was thinking more because of the neck issue in case it is a disc issue or a trapped nerve rather than brain but they should be able to include both (they did for our Whippet)

My suggestion is no criticism of your vets at all, it was just my feeling as I was reading your post as it just seemed an obvious next step.

When Jimmy had his done a few years ago it cost £1700 for full head and body scan. I was glad he was insured but tbh I was so desperate to get a treatable diagnosis I would have put it on my CC!

It is good to hear he has some signs of improvement.

red_slr

Original Poster:

18,034 posts

195 months

Sunday 22nd October 2017
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Thanks. He seems to be improving again slightly today, although only ate half his breakfast but he was up a bit early, 530am , but that's probably because he has been sleeping a lot and not really active last few days. He is a very sensitive creature and anything slightly wrong and he gets upset. The other 2 don't bat an eye at anything but if something goes wrong out of his routine he is not happy.

Blowing a good un outside due to the storm so I think that's not helping today.

Thanks for the info on the MRI. I had a look around and there is a company local to me who just do MRI / CT scans for animals. Will drop them a line.

I think if he improves / recovers there will be no need but if he does not improve over the next week or so as a min its going to have to be x-rays. I am just unsure on this neck pain, if he had been really active our off playing out of our sight then perhaps but the few days leading upto this issue he was only ever out of our sight to go toilet or asleep in his crate.

If he had fallen down the stairs or something then yes but we have the stairs gated off so they can only go up or down when supervised. We have always had it that way as with 3 dogs it would just be chaos if they could free roam the house plus we are on 3 floors.

Start the ABs again tonight so lets see what happens! I am an expert in collecting urine samples now, even have my own little system, the man at the post office has stopped asking me whats in the package now... biggrin

red_slr

Original Poster:

18,034 posts

195 months

Thursday 26th October 2017
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Been back to the vets today. He is going from normal self to panting and now started to cough. Has no energy other than brief spells when he will get up and have a trot around the house but been sleeping a lot.

Vet has diagnosed heat failure.

Its been a long day for him and he is struggling tonight (breathing really bad and cough bad) so hoping he will settle down. Starts heart meds tomorrow.

moorx

3,777 posts

120 months

Thursday 26th October 2017
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I hope the meds help to make him more comfortable.

bexVN

14,682 posts

217 months

Friday 27th October 2017
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I hope they can help him feel better, it becomes very hard when they seem to develop several debilitating condtions

red_slr

Original Poster:

18,034 posts

195 months

Friday 27th October 2017
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Oh don't I know it. We have 3 dogs and all getting on in years now, oldest is 13. They all have something wrong with them. My kitchen is like a pharmacy.

Been up with him all night, really struggling with his breathing and coughing. Just get him settled and something will set him off be on and off like that now for 12 hours. He is just finally settling and slept the last hour or so. Still 50-60bpm. Was 100 last night at its worst. Settled to 40 occasionally.

Vet not in till this afternoon now so just trying to keep him settled.

Hopefully the Cardialis will start to bring it under control.

Thevet

1,798 posts

239 months

Friday 27th October 2017
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Ask for referral to a cardiac specialist, they have a much bigger arsenal of tricks for managing heart failure. Sorry can't offer more.

red_slr

Original Poster:

18,034 posts

195 months

Tuesday 31st October 2017
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Quick update.
Breathing rate back down to 20 ish now. Much better on his food too.
Had a couple of tweaks to his meds but holding station for 2 weeks now to see how he does.

Autopilot

1,308 posts

190 months

Thursday 2nd November 2017
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When you say kidneys and liver are normal, was this conclusion down to the urine test or were bloods taken?

red_slr

Original Poster:

18,034 posts

195 months

Thursday 2nd November 2017
quotequote all
Autopilot said:
When you say kidneys and liver are normal, was this conclusion down to the urine test or were bloods taken?
Both, twice. He has bloods done regularly because of his cushings they do a blood test out of routine now at the same time. He looks like a pin cushion after! We post off urine every few weeks so they can monitor him for UTIs.

However, on the second blood test they did last week they did mention his liver was looking a bit iffy but probably down to fluid etc but they will monitor.

Without jinxing it now he is much better the last couple of days. His gait is much better you can see a lot of the fluid from the abdo area has gone.
We are being realistic with his age etc but hopefully the medication is doing its thing.

Whats annoyed us a little is we mentioned his pot belly at the start of the year and the vet said it was just a thinning of his abdo wall due to the cushings. We suspect his heart has been an issue for a while.

Last 4 days his breathing has been <22 / min.

red_slr

Original Poster:

18,034 posts

195 months

Thursday 2nd November 2017
quotequote all

Autopilot

1,308 posts

190 months

Thursday 2nd November 2017
quotequote all
red_slr said:
Both, twice. He has bloods done regularly because of his cushings they do a blood test out of routine now at the same time. He looks like a pin cushion after! We post off urine every few weeks so they can monitor him for UTIs.

However, on the second blood test they did last week they did mention his liver was looking a bit iffy but probably down to fluid etc but they will monitor.

Without jinxing it now he is much better the last couple of days. His gait is much better you can see a lot of the fluid from the abdo area has gone.
We are being realistic with his age etc but hopefully the medication is doing its thing.

Whats annoyed us a little is we mentioned his pot belly at the start of the year and the vet said it was just a thinning of his abdo wall due to the cushings. We suspect his heart has been an issue for a while.

Last 4 days his breathing has been <22 / min.
Aww, poor dog! Still, I'm pleased that he's perked up over the last few days and hope he stays that way!

The reason I asked about the bloods was because we lost one of our dogs last year due to a renal issue which first became apparent when she kept wetting her bed. Urine tests weren't normal as such but were within tolerance. We kept insisting on a blood test but the vet wouldn't do it so asked to see a different vet and he agreed immediately (he knew the dog quite well and absolutely adored her as she was such a lovely gentle creature). Liver enzyme levels were in the 1000's (normal is up to 70 if I remember rightly) and bilirubin was in the red level too!

Her abdomen was quite swollen too and she looked very 'blocky'. She was a big girl (Cropped and Docked Dobermann from working lines imported from Serbia) and she used to tremble which were diagnosed as small seizures and had to administer Keppra. Anyhow, blood works proved vital for diagnosis and had they been done earlier when we first requested she may have had a different outcome.

Good luck with yours, he sounds like he's getting the right treatment but you'd be right to question the pot belly!

red_slr

Original Poster:

18,034 posts

195 months

Thursday 2nd November 2017
quotequote all
Cheers for the info.
He has been in and out of the vets for various things the last 2 years. Since he turned 10 really.
Half the time I think they just guess tbh, but they are the best we can find and they have a good rep so we will stick with them for now.
Part of the problem is they are running it under 2 vets so often its the case you see one vet one visit and the next visit the other vet. They have to just rely on notes. I have started taking photos / videos to help them now.

bexVN

14,682 posts

217 months

Thursday 2nd November 2017
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There is no excuse for a vet not to consider bloods as a part of investigations, especially if an O' wants more done! The only reasons not to would be owner refusal or (and this is very rare) not being able to get bloods from a patient!

OP I am glad things seem stable at the mo.

red_slr

Original Poster:

18,034 posts

195 months

Tuesday 28th November 2017
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Quick update had another wetting incident over the weekend, urine sample has been cultured and shows Proteus and Staphylococcus.
Another week of meds to come..