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Old 09-04-2011, 09:54 PM
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grab bag of health issues

My 10 year old girl is hitting the wall of problems. I know that with age, comes the risk for more health problems and we're now staring down several. I've searched the threads for more information, and hoped that putting it all together would help me and I know that members here have a wealth of experience as well.

In late May, she was having loose stools (things had never been "good and firm" since she had been on Blue Buffalo, but at the time she had been vomiting her previous food and it was the only one she would eat, so I kept her on it).

We had a checkup with our regular vet (#1) to check the stool. As a precaution, she was prescribed flagyl until the fecal exam came back. I also had a them run a urinalysis from a free catch sample as a precaution (her urine looked darker, but no other symptoms). During the exam a cataract was discovered. However, because of a likely cancerous mass, we were referred first to a local surgeon and told to deal with the cataract later. At the meeting the morning of the surgery, the local surgeon referred us to a teaching hospital because of the location of the mass.

In the meantime, the fecal came back negative for parasites and bacteria, but no change in the poop...everything from liquid to formed but too soft to pick up. So we upped the flagyl. The urinalysis showed blood and bacteria, so we had a sterile sample drawn from her bladder during the cancer surgery. The mass was removed and, although they did not get a clean margin, it is a slow growing tumor and we are doing monthly checks for regrowth instead of chemo or radiation. They also submitted another fecal. The results of the fecal were all negative and the urinalysis showed some elevated numbers, but "not enough to worry about" at the time.

In discussions with the oncologist, he suggested we see a dermatologist because of her more atypical allergic reactions and general history. He was thinking autoimmune disorder.

The loose stools continued so we got a second opinion (vet #2) who suggested we drop the flagyl and started us on probiotics. We had a slight improvement for 2 days and then right back where we were.

We recently had a check for a vaginal discharge, recheck the stool, free catch urinalysis and then vet #1 referred us to have her blood pressure checked. Free catch shows high protein. The vet (#3) we were referred to did a sterile draw and also checked the blood pressure which was about 150 (?) and they want to do it again when she's calmer. Friday afternoon I learned the urinalysis protein/creatinine ratio was 1.8, but they gave me no more information except they think it is glomerulonephritis. Vet #1 said if it's kidney disease I will need a referral, but the Vet #3 said I didn't need one and they could prescribe medications.

We're addressing the loose stools now as a food intolerance and she's been on a new diet for two weeks now and we do have improvement. Maybe 70% normal. If no permanent improvement, we'll look at digestive enzymes, etc.

Past history....She's had allergies problems since she was a few months old - not just itching & breakouts, at times her feet were so swollen the pads would start to peel away from her toes. Vet #1 has always handled this problem. Around two, she started allergy shots and within a year, combined with steroids and antihistamines, she began to have a real quality of life. (I cannot afford Atopica and she has had to remain on a low dose maintenance steroid.)

A few years ago, her thyroid was tested. In order to show a reading on the thyroid panel, we worked up to 3 times the basic dose and she hit the lowest reading. Unfortunately, this sent her allergies into overdrive and I was having to increase the prednisone so much that she was miserable. I opted to taper her off the thyroid medication.

Around the same time she had ACL surgery and during recovery, her skin infection finally cleared up. We tried rounds of antibiotics, but she would have a skin infection within a few days - so she's on a maintenance antibiotic too.

I feel like the priority is the kidneys since the cancer care is a monthly lump check. Even though it's a drive, I want everything to be going on at the teaching hospital. At least that way, the oncologist, dermatologist and internal medicine doctors are in the same building and can/will freely talk to each other. Of course, everyone's off for the holiday weekend, so I'm stuck waiting until Tuesday for phone calls to be returned.

I can't change any decisions I've made in the past, but each decision was made with love and with her in mind.

If you've read this far you are incredible!.....Anything I should be asking about as we head forward?

Last edited by hubbub; 09-04-2011 at 10:19 PM.
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Old 09-04-2011, 11:14 PM
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Oh My Gosh. You must be so overwhelmed. I'm sorry you are going through all these things with your sweetheart. I have no experience with any of this or advice, but i wanted to let you know I am sending prayers your way for you, your family and your Golden girl.
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Old 09-04-2011, 11:17 PM
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You are doing a fantastic job of managing so many conditions for your girl!

Some thoughts about various issues:
Being hypothyroid is miserable. I tell you this from living it myself, so I would consider adding back a thyroid med.

The loose stools could be caused by sensitivity to wheat gluten (in humans this is often caused by celiac disease, which also occurs in some animals). Since you have to move to a low-protein diet for the kidney disease, maybe a food that is based on rice would work? Somewhere I have a recipe for making your own low-protein dog food and I know it's based on rice. I'm sure I can find it if you need it.

Except for the cancer, a lot of what you describe sounds like some form of autoimmune disease. Hypothyroidism and gluten intolerance are both in that category. Probiotics are helpful, so that's a good start.

And you'll hear from a lot of other people who know a lot more about these conditions than I do.

Holding you and your sweetheart in my thoughts and prayers,
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Old 09-04-2011, 11:51 PM
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Quote:
Originally Posted by Jax's Mom View Post
Oh My Gosh. You must be so overwhelmed. I'm sorry you are going through all these things with your sweetheart. I have no experience with any of this or advice, but i wanted to let you know I am sending prayers your way for you, your family and your Golden girl.
Thank you so much! It's like controlled chaos sometimes. I know it sounds unbelievable so I didn't include it originally, but shortly after her clearance from the oncologist, my formerly feral cat was attacked by something and spent 4 weeks at the vet. He's been confined on my porch for several additional weeks while everything continues healing and is VERY unhappy.

Quote:
Originally Posted by GoldensGirl View Post
You are doing a fantastic job of managing so many conditions for your girl!

Some thoughts about various issues:
Being hypothyroid is miserable. I tell you this from living it myself, so I would consider adding back a thyroid med.

The loose stools could be caused by sensitivity to wheat gluten (in humans this is often caused by celiac disease, which also occurs in some animals). Since you have to move to a low-protein diet for the kidney disease, maybe a food that is based on rice would work? Somewhere I have a recipe for making your own low-protein dog food and I know it's based on rice. I'm sure I can find it if you need it.

Except for the cancer, a lot of what you describe sounds like some form of autoimmune disease. Hypothyroidism and gluten intolerance are both in that category. Probiotics are helpful, so that's a good start.

And you'll hear from a lot of other people who know a lot more about these conditions than I do.

Holding you and your sweetheart in my thoughts and prayers,
Lucy
Thank you! I appreciate you insight and ideas. Vet #1 suggested last week that I consider a non-flavored thyroid tab and see if perhaps she was reacting to an additive in the flavored tab. I'm open to it certainly. I wondered if there were tests for immune disorders or if the diagnosis is really symptom based. Again hindsight is 20/20.

Since we just got the kidney news, we haven't swapped to a kidney diet yet, but I know it's coming. She's just moved to lamb & rice. We tried a turkey & potato food first, but she was itching and chewing like a maniac within an hour of eating it so we dumped it. The original food was chicken and rice. I hope we can get her tummy settled a little more before the kidney food transition. I'm going to look through all her treats for gluten tomorrow - it certainly can't hurt.

Last edited by hubbub; 09-05-2011 at 12:31 AM.
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Old 09-05-2011, 12:26 AM
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You are making so many decisions and doing what is best for her out of love. I am quite confident that they know that on some level. She is so lucky to have you for her advocate. Take care of BOTH of you!
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Old 09-05-2011, 01:35 AM
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Just a couple of suggestions to talk to your vets about -

For allergies, my Joey takes a low dose of Temaril-P (contains trimeprazine (5mg) and prednisolone (2mg)) in the a.m./Cetirizine HCI tablet in the p.m.

I have had two dogs in the past diagnosed w/ chronic renal failure. I used Azodyl w/ both and had good success with both.
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Old 09-05-2011, 05:57 AM
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Gosh, you are dealing with a lot of multiple issues. Poor Hannah and thank goodness she has a loving and diligent owner like you!

What type of cancer was she diagnosed with?

I've not dealt with kidney issues in a dog but am currently treating Toby for a digestive enzyme deficiency (cobalamin and folate), which presented with loss of weight and lots of loose stools. We are still dealing with it, with slow improvements. I can share our experiences (and the tests) if you end up testing for that.

Toby was just placed on hypertension medicine in preparation for his cataract surgery. His pressures were always very high in the clinical setting, and high normal to elevated under sedation, and normal to high normal at home during home testing. It may be Hannah's hypertension and the kidney issues are related, because I've read here it they tend to go hand in hand (we haven't seen that with Toby). I hope they can help you find a kidney friendly diet that helps the skin/allergy issues and the possible hypertension issues. You might ask the vet who did the cancer surgery to check and see what her pressures were during the surgery to remove the mass. That should give you a pretty good idea of her pressures when she's not overly stressed out. The hypertension medication prescribed to Toby is a human medication that I get at Walmart for $6 a month.

Toby's thyroid bounces like a ball based on seasonal changes. We get his medication from KV Supply (thyro tabs). I checked but cannot tell if they are flavored.

I think you are making a good choice in concentrating her care at the cancer center, at least for now, while you are chasing down so much.

As far as the cataract surgery, it's a good approach to wait on it and get these other issues under control. Toby's ophthalmology vet calls it elective since many dogs live good quality lives being vision impaired or blind.

Give Hannah some ear rubs from me.
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Old 09-05-2011, 07:26 AM
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Quote:
Originally Posted by Dallas Gold View Post
Gosh, you are dealing with a lot of multiple issues. Poor Hannah and thank goodness she has a loving and diligent owner like you!

What type of cancer was she diagnosed with?
Thank you! It's called hemangiopericytoma (realized I never said what it was (new to cancer issues - how to organize?)) which is locally invasive and usually doesn't metastisize, but goes to the lungs if it does.

Quote:
Originally Posted by Dallas Gold View Post
I've not dealt with kidney issues in a dog but am currently treating Toby for a digestive enzyme deficiency (cobalamin and folate), which presented with loss of weight and lots of loose stools. We are still dealing with it, with slow improvements. I can share our experiences (and the tests) if you end up testing for that.
She's never had a problem keeping weight on. Since her ACL surgery (at 80+ lbs), I've gotten to a stable weight of 67 lbs (orthopedist was THRILLED). I had noticed your posts before about the enzyme deficiency and that is the next step if a food change doesn't bring normalcy.

Quote:
Originally Posted by Dallas Gold View Post
Toby was just placed on hypertension medicine in preparation for his cataract surgery. His pressures were always very high in the clinical setting, and high normal to elevated under sedation, and normal to high normal at home during home testing. It may be Hannah's hypertension and the kidney issues are related, because I've read here it they tend to go hand in hand (we haven't seen that with Toby). I hope they can help you find a kidney friendly diet that helps the skin/allergy issues and the possible hypertension issues. You might ask the vet who did the cancer surgery to check and see what her pressures were during the surgery to remove the mass. That should give you a pretty good idea of her pressures when she's not overly stressed out. The hypertension medication prescribed to Toby is a human medication that I get at Walmart for $6 a month.
Great idea to call the teaching hospital! I've added that to the growing list of things to do. It would provide an excellent reference.

Strangely, the Walmarts around me are sort of out of my way. Unlike everyone I know, I probably go 5-6 times a year. LOL! However, I don't know how I overlooked their rx program. All the medications (dog and cat) are on the $4/$10 list!

Quote:
Originally Posted by Dallas Gold View Post
Toby's thyroid bounces like a ball based on seasonal changes. We get his medication from KV Supply (thyro tabs). I checked but cannot tell if they are flavored.
I think it's a human version, but I'm not sure.

Quote:
Originally Posted by Dallas Gold View Post
I think you are making a good choice in concentrating her care at the cancer center, at least for now, while you are chasing down so much.

As far as the cataract surgery, it's a good approach to wait on it and get these other issues under control. Toby's ophthalmology vet calls it elective since many dogs live good quality lives being vision impaired or blind.

Give Hannah some ear rubs from me.
Thanks again. I think if I keep considering the opthalmology issues it's a way of looking forward beyond the current problems.

OOOooOO if you could hear her grunting in pleasure from those ear rubs!
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Old 09-05-2011, 07:36 AM
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Originally Posted by jealous1 View Post
Just a couple of suggestions to talk to your vets about -

For allergies, my Joey takes a low dose of Temaril-P (contains trimeprazine (5mg) and prednisolone (2mg)) in the a.m./Cetirizine HCI tablet in the p.m.

I have had two dogs in the past diagnosed w/ chronic renal failure. I used Azodyl w/ both and had good success with both.
Thank you! I'm going to ask about those allergy meds. She's currently on 10 mg on MWF and then either 10 or 20 on Sat and Sun (depending on the time of year and her breakout level) - in addition all the benadryl. We had gotten down to a 10 mg tablet a week prior to starting the thyroid medication. Even after stopping I've not been able to ween her back down - she just falls apart.

It's so good to hear about success with kidney disease....we've usually got a LOT of hope here, but sometimes things build up and seem like they're going to topple over. BUT, I haven't started grinding my teeth yet so, it's not too bad yet!
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Old 09-05-2011, 07:37 AM
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You are going through so much with your girl! Having your cat in recovery too must be overwhelming. Many of us who have multiple animals can relate.

Quote:
Originally Posted by hubbub View Post
Thank you! I appreciate you insight and ideas. Vet #1 suggested last week that I consider a non-flavored thyroid tab and see if perhaps she was reacting to an additive in the flavored tab. I'm open to it certainly. I wondered if there were tests for immune disorders or if the diagnosis is really symptom based. Again hindsight is 20/20.
Hypothyroidism, which you already know she has, is an autoimmune condition. So is arthritis, which is common in older dogs, and so are allergies. I think a lot of diagnosis is just based on the symptoms, though some autoimmune conditions often come together.

The ongoing antibiotic may be causing problems with digestion and thus causing food sensitivities and loose stools. Probiotics may be helpful with that, though it takes a while to see results.

Quote:
Originally Posted by hubbub View Post
Since we just got the kidney news, we haven't swapped to a kidney diet yet, but I know it's coming. She's just moved to lamb & rice. We tried a turkey & potato food first, but she was itching and chewing like a maniac within an hour of eating it so we dumped it. The original food was chicken and rice. I hope we can get her tummy settled a little more before the kidney food transition. I'm going to look through all her treats for gluten tomorrow - it certainly can't hurt.
The kidney disease food that we used with Sabrina was a prescription product. What I remember most about it was that it was much lower protein than other dog foods. Since protein is harder on the kidneys, we had to restrict Sabrina's treats, so she didn't get much meat of any kind, no eggs, no fish, etc.

Through all of this, remember to take care of yourself and to make time for having fun! That's important, since nobody can give all the time.
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