Tag Archives: treatment

Diagnosis and the way ahead…

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Anyanka had her follow-up exam with the ophthalmologist today and we’ve arrived at several conclusions. 

First, Anya is a carrier for feline viral rhinotracheitis (FVR), often called “cat flu” or less popularly known as kitty herpes. Odds are the virus was transmitted by her mother at or shortly after birth. The virus often presents as a standard upper respiratory infection with the expected coughing, sneezing, and watery eyes, but it can also cause a nasty infection of one or both eyes – in Anya’s case, her left. 

There’s no “cure.” Barring a breakthrough treatment, Anya will be a carrier for the rest of her life and may or may not experience further flare ups. One of the most common causes for these flares is stress – things like living in a shelter environment or suddenly finding herself thrown in a crate and taken to a new home. Given how little I enjoy change myself, I’m optimistic that as things settle into a routine here, we’ll be able to minimize whatever stress she may experience going forward.

Second, most likely as a result of ongoing infection in her eye from a very young age, Anya has conjunctival symblepharon. For lack of a proper veterinary explanation, this is a condition where her third eyelid and portions of her inner eyelid are adhered. It’s why even now that the infection is controlled, you can really only see about 1/3 of her eye. Fortunately, the eye itself doesn’t appear to be damaged. Assuming no further issues, we’ll schedule surgery in about a month to correct the adhesion and try to get her a wider field of view in that eye.

Even with surgery, it’s never likely to look “perfectly normal.” That, of course, is an issue I’m perfectly indifferent about so long as it improves her overall health and quality of life. The vet’s recommendation is that this is a “one and done” effort. If for some reason the surgery doesn’t take, it’s better to leave well enough alone than try repeatedly.

I had a hunch I was getting into something when I decided on this little gray kitten hunkered down in the back of her cage at the shelter, though admittedly this has gotten more involved than I planned for originally. Whatever. Everyone wants an “ideal” kitten. After already spending three months getting passed over, there’s no telling how much longer “the cat with the weird eye” would have lingered there or worse, been returned or dumped somewhere, once they realized the cost and level of effort required to get her fixed up. She’s in no danger of that fate here.

On the good news front, the cone of shame is now tucked in the cabinet and we’re down from four medications three times a day to two medications twice a day. That level of treatment feels much more manageable, especially since the two meds we’re continuing are basic eye drops rather than the ointment that stuck to everything or the oral suspension that she disliked mightily.

Now that we have Anya on the mend, it’s probably time to shift a little focus towards helping Cordy come out of her shell a bit. Given her background as having been “caught in the wild” just a few days before I brought her home, I can’t help but feel like this is going to be a whole different kind of project. But at this point, what’s one more thing to do?

The slightly abridged story of another sick dog…

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Since I seem to be permanently destined to have at least one sick dog on the premises, I suppose it’s only fair that I throw out a little update on what we’ve been up to since late last Friday.

The short version is that over a span of about an hour on Friday night I watched my already sickly chocolate lab go from her normal self to drooling, vomiting, and blasting out unimaginably large quantities of liquefied, high pressure shit. I undertook the “40 minute” drive to the nearest emergency vet with great vigor and complete disregard for pesky details like traffic laws and personal safety. I was more or less convinced that by the time we got there, I’d be dropping her off for a necropsy rather than treatment. I never thought I’d be happy to hear a dog retching and hacking in the back seat. For Friday at least it was the sound of not being dead yet.

After 36 hours of treatment, blood tests, fists full of medication, an ultrasound, and round the clock monitoring, the official diagnosis is “we don’t really know.” The symptoms don’t really present as something directly related to her Cushing’s disease and the ultrasound didn’t show anything radically different than what we saw back in March. Inconclusive.

In the absence of a solid medical diagnosis, I’ve arrived at a speculative cause for all this last week’s problems. What I think happened is that sometime around 6:30 Friday night the dogs found something in the yard – perhaps a mushroom – and noshed on it. For Maggie, already compromised with Cushings and general old age, the result was sudden and violent illness.

The key to my speculation doesn’t actually involve Maggie at all, though. When I got home from the emergency vet around midnight Friday, Jorah’s crate floor was spotted with drops of something. At first I attributed those drops to a reversion to peeing in his crate, but a closer look showed that he too was drooling prodigiously. In Jorah’s case, though, it lasted just a few hours and dissipated. He never showed any signs of feeling badly otherwise, which I know from sitting up through the small hours of Saturday morning waiting to see if I needed to drag another dog in for heroic measures of treatment at weekend rates.

I talked to our regular vet last night and laid out the timeline of events, went over the details from the file, and presented my own observation of the events. Without being led there, his first opinion was that it sounded like they had both eaten something and promptly got sick in proportion to the strength of their respective systems. It’s not exactly a confirmation of my logic, but I was glad to see that his analysis of the available evidence mirrored my own. Unless something is proven otherwise, “ate something” is going to be the official story of what caused this week’s series of unpleasant events at Fortress Jeff.

With leaves coming down and the ground covered it’s going to be horribly difficult if not outright impossible to verify any of this. It’s going to be harder still to comb the area for anything that could further agitate the situation. Part of me knows we’ll be relying on some level of luck in avoiding future problems. It’s not optimal, but we’ve lived here a fairly long time now without something in the yard causing mayhem and chaos. One bad day out of 1200+ isn’t necessarily a cause for panic, but I’d be lying if I said I wasn’t looking at the compound with a new level of unease.

The screecher next door…

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Sitting around the emergency vet on a Friday night with not much to distract you leaves a lot of time to think… and to observe the comings and goings of those moving around you in the world. The thing I observed most on Friday night… and then again on Sunday morning was the genuine imitation outrage that so many people felt when they were expected to pay for their pet’s emergency treatment.

The ones in the treatment room right next to mine would have been hard to miss, even if I wasn’t casting around for something to occupy my mind while we waited. They’d have been hard to miss because just after 11PM, one of then started screeching that the estimate to treat their dog was “too damned much” for what they seemed to think was a simple treatment – blood work, xrays, and emergency surgery to set or amputate a broken leg.

The value people put on things is always curious. You’re at a vets office in the closing minutes of a Friday night. They have a huge staff who are all being paid for overnight weekend work. They have diagnostic imagery tools that a decade or two ago would have been rare at a lot of rural hospitals treating people. You’re paying to have access to doctors, techs, and technology at a time when almost nothing else is open. As much as the staff at one of these places may love animals, money is what keeps the doors open at times when you might otherwise have to wait 48-72 hours to have your dog seen.

Look, I don’t love spending emergency vet kind of money, but I get why it comes with a premium price tag. Even if I didn’t get it, I’d know better than to scream at the twenty-something young tech who’s trying to walk me through the options because I’m not an awful human being. I’m sure someone will say lashing out angrily is a perfectly natural response in a stressful circumstance… but I’d really prefer it if they didn’t lash out and agitate the people who I’m going to need focused in on taking care of my own pup after they’ve finished up with the screecher next door.

Optimal control…

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We were back to the vet this past Friday with Maggie. She has to stick around with them for a few hours for a bit of follow-up testing for her Cushing’s. There’s no remission or recovering from it, but symptoms are treatable, so finding the best course of treatment for her is important to me.

This last test shows that we have the meds dialed in to the point of “optimal control” for her ACTH levels – meaning we’re able to hold her cortisol levels more or less where they need to be to reduce the laundry list of Cushing’s symptoms. Under the circumstances, it’s just about the best possible outcome available.

It was a long six months in getting here – with three or four visits to the regular vet for testing, schlepping across Pennsylvania for an ultrasound, and several variations on the medication of choice to get things under control. It hasn’t been an inexpensive proposition, though I refuse to do the math on either the amount of time or money expended. I know I’m incredibly fortunate that neither one of those factors drive the train when deciding what’s best for my sweet, lazy chocolate lab.

The fact is, Maggie is an old dog. She’s coming up on her 11th birthday in October. I’m under no delusions about how this ends – for her, for me, or for any of us. For now I’ll appreciate that I, through the marvel of modern veterinary medicine, was able to buy her some more quality time. Beyond that, everything else is background noise.

Something of a novelty…

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After six days of waiting impatiently, I got a call back from the emergency vet Maggie visited last week. The good news is that the tests they ran confirmed the preliminary diagnosis of a urinary tract infection. After the long and growing list of canine ailments I’ve dealt with over the years, a run of the mill UTI was just about as good an outcome as I could hope to have.

Because in this household we can’t do anything entirely basic, Mag’s urine culture showed that the E. coli bacteria causing the infection wasn’t likely to be fully treated by the particular antibiotic originally given. It did, fortunately, help alleviate the worst of it. Since I’m looking for knock-down, drag-out eradication, though, I’m more than happy to spring for the second 10-day course of targeted antibiotics. It’ll be a small price to pay to get my girl to a place where she’s a) more comfortable, b) not as likely to pee all over the house in the dead of night, and c) can resume her duties as my 70 pound live action foot warmer.

A few weeks ago I laughingly posted on Facebook about a meme showing the average dog owner spends $1000 a year on care and feeding. That sounds awfully low to me, even for a bare minimum of food and medical care. As the science of human medicine marches forward, veterinary medicine marches along a few steps away… with the a corresponding increases in price for the kind of services that owners can now expect and demand.

I’m very thankful that this time around, we didn’t have to chase down anything too dramatic or crash into an aggressive treatment plan. You’ll forgive me, I hope. “Normal” illnesses are still something of novelty here.