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by hodie on 25 January 2010 - 16:01
There is some positive news here. You meant he could not feel urine in her bladder? Were any x-rays ever done? The fact that the temperature is down is a very good sign and indicates the antibiotic is likely working. The issue of the dog not urinating is a main issue, and she should be encouraged to drink lots and you continue giving the pedialyte multiple times a day. She does not want to eat because she does not feel well, but if she is eating something, and drinking now, I bet in a day or two more with continued antibiotic success she may well perk up. Just remember how you feel when ill with a fever. One feels like a truck hit them and generally miserable and not interested in eating or drinking. If she will eat, great. But I would still not get too concerned about this for the moment. It is the dehydration that must be corrected.
The fact that she is not vomiting, or that you don't see diarrhea at this point is also a good sign. Should you put her on an IV? You could, but if you can get her to drink without it, I probably would not. What I would watch for is her worsening condition and based on what you are saying, she is getting better, although slower than you would like. I suspect she has some sort of infection and that alone might be causing all the signs you mentioned. Again, were liver and kidney function results done with bloodwork and, if so, what did they show?
Is she coughing? Is she struggling to breathe? If not, I think you might just be patient and continue the good care you are giving. You are in a difficult situation. She may well do just fine on the trip to KL, or might not. It is difficult for me to say. But the fact that she seems to be improving to you is a good sign. You may get to KL and spend a lot of time and money and have nothing to show for it if they can find no real clear reason for her situation. Based on what you say, at this point, I don't think the dog is in immediate danger of dying, but again, I am not there. I can only base what I am telling you on what you are reporting and it may or may not be accurate. As well, as you know, the best option is to keep working with a vet there who can see her. So at this point, what is the vet recommending that has been seeing her? Does he think she has improved? Has bloodwork been repeated and if so, is the white count coming down?
by Robin on 25 January 2010 - 16:01
That way you can hydrate her with the bag and the syringe??
by hodie on 25 January 2010 - 17:01
A friend reading this thread has also brought up another good idea for what is going on here. The confounding issue is your present vet suggesting there is fluid in the abdomen. If so, I am most worried about some sort of blockage, partial or otherwise, or a twisted intestine etc. That certainly could lead to all the signs you have reported. However, my friend mentions a pyometria....a uterine infection. They can be closed, meaning you are unlikely to see drainage of pus etc., or open which is often very obvious that something is very wrong. At 18 months, has this female been spayed? If not, the vet can check for this condition by getting a smear and checking it under the microscope.
And yes, Robins' suggestion of an IV for under the skin hydration is fine too, but if you are going to use IVs i would personally elect to simply give it IV. There is a risk however in this course of action if there is some sort of cardiac condition involved. I cannot say whether there is or is not. But, if a heart is already not performing and pumping as it should, giving fluids IV can add to the problem. The fluid in the belly, if it is really there, may be from the gut inflammation caused by what I wrote above. Or it could be a result of cardiac or lung problems where the fluid backs up and ends up being called ascites....fluid in the belly.
It is difficult to know what to suggest Sabrina. I think you are the best to judge what you must do. If you think the vets in KL are likely better, I might go there ASAP. IF you think you see real improvement, then perhaps working with the current vet is an option. I would ask your current vet about ruling out a uterine infection. Does he have the ability to do a barium x-ray? That might help show whether the intestinal tract was patent and unblocked....... Has she ever vomited or retched as if she were trying to vomit? Has she had any stool since this all began? If so, what was it like?
The problem here is you may be ok just being conservative, but if you miss something, or something REALLY serious is there, such as an impacted or obstructed bowel for instance, the dog could die.
You are in a tough situation. Our suggestions are meant to help you, but remember, the best help is getting competent veterinary care, especially when you are in such a country as Maylasia.
Keep us posted. If you were here, I would recommend she see a vet and they keep her until they know what is wrong. Period. Otherwise, you are guessing and if you guess correctly, or treat signs correctly which then resolve, great. But the consequences of not doing so are very serious for the dog. It is clear you love the dog, so do what is right in your heart. Don't rely on us. We could be all wrong. I might be all wrong.
by SabrinaT on 26 January 2010 - 15:01
Hodie, thanks again so much for all the advice, I will try to answer some of your questions now as well.
Tuesday UPDATE:
We took Sam to the vet again today and her temperature is still normal.
Her general condition, to me, seems to also have improved.
She is drinking quite well, much more vigorously than the last few days (I am still giving Pedialyte as well). Though her appetite is still quite poor, she managed to eat a fair amount around 12:00pm (our time).
She is also more active today, she is showing more movement and has followed me outside into the garden two or three times (which she has rarely done the last few days, maybe just coming outside once a day)
And she has also urinated for the first time for 4 days. Just when we were taking her to the vet around 4:00pm (our time) I was bringing her outside and she urinated for a fairly long time. (Though not again since then)
And Hodie, I will try to answer the questions you asked in your last few posts;
You meant he could not feel urine in her bladder? When we took her on Monday morning (our time) I asked the vet to check if there was any fluid in the bladder. He said that he could not feel any faeces and that she was very tense / uncomfortable when he was checking her bladder.
Were any x-rays ever done? We did an x-ray of the lateral abdomen on Friday, should I try to take a picture of the results and post them here / send them to you?
Again, were liver and kidney function results done with bloodwork and, if so, what did they show? According to the blood test we did on Monday, the kidney function was fine and the liver function was fine exceptthe SGPT (ALT) which was 106 (norm 15-90).
Is she coughing? She has not really been coughing since this began, only a very occasional retching.
Is she struggling to breathe? When we first noticed the problem, Sam was breathing very heavily and when breathing I could her a wheezing noise. The vet has also mentioned a few times that she is breathing more through her stomach than her chest. Though her heatbeat still appears slightly rapid, there is no longer any wheezing while she is breathing.
What is the vet recommending that has been seeing her? He recommends that we take her to KL and to a Heart Ultrasound and an ECG and if the results come back ok for the heart to then do an Ultrasound of the abdomen (He says that if it is not a heart problem, he would say it is a problem with the gut-though he is still very unclear if / how he would be able to treat either problems even if we had the results.
Has bloodwork been repeated? When I asked the vet about this he said it is not necessary and we must just accept the results given. Would you recommend we request to redo the bloodtest?
Has she ever vomited or retched as if she were trying to vomit? She has not vomited since this began though has, rarely and not in the last few days, been retching.
Has she had any stool since this all began? Though I cannot say for sure since all this began, definitely not since Saturday.
So, I really am sorry to have to have to ask you again but please read through this and offer any more advice that you can. We are still trying to decide whether to attempt to take Sam to KL or to try and treat the symptoms here with our current vet so any further advice on this would be really very helpful.
Thanks so much,
Sabrina.
by hodie on 26 January 2010 - 16:01
I would ask for a repeat of the bloodwork to make sure the white cell count continues to come down and that liver and kidney function are ok. The liver enzyme that was high was only a bit high, but still you would like to see it improving. The fact that she has gagged a few times and that she has not had a stool for some time could be coincidence, or it could be real trouble. The concern about an impaction or blockage, or a twist in the intestines somewhere remains. Sometimes that can be seen on x-ray and sometimes it takes more specialized barium x-rays. The fact that she is drinking well now is a very good sign, as is the temperature. I would certainly continue the antibiotic and if she is not in distress breathing, you may want to talk to the vet at some point about discontinuing the lasix. I am not at all convinced the dog has a cardiac issue here first and foremost.
Is the female spayed? If not, a uterine infection should be ruled out. I have no idea where your vet was trained or whether he is or is not really competent. It is a good idea to repeat bloodwork, although yes, here on this forum if a vet suggested it some of these people would be up in arms. But you have a dog who has been very ill. The fact that she is following you around a bit now also suggests she is feeling better. If, however, she has something like a blockage or twist in the intestines, this could all change very rapidly again for the worse. What you would like to see is a bowel movement and one that is normal in all respects.
So again, it is up to you whether to take her to KL (and what are those vets qualifications?). I am a bit puzzled by what you say as to why your vet is hung up on a cardiac reason for the illness. One of the cardinal signs for congestive heart failure would be coughing and respiratory distress. Wheezing was possibly a sign, or it might have been positional, in other words, just the way she was lying. A dog with a fever would breathe faster and heartbeat would also be elevated. It is possible that she has some sort of acute cardiac infection, but the lack of appetite, the retching, the no stool, the dehydration etc. makes me think more of an abdominal issue.
The good news is you see improvement. What does the vet see? The question is whether she is making significant enough improvement to make you feel she is going to be ok, or whether you feel she should see another vet. I cannot make that decision for you. But I am glad to hear she seems to be improving. You are there, and you know the dog best. Only you can tell what is and is not an improvement.
Keep us posted.
by Sunsilver on 26 January 2010 - 16:01
Obviously, she has an infection somwhere. The big question is WHERE. Did the vet ever think she might have pneumonia? (Hmmm...if she did, why wasn't she coughing?)
Normally, with a problem with the gut, a dog would be vomiting or having diarrhea, or abnormal stools. That's why no one suggested a gut issue when all this started. However, the vet did say she was very uncomfortable when he palpated the bladder area. (BTW, she would not have feces (or stool or poop, to use a more common word) in her BLADDER! That would be in her bowel, but he would have been able to feel that too, while palpating the bladder. The fact she has discomfort in that area, and in her belly in general may indicate a problem with the bowels.
All I can say for certain is this is a diagnostic problem. The best diagnosis anyone would be able to give at this point would be FUO...Fever of Unknown Origin. We can speculate...maybe it's a uterine infection (pyometra) maybe something wrong with the kidneys, etc. etc. but without further tests, and being able to see the dog, we're just guessing.
You really have 2 choices at this point. You can just continue to treat the symptoms, and hope she returns to normal, or you can go to the other hospital, and have her heart and belly examined via ultrasound to (HOPEFULLY) get an accurate diagnosis of what's going on.
I WOULD get her checked for pyometra, though. That's a quick and fairly inexpensive test to do. And if she has pyo, she WOULD be very uncomfortable in the bladder area, as the uterus and bladder are very close together. Pyo most often happens about 4 to 6 weeks after a heat, as being in heat makes the uterus vulnerable to bacterial infection.
I can only think of two experiences I've had with animals that are vaguely similar. I'll mention them here for what they are worth.
We had a cat that loved to hunt birds. He suffered a punctured bowel from a bird bone, and developed peritonitis. His symptoms were similar: fever, loss off appetite. He wasn't vomiting or having diarrhea, but he WAS straining to pass feces. After several days in the vet hospital on IV antibiotics and fluids, he passed the bone, and the bowel healed on its own without surgery. (He was VERY lucky!)
On another occasion, my idiot husband wasn't watching our GSD, and let her escape from the yard. She got into something rotten/poisonous. She vomited a large quantity of undigested food all over the carpet in the middle of the night, and by the next morning, could barely walk. She had a fever of 105 F. After treatment with antibiotics, she made a good recovery, except her liver enzymes were elevated. The vet gave me all sorts of dire predictions: cancer, adrenal gland failure, etc. etc. I spent a small fortune on different tests. Finally, I said ENOUGH!! The dog is healthy, active, eating well, pooping just fine. Until she develops some sort of new symptoms, I'm not doing any further testing.
When I took her in for her annual shots a month or two later, I asked for the blood tests for liver function to be repeated. They came back NORMAL. I was overjoyed!
The conclusion was she had eaten something which had damaged her liver. SInce the liver filters out all the poisons in the blood, it is one of the few organs in the body which has the ability to heal itself, as long as the damage isn't too severe. So, given sufficient time, her liver did exactly that. She lived to the ripe old age of 14 1/2!
by hodie on 26 January 2010 - 16:01
by Jenni78 on 26 January 2010 - 16:01
Sure hope Sam continues to feel better, whatever is causing this.
by hodie on 27 January 2010 - 16:01
Hello Sabrina,
How is the dog doing now?
by SitasMom on 27 January 2010 - 17:01
this could cause a sporatic issue with eating and hard belly, high white blood count, and depression.
just somehting to cross of the possible list.
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