Hello, I'm Dr. Deb and will do my best to help you today.
I'm so sorry that Sunny is having these issues; this must be quite distressing for you both:( I do have a few additional questions to ask about him first if you don't mind:
1. Is he currently taking any medication? Is so, can you provide the name and dosage amount?
2. Is he taking any supplements?
3. Can you take his temperature?
4. Will he eat if you offer him food?
There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb
Thanks for the answers to my questions. My fingers are typing a little slow today so please be patient while I type back a response to you.
I can understand your confusion about whether or not he actually has congestive heart failure with secondary pulmonary edema but even if he does have these problems, they shouldn't cause issues with his back legs. Weakness, perhaps, but I wouldn't expect him to be dragging a back leg or have difficulty walking. Nor would I expect these conditions to be painful.
Based on your description of his behavior, it sounds as if he may have issues with his spine (compression of the cord by a disc or mass) or possibly he's exacerbated a previous arthritic condition since I'm fairly certain he has arthritis somewhere in his body. There are other conditions which might also explain his behavior such as:
tick diseases or
Discospondylitis (infection along the vertebrae) or
Fibrocartilaginous embolic myelopathy (or FCE which is a condition involving necrosis or cell death of a region of the spinal cord secondary to infarction (obstruction) of the blood supply.
But I'd want to rule out spinal issues and/or arthritis first. This isn't always the easiest thing to do, even with diagnostic imaging. -X-rays may be suggestive of the first but not diagnostic....although they're usually pretty accurate at detecting arthritis. Often an MRI or CAT scan are required to definitively determine if there's a spinal cord problem.
Spondylosis might cause some issues but not to the extent that you're seeing, at least not in my experience.
I must confess to being somewhat disappointed with your vet that they didn't examine him thoroughly or take xrays since he was there. Even though he may have shown improvement at the time, I would have wanted to know what was going on. But, be that as it may now, I do have a few suggestions if you can't get him back to the vet's office and since he seems to be so uncomfortable.
1. Since I don't see where he's taking any steroids or nsaid medication and he's not vomiting (I assume), then otc Aspirin can be given which may be of help for it's anti-inflammatory and anti-pain properties. The dose would be 10 mgs per pound of body weight twice a day with food to avoid stomach upset.
I honestly don't know if it will be strong enough to provide relief for him but it may help to a certain degree. One hesitation I have about it's use would be if you manage to get him back to the vet's office and they want to prescribe something different for him; Aspirin may interfere with this medication but several doses should be fine.
I don't like to use nsaid medication long term for my cardiac patients if can avoid it but sometimes we have to balance the pros and cons of doing so when there's a patient with multiple issues...such as in this case.
2. If you have access to specific pain medication such as Tramadol or Gabapentin, I can provide the dosage amount of I know his weight. It would be illegal for me to advise the use of a drug which had been prescribed for another patient (human or otherwise) but I can provide the current dosage for a canine patient.
3. I wouldn't necessarily discontinue any of the drugs you mentioned since they aren't likely to be causing his current back end issues. I'd worry if you discontinued them abruptly without discussing this with your vet first.
4. It might be helpful to take his temperature since I wouldn't expect it to be elevated with a spinal or arthritis issue. Normal is between 100 and 102.5 degrees Fahrenheit.
I do have a long list of supplements that I typically recommend for my patients (in addition to the joint supplement he's taking) which I'll be happy to provide; however, they aren't going to help him now since they take weeks to build up in the system (which you probably already know).
It certainly sounds as if he's in a bad way, unfortunately, and I'm not certain if what I've suggested above will be enough to improve his situation but if you can't get him back in the car for a recheck vet visit, then hopefully the Aspirin alone (if that's all you have) will help him.
It certainly sounds as if he's had more than his fair share of issues, doesn't it???
That's a real shame that he can't handle any nsaid medication although I don't typically prescribe steroids for my patients with either arthritis or mildly problematic spinal issues.
However, it definitely sounds as if he'd benefit from specific pain medication such as Tramadol and/or Gabapentin. I have had a few patients for whom nsaids caused issues but they've been able to handle these drugs....although they would have to be prescribed by your vet.
I'm glad that he seems a little better. I'm assuming that you're using a towel (or something similar) as a sling to help him stand and to support his weight once he gets up? Most dogs appear to tolerate this sort of assistance fairly well and it doesn't appear to cause more harm or pain.
I'd be pretty upset with the vet as well if I were you. I really don't like to second guess fellow professionals but since he's had so many issues, I just really don't understand why more wasn't done!!!
I wholeheartedly agree that he should be rechecked so I'm glad that you're planning on doing so.
Unfortunately, my role is to only answer questions, not deal with the financial end of things. But, I can absolutely assure you that you shouldn't be charged for anything which you didn't agree to spend or sign up for. If there's any question about this, then customer service can be contacted and things can be straightened out.
I know you've got enough on your mind without worrying about being overcharged by this site and my sincere apologies that this burden has been added to what you're already carrying:( But, this site is very, very responsive to correcting mistakes if any were made in the emotional moment of worrying about your pet.
Please continue to keep me posted about him if you have a chance. I'd very much like to know the outcome of your vet's visit. There's no additional charge for repeated questions; in fact even after you've rated (if you do, of course), we can continue to communicate about this issue at no additional charge to you.
Good luck with him. Kindest regards, Deb
You're more than welcome.
I feel quite certain that things will be worked out satisfactorily about the monthly plan if you did, indeed, unintentionally sign up for it.
I'll look forward to an update after the visit, then. I tend to be on my computer multiple times during the day so if I'm not logged on when you respond back, I'll get back to you soon.
I'll be sending many positive thoughts your way across the pond:) Kindest regards, Deb
I will contact customer service on your behalf.
Again, best of luck with Sunny. Deb
Thank goodness you saw a different vet this afternoon!!!
I've been heard to say more than once that age is not a disease and it troubles me greatly when I find out that our beloved canine (or feline) senior citizens are viewed this way.
It sounds as if you both were extremely fortunate to have found each other and the bond that you've created is a special one.
I can't know for sure, of course, if this is why medication was prescribed but some vets will automatically dispense heart medication and associated diuretics when they detect a heart murmur without running additional diagnostics such an x-ray or ultrasound. This is not something that I ever do nor advise.
I would trust the cardiologist when they say that he doesn't suffer from cardiac disease. It is distressing when you think how long he's been taking unnecessary drugs but at least no apparent long-term harm has been done from him doing so.
I do know that this site can be confusing from what other owners have told me but I can't see what you do on your end of things. And, since I don't handle anything to do with the financial end of things, it is a little frustrating that I can't help out when issues arise. But, again, I emphasize that you won't be expected to pay for anything that you haven't authorized. And, I did contact customer service on your behalf and asked that they also contact you; however, it would be best if also directly contact them to confirm....which I know you'll do.
At least Sunny received the care he needed at this last appointment. If you have a minute, I'd be curious to know what injection they gave him...if you know, of course. And, I would appreciate continued updates about him if/when you have the time.
First, let me thank you for the rating; it's greatly appreciated. And, no worries about a few days delay in contacting customer service; they'll still handle the situation regardless of how much time has passed.
Second, let me say how incredibly sorry I am that he doesn't seem to be responding as expected. I wouldn't necessarily expect any injection he received to trigger increased thirst but I suppose it depends on what he was given.
I certainly hope that he wasn't given a steroid injection since I'm quite certain that you told the vet how sensitive he is to these drugs!
I'm fairly certain that you have dealt with his colitis issues enough in the past that whatever suggestions I have you've already done or considered...bland diet, probiotics, etc.
If he does have a spinal issue (which is likely) and he can only be treated with pain killers and not nsaids or steroids (because of his colitis), then we are definitely between a rock and a hard place, as they say. Pain killer drugs alone aren't likely to help with inflammation and thus won't specifically address the problem, unfortunately.
I would love to know what they gave him if you can perhaps find it listed on your receipt??? Deb
I'm also having a bad feeling about him but I desperately hope I'm wrong:(
I'm hoping that whatever he was given is causing his loss of appetite and increased thirst....and possibly a flare up of his colitis although stress might also be responsible.
I'll definitely be keeping both of you in my thoughts. Deb
I just wanted to follow up on Sunny and see how he was doing today.
I also wanted to let you know that I received the following message from Customer Service so all should be good as far as this aspect of things is concerned:
We had processed the request of the customer. We cancelled the free trial for the membership program. We also send her an email about the cancellation of the program.
Thanks for the update which is something of a mixed bag in terms of good news/bad news, isn't it??
1. It's not been my experience that fish worsens diarrhea unless you're allergic to it or it's terribly fatty (we want to avoid fat in diarrhea canine patients) . I typically suggest and recommend boiled, skinless, boneless chicken breast and 20-minute boiled white rice for my patients with diarrhea issues, just so you know.
2. I rarely, if ever, sedate or tranquilize my patients when I'm taking x-rays although I do understand that every vet practices differently.
I don't know that it would have been absolutely necessary to take one but it might have been helpful.
3. So glad that he's on Gabapentin which, hopefully, will help control any pain he has.
4. I agree that discontinuing his cardiac medications would in no way cause these current issues or make them worse.
5. No, you don't have to pay every time we have contact. What they meant is that if you post or start an entirely new question, then you'll have to pay.
I, too, am glad to hear that he appears to be responding and will hope that he continues to do so. I know how desperately concerned and worried you are about him but you're doing all you can for him and that's all anyone can do.
1. There are many probiotic products available these days so I'm not familiar with Yudigest. I don't think it matters too much how you get it into him but if you're concerned, you might call the vet's office and ask them.
2. It's very difficult for me to second guess the vets who have been caring for him since I'm not on site. I personally think his colitis is incidental and not the primary problem....which to me, is the issue with his legs. Stress can exacerbate or trigger colitis in canines (as well as human) patients and he's been under a lot of stress lately.
Could something else be going on with his abdomen? I suppose but I'd want to focus on his back legs and possibly spinal issue first if he were my patient and this is being done with the steroids and Gabapentin he's taking.
3. If they absolutely require sedation for an x-ray, I'd refuse if he were my dog. The potential risks involved would not outweigh the benefits...not for me, anyway.
4. Was blood work done on him? Have other conditions such as a tick disease or Leptospirosis been considered although I don't know if you have these diseases in the UK????
From the initial description of his behavior, a spinal issue sounds more likely but I wouldn't completely rule out other possibilities either.
1. Gabapentin doesn't have to be given with food although it can be. The capsules can be pulled apart and the granules sprinkled on the food or it can be given in a small piece of cheese (or whatever) or it can be mixed with a small amount of water and syringed into the mouth.
It doesn't really matter.
2. I may be at risk for repeating myself but there's no guarantee that an x-ray will definitively diagnose any spinal issues. It may be suggestive but not 100% reliable.
3. I'm becoming more and more unhappy with your vet based on your recounting of what's being told to you!! Obviously, you can't insist that x-rays be done without anesthesia but as I said before, I rarely (if ever) sedate a dog who will lie quietly on his side or back to take them.
And, my x-ray quality is just as good as for those dogs who are sedated.
4. I don't typically run bloodwork if I suspect a spinal issue either but it may be helpful to rule out certain things such as Leptospirosis...which can mimic a lot of other diseases.
Tick diseases are sometimes more of a challenge although if Ehrlichia or Anaplasmosis are present, then the cbc may reflect changes.
We do have tests for many of these diseases, but we are testing for antibodies, not the organism itself, in most cases. If antibodies are not being produced (for whatever reason) then the tests could be negative and yet this is still the underlying problem.I've also come to believe that there are tick diseases that we haven't even been able to identify yet and thus would not have tests for all of them. Doxycycline is the drug used to treat most tick diseases and I'll often start this drug in the absence of proof that this is what I'm dealing with. If my patient improves within 3 days, then this is the diagnosis as far as I'm concerned until proven otherwise.
I know you're in a really tough situation here and sleep deprivation isn't helping you process all of the information with any clarity.
But, at the end of the day, I know you'll do what's best for Sunny. Deb
You're clearly being put in a very difficult position but I might