Po's saga

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PofiMia
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Po's saga

Postby PofiMia » Mon Jan 18, 2016 11:57 am

Need help, opinions on the latest chapter.

After Christmas Day and day after when he was clearly having pain in the wrist of the let with toe amputation which also has the latest non cancer growth RIGHT at the wrist joint, we saw our vet and the lump was bigger and a bit oozy. Clearly painful. Aspirated again. Off to lab again. Not cancer again. Signs of reaction to infection, but no clear reason/source of infection. Also was cultured for sensitivity to antibiotics and this indicated staph infection that was resistant to the original abx. So we switched to Clavamox and it started responding. Was also giving a Carprofan every other day for the anti inflammatory impact. Quickly less irritated looking. Everything great until Tuesday (day 9).

Got home from work and he was clearly feeling poorly - unhappy, mopey. Not energetic. Did not want to eat, but I was determined to give him the antibiotic, so I put canned dog food in his mouth and he ate it and I pilled him. Then, just before bed, I found evidence that he had gotten sick from breakfast (and likely Mia cleaned most of it up). Not bile, not lots of fluid, just his food (just little bits of it she missed). Talked to vet in the morning and we decided on 24 hour break from Clavamox. Get him to eat most of a turkey hot dog mid day. Cooked him boiled chicken and rice for dinner on Wed (did not want breakfast) and he ate it eagerly, but I tried not to overfeed. Next morning, Thursday, he didn't want anything. No treats. No boiled chicken and rice. Nothing. Seems to be drinking a lot from Tuesday night and peeing (of course) more frequently. Having bowel movements, so not obstructed. Wants to eat snow.

Went to see another of the vets in my practice on Thursday evening. The dog makes a liar of me and eagerly takes treats from the doctor right as I am saying he won't even take treats. Eats several large biscuits and countersurfs for more while we check out. The vet and I talk about the sudden aversion to food, the puked up meal, the Clavamox. He looks at the growth and thinks it looks much, much improved (it does) and says maybe we don't even go back on the abx. Thinks, as I do at this moment, he doesn't look like a sick dog, but we both think he clearly was having intermittent nausea. Hungry, but turned off by food.

We decide on a an anti nausea injection to see if he will eat after that. It is supposed to be effective quickly and last 24 hours. Pofi helps himself to more treats on the way out. We get home and he won't eat ANYTHING. Not treats, not canned food, not cheese.

I talk to the vet in the morning and mention that I have realized nearly all the food I have in the house is chicken based and all the treats too. It is normally Pofi's preference. Wonder if he is associating these foods and chicken with feeling sick. Decide I will go out and get Lamb and Beef based canned food and also ground beef. Brown the ground beef. He eats it. Offer him some lamb based canned food and he eats a little of that. Also discover he will eat little peanut butter flavored treats by Nutro (little biscuits). I also asked doctor for possible Mirtazapine for appetite stimulation (short term) and we agree I can call back for that on Saturday if it seems necessary. We also took a nice walk on Friday morning, but that did not seem to stimulate appetite immediately (though he did eat later in day - the ground beef and canned food).

Saturday, won't eat anything but treats (not ground beef even). He stopped the excess water drinking on Friday. Eating Peanut Butter little treats and little Charlie Bear treats. Perscription for Mirtrazapine called in and I pick it up Saturday evening along with more PB treats and other treats he usually likes and some different dog foods (beef steak food from Weruva). Give him the Mirtrazapine and 30 minutes later he is bouncing around and demanding food. Eats nearly a whole can of the Weruva beef. Takes treats. Has a Sweet Potato chew. Begs for our dinner.

Sunday morning, picky again. Will eat some treats. Does not want breakfast, but eats some when I am pushy. Give him Mirtrazapine at 4:30 and he wants to eat soon after. Eats canned rabbit and small amount of regutlar kibble. Complication, though, is that the lump on wrist is bigger again and he is licking it more and it seems to be bothering him. Restless night, but sleeping well in the morning and sleeps late. Comes downstairs easily, but only willing to eat a few small treats. I try to bring him another new canned food and it is not a hit. I gave him Mirtrazapine 2 hours ago, but he has not come looking for food.

Pofi can be very finicky and hesitant about eating when it is really cold, and when he is not getting much exercise because it is cold. Both are true. And he almost never has thrown up or had a sick stomach. And he can be a huge baby about this sort of stuff.

Vet said maybe bloodwork next. What would YOU be looking for? What else can I try to help his gut if perhaps this is still carryover from the Clavamox (doctor said a few days to flush completely out of system)? WHY WON'T MY DOG EAT (much)? I am losing my mind.

ANY thoughts welcome.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 12:14 pm

Also. No weight loss. And up until Tuesday evening, his appetite was quite good. This really was like a light switch. Nothing gradual about it.

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Re: Po's saga

Postby connie » Mon Jan 18, 2016 12:42 pm

So he's been off the abx since last Thursday, and today (Monday) his appetite is still iffy or nonexistent? That would seem like it's not the Clavamox causing the stomach discomfort, unless it never really left and everything since has just made him feel queasy.

How long was he on any antibiotic? I think you said 9 days, but I might have missed something?

When you gave him the abx, did he also get a probiotic (same day, away from abx) to keep his gut flora good?

Has he had previous courses of abx for this? (I think he has, but I am of feeble mind so I could be wrong.)

Since he has not lost any weight, malnourishment would seem not to be an issue here, so would you consider fasting him for 24 hours, with nothing but water and maybe some honey in it, and then starting him back on very bland foods -- scrambled egg with wheat bread, or white rice cooked in chicken broth -- for a few days, while making sure to give him probiotics daily? You've likely considered this already, I'm just trying to piece together what my response would be if this were my dog. (And no meds during the fast.)

I don't know how I'd deal with the lump, in the middle of this; I'd probably bandage it to keep my dog from bothering it. But if it's getting larger, that's an issue too. Is it related somehow to the stomach upset, I wonder?

When are you going to run bloodwork?
Last edited by connie on Mon Jan 18, 2016 12:47 pm, edited 1 time in total.

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Re: Po's saga

Postby connie » Mon Jan 18, 2016 12:44 pm

I'm wondering if his gut is churning from the various meds. If it is, that's a pretty simple fix; but the question then is how you treat the condition that the meds were addressing. Hmmmmm.

Nausea is a listed side effect of both mirtrazapine and Rimadyl. That, following a course of abx, might just have turned his gut into an unhappy place. Is he pooping okay?

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 12:53 pm

Hi, Connie.

9 days of Clavamox, but last dosage was late Tuesday. There was an earlier course of abx - a different one. Mid November to mid Dec. Less effective. And many, many courses of antibiotics stretching back to beginning of May with start of toe issue and then amputation and second lump surgery beginning of September. The only probiotics have been in his daily Greek yogurt.

Suggestions on probiotics (brand, source, and amounts) appreciated. And yes, appetite iffy to nonexistent since Tuesday.

Pofi never pukes - less than 5 times from puppyhood.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 12:55 pm

Pooping is normal in appearance and frequency considering reduced intake. Was normal even Tuesday night when this all started.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 12:57 pm

Probably tomorrow for blood work as they have later hours.

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Re: Po's saga

Postby SherriA » Mon Jan 18, 2016 1:56 pm

For Probiotics I like NOW 4x6 and I find it's pretty readily available around here. You can get powder or capsules, whatever is easier for you.

Sending good thoughts for Prince Pofi.
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Re: Po's saga

Postby connie » Mon Jan 18, 2016 2:06 pm

In the absence of any conclusive disorder indicated by anomaly in bloodwork (fingers crossed), I would probably think gut exhaustion brought on by abx and meds. Different dogs tolerate that stuff differently; it always amazed me that my Mikey seemed not to have any reaction to doxycycline, all the times he was on it, when plenty of other dogs get yucky tums from it, for instance.

If this were my dog, I'd give him some gut support and some liver support. His body's had a lot to deal with. Milk thistle for the liver, or Livaplex by Standard Process, or HepaClenz, which I like best because it's got milk thistle and other herbs too; and probiotics for the gut and just 'clean' food for a while -- nothing processed, bland cooked foods for a week or 10 days, and raw honey in water for energy and also to help heal the gut.

That's assuming, as I said, that the bloodwork doesn't flag something that requires attention or indicates a problem somewhere.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 3:21 pm

Probiotics mixed in with food? Or with capsules, can I give as a pill?

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Re: Po's saga

Postby connie » Mon Jan 18, 2016 3:22 pm

Either way is fine.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 3:36 pm

Thanks!

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Re: Po's saga

Postby MaisyPancakes » Mon Jan 18, 2016 3:37 pm

So sorry for the worry, LM. For the tummy, I'd try slippery elm or marshmallow, whichever he'll take to sooth/help heal. It would make any meds less absorbable so would do it apart from that. I agree about not doing anything processed for a bit, too. If you feed any grains, I would cook the bejeezuz out of it, like a loose congee. I think barley water type stuff can be very soothing for tummies, too, and is usually easily accepted.

When MP wouldn't eat for the first and only time, Mirtazapine was GREAT. Since he was eating well right after the previous doses, I have a feeling that's not what's making him feel icky, but I guess it could start to not work as well,too. FOr humans who use it as an antidepressant, you're supposed to wean yourself off of Mirtazapine—no animal person told me I need to, but I did anyway with MP. I tapered off over 2 or 3 days, I think.

No puking since that one time, though, right? I wonder if his appetite is related to how much his wrist is bothering him?

Everyone if different, but the pbx I feel like I am pretty sure has worked (as opposed to just an inkling... ;) ) is this Garden of Life one (http://www.gardenoflife.com/Products-fo ... spx)—Whole Foods has it for sure, most co-ops have it in town. Kind of pricey, but it has a lot of cultures in there. (30 billion per cap; I split mine, usually.)

Does he willingly drink water? If not, and if he is eating less, I would give broth (pref homemade or not without all the salts and things) or something to encourage fluid intake so he'll flush out the ickies, too. Check gums for dehydration, etc.

Hugs sent your way!! Lemme know if I can do anything locally!

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 4:31 pm

Nana, Slippery Elm and Marshmallow - pills?

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Re: Po's saga

Postby MaisyPancakes » Mon Jan 18, 2016 4:37 pm

They can both be found in bulk (cut+sifted/powdered) or in capsules—I know the Wedge has had both in both forms. They also have tinctures, but I like the other forms better for actually creating soothing mucilage to sooth the tummy. Sometimes I make slurries (with the bulk stuff), and sometimes I just add on top of (wet) foods or mix with broth. They are both dehydrating to some extent (like psyllium), so you want to make sure there's plenty of fluids.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 5:50 pm

On my way to Seward Coop now. Thanks all. Appt tomorrow afternoon for bloodwork. He just grabbed a squeaky to and had me chase him upstairs to play. Just not acting like he feels poorly overall.

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Re: Po's saga

Postby whiteboxerboy » Mon Jan 18, 2016 6:23 pm

Poor Po, I'm sorry this has been going on for so long.

I wanted to add that I would start off *slowly* w/ the probiotics. I start off with 1/8 teaspoon once a day for 2-3 days so the dog's tummy can adjust. I remember giving a foster dog half teaspoon to start. Yikes, too much too soon.

I second what the others have said about no processed food for a bit. Baked potato, rice cooked really mushy in broth, lean meats.... That's what I would do.

Has the vet tried cold laser on Po's wound? I don't even know if that's an appropriate use of cold laser but isn't it supposed to speed healing?
Sending lots of feel better vibes to your Po.

I hope he's feeling better soon.

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Re: Po's saga

Postby PofiMia » Mon Jan 18, 2016 8:02 pm

Lynn - it is a growth that ruptured rather than a wound. Staph infection. I will ask about cold laser.

So I found the probiotic capsules Nana mentioned and Milk Thistle capsules and bulk Slippery Elm. Had a probiotic and milk thistle with peanut butter. Had some chicken broth and I dissollved just a little Slippery Elm in that. He wanted to know what was in my bags. Acts like he wants to eat, but nothing that I have to offer...

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Re: Po's saga

Postby MaisyPancakes » Mon Jan 18, 2016 8:15 pm

I'm glad you found the stuff. :)

Your vet will know more, but IIRC, one needs to be careful with lasering on/near some types of tumors/growths because it can "activate" them or make them worse. Hoping for improvements and answers tomorrow!

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Re: Po's saga

Postby LisaT_II » Tue Jan 19, 2016 1:56 am

I only skimmed the thread. My first suspicion actually would be the Rimadyl, but the abx certainly don't help. I've seen susceptible dogs near death after two days on Rimadyl. Now, lower dosages are used, but you still see dogs get really sick from it. So, yes, definitely agree with the liver support - my favorite is Country Life's Liver Support Factors, but Milk Thistle will work, unless you run bloodwork and see elevated enzymes, then I would switch to something stronger. Good probiotic and the slipperly elm or marshmallow (jazz here is allergic to elm).

If the stools were kinda mushy, I might suspect that the abx may have triggered something like a clostridium flair. If they are more pale than usual, I'm more inclined to suspect liver enzymes.
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Re: Po's saga

Postby PofiMia » Tue Jan 19, 2016 6:22 am

Lisa T_II, he had only had one Rimadyl every other day and the last one was last Sunday morning. He had a lot more Rimadyl earlier this year with toe issues and surgeries. Never a problem. He had a few different abx, but I do think this was first time ever with Clavamox. Poops have seemed normal firmness - maybe slightly light in color.

He at about half a large scrambled egg this morning.

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Re: Po's saga

Postby PofiMia » Tue Jan 19, 2016 7:25 am

He also ate about a half an English muffin for me just now.

So worried....

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Re: Po's saga

Postby emmas_mom » Tue Jan 19, 2016 9:40 am

I'll be interested to hear the blood test results. The eating issues are so similar to what I experience with Mitzi - I know how frustrating and worrisome it can be. By the way, my vet tells me mirtazapene has a levelling-off effect - the more often it is given, the less effective it becomes (takes longer to act, takes more to effect appetite). I experienced this with Mitzi. Now, I only give her a dose when she has been refusing most food for 2-3 days (but I try to catch her before she refuses absolutely everything as she is very hard to pill. I have sometimes had to crush it and mix it with water which I can syringe down her throat). I have noticed that the less often I give it, the better and more immediate effect it has.
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Re: Po's saga

Postby UpwardDog » Tue Jan 19, 2016 9:57 am

Oh how frustrating. Both Carprofen and abx can be tough on the belly and those effects can last a while. Maybe the combination upset things and it'll take a bit of time to get things back to normal?
I second the idea of slippery elm and probiotics.Milk thistle certainly worth a try too, I just hesitate to add too many things at once because then it's tough to tell what helped/didn't help.
I've had great success with slippery elm for this sort of situation with my mother. She had to take a Big Gun antibiotic and her guts were miserable. Slippery elm made it so much better. (I put the powder into capsules for her since she probably wouldn't eat the slime poured over her food lol ) I was glad to have that experience from someone who could tell me how they felt in words, instead of a dog.

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Re: Po's saga

Postby PofiMia » Tue Jan 19, 2016 11:14 am

Thanks, Heather and Jean. Will share the blood test stuff. I did get vegetarian capsules I can put the slippery elm in, too. Today he had a lesser dose of the Probiotic and another Milk Thistle capsule.

I definitely could see the leveling off on the mirtazapine with him - Saturday night he was bouncing and demanding food within 1/2 an hour. Sunday was still effective, but less dramatic. Yesterday seemed to have no impact.

He had not had any weight loss as of Thursday - he is really at his long time ideal weight of 75 pounds. He was heavier earlier this year during the toe saga after a long, wet and cold spring where he got less exercise, but we got him back down with intent (he and Mia both came down a few pounds) over the summer and fall (slightly lowered calorie intake and much more exercise).

When I think of everything he has taken in the last 9 months....3 different antibiotics or maybe 4. Carprofen, Tramadol, Trazadone, Prednisone. It is a lot.

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Re: Po's saga

Postby whiteboxerboy » Tue Jan 19, 2016 1:47 pm

Don't forget about Pepcid AC (20 mg) for empty rumbly sour stomach.

I hope you can get him to eat this evening.

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Re: Po's saga

Postby PofiMia » Tue Jan 19, 2016 4:10 pm

Back from vet where he acted like not a sick dog at all for Dr. S. Dr. P is on vacation this week and Dr. T who we saw on Thursday was on surgery today and had no openings till Friday. Dr. P did first surgery and Dr. T did second surgery, fyi. Bloods taken. Also Pancreatitis test, which seems reasonable, but I would be surprised if this were Pancreatitis.

One of the doctors will call me tomorrow morning to talk over the results of the blood chemistry. Other thoughts discussed, if we feel we need imaging, x-rays, there is no way Pofi would be compliant and lie still for that. Meaning a sedative at least. So if sedation, why not anesthesia and remove the growth at same time. Which had occurred to me, but Dr. T and I had also talked about surgery for the growth and said we didn't know if we want to keep putting him under. Dr. S tonight also said what about an injectable abx if bloods seem to indicate no problem and we get him eating again and found one that should work based on the culture for sensitivity.

Right now just need the bloodwork and then talk next steps.

He ate 6 to 8 Iams biscuits from the clinic rabidly - would have taken more if we had let him. Dr. S then threw out - what about just a way, way different food than you would ever feed. Maybe pick up Purina Dog Chow on the way home just to see if the different smell will entice him - might give him diarrhea, but I would feel better knowing he ate. Did so. No go.

THIS DOG. Maybe I should just drive him to the vet clinic every day to feed him.........

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Re: Po's saga

Postby emmas_mom » Tue Jan 19, 2016 7:09 pm

THIS DOG. Maybe I should just drive him to the vet clinic every day to feed him.........
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Re: Po's saga

Postby whiteboxerboy » Tue Jan 19, 2016 8:16 pm

You could try warming some water from a can of tuna or salmon.

Or, crumble some of those biscuits from the vet clinic into his food.

Good grief, he's making this hard on you guys. ;)

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Re: Po's saga

Postby PofiMia » Wed Jan 20, 2016 7:48 am

Liver. Bad. Values were fine in July. Very bad now.

Sick to my stomach. Bringing him in tonight for blood clotting panel they can send out and then tomorrow morning GA for ultrasound and biopsy.


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