12_30 Update

My company left on Monday and yesterday was a day of extreme rest. :)

Like I mentioned in my last update, Elvis handled all of the activity here over Christmas very well. He was quite engaged in what was happening, and if someone rang the doorbell and came in to the living room, he was quite curious about them and wanted to at least come in and sit across the room and observe. A far, far cry from his earlier actions with company.

He's been on the 1/3 Pred a day regimen now for several days, and will continue it through Friday. Beginning Saturday, he starts on the 1/4 tablet per day for two weeks. Though I've noticed a bit more coughing in the last day or two, I'd say the Prednisone treatment has handled 85-90% of his cough/wheezing. This is very good. Now what will transpire when he moves down to the 1/4 tablet, we won't know until it happens. And then we'll have to see where we are when he comes completely off of it. Currently the improvement is such that he's not really being given any Torbutrol, and his Guafinisen is reduced.

Sunday night will be another heartworm pill. This is to treat the incubating heartworms again...just like last time. Once we see how he responds to the reduced Pred dosage (and then life without it), Dr. Walthall will make the decision on whether to treat the adult heartworms.

So that's where we are. Unless there's some extreme change, I suspect I won't post another update until sometime Monday or Tuesday after he's cleared the treatment hurdle. I don't expect any problems since there weren't any last time, but I do want to keep a close eye on him three or four days after the treatment because that's when he started having problems with the serious cough/wheeze.

I hope everyone has a happy and safe New Year, and I'll see you next week. :)

Christmas photos

Here are three photos from yesterday. And yeah, we got the space alien look going.

Elvis:


Skeeter and Elvis

Haley and Elvis

12_26 Update

I know I said I probably wouldn't update until Sunday, but I think I forgot what day it was when I said that. :)

This will be quick, though, since we've got out of town company that won't leave until Monday.

Elvis has handled the Christmas spirit really, really well. He had no problem when my dad and stepmom were here earlier in the week. He's handled all the decorations and kitchen banging and rattling really well. And he handled all yesterday's activity really well. An enthusiastic "Attaboy!" for him.

He went down to 1/3 a Pred yesterday, and he'll have another six days of that. The Pred has helped him enough to where I'm only giving Guafinisen at need now and Torbutrol if he can't seem to stop coughing....and that's pretty rare. He's also at 8.4 pounds, so as much as he's food motivated right now, his weight is still in good shape.

It looks like the steroids have really helped stabilize him, which is great. I do want to speak with Dr. Walthall about continuing to use the Enalapril. I'm honestly forgetting what benefit that medicine is supposed to have. And am I seeing it? (SOOOOOO many drugs. LOL) I won't talk to them until sometime next week, though, so we'll just keep on giving him his small dosage twice a day.

That really is all, though I am going to post a picture or two in another post. We got some of him, Haley and Skeeter yesterday, so I want to get them on here.

I'll post another update in a few days.

12_24 Update

Since I've got a ton of stuff to do today in preparation for Christmas Day tomorrow, I'll make this brief.

Elvis has now had four days of 1/2 pill (5 mg) of Prednisone, and it's definitely making a difference with him. There's MUCH less wheezing/coughing going on, and I've been able to seriously cut back on his Guafinisen and Torbutrol. He still gets his Robitussin DM (which has Guafinisen in it) with breakfast and dinner, but the Torbutrol has been cut back to may 1/4 pill per day. He got one this morning, and he got one at dinner last night, but I'm generally seeing that instead of two 1/4 and one 1/2 Torbutrol, it's really about one 1/4 pill.

So that is a definitely improvement.

The Prednisone is certainly ramping up his appetite and I am having to watch him. He's highly motivated to grab stuff that falls on the floor, which is something he has never done before. I'm pretty sure he's going to put on some weight during this course of medicines, but I'll weigh him today at the normal time and make the necessary adjustments.

This will probably be my last update until maybe Sunday. I did call his clinic yesterday to let them know the Pred is helping him. He'll move over to 1/3 pill starting tomorrow, and I will call the clinic early next week and give them an update.

So with that, I'll close and wish everyone a very happy and safe Christmas.

War vets, shelter dogs heal together in program

War vets, shelter dogs heal together in program

Soldiers with PTSD find comfort, inspiration in needy pooches

One of the goals of Pets2Vets is to raise awareness about post-traumatic stress disorder. Sharpe says that while a few groups provide veterans with service dogs, many PTSD and traumatic brain injury patients do not qualify for these programs. Even when they do, because of the stigma still
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http://www.msnbc.msn.com/id/34572712/ns/health-pet_health/

12_22 Late update

Apparently the Prednisone is acting faster than I thought it would. Elvis has hardly coughed or wheezed all day.

With that in mind, I'm going to delete his bedtime Torbutrol since it's rather pointless to give him the Super Duper Cough Stopper pill if he's not coughing. I'll give him 1/2 of a Guafinisen since he never got one this afternoon. If he doesn't cough tomorrow, I'll just go with the Guafinisen like I used to.

One thing the Prednisone is definitely doing is making him a really hungry fella. :)

Not unexpected, but he's been seriously looking for food whenever there's an opportunity. I'll weigh him tomorrow to be sure he's not doing anything funky with his weight.

I'll post another update sometime tomorrow or Thursday.

12_21 Update

Elvis got his first dose of steroids today. So far. So good. He'll be on them for the next 3 1/2 weeks. It's Prednisone, so he gets a full dose (half a 5 mg tablet) for four days, then eight days of 1/3 tablet and then two weeks of 1/4 tablet.

Since it takes a few days to kick in, I doubt we'll see much in the way of improvement until Thursday or so. I have hopes this will help his wheezing and coughing.

Randall and I had my dad and stepmom over today for a gift exchange, and I wasn't sure how Elvis would do since there would be packages and tissue paper. Lots of rattling stuff tends to make him nervous.

Everyone was crated when they first came in and then we put up the gates and let everyone out of the crates so they could be in here in the den, loose but hearing the noises. When we took the gate down from the kitchen into the living room, Haley and Skeeter came right in (they'd been up at the gate and Elvis had been with them). Elvis came in and skittered around a bit, ran out of the room and then came right back in.

Randall picked him up and put him in the chair with me where he watched while I took stuff out of bags and had tissue paper rattling around, and he did beautifully. He was sort of big-eyed, but more out of curiosity than anything else. When I was done and he'd had a chance to sniff stuff, he promptly curled up and took a nap.

We were really proud of how he handled himself. He only wheezed and coughed a couple of times, but not loudly and not for long. He just continues to surprise us when he's asked to handle situations that are different than the usual. We don't push or stress him, but when he can move at his own pace, he really does well. A far, far cry from how he was five months ago.

I suspect I won't post another update until later this week. My mom is coming in from Dallas on Friday, so I'll try to get something up on Thursday...hopefully I'll have news about the steroid treatment.

12_19 Update and Future Plans

The update part is actually very short. :)

Elvis continues to wheeze some and cough some, but if I had to put it on a scale of 1-10, I'd say he pretty well stays at a 2. Sometimes up to a three, and sometimes down to a one, but on average it's a two. This is good because it means he can continue to sleep through the night, and I don't have to push water on him because he's coughing so much and dehydrating himself. A definite improvement there.

Now, for the future plans. :)

He will begin a small dose of steroids on Monday to help him with his wheezing/breathing. I had hoped he'd be able to go on them, but Dr. Walthall wanted to consult with some other vets to ensure that the steroids would be OK for a dog with his physical problems. It is OK, so Monday Randall will drive out to the clinic and pick up his pills.

If these help stabilize him, Dr. Walthall wants to look into treating the adult heartworms that he has. She feels that many of his problems may actually be coming more from that situation, and if he's stable, addressing it could very well help.

Making the assumption here that the steroids will do what we hope, I've emailed Fallon (the new foster care director at the shelter) to find out how she wants to handle this. Normally, heartworm treatment for positive dogs is given by injection, but because that is so very debilitating, Dr. Walthall wants to use a monthly treatment pill each week for a few weeks. Right now, I'm not sure where I'm getting the pills, but since this is a treatment like his Lasix and other heart drugs, the shelter should pick up that cost. Once he's been treated successfully, then he can move over to the preventative I use for my guys and it will be treated like just part of his diet.

I did ask that we not make any plans to start this until after the first of the year. There's just too much going on at home to add something like this. I want us to be able to give him our undivided attention. I doubt we'd make the decision to move to the new treatment before then, but I wanted to mention it just in case.

And that's where we are. I'll post another update after he's had a chance to be on the steroids for a bit and we can see if they're helping.

12_18 Medicine/Feeding Update

Posted because I'm afraid I'll lose my mind (and my notes) over the weekend. :)

Elvis, btw, is doing pretty well. Still sleeping through the night. Still wheezy (but a bit less so) and still coughing (but less so), but all in all, he's doing better than he was earlier in the week.

Breakfast
1/3 cup food
1/4 cup water
1/4 Enalapril
1/4 Torbutrol
.5 ml Robitussin DM
.75 ml Lasix

Midafternoon (if needed)
1/4 Torubtrol
1/4 Guafinisen

Dinner
1 1/2 Tbsp food
1/8 cup water
1/4 Enalapril
.5 ml Robitussin DM
.75 ml Lasix

Bedtime
1/2 Torbutrol
1/4 Guafinisen

We're still waiting to hear about the steroid situation, but right now he seems stable, and that's the main thing. His weight is definitely fluctuating, but I suspect that's because I've been tweaking the medicine and food/water amounts. He's down closer to 8 pounds, so it's not too radical.

We're having family over Monday afternoon, and I've got quite a bit to do this weekend, so unless his situation changes, I probably won't update this blog until Monday night.

12_17 Update (Thursday)

Just a very quick update here.

Elvis is about the same. Still sleeping through the night with some very mild coughing, so that's good.

Dr. Walthall is still waiting for information on the consultation on the steroids for him. Not sure if we'll know anything this afternoon or not. Might be tomorrow. I will say that 1/4 of a Guafinisen given with either 1/4 or 1/2 of a Torbutrol really helps. The two drugs seem to work very well together in controlling his cough...better than they do alone.

Right now, he gets 1/2 Torbutrol and 1/4 Guafinisen right before he goes in his crate for the night. At breakfast, he's getting .5 ml of Robitussin DM (has Guafinisen in it) and 1/4 Torbutrol. If he needs it during they day, I'll give him 1/4 Torbutrol and 1/4 Guafinisen. That seems to be working with him right now. He's also back down to .75 ml Lasix twice a day, and 1/4 Enalapril twice a day.

His antibiotics ended yesterday, so that's one less pill for him. Yeah!!

That's where we are right now with him. Hopefully I'll have some information about the steroids late this afternoon or tomorrow. If not, it will be Monday.

12_15 Update

Whew! What a day.

We stopped in for Dr. Walthall to check over Elvis since her last time to see him was last week in the middle of the night. From what she could hear, his heart sounds good (for what we're working with here), but his lungs sound like the Rice Krispie guys. Snap. Crackle. Pop.

His medicine was refilled and didn't particularly change. He's got 1.5 ml Lasix (that's been .75 twice a day, but I think I'm going to split this into three doses and see if it helps. He can have a morning, lunch, dinner dosing). His Guafinisen stays at three 1/2 pills a day. His Enalapril (heart med) will stay at 1/4 pill twice a day and his Torbutrol will stay at 1/2 pill before bed, and another 1/4 during the day if he needs it. He'll end his anti-biotic tomorrow night, so that that will be one less pill to fool with.

Dr. Walthall wanted to consult with another vet about possibly using steroids on him for his wheezy breathing. The concern here is that it could thicken the fluid he's got with his congestive heart failure, but I suspect we may try it for at least a little while if we can. His breathing is really bad.

He's also going to get a monthly heartworm treatment like the rest of the house does. I want to talk to her about that again, because the shelter doesn't provide the treatment for fosters, and I use Ivomec liquid. He would get a tiny dose, but I'm going to have to get a 1 cc syringe before I can do much. My syringe isn't calibrated that finely.

So that's where we are right now. There's no question he's improved over last week, but I really would like something that would help ease his breathing because that seems to be what triggers his bad coughing spells.

Not sure if I'll update tomorrow or not. A lot depends on what I hear about his steroids and if his sleeping habits change (we're back to sleeping through the night which is MUCH appreciate).

I'm hoping to get a few pictures in the next week. I'd hoped to get some before now, but there's not much point when he hasn't felt well. He's feeling much better now, though, so pointing a camera in his direction is more likely. :)

12_14 Update

Thought I'd done an update earlier today. Oops. So I'll make this one quick.

Elvis did well again last night, so we all got sleep. Tonight, I'm going to dial him back to 1/4 Torbutrol rather than 1/2 and see how it goes.

I've scheduled an appointment for him tomorrow to see Dr. Walthall. I did talk to her briefly today to check on medicine amounts for his cough and she asked me if it was dry of wet. Most of the time it's dry. Sometimes it's wet. And sometimes I have a hard time telling.

So we'll deal with this tomorrow. Fortunately he'll be in the room with her and I'm pretty sure he'll cough, so that should help.

He's gotten some ottoman time today which is VERY important to him. :)

I'll post tomorrow afternoon after we get back home and update how things are going with the little guy.

12_13 Evening Update (Sunday)

This is going to be short post because I'm beat...been in the kitchen all day.

Elvis had a good morning and early afternoon, but his day started going downhill the more the smells from the kitchen increased. I was actually roasting a turkey and about 3:30, it began to smell good and Elvis' wheezing increased.

Got worse at dinner. :) As he gets excited, he wheezes a lot and coughs more. He's felt good enough, though, to race Skeeter out the back door. I know that's not in his best interest, but he loves it and he's not really felt up to it until today. He also spent a lot of time meandering around the yard since it was a really pretty day and warm enough that Haley and Skeeter both wanted to spend time in the sun

I'm going to go give the old man some ottoman time this evening. He got a bit before lunch and he was VERY happy. I've been pushing the water today some since his coughing has been more pronounced. He'll be getting some of that here shortly and then we'll head in for time in his favorite nap spot.

Hopefully we'll have another good night tonight. I'll call the clinic in the morning and set up an appointment. I'll need to restock the medicines, too. And he's down to 8 pounds which is good.

I'll post again in the morning.

12_13 Morning Update (Sunday)

Hhmmmmmmmm....I don't want to be TOO optimistic here, but Elvis slept mostly through the night. Which meant I wasn't up at 4 am giving him another cough pill and shoving water down him.

Randall said shortly after midnight he started coughing about every hour, but that it was fairly soft and only went on 30-45 seconds. I suspect he would get up and shift around.

He was VERY happy to see me this morning. This is the first time since Wednesday that he's gotten up and greeted me with his wagging stump and goofy grin. Coughing? Yes. Wheezing? Yes. But still very happy. Randall said he went over to the gate a couple of different times to look through and see if I was coming.

He also cleaned up his breakfast dish. Not really surprising since he didn't get fed in the middle of the night.

There is also a tremendous amount of interest in what I'm doing. As in..."You going to the ottoman, yet?" sort of interest. So I suspect in the interest of keeping him comfortable, I'll head in there so he can have a half hour of his favorite past time.

So, things are better today than they were yesterday. He's less wheezy for the most part. The cough is still definitely with him, though it seems to stop sooner than it did yesterday. So this is very good news. It looks, too, as if the dietary distress is ending. I've not seen him straining to potty and he's not taking nearly as long when he poops.

I'll definitely call Dr. Walthall tomorrow because I want her to see him. If not tomorrow, then Tuesday. I'll need to reup the drug supply, and I want a good talk with her (and I'll pass on the info to Fallon at the shelter), but I'm really wondering if what we're seeing isn't the new normal for him. There is still no distress when he's coughing, though he does look at me as if he wants me to make it stop, but it seems as if he's treating it as an annoyance rather than something that's interfering with him getting his breath.

With any luck, what we're seeing is something that can be handled. His heart disease is never going to go away, and at some point it will mean the end for him, but as of today, I don't think that point is right now. It could rapidly change, but my fingers are crossed that we're not going there tomorrow.

I'll post again tonight.

12_12 evening update

It's been a mixed bag here, today.

Elvis is still hacking, coughing and wheezing, but what is interesting is that he doesn't seem to be in any real distress. Obviously he's not real happy when he's having a bad bout, but he's very alert, interested in what's going on, and eating everything we put in front of him (or doing his level best).

In a way that's encouraging, but in a way it also disturbs me. If he had some infection causing this, I would expect some lethargy and lack of interest in food and household happenings. That's not the case. Now, he's also only had three full days of Clavamox and Dr. Walthall did say that the blood panel showed high normal for infection, so I guess it's possible this is something low grade. Sure doesn't sound that way, but maybe it is.

One GOOD thing is his weight is down some. Yesterday he'd ballooned up to 8.8, and today he's down to a more normal 8.2. I'd still like to see it a bit lower because looking at him gives me the impression he's retaining fluid. And there's only so much Lasix he can have. I've actually given him a bit more last night and today than I feel really comfortable with, so tomorrow I'm going to have to dial it back some. Ditto with the Guafinisen. He's not showing much in the way of drowsiness, but I'm having to use more than I'm comfortable with. And he won't take liquid Robitussen DM unless its well camouflaged in food. I can't blame him. That stuff is cherry and its vile.

I'm iffy on how his stool is doing. The only reason I noticed blood in it at all yesterday was because he'd pooped in the house. He's not done that today. I think it's still somewhat loose based on how he's acting outside, but I would say there's definite improvement in the length of time he tries to potty. That's a good sign. I'll keep with the rice and yogurt until I see a reversal, but I am almost 100% that this was invoked by the turkey stock. Won't make that mistake with him again.

This is where we are tonight. He's been haunting the hell out of me most of the afternoon, so I know once dinner is over, I will be heading into the living room with my book so he can spend some ottoman time. He's not had any of that in the last several days, and he's obviously missing it. The fact he hasn't been pushing until now may mean something. Usually he starts bugging me nightly if I haven't gone in there, but the last three days haven't been that way. Maybe this is a good sign. I sure hope so. Because even if he's not seeming to suffer from his coughing spells, it's killing me to hear them.

I'll post again in the morning.

12_12 morning update

Not a great night here.

Elvis' half pill of Torbutrol only held him until 4 am. He started back in coughing and hacking, so I got up and let him outside after giving him 1/4 of another pill plus some Guaifinisen. Since I knew he would also need fluid, I gave him a bit of food, Kaopectate and water. He gobbled that down.

Haley and I took benedryl, and even with that Haley wouldn't go back to sleep, so about 4:30, Randall went out and got her and stuck her in bed with us. I hated to "reward" her bad behavior, but in the middle of the night there is only so much whining and yipping we can stand. Not only that, but since her crate is right next to Elvis', she was disturbing him.

Randall got up and left me to sleep. Elvis got his Clavamox and heart pill. When he came to wake me up at 9:30, he said Elvis wasn't doing well. Lots of coughing going on...bad enough that he finally had put him in his crate.

I gave him breakfast, and he didn't clean the bowl. Not so much that he wasn't finished, but I think he was slow because he wasn't as hungry. Everyone has been outside, and I'll put Elvis back in his crate in a bit with the bowl. I suspect he'll polish it off then.

So here's where we are. Still a lot of coughing, hacking and wheezing. This isn't good. My fear is that either the Clavamox isn't working or, worse, this isn't an infection but a progression of his heart disease. If it's the latter, I suspect we're at the end for poor little Elvis.

I plan on calling Liz at the Humane Society in a bit and having a talk about how to handle things from here on out. Randall and I will do everything in our power to pull him through this, but I think Dr. Walthall suspects this problem is from his heart disease, but she's willing to go with an infection as a possibility. Ultimately while we'll do whatever we can, we also won't let him suffer. Right now he's a bit unhappy and uncomfortable, but his problems are controllable. If, however, there won't be any improvement, we'll have a decision to make.

I've got a lot of kitchen stuff to do this morning, but I'll post an update this afternoon.

12 _11 Early evening update

Man. What a day. Not that Elvis is doing worse, really, but that there comes a point where I'm up to my ears in medication and problems and I begin to think I'm losing my mind.

There is still a lot of wheezing and a lot of coughing going on. Stress, excitement and movement seem to be the main drivers.

I did finally talk to Dr. Walthall late this afternoon (she's had the day from hell), and we talked over some options.

The main concern right now after the wheezing/coughing is the blood in his stool. It's possible he's going into kidney failure (though that panel was excellent last week and he doesn't act the way other dogs of mine have acted when going into late stage renal failure). It's possible it's cancer. That's always a shadow. But the most likely culprit is yours truly helping him get more fluid down by giving him the smoked turkey stock. Even defatted and with very low sodium, it's rich. It just seems too likely that I've caused the problem. Right now, it's being addressed by giving cooked rice, kaopectate, yogurt and canned pumpkin. I'll keep an eye on it, but his stools are loose and that didn't start until today after a couple of goodly amounts of stock.

Dr. Walthall and I will look at this again on Monday if it's still happening, because it's also possible he needs a GI protectant. I know antibiotics can also sometimes loosen stools, so while it's in the back of my mind, my main worry is dehydration. So this stays as a "monitor and try to clear up with diet change."

He's getting his Clavamox twice a day in a little ball of food. This is the one thing that might change on Monday. Dr. Walthall can give him an long acting antibiotic injection, so if I'm not seeing improvement by Monday and need relief from pill handling, he'll go in for that.

His Enalapril is another twice a day, and that's going easy because, like the Clavamox, it's in a food ball and he scarfs if down. That's one thing you can say about Elvis: whatever he has that's going on really isn't causing an appetite problem. He's a proper little pig.

So the two main things now are the Lasix and the cough medicine.

The Lasix is really a no brainer provided he's getting enough fluid. I did give him a pill today rather than the liquid because he was drugged from the middle of the night Torbutrol. That's a once a day thing (and I've only got one more), so I'd like to get him back on the liquid tomorrow. That gets tweaked just about daily, so there's no real issue with it.

Back to the cough. It can get bad. Obviously NOTHING like it was two nights ago, but he's wheezing and the cough can get hacking. On a scale of 1-10 today, I'd give it a 2 or 3. Not bad, but I want him to sleep tonight.

I will give him a bit more rice, yogurt, kaopectate and pumpkin with a bit of water about 10. I'll also give him 1/2 of a Torbutrol at the same time. I'm going to have to go out and see how Guaifenisin reacts with it because I don't want to overdo it, but I do want that available if I need it later tomorrow.

So that's where we are. His weight is up to 8.8 lbs which is a significant gain for him, but since we've been pushing food/liquid, I think that may be where some of it's coming from.

Hopefully the night will be uneventful since everyone here needs a full night of sleep. I'll post in the morning on what's gone on.

12_11 - early afternoon update

For now, I'm going to have to start posting more medical note taking stuff in here. If I'm not careful, I'm going to start having trouble reading my hand written notes, so this is the best place for them.

8:10 am. Pooped in his crate. Loose stool, but not unexpected because of the turkey stock (it's rich). He moved out onto one of the dog beds, and there's been no sustained coughing. Offered him some liquid and he showed no interest.

9:30 am. Gave Clavamox and 1/4 Enalapril in a bit of food. Still not interested in breakfast, but he's gotten up several times for water. This is the first time in two days he's really done this.

10:45. 1/2 Guaifinisen, 1/4 of 50 mg Lasix tablet (he won't have more Lasix today). He's more alert. Still coughing, but less intense (2-3 on a scale of 10).

11:25. Pooped a little in house. Very loose and a bit of blood in the mucus. Went ahead and called the clinic, but they'll have to call me back.

12:15. Ate 1/4 cup rice, 2 Tbsp plain yogurt, 1/4 C stock. Was looking for more. I could hear him wheeze when he was eating, but it seems that that and drinking tend to increase it. Once he was finished eating, the wheezing eased.

He's been outside and followed everyone around. He's in the basket now and resting with no coughing and little wheezing. I'll call the clinic again after 1:00. I hate to be a pest, but I also want a nap this afternoon, so if Dr. Walthall wants to see him, I want to be sure and talk to her.

Also, I really do want some sort of game plan for over the weekend. Some things I want to check are whether the Clavamox will help address the wheezing at some point. I also want to verify the amount of fluids/day, whether I should worry about the loose stool (Pepto maybe?) because of dehydration, and what the dosage/24 hours is for Torbutrol. There's probably more, but I'm forgetting it. :(

I'll post again later this afternoon.

12_11 - morning update

Well, while last night wasn't what Wednesday night was, it sure could have been better.

Right after 7:30, Elvis started in with the hacking cough. You could see him getting worse as time went on. Finally at 8:15, we tried 1/4 of a Torbutrol. Dr. Walthall had suggested that dose first, but after an hour had passed, there wasn't any improvement. He hadn't gotten worse, but he hadn't gotten better. So, the second 1/4 tablet was given.

Things stayed pretty much the same. No worse, but not really better. That's something I'd noticed with him with his milder cough tablet. Two 1/4 doses, even given within an hour of one another don't work. He has to have the 1/2 dose all at once. It appears that this is the same problem with the Torbutrol.

Finally at 10:10 when he began hacking badly, I gave him a full dose of Guaifenesin. That did it, and Randall and I got ready to head to bed...gratefully, might I add.

Before shutting down for the night, I wanted to see what the maximum dosage would be for a dog his size. Ideally he would have had 1/2 tablet within a 20-24 hour period of time, but if he started back up coughing, I didn't want to have to go in search of information at 2:00 in the morning. Getting Randall involved for the numbers conversion from a medical website (I suck at math), the prescribed dosage was 1/4-1/2 of a 5 mg tablet every 6-8 hours for a slightly smaller dog.

Armed with that information, we headed to bed.

At 4:45, Randall shook me awake. Elvis was coughing again and had been for 7 or 8 minutes...plenty of time for him to have shifted around in his crate, coughed and settled back down.

So I went ahead and let him outside to potty and then gave 1/2 a pill. Sadly, I totally forgot to give him fluids, and when I tried, you could tell the narcotic side effects had started, and he just didn't comprehend the dish. Unfortunately, when I first wake up, I'm seriously sleep walking...the brain doesn't engage at all until I've had coffee. If this happens again, though, I'll remember. Hopefully the coughing won't keep him from being interested...I won't know until I try.

Randall and I went ahead and got up. At nearly 6:00 am, he's coughed a bit. I can't compare it to what he did in the wee hours of yesterday morning because Randall and I had passed out in bed.

I'll update this blog, and email a link to the clinic. Unless things go south, I suspect he'll be fine this morning. I do want to touch base with them this afternoon, because the clinic is closed on Saturday and Sunday.

Medicine change - update

OK. The results from the CBC are in, and I spoke to Dr. Walthall. Essentially there is one count that is high (and it relates to infection), but his white cell count is normal, though it's a high normal. With that in mind, Elvis will start a course of antibiotics today.

Talking back and forth through some medicine options has given us this: he will stay on his current Lasix dose (.75 CC twice a day), the Guafenisen will stay, but it may get swapped around with Robotussin DM, and, obviously, he'll have an antibiotic through however many days the course is for.

We're also going to add 1/4 of a 2.5 mg dose of Enalapril twice a day. That's a heart drug that dilates the blood vessels and it may or may not address some problems. The issue is just what exactly his heart is doing. If it's working too hard because of blood vessel constriction, it should help. If the heart is too enlarged and pushing against his cough "reflex", it won't. There's no real way to know, so since the Vetmedin gave him such a wonky behavior problem, Enalapril is the way we'll go.

The high powered cough pill is our ace card. He may or may not end up having a dose of that every night...it's too soon to say. Dr. Walthall did say that on a scale of 1-10, last night he was a 10 and, by rights, shouldn't be alive. Elvis is basically a strong dog, though, so he came through something that might have killed another dog.

The other concern here is the fluid level. That was apparently what was contributing mightily to his disorientation last night. We're going to take a wait and see approach on what's needed here. The fluids are given sub-Q, so that may be something that we end up doing here at home at some future point (that's me talking, not Dr. Walthall, but I'd have absolutely no problem with doing it if it helped). Keeping him hydrated may also be a key to keeping these bouts under control. It's another thing to consider.

Randall has run to get his antibiotics. Since Elvis kept down his breakfast and hasn't shown any gagging or real coughing problems, I'll give him another couple of tablespoons of food and start his antibiotic then. The Enalapril will be started tonight with his dinner.

So that's where we are. Sort of an exhausting and non-definitive end, but I suspect that's the way his crisis we'll go. He'll rock along fine, and then head off into the land we don't want to visit and we'll reassess him at that point. Tiring, but that's the way it is really.

Elvis' Midnight Ride

Or maybe 12:30 am would be more accurate.

He was coughing and hacking all evening, and I finally called Dr. Walthall at home shortly before 8 pm. We settled on giving him 1 ml of Robotussin DM at 8:00 and then again at 9:00 if he was still having problems. I ended up giving both doses and that seemed to help some.

The humidifier ended up not making that much difference, so we went ahead and brought his crate back out here for the night. He went in fine, and seemed to be settling down, but when we turned out the light at 11:20, he started coughing. Finally at 11:30, I got up to take him in to the living room to sit on the ottoman.

Bringing him in and sitting him down allowed me to really take a good look at what he'd started doing. The coughing had progressed seriously and his breathing was terribly labored and wheezing. He also seemed extremely disoriented and when I opened his mouth, I could see his tongue was turning blue. He just wasn't getting enough oxygen.

Yelling for Randall, I called Dr. Walthall at home and, bless her heart, she met us out at her clinic around 12:30. She had told me on the phone that she wouldn't go to heroic measures to save him, and that was something I could understand.

We got him in, and, fortunately, that wasn't called for. She gave him fluids, an antibiotic and Lasix shot and drew blood to run a CBC on Thursday morning. He perked up, and the coughing slowed and his breathing became less labored, though he was still a bit wheezy. 1/2 of a Torbutrol (cough suppressant) and 10 minutes latter, and we had us one dozy Elvis.

The ride home was uneventful, and he went right to sleep once we got his crate in place.

This morning at 7:15, Randall woke me to let me know Elvis had vomited a bit but, other than REALLY needing to pee, seemed normal.

When I got up at 8:00, I decided I would cut his food back some. So instead of 1/3 cup food, he got 1 tbsp with 1 cc of Lasix and 1/4 cup of water. He cleaned all that up, and did his normal morning potty routine. He's still dozy, but more alert. Still a slight occasional, but very soft, cough despite the kick ass cough pill at 1 am. Picking him up and listening to his chest still gives me a bit of a wheeze, but I'm listening with the naked ear, so I won't lay money on what I'm hearing.

I've got a call into the clinic...they still need to run the CBC. Dr. Walthall and I agreed that he most likely will need to come in again later this morning to be checked. I really would like that because today is their half day, and I sure don't want a repeat of last night if I can at all help it.

I'll post another update once the results of the CBC are in and after our visit back out to the clinic.

12_9 Update: Coughing Elvis

I think the dry cold is really causing some problems for Elvis. He was coughing some yesterday when it was cold and humid, but today it's been very cold and quite dry and his coughing has escalated alarmingly through the afternoon.

I've given him four doses of his cough medicine today, which unfortunately isn't really doing the trick. I also upped his evening Lasix to 1 CC. I'll do that again with his morning dosage, but I want to keep the evening dose at .75 CC. I'm hoping bumping that one dose up in the morning while keeping the regular dose with the evening meal won't trigger the behavior issues. Also, I'm hoping that if it helps it's something I only have to do when it gets really cold and dry. Our heater has been coming on more today, and I know that's contributed.

We've also moved him into our room since there's a humidifier in there for me (no salivary glands means that's an absolute must for me), and he'll be in there tonight. So far, his coughing has lessened some, but it's hard to say what's helping the most...the moister air or the drugs. No real way of knowing right now.

I called the clinic this afternoon, but never heard back. I'll call in the morning and see if Dr. Walthall has any ideas or suggestions. I first thought it might be some delayed reaction to the heartworm treatment, but that doesn't make much sense to me. Not sure what the answer here is, though. :(

Everything Looks Good

(I meant to post an update late yesterday afternoon or early evening, but got busy and forgot. Oops!)

It looks like Elvis has made it through his initial heartworm treatment with no trouble. It's now been nearly 36 hours since we gave him the tablet, and we've seen no side effects at all.

I put a call in to Dr. Walthall's clinic yesterday afternoon to give a quick update and also to ask what the dosage would be for him for the heartworm medicine I use. Since it's a cattle wormer and he's a toy breed, I really need to be sure I don't overdose him on it. I think I'm even using a bit too much for my standard dachshund. I suspect that since I've been using it for 15 years, the thinking on the dosage amount has probably changed.

Anyway, starting next month he'll join my other two in the monthly preventive, which I am very happy to see. His little heart has enough going on without adding more of a load to it.

Cautiously Optimistic

It's now 3:30 pm, and Elvis doesn't seem to be showing any negative reactions to last night's heartworm pill. I'm cautiously optimistic at this point, and if he continues in this same way through the rest of today, I suspect he will have handled the treatment just fine.

If he goes through this, then starting next month he will join my guys on a monthly preventative which, while it won't address the adult heartworms that he currently has, will at least prevent further infestation.

I'll post another update tomorrow morning.

Heartworm Pill Tonight

In about a half hour, Elvis will receive his heartworm pill.

Dr. Walthall wanted us to this tonight so that in 12 hours (when I assume the risk would be the greatest), her clinic will be open.

With any luck, there will be no complications, but, of course, we're going to worry about him. I'll post an update sometime tomorrow. I plan on calling the clinic before lunch and letting them know how things stand and then again before they close. Obviously if there's any problem, we'll take him in as soon as we can.

Cross your fingers for the little guy.

December 3, 2009 - Major Update

A rather lengthy and involved update today.

First. Elvis is doing great.

Randall and I have been decorating the house for Christmas, and Elvis has handled the addition of two Christmas trees into his world just fine. He basically just gave them a quick look when he walked into the room(s) and didn't blink. More importantly from my perspective he didn't act like my foundation male dachshund did every year he saw them...."Oh Mom!! My very own personal tree...in the house. You SHOULDN'T have!" Gusto never did care for my reaction to his attempt to claim ownership of the tree. So it's great that Elvis hasn't even given that a thought.

And, like I mentioned in my last update, since I have a loaner laptop, I'm able to catchup on my political news addiction which, of course, means being at the computer a lot more. This definitely doesn't meet with Elvis' approval since he'd gotten incredibly used to spending lots of time laying curled up on the ottoman with his head on my leg. He misses the hours of soft spot time. :)

I'm also happy to say his medicines are now where they should be and he is stable both physically and mentally. With any luck I won't have to tinker with them again for a while. And when I do, I'll keep in mind his behavioral reactions.

The other really good bit of news is that Randall and I took Elvis in to see Dr. Walthall for his follow-up appointment this morning. She was very pleased with the way he looked (and so are we). Everything about him looked good today and he acted well, too. He showed some minor stress, but it was what you would expect from any dog...some panting, some shedding, and a bit of shaking until he realized no one was out to kill an Elvis. Even after he came back in the exam room after getting the x-ray taken (and we could see his reaction from where we were to being laid on his side for the picture). He settled right back down. He coughed once the entire time we were there, so that was really excellent.

Dr. Walthall ran a blood panel on him and everything looked really good. Dead in the range for a healthy dog, which he isn't, so it's even better in my book. The one area that was a bit elevated was the sodium, which is not unusual for a dog with a heart condition. She was happy to see the albumin was dead on and I was glad to see the glucose level at normal (I've been sitting here expecting diabetes at some point). So all this was excellent.

She went ahead and took a picture so she would have a baseline on what he's like on a good day. You could see the heart was enlarged and some of the shadowing showed scar tissue from the heartworms (that's really a best guess). One perplexing thing was a shadow down at the bottom of the picture (I'm guessing close to between the front legs or close to that area), and it could be a mass. No real way of knowing, and it's something that she's not interested in right now and, really, neither am I. I wouldn't be surprised if there was something there, but since we're looking at palliative care, really, it's simply something to recognize is there. So we nod and wave at it, and move on.

The really good news is that Elvis will have a dose of heartworm medicine Sunday night (provided weather cooperates and Monday is clear in case we have to high tail it to the clinic). This is the option she had mentioned to Randall six weeks ago, but it really did have to wait until he was stable. Since he is, we're going to give it a shot. It's not as debilitating as the shot treatment, but there is some risk, obviously, and we want to be where we can get to her clinic if something goes wrong. With luck, all will go well and my next update will talk a bit about how the treatment went.

Also, there's no further follow-up scheduled unless something happens with him. That is probably the best news in my book. Obviously everyone knows this dog is on limited time, but having him healthy and stable and content is just about the most important thing he can have. He's definitely a gift, and I'm very grateful that Randall and I have been given the time we have to help make his life comfortable and happy.

Now. Fingers crossed for an uneventful treatment. After the pill Sunday night, if all goes well, he'll move over to the monthly treatment we give our other dogs. That will address the baby heartworm issue, and the adults should die off over time.

The last bit of news is his weight. The battery on our digital scale died three weeks ago, so I hadn't been able to weigh him. The clinic showed him at 7.6 and we got him at 7.4 when we got back with the new battery in hand.

So all in all, everything looks really good with him. Tomorrow is supposed to be very cold with a chance of snow. I'm sort of hoping we get some (and that it sticks) because I really would like some pictures of him in it. Skeeter and Haley both hate snow, but Elvis has enough coat on him to handle it provided he's not out for a long time. So maybe there will be some new pics of him soon. :)