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.