Sunday, January 31, 2010

1_31 Update on the update

Randall and I talked it over, and we've decided that Elvis just needs to stay on the 1/4 Prednisone a day. As much as I'd love to have him on a staggered dose, he just isn't reacting well. Waiting two days to make a decision just means he gets to feel icky tomorrow. So with that in mind, I've decided to go with a dose a day.

Also, I moved his heartworm tablet back to tonight and won't cut his nails until Tuesday. Randall thinks it's best to give him a bit more time between the heartworm pill and the Valium...and I'm just about 100% sure that he'll need one after the nail clipping. He's gotten where that really seriously upsets him. Unfortunately, he can't go forever without have them trimmed. So Tuesday I'll try the clippers (and plan on the Valium).

I'll post a bit later in the week after he has his nails trimmed.

1_31_10 Update

Something of a quick update.

Elvis has been taking Prednisone on/off for the last few days.

On the days he doesn't get the 1/4 Pred tablet, he's definitely more wheezy. Actually, as the day progresses into evening, the wheezing and coughing increases to the point that I'm giving a Torbutrol. That's not the result I was hoping for.

When he gets the 1/4 Pred tablet, there is a definite reduction in coughing and he's almost wheeze free.

My gut is telling me he's going to stay on that 1/4 Prednisone per day. I want to give it one more day off (tomorrow), but I'll make the final decision Tuesday afternoon/evening on what the more permanent dosage is.

Also, he's not been sleeping alone yet. I decided a good first time to give him a Valium was NOT at night when his response couldn't be monitored. He needs his toenails cut, so tomorrow morning, I plan on doing that and, unless his response this time is different than the last two or three, he will get a Valium then. The vet clinic will be open, and I can keep an eye on him for adverse reactions.

Once I know how he reacts to it, I can make plans to shift Skeeter back into his crate at night.

I'll call the clinic Wednesday with the results of the Prednisone experiment and also let them know how he handles the Valium (unless, of course, he has some horrid reaction tomorrow and we have to take him in).

Thursday, January 28, 2010

Update 1_28_10

Well, it seems I've created a monster. :(

Having Skeeter and Elvis sleep together at night was such a wonderful fix for his issues sleeping through the night, that I really didn't think about it causing a new problem. **sigh**

It wasn't until yesterday that it dawned on my why he's seemingly reverted to a fear of people (though that's a little harsh a term for it). However, yesterday, when everyone went outside to potty, Skeeter climbed the short fence we have that divides our backyard and Elvis followed him. Twice! I'd noticed Elvis was pinging in heavily on Skeeter (like he did with Haley when we first brought him home), but I didn't connect the new sleeping arrangements to it. Or, well, some of it, sure, but not the increased spookiness. He has tied himself so tightly to Skeeter that he's not able to handle people interactions again. Basically, if Skeeter isn't getting the exact same sort of attention, Elvis goes into a panic.

So this is going to have to stop. Tomorrow, Randall and I will hopefully get down to the shelter to pick up his Valium. With that here, I'll move Skeeter back into his crate tomorrow night, and we'll deal with the separation anxiety that's bound to crop up. There's really nothing for it, though. I told Randall there will be some nights we'll want to put the boys together (like when we have storms in the area or if he just won't settle down and it kicks off his coughing), but tomorrow night, we're going to have to go back to the regular sleeping arrangements.

That said, I talked with Dr. Walthall this morning about Elvis' heartworm treatment. I was really having concerns about giving him the injection because it's so debilitating and you have to watch them like a hawk. That could normally be done , but since I'm going to Dallas for two weeks in March, it became even more of a concern. Randall can handle the normal stuff we're doing, but for the heartworm treatment, I really need to be here.

What we'll do is continue giving him the heartworm pill (like a normal preventative would be given) until April. At that point, we'll reassess his health and breathing condition and if he's doing well, we'll go with staying on the monthly preventative without a shot. Essentially if he lives two years and is on the monthly preventative, the adult heartworms will die of old age. So that's what I'm hoping for. He can get the treatment that all dogs should have, and if he lives two years, he should be heartworm free. I think that's the best way to go with him. He may not be with us two years, but if he is, then the heartworms shouldn't be an issue any longer.

As far as his steroids go, he is doing well on the 1/4 Prednisone, but today is the first day he's been off it (we're doing one day on and one day off). I should have a pretty good idea by early next week if he's going to do OK on the every other day schedule or if he needs it every day. Regardless of the timing, it looks like Pred is a permanent part of Elvis' meds routine. It seems to handle the vast majority of his breathing issues, so he'll stay on it, Lasix, Robitussen DM (or Guafinisen), Enalapril, and Torbutrol (as needed). The Valium will be for the times he's gotten into a panic attack and can't be talked out of it.

Friday, January 22, 2010

1_22 Quick update on Prednisone reaction

I wanted to put in a quick note because today is day two of his 1/2 of a Prednisone, and Elvis has started acting spooky. Nothing terrible, but enough to where it's noticeable and can be a problem at times. I *think* he went through this the last time for the first couple of days and then he went back to being normal. I went back in the blog and didn't see it, but I seem to remember it, so I thought I'd best get this in here so I'll be sure and remember it if it happens again.

Other than that, everything is going well.

Thursday, January 21, 2010

1_21_10 Major Update

This is a fairly major update since Elvis went in to see Dr. Walthall this morning for a checkup.

First off, she said he looks very, very good. He's put on weight since his last visit, but it's weight and not fluid. You could really tell that just by looking at him because the weight is distributed right. It's the sort of intangible that you know when you see it. So this is good. My feeling is the Prednisone he was on until last Saturday helped with this.

Now for the news that isn't the greatest. He came off the Prednisone on Saturday and there was a definite regression in his coughing/wheezing. This was the main reason I was hoping she'd want to see him (his last visit was nearly a month ago), because I really felt that the Pred was making a big difference in a lot of ways. Talking options led us to agree that Elvis needs to be on Prednisone on a full time basis. I say "full time" but that's a bit misleading. Like his last course, he'll start out with a half a 5 mg tablet once a day for four days, but then he'll drop down to 1/4 of a tablet once a day and then I will drop him down to 1/4 of a tablet every other day. How he reacts to that 1/4 once every other day will tell us if that's the maintenance dose he'll stay on or if he needs the 1/4 every day. We'll simply have to see how he reacts.

He's also going to have a prescription of Valium. What I was talking about with Dr. Walthall is that while the Prednisone seems to not only address the wheezing/coughing he has as a normal thing, it also seems to help with wheezing/coughing that stems from stress. But Elvis wakes up in a new world every day and things that didn't bug him yesterday bug him today. It's sometimes hard to know what's going to trigger his panic attacks (and that's really the only way I can describe them). The Prednisone really does help, and when he's in a coughing cycle, the Torbutrol can help knock that down, but the problem is he's a small dog. And while I can give him 1/2 a pill of Torb, if he needs something else, I'm SOL. So, the Valium is going to be for the times when the stress is evident and we can see he's having problems. There's a great deal of caution in mixing the two or even in giving Valium to a dog with a heart condition because it slows the respiration, but what I'm hoping is this will be a very rare thing.

So, we've got the Prednisone at some yet-to-be-determined dose as a permanent addition to his medicines, we'll have Valium for those times when the stress is getting to him and I can't get him calmed down, and he'll have Torbutrol for the times his cough won't quit. He also stays on Lasix, Enalapril and either Robitussin DM or Guafinisen depending on his breathing/coughing.

Whew!

Next up is the heartworm situation. He's now got a six month supply of a heartworm medication to help deal with the baby heartworms (this is the normal treatment all dogs get), but next up is dealing with the adult infestation. Dr. Walthall really believes this is what is causing his wheezing, and once he gets stabilized again, she wants to start a treatment. I want to talk with her again about the method because originally she had talked about giving a heartworm tablet once a week for a few weeks rather than giving the injection because it would be easier on him. Today she mentioned the injection, so I want to confirm which way we're headed.

The issue with the injection is that it is very debilitating and needs to be done when our world is going to be boring for a month. I want to get the timing right on this because I'm supposed to go to Dallas in March to get a set of bottom teeth to replace the ones I had pulled prior to my cancer radiation treatments. I want to be sure that Elvis' treatment isn't going to bleed over into the time I'm gone. I can put off my trip, but I need to know in advance.

So, that's where we are. Even with the wheezing/coughing returning after the Prednisone ended Saturday, he looks good. And I think going back on Pred is going to be a real big help for his symptoms. I hate to add yet another pill, but if it's helping, I think he needs to be on it. Perhaps after the heartworm treatment we can reassess the need, but that's a ways away.

If the weather stays nice and his coughing gets back under control while the sun is shining, I'm hoping for a few outdoor pictures. If I get some good ones, I'll post a couple. Meanwhile, I suspect I won't post another update until sometime next week. I told Dr. Walthall I'd call later next week, so unless something happens between now and then, look for me to post something then.

Monday, January 18, 2010

Major Oops!

Randall and Skeeter and I caused a serious coughing problem for the poor Stumpy Fellow late yesterday afternoon.

Skeeter was in serious need of some quality play time with mom and dad, so Randall and I took him into the living room to play fetch and tug with his rope tug toy. We put the gate up in the kitchen (mainly to keep Haley out because she would destroy the toy in nothing flat).

For Skeeter, this is the prime time he gets to growl and bark and generally sound very mean and vicious, and Elvis was completely stressed out about it. He was at the kitchen gate jumping up and looking over and generally getting very worked up. Unfortunately, Randall and I simply tried talking to him and continuing the play time. That was a mistake.

Elvis got so stressed that I ended up giving him 1/4 of a Torbutrol and then, when that didn't work, 30 minutes later giving him another 1/4. And it really took him all evening to calm down. Even after his cough stopped, he was horribly skittish and nervous.

So Randall and I have learned our lesson. Tug Toy Time is going to mean having Elvis outside in the backyard with Haley for the five minutes or so Skeeter is playing. There's just too much noise that triggers anxiety for him, and he really doesn't need that.

Fortunately he's fine this morning...no skittishness and no coughing. He came off the Prednisone Saturday, so I'll monitor him closely and call Dr. Walthall either Thursday or Friday to find out what she wants to do. I'll update again then.

Friday, January 15, 2010

January 15, Update

Tomorrow is Elvis' last day on Pred.

I called Dr. Walthall and she wants to see how he does when he comes off it before making any further decisions. Obviously the hope is that his symptoms won't return and we can move on with treating the heartworms.

Currently he's getting Lasix and either Guafinisen or Robitussen DM (it depends on whether he's "wheezy" or not) twice a day. He's getting Torbutrol as needed, but so far, that seems to be once or twice a week in a 1/4 tablet dose. He's not needed a 1/2 tablet in quite some time.

So things look good on that front. Now we'll just have to see what happens after the Prednisone ends tomorrow.

Also, the new sleeping arrangement (with he and Skeeter in one crate) is still working really well, so I don't see changing that unless something crops up. Each of the boys still has his own crate for eating and in case we need to put one of them up for some reason, but nighttime has them bunking together.

I'll post early next week once he's had a couple of days off the Pred. Fingers crossed that the coughing/wheezing don't come back.

Monday, January 11, 2010

Just a few more days of Prednisone

And Elvis has really done well on it. His last dose is Friday, so I'll call Dr. Walthall in a couple of days and see what she wants to do next. I know nothing with the heartworm treatment could happen until he was finished with the Pred. He still coughs occasionally and wheezes a bit at times, but what's going on now is a far, far cry from what he went through a month or so ago after his first heartworm treatment. The coughing now is a 1 or 2 on a scale of 10...when he coughs at all.

Also, the new sleeping arrangements with him and Skeeter in one crate is working beautifully. I'm a firm believer in a crate for every dog, but in this case, these two sleep very well together and Elvis does so much better with company. These crates are Doskocil 200 crates that I used when I showed smooth standard dachshunds, so they are plenty large enough for the two boys (at about 8 pounds each) to bunk together. Each still eats in his own crate and goes up in his own when we leave the house or need to put them up for some reason, but nights have them crated together.

That means Elvis sleeps through the night without barking...even when Haley gets Randall up at 4am to let her out. Since she's a pill about coming back through the den to her crate in our room, it's good. Randall has to yell at her to get her back in the bedroom, and that used to set Elvis off barking and wanting out. Now he's content to ignore it and go back to sleep.

I probably won't post another update until I call Dr. Walthall...and that probably won't be until Friday. She may want to see him again before we progress to the next step, but I don't think we can get out there until next Monday.

Anyway, I'll post again when I have more to report.

Friday, January 08, 2010

I like it when a plan comes together :)

Since the weather here last night was supposed to include some gusty winds, and since Elvis apparently has noise sensitivity during the night, Randall and I decided to try putting our rescue Chihuahua, Skeeter, in the crate with him to sleep.

I gave Elvis 1/4 of a Torbutrol and 1/2 of a Guafinisen to handle some soft, light coughing/wheezing that came on late in the evening, and then we plopped the two of them into the same crate. Worked beautifully.

There was a tad of coughing that went on until the two of them got their sleeping arrangements worked out, but after that, not a peep was heard out of the den all night. We'll repeat this tonight and tomorrow night while the weather is going to be so cold, and I want to do it whenever we've got thunderstorms rolling through this spring because I know that will kick off Elvis' panic reflex.

It's so nice when something like this works because it will make it easier on Elvis and will mean that Randall and I will not be woken up in the middle of the night when Elvis panics and coughs..

Thursday, January 07, 2010

A Tranquilizer Would Be Good....

Oh yes. Definitely.

Elvis woke Randall up coughing and wheezing at 5:00 this morning. When he didn't settle back down, Randall woke me up and I poked my head in here in the den to listen. Sure enough, the poor little guy was really going bad.

I went ahead and got up, though I at least was able to keep Randall from following me out...no point in both of us being up so early.

After Elvis, Haley and Skeeter ran out the back door to potty, it didn't take long to figure out what had set Elvis off. The wind had kicked up something fierce and was whipping around and howling. That was expected since a cold front is due through here, and the winds had been predicted. Matter of fact, I'd told Randall a couple of days ago that if they came in like the forecast said, Elvis would probably have a problem with it.

Sure enough. I really want to see about getting a tranquilizer of some sorts for him. Since he was coughing, I gave him a quarter of a Torbutrol and, with Haley in the basket, he crawled in with her and settled down in about 15 minutes. As you can see from the picture below, he doesn't have a care in the world now. Bless his heart...loud, protracted noises just aren't something he deals with well at all.

I am glad that his problem had an outside cause, but I am less glad that it happened at 5:00 in the morning!

(But other than this problem, he has actually had very few coughing/wheezing spells. He's got another week or so on the Prednisone, and then I'm sure Dr. Walthall will want to see him and check him over good before she decides about further heartworm treatments.)




Tuesday, January 05, 2010

1_5 Update

Elvis had a little more coughing last night than I would have liked, but this morning, all seemed well.

Randall said he coughed a bit when he came out of his crate, but it was the normal amount and stopped soon after. Once I got up, I didn't hear anything and still really haven't. I'm hoping that means that the horrible coughing problem he had shortly after the first heartworm tablet isn't going to rear its ugly head. I won't feel completely confident for another three or four days, but I have my fingers crossed.

The one thing I did notice when I put him in his crate last night was he was wheezing a bit more. I felt a bit of that this morning when I put him in this morning for his breakfast, but it's not gotten any worse. I went ahead and switched over to the Robitussin DM rather than using the Guafinisen...just to be on the safe side.

I also checked his weight since he's REALLY food motivated right now. He's good. Actually he's lost maybe a half a pound, but that is probably a good thing since he had gained a few ounces over the last month. He's at 7.4, so that's right in his "good weight" range.

I called the clinic and spoke to Dr. Walthall so they would know what was going on. I did tell her that unless things took a turn south, I'd probably call for an update later in the week.

While I'm at it, I want to wish Melody (the jewel who works the phones and front office for the La Vega Vet Clinic) a very uneventful week. Melody is pregnant and was due at the end of the month, but when she went in for her checkup yesterday, her blood pressure was high and she was admitted into the hospital. Dr. Walthall said there's a possibility that they'll induce labor tomorrow, so Randall and I and Elvis wish her all the best. Not sure if she'll be back to the clinic this week or not (sort of depends on what happens with the baby), but the main thing is that momma and baby are healthy.

And with that I'll end my update. Unless things change here, I probably won't post another update until later in the week. I've come off the Aleve I take so I can have a week's break to let me system rest and reset, and that always makes typing hard...so the next update will probably be short unless things change.

Monday, January 04, 2010

1_4 Afternoon Update

Elvis got another heartworm pill last night about 10:30. 

When I got up this morning, Randall said he'd been coughing some and, indeed, he was. Not bad...probably a 2-3 on a scale of 10, but he hadn't really been coughing at all over the last several days. So, when I gave him his food ball this morning he got 1/2 a Guafinisen and 1/4 of a Torbutrol along with his Prednisone.

I also called the clinic to let them know he was doing a bit of coughing and what medicines I'd given him. I also told them I'd keep a close eye on his fluid intake since that was apparently a major contributor to the problems he had with his first heartworm pill.

Fortunately, nearly 5 hours after his dosing, he's not coughed.  

So that's where we are. Right now he's crated in the living room since Randall is taking his Christmas tree down here in the den and there's just too much activity for Elvis to handle easily.

I'll post again tonight or, if things remain calm, tomorrow once I see how he's handling the heartworm pill. I'll be keeping a close eye on him for several days so we don't have a repeat of the last midnight ride to Dr. Walthall's clinic.