Update, Sept 28, 2010

OK. Now that I've had a good night's sleep, I can think straight and type straight. :)

Elvis had a pretty good going over yesterday at the clinic. As Dr. Walthall said, she's learned that with Elvis, it's not so much about his heart as it is about his breathing. And it's true. The heart condition seems to be well managed (as much as it ever can be), but the damage to his lungs really can be a bitch to get a handle on.  His condition reminds me more of my father's with COPD anything else. It and congestive heart failure go hand in hand, though, so it's not surprising.

Anyway, Elvis white cell count was way high...25,000...yesterday, so he's now on an antibiotic (liquid doxycycline) at 1 ml twice a day. If there's no improvement by Friday, we'll change medicines. However, he has had a slight case of pneumonia in the past, and that was the drug used, so I'm hopeful it will begin to work soon.

One thing I told Randall yesterday was that if that hacking cough starts again in the future, I'm not going to mess with upping his Prednisone. Yes, that definitely helped in the short term, but I suspect that the hacking cough is going to be directly related to an infection, so it's better to just start him on antibiotics. The Pred might get increased slightly to help him over the bump until the antibiotics kick in, but it's pretty obviously going to take both types of drugs. In the past several months the Pred has been enough, but I think we're progressing past that. I at least will want to check his white cell count early on.

He also had a new x-ray taken. His last picture was about this time last year, and yesterday's showed a definite area that was pressing on his "coughing reflex" location. Is that where the infection is? We're not sure, but Dr. Walthall was going to compare yesterday's picture to last years. If my memory serves correctly, though, it wasn't there last year, but there was a mass down low in the chest cavity. So what are we looking at here? Not sure, but I'm going on the theory that the infection is in the picture.

His coughing is improved (though a lot of what we saw two days ago was definitely triggered by excitement of me being in the kitchen again...all the dogs were worked up, and Elvis takes his cues from them.), but the wheezing is still there. I suspect it will take a couple of days before we know whether he's responding to the antibiotic. Mean time, keeping him calm is a priority so bathing him and clipping his nails will have to wait until next week (**sigh** His nails look like talons.) once the wheezing and coughing have lessened.

Right now, I'll plan on posting an update sometime tomorrow unless things change.