Bad Factory Parts & Old Age

I guess I have to get used to the fact that Lucy's health issues are cyclical. She's once again had several days of reverse sneezing and a runny nose. The last two days she's thrown up her food. That's a new feature, one that I'm unsure is caused by her partially paralyzed larynx or the drugs she must take for rhinitis...or both. She remains eager for a walk, but not so eager to eat. I don't blame her; I wouldn't want to eat either if it meant food wasn't going to stay down.

We were at our in-laws home for Thanksgiving and Lucy piddled inside. This was done purposefully, not like the past where she was dribbling in her sleep. None-the-less, I was a tad embarrassed. Lucy also had a sneezing attack that was severe enough to give her a bloody nose. I think her problem lay with the commotion of Thanksgiving with the puppy, all the extra people, and the fact that she couldn't find that damn cat she could still smell. (The cat is one of their many past pets that has been squished on their street. We won't go there, but the cat met its demise about a month ago.)

This morning she didn't eat her breakfast, but waited until several hours later. We'll see if she keeps it down.

Spunky

Lucy felt spunky last night. In fact, she was downright annoying in her persistence. It was great to witness! She wanted her cocktail ball now. I didn't want to give in, but she persisted. Talking, woofing, pawing, groaning—generally making herself heard and catered to. Did I give in? Yes. Eventually. I waited until she was quiet and then armed her toy. Here she is telling me to get a move on!

Play with me!


Pay attention to ME!

A bit of a set back

Lucy is experiencing a bit of a set back. I'm not sure why. She's been on Doxycycline since Friday evening and seemed a bit better by Sunday—not so typical of past antibiotics usage where she's been noticeably better in a couple of days. She improved, but only an iota. The improvement could have been my wishful thinking. Her runny nose seems to have gone away (thanks to the Piroxicam or the antibiotic?), but her hacking and coughing have started back up. The heavy breathing is back too.

I am wondering if it's because I have allowed her to play with her cocktail ball the last three nights which takes a lot of nose action and swallowing from a greater distance. Could this cause the hacking? Or is it because on a recent car ride, I let her hang her head out the window. Perhaps a snootful of air is irritating. I'm going to wait until the end of the week, unless things become far worse, before calling.

I like this picture of her. I'm aware most of her pictures show her lying down, but that's what an old girl dog does best. In this shot, she is eagerly waiting by her bowl for dinner. I've elevated them in hopes it will mitigate the coughing. She is looking at me askance because as far as she's concerned it is way past her dinner time and I should be feeding her NOW. This goes to show her appetite is just fine—as is her energy. She's always eager to go on a walk and still manages a fast clip.

Answers?

The internal medicine vet called today. That pleased me as I was feeling disgruntled that no one from that clinic had called since Lucy's procedure or after I brought her back in on Sunday. Kate's office had already called twice to see how she was doing and they were not involved with the rhinoscopy. (A loyalty booster there!)

The vet (Matt Vaughn) said she has chronic rhinitis. (A friend told me it's the same as hay fever in a person. That sounds so benign compared to the problems she exhibited.) He said there are five types of inflammatory cells. The two he expected to see in Lucy—and did—were lymphocytes and plasmacytes. But with Luce, he also saw neutrophils which usually indicate a bacterial infection which he did not see. He wanted to know how her appetite and energy levels were. I was pleased to report: good! Her nasal discharge is diminishing. My concerns are the reverse sneezing is still with us and she now is constantly clearing her throat via coughing or hacking and she still goes through periods of panting.

I asked him if the intubation could have caused this temporarily or if might have permanently injured her throat/trachea. He said no to the latter and that it is possible the balloon that is used to close off the throat (so she doesn't swallow anything) may have irritated the lining, but felt this not as likely. More probable he said was that she may have aspirated something.

He was very clear—and emphatic—if she isn't better, or she gets worse, by Monday to let him know. It may be the Piroxicam isn't her drug or that we need to put her on an additional antibiotic to clear up what ever is bothering her throat.

She has only barked a couple of times since she's been home and those are feeble, weak barks. They were followed by coughing. He kept referring to her laryngeal paralysis. Initially I thought this was simply the issue of an older dog losing its voice. Au contraire. It's a much bigger deal than I thought. A bad episode in which the dog is heavily panting may see the dog's gums turning blue from lack of oxygen. The dog can collapse and die.

Matt said he didn't recommend surgery on Lucy at this point because she is in a cool climate. He said if she was a warm climate, he'd definitely urge us to have the surgery. Here is a website that has some good information and three short audio files to hear what the stressed panting sounds like. At this point, Lucy only sounds a bit like the last black lab with a cough interspersed. Hopefully this is something we don't have to worry about with her beyond managing her activity level.

His warning, however, is well taken. We'll keep her calm and cool if possible. I didn't think to ask him at the time if she can go mountain biking. I guess we'll just have to closely monitor her.

What a Weekend!

It was a tough weekend for Lucy and me. She felt awful and I felt guilty for putting her through all of this. She slept all day Saturday, though I would consider it fitful. She was definitely conked out, but all of sudden would wake with an hour or more of heavy panting. Whether caused by pain or the inability to breath comfortably through compromised, tender nasal passages, breathing easily was not in the cards.

Saturday evening we had friends over for dinner and she not only got up to greet them, if slowly and quietly, but moved into the living room to sleep. Both big deals as far as I am concerned. The evening though, she woke around 1AM and had a good hour plus of heavy panting. She was obviously quite uncomfortable.

Sunday saw more of this labored breathing, heavy panting, hacking and her nose begun bleeding. Of all of those, I was least concerned about the blood as they had warned me that might happen. It wasn't excessive, so I figured it was okay. However, the laborious breathing did concern me. I took her back into the clinic and they felt she was okay, but gave me some pain killers (Tramadol) to relax her, help her sleep and maybe heal the irritation in both her nose and throat by relaxing her and therefore not stressing those areas.

What they were most concerned about was her lack of appetite as she needs food in her tummy for the Piroxicam they've sent home with her. They still lean towards chronic rhinitis, though the biopsy results will be in sometime this week. They recommended I warm her food to make it stinky and therefore more appetizing for her as her sniffer isn't sniffing very well at present.

I think her care was good. I think the tech did a good job debriefing us before we brought Lucy home. I'm also sure they told me things that I didn't hear as I was anxious about Lucy's well-being. However, I don't think they gave me enough information. I don't believe they told me that it would be days before Lucy returned to normal. I don't think they mentioned that her breathing would be labored and uncomfortable for her for days because both her nose and larynx/throat had be compromised by the procedures. They didn't say anything about how long it would take her nose to "come back." I mean, if she can't smell her food without warming it, that's pretty bad! And I know they didn't say whether the Piroxicam would eliminate, or affect at all, the symptoms that brought us to this event. This morning she had several bouts of reverse sneezing and anytime she gets up she starts a slow cough sequence that may or may not end with hacking. These are all things I wished they'd covered with me. Do I worry about this or not? The vet I saw yesterday said to give Lucy a week to return to normal, but she didn't think the Piroxicam would alleviate symptoms. It is an anti-inflammatory.

Rhinoscopy Completed

Dropping Lucy off at the vet yesterday morning was awful. When they led her away, she just turned and stared at me with those frightened, accusatory eyes. "What are you doing to me? Are you giving me away?" The CT and rhinoscopy both corroborated no (visible) cancer or aspergillosis. The vet took some biopsies and we won’t hear back on those until the middle/end of next week. His guess is chronic rhinitis. The good part is it can be managed, the bad part, it’s with her forever more.

Last night was pretty awful for her (and me) because she was so restless. Lots of panting and pacing. She did have a bit of nose bleeding, but nothing of concern. I put a mat on the floor in the kitchen (where we've had her at night since she had been piddling) and laid there thinking that having me close by might make her less anxious. Maybe it worked a little, but neither of us slept a wink. I called the vet around midnight and they recommended bringing her in (approximately 45 miles round trip) or give her a Benadryl. I opted for the Benadryl. She did lay down for almost 2 hours (I think I slept then), but she was up again and barfed.

So I called again. I didn’t know if her activity and panting were caused by pain from the procedure, drugs wearing off, or a bad reaction to a drug combination. They said come in or give her another Benadryl. The second one didn’t seem to have any effect on her at all. I got dressed to bring her in around 3AM, but again opted out and brought her bed into our bedroom.

She was more calm there and I think she was quiet for nearly an hour, before getting up and pacing again. I fed her some brown rice and turkey stock and she snarfed it, so I know her appetite is okay. I’ll give her some more time this morning and see if she evens out. I’m absolutely bleary-eyed from lack of sleep and would prefer not to drive in the dark and rain (my least safe driving conditions).

My guess is she’s okay and it is the pain and the anesthesia/meds (for which she’s always had a low tolerance) that are causing her anxiety. Now, nearly 4 hours since I fed her, she's sleeping comfortably and I'm getting ready for another cup of coffee—and hoping I make it until 8PM tonight!

Fingers Crossed

Tomorrow is Lucy's rhinoscopy/biopsy. Again, another morning without a biscuit or food. What a bum deal. More needles and even a snip with something shoved up her wonderful snout. I'm hoping—we're hoping—that it tells us what's going on and gives us a realistic route to pursue.

Interestingly enough, with only 2 days on Clavamox, her nasal symptoms improved dramatically. Kate felt she shouldn't remain on the drug though as she didn't see enough evidence to elicit their use. Therefore, Clavamox is out, Pro-in for urinary incontinence is in. What I'm hoping, evidenced by the 48 hour use of it, plus the results of the biopsy, we'll be able to lick whatever she's suffering from with another stint on antibiotics of some kind. Of course, I still have the urinary incontinence to deal with, but I guess that's okay if her breathing is okay.

Early Morning

Sometime around 4AM, Lucy must have peed in her bed. (She's being sequestered in the kitchen overnight, but has access via the dog door to outside.) We heard her collar shaking outside and saw her lying in the grass in the backyard. Deviant behavior is an immediate red flag for me, particularly now that she's not feeling well. Why would she choose to lie in wet grass in the pouring rain? Something's not right.
When I got up about 15 minutes later, I went into the kitchen and there was a huge, fresh puddle on her bed. The washing machine is jugging away now as I type. I couldn't get her bed in to wash it, but put her cover in along with the towel I used to clean her bed.

The vet gave me Clavamox for the infection and Proin for incontinence. Although I gave Lucy 1/2 a tab of Proin last night, I decided to hold off giving her anymore until I clear up the bladder infection and then see if she needs it. And then I read the article. Egads!

What's happening to our little girl?

Another roller coaster

Good news from the CT scan, right? Or at least not bad news. But now Lucy's peeing on her bed, on the rugs, on the floor. Not dribbling, peeing a full bladder's worth. When she's sleeping or lying down. Can she not feel it?!? This started last week and hit full stride by the weekend. What I originally thought was her runny nose, I know now was the start of her dribbling.

I took her to her normal vet this morning, but Kate was gone so the back up vet saw us. She took blood and a urine sample and said Lucy's white blood count was elevated, so gave me very expensive antibiotics for a bladder infection and another drug for urinary incontinence.

Friday she goes in for the rhinoscopy and there goes another four digit vet bill. Not that she isn't worth it, but the loss of personal income because of how the economy affects my job, along with the accumulation of unexpected large veterinary expenditures, is becoming overwhelming. The outlay makes me anxious, Lucy's health makes me anxious...

On the other hand, her appetite remains top notch!