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Some of you know that I've been training a Doberman Pinscher named Lazarus. I don't own him, but I've been the one giving him TLC since just after Kama Con. He has always been thin, and one of the things I was doing was trying to get him to eat. His name is Lazarus because he came back from the dead 3 times as a puppy.
He caught an infection in December and never really bounced back, but had been in steady decline. He went into a serious decline Thursday of last week and we got him into the vet on Friday thinking he quite possibly had an intestinal blockage, and knowing in that case he'd probably have to be put down.
The good news is, that he's still alive. The bad news is, that he's got two things going on. 1) The thing that had him in slow decline was an infection involving his liver. He had high white blood cell counts. They think they've gotten this under control
2) What made him suddenly spiral downward was acute kidney failure. It was probably borderline before, but he managed to drink toilet bowl cleaner (my fault) and that was what pushed him over the edge. They've had him on IVs, and weren't sure if his kidneys would come back or not. If they shut down completely he will have to be put to sleep, dialysis on dogs just isn't feasible, nor are transplants. The kidneys came back stronger than they were expecting but are still in the critical 10-11 range for gravitation levels. They would prefer 12 or higher.
So I'm getting him back, because his owner didn't have the time to spend on a "special needs" dog to begin with. They say he is eating, but will have to stay on prescription low-protein diet for his kidneys. He is happy but still lethargic.
If there is another crisis he will behave exactly as before, and at that point we will have to put him down. He's only 2.5 years old. They don't know if he will live days, weeks or years. I'll give him the best care I can, in the mean time.
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I appreciate all of the warm thoughts. I feel very drained right now. I left work early on Friday. My boss understood I had to do what I had to do. And it got him to the vet in time to save his life in the short term.
But trying to catch up now at work seems overwhelming and I'm emotionally drained. Blacwolve and ceila were at my place for the weekend too (why I was worrying about clean toilets in the first place ) We had a great time, and having them here kept me from fretting as much as I would have otherwise.
Hopefully things will get better. But he's still in a pretty touchy state it sounds like. But if he's happy and eating I think he'll come back. You could see in his eye (only one, because of one of the puppy hood infections) how sad and miserable he was. He was suffering and on Friday putting him down seemed like it might be the only kind thing to do.
Otherwise as long as he is happy, its worth the extra effort.
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It will be interesting juggling this with the upcoming puppies in 2 weeks. On the other hand Laz was getting so much of my attention before, because I was worried about him, that it may be about the same for him even though he's now technically more convalescent. I'd sit there with him every night and watch him eat, either holding his bowl while out on the couch with the TV on, or back by the computer.
Now at least we know what is going on. Before, I was inadvertantly doing some of the *worst* things for him. Normally if a dog isn't doing well you add more protein to the diet, which is what I was doing. But, in the case of kidney issues, it's the opposite.
AJ
CT you are going to come down and see Ciara's babies right??? You know you like babies... even if they are the furry kind. Dave is welcome too, of course. I realize Sophie is closer for your baby fix, but playing with puppies is fun too.
Sounds like he's a lucky dog to have you looking after him AJ.
(By the way, Tony and I now have a new dog named Chelsea. German Shepard/Kelpie cross, almost a year old. She can *jump*. And she'd be the kind of dog to drink toilet cleaner also.)
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posted
I heard a story on the radio today that a baby Orang got out at the National Zoo and drank Windex. Don't know if anything happened to it, though.
The mama Orang got a pitchfork and wouldn't give it back until they gave her a cookie.
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I had a cat and dog both with kidney failure. The dog lasted a really long time on a restricted diet. The cat did less well and we ended up doing the daily bolus of saline solution under the loose skin of the shoulder. Even as sick as he was, though, he lasted about another year.
As with you, had either critter been miserable, I would've had to put them down (eventually did). In both cases, however, they perked right up with the change in diet and, in the cat's case, some extra fluids to flush things out.
I was surprised at how well the cat tolerated the saline loading. He would sit there and let us pet him for the time it took to get the fluids into him. He didn't fret over the lump riding on his shoulders (where the fluid sat) and he didn't make us chase him each day when it was time for the treatment.
I was more bothered by it than he was.
Anyway, good luck with Lazarus. I hope he snaps back from this latest trial.
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Poor guy! We had a cat who hung on for years with kidney issues. She would slip, we would be about to make "the decision," and then she would bouce back. I hope he makes it through this.
"I realize Sophie is closer for your baby fix, but playing with puppies is fun too."
Banna, when I was pregnant with my first child, I dreamed, quite often, that I was having a litter of puppies. I had two dogs at the time, who were my babies, and we rented our house from a woman who raised German Shepherds.
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What I e-mailed to Cindy this morning... I picked him up last night from her. He was asleep in their van and wasn't hugely excited to see me, but was awakened I think from a pretty sound sleep.
After we got home, Laz seemed happy to be back. Ciara sniffed him all over and licked him a couple of times. He got his stuffed cat out of his crate and played with it for a while, terrier-shaking it in the living room, which was really encouraging. Then he curled up on the couch with me and Ciara. I wrapped him up in his favorite comforter and he snoozed with only his nose sticking out. He had his pill and about 3/4 a can of dog food I tried mixing it with the dry but he only ate the wet. He's definitely sleepy and I'm not sure how much of that is anemia from the kidneys or if he just didn't get a decent nights sleep with all the needles stuck in him.
He ate a full can of food this morning and maybe a third of another can. I left a bit of it in his crate for him to snack on if he wants it. Betty is going to feed him the rest of that can at lunch time to see if he'll eat it. At this point he's too weak and if he insists on only wet, that's what he'll get, though I know he'll take advantage of that if he does get better. He's smart enough to figure it out. He drank Ciara's water but not his own, even though it is fresh and clean. He's got a full clean water pail in his crate.
He's got a little weakness in his rear but more on one side than the other, I wonder if that corresponds with which kidney is painful. He peed this morning ok, and it looks like he pooed when Steve let him out earlier. Not a lot, but it was there. He also hopped up and curled up on the couch by himself while I was getting ready for work, and gave me the old "you aren't going to make me move, because this is so soft and comfy" guilt trip when I escorted him back to his crate. (He did that every morning more often than not when he was healthier so that was encouraging too.) He's got two extra pads on top of the 2 he normally has in his crate along with his blankets, and the entire crate except the front is covered with a quilt so it isn't like he's actually suffering in there, even if the couch is softer.
AJ
Bob thank you for the idea as far as the saline injections go. I'll ask Cindy whether the vet would even suggest them. The one thing they said that could help the anemia at this point is EPO like they give to cancer patients (and athletes sometimes dope with) to improve his red blood cell counts. It was prohibitively expensive though, and I don't think the vet even had it on hand.
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Today's update that I e-mailed to Cindy. He hasn't really improved, but he's stopped getting worse. From yesterday morning to evening he did get a bit worse.
*** I called the vet this morning because I had a couple of questions. He's very stiff and weak. He isn't putting a lot of weight on his front right foot (I thought it was the back first because the back was thrown off balancing.) I wanted to know how much to encourage him to move around, because I think some of the stiffness is just from lying around so much. Dr. Bob said that encouraging to move wasn't going to hurt him. What happens is, when he gets up, he's really really stiff and unsteady for about the first minute or so, but as he moves around he loosens up. Then after about 10 minutes of moving around he's tired, but even at the end when he's tired, he's much freer in movement than he was when he first got up.
Last night he wasn't doing as well IMO, but this morning he was happy and wagging his tail and he actually followed me into the kitchen of his own accord. He's definitely no worse than last night and probably slightly improved.
He ate a total of 2 cans of dog food yesterday which is encouraging. But I don't think he's drinking enough and that part of the reason he isn't doing as well as when I got him is because he isn't on IV fluids. He only drank about 4 cups of water yesterday though he drank another 2-3 this morning with a couple of bites of wet food. The water had to be "flavored" water off the top of the wet dog food, he wouldn't drink the plain water in his crate bucket. I discussed this with Dr. Bob as well and he agreed with my concern.
I know saline injections work with cats, but cats are so much smaller and Dr. Bob said it just wouldn't work for a 50lb Dobe. We are going to try mixing electrolytes into his water. Betty (my neighbor) is wringing her hands and needing something to do, (even though there isn't much you can do) so I'm going to have her call up our local vet and see if he's got a good powdered electrolyte mix. Otherwise I'm going to tell her to try feeding him diluted gatorade (also Dr. Bob's reccommendation).
I almost wish they would have left the IV port in, so I could give him fluids every evening. But his system has to take over at some point too. Keep him in your prayers.
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Well he's getting subcutaneous electrolytes now. 150mL 2x per day.
He had his first doese last night and was definitely improved this morning. My vet wanted to take bloodwork so I let him. If it comes back saying that his red bloodcell production has shut down completely, then we will probably have to put him to sleep.
However I'm guardedly optimistic. I think the results are going to come back borderline and as long as they are borderline, he's got a chance.
The amount of improvment, to me, seems disproportional to the actual amount of electrolyte he recieved. So I'm hoping my theory is correct and that he just needs a little bit of an extra push to help him heal. Otherwise at least it is keeping him more comfortable and I'll continue the fluids until Monday when I would take him out to his real owners so that they could say goodbye before they put him down.
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Encouraging news. I just got a call from the vet office with the test results. The vet (who is off today) called in very specific instructions. The kind of instructions he wouldn't give unless there is hope.
The results were sent directly to him at home so the hospital couldn't convey them on just the instructions, but I'm supposed to be giving him 1L of subcutaneous fluids every day and also pick up a phosphorus binder, that is available over the counter at human drug stores.
They are currently figuring out the doseage on the binder based on his weight and are calling me back. What this means to me is that his anemia isn't as bad as the doc feared, and that he is still producing red blood cells. This vet wouldn't tell me to put this much work into the dog if it was hopeless so I'm more optimistic.
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Not going to be able to start him on the phosphate binder until tomorrow. If I ordered it online it wouldn't get here any faster. It is an OTC antacid called Amphogel or Atlernagel but an exotic one that major pharmacies don't carry. (Where's Allucard.. wonder if he could get it for me, though it would take just as long.) Mylanta II has some of the correct stuff in it, but the magniesium might interfere. It might be worth getting some Mylanta II tonight to give it to him now and then go to the better stuff tomorro when I can get it.
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I thought amphogel was pretty standard. Someone in CHicago should carry it. *fingers crossed for you
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CT, most of the big chain store pharmacies aren't carrying it. It was most commonly used as an antacid rather than a phosphorus binder, and prilosec OTC, Zantac etc. have made it much less profitable. I would bet you could find it in hospital pharmacies because it is commonly used in humans with renal failure, though not always when they get on dialysis. (I've now massively read up on this stuff.) It is readily available online, where I'm guessing many humans with kidney problems get it from because it is cheaper.
I have the actual number of milligrams per day he needs and so it is a matter of figuring the unit conversions. We are going to put him on mylanta for tonight (I cleared it with the vet) and tomorrow morning, and then I will get him switched over to the better stuff once I pick the Amphogel up from the pharmacy tomorrow.
AJ
*grin* my mad scientist hat was on. If I really couldn't have gotten any anywhere I was pretty sure I could synthesize it here in my lab. We have the raw materials needed and it is a very simple compound.
I hope this is really an upturn and the treatments are temporary. This doggy sounds like a good one.
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Well he hasn't been eating much. I actually had to force feed him some syringes of blended food when I gave him the mylanta tonight. I'm hoping the extra fluids perk him up enough so that he's hungry in the morning. Overall I see a slight improvment. More weight on the swollen paw and it isn't as swollen anymore. He still needs help getting up but is walking around a lot more on his own once he is up. I've got to give him 200 more mL of fluid tonight, but he's already got 300mL in him this evening. He's now starting to give me dirty looks when I stab him. I'm *not* his favorite person. But oh well.
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He got 300mL more fluid this morning. Very encouraging news. He ate, by himself, nearly an entire can of food. Yesterday voluntarily he only ate about a half can, and I put the rest in a blender added water and syringed it down his throat. I had to do this partially because he needs to have food with the phosphate binder, and I had to give him the mylanta on my schedule, not his, so that he could get two doses last night. One when I got home from work and the other at 11pm. Today I only had to syringe the mylanta down him because he ate the food.
He walked into the kitchen by himself and gave me a dirty look until I pulled the food out of the fridge and gave it to him.
The one thing I have to do though is talk to my vet today and get him to give me a prescription for the fluids he's getting. (If he won't give it to me I'll call Cindy's vet because I'm pretty sure I could talk Dr. Bob into it.) The reason why I need a prescription is because they are charging me $18/L for the lactated Ringer's solution(if this is redundant I apologize.) Online through valleyvet.com I can get the same stuff for $3/L. I have a feeling he's going to need fluid supplementation for a couple of weeks, and may always need a little bit, but hopefully we can wean him down. Once he's eating better and gains some reserves of his own, then we will take the fluids away.
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Also, please, if you see me posting elsewhere on Hatrack a lot today holler at me. I'm really behind at work as a result of all of this and I need to focus on it today. It's so hard though when half my thoughts are always with Laz.
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) We had a great time, and having them here kept me from fretting as much as I would have otherwise. ![[Kiss]](graemlins/kiss.gif)
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Not going to be able to start him on the phosphate binder until tomorrow. If I ordered it online it wouldn't get here any faster. It is an OTC antacid called Amphogel or Atlernagel but an exotic one that major pharmacies don't carry. (Where's Allucard.. wonder if he could get it for me, though it would take just as long.) Mylanta II has some of the correct stuff in it, but the magniesium might interfere. It might be worth getting some Mylanta II tonight to give it to him now and then go to the better stuff tomorro when I can get it.![[Hat]](graemlins/hat.gif)
