Tuesday, July 12, 2011

The Easy Answer Isn't Always The Right Answer: Buddy's Nosebleeds

Buddy's story is shared with us by Mary Kara, thank you, Mary.

Buddy is a 10 year old Golden Retriever (neutered male). He is my little brother… he is a wonderful dog.

Even as a puppy, he was always a soft, sweet-tempered gentleman, with none of the crazy, challenging puppy antics that most people expect from retrievers.

When we answered the ad in the newspaper, he was the last puppy in the litter left, apparently the runt. He had been adopted once… and returned because he had diarrhea. How dumb was that? I’m so glad they were ignorant and petty, because that gave him to us.

All through his life, Buddy had been a vocal dog; always “talking” to us with whines, moans, sighs, and groans. 

So when he started snorting, that was just an addition to his repertoire. Once or twice last spring, he had a sneeze so strong that he struck his chin on the floor where he laid.

The vet suggested that he was experiencing some seasonal allergies. 

That was definitely possible. His symptoms at this point were some snorting, some sneezing, and infrequent reverse sneezing.

That April (last year), Buddy's left ear developed a hematoma

In his case, the ear flap inflated with fluid like a balloon.

At the vet, they decided that this was due to a mild ear infection, and the scratching was what triggered the hematoma. Ear wash cleared the infection, but nothing would clear the hematoma.

Our longtime vet, Dr. E, drained the ear several times of its fluid, but it wouldn’t stay empty for long. 

We tried binding his ear down close to his head and we tried more compression except with the ear up, but he hated it and it didn’t seem to help. Finally, after draining, compression, and then trying to leave it to resolve on its own for a month, we ended up having Dr. E surgically repair the ear flap at the end of June.

He drained it, opened a long slit on the underside, and stitched the flap in a quilt-like pattern. The ear stayed flat (but obviously a little swollen) while the stitches were in, and two weeks later the stitches were removed.

Three days after that, his ear started to fill again. 

We were leaving town for the weekend the next day, so we boarded him with Dr. E just to be on the safe side.

If we had left him in the care of our neighbor like we had planned, he would have died.

The next morning, as the techs took him on his walk, he had a big sneeze and began to violently bleed from both nostrils. 

They called Dr. E in from home and he later told us that he had never seen as much blood coming from a dog that wasn’t just shot or hit by a car in his 20+ years of practice.

Buddy got a blood transfusion and they stabilized him. 

X-rays of his head looked normal, but when monitoring his blood pressure they noticed that it was very high. So at that point, we began medicating him for hypertension and we thought that the stress of boarding and his high blood pressure had triggered the bleed when he had a powerful sneeze.

We took him home and things went back to normal for a while.

In August we adopted a three year old female Golden named Coco from the rescue SEVA GRREAT. She’s a big girl with some socialization problems but otherwise sweet and normal. Buddy loves canine company and he loves to wrestle, so while they took a little while to become friends; it is impossible to compare his happiness level before Coco and after Coco when referring to his sickness.

In the beginning of November, Buddy had another bleed. 

It started sometime in the early morning before anyone was awake. This time it was much less violent than before, but it was a steady, quiet gush from his right nostril. It would bleed for an hour and subside for an hour, which went on a few times before we could get him to the vet.

When I went to put him in the car to go, he got excited and started spurting and sneezing all over the wall.

Our house looked like a murder scene. 

In this case, he didn’t need a blood transfusion, but when we took him home he kept bleeding, so we decided to board him with Dr. E. and get a diagnostic procedure called a rhinoscopy done, which is a small scope that goes into the nose and throat under anesthesia. We went to a doctor of Internal Medicine to do this (Dr. B).


Dr. B found multiple tumors of granulated tissue in his nasal passages and a small area of the pharynx!

The right nostril was completely occluded by tumor growth and the left was in the beginning stages.

Although he took biopsies and cultures for bacteria and fungus, no definite cause was found by the pathologist.

Because all other diagnoses were essentially ruled out, we accepted possible cancer as our functional diagnosis. 

Blood and urine tests also suggested that Buddy was in the early stages of chronic kidney failure, but it was far more likely that the cancer would get him before the kidney disease would affect him.

Buddy recovered from the rhinoscopy pretty well and soon was back to wrestling with Coco.

Due to costs, quality of life concerns, and especially since we didn’t know what cancer we were dealing with, we decided against allopathic treatments like radiation or chemotherapy. 

I decided to see a new vet, Dr. C, who is a doctor of Internal Medicine and trained in acupuncture and Traditional Chinese Veterinary Medicine (TCVM). We started a few herbal formulas and I changed from meat+veggie dehydrated raw food (The Honest Kitchen), to only a small amount of THK and mostly raw meat.

His blood and urine panels quickly improved—you wouldn’t at all be able to suggest that Buddy had kidney disease. 

We also started acupuncture which his joints have benefited from.

Buddy has had one more bleed since then, and we are doing a course of the cancer apoptosis drug Neoplasene.

At the time of the first nosebleed, I tried to ask if there was something that caused this nosebleed, and how we could find out. 

Dr. E said that since our X-rays were clean, we would do some antibiotics to go after any possible infection in the nose.

I was sort of unprepared to ask better questions at the time, but now better informed, I wish he had done more to inform us of the different causes of nosebleeds. 

I probably would have really pushed my family to have him go for the rhinoscopy at that time if I knew it was an option. I knew in my gut that something wasn’t right with him, ever since his ear swelled up (and his nose has had a correlation to his ear hematomas.)

8 comments

  1. Wow, that's quite the story. I'm glad things are looking good now. Best of luck.

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  2. Wow. I am going through a very similar situation with my dog Cyrus. He is a 10 year old Rhodesian, Shepherd mix as far as we know. He started doing the Reverse sneeze on and off for the past year. It has been getting more frequent. He recently had an aural hematoma and luckily draining the ear has stopped that problem. Just a few days ago he started having nose bleeds. We did blood work all that seems normal. For now the nose stopped bleeding after two days. It is so horrifying to see this happening. I feel so bad for him and torn up over this. I'm not sure what course of action to take next. The vet suggests either going to see a specialist, or staying with her and getting x-rays done, or going the chinese medicine route.. which she practices. I would love so very much if you could give me any advice. My email address is rachelorke@gmail.com. Thank you for sharing your story. I have been feeling like these things reverse sneeze, hematoma, and the nose bleeds should add up to getting a diagnosis.. without a diagnosis I feel my hands are tied. I'm glad you found a plan of action and sounds like it is going well!

    ReplyDelete
  3. Wow. I am going through a very similar situation with my dog Cyrus. He is a 10 year old Rhodesian, Shepherd mix as far as we know. He started doing the Reverse sneeze on and off for the past year. It has been getting more frequent. He recently had an aural hematoma and luckily draining the ear has stopped that problem. Just a few days ago he started having nose bleeds. We did blood work all that seems normal. For now the nose stopped bleeding after two days. It is so horrifying to see this happening. I feel so bad for him and torn up over this. I'm not sure what course of action to take next. The vet suggests either going to see a specialist, or staying with her and getting x-rays done, or going the chinese medicine route.. which she practices. I would love so very much if you could give me any advice. My email address is rachelorke@gmail.com. Thank you for sharing your story. I have been feeling like these things reverse sneeze, hematoma, and the nose bleeds should add up to getting a diagnosis.. without a diagnosis I feel my hands are tied. I'm glad you found a plan of action and sounds like it is going well!

    ReplyDelete
    Replies
    1. Draining aural hematoma stopped his reverse sneezing? One wouldn't see the connection, interesting.

      The good news about his nose bleeds is that if it was something really bad, such as cancer, they wouldn't stop but continue to get worse.

      It would be good idea, though, figuring it out. So you did full blood panel which didn't show any abnormalities?

      Did you also test for tick borne diseases?

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  4. His nosebleeds started again. It has been a little over a week now and they have been on and off. I meant that the hematoma draining stopped any further ear problem, not the reverse sneezing. He still is doing that. My vet wants me to see a doctor of internal medicine. I have an appointment for this Wednesday where we will discuss different routes. My vet said that I should do more than x-rays while he is under anesthesia. The doctor of internal medicine is talking about doing an MRI and whatever else goes along with that. I am very worried that what he will be doing will be costing $4,000 range before any treatment. I am also worried that a biopsy will cause more bleeding than there already is. Unfortunately I don't think I have much more than that to spend and maybe not get any information.. I am expecting my first child soon and this is all coming at a hard time... I hope this vet is better at helping me choose a route of action because there are so many different tests and it is hard to know what to do. I am very interested in treating this naturally with chinese medicine, diet, and herbs. Any knowledge about this before getting a diagnosis?

    to answer your questions.. there was a full blood work up with no abnormalities, and I'm not sure about tick borne diseases. How do they check for that?

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    Replies
    1. Well, unfortunately, you need to get to the bottom of this. Nosebleeds aren't as common in dogs as in people and it could have quite a serious cause.

      I believe the specialist should be able to recommend which diagnostics would be most effective. I'd think MRI probably might be best. If I remember correctly, and MRI goes for about $1700, though it might vary by place.

      Holistic or TCVM might be a good treatment option, but any integrative vet would likely recommend some of the modern diagnostics as well. Gotta know what you're treating.

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  5. I took him to the specialist and he believes that he has a tumor. Unfortunately there are big risks with disturbing the tumor in the diagnostic tests and possibly causing a bleed that wont stop. If the diagnosis is tumor the only treatment is chemo or radiation, which I don't want to put him through. I am following up with a TCVM but I have to wait two weeks to get him in. They said if he has this tumor they would estimate under 90 days to live. This is shocking and out of nowhere seemingly. I have taken him to four vets now and am waiting for the chinese vet. I hope that something can help him. He is in good spirits between the bleeds and still quite active.

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    Replies
    1. Hi Rachel, so sorry! It was kind of what I suspected, that's why I felt you need to find out what's going on.

      You know, depending on the tumor size, type, grade and all ... considering the conventional options might not be the worst idea. In general, dogs don't have such horrible side effects from chemo as humans do, and together with the alternative medicine, it might be a positive thing to do.

      I think you best talk to Dr. Sue, she is a cancer vet
      https://www.facebook.com/DrSueCancerVet?fref=ts
      http://www.dogcancerblog.com/

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