Continued form part 9
When we last checked in with Billy he was battling skin issues and his owners were thinking of trying cyclosporine.
Dr. Mitelman: We hoped our magic bullet, cyclosporine, would be effective, as it has with many other patients with similar signs.
The medication works by modulating the immune system's recognition of foreign allergens, thereby desensitizing the body. Sounded great. We were so very hopeful.
During the first few days, we crossed our fingers. Billy commenced at the recommended dose. No whammy's, please, no whammy's. Do you remember the game show "Press Your Luck"?
Sure enough it didn't take too long for Billy to exhibit some adverse effects.
Barbara: The third day in to the cyclosporine treatments we started to hear the most disturbing sounds coming from Billy's tummy. The gurgles were so loud that we could hear them from the next room. And you can probably guess what followed. Diarrhea.
For the first time in memory Billy had diarrhea.
We always joked about his 'gut of steel'. Not any longer.
Seven urgent trips out per day. With all of the "unpredictables" in Billy's life, this became a constant. He couldn't be left home alone for long, so Billy stayed with Dr. Mitelman at the clinic in order for us to carry on with our busy family life.
I am appreciative of the way his wonderful staff stepped in to help us care for Billy.
Dr. Mitelman: Vomiting was a commonly described effect of cyclosporine, potentially lasting some weeks until the body accommodates. But diarrhea was not as common.
I felt our best treatment plan was to stay the course. So we lowered his dose, changed the administration routine, added pumpkin as a fibre source to soothe his gut. No luck.
We backed down to dosing him every other day. Still no luck. Should we sacrifice his gut comfort for the restful skin we were vying for?
We treated symptoms of one medication with others.
Barbara: Billy's diarrhea lingered for weeks. The discovery of blood in his stool brought a heightening sense of alarm. "Staying the course" was becoming very difficult for me. It was hard to watch Billy so uncomfortable, not only with unresolved itchy skin, but now an upset, and at times, painful gut.
Dr. Mitelman: It was at this time Barbara gave me the go ahead to pursue the neuronal ceroid lipofuscinosis (NCL) testing. Some of Billy's exaggerated behaviors were pointing to this degenerative condition seen most often in dachshunds.
The relief was only partial, as the hunt for answers and solutions continued.
Barbara: I felt such relief when the NCL testing showed Billy didn't have the condition. The fear he carried the genes had weighed on me for a long while. Delayed due to the mounting costs, I was glad we had finally followed through on this.
Still looking for something to help Billy, I asked Dr. Mitelman to order the allergy serum which would be tailor made with the results of the testing we had already done.
We had put this aside in hopes the cyclopsorine would do the trick.
The allergy injections are not always 100 per cent effective so we opted to try the other way first. Billy's constant upset tummy and diarrhea were making me doubt he would ever adjust to the cyclosporine.
Dr. Mitelman: Added to the list of mounting surprises we didn't need at an already tense time, we learned about a food recall affecting several lines at IAMS.
The KO he was doing so well with was taken off the market due as a precaution because of potential equipment contamination. The return to production date was unknown and the well-stocked supply Barbara kept all carried dates that fell under the recall.
This meant an abrupt and immediate change to Billy's diet.
We switched to a home cooked variety: whitefish and white potatoes. Billy eagerly adapted to the change and Barbara accepted that everyday would be like the Friday's of her childhood.
She joked about clothes pins used as nose plugs.
Barbara: At first I viewed cooking Billy's daily diet as a stressful addition to our already challenging days.
Cooking his fish at breakfast time each day left a lingering odor in our home. And Billy literally howled for the 10 minutes it took to cook the whitefish. But he loved it.
Unfortunately, it didn't love him, and the diarrhea reappeared despite the fact we had by this time discontinued the cyclosporine.
Dr. Mitelman: One afternoon Billy was so agitated and anxious he was aggressively chewing on his "for powerful chewers" nylon toy. Barbara noticed he had actually destroyed the item, leaving pieces all over the living room floor.
Later when Barbara was picking up Billy, who had been left at the clinic while the family took a much needed break, an assistant brought us a plastic bag and proclaimed "look what Billy barfed.”
"You have got to be kidding.”
Radiographs done immediately showed large pieces of foreign matter sitting in Billy's stomach. I explained that the pieces seemed sufficiently big that they were unlikely to make a quiet exit. I needed to use our endoscope to get them out safely.
Foreshadowing works in strange ways. Maybe Billy was trying to lead us down a different path and tell us something else was going on in his gut that needed discovery.
***
The hospital is a full service emergency/after hours/critical care facility that provides around the clock care. There is a doctor on site 24/7/365. Owners Dr. Samson and Dr. Mitelman oversee all cases, providing continuity of care.
Referrals from other hospitals are examined, stabilized and treated, then returned to their regular clinic. Follow ups are done with both the referring veterinarians and the pet's owners.
As a full service hospital we have the following:
- on site ultrasound
- on site endoscopy
- laser and orthopedic surgery
- emergency/critical care specialists, internal medicine specialists, and surgeons on call
A full listing of diagnostics and additional services is available on our website, www.vetstoronto.com
www.vetstoronto.com
www.vetstoronto.com/blog
www.facebook.com/vetstoronto
Twitter. @vetstoronto & @iambillysmom
Ask Dr. Mitelman vetsdrjm@gmail.com
Related articles:
When A Small Sore Turns Into A Catastrophe: Billy's Story (Part I)
Life-threatening Infection Resolves; All Is Good? Billy's Story (Part II)
What Is Going On With Billy's Skin? Billy's Story (Part III)
The Plot Thickens: Billy's Story (Part IV)
I've Never Seen That Before: Billy's Story (Part V)
Billy's Diagnosis Still Unknown: Billy's Story (Part VI)
Neuronal Ceroid Lipofuscinosis (NCL)? Billy's Story (Part VII)
Time To Make A New Plan: Billy's Story (Part VIII)
Atopic Dermatitis? Billy's Story (Part IX)
Doggy medical issues tend to make you wanna bang your head against the wall on the best of days, even if it's a small thing. People rarely get dogs hoping for the challenge of discovering an unknown illness that will potentially cost them time, money, and resources.
ReplyDeleteMost of us get pets in order to have someone to stand by us in hard times, but so many people seem to be having a hard time AND trying to stand by their pet, who is also having a hell of a time.
It really sucks, but Billy is lucky to have the family he does; I know plenty of good people who would have thrown in the towel long ago...and that's minus all of the extra things going on in this family's life. Yikes.
I read this all at work (when I was, of course, supposed to be doing something else) and thought I'd throw in a comment.
I wish I could help, but I fear I'm headed in a similar direction with Ko...so the best I can offer is understanding and the hope that - whatever it is - they figure it out and can deal with it.
That's just so much on one person's plate.... I don't even want to think about trying to handle all of that. I think this family is run by superwoman.... =]
In any case, best of luck.....and I hope things turn out for the better in the end.