Toy Review Tuesday (and an Oliver Update)

Oliver had a good day today – very quiet and subdued, but that’s what he’s supposed to do.  The doctors do want him moving around a bit so that he can work out some of that edema and fluid build-up and he was feeling pretty spry at certain times of the day.  He does love his boiled chicken and rice.

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For the record, this is his pill dose – twice a day.

O Pills

 

 

 

 

 

 

 

 

 

And, also for the record,we can’t decide if he looks like a beached beluga whale or a baby albino hippo. Either way, and all kidding aside, we are seeing the swelling and fluid build up going down – slowly. Follow up appointments with specialists have been scheduled.

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Now on to the Toys . . . Dads went on vacation, as we mentioned, and had a brief stop in one of The Buck-White Boys’ favorite places, Seattle! And, even more specifically, Pike Place Market.

Three years ago they passed through Seattle and picked up the greatest dog toy at the Market – it was this rope tied in loops and knots. The guy who was selling it said that it was made from recycled or discarded climbing rope.  So, that’s cool.  We loved it immediately.  Check this thing out:

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We have chewed this, tugged it, dragged it around and every foster that came through took their time with it as well.  Sure, it’s a little frayed in some places, but it’s holding up REALLY well!

Well, we’ve all talked about that toy for three years and we’ve even sent people also passing through Seattle to pick ’em up.  We seriously love this thing.  And wanted more.

Guess what!  Looks like this has turned into a really good business for these people – they’re called Adventure Day Treats and they also make what sound really yummy, all-natural treats.  We think Tucker should try the Breath Nuggets and Barclay ought to have a crack at the Calming Nuggets, don’t you think.

But, of course, the real draw was THE ROPE TOYS!  They call ’em the “Monkey-Fist Tug” and they are just as much fun as we remember!

Dads picked up a couple and brought ’em home:

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You can tug ’em, you can chew on ’em, you can fling ’em around (gently and if you’re outside).  Here’s the thing, though, they are so well made they don’t fall apart.  A lot of rope toys come apart once you start chewing on them, or they get so frayed so quickly that they’re not fun and leave shreds all over the house.  These “monkey fists” are the real deal and are super, super awesome.

They also make other kinds of pulls and rope toys – different materials and different sizes.  There are also these really cool leashes.  And treats.  Did we mention the treats?  And gift baskets.  Of treats.  We might be hungry . . . . we’re labs and we’re awake, so, yes, we’re hungry.

Definitely go check these out on their website www.adventuredaystreats.com.  Looks like you can order them online – they’re worth getting your paws on, especially if you’re a big chewer or tugger.  Or, even better, make a trip to Seattle and visit them in Pike Place!

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Filed under Christmas, Food, Oliver, Recommendations, Toys, Uncategorized

Interconnected Confusion

Yesterday when our Critical Care Vet was talking it reminded us of this:

With Oliver it’s like something caused something which affected something which caused something which affected something and they all have different treatments or medications which are causing this or that effect . . . . we’re all beat.  Except Barclay who’s enjoyed having all the toys to himself.

Oliver came home today – hooray! We’re really hoping some good rest and familiar surroundings will help a lot.  We figured out that he’s essentially been in puppy prison for nearly a full month now.  It helped all of us to sit down and piece everything together, and enough people have asked that we thought we’d list it all out  . . . ready?

Oliver was first admitted to the vet on Sunday, August 25th with vomiting and melena.

On Monday, August 26th our regular vet recommended Oliver be moved to Emergency and Critical Care; we knew he was bleeding internally, but did not know why.  He had 3-4 blood transfusions and an albumin transfusion, along with a lot of other treatment.

There is no canine albumin for transfusion so human albumin is used.  A dog’s system CAN see that albumin as a foreign body and attack it and a dog can only have a human albumin transfusion once in their life as the second time the “allergic” reaction is extremely severe.  We were warned of the possible complications and were very clear.  This will come up later, so hold on to it.

Oliver had surgery on Friday, August 30. They sutured a bleeding artery in his stomach and sent a tissue sample for biopsy.

Oliver came home on Monday, September 2.

On Friday, September 6 Dads left for a long-planned-and-already-paid-for vacation.  Barclay & Tucker stayed at home with Aunt Lady; Oliver stayed at his regular vet because everyone just felt better in case something happened.  When he went in he seemed perfectly healthy, was in great spirits and only needed some tummy meds and ultimately to have the staples from his surgery removed.

Saturday, September 14 Dads were back in cell phone range.  They’d talked to the vet a couple of times earlier in the week and everything seemed cool – they decided to keep him on his tummy meds awhile longer just ’cause he seemed a little oogy still. Checking in, they learned the results from the biopsy had come back, Oliver was his normal self and the results indicated that pathology wasn’t sure what had come first, an ulcer that caused the artery to burst or the burst artery caused an ulcer.  

The pathology report noted that the tissue sample, or lesion, ” . . . may represent a case of systemic necrotizing arteritis or polyarteritis nordosa.” But their findings were inconclusive because the ulcer could have occurred first.  The only way to 100% diagnose arteritis is through pathology. 

On Sunday, September 15 Dads were headed home.    Sunday morning at about 5:00 a.m. the overnight vet tech noticed Oliver’s face seemed a little puffy.  Thinking it might be an allergic reaction to something, the on-call vet prescribed a shot of an antihistamine.

By about 10:00 a.m. when Dr. C. came in, Oliver’s face was still puffy and he had bruises on his abdomen.  He’d been in a very controlled environment so this was puzzling.  A shot of steroids to reduce the swelling was prescribed.  By mid-day, several veterinarians had been consulted and we all begin operating under the theory that Oliver does, indeed, have this arteritis.

Arteritis is very rare in humans and even rarer in dogs.  There’s very little literature or case studies on it, but what is known is that it is usually immune mediated, that is where the immune system essentially attacks the arteries.

On Monday, September 16, Oliver begins aggressive steroid therapy to try to get his immune system somewhat suppressed.  He also came home that day.

On Wednesday, September 18, it appears Oliver is not getting particularly better, having vomited several times and he is referred back to the Emergency and Critical Care vet.  He is admitted to the hospital again to be watched and have his medicines adjusted.  He begins having diarrhea and continues vomiting.

So here’s where the connections start happening:

— It appears that the vomiting and diarrhea are a reaction to one of the medicines; he’s taken off of it and it slowly gets better.  But this was a medicine we really needed to try for the immuno-suppression;

— During blood tests his BUN and Creatinine numbers start increasing.  These are measures of how the kidneys are processing toxins;

— His blood pressure starts to increase, so he goes on blood pressure medicine;

— His tummy starts to fill with fluid and he gets edema in his back legs.

Now, as time goes on these issues start to get better – kidney values get closer to normal, blood pressure is lower, etc.  The continued issue is the fluid build up.  SO, here’s what we’ve got:

1) The Arteritis – very rare, suspected to be an immune system dysfunction – treatment is steroids;

2) Steroids and Other Medication – can cause diarrhea and vomiting and also fluid build up (a relatively common side effect of prednisone);

3)  “Lymphoplasmacytic Gastritis” – or Inflammatory Bowel Disease – this was also identified on the biopsy, but could have been caused by the bleeding and the ulcer (if the ulcer came first);

4) The Ulcer – did this come first?  Were the arteries already weakened because of the Arteritis, so the Ulcer caused them to be weaker? Or did the injury to the arteries cause a loss of blood flow to his stomach?  Unknown;

5) Vomiting and Diarrhea – is this due to the Gastritis?  Or is it a reaction to one of the medicines?  It seemed to get better once he went off that one medication, but it’s still too soon to tell for sure.  Or it could be a combination;

6) Protein-Losing Nephropathy – he’s losing protein through his urine.  Could be because of the weakened arteries, or — ready for this? — it could be an adverse reaction to the albumin transfusion he had before his surgery;

7) High Blood Pressure – who knows?  Could be related to any or all of the above – any of these issues can cause high blood pressure as can a couple of the drugs he’s on;

8)  Edema and Peritoneal Effusion – the fluid retention is most likely due to the weakened arteries and the vascular disease, but it could be because of the low protein in the blood.  Y’know, that he’s losing in his urine.  Because of the weakened arteries or reaction to the albumin transfusion.

9)  Chronic Thrombocytopenia – low platelets in the blood.  Part of the protein loss?  Left over from the anemia when he was bleeding internally?  Because Thrombocytopenia is fun to say and difficult to type?

10)  Chronic, Variably Regenerative Anemia – his packed red blood cell counts are lower than we’d like but significantly higher than they were, so we’re not too terribly worried about blood loss, but we do have to keep an eye on if he’s peeing/pooping/vomiting blood or appears pale, lethargic, etc.

So, all told the diagnosis and prognosis are:

Sick Dog Meme

 

 

 

 

 

 

 

The plan now is that he’s home, getting plenty of rest and love and we will continue to monitor him, work with the specialists, slowly wean him off of these medicines and see where he gets it.  We’re hopeful and confident that he’ll do great, but it’s going to be quite the haul — and, truthfully, all of this may prove too much.  We don’t know what long-term affects these illnesses have caused and we don’t know what could happen.

But we do know that he’s an awesome, awesome boy and is doing really well handling all of this and being chipper about it. If that changes, we’ll know that means he’s really, truly sick.

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Filed under Oliver, Uncategorized, Veterinarian

Poor Little Guy

This is a tough post to write – through all of this, even when the internal bleeding was the worst, Oliver never lost his spirit or his joy.  To see him with his tail tucked and clearly not feeling well was so sad.

It appears that the arteritis has begun to affect his kidneys.  With a blood test on Thursday, his BUN result (Blood Urea Nitrogen – a test of the amount of nitrogen in the blood that comes from waste) was very high, indicating that the kidneys weren’t processing toxins correctly.  At the time, his creatnine (another indicator of kidney function, releasing waste) was fine.  Our primary veterinarian felt it important that we consult with the emergency vet where he was first diagnosed.

This condition is so rare that there are a lot of experts being called and involved in determining best approach.

The emergency vet really felt strongly about admitting him and administering “aggressive IV fluids.”  He stayed overnight Thursday, hoping to come home today.  Unfortunately the BUN and creatinine levels continued to rise, so he is there again tonight.

He is not happy, he does not feel well and he’s just not himself.  Tomorrow will tell us more and we hope beyond hope that he’ll come home sometime on Saturday.  The doctors remain confident that the course of treatment is correct – the approach was changed slightly yesterday so we need to give it time to work.  In the meantime, we do everything we can to keep his spirits high – dads visited him today with snacks and toys and a cozy blankie.

Please keep the good thoughts and prayers coming – we are all very, very thankful.  Especially Mr. Oliver.

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Artery + Itis

Dads went on vacation – one that had been planned a long time and couldn’t be changed (they felt bad about going, but they did get some much-needed away time).  Barclay and Tucker stayed at home with their favorite Aunt Lady (thanks again, Aunt Lady – we love you!).  Oliver, on the other hand, got ten days at Camp Vet.

Everybody was a little concerned about Mr. O-Man after his “adventures” the week prior, but it was the best solution having him stay with the doctors while dads were away.

Oliver did really well.  Dads talked to the vets every day they could (some days there was no cell service) and Oliver did great – he was happy, healthy and charming.  On Saturday of this past weekend, everything was a-ok . . . Oliver had his staples out and was his bouncy, normal self.  Ready to come home and, believe-you-me, Dad & Dad were ANXIOUS to see him and get him home (and see B&T, too, of course).

Sunday morning the vet tech noticed that Oliver looked a little puffy and then that he had some bruises on his abdomen.  First thought was that it was an allergic reaction to something . . . which would be odd, given that he hadn’t been exposed to anything in the vet’s office.

Let’s make the long story very short — specialists were called, there were conferences and blood tests AND the pathology report came back from the biopsy from the surgery.  It is possible that Oliver has a very rare condition referred to as “Arteritis” or “Artery” plus “-itis.” Which, essentially, is a condition where the white blood cells attack the arteries as a foreign body.

This is typically diagnosed by a pathology report from a biopsy.  Oliver’s says it COULD be this issue, but it’s unclear whether the ulcer happened first and caused the arteritis or the arteritis caused the ulcer.  Given that symptoms seem to be occurring again – edema and unexplained bruising – this is the operating theory now.  It is treated with a course of steroids and “most dogs respond very well to the treatment.”

Here’s the thing – it’s so rare that there’s really no way to know what is normal or really have a strong prognosis.  We are in another “wait and see” mode.

Oliver is a little puffy and swollen and he clearly doesn’t feel well.  There’s a bit of diarrhea, some throwing up, he’s lethargic and a little wobbly.  Some of this is reaction to the steroid treatments and he’s on big doses of Benadryl, so it’s to be expected.  Once the course of treatment is done we’ll run more tests and evaluate.

Right now he’s getting a lot of love (which makes Tucker very, very jealous), a lot of sympathy and pretty much anything he wants whenever he wants it.

Barclay would very much like for all of this to be over because he’s not getting nearly enough play time.  Tucker is jealous of all the attention Oliver is getting.

We are confident in our vets, confident in Oliver’s resilience and so appreciative of everyone who’s asked about our Goofy Guy.  Who tends to take naps in the most wonderful positions and inopportune locations:

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Home

Oliver is home.  He is home and happy and on the way to recovery.

His blood counts held steady overnight and was at 26% this morning, so they decided to let him come home.  He has a long road to go, of course, but the worst of it is over and he’s home where he can plenty of rest, attention and TLC.

We stopped by our pals at Barking Dogs Self Wash and Grooming on the way home, picked up some high protein, soft food for Mr. O; he was greeted by his fan club and can’t wait to get back to 100% so he can get in there and tear the store apart as usual.

New Toy!

New Toy!

 

 

 

 

 

 

 

 

 

 

The responses and notes and comments and emails and phone calls we’ve received have been overwhelming.  Everyone who’s been following this blog, Facebook posts, etc., knows what a long week this has been.  We are completely confident that it is the prayers, good thoughts and positive energy that brought our Oliver home.

Happy at Home!

Happy at Home!

 

 

 

 

 

 

 

 

 

 

The doctors, technicians, and staff at Las Vegas Veterinary Emergency and Critical Care were absolutely amazing.  Their attention to detail, patience and compassionate care was absolutely unparalleled.   Our regular vets at Town Center Animal Hospital were involved and attentive every step of the way.

On the Way Home

On the Way Home

 

 

 

 

 

 

 

 

 

 

We have a lot of meds to take and a whole bunch of abdominal staples that have to come out in two weeks.  He’s not supposed to have any major activity – like climbing stairs, running, jumping on or off furniture.  Clearly these vets have never lived with a Labrador before.  For now, Oliver is pretty calm . . . but once he starts to feeling better, he’s going to be a hard guy to keep down.

Oliver is the foster dog who got to stay.  The vets told us they’d never seen anything like his burst artery, and everyone that interacted with him told us that he was their favorite.  We called tonight for some additional information – the night shift said they came in to work and were glad he’d gone home, but were sad he wasn’t there any more.  What a flirt.

A dear friend told Oliver today, “God wanted you to stay for a reason. You’ve got a role to play and that role is all about love.”  Or joy, either way, but that’s our guy.  And we’re just glad he’s home.

The pack is back together.

The pack is back together.

 

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Holding Steady . . .

After the high stress, high drama, high tension of yesterday, today was a welcome respite for everyone.

We talked with the Critical Care vet this morning – Mr. O had made it through the night with no problems.  He came out of the anesthesia just fine, no vomiting and no diarrhea.  These are good signs.  He’d had a transfusion during the night and had responded to it well.

According to everyone he was up and paying attention to what was going on, if a little groggy.  The vet told us they were going to watch his vitals during the day, see if he could hold down food, and at 4:00 p.m. check the blood counts.  And then the phrase “going home” started coming up.  We’d know more once the afternoon/evening came.

The vet called around 5:00 or so.  His blood counts had held steady – the packed red blood cells was holding at 24%.  We’d like to see it higher, still, but it was holding and that was the highest we’ve seen it yet.  With that said, she felt that she’d feel more comfortable keeping him one more night and, as she put it, “It would be awful to have put this much work into this and have something happen.” We agreed.

We stopped by tonight to visit Oliver.  He’s groggy and it’s clearly uncomfortable.  He looks a it like a Franken-puppy.

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And boy was he glad to see us!  So glad that he relaxed and pretty much fell asleep.

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He really didn’t want to go back in the ICU, but he’s got plenty of people around him and the vet techs said he’s back there flirting with everyone and, despite not being 100%, is Mr. Charming.  We’re not too worried about him being lonely, but so very, very happy that he’ll be coming home sometime tomorrow.

The relief is palpable and it was a pretty quiet day at the Buck-White house.  We’ve got three major hurdles in front of us:

1)  Oliver’s recovery from surgery and all the tests and procedures of this week.  He’ll be weak for awhile and probably have a fairly long road ahead of him.  We’re confident that will go well;

2) Making sure that there’s no re-occurrence and that the results from the biopsy are positive;

3)  Getting this two knuckle-heads to leave him alone:

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They’ve been a little spoiled while Oliver’s been away . . . and they’ve taken advantage of there being just the two of them.  They’ve played hard – and there’s been nobody here to steal their toys like O does – and they’ve gotten away with a few naughty things while Dads have been distracted.

Barclay and Tucker will be happy to have their little brother home – in their quiet moments, it’s clear they’ve missed the little guy and we’ll all be happy when he’s back to his goofy, nutty self.

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Weight Lifting

Oliver is resting.  Poor guy has had a day and we all could use a good, solid, (relatively) stress-free night – but we all feel as if weights have been lifted off of our shoulders.

We saw Oliver this morning, knowing he’d had the albumin transfusion last night.  He looked pretty good and was up and alert.  His blood protein levels (from the albumin) were holding steady, but the blood numbers were dropping slightly.  He was really happy to see his family, but we hear he’s entertaining everyone at the Critical Care vet.

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They proceeded with the endoscopy and called us as soon as it was done.  They found the bleeder in the cardia of the stomach, where the esophagus meets the stomach, a very difficult place to scope and to possibly operate on.  Despite the risks, we knew the bleeding was continuing and he was losing blood as fast as they could pump it in.

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They moved him directly into the surgical suite and we waited for what felt like centuries.  The surgeon called about two hours later.

During the surgery they found what looked like an artery that had been severed; the surgeon said he’d never seen anything exactly like it.  He sutured it and examined everywhere for additional bleeders and found none.   He also sent an “area about the size of a quarter” out for biopsy, but said he noticed none of the things you typically see with cancer, ulcers or any other GI disturbance.  Everything looks good.

Here’s the visual we got from the way he described it:

So, as best we know right now, everything should ultimately be ok once he recovers from this surgery.  He’s having another transfusion tonight and they’ll continue to watch the counts.  We’ll get to see him sometime on Saturday.

It’s been a long haul and we’re, of course, not out of the woods but at least we know.  We’ll be on pins and needles until we get the biopsy results back in about a week, but we’re confident that will show everything’s pink and perfect and goofy and fine.  Just like Oliver.

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