Well I'm on the roller coaster again, and it's not the fun kind. I'm pretty frightened.
Getting her to eat right now is top priority. She's not exactly co-operating.
She began this by slowly eating less and less. I watched her. Then the weight started to drop and I called her vet. I wasn't too worried at this point as I have a group of finicky eaters. So they do go back and forth.
Last Monday, the 19th, she saw her doc and her bloodwork was messed up and the liver very high. We decided on an US. I asked if an internist, rather than a regular 3rd party reviewed one would be better. The vet agreed. We managed at date of Sept 10th which was pretty far off but at that point I was worried but not panicked.
After mondays visit - she started to really tank. She went from eating bits to zippo and then zippo water on Wednesday. This happened incredibly fast.
BY thursday morning I was on the phone to her Vet letting them know - she's not going to make it to Sept.
Bless my Vets office and the amazing Vet tech... they fought for her and got her into an ER place with an internist. The kick was it's near 2.5 hours away. I sucked up all the bravery I had in me knowing I was going to have to leave her there without being able to visit and dropped her off Thursday night. I made another horrible choice and signed a DNR after reading all the stats for CPR. THis ER place was freaking amazing in everything they did and how they treated her.
She has a nasal feeding tube placed friday or sat?
They called yesterday afternoon that she had been eating on her own and liver values were going down. I picked her up and we got home last night 8 - 8:30 pm. She hasn't eaten since. When I called last night to find out what time she last ate, it was 9 am and 3 pm a few bites. Well crap. I think they released her back into the wild with me too soon.
I shoved some Mirtz in her about an hour ago. I called her vet and we have arranged tomorrow 8 am to have a tube placed because right now with her liver, this is way to risky to not have access to get food into her.
I'm trying as best as I can to prepare for the fact that I might lose her or have to let her go. I understand that might be the reality... but I'm not accepting that without a fight. No way. She deserves to be fought for.
--------------------------------------------------------------------------
Results of her testing:
There is a lot to this - I'm just giving you the basics
Bottom line is no one is 100% sure what even happened or is happening.
Blood:
To give you one of her liver values on Monday:
ALT 354
AST 131
ALP 114
Bilirubin - Total 4.8
By Thursday of Friday her alt was passed 630
Sat they started to come down and the atl was 524
There were issues in the urine on Monday we did a C and S - no bacteria.
US on Sat:
23-Aug-2024 Ultrasound Abdominal
14:48 Order item: US Abdominal [23.1]
Findings ULTRASOUND FINDINGS:
Routine abdominal ultrasound is performed in dorsal recumbency.
The liver is normal in size and subjectively coarse echogenicity. The gallbladder is normal.
The spleen is normal in size and echogenicity.
The kidneys are normal in size and echogenicity. The left kidney is 3.63cm in length. The right
kidney is 3.98cm in length with mild renal pelvic dilation up to 0.16cm. The urinary bladder is
markedly distended with anechoic fluid.
The adrenal glands are normal. The left adrenal gland is 0.25cm. The right adrenal gland is 0.32cm.
The stomach is mildly distended with echogenic material however amongst this material there is a
region of heavily shadowing material within the gastric lumen that affects a length of ~ 2.66cm.
The stomach can be traced through the pylorus to the duodenum with no active obstruction at the
time of the study. The duodenum is empty with preserved wall layering detail and is mildly
thickened at 0.23cm. The remainder of the gastrointestinal tract is unremarkable.
No other substantial abnormalities are noted.
Interpretation
1) There is a possible gastric foreign body amongst normal appearing ingesta in this study. This
material may be intermittently causing gastric outflow obstruction.
2) There is mild duodenal thickening. This may be secondary to non-specific enteritis, however
dietary sensitivity, IBD/CE, or LSA are also potential differential diagnoses.
3) There is mild right renal pelvic dilation. This may be secondary to partial or previous ureteral
obstruction (d/t ureterolith or circumcaval ureter), or could be secondary to diuresis or
pyelonephritis.
4) A cause of elevated liver parameters is not apparent in this study. Given the patient's history of
chronic gastrointestinal signs, triaditis/cholangiohepatitis, should be considered. Hepatic lipidosis
is also a possible differential diagnosis.
Recommendations Consider ongoing supportive care for non-specific gastroenteritis/pancreatitis.
Consider the initiation of a beta-lactam (ampicillin) +/- metronidazole, ursodiol for
cholangiohepatitis or pyelonephritis
Nasogastric tube feeding is indicated if the patient continues to have a poor appetite.
If patient continues to be anorexiac and/or is vomiting, repeat imaging of the stomach +/- upper
gastrointestinal endoscopy may be beneficial.
---------------------------------------------------------
Meds - she is taking antibiotics in spite of no indication of infection as a precaution.
No one knows what's in her tummy but I would be really shocked to find out she ate anything weird as that would be really strange for her. Charlie - maybe - but not BH.
------------------------------------------------------------------
We will be talking about an endoscopy once we get over this emergency. Right now the main thing is to get her through this critical phase.
--
Getting her to eat right now is top priority. She's not exactly co-operating.
She began this by slowly eating less and less. I watched her. Then the weight started to drop and I called her vet. I wasn't too worried at this point as I have a group of finicky eaters. So they do go back and forth.
Last Monday, the 19th, she saw her doc and her bloodwork was messed up and the liver very high. We decided on an US. I asked if an internist, rather than a regular 3rd party reviewed one would be better. The vet agreed. We managed at date of Sept 10th which was pretty far off but at that point I was worried but not panicked.
After mondays visit - she started to really tank. She went from eating bits to zippo and then zippo water on Wednesday. This happened incredibly fast.
BY thursday morning I was on the phone to her Vet letting them know - she's not going to make it to Sept.
Bless my Vets office and the amazing Vet tech... they fought for her and got her into an ER place with an internist. The kick was it's near 2.5 hours away. I sucked up all the bravery I had in me knowing I was going to have to leave her there without being able to visit and dropped her off Thursday night. I made another horrible choice and signed a DNR after reading all the stats for CPR. THis ER place was freaking amazing in everything they did and how they treated her.
She has a nasal feeding tube placed friday or sat?
They called yesterday afternoon that she had been eating on her own and liver values were going down. I picked her up and we got home last night 8 - 8:30 pm. She hasn't eaten since. When I called last night to find out what time she last ate, it was 9 am and 3 pm a few bites. Well crap. I think they released her back into the wild with me too soon.
I shoved some Mirtz in her about an hour ago. I called her vet and we have arranged tomorrow 8 am to have a tube placed because right now with her liver, this is way to risky to not have access to get food into her.
I'm trying as best as I can to prepare for the fact that I might lose her or have to let her go. I understand that might be the reality... but I'm not accepting that without a fight. No way. She deserves to be fought for.
--------------------------------------------------------------------------
Results of her testing:
There is a lot to this - I'm just giving you the basics
Bottom line is no one is 100% sure what even happened or is happening.
Blood:
To give you one of her liver values on Monday:
ALT 354
AST 131
ALP 114
Bilirubin - Total 4.8
By Thursday of Friday her alt was passed 630
Sat they started to come down and the atl was 524
There were issues in the urine on Monday we did a C and S - no bacteria.
US on Sat:
23-Aug-2024 Ultrasound Abdominal
14:48 Order item: US Abdominal [23.1]
Findings ULTRASOUND FINDINGS:
Routine abdominal ultrasound is performed in dorsal recumbency.
The liver is normal in size and subjectively coarse echogenicity. The gallbladder is normal.
The spleen is normal in size and echogenicity.
The kidneys are normal in size and echogenicity. The left kidney is 3.63cm in length. The right
kidney is 3.98cm in length with mild renal pelvic dilation up to 0.16cm. The urinary bladder is
markedly distended with anechoic fluid.
The adrenal glands are normal. The left adrenal gland is 0.25cm. The right adrenal gland is 0.32cm.
The stomach is mildly distended with echogenic material however amongst this material there is a
region of heavily shadowing material within the gastric lumen that affects a length of ~ 2.66cm.
The stomach can be traced through the pylorus to the duodenum with no active obstruction at the
time of the study. The duodenum is empty with preserved wall layering detail and is mildly
thickened at 0.23cm. The remainder of the gastrointestinal tract is unremarkable.
No other substantial abnormalities are noted.
Interpretation
1) There is a possible gastric foreign body amongst normal appearing ingesta in this study. This
material may be intermittently causing gastric outflow obstruction.
2) There is mild duodenal thickening. This may be secondary to non-specific enteritis, however
dietary sensitivity, IBD/CE, or LSA are also potential differential diagnoses.
3) There is mild right renal pelvic dilation. This may be secondary to partial or previous ureteral
obstruction (d/t ureterolith or circumcaval ureter), or could be secondary to diuresis or
pyelonephritis.
4) A cause of elevated liver parameters is not apparent in this study. Given the patient's history of
chronic gastrointestinal signs, triaditis/cholangiohepatitis, should be considered. Hepatic lipidosis
is also a possible differential diagnosis.
Recommendations Consider ongoing supportive care for non-specific gastroenteritis/pancreatitis.
Consider the initiation of a beta-lactam (ampicillin) +/- metronidazole, ursodiol for
cholangiohepatitis or pyelonephritis
Nasogastric tube feeding is indicated if the patient continues to have a poor appetite.
If patient continues to be anorexiac and/or is vomiting, repeat imaging of the stomach +/- upper
gastrointestinal endoscopy may be beneficial.
---------------------------------------------------------
Meds - she is taking antibiotics in spite of no indication of infection as a precaution.
No one knows what's in her tummy but I would be really shocked to find out she ate anything weird as that would be really strange for her. Charlie - maybe - but not BH.
------------------------------------------------------------------
We will be talking about an endoscopy once we get over this emergency. Right now the main thing is to get her through this critical phase.
--
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