Friday, March 25, 2016

Makana's Not Feeling Well - A Day at the Vet - Liver Disease or Failure?

What's wrong with Makana?

Last night Makana had another barfy episode. Since last week's barfing day, she seemed to recover okay, with some constipation like symptoms which cleared up with boiled chicken and rice diet and rice noodles when she didn't want regular rice. Makana was raised in Hawaii and loves to eat long noodles whenever her mommy was having some, so it's a treat for her to get noodles.

Anyway, after few days on chicken and rice it seemed her stomach settled down, she was placed back on her dry kibble, the (half/half) of her new Natural Balance Vegetarian formula and Fromm's food - see her food post on Should Makana go Vegan. At first we thought it was the change in food but today we decided it was time to go to the vet as she was also having a couple of urinary accidents, so a UTI was suspect.

Both Makana and Mommy Never Like Vet Visits

Went to the vet with the expectation that they would do a urinalysis but the vet said he found a lump that was on her lower belly area but Makana wasn't going for a 2nd or 3rd try and he said it sort of moved. I felt that same sort of hardness, several times of the years and the other vets didn't think it was an issue - basically cause she's chubby and wasn't showing any problems. Makana's last full blood work up was last July, not even a year and all was clear. She had been having UTI issues repeatedly that the vet said most likely was from being overweight since all of her blood work was in normal levels.

Office Visit, Labs, Tests, IV, oh boy!

So today, the vet said everything looked good except her liver. About $600 later - we don't know why Makana is showing signs of liver disease but it seems to be a top contender for non-accidental deaths amongst canines. Bad news? Well the vet said the good thing is that the liver is the one part that can regenerate itself. The vet suggested a number of tests and we decided to go with the blood draws, pancrea test, IV hydration, shot to reduce nausea, meds include Cerenia to prevent nausea (more barfing), Denamarin to help liver function and antibiotics. The one thing we decided not to do at this time was the xrays to check the lump, for multiple reasons. One because it's been there for a couple years and hasn't been an issue, also if it was something I didn't want her to have any surgery due to her age and we're having PTSD since we lost our golden a year ago while on the table for a mass they were removing, she never made it through the surgery.

Decisions Before You Go to the Vet

I had to think as Makana got older, what to do - if a health situation occurs. I've put some of my dogs through multiple surgeries and tests and financially at this stage in my life and hers, I have to think more practical, based on her age and is it truly treatable, can we make her comfortable or what are we really doing? I decided a few years back, no surgery - even before Makana's sister died suddenly, we never knew why but she was also 14 at the time and in a way it was best for all of us and she didn't suffer endlessly.

Anyway, we would have considered the xrays only if the blood work and other tests did not show any results. Since the liver labs came back high, (one result should have been in the 100-150 range and Makana's lab was 1,000) the vet said he would normally do more two more tests, right now I can't remember what it was to test for but it would include an ultrasound ($800) and another blood test ($200). At this point, the vet said that he would have needed to schedule the ultrasound and since Makana wasn't showing lethargy or actively having any other issues and ate last night, not barfing now and was still drinking water and peeing - he was felt fine about sending her home to be treated at home but to be on the look out for jaundice and not drinking water.

Makana's Treatment Plan for today:

Today's conclusion: Possible that Makana ate something in the yard, on a walk or in the house that was toxic to her liver. - Reason the vet gave was because her liver function was fine last year, no other symptoms prior.

Treatment at home and be sure she is hydrated. As long as she continues to eat, drink, poop and pee - she will go back next Wednesday for a follow up visit - test urine and labs.

Monitor for jaundice. The vet showed me how to look at her gums and whites of her eyes for yellowing. Right now they look normal.

Hopeful: The liver is the one body part that can regenerate as long as it's not end-stage liver failure, which although her lab results were high enough for the vet to keep her in the clinic overnight, he thought she would do better at home and they do not have any overnight staff.

Medicines and Supplement:

  • Cerenia - to prevent nausea - 1- 16 mg tablet per day for 4 days.
  • In the office - she got a shot to prevent barfing and the Cerenia will begin tomorrow.
  • Denamarin - I looked it up and it's a supplement for liver heath - or dysfunction - doesn't need a prescription and I found I can get it on Amazon which is probably cheaper. She is 12 lbs so she will take 1 tablet daily, one-hour before or two-hours after a meal. Even though it's supposed to be before or after a meal, in order to give it to her, I wrap it in a little peanut butter and she took it down. It's a small pill so not a problem.
  • Amoxicillin - liquid antibiotic for possible UTI - 2.5 ml, twice a day - keep refrigerated.
  • Diet - boiled chicken and rice, can add chopped green beans, broccoli or carrots for fiber. I boiled the boneless, skinless, no antibiotic/free range chicken breast and shredded it to small pieces, added cooked rice and small chopped green beans, bland - due to her barfy episodes. Today, Makana preferred to just eat the chicken. I'm okay with that for now since she didn't eat today and it's been a stressful day for her. The vet said with her weight she can have 3/4 a cup twice a day or a total of 1.5 cups daily. He said less is better than more, right now and she if she will eat it.

Follow up visit with the vet Wed and we'll see how she does.

Tune in - Makana's napping now, breathing okay, not heavy as she did when she wasn't feeling well, no more barfing or peeing accidents since this morning before the vet and she seems content. About an hour or two after the IV hydration, she seemed much more alert and in good spirits - whereas just prior to going to the vet she could barely get herself to walk down the street. God is good. Thanks for praying for her. - Makana's Mom.

Note: I wrote this to try to remember the enourmous amount of information I got from the vet today, they really should write all this stuff down. It's the same as when you go to your own doctor, need to bring a notebook and pen next time - cray cray.

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