An aging pup…
The past week has been a complete and total shit-show. On top of a few family members having heart issues, Bella is now having them as well. On Tuesday I accidentally kicked her and she cried in a way that I’d never heard before. Immediately after she peed in the carpet in the living room and had a bowel movement while she was laying down hiding in the corner. She was brought to vet because on all accounts nothing was normal about the situation. I felt horrible for kicking her, then to see the aftermath I knew her going to a doctors office was important.
During the exam the Vet noted that she heard some crackling in Bella’s lungs and wanted to do a chest X-Ray. Per the xray she claimed that the striations on the lungs confirm the sounds she heard and wanted to start her on medications for Congestive Heart Failure. I was given Lasix (Diuretic), Enalapril (ACE inhibitor), Vetmedin (for CHF) and then Metronidazole (an antibiotic) to address the stomach problems. $500+ later we were out the door and heading home with her. Being as it was fairly late in the evening, and I wanted to be sure I was fully awake for any possible side-effects to occur I waited until 12 hours after leaving the vet (Wednesday) to administer the first round of meds in addition to her daily Insulin routine. Within 1 hour of receiving the pills her water intake increased dramatically. I expected this with the Lasix but it was needed to remove the build up of fluid around her heart. A few extra wee-wee pads down in the house was just going to have to happen. Note: I’m very good about bringing her outside on a regular basis rain, snow or shine. We just put new floors down in a few areas of the house that have yet to be ‘water proofed’ so an increase of pee pads in case of an accident was a must.
Seeing her reaction to all of the pills I made the choice to only give them to her once daily instead of the recommended twice daily. This decision I believe, is ultimately the only reason she is still alive.
As of Thursday morning, 14 hours after receiving all three pills and having two accidents in the house and consuming approximately 64oz of water because of the Lasix, we started having issues with diarrhea. I assumed there would be some kind of issues there based on the introduction of new medications, even with an antibiotic she’s always had a GI reaction to something new going into her body. But this was something different, this wasn’t just liquid bowel movements every few hours until the Pepto Bismol (2 units) worked its magic. This was borderline amoebic dysentery as she was going both in the house and in the yard every 45 minutes or so. There was absolutely no form to it, pure liquid. I knew I needed to call the vet but I was doing a late mothers-day dinner for Karen so we had dinner. During dinner, not thinking twice about it, I gave her the second round of pills because we were in that 24 hour mark. After the pills we drove Karen back home and then when we walked in the house we entered into a complete shit show. She was vomiting, pooping, gagging. I called the vet. While on the phone explaining all the symptoms she was in the den crapping pure blood. Before the vet even got the chance to say “Bring her in.. this is the emergency fee…” we had the key in the ignition and were on our way to their office.
She threw up a few more times in the car on the way over. I had her on a towel for the blood leaking from her back end and thankfully the towel had enough slack towards her front end for me to catch what was coming out of her mouth. We get to the office, they bring us into an exam room and she continues vomiting. I’m seeing every single one of the pills making an appearance and listing them as each one showed up. It was to the point that the vet tech asked if I was a tech myself (or just in the medical field in general) because I identified every pill by proper name. No, darlin’, this just isn’t my first rodeo and I know which 4 pills went into her, obviously I’ll know which are coming out of her.
They ran blood work, did another x-ray, took urine samples and then brought her back to us. While waiting for results she started back with the diarrhea, I purposely left one (of 7?) instances on the floor for the doctor to see because he wasn’t in the room at the time. It had a lot more blood than he’d thought it would have at this stage of the evening, and now we’re looking at blood clots which is 100% abnormal. He decided it would be an overnight stay for her and ran down the list of treatments to be provided. After 3 hours in the office Sean and I were on our way home, no doggie.
I didn’t sleep last night, I was too busy in tears wondering why this was going on and could I have caused everything with the kick on Tuesday. About 5:30 in the morning I called the office, the vet noted that she’s resting but stable and had her insulin to help her sugars. He noted I would hear from someone either this morning or this afternoon after the next shift of doctors came in and did their rounds for the day.
I don’t know how but I was able to finally catch a few hours of sleep to be woken up by a vet tech around 2:30pm. She noted that Bella is doing much better and actually trying to eat something (which is great) but since it’s dog food and not her usual human-food based diet she’s turned her nose up a few times. She’d basically called me to say “come and get her”, I declined.
I was not rushing over there to pick her up (as badly as I wanted to) because I’m really unhappy with how quickly they wanted to send her home when the issues have yet to be addressed. Why was she crapping blood? Why was she throwing up every five minutes? Why did one doctor put her on Lasix and Enalapril only to have the next one take her off of them because he didn’t hear the same crackling noises in her chest that that the first one did? I wanted a THIRD opinion there. Why is she still hooked onto the IV to help rehydrate her if I can just walk out the door with her? Why are her liver enzymes through the roof? Is it Cushings? It sure looks like it. Why (minus sickness) was her Glucose so high considering she’d only had her insulin a few hours before I brought her in. Does that need to be adjusted? Why did you go out of her way to tell me she has a high fat content in her blood and then not say anything further about it?
I appreciate that they ran every possible test that they could on her and ruled out countless things, but the “cause” of these issues is still up in the air. OK, I get it – she’s a senior dog with Diabetes and CDE/Blindness – but there’s absolutely no reason for any of the problems noted above to be there as they are not connected to her Insulin or Eye Drops. There’s more damn questions than there are answers right now and they just wanted to boot her out the door. The tech went as far as saying “If you’d prefer us to deal with the little bit of diarrhea she still has, that’s fine.” I wanted to scream that she was literally crapping all over me while we were talking to the doctor and I didn’t even budge – but I didn’t. Poop and Vomit don’t bother me, never have and never will. Sean got a little light headed but he can’t even handle a pimple being popped in front of him. No aspect of bodily function bothers me, I can deal with it – so don’t even try to throw that one in my face. I’m not leaving her in your office to wipe her ass, I want to know why these issues are there to begin with damn it.
I 100% believe that, while a few areas of bloodwork were something that’s been ongoing, the introduction of 4 medications this week is exactly why we are where we are, but not a single person will admit to it verbally. I could tell on the vets face last night that he thought the Lasix/Enalapril was the wrong call but he said absolutely nothing because it questions a colleagues decision.
Fast foward to 5:30 this afternoon (Friday). I receive a second call from the same tech and she kind of mumbled to me in a “You were right…” kind of tone about my decision to leave Bella under observation for just a little bit longer. Bella did eat dog food, which is a choice I don’t agree with but it’s the vets office they aren’t going to be sharing their lunches with her. The only way to get her to eat was by hand feeding her and she wasn’t overly thrilled about what she was consuming. She then received her insulin. Around 4-4:30 the diarrhea restarted. She then went on to note that the IVs will continue to keep her hydrated and Enalapril will never be given to her again. Lasix is something we may need to reconsider in the future but Enalapril is the cause of everything that’s happened in the last 24 hours so there is no reason for her to be on it. The Vetmedin is the heart medication she will remain on, and it has the least amount of GI interference. She will not be getting a dose of that until tomorrow afternoon though. They want her system to fully flush the Enalapril as it is now over 48 hours later still upsetting her system. We all could easily confirm via the contents of her vomit and the xray that no pills were left in her stomach last night so her only dose of the Enalapril is there from Wednesday, maybe a micro-dose before vomiting last night but the full dose from Wednesday is what’s working through her right now.
After a half hour conversation with the tech I’m feeling more confident that two nights will do the trick for her. Another 12-24 hours on an IV to fully flush her system out is what is necessary for her to move forward right now. I’m fine with giving her ONE heart pill per day if it helps with her quality of life. She’s already getting her insulin twice daily, and having her eyes treated twice daily as well so that won’t change. By tomorrow we’ll see where we are and hopefully I get to take her home.
There are still a lot of unanswered questions, based on bloodwork I’m pretty much convinced of Cushings based on her liver enzymes but that could also be connected to the Enalapril and would need to be something we revisit in the future. I also want to know if since they’re monitoring her glucose for the next 24 hours if that counts as a glucose curve exam for insulin adjustment at home. We’ll see what they say tomorrow when I’m standing face-to-face with the doctors.
Now: I know there’s at least one asshole out there who says “Just put the dog down”. I can assure you that’s not going to happen for not only my own selfish reasons of not wanting to lose her, but knowing full well that she has plenty of fight left in her and has yet to give me “The Look” that all pet parents know too well. Someone telling me “Just put her down” when I know it’s not time is the equivalent of someone throwing Grandma into the garbage instead of a nursing home because their care is an inconvenience for them. To that kind of person – all I can and will ever say is fuck you and fuck off.
I should be receiving an update either later this evening or tomorrow morning. In the meantime, I have a house to tidy up because I thankfully have nothing to work on today. I need to clear my head and the best way to do that is to blast some music and vacuum up the house. Gives the little patient a nice obstacle free zone for her to walk around in when she gets home anyway.