Thursday, January 26, 2023

Our visit

Wow, I guess one might say I am a Misty Mess!!!  Mom and I spent 65 minutes with the very nice Dr. B this afternoon.  Mom says he is really nice, but I am not as sure because I ALWAYS get treats when i visit him and this time there were NONE!!!  Sheesh!!!  He says it is because I have to go on a totally restricted regimen of food that only allows my prescription z/d dog food.  No extras whatsoever!!!  No treats, no pumpkin, no yogurt, no tidbits from Dad (Dad says it isn't fair to punish him too), no bedtime milkbones.  This is AWFUL.

So WHY??  I will let Mom take over now,

Thanks, Misty.  Yes, you are a mess. Well, your gut is a mess.  I am so glad I had the time to talk to Dr. B.  He was wonderful.  He explained in detail exactly what the lab report entailed.  He was very surprised that things are this bad as the only real symptom Misty has had is the bloody stool.  She never vomits, never refuses to eat, never has diarrhea (only the occasional looser bit at the end of an occasional poop).  But she definitely has problems.   The bottom line is Inflammatory Bowel Disease.  She has substantial gastritis issues.  He described in detail the three kinds of gastritis found in her stomach.  I am never going to be able to describe the technical terms accurately, but the gastritis includes issues with lymphplasmaetic cells, helicobacter, and esosinophils.  That's why the report says "mixed IBD".  There is no evidence of cancer, but left untreated the condition can develop into cancer.  Her colon also show signs of the same inflammatory conditions.

Treatment will include adding Prilosec to her diet daily, an antibiotic for a few weeks, and unfortunately at least a month of prednisone followed by tapering and possibly some time off it to see if it has worked.  For the prednisone he suggested we split the dose in half and give twice a day rather than the larger dose once a day.  If her tolerance of it gets really bad, we will revisit and see what other options we can try.  Meanwhile, Misty is correct.  We will be removing so many things from her diet.  No more pumpkin, green beans, yogurt, canned food unless the prescription food, no treats, nothing extra from the human food.  No more probiotic, no fish oil, no joint supplements.  He wants to start with a baseline of the z/d diet only (luckily she has been on it for 9 months now and she likes it) and gradually add what may be needed such as the probiotic and joint supplement.  I have made her some treats from the canned z/d, but she is really going to miss her bedtime milkbone:(

We talked for over an hour.  And when I got home and looked at my invoice. I was only charged for the medicine and the prescription food.  There was no fee for my time with Dr. B.  He is a great guy who knows his stuff and loves his furry customers.  He is also a great communicator and helps people understand things so much better. Now let's hope we see some improvement in Misty.   It won't be easy and the improvement won't come immediately, but we are hopeful.

Me too!!!

Hey, friends, if you can figure out a way for me to get some tasty treats, drop me a line:)

Woos - Misty and Mom

Wednesday, January 25, 2023

Misty Misty and Mad Mom - so NOT a Wordless Wednesday

Today's post is being taken over by the Momster.  

So here we are, two weeks post-surgery for Misty, and I still have not talked to her internist.  To say I am beyond frustrated would be an understatement.  Please forgive my rant.  I was expecting the results from the biopsies to be in last Wednesday, and so I had expected that I would hear something by Friday.  On Wednesday of last week I just happened to be at my vet's office to pick up some food for Misty, and the lady at the desk asked if I had heard anything on Misty. When I told her no, she said she would forward me anything they got from the specialist.  This was because it had taken four voicemails and three weeks for me to get some questions answered BEFORE the two procedures, and even then it was a vet tech, and NOT the doctor, who finally returned my call.  On Friday morning, my wonderful vet's office forwarded me a copy of the lab report that they had received from the specialist's office - more on that later.  Still no contact from the specialist.  Monday came and no call.  I was going to give her through Tuesday before I called for an explanation of the report.  Early Tuesday afternoon, the call finally came. BUT it was from a "vet nurse" because the internist is out of the country until Feb. 3.  Who lets a client go two weeks waiting for test results, goes out of the country, and doesn't have another doctor call with the results in her absence???????  THEN the "vet nurse" begins by saying,  "Well, Misty doesn't have cancer at this point.  She JUST has irritable bowel syndrome."     As  you will see below, Misty does NOT have "irritable bowel syndrome"; she has inflammatory bowel disease!!!  There is a world of difference between the two and inflammatory bowel disease is much more serious.  So after the fiasco of unanswered phone calls, sending her home with her catheter in, sending her home with no discharge papers, and giving her a prescription for prednisone with no information about what to do if it had to be discontinued, and now a results report from a vet nurse who can't even get the results correct, I am moving on.  If they couldn't have another doctor make the call, at least have someone call who knows what they are talking about!!!  Misty and I will be meeting with our own vet Thursday to see if we can come up with a treatment plan for my sweet girl.

Now for the results.  I don't know a lot of the details of what all this means but I copied and pasted the comments from the doctor who did the biopsy tests at Kansas State Veterinary Hospital.  

The changes in all sections are consistent with chronic mixed inflammation dominated by plasma cells that is much worse in the stomach (includes both pylorus and fundus). In addition to the inflammation, there is prominent lymphofollicular hyperplasia in both pylorus and fundus lamina propria, as well as regions of gland atrophy and fibrosis. There are increased eosinophils (and some mast cells) in all sections of the gastrointestinal tract; there is no evidence of neoplasia in any section. In the stomach, there are a few spiral shaped bacteria mostly along the superficial surface. The significance of these organisms (consistent with Helicobacter) is unknown. Some studies have linked Helicobacter to gastritis, which is prominent in this case. Other studies have linked Helicobacter with clinical signs, while still other studies suggest there is no correlation because Helicobacter can be frequently found in normal canine stomachs. There are few regions (stomach) of surface erosion, but no overt ulceration is evident. Overall, these changes are not supportive of neoplasia, infectious disease, or lymphangiectasia and is most consistent with a diagnosis of chronic inflammatory bowel disease (IBD). IBD is a diagnosis made while weighing the clinical signs and the histologic lesions and as you know is a diagnosis of exclusion. This disorder is characterized by persistent or recurrent gastrointestinal signs with histologic evidence of inflammation, and so the clinical history is important; it is a diagnosis of exclusion. Definitive interpretation of true idiopathic IBD requires exclusion of recognized parasitic, allergic, and/or infectious causes of intestinal inflammation.

The day of Misty's procedures, the internist was expecting the results to most likely show inflammatory bowel disease, although there were still other possibilities.  She wanted me to start Misty on prednisone right away.  I was a little hesitant because I know the side effects of prednisone and I would have preferred a firm diagnosis.  But I reluctantly agreed.  She got her first dose the next day. Within a couple of hours, she was pacing, panting, irritable, and wanting to go outside every ten minutes.  She totally flooded the kitchen floor that night with her peeing, and I am not exaggerating even a bit.  Misty has trouble with just about every medication she has ever had to take.  I don't know why, but she just doesn't tolerate meds.  All of the symptoms she exhibited are typical with long term use of steroids, but not a couple of hours after one dose.  I reached out to the doctor, and guess what? - I got voicemail.  When I did not hear back from her by the next day, I made the decision to stop it on my own.  Prednisone is one of those drugs that shouldn't be stopped abruptly.  It needs to be tapered off, but since she had only had one dose, I thought it would be OK to stop it.  I never did hear back from the internist.  I guess she went off on her trip.  OH, and I must also note that there were no precautions on the bottle's label about tapering off - I just knew that from past experience with another dog.  Grrrr.  I do believe that the endoscopy and colonoscopy were done correctly and that I can have faith in the lab results, but all the peripheral stuff has me infuriated.

I will stop my rant now and hope that tomorrow's visit with Dr. B. brings a plan to treat Misty.   I will let you all know how things go

Mom K.

Hey, Mom, you forgot to tell them we got a little bit of snow!!!

And NO, we don't want to come inside:)

So NOT wordless, but let's hop along anyway with the Wordless Wednesday Blog Hop sponsored by Comedy Plus.

Wednesday, January 18, 2023

Wet Wordless Wednesday


Wet and cold outside today.  No snow, just mud.  Woe is me!!!

Woos - Lightning

I know I had a few words to share here, but it is still fun to join in on the Wordless /Wednesday Blog Hop sponsored by Comedy Plus.

Tuesday, January 17, 2023

Happy (silly) Tuesday

Who's who?  Mom says upside down we look the same:)

Woos - Misty and Timber

Who doesn't love to be happy?  Let's hop along with the Happy Tuesday Blog Hop sponsored by Comedy Plus.

Monday, January 16, 2023

Awww Mondays

 I am so lucky.

I have my own private cave:)

Woos - Lightning (I know I am lucky for many more reasons)

Won't you come along with me as we hop along the Awww Mondays Blog Hop sponsored by Comedy Plus?

Thursday, January 12, 2023

Thankful Thursday

Misty is home!!!

And for that we are thankful!!!  She was still a little loopy when we took this photo.  We are going to let Mom give the update on our special girl.

Mom here.  So we still don't have any definitive answers, but we were at least able to eliminate polyps and find the location of the bleeding.  There were no polyps found throughout the intestinal tract.  They are typically benign but would need to be removed if they were the cause of the bleeding.  Not finding any also reduced the cost of the procedure by $1500, although the final bill is still multi-thousands.  Samples were taken from multiple areas throughout her system and have been sent for biopsy.  The descending portion of the colon at the last section is very irritated and inflamed and showing signs of bleeding.  Per the internal medicine specialist, there are several possible explanations that hopefully the biopsies will determine.  It could be irritable/inflammatory bowel disease.  It could be food allergy-related although Misty has been on a prescription diet for over 8 months.  It could be caused by some rare parasite, fungus, virus, or bacteria that did not show up on any of the myriad of tests she has had over the past several months, even ones for the most elusive culprits.  And, of course, lastly it could be cancer.  A lot of "could-be's" and still concern.

If it IS IBD, most likely it cannot be cured, but it can be treated to try to keep it under control.  That would most likely be a trial-and-error period of trying various steroids to find the most effective one and maybe a change again in food.  She is now on a low dose of prednisone until we get the biopsy results.  Misty is one of those rare creatures who doesn't tolerate a lot of medications.  Steroids come with their own problems so we just have to hope they will work for her if IBD is the issue.

I apologize for not posting an update sooner.  I did not hear from the doctor until after dinner last night.  Misty was ready to come home around 8:00 p.m.  I do not drive at night unless absolutely necessary because of poor night vision, but I did go to pick her up (very carefully).  Unfortunately I did not look her over very carefully, and when I got home, I found that they had forgotten to remove the catheter from her leg.  So then I had to head back to the hospital and have it removed.  I was not very happy about their mistake.  But at least she is home and doing well.

So that's the story, folks.  It is so good to be a trio again.

I was so happy to get home last night.  I was still pretty groggy and sleepy, but I was super thirsty and absolutely famished. That place really needs to work on their hospitality:). Mom gave me a light dinner so that I could reintroduce food to my tummy slowly.  I am happy to report that I am totally back to normal this morning.  I got my full breakfast and even an extra treat.  Thank you all for your good thoughts and prayers.  I might need you to keep them coming for a while too.

Woos - Lightning, Misty, and Timber, and Mom

We always try to be thankful for all the good in our lives, but today it is time to join Brian's Thankful Thursday Blog Hop and share our thanks.

Wednesday, January 11, 2023

A Few Words Wednesday


Missing Misty:(

Waiting is so hard!

Woos - Lightning and Timber (who have been moping around since Misty left yesterday afternoon)

Time for the Wordless Wednesday Blog Hop sponsored by Comedy Plus.  Let's hop along.