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
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.