Ami James - stones, skin issues, enlarged liver, and more

[spamgirl]

I went to the vet today as his panting and itching was getting worse. She cultured his toes as she thinks it's yeast. There was nothing in his anal glands to culture, so we'll wait 2 weeks to do that. He had no pee, so she couldn't culture that either, which we'll do in 2 weeks as well. We'll discuss the specialist referral in 2 weeks as well. I want to see if taking him back off the potassium citrate has any effect.

Here is his results of the UA and blood work:

The high pH was from the potassium citrate, which I have stopped. The high protein and cholesterol are from being fasted overnight, my vet believes.

[Traci]

She's simply wanting to "monitor" all the itchiness, infections, etc, and if that's all she's going to do, then it's time to see a more qualified vet.

Cultures: urine, any exudate from ears and the pus from eye, or any exudate from open sores elsewhere on the body. Culture for both bacteria and fungal disease.

Re: the anal glands - if they are persistently infected, then it should be closer looked at to rule out masses, GI tract disease (particularly intestinal bacteria that resides in the intestine and passes through the colon) - also, evaluate the food you're feeding, because if the food is inappropriate, your dog may strain to defecate, which can cause anal gland secretions or infection. If his stools are abnormally hard or abnormally soft/diarrhea, then you know the diet is inappropriate, or, there could be infection present in the GI tract. A fecal test would be a good start.

Re: the sinuses, an exudate from either the eye pus, a throat swab or flush can be tested/cultured for bacteria or fungal. Likewise, check oral health and ensure there are no oral infections, oral abcesses, abnormally grown teeth/roots that could be affecting the sinus cavity - any such infection can lead to the heart and you don't want that to occur.

There are a host of tests one can consider, but since your vet isn't interested in performing them, this is where a consult with a specialist is handy in that, the specialist can advise which test(s) to start with, keeping costs down as you go along in deciding what further tests may be necessary. Cultures, a fecal exam, for example, are relatively cost-effective to start.

[spamgirl]

She's simply wanting to "monitor" all the itchiness, infections, etc, and if that's all she's going to do, then it's time to see a more qualified vet.

Cultures: urine, any exudate from ears and the pus from eye, or any exudate from open sores elsewhere on the body. Culture for both bacteria and fungal disease.

There are no sores, and nothing in his ears, and the pus in his eye is so minimal she said there wasn't enough to test. The urine will be done on the 23rd.

Re: the anal glands - if they are persistently infected, then it should be closer looked at to rule out masses, GI tract disease (particularly intestinal bacteria that resides in the intestine and passes through the colon) - also, evaluate the food you're feeding, because if the food is inappropriate, your dog may strain to defecate, which can cause anal gland secretions or infection. If his stools are abnormally hard or abnormally soft/diarrhea, then you know the diet is inappropriate, or, there could be infection present in the GI tract. A fecal test would be a good start.

They've been infected for over 2 years, and he's had multiple fecal tests in that time to figure out what was going on - they all came back normal. By multiple, I'd guess at least 10 over the last 3 years total. His fecal matter is much better (easier to pass) since I took him off "vet" foods. When he was on those he had constant diarrhea. Now he has soft stools that come out in about 10 seconds. Definitely no straining

Re: the sinuses, an exudate from either the eye pus, a throat swab or flush can be tested/cultured for bacteria or fungal. Likewise, check oral health and ensure there are no oral infections, oral abcesses, abnormally grown teeth/roots that could be affecting the sinus cavity - any such infection can lead to the heart and you don't want that to occur.

The teeth were checked and they said it looks good - in fact, they said his teeth were better than any dog with yorkie blood in it they had seen at his age. The throat swab is something to test for sure, though.

There are a host of tests one can consider, but since your vet isn't interested in performing them, this is where a consult with a specialist is handy in that, the specialist can advise which test(s) to start with, keeping costs down as you go along in deciding what further tests may be necessary. Cultures, a fecal exam, for example, are relatively cost-effective to start.

I agree - after these basic cultures, the next step will be the specialist!

[spamgirl]

I just got a call from the vet - his foot scrape was positive for yeast. They said to keep his feet clean and dry, but there wasn't much else that could be done until we get the other cultures and proceed. Thoughts?

[Traci]

What is she treating the yeast with?

[spamgirl]

What is she treating the yeast with?

Nothing - she said just keep it dry. The diet he's on now is alkaline, so that should keep him in the 6.2-6.5 range for dealing with yeast. I'm treating him with a mild solution of apple cider vinegar on his feet. His ears are okay, so I don't see a point in treating them. His liver is back to normal (since he went on the "real" food diet), which is also a plus. I think I finally know what to do! Yay

[spamgirl]

I don't think the yeast is even remotely a part of his issues. I'm sure he DOES have yeast, but all dogs have some yeast. His situation has actually gotten worse and his ears are a mess. The pus is back in his eyes. I'm having him tested for staph on Saturday as my daughter has been diagnosed with it. His thyroid test (the comprehensive one) came back normal, too.

[Traci]

Time to see a specialist and get all these issues addressed at once, have your vet refer you, then fax all Ami's records and lab results to the new vet (I suggest a veterinary dermatologist, or, virologist, your vet should have done this in the beginning).

[spamgirl]

Time to see a specialist and get all these issues addressed at once, have your vet refer you, then fax all Ami's records and lab results to the new vet (I suggest a veterinary dermatologist, or, virologist, your vet should have done this in the beginning).

His anal gland culture showed a ton of e.coli and something else (I'll update tomorrow when I go pick up a copy of the results.) Which type of specialist do you think he should see now? The dermatologist? Virologist? Or someone else?

[Traci]

I would suggest the dermatologist, since Ami has had so many skin/ear/eye issues.

Be sure to have your vet fax Ami's records to the specialist, including lab results, culture results, and his full health record if possible. The specialist can review the records and be a bit prepared for your appointment.