Happy Birthday Sweet 16!!!....msg/pics

[LM]

Hopefully some of you remember us.

Leilah, the Queen of August, just enjoyed a Sweet 16 breakfast with turkey that DID fly...











She's sure living up to her middle name "Lucky". We're both so very lucky that she's hitting 16 with most all her faculties intact, only a bit more eccentricity than in her prime, still silly and playful, and excellent overall health in spite of her history. Especially when you consider that only a few months ago we all thought she was dying, she's doing well above and beyond any reasonable expectations. Best of all, I still get to see this wonderful smile every single day.

[Tambrey]

How Beautiful!!! Happy Sweet 16!!
Enjoy many more!!

[k9Karen]

HAPPY BIRTHDAY LEILAH!!! That is indeed a beautiful smile!

[Traci]

LM, Leilah doesn't look a day over 5

She's just as beautiful as ever, and celebrating 16 years is something to smile about! HAPPY SWEET 16, LEILAH!!!!!!!!

(what happened a few months ago?)

[LM]

LM, Leilah doesn't look a day over 5

She's just as beautiful as ever, and celebrating 16 years is something to smile about! HAPPY SWEET 16, LEILAH!!!!!!!!

(what happened a few months ago?)

Thanks everyone!! It really is a sweet sixteen for this girl. She is everything to me.

Traci, it's a loooong story, but here it is:

A few months ago, after getting fussier slowly for over a year, starting after with a very close call with pancreatitis (caught on a routine checkup, never became acute), she'd just about totally stopped eating. Of course she was closely monitored that whole time and nothing unusual was ever found. For quite a while I attributed it to aging.

But last spring it accelerated. Before I knew it I was trying anything and everything to feed her. It got to the point that it didn't really matter what she ate (lower fat of course for her theoretically now okay pancreas) because she needed the calories so bad. Lots of nutrical was shoved into her mouth. I was not about to quit on this dog, especially with no diagnosis on the horizon, especially since she was still smiling quite a bit. It was a tough fight for a while.

She went from a slim 31 lbs to about 26 and was getting skeletal (she's just shy of 20" tall). No reserves whatsoever if something went wrong. I had to take in the elastic braces I made for her problem shoulders and elbows (she's an orthopedic mess). She was confounding some of the best specialists in this city. Test after test, and nothing could account for any decline, especially such a serious one.

She hasn't had any sign of cancer since she was 7 years old, her bloodwork was spot on perfect including tests for mast cell, urine and fecals good, echo cardiogram normal (for her--she's had a heart murmur for a few years now), abdominal ultrasounds okay, pancreas wasn't great, but not nearly bad enough to cause anything like this, thyroid slightly off but again not enough to cause this, specialized tests for Addison's were negative twice, blood pressure good with no spikes detected...

It didn't make any sense to me or any of these vets that such a healthy dog on paper was obviously in so much trouble. It was maddening for everyone and I was losing my girl!

Internist vet decided to take an educated guess that it was something in her gut (as opposed to a sick organ), and he put her on wormer, flagyl, and prednisone. That did it! She's gained over *8* lbs, is now on a diet to lose two of them to help those poor shoulders of hers. We are likely to leave her on Flagyl and pred for the rest of her life for palliative reasons if nothing else. She's been on traumadol for quite a while now due to those ortho problems. Better living through chemistry!

Last Friday her checkup was excellent and she's up to 34.5 lbs. Vet wants me to leave her there but I feel it will be too much for her ortho problems (hips too) and want to get her down to about 32. Bloodwork is still pending but I expect no surprises. I am just amazed at her comeback. Old dogs don't usually make such a dramatic turnaround.

She's feeling great again, enough to raid my bagel that I left on my nightstand only for a second last weekend as well as try to climb up the piles on my night stand to see what's there. I haven't needed bitter apple since she was a pup but I'm using it now! She hasn't acted this bored in a very long time.

I still take her to agility class to let her play on what she wants to, which is usually tunnels, weaves, and occasional dog walk and teeter. She wears a modified life jacket for me to hold her steady when she needs it. She will take tunnels on her own over and over, it's hilarious. We walk up and down the sidewalk along my house for about 15 mins most nights after work. It's up to her when she's had enough to stop at our gate but often she has me picking up MY pace a bit as she beagles along.



Sleeping through the tunnel?

[Traci]

Wow, LM, what a scary rollercoaster ride that must have been.

In pancreatitis, sometimes we forget that a great deal of the problem can (and often does) reside in the intestines, whether that be inflammation, bacteria, non-absorption of nutrients, etc. I think there are more cases diagnosed with IBD as well, particularly when there is a chronic case of pancreatitis that doesn't respond or recover well with typical treatment.

My Cere (cat) has that problem, although there were several periods of anorexia, there was no wasting, such as with Leilah's case, she didn't respond after 3 courses of typical treatment after her third course of pancreatitis (she's considered chronic) - now she's on dex injections every third day and eventually tapering. Without the dex, she stresses and vomits almost uncontrollably. Each time we taper or take her off, she reverts to mildly acute. Since cats are different than dogs in the food area with pancreatitis, we didn't change anything about her diet (except in those periods of anorexia), and she's diabetic as well so we're taking it one day at a time (her third episode was in January, the dex has been given since March), so far so good.

With that said, don't dismiss a mildly chronic classification of pancreatitis, not saying Leilah has it, but don't dismiss it entirely. Or IBD, since they often occur together, the IBD is almost always chronic, even if only mildly so. In any case, it sounds like you have it figured out and I hope her treatment remains successful! Thank goodness you didn't give up and had an internist who caught on to something!

[LM]

IBD (IBS? I get them mixed up) was seriously considered, even though her bowel habits and poop hadn't changed at all, and that's essentially what she is being treated for. She had no symptoms of anything like your kitty, other than not eating. (what is dex?) No vomiting even once, no diarrhea, none of that. I have a hard time thinking of anorexia for a non-psychological problem, but I guess that's the proper term. (So what is the difference between anorexia and cachexia?)

I don't think it was malabsorption because you need to eat for that to be a problem. She wasn't eating almost anything. Some days I could only get her to eat a couple of beggin' strips or baked (not fried) potato chips.

She had chronic colitis as a young dog, especially evident after the stress of a long day at obedience trials or sheepherding, but I've fed her extra fiber since it was diagnosed and we've had almost no trouble with it since. A working diagnosis of IBD made sense in a way, and that has worked wonderfully, but her colitis has been under control for soooo long. The internist didn't want to subject her to a colonoscopy due to her age for anesthesia.

I don't know if her pancreas is clinically chronic, but I assume it is just to be on the safe side. Do you remember Knuckles? She lost her 14 yr old JRT Soccer to pancreatitis like a month after we found it in Leilah (a chronic thief, he'd somehow gotten hold of a pound of raw bacon) and I've been very VERY conscientious of it ever since. I also don't forget her colitis either, even though it's been a very long time since I've seen any sign of it in about ten years. I assume it would still be an issue even now if I didn't feed her with it in mind. I try to keep ALL her issues in mind, on case one ends up affecting something else even many years later.

Ohhhh, regular vet just now called with Friday's results. Her liver values are apparently up a bit, but after consulting with both the lab's internist and the internist we worked with, they've all decided it's a side effect of a few months of pred and to recheck in three weeks. I am less than thrilled with this turn of events and I hope they're right. This is the worst blood panel she's ever had, but she's doing so well!!

You're not kidding about letting pancreas issues overshadow other problems, and thank goodness the internist didn't. That's why he's the specialist and I'm just the paranoid owner. But then I've earned my paranoia fair and square!

[k9Karen]

Prednisone can be like a miracle drug in old dogs. It's primary function is as an anti-inflammatory agent, and in old dogs with bad joints, it can make a striking difference. I'm sure your vet discussed the potential side effects (if he didn't please ask him to) including increased thirst and appetite (leading to weight gain) and in some cases even diabetes melitis or diabetes insipidus. By suppressing the immune system, it can also increase susceptibility to infection. Pred is a very good drug that can have a place in treatment and it definitely sounds like it's the right treatment for Leilah, but please make sure you know what to look for with potential side effects.

[Traci]

LM,

IBS (Irritable Bowel Syndrome) is a term used for the human condition. IBD (Inflammatory Bowel Disease) is a term used in veterinary medicine. I don't know of any vet who uses the IBS term because it further confuses the client, and it's not useful to extrapolate much from human side of things because IBD and it's treatment can be very different in pets.

Here's a good article to answer your questions about anorexia vs cachexia:
http://onlinelibrary.wiley.com/doi/10.1 ... 838.x/full

IBD can manifest differently in pets, the most common forms may include diarrhea, vomiting, gastritis etc, although other symptoms like enteritis, inflammation, stomach irritation and other problems can be present, and sometimes not at all noticeable to the owner until more than one symptom is noted. There are also various forms of the disease (technical). Anorexia would be a secondary or subsequent problem to any primary disease, cachexia could be secondary or primary, and caused by various things including process of aging. Cachexia can definately cause malabsorption, depending on the mechanism causing it. When illness strikes and when cachexia is present, it is always wise to test exclusively for common causes, (which your vets were on track). The process of rule outs can be long and frustrating but often necessary.

Cere only had diarrhea once, during her first episode. Her main symptoms were vomiting (intermittently), painful abdomen, anorexia and depression. Prompt testing afforded quick and successful treatment. A minimal workup would include a full blood profile and urinalysis, fPLI, radiographs (and since she's diabetic, glucose and fructosamine check to ensure there was no urinary bacterial infection which can be common in some diabetics). We did not rule out IBD because her symptoms and test results were indicative of pancreatitis. Her first two episodes responded well to typical treatment (IV fluids, antibiotics, antiemetics, pain control, nutritional support and ceasing insulin during the crisis). Her third episode presented the same symptoms but she did not respond to 3 courses of treatment so we changed the treatment protocol to include injectable medications (for faster action, mainly to control vomiting, and extended pain control). Dex was added to treatment this time to address potential IBD, Dex is dexamethasone, it's a glucocorticoid similar to prednisone. It's of course a risk with Cere already being diabetic, but we have to weigh the benefits against the risks, and are keeping her strictly monitored.

Short of an ultrasound or biopsy, we are trying the Dex, and it is working for the time being. When we eventually cease, we will know if we're dealing with something else in her intestines. We opted out of a biopsy/surgery due to her chronic state, her diabetic state, because if there were anything (such as a lymphoma-type problem), the treatment would be the same anyway.

As for the liver elevations, I don't think you should worry yourself sick over it, and it might not even be from the pred use, it could be from any number of things related to disease process. There may be a slightly higher probability it is high due to the pred, but just keep it monitored, and the goal is to reduce the dose to the lowest effective dose.

[Auntie Debbie]

Happy belated Birthday. She's suh a sweet looking girl!