Saturday, July 13, 2013

It is not a tumor...

AP here:
With the breathing problem getting worse and his inability to get comfortable I was becoming more worried that we were dealing with a tumor in his nose and that perhaps he had a broken rib. There are always options for diagnostic tools in our immediate vicinity as we are very fortunate to have not only specialists less than 20 miles away but also an MRI machine at VIoC. Tonka had 2 MRI's when he started having difficulty walking and both showed nothing abnormal at the time. An MRI requires full anesthesia and since he just had such a lengthy surgery I decided that perhaps we should just do some x-rays to get started. I had the x-ray of his nose from May which showed how congested his right side had become.


Several Dr.s had looked at the x-ray and since it did not show any bone loss at that time the thought was it was just a sinus infection. From April to mid-June he was on 2 rounds of Amoxicillian and Baytril as well as an antihistamine hydroxyzine  and Flonase as an inhaled steroid. None of the medication seemed to help so now I wanted a new x-ray to see if anything had changed.

We scheduled an appointment at GAVH for June 25th and Caitlin happened to be working that day so that worked out perfect. Tonka loves Caitlin and she would be able to help. They gave him a 1/2 a dose of a sedative and took x-rays of his nose, his chest and shoulders and abdomen.

Groggy


No broken bones or fractures  were apparent so that left either a muscular or neuro muscular problem.  The nose looked the same as it had in May so no overgrowth that would indicate infection and no destruction that would be indicative of tumor. The theory became that it could be a polyp and unfortunately with canine noses a CT, MRI or scope would be the only way to know for sure. Dr. Woodburn and I discussed the fact that since this seemed to all be muscular we should try some muscle relaxers and pain medicine and see if that would help.  He also made sure I understood that this could also be caused by a brain tumor. I could tell a difference already as he was more relaxed from the sedative and his muscles were no longer twitching under my hands. He was groggy all day and slept really well and that night we did not have the bizarre grimace breathing episode.



He seemed to be more relaxed on the meds but still not breathing well especially when laying on his left side. Then one day out of the blue his right hind leg no longer wanted to support his weight if I put him in a stand. This gave me something new to worry about and I thought that perhaps he had tried to get up and fallen and torn something. I called and made an appointment with the surgeon that removed his tumors Dr. Roa at CVSS to rule out anything orthopedic. The first appointment I could get was 2 weeks out so in the meantime I started icing the leg just in case.

While working on a blog post I happened to look up the proper spelling of metoclopramide which is the official name for reglan. This is a drug that is given along with chemo to help with motility and nausea. It occurred to me as I looked it up that I had researched the Palladia up one side and down the other. I had even joined some canine cancer groups to specifically ask about it but I had not really looked into the Reglan. This was the first site I landed on http://www.nlm.nih.gov/medlineplus/druginfo/meds/a684035.html
The first thing I saw was the huge warning box and in reading through the symptoms my stomach turned and my heart sank.......  These symptoms were some of the things he had been exhibiting and upon reading further it was contraindicated if there was a history of seizures. That hit me hard and I looked back through his history that  I had given when we started down the chemo road to make sure I had not forgotten to include that. His seizures had always been so infrequent it was not always the first of his medical problems to think of. It was listed in his history so I had not forgotten which made me feel a tad bit less sick but no less angry with myself for not having researched it before letting him take it. Tardive Dyskinesia is the name of the disorder and when I started looking for that in animals I did not find much but I did find people on the canine cancer group whose dogs had developed the same symptoms.Everything I read said the symptoms could disappear once off they medicine or they could be permanent. Thankfully he had only been on it a week but the problem with Tonka is he is so sensitive to medication that a week on something that does not agree with him is a week too long. Hopefully I can wean him off the muscle relaxers and the symptoms will be gone.

1 comment:

Zoo Crew said...

He has the most thorough Mom in the world. Hugs to you both.