Tonka update

AP here:
Tonka and I returned to the CVRC at 7:30am this morning and the minute he got out of the truck he started sneezing blood everywhere. They hurried him to the back to take care of him and I setup camp for the day in a corner chair. Dr. Gonzales http://www.atlanticvetintmed.com/pages.aspx?content=35 was not free to talk to me until about 11:00. They put Tonka and I into an exam room and he checked him out and made him sneeze a few times. He then explained how the rhinoscopy procedure would go and what they would be looking for. He was very thorough and wanted me to understand that it would not be a fix for the nosebleeds unless they found a cause such as a tumor, polyp or foreign body. He would take some biopsies to send out to a lab to look for other cases such as fungus, allergies or a blood disorder. There is a rare platelet disorder that is found in Otterhounds and Great Pyrenees. http://ahdc.vet.cornell.edu/clinpath/modules/coags/Glanz.htm . Since Tonka had trouble with his femoral artery and bleeding during his heart surgery he wanted to make sure I understood that the scope procedure could become messy. He wanted to do a clotting test before doing the procedure and take some skull x-rays. I started to think that perhaps we should wait and do another week or so of medicines and see it that would stop the nose bleeds but it also seemed like it was the perfect time to do it if we were going to do it. The Cardiology center CVCA is part of the same group and Tonka's heart surgeon Dr. Rosenthal happened to be working at that location so I consulted with him as well.  In the end we had the procedure and this is the update:
No nasal tumors, no polyps, no foreign body,l no obvious cause of nosebleeds
Took biopsies to send out for infection and possibly some rare platelet blood thing that Pyrs can have.
He did real well with the anesthesia - heart was solid- some bleeding still so can't come home till tomorrow.

Now we wait

Yay for the Eyeball - Boo for the Nose

AP here:
I spoke to Dr. Woodburn this morning and he felt that we should have a rhinoscopy done to try and figure out what is going on with these nosebleeds. I called the internal medicine department at Chesapeake Veterinary Referral Center (CVRC) and scheduled it for 8:00am Wednesday. Tonka's recheck for the pressure problem in his good/bad eye was also today and we got to Dr. Weigts office at 3:30. As soon as he walked down the ramp from the truck he started to sneeze and blood went everywhere. He bled down the ramp, down the sidewalk and into the office. The staff hustled him into a room and Dr. Weigt put some drops of Epinephrine in his nose and stopped the bleeding. Once that was over she numbed his eye and took his pressure and it was down to 10 which is the best news we have had in a while. The debris in the eye is also down so the medication is working. We can drop the pred. acetate down to once a day again but keep the azopt twice a day. Once we got home Tonka's kids came up and visited for a few minutes and then he took a nap. Around 5:45 he got up and went outside and after a minute he started sneezing and the blood started pouring. I tried for about 15 minutes and couldn't get it to stop even with some epinephrine so off to the ER we went http://www.aavec.com/. They checked him out and we all agreed that he should get the scope done Tuesday instead of Wednesday. After a complete blood work up and chest x-rays they let me take him home for the night and we are to return at 7:30am to transfer him from the ER's care to Internal Medicine.

Out Go the Lights!

AP here:

Cathy's sister Julie came to visit and they were supposed to go to the beach for a long weekend. They drove down but the next day they were forced to leave the beach and come home due to mandatory evacuations. Then Hurricane Irene came and took out the power. Not that Tonka cares about the lights but he does care about the Air Conditioning. I care about the monsoon rain since I have to drag him out to go potty even in regular rain. The wind was whipping and the rain was really coming down but we had power when we all went to bed on Saturday. At 2:00am the power went out and by 3:00am the house was stuffy and Tonka was barking to go potty. He went out and laid down under the porch where the sideways rain had already gotten the carpet wet about a quarter of the way in towards the house. I stayed up to keep an eye on him and the water and afeter about an hour he came back in and went back to bed. I sort of slept another hour in the recliner in front of him for a while and then got up. Time to get the generator in place and full up with gas. Thankfully the generator we have (thank you Mom and Dad) can power the refrigerators, the fish tank and some fans just fine. It stayed windy for most of the day and Tonka was enjoying the breezes. Once the wind died down the sun came out and it got hot and humid. Everyone moved to the basement for the night since it is cooler and that is where Tonka usually sleeps anyway. The power was only out from 2:00am Saturday to 12:30am Monday but definitely long enough to make you miss it. When it came back on of course all the lights that we had flipped the switch on came on and woke us up. Julie and I shut all the windows, and put the house back in order.  It was great to turn off the noisy generator and climb back in a real bed in the air conditioning - it was not great to wake up to a blood stained carpet where Tonka had another nose bleed.

Back to the Bus Stop (well almost)

I love it when the kids go back to school because I get to "see" them at the bus stop. Today was the first day back and I took off  on my walk in the hopes of hitting all the stops. When I got up to the field by the pool it was so nice outside that I decided AP and I should run around and play.
Then I got to the 7'11 and Mr. Steve was there with Henry so I stopped to try and beg some of his breakfast pastry but AP said NO. I didnt realize it but that made me just late enough that when we crossed the big street the kids were already getting on the bus. I was not happy that I missed them but then the Moms fussed all over me and told me how handsome I was so that made it better. Tomorrow I will make sure I get to "see" the kids.

Oh Poop!

AP here:
I am very happy to report that there have been no nosebleeds for the past 3 days. I am not so happy to report that the other end of the Tonka has been emptying it's contents profusely. He started with diarrhea yesterday and it continued on into today. he got me up at 1:30 then again at 3:30 to go out and then one last time at 4:00. The 4:00 woke me up and I basically just stayed up because I was not sure which end of him a large clump of hair actually came out of. It was centered in a puddle of rust colored liquid. Rust colored or dark brown vomit is not a good sign and usually indicates blood from an ulcer. Prednisone and NSAIDs can cause this and since he is on a steroid drop for his eye and nose I was concerned. Not being 100% sure of where it came from I bagged it and stayed up with him and monitored him for any signs of distress until the vet opened. His breathing and heart rate where normal and his gums and capillary reflex were fine so I didn't want to drag him out to the emergency vet unless he either showed signs of stress or we had another episode. Now his vet is only open on Sundays for emergencies and I respect that and he was not in any obvious distress. Of course in my mind suspected vomiting of blood with a huge hairball that could be part of a larger obstruction is an emergency. So I was at their doorstep with the sample bag when they opened this morning but they were really busy. Their phone was ringing off the hook and we did not have an appointment so... off we went.
Since my first concern was for Tonka I went up the road to the emergency clinic which I should have just done at 4:00 in the morning. We saw Dr. Coles at Anne Arundel Veterinary Emergency Clinic http://www.aavec.com/ and she was great. I had to give her the whole history and she took the sample and came back to tell me it was not vomit which was a great relief. She told me that the amount of steroid he is on for his nose and eyes would not be enough to cause stomach bleeding. The hairball is most likely from him licking his paws to clean off the blood for the 3 days last week. I showed her his youtube video of him romping at the beach last weekend and she also told me that sand can cause stomach upset and diarrhea. We started Metronidazole today so the hind end of him should be fine within 24 hours and now I need to go take a nap

First Aid and CPR for Pets

AP here:
Today I attended a class for First Aid and CPR for Pets in Columbia Maryland. It was the PetTech^® Pet Saver™ 8 Hour Program taught by Merrill Warchal owner of PetStructor www.petstructor.com/
The class was really informative and the other students were all engaged and eager to share additional knowledge and help each other out. I hope I never have to use life saving emergency measures on an animal but it is good to know that I now know what to do if I had to. Merrill kept the infomation easy to understand and the hands on helped reinforce what we were learning. You can find out more about the course here www.petstructor.com/petsaver_curriculum.html and I recommend it to pet owners as well as those working with animals such as rescue and shelter personnel or pet sitters. She has a snout to tail assessment sheet that is well laid out and should be used by all pet owners to help notice and keep track of any changes in their pet. Catching things early is key in keeping your companion happy, healthy and leading a long life.

Dear Mother Nature

Dear Mother Nature,
Every animal is special to the people that love them and my dog is no different. My Tonka dog is also very special to those that know him and I could not ask for a better companion, but Tonka is also physically special as well.
He is classified as a special needs dog. He was born blind, with a hernia and a hole in his heart; he averages about 2 seizures a year. He has had glaucoma and a cataract and now has either seasonal allergies or a nasal polyp or tumor that is causing nose bleeds. He is a genetic misfit and there is no doubt that in your grand plan of "only the strong survive" he was not supposed to make it this far. However, he is not in the wild where "only the strong survive", he is with me and a whole lot of other people that love and support him.
Every time you throw something new at us with the intent of weeding out the weak, we fight you, and we are going to continue to fight you. So Mother Nature it is you against US. The US also happens to include an amazing team of Doctors and all the technological medical advances of the human species. This tends to even the playing field a bit.
In the end you ultimately always win and death is inevitable for all, but that should be many, many years down the road.

I am simply requesting that for now you just give the boy a break.

Sincerely,
Tonka's Peeps

Bloody Nose

AP here:
Tuesday Tonka and I went for our morning walk and he had some blood on his right front leg so after looking all over I found some on the floor next to his red rubber nylabone. I chalked it up to a tooth or gum thing form chewing on the toy. We played a little at the park and he was prancing around.

We looked under some toadstools trying to find the toads.

When we came home we had a normal morning routine, he ate well and everything seemed fine.

In the evening we went for a early walk because we had a vet appointment to discuss his breathing, sneezing and his itchy ears. We ran into his friend Pepe and walked with him for awhile.

Then we were off to the vet. Tonka was seen by his good friend Dr. Woodburn who came back with a diagnosis of allergies and no ear infection. So Benadryl twice a day and Genesis spray for the ear flaps. So much for no more medication - now it was drops for the pre-glaucoma eye and pills and spray for the allergies.Oh well allergies we can deal with right?

Wednesday morning was just like any other until after he ate his breakfast. I heard him go out the doggie door and went down to check on him. The first thing I noticed was something liquid on the bottom of his food bowl and when I swiped my finger at it I came back with a finger covered in bright red blood. I immediately went out and found him in the yard and checked his mouth, his gums, his tongue and found -nothing. I called the vet and they suggested I come in so I grabbed his leash and out the door we went. As he was making the turn to go up the ramp in the truck he sneezed and bright red blood came running out of his nose. He licked right off and you couldn't even tell it had been there. Mystery blood solved and now I knew the blood from yesterday was not from chewing a bone! I got him up the ramp and started up the truck and called the vet on the way to tell them the origin of the blood. I then called the cardiologist to see if this could be heart related and then called the opthomologist to see if it could be caused by the new drops. the specialists all came back with a no-not likely but wanted to be get up to date with whatever the primary care vet had to say. Dr. Woodburn was in surgery so we saw Dr. Gerity whom Tonka also really likes (she took care of him when he had the heart arrhythmia). She looked up his nose, checked all his vitals and had his blood pressure taken. Since Tonka had just been there the night before and had been fine the belief is that he has allergies that have caused rhinitis of his nose and has probably broken a blood vessel and when he sneezes it breaks open and bleeds. So she added to his on going medicine list two additional drops of the same steroid that goes in his eye but these two go up his nose. I also now carry a bottle of Epinephrine to use in case the bleeding will not stop.

Thursday morning came and Tonka got up and went outside to sleep on the back porch. When I went out to check on him I found him with bloody paws and a small puddle of blood in front of him. I cleaned him up and he laid his head back down to go to sleep. He came in later and wanted to go for a walk so we started off down the street and ran into his friend Marie who was coming up the street. He decided he wanted to walk with her so he turned and we headed back up towards the house. Once we got past the house he decided that it was best if we just turned and went home so that is what we did. Hopefully the medicine will start to work and this does not turn out to be anything other than a blood vessel.

Beach Friends

I got to go to the beach and Saturday night I hung out with my human friends Wally and Gwen and their granddaughter Sydney. We made Smores and I got to have a mini marshmallow. Sydney went with me for a walk and we went up on the jungle gym and since the slide was too steep for me she helped me get back down the steps by telling me where they were.
Sunday morning I went to the beach and ran into some old friends and made some new ones. AP took some video of me but missed me playing in the surf and I was really blippity blopping in the water.

Then we went and picked up breakfast from Robin Hood down on main street and after we ate we walked around and window shopped. I dragged AP and CM to Odysea to say hello to Rick but the store wasn't open yet. AP tried to get me to leave the door and I wouldnt it I wanted to wait and dug in and kept my nose to the door. She finally told me we would go get her coffee and come back so I agreed and when we came back the store was open but he wasn't working. I got some treats from his employee and laid down and took a little power nap while AP and CM shopped.

We walked around some more and I got to kiss a kid on the ear and met a 7 month old puppy named Mickey. Hopefully I will "see" Mickey again down on the beach and we can play.

I had a great weekend!

Sneaky Glaucoma

Today I went to see Dr. Weigt to have a checkup on my eyes. They used the Tonometer which is a device that measures pressure on my right eye (they don't have to do my left anymore since it is a prosthetic) and the pressure came back at 26. The normal reading range is 11-22 which means my pressure is high. This is what happened with my left eye before it started to swell due to secondary glaucoma. Pressure build-up causes glaucoma and it happens when the fluid that nourishes the iris (aqueous humour) cannot drain away.

The eye has two chambers, the anterior and posterior, separated by the lens. The anterior (front) chamber contains the visible eye components, such as the coloured part you can see(the iris), and is kept plumped up and nourished by fluid called aqueous humour. The aqueous humour has to keep draining to keep a constant, normal pressure inside that anterior chamber. When the fluid can't drain away, it leads to a build-up of pressure inside the eye. This is called glaucoma. and there are 2 types, primary and secondary. Primary occurs without previous trauma or eye disease and secondary is caused by trauma or is a by product of some other eye problem. It is a sneaky disease because it has no symptoms in the early stages.

Secondary glaucoma is now sneaking up on my right eye and so I have some new medication (drops) to take to try and get the pressure down. Dr. Weigt says we have other options with this eye as well so if this doesn't work AP will have to do some research to see what option would be best for me. She says she should go back to school and become a vet because she already has to do so much research for me.

First Day Medication Free

Today is the first day I did not have to take heart medication so AP kept a close ear on my heart. I have been on Sotalol since March which keeps my heart beating correctly. We have been decreasing the dose over time since my surgery and today I didn't have to take any.
AP has to monitor my heart rate but I make it difficult by not staying still. If I am laying on my side I bat my paw at her and knock her arm away or roll on my back for a belly rub. If I am standing and she puts her fingers under my arm to start counting then I walk away. She decided that it was best to get a stethoscope and see if I would be better and behave since I am always good for the Doctors.

She has gotten pretty good with it.

I had a good first day without the medication and got to play with my friend Nala and go for a long walk!