Roid Rage (well more like roid naps)

AP here:
Four days of the prednisone and benadryl combo and Tonka is a slug. He has no interest in going for a walk, he does not care that I am in the kitchen making English Muffin pizzas (which usually brings him running for CHEESE), he just does not care about anything.

The results are in!

AP here:
Dr.Gonzalez called this morning to give me the results of Tonkas biopsies from the rhinoscopy.
Diagnostic findings and information:

Nasal biopsies: Mild lymphoplasmacytic rhinitis, left and right
The results were suggestive of mild lymphoplasmacytic rhinitis in both nasal passages. This type of inflammation can be seen with allergies or an autoimmune rhinitis. However, the changes were mild, so it is difficult to say if this could be the cause for the rhinitis. However, rhinitis can results in epistaxis in some cases. No obvious infection or cancerous changes were noted on biopsy.

The recommendation would be to start a course of corticosteroids (prednisone) to treat the inflammation noted to see if this helps with the intermittent epistaxis. If the epistaxis persists and no improvement is noted with the steroid, we discussed that the next step in trying to manage the epistaxis would be to consider ligation of the carotid artery or referral to U. Penn to discuss embolization therapy for epistaxis.

The plan at this time is to continue the antihistamine and to start a course of prednisone.

Assessment:

1) Intermittent epistaxis

2) Mild lymphoplasmacytic rhinitis

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Sylvia Comes to Visit

My friend and fellow rescue Sylvia went swimming today at the canine fitness center. AP and CM took me there once but I didn't like it much see http://tinyurl.com/4ys38mh
Sylvia is still working on getting her hip back in shape after her FHO surgery http://tinyurl.com/3vfu3zf
and swimming is good therapy. Since the fitness center is pretty close to my house her and her human Trish stopped by to say hi. I have been sort of groggy after my anesthesia on Tuesday but I perked up for my guests and strolled the yard with Sylvie. AP said Sylvia is looking really good and the hair has almost grown completely back on her hip and leg.
I really like Sylvia she is so sweet.

Trish will be updating everyone soon with a new blog post and AP wanted to put up some pictures so everyone can see how well she is doing. Isn't she a cutie?

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