Gracie's Blog

Relocating to Wordpress

2009-11-09T22:52:00.002-06:00

It is true...in a few days the Wordpress blog will look better...we've been having some troubles with this one and hope WP will help.

http://goldengracie.wordpress.com/

Not for the faint of heart...anal gland issues

2009-11-06T21:16:00.000-06:00

Alas one of the troubles that Miss Gracie experiences due to the variable firmness of her stools (I'm sorry, I promised this would be a graphic post), she has anal gland problems. Boy it sure can stink.

We will go to the vet for her check up in a week or so, and the poor girl will have the very undignified procedure of expressing the anal glands.

What a lucky girl that they are so nice to her before and afterwards.

Holy Smokes! There is so much more info online about IBD!

2009-11-02T23:12:00.000-06:00

Good Ol' About.com

http://ibdcrohns.about.com/cs/ibdincatsdogs/a/ibdcatsdogs_2.htm

Holistic Dog Care Chat about IBD

http://www.doghobbyist.com/articles/IBDChat.html

Update on Managing IBD in Dogs (More about traditional methods: steroids, which were not good for our Gracie)

http://veterinarycalendar.dvm360.com/avhc/Gastroenterology/Update-on-managing-IBD-in-dogs-Proceedings/ArticleStandard/Article/detail/588609

Vet Info has a Q & A with one particular piece about IBD and Lymphangectasia

http://www.vetinfo.com/dibd.html

Cyclosporine Side Effect Profile

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=516503&sk=&date=&pageID=2

End of the Summer

2009-09-07T11:51:00.001-05:00

We love fall over here. Gracie loves to chase the leaves ... she has ever since she was a puppy. I appreciate the cooler temperatures and the crispness of the air (not here yet, but I'm ready).

We're getting ready for the Alzheimer's Memory Walk in Kalamazoo. Gracie will be joining us this year for the first time! I am in clean up mode today so hopefully I will find that bandanna she won last year that is purple and says something about Alzheimer's Fdn.

If you would like to contribute, we would be very grateful.

This dog knows how to relax!

2009-06-07T07:41:00.000-05:00

Happy Summer!

Gracie has a Cafe Press Shop

2009-05-30T19:24:00.000-05:00

Golden Gracie's Shop has lots of cute items with your favorite Golden (or maybe just one of your favorite Goldens). All proceeds go towards Gracie's medical bills. Thanks for thinking about ordering!

Been a Long Time!

2009-04-16T09:11:00.000-05:00

Gracie is doing well! She's a goofball and she is cute. We had her shaved a while back due to the snow induced matting that was beyond the mat brush.

We let her sleep in the bed the other night and I am certain that the only one who slept well was Gracie. What with all of that kicking and woofing in her sleep!

She looks cuter in her own bed anyway.

Gracie on the Mend ... Again

2009-01-29T10:24:00.000-06:00

This dog is pricey. But we love her so much.

She's now on the max doses of everything...but she's doing great. Thank goodness. We are due for another vet visit to check albumin levels. Goody goody.

Thanks to all of you for keeping tabs on her I am sorry not to keep up her blog. Dang Facebook...I've been weaning myself off of that craziness.

Well Snort.

2008-12-29T22:27:00.000-06:00

Gracie snorts sometimes...but today, I was feeling a little snorty. Gracie's vet (bless her) called today and alas, Gracie's albumin has dropped again. We are back up to 200 mg of cyclosporin a day, doubling up the colostrum, and continuing bi-weekly B12 and folic acid shots.

She's showing signs of increased need to pee, and has lost some weight again but she's okay and we hope she'll bounce back from this.

As always, thanks for all of your support!

Merry Christmas from a Happy Healthy Gracie

2008-12-24T12:15:00.000-06:00

Merry Christmas from Gracie

Still Healthy, and Silly

2008-11-02T16:39:00.000-06:00

KJ and I took Gracie for an afternoon constitutional, which was very lovely on this rather warm fall Sunday afternoon.

Now, Gracie is a Golden Retriever who slobbers like nobody's business when she exerts a lot of energy or when she is begging for food. Allow me to draw your attention to exhibit A which is a close-up of aforementioned slobber.

As you well know, we love this dog despite her grossness.

KJ was exceptionally grossed out and promptly went inside to get supplies needed to clean up our girl...

Notice the look in Gracie's eye. She loves the attention. Seriously.

New Readers, yay!

2008-09-17T22:36:00.000-05:00

Just got two new comments from new readers of Gracie's blog. I'm so happy that Gracie's story is helpful.

If your dog has IBD -- be sure to check out the yahoo group (link on the right). It is a source of wonderful support and information about the different kinds of Inflammatory Bowel Disease.

The picture is of one of Gracie's old ones. It is from 2005, she looks so young :)

Gracie continues to do well. We are down to one B9 shot a month, one B12 shot a month in addition to one cyclosporin a day. I am ever so grateful and love this darn dog so much.

All the best!
Gracie's Fan Club President

Healthy Gracie

2008-09-07T23:33:00.001-05:00

So, I've taken a photo of the meds that Gracie takes. From left to right:

Pepcid (actually, the Walgreen's generic) she gets once a day now.
Tylan 1/2 tsp with food twice a day.
Prozyme Powder 1/2 tsp with food twice a day.
Generic Benedryl 50 mg with food twice a day.

Not pictured:

1000 mg of Colostrum powder (capsule) once a day with food.
100 mg of Cyclosporin Modified (down from 200 mg per day)!!

We are so happy to report that she's taking half the dose of her immunosuppressant...this is good good news. She's also gained back all her weight and then some. So now, mama and Gracie need the exercise. Thankfully it is getting cooler and walks don't wipe us out too quickly.

First Visit to the Groomer Since ...

2008-08-22T07:30:00.001-05:00

Our groomer is amazing. She adores dogs, and she is exceptionally talented. But, she also gives a LOT of treats. So, you can imagine my terror at the possibility of Gracie getting just one treat from there with wheat in it, and starting another flare up.

Well, we...no, actually, I mean Gracie's other mama aka Lehu, called the groomer and told her the whole story.

Lehu brought with her a bag of kibble (works as treats, it's amazing) and Miss Gracie is looking gor-geous!!

She even got to have a pink bandana.

Continued Hopeful News

2008-08-16T00:02:00.000-05:00

Photos is from several summers past, but Gracie sure is enjoying this summer. She's taking smaller doses of her meds, yay!

She just loves playing in the water, with the hose, in the Gracie pool, wherever. It's hilarious.

Have a happy one!

Happy Shiny Doggie

2008-07-15T09:14:00.000-05:00

What a relief.

We went to the vet yesterday and the first thing the vet said was, "she looks really good."

Before we went to the vet, Miss Gracie reluctantly allowed me to give her a pedicure which consisted of me clipping very long toe nails and trimming the fur on top and underneath each paw.

She's going to be going from 100 mg Cyclosporine twice per day to alternating days with one per day and two per day. Does that make sense? I hope so. We will do that when the vet calls with results to make sure the albumin/proteins are where they need to be.

Happy Summer!

Vet Visit

2008-06-04T09:07:00.000-05:00

A little update:

She's up to healthy weight, the muscle wasting from the pred is a thing of the past and this girl is happy!

We will hear back Monday about the test results (albumin, liver function, etc.) and then talk about med reduction. I honestly didn't think we'd ever get here.

We have discontinued the spironolactone, which is great news.

Gracie is Doing Much Better

2008-05-30T07:30:00.000-05:00

In fact, I think we need to step up the exercise and cut down the food a bit. This is great news!

We go to the vet on Tuesday for another check-up. If proteins continue to increase and the B12/B9 are getting to the right place, we are in good shape. Hooray for our new vet!!!

Doesn't Miss Gracie look cute when she first wakes up?

Monday in Mid-May

2008-05-12T07:40:00.001-05:00

This is a night-time shot of Miss Gracie. She LOVES springtime. All that grassy-looking green stuff on the right side of the photo: chives! Lots of chives.

Gracie's fur is growing back, her tail looks so scraggly since all the fur fell out and now it's new baby fur with some chunks of old fur...but she's so freaking cute so it's all good.

Lots of loss on the IBD Dogs List this week. I'm feeling very lucky that this past flare up wasn't Gracie's time, but also very humbled by the effects that this disease can have. All we can do is appreciate each day.

Pleasantly Surprised the Vet

2008-05-05T16:35:00.000-05:00

One step at a time, sweet Gracie, one step at a time.

Gracie is back to her pre-illness normal weight of 53 lbs. We are amazed and overflowing with gratitude.

The vet was surprised by how much better Gracie is doing and said so more than once during our visit today, she's so real it's refreshing.

Gracie made friends with the moms of a hedgehog, a ferret with a chronic glucose-related but not diabetes - illness, and the grand-mom of a dwarf hamster with a tumor today. She most emphatically was not introduced to the hedgehog, ferret or the dwarf hamster. But, oh how she wanted to!

We are going to stay with our current regimen (not adding a new probiotic right now) until labs come back at which time the vet would like to work Gracie off of the Spironolactone/HCT. There was talk of - if after 3 consecutive months of good albumin numbers - weaning her off the cyclosporin, but for now we are staying where we are since it is still very early in the process.

ETA (5/7/08) : Vet called with lab results, albumin is 2.2 now (low normal is 2.5). A month ago it was 1.6 and at her sickest in January it was down to .3!!! We are halving the spironolactone (yay).

Staying the Course

2008-04-29T07:25:00.001-05:00

Last night it was chilly. Gracie was curled up into a little ball and she was a little shivery so we swaddled her in the vellux blanket. How cute is she?!

It is now day 2 of the Spectrabiotic, week 2 of the prozyme, week 3 of the colostrum and benedryl additions.

I'm feeling cautiously optimistic. I am feeling like I am enjoying her every minute that I can. In the mornings, she has been getting up about 6 to go out...then we go into the spare room next to the kitchen and I lay down for 1/2 hour. She hops up next to me and naps for a bit too. Then we get up and get the food ready.

What I've been doing is blending the kibble to a coarse to less coarse "powder" ahead of time, put that in a container and scoop out what we need each day. I make the morning and evening at the same time...1/2 tsp of prozyme and tylan in each...open up two 25 mg capsules of Wal-Dryl (yay for generics) into each...open up one spectrabiotic capsule in the morning bowl and one colostrum in the evening. Put the lid on the container for the evening and set it aside.

Then I add a little water to the morning meal and mix it up really well. All the while, Gracie is sitting there drooling with her ears perked up. It's the cutest thing.

We are going to the vet for our 4 week check up on Monday, May 5th at 3 pm. I have to remember to feed her early that day so that she's "fasting" for 8 hours and they get accurate labs.

I also need to compile my list...here's a start:

red eyes
learn more about the bumps on her body
get more folate (or order online?)
prescription for spironolactone
prescription for cyclosporine modified
thank the vet profusely for being so human

How do we love thee...

2008-04-27T22:41:00.000-05:00

We love Gracie. She is such a clowny gal sometimes. Tonight she was running back and forth between us with her bear in her mouth trying to get someone, anyone, to play with her. The bear, you must understand is rather drenched in slobber...

She is doing okay. Her stools not as soft (for readers who aren't dog people, or people who think about such stuff I do apologize).

Right now she is lying on the rug "her rug."

A Golden Dog is Golden Indeed

2008-04-25T23:54:00.001-05:00

Gracie is so thrilled with the weather we had yesterday and earlier today. The rain, not so much. She goes out on the back porch, sniffs the air, looks back at me and gets this perplexed look in her eyes...like she wants to go out but the rain might give her the frizzies or something.

When it isn't raining, she just sits contentedly in the sun. It is precious.

She's done well with the first week of new meds and supplement. We started Colostrum (as you know) last week. This week we started Prozyme powder. Her stools are not at all runny and she still seems to be improving. Her hair, however, is still not right and she's getting skin problems, red eyes and ears that needed some cleaning (did it this morning).

I called the vet and left a message to set up our next visit (May 5th). I am feeling hopeful. Either way, Gracie is adorable and loving and has much of her normal energy.

In Which Miracles Never Cease

2008-04-20T19:30:00.000-05:00

It seems that with chronic illness, tolerance to the ambiguity of it lies only with the very steadfast. I will admit that I am, when it comes to Gracie, steadfast in my dedication to feeding her right, giving her medications exactly as prescribed and getting up in the middle of the night to let her out because the diuretic makes her need to pee.

The days when I lose my steadfast and begin to feel desperate are the ones when she is so sick that she won't eat, or that she has some kind of episode. Those days are almost more than I can bear.

Today is not such a day.

The asceites (fluid in her gut) has reduced greatly. Gracie is eating, playing, being generally adorable but sort of annoying (which has grown to be very endearing), and she's doing a lot of sleeping. She's tolerating the medication and food changes and we are doing them one at a time for a week at a time.

Tomorrow we start the Prozyme powder. I think I'll likely add it to her morning along with the Tylan and Benedryl.

Steady and Stable

2008-04-18T07:10:00.000-05:00

Talked to the internist. Gracie's albumin is low but stable. When we hospitalized her in January it was at .3 which was terrible. She was very near death at that point. It was so scary.

We are going to see the internist again in a month. A MONTH! Isn't that wonderful. The vet is trusting that we are doing alright and respecting that we can't afford $500 every week for vet visits.

Gracie is tolerating the Colostrum without any problems at all. Also added the Benedryl. Poor baby is so sleepy with all these meds...but she has a lot more energy than she did when she was sicker. And, no steroid side effects (which as you might remember, very nearly did us all in).

Note to self: write a thank you note to regular vet for this amazing referral. And, write one to the new vet just because.

Update

2008-04-17T07:53:00.000-05:00

The internist called and left a message yesterday afternoon. Gracie's White Blood Cells and Red Blood Cells are looking okay (I don't know the numbers yet, I'll ask her to fax them), but her albumin is really low at 1.6. I imagine (I hope) that this is improved since Monday.

I will post more later.

New Internal Medicine Specialist - Hooray

2008-04-14T22:22:00.000-05:00

We saw our new internal medicine specialist today. Gracie has a particularly complex set of medical conditions (IBD, PLE, SIBO) which were diagnosed well but treated poorly somewhere else.

Our regular vet referred us and I am eternally grateful.

The new vet spent time reading all the records we brought with us (and there were a lot), and spend time talking with me (and Gracie) earnestly. She was up front and open to possibilities. She understands that all dogs are different and was honest with me about Miss Gracie's prognosis. Despite the fact that the news today wasn't great, the delivery of the news was done with kindness and compassion and hope (that at least while Gracie is really ill, that we are doing what we can reasonably do and that she is supportive of it).

The news today was this: Gracie's IBD, specifically the PLE, is not undercontrol. It's not out of control, but it isn't great. The plan is to add three supplements, but only one per week to our current regimen of:

California Natural Herring and Sweet Potato (blended with water)
1/4 tsp (increased to 1/2 tsp) Tylan Powder with food twice daily
B12 Injection Tuesdays
100 mg of Cyclsporin twice per day
50 mg of Spironolactone/HCTZ twice per day

This week:

add folic acid injection on Friday
added Benadryl 50 mg twice per day Thursday (because that's when I got it)
add Colostrum (it is 100% Pure New Zealand from Sedona Labs) to pm meal

Next week (if all goes well):

add Prozyme Powder ½ tsp twice daily

The Next week (if all goes well):

add Spectrabiotic 1 cap. once a day

She also took labs and will call me later in the week to discuss lab values and any potential concerns. She said we’d see her in 4 weeks unless there is something untoward in her lab results.

Food Allergies Update

2008-03-14T19:01:00.000-05:00

I went into my local independent pet store this morning with hopes of garnering more information about feeling my Diva Dog. In the window they had a collar that said Diva Dog...with a matching pink leash. I was tempted, but I turned and saw pink Cubs collars and I was hooked. It even has a heart with the Cubs logo. Crazy, I know, but I bet Natalie will want one for her Abby.

I did learn a lot about food and will be doing some more research, but it does not appear that commercial food is the way to go for our delicate flower.

Wellness Formula Venison and Potato has flax seeds which causes Gracie to chew on her feet a bit and it caused her little eyes to water a bit. Enough that we know this food won't work.

We're back to the d/d only. We added probiotics today.

I will keep you posted.

Happy Birthday Gracie and Georgie

2008-02-27T09:26:00.000-06:00

For today's post, I direct you to my knitting blog which announces the birthdays of our G babies.

Gracie Photos and Update

2008-02-26T07:51:00.000-06:00

For today's update, I've put a post on Gracie's Mama's Blog. Here's a preview...

Slow Improvement and Adjustments

2008-02-24T14:41:00.000-06:00

Well, I weighed Gracie the other day (yesterday, in fact) and she has gained 2 lbs. Granted I have not weighed her on our scale before so we have no scientific baseline to work from, but she does have a little more "meat on her bones" and she has been eating better.

We have made a number of adjustments ... first she gets her meds after she has eaten so we avoid tummy aches, second she gets her tylan powder in a little bit of pumpkin from a can (she won't touch her food with tylan on it), third, she is completely off pred now.

We are going to start calling internal medicine specialists tomorrow. I really felt shell-shocked after our experience last Monday. I'd had enough of veterinarians for a while (except our regular vet who was gracious and kind, and honest about what he felt comfortable managing).

Funny story...last night, I was grinding up the dry food with some water (too much water) in the food processor because Gracie won't eat the kibble (she can't digest it and it ends up coming back sooner than it should and out the same end it entered, if you know what I mean).

Too much liquid in the food processor makes for something like a sprinkler only the liquid smells nasty, like gross dog food and is a little icky to clean up the 2 foot radius around the food processor including the holder for the accessories, the cabinets, the stove, the tea kettle, and my shirt. And...I was on the phone long distance with a friend as this was all happening.

Ahh, the trials and tribulations. But hey, the accessory holder looks GREAT!

The Roller Coaster Ride Continues

2008-02-19T21:37:00.001-06:00

We took Gracie back for her 5th re-check in 4 weeks today. She had been having TERRIBLE side effects from prednisone including muscle wasting, severe weakness, trembling, loss of appetite, increased liver numbers, possible ulcer, and the list goes on.

Two visits ago 2/8, I expressed my concerns about the pred side effects, and my concern was met with an explanation of the fact that we had also started her on cyclosporin modified and he wanted to see how the two would do for another week. He also said that Gracie was very slow to respond and we just needed Gracie to cooperate now.

Over the weekend after that visit (last Friday), the symptoms went from bad to worse. She could hardly get up and slept more often than not. When she was awake she was so weak that she didn't move much. She didn't eat, she vomited, it was just plain awful. KJ took Gracie
back to the vet that Monday (3 days later).

When KJ asked about titrating Gracie off the pred completely (but safely, of course) the vet didn't want to do it. He finally agreed on 10 mg twice a day!! From 20 mg twice a day which was wreaking havoc on her system. She only weighs about 42 lbs right now. His plan was to decrease it in the short term so she could get her strength back and then increase it again.

We were not on the same page as the vet, clearly.

I realize that we should NOT have changed her pred dose without his consent, but we did anyway (with a safe titration plan). We really need a vet who we can work with and who will recognize that we know our dog. We also need a vet who will see that pred isn't the only med
that works for IBD Dogs. I won't rant.

Anyway, her numbers came back:

ALKP 394 from 539 2/11 and 439 2/8
ALT 306 from 404 2/11 and 283 on 2/8
hematocrit 32% from 29% on 2/11
albumin 1.9 from 1.7 on 2/11, 1.9 on 2/8
BUN 3 from 10 on 2/11, 12 on 2/8 (this seems significant)

I'm going to need to look up what all of this means.

The specialist doesn't want to see us if Gracie doesn't take pred as he prescribes it. He was very condescending, which made it hard to talk with him about anything at all. He wants her to take 15 mg daily now.

Basically, we left with the whole chart and now need a new vet. I called our regular vet and left a message to ask for help, and he gave me the name of another specialist. I'll call her. I also got names from a few other trusted sources. I intend to interview these folks by phone before I schlep Gracie to their offices for a long wait and a big bill.

Friday Update from KJ

2008-02-15T08:18:00.000-06:00

As you may know, AJ is out of town this week visiting Family in California.

Gracie is doing much, much better since getting the Dex out of her system. She has been eating well and is looking healthier. She sleeps a lot, but is more energenic and playful. More strength during our walks (no more getting stuck in snow).

Her belly is better too! AJ & I will bring her to the Vet for follow-up Monday. Keep her in your thoughts for seeing improved blood work results. Happy Presidents' Day weekend!

Side Effects that Outweigh Therapeutic Benefit

2008-02-11T07:57:00.001-06:00

It was not an easy day yesterday. We believe that the side-effects of the steroid "therapy" are causing too many problems. We have a call in to the vet, and we have a fax ready to prompt their response. Here's hoping for a PROMPT response.

She is well-cared for though. As you can see, when she was feeling too much weakness to get herself up, we brought the food and water to her. She is eating okay, but it has to be the canned stuff. The dry - even with water - doesn't seem to stay down comfortably. We will have to determine a way to make it really mushy so she'll be able to keep it down. She had a very tough morning yesterday, and the fact that the temperatures were the lowest in a LONG time did not help. She wanted to be outside to do her business but didn't find a spot she "liked" so we were walking or standing outside for FAR too long.

After that, we came in and she slept much of the day. We held the steroid dose (she's never missed a dose) and let her sleep. She's getting all her other meds:

Cyclosporine Mod 100 mg twice a day
Spironolactone/HCT 20 mg twice a day
Pepcid AC 20 mg twice a day
Furosemide 6.25 mg in the morning
Denosyl 425 mg in the evening
and the blasted steroid.

Our goal today is to get the plan set for how to safely decrease (toward discontinuing) the steroid. We'd like to go back to the pill (pred) because the injection is so strong.

Vet Visit Re-Check Report

2008-02-08T20:02:00.000-06:00

Back to the vet again.

Gracie's albumin has come up a bit, as has her cholesterol. Still not where they need to be. Meanwhile, the steroid is really making Gracie weak and quakey.

The vet said that nothing is alarming at this point, just very slow moving. We are trying to stay positive about it, but we'd really like to have her off the steroids. The plan is to go back AGAIN on 2/18 and hopefully at that time reduce the steroid.

Tuesday - a little Bloaty again

2008-02-05T07:58:00.000-06:00

C'mon ride the wave of this chronic illness thang. Poor Gracie, I think that steroids are too much for her. I really hope that on Friday her proteins are higher and we can reduce the steroid.

With the big piles of snow in the yard last night, and all the fog, and her steroidal stupor the poor dog was barking at a snow bank. She'd bark, then look back at me then bark again.

Somehow I know all of this will be worth it. I wasn't sure at first but a comment I got yesterday from Zoe Bean's mom and comments we've gotten from Boomer's mom have really helped. They have both been where we are now and are doing well.

I am eternally grateful for IBD Dogs on Yahoo. There is a wealth of love and experience there that is beyond priceless.

Gracie's Belly Not So Bloaty

2008-02-03T23:49:00.000-06:00

Look, she's not as bloated, the fluid is going away! She's so skinny though so we are hoping she'll start putting on some pounds soon. I'd gladly give her a few of mine...

Progress not Perfection

2008-02-02T18:49:00.000-06:00

Since the vet visit on Thursday, this mom of Gracie has been sick. But, Gracie seems to be a little better. The fluid in her belly has reduced significantly (it's at about 25" around now, down from 30 earlier this week).

The vet discontinued prednisone and started an injectable corticosteroid (2 doses a day for tolerability). He also started her on cyclosporin which is EXPENSIVE. I spent several hours yesterday morning searching various pet meds and other discount programs and found the best prices for each of Gracie's meds.

I am very grateful to our specialist vet who said, "just tell us where to send the prescription," in response to my concerns about containing our costs.

Our AAA membership gets us great prices on certain meds at our regular pharmacy, including cyclosporin (hooray) but it's still really pricey.

Results we are seeing. Gracie has slept a LOT since we visited the vet on Thursday. The new meds are kicking her butt...but not in the same way that pred did. She's eating fine, and no diarrhea so far (thank goodness), and no vomiting.

Snowy Sick Day (photo essay)

2008-02-01T09:07:00.001-06:00

Vet Visit Re-Check Report

2008-01-31T18:25:00.000-06:00

Here's the vet's report for today:

Gracie presented today for recheck of her IBD. She has been doing well at home with an excellent appetite and improving energy level. Physical exam found her to be bright and alert with a BCS (Body Condition Score) of 2/5 (thin, 1 = emaciated). She had lost weight (mostly fluid from her abdomen and now weighed 20.8 kg (45.86 lb). She had moderate dental disease. her abodomen was sof and non-painful, but here was a palpable fluid wave presented (decreased in severity). She had moderate, generalized muscle wasting. Bloodwork performed and found mild elevation in white blood cells @ 19,000/uL (probably stress leukogram) and mild anemia @ 34%. Her platelets were normal @270,000/ul. Her albumin had improved slightly to 1.7 g/dL, but her total protein and globulins had decreased to 3.5 g/dL and 1.8 g/dL respectively. Her cholesterol was decreased @ 91 mg/dL.

Her ALT and ALKP (liver enzymes) had both become elevated @266 u/l and 234 u/l at this time. These elevations are not considered to be severe, but we are starting a hepatic antioxidant (denosyl) to try and protect liver cells from damage.

Her proteins are not improving as much as we would like at this time. It may be that she is not absorbing her prednisone well, so we are switching her to an injectable corticosteroid called dexamethasone. Additionally, we are adding a second immunosuppressive agent called cyclesporine. We will start the drug slowly and ramp it up after three doses. Please give as indicated. In can sometimes cause antibiotic responsive diarrhea, so please call if Gracie gets diarrhea after starting the drug. We want to recheck her in 8 days.

It is Freaking Cold Out There

2008-01-30T08:07:00.001-06:00

This dog seems to LOVE the outside. Ever since the hospitalization, she has been very focused when she goes outside (out, down the stairs, do your business, and come back in). The last few days she has been dilly dallying and sniffing the air outside again. Even tried to sneak into the side yard (where I think there might be evil cat poop, I will have to go over and block that off today).

I've heard of people who put muzzles on their dogs with IBD and other illnesses that require strict diets. I just don't want to do that...but I'll tell you, sometimes she is FAST. I have been watching her like a hawk so I have been able to stop the "almost ate that sandwich from the sidewalk" caper of Monday afternoon. And, she listens to me when I tell her NO as she is contemplating the side yard.

Just some ponderings for today.

Oh, belly measurement is down to 29 1/4 from 30 over the weekend. I'll keep you posted.

Status Pictures

2008-01-29T07:41:00.000-06:00

And, on your left is Gracie on 1/23/08, the weekend after she was discharged from the hospital. She was still holding a lot of fluid in her belly -- and the wasting from the pred hadn't started.

On the right (yes, the I Stole the Cat Toy pic) is Gracie on 1/28/08. Notice that it looks like she has a mohawk and her head and face look slimmer. This is the effect of wasting, from the pred. Poor pooch. Good thing she's not completely snowed by the pred at this point.

Right now she's laying on the floor with her toy frog in her mouth. It is beyond cute. I am so relieved that she is feeling a little better. On Thursday we are going to a re-check at the vet and will learn if the dosing of the pred will be altered an any (other) way.

We are still seeing very mild neurological side effects in the form of tremors of her head. The duration, severity and freqency are much reduced. Thank goodness...

The Infirmed Diva

2008-01-27T17:19:00.000-06:00

I have to laugh. It is really nice that despite medication side effects, ascites (fluid in her abdomen), and general malaise...just a few moments ago, Gracie stumbled up to her feet to chase Georgie who was carrying a little toy I made for the cats.

Granted, the chase was not full-force (due to above named issues). However, it was adorable to see the zany comic dog is still there. I think she might be feeling a bit better. We split her pred dose in half today and gave her 20 mg this morning and will give her 20 tonight. I think that the impact of the pred on her was doing her in. I recognize the need to have the vet on board with this process, and I recognize the importance of NOT stopping pred rapidly. But after a great deal of research about tolerability versus effectiveness, we made this decision.

Her belly seems to be filling up again since yesterday. Not sure to what this would be attributed (aside from the obvious, this girl has IBD and we can just expect that she's going to have issues). We measured and will measure again today to check. I measured around her belly equidistant between her front and back legs. It was 30" yesterday.

Sunday Morning Couch Time

2008-01-27T10:56:00.000-06:00

Gracie needed to get up to pee at 5 am, I am thankful to Gracie's other mom, KJ, for getting up and taking care of her.

I got up at 8 and fed her. She ate all her food and the Tylan. I put the Tylan on her food with a teaspoon of pumpkin just over it. I gave her meds to her by mouth instead of on her food, I suspect that this might be part of her distaste for the food yesterday. Only time will tell.

She has had a few tremors this morning but they seem less severe in movement, not in duration.

KJ has been researching like crazy this morning and come up with a lot of new interesting information and links. We will put those up later on.

The photo is of Gracie's feline siblings, Idgie (the little black and white kitty) is hiding behind Georgie. Ruthie is on her own on the right.

Pumpkin to the Rescue

2008-01-26T19:25:00.000-06:00

This morning, Gracie ate 2/3 - 3/4 of her food then just stopped. I added a little pumpkin at the suggestion of some of the other folks on the Yahoo IBD Dogs Group (link on the right), thinking it was because of the Tylosin (Tylan). No go. Then I sat and spoon fed her for a little and she ate some more, but not all the food.

So, tonight, I just put the Tylosin in a tablespoon of pumpkin and gave it to her before the regular meal. All gone. She ate it without any event. So, then I gave her the food from this morning (having warmed it ever so slightly since it had been in the fridge all day) and she ate that without comment.

Then...gave her the can of food for tonight. she ate a little more than 3/4 and she was done. So, all in all not bad. I am trying to not freak out when she does something out of the ordinary. Just collecting data and altering what we do to help her.

She is still having neurological quaking/tremors. They haven't really changed.

There are life lessons here.

Medication List

2008-01-25T22:02:00.000-06:00

Prednisone 40 mg in the morning - decreased from 45 mg on 1/24/08
Flagyl (Metronidazole) 250 mg in the morning and in the evening - discontinued 1/25/08 due to neurological side effects (tremors of her head and body)
spironolactone/HCT 25:25 1 tablet in the morning and the evening
Lasix (Furosemide) 6.25 mg once daily in the morning
Tylosin Powder 1/8 tsp over food twice a day - added 1/25/08 to replace Flagyl
Pepcid AC 20 mg tablet twice per day
Vitamin B12 subcutaneous injection once per week for two more weeks then every other week indefinitely.

As of today, Gracie is still having tremors and they are pretty scary. We hope that in another day or two we will see that these symptoms dissipate.

Diagnoses & Problems

2008-01-25T09:03:00.000-06:00

I haven't actually posted the diagnosis/problem list that Gracie's vet has identified:

Inflammatory Bowel Disease
Hypoproteinemia
Hypcholestrolemia
Protein Losing Enteropathy
Hypocobalaminemia
Ascites (fluid in abdomen) "leaky gut"

I am getting ready with list of questions for the vet when we go on Thursday.

1. Ways to manage costs of meds, of food, etc.
2. More detail about the biopsy results that clarified the IBD Diagnosis. I would like to know what kind of IBD we are dealing with.

This list is in formation so any ideas you all have would be helpful.

Tremors Can't Be A Good Thing

2008-01-24T10:20:00.000-06:00

If it isn't one thing it is another. Gracie has been having tremors of her head, sort of like a person with Parkinson's Disease. It's scary for her and for us, I'll tell you. And, that vet of ours is getting to know us - like it or not.

I called last night and this morning. I actually made a movie of it in case it doesn't happen in the vet's office. I'll think about whether I'm going to post that movie here. It seems like it would be helpful to some and disturbing to others so I'm going to reserve judgement on that.

It doesn't happen all the time, but it has happened four times today already and they last about 15-30 seconds (maybe more, I don't know).

I will be putting up some links later on about Canine Health and IBD. Any links you are aware of are of interest to me.

Thanks!

Updated: Vet called and said they thought it was from prednisone (grr), I suggested it might be from the flagyl. They agreed and are changing her to Tylan powder. I am incredibly thankful for the IBD Dogs group on Yahoo Groups! What a wonderful resource.

Getting to Know Her Rhythms

2008-01-23T17:17:00.000-06:00

"We are learning this together," the vet told me today. I know that he knows what he is doing, but certainly each patient responds to treatment differently and so we all have to get to know Gracie's patterns to learn what is alarming and what is expectable.

I'm not really enjoying this, but it is a life challenge which offers a learning opportunity (or more than one) for me and for us.

This is Gracie last night after climbing up onto the ottoman to sit next to the mom who isn't writing this entry. She was a little wiped out after all that effort. You can see her pretty pink belly and her bracelet (where the IV was when she was in the hospital). She's so sweet, isn't she?

Since we were so worried this morning, we decided along with the vet's team, to take her in to see the doctor.

Here are the results of today's visit:

Gracie was presented today for abdominal distention and lethargy. Her appetite at home is increased with increased thirst. No vomiting or diarrhea has been noted. On physical exam she was bright and alert, her mucus membranes were pink and slightly tacky, she was tachycardic and had a distended abdomen with palpable fluid wave. She had mild generalized muscle wasting. Her weight was 49.1 lbs., down from 52.3 lbs on 1/17/08. Bloodwork was performed and showed decreased albumin of 1.6 g/dL (2.3-4.0, globulins 2.1 g/dL (2.5-4.5) and TP 3.7 g/dL (5.2 - 8.2). These values are improved from when they were last measured while she was in the hospital (alb 0.9 g/dL, glob 1.7 g/dL, TP 2.6 g/dL). A complete blood count was within normal limits. Electrolyte measurement showed mild decreat in Sodium (129mmol/L, 144-160) and Chloride (104 mmol/L, 109-122), and normal Potassium (4.6mmo/L, 3.5-5.8). Her blood pressure was measured and was 99 mmHg (low-normal value). Gracie's increased abdominal distention is most likely due to fluid accumulation within her abdomen secondary to her low proteins in addition to muscle wasting that is a side effect of the steroids (prednisone). We are pleased with her bloodwork today and the fact thaty shw is continuing to have good appetite at home. An increase in her diuretic dose (furosemide, spironolactone/hydrochlorothiazide) may help decrease the amount of fluid in her abdomen, but due to her blood pressure being low-normal today, and the fact that she does not seem to be experiencing any ill-effects secondary to the abdominal fluid (diarrhea, inappetance) we have decided to leave the doses the same. We are however, going to discontinue the 5 mg Prednisone due to the weight she has lost. We would like to see Gracie back next week at her previously scheduled recheck appointment.

We are relieved. Gracie is now resting in one of her favorite places on the kitchen floor.

Poor Doggie

2008-01-23T08:08:00.001-06:00

Gracie seemed to be doing better. But this morning her belly looks like it's filling up a little more with fluid again. We have left a message for the vet and his team of techs. They come in at 8:30 or 9 so I'm waiting. I don't like waiting very much.

She seems to need to go out a LOT with all the prednisone. As soon as she goes out and does a long pee, she comes in and drinks more water. This is the pattern that we started all of this with, so it is a little scary so we are watching her closely. She is also a bit fearful of things, but this could be just because she doesn't feel good, and any aberration from her primary focus at the time might be too much.

More later with the vet's input.

Doctor's Notes - from Hospitalization

2008-01-21T13:29:00.001-06:00

Notes from the Specialist Vet:

Gracie is a 5 year old FS Golden Retriever that presented as a transfer on 1/14/08. She had 2 days history of polyuria/polydipsia, abdominal distension, and lethargy. Bloodwork at the rDVMhypoproteinemia. On presentation she had a temperature of 101.0, pulse 100, respiratory rate of 56, scleral injection bilaterally, a distended abdomen with palpable fluid wave and muffled lung sounds ventrally. Bloodwork showed hypoalbuminemia 0.3 g/dl (2.3-4.0 is normal), decreased cholesteral 30 mg/dl (110-320), decreased globulins 1.3 g/dl (2.5-4.5), and decreased total protein 1.6 g/dl (5.2-8.2). Thoracic radiographs showed a small amount of pleural effusion.

An abdominal ultrasound was performed and showed a moderal amount of abdominal effusion, a hypoechoic body of the pancreas consisten with pancreatitis, and the jejunum was questionably thickened and contained a slightly hyperechoic mucosal layer consistent with the possibility of protein losing enteropathy. The abdominal effusion was submitted for analysis and was faound to be consistent with a transudate secondary to hypoalbuminimea. An ACTH stimulation test was performed to test for Addison's disease and was normal. Gracie was placed on IV fluids, hetastarch, famotidine, metronidazole, orgal aspirin, and given a plasma transfusion. G GI panel was submitted and showed an elevated TLI 38.5 ug/L (5-25) and decreased Cobalamin 231 ng/L (284-836), and Folate 4.2 ug/L (4.8-8.6) these findings are consitent with diffused small intestinal disease. Spec cPL was normal which is not consistent with pancreatitis.

On 1/15 bloodwork showed hypoalbuminemia 0.6 g/dl, Cholesterol 46 mg/dL, globulins 1.7 g/dL, total protein 2.3 g/dl. Endoscopy of her upper and lower GI tract was performed. The esophagus, lower esophageal sphincter, and cardia were all within normal limits. The fundus, body, antrum and pylorus of the stomach were within normal limits. The duodenum was craterous and roughened in its appearance. the colon was unremarkable. We were able to enter her ileum and obtained biopsies of that segment of her bowel as well. Biopsies of her stomach, duodenum, ileum and colon were submitted and are currently pending. Gracie was started on Cerenia (she had one episode of vomiting after the anesthesia) and given an injection of Vitamin B12.

On 1/16 bloodwork showed persistent low albumin 0.5 g/dl, globulins 1.4 g/dl, and total protein 1.8 g/dl. She was offered food and had a good appetite. Gracie was started on immunosuppressive therapy for her suspected inflammatory bowel disease.

On 1/17 bloodwork showed albumin of 0.9 g/dL, globulins of 1.7 g/dL, and a total protein 2.6 g/dL. She is being discharged on prednisone (steroid), metronidazole (antibiotic), famotidine, furosemide (diuretic) and spironolactone/Hydrochlorothiazide (diuretic). The results of the GI biopsies are pending. Her clnical signs and bloodwork are most consistent with a diagnosis of inflammatory bowel disease. The biopsies will help us come to a definitive diagnosis.

Follow Up care:

Recheck physical exam and bloodwork in 10 days.

Gracie's Blog Post #1

2008-01-21T10:46:00.000-06:00

The purpose of this blog is to focus on Gracie's health. Now that she has been diagnosed with a chronic health condition, Inflammatory Bowel Disease (not to be confused with Irritable Bowel Syndrome, which is something different), we will be monitoring her health MUCH more closely.

I will begin at the first signs of trouble and continue in chronological order.

Age of Dog: 5 years and 11 months DOB 2/27/2002
Breed of dog Golden Retriever
Male/Female Female
Name of dog Gracie

Sunday, January 13, 2008

We had no idea what was wrong. She had been drinking so much water and needing to go out to pee every couple of hours. She got so dehydrated that she was getting weak and her eyes were red. Her head started shaking ever so slightly and we took her to the Emergency Vet. I got there around 11:15 this morning, and I got home around 2:15. The took blood, x-rays. The don't know what is wrong. It isn't straightforward. There was talk of a heart problem, a tumor, liver or kidney problems, not that the vet was mean or anything. Just trying to be thorough. The cost for today was a $300 deposit toward the estimate of $900-1500. They are keeping her overnight to do an EKG, give her fluids and get a urine sample. Her electrolytes and proteins are out of whack, and the red blood cell count was high.

When I called for an update the vet said that she is stable, and "looks good from the outside but has a lot going on on the inside." She has ascites, abnormal build up of fluid, in her abdomen. They have run a number of tests and worked to get her stable. Her proteins are low, tomorrow we will have to get her to our regular vet to start the next steps of diagnosis: an ultrasound of her liver.

Monday, January 14, 2008
6:30 am a wake-up call from the Emergency Vet. We were already awake and ready to get her. We were certain that we were in for decisions about whether we'd have to say goodbye.

8:00 am We open up our regular vet's office. Gracie is barely able to stand up, she is exhausted and lays down at the first opportunity. We see the vet at 8:15 and are immediately referred to a specialist. The liver and kidneys were "ultrasounded" with few noted problems. But, her proteins continue to plummet. They will be doing an endoscopy and biopsy of the intestinal tract tomorrow. She's likely to be in the hospital for three days.

Tuesday, January 15, 2008

We just got home from visiting Miss Gracie at the hospital. She is very weak, and was recovering from procedures and tests from today. They drained some of the fluid from her abdomen yesterday, poor thing.

Today, they did an endoscopy and a colonoscopy. The doctor told us "we got a lot of good biopsies." I hope that this means they will find out what's wrong and fix it. They also said that poor Gracie's intestines are very diseased. They just don't know with what.

Wednesday, January 16, 2008

The report from the vet today was that Gracie had solid food. Prescription food. They have been giving her some kind of digestive enzymes and she is feeling better.

Still no pathology reports, but they will know tomorrow by 10:30 am whether she's coming home! I plan to take the afternoon to go up and 1) visit or (preferably) 2) take her HOME!

They are thinking this is a chronic condition treatable with prescription food and supplements.

Thursday, January 17, 2008

Gracie is on the couch dozing off...it took us over an hour to get home from the veterinary hospital. She is very relieved, as am I.

Anyway, we have 5 medications and a vitamin B12 shot as our discharge meds. And, special prescription canned dog food. The poor thing is on a mega dose of prednisone...

The pathology reports have not yet returned, but the doctor thinks this is Inflammatory Bowel Disease and that most dogs respond well to treatment. It is still possible that this is some kind of Cancer, but she is certainly looking and feeling much better. Cautious optimism.

discharge diagnoses:
hypoproteinemia
protein losing enteropathy
hypocobalaminemia
Suspect Inflammatory Bowel Disease

Medications:

Prednisone 25 mg in the morning
Common uses : This medicine is a corticosteroid used to treat severe allergies, arthritis, asthma, and skin conditions. It may also be used to treat other conditions as determined by your doctor.

Metronidazole (Flagyl) 250 mg every 12 hours
Common Uses: This medicine is an anti-infective used to treat infections.

Spironolactone/HCT 25:25 Tab 1 every 12 hours
Common Uses: Spironolactone is used as a diuretic to remove the excess fluid caused by congestive heart failure, cirrhosis of the liver, and kidney disease. It can also be used to treat elevated blood pressure in combination with other drugs and in resistant cases of low potassium (hypokalemia). Spironolactone is also used to counteract the effects of excessive adrenal aldosterone production. Aldosterone overproduction can occur from a tumor in the adrenal gland, or when enlarged adrenal glands produce an excessive amount of aldosterone.

Furosemide (Lasix) 12.5 mg tab: 1/2 tab (6.25 mg) every morning
Common uses : This medicine is a loop diuretic used to treat high blood pressure, congestive heart failure, and swelling due to excess body water. It may also be used to treat other conditions as determined by your doctor.

Famotidine (Pepcid AC) 20 mg twice a day
For tummy issues (poor doggie)

Vitamin B12 1000 mcg (1 ml) subcutaneously every 7 days for 3 more doses then every other week indefinately. Next dose 1/22/2008.

Friday, January 18, 2008

It isn't cancer. It is Inflammatory Bowel Disease. We are to continue on the medications we were discharged with yesterday (listed above).

How was the diagnosis of IBD confirmed.:

Ultrasound of abdomen (kidneys, liver, etc.)
Ruled out Addison's disease with ACTH stimulation test (was normal)
Endoscopy & Colonoscopy and biopsies which showed severely diseased small intestinal tissue.

Current Diet:
Hill's d/d venison and rice canned food - 2 cans per day

What diet has your dog previously been on
Iams which we stopped due to chronic itchiness (feet)
Solid Gold Lamb and Rice most recently for the past 3-4 years.