Tuesday, September 29, 2009

Update on Ava #2

The blood work came back today and once again, it was inconclusive. The vet said that there were some liver levels that were elevated (for those of you interested - her AST was 541, her ALT was 736, and her CPK was 318) that he was concerned about, but everything else was in the normal range.

The immune panel came back normal as well, but he said he was STILL thinking it was an immune problem. He said sometimes these results get false negatives and all her other symptoms screamed auto immune to him. He wants to treat for auto immune, which would mean upping her Prednizone to three times the amount she is getting now, but is hesitant to do so without a cardio consult.

She has developed a heart murmer amidst all of this and he said he needs to rule out heart damage before upping her meds. He said if he ups the meds and she has heart damage, the Prednizone will make it worse and her heart will just give out.

My concern is this - if the echocardiogram shows heart damage, she can't stay on the Prednizone, but Prednizone is the only thing that has helped so far. Not sure what the treatment will be if she has heart disease. I suppose I need to ask the vet some more questions.

Why can't anything be cut and dry? There are so many iff's and inconclusive results. I just want to know what is wrong!

Update on Ava

Ava has been on Prednizone since Saturday, and I don't want to jinx myself, but I think it may be working. She seems to be a tad bit more peppy, and she is eating much more than she was. She is also drinking and peeing a lot, but I am told that is a typical side effect of Prednizone.

I am also taking a fellow iggy-owner's advice and putting Lanolin on her ears to keep them moist. Italian Greyhounds are prone to getting cracked ears in the cold and it's really hard for them to heal because the skin is so thin. So Lanolin is supposed to keep them from re-cracking every time she shakes her head, and therefore give them more time to heal.

She still doesn't let me hold her or pet her much, which kills me. She seems so scared and anxious all the time, and backs away from me or whines when I try to pet her. I know that is caused partly because she can sense my fear and nerves and partly because lately when I come near her it's because I need to put medicine on her ears or examine her to see if there is anything different going on. But I just wish she would realize that of all people in this world, she can trust ME.

She hasn't cuddled on my lap in, like, three months. That used to be her favorite spot in the world. I'm wanting my cuddle bug back! But as long as she is possibly getting better, that is all that matters.

Cute little feet!

She still loves to burrow!

Sunday, September 27, 2009

Joe in Vegas, A Visit From Mom, & Drugs for Ava

Joe left for Las Vegas on Thursday afternoon. He and his boss went to a chiropractic conference at the MGM Grand. Even though I was sad to see him go (and even sadder I couldn't join him), I was hoping this would be a good time for him to relax and have some fun, but unfortunately, he woke up on Friday morning with a raging cold and has been fighting it ever since. He hasn't really been able to live it up as he would have liked.

The day he left, my mom called and told me that the woman she is dog-sitting for was coming home for the weekend because her grandmother had passed away. Mom needed a place to stay while the family had their time together. So, she came up here and stayed with me, which was great, especially because Ava has been going downhill again and it was hard for me to be all alone.

My poor little puppy. She has been going through such crap over the last few months and I really started to feel myself losing hope. I finally got in touch with the specialists I took her to, the ones who did all the tests, and they told me that her test results were inconclusive and they needed time to think about next steps.

Basically, all the vets were telling me that they had no idea what was going on with her and I needed to just wait until they could come up with other ideas to try. Well, I was sick and tired of just sitting around listening to Ava cry in pain and watching her lose weight and not eat. I started doing tons of research online and tapping all the resources I had in the Italian Greyhound world. As always, my iggy people rallied behind me and gave me some possible diagnosis. I heard things like Spotted Fever, Addison's Disease, Auto Immune Disease, and Lupus (this one especially seemed to fit with Ava's symptoms).

I called my vet yesterday morning and told him I wanted to come in so they could take more blood and test for all these possibilities. He agreed to see me and examined Ava again. He said he didn't think it was Addison's or Spotted Fever, but he would test for them just to rule them out. The blood tests would also be a good indicator of Lupus and Auto Immune. In the meantime, he decided to put Ava on Prednizone (a steroid). Prednizone is the treatment for about half of the possible illnesses Ava could have. Unfortunately, Prednizone will make the other half of the possibilities much worse. But in the vets words, "What have we go to lose?"

So, the best case scenario is that the Prednizone will actually make Ava better and once we get the test results back, we will see something that will indicate what she has. The other case is that she gets worse and we at least know that whatever she has is NOT one of the illnesses treated by Prednizone. Either way, at least I feel like I am doing something proactive and not just sitting here watching her die.

I'm still doing research and touching base with everyone I can. I just don't understand how I could possibly have two dogs in a row that have these crazy, rare, incurable/undiagnosable diseases! How fair is that??

Mom just left to head back to Annapolis and Joe should be back tonight around 6 p.m. It was really nice to have my mom here with me this weekend so I didn't have to be alone, but I'm really happy to have Joe back so our family can be together while we fight this.

Thanks again for all of your support and advice through this. I don't know what I would do without the love and support from my family and friends. :) Keep those good thoughts coming.

Monday, September 21, 2009

Long Day

Yesterday was a long day for Ava. And not only was it a bad day for her, but because her mom is such an idiot, it was also a long and horrible night the night before. I have been trying to find stuff to feed Ava that she will like, but will also be high calorie and fattening so she will gain some weight. I found this new dog food from Alpo that was chicken in gravy and I thought - perfect. WRONG. I should have known that would tear up her little system; it was waaaay too rich. So, she spent the night before her hospital visit with horrible diarrhea. I wonder what is wrong with me sometimes. I should know better. We are back to bland boiled chicken and scrambled eggs now.

Anyway, we left the house yesterday about 8:45 a.m. and headed up to Massachusetts. Her appointment was at 11:00 and we got there about a half hour early. The hospital at Tufts University is called the Foster Hospital for Small Animals, and the whole campus is actually very beautiful. Here is the front of the hospital:

We spent the first hour with another doctor, where I had to go over all her history again and explain again what exactly has been going on. Which was okay, since I wanted to make sure that all the vets there thought she probably had the same thing. And when I was done, the new vet said she agreed with the original diagnosis, that it was probably an immune-mediated issue.

She said she would take Ava, put a catheter in her leg and wait for the next available time to get her in for her tests. They had to sedate her for both tests - first to take fluid out of her front two knee joints and second to cut off a small section of her ear so they could do a biopsy.

I handed Ava over (I made them take her blanket so she would have something familiar) and then headed outside to wait. They said it could be five hours! I walked around for a while, and then found a park bench to just wait. I napped for a while (haven't been getting good sleep lately) and read a book.

Finally, they called - she was ready to come home.

We finally got out of there about 5:00 p.m. to head home. My poor baby girl was all bruised and swollen. Her ear was bleeding from the biopsy and her leg was swollen all around this lime green tape they had used to cover where they stuck the catheter. She was very happy to see me, though, and all too excited to get the hell out of there. She slept all the way home.

The doctors said I could take the tape off her leg when I got home, so I did that immediately. It was scaring me, how swollen it was, like the tape was cutting off circulation. You can see how swollen it is here:

And that was just from the catheter. Both front wrist joints are also swollen (but not as badly) from them taking fluid out.

Here is a picture of her ear. You can't really see it that well, but they cut just a little snip from the side to test. It's also all bruised behind her ear, not sure why that is.

We have to double our efforts of watching her now and making her wear the cone so she doesn't lick or scratch her new wounds. She is in more pain now, so I have to give her pain medication more often. I hate drugging her up, but she just sounds miserable.

Unfortunately, we won't get results back from the tests for 3-5 days. Another waiting game. Please just keep your fingers crossed that we will hear something conclusive. If they don't see something major in these tests, I have to drive back up later in the week for an ultrasound and echocardiogram.

On a light note, Jackson is the best dog EVER! Poor boy had to stay cooped up in the house for over 10 hours, and he didn't have one accident! And he was so excited to see us when we got home, but as soon as Ava walked in, he very calmly and sweetly went over to her and started sniffing her. It was like he knew she wasn't feeling well and he needed to be careful with her. He is seriously such a sweet dog.

Sunday, September 20, 2009

Livin' It Up At The Mall

Joe had the pleasure of working a booth at the local mall this weekend. He will have to work Saturdays from now on. Normally, he will be seeing patients at the office, but occasionally he will be out in the community like this. Going forward he will get Thursdays and Sundays off, which he isn't that happy about, but he's dealing with it. The good news is that he got 6 new patients from his time manning the booth, and his boss was hoping for five!

Saturday, September 19, 2009

Specialists, Emergency Rooms, and Deja Vu

Well, we've had quite a tumultuous few days. I took Ava in to the vet on Wednesday because she started declining again. She had lost more weight and was walking around so gingerly, seeming to be in pain all the time. One of my iggy friends mentioned Lyme's disease, so I looked it up. She had all the symptoms, so I was pretty convinced she had it - possibly caused from her vaccination in May. I had the vet test for it and no such luck. (You know it has to be bad when you are actually hoping for Lyme's disease.)

Our vet was at a loss, so he referred us to Tufts Hospital for Small Animals in North Grafton, Massachusetts. They are a veterinary hospital filled with specialists. We went up there on Thursday, through Emergency (on our vet's recommendation).

After a lot of talking and explanation of her symptoms, the vets there came up with a preliminary diagnosis - immune-mediated polyarthritis. They think that when she originally got the sores on her ears, her body went haywire and started attacking her own body as opposed to her sores. Her joints are inflamed, making it hard for her to walk around, and the immune disorder is causing her ears not to heal.

She had a lot of poking and prodding that day, and eventually got tired of it and snapped at the vet. They had to dig through three boxes to find a muzzle small enough for her, so I present our little Hannibal Lector:

Sad, huh? They sent her home with pain medication and scheduled a follow-up appointment for Monday. I have to take her back (unfortunately, Joe will be working) and get the really expensive tests done to confirm the diagnosis.

After all this, I'm just hoping everything is confirmed on Monday so we can start with the treatment. From my research, it looks like treatment will be Prednizone (a steroid) and she may have to take it the rest of her life. BUT she should go back to the spunky little girl I've missed so much these last couple of months.

So this post is not all bad, I wanted to share some super adorable pictures of the kids lounging around on the couch. (This is where we have been spending much of our time these days.)

Keep sending good thoughts, please! Thank you!

Monday, September 14, 2009

Pretty Boring

So, we haven't really done much this last week or so, so I really have nothing to report. It's kind of sad, really. We've been so boring! We're just staying home a lot, since we can't leave Ava unattended. We try to get out for walks and stuff, but that's about it right now. (Ava is still getting better, though, so that is great news. Her ears really look like they are healing, so please keep those good thoughts coming!)

Sunday we went to the local carnival/fair, and that was pretty funny. We took Ava in her carrier (which she has really taken to recently!) but by the time we got there, most of the booths were packing up, which left us listening to a really terrible cover band and dodging all the preteens who were bouncing around making fools of themselves. There was an old car show, though, and Joe saw a car that was the exact car his dad owned when Joe was growing up. That was pretty cool.

In other good news, the internet we are "borrowing" came back up, so we now have internet access again. We are going to get our own set up as soon as possible, but for now, it's nice to have it back up and running.

So, hope all of you are having a more exciting week than us!

Thursday, September 10, 2009

Good News For Ava

Ava went back in to the vet on Tuesday and we got good news! The vet said that what we are doing (cone, no scratching, watching her closely, bleaching and cleaning the house) is working and that she no longer is in danger of losing her ears! He was very happy to see such a positive change because he said he was pretty convinced when he saw us last week that those ears were going to have to be amputated. The scabs are even looking better, so we are very hopeful! Thanks for all your well wishes!

Also, to let you all know, the internet we were using at the apartment went down, so I'm going to have to go to an internet cafe to get online until we can get our own internet set up. So, be patient if you don't here from us as often. We'll try to keep in contact as much as possible though!

I did get my replacement phone finally, so you can text or call me again. :) Same number.

Sunday, September 6, 2009

General Update

So, amidst all of the drama with Ava, there has been some other things - good things - going on, and I wanted to share those as well.

Joe's boss went on vacation last week, leaving him in charge of the office. He saw several new patients (which are now HIS patients) and treated many of Dr. Grant's too. He seemed to make a great impression and handled everything smoothly. He had a couple records as well. The most patients treated in a day (22!) and the youngest patient ever treated (5 years old).

He was also able to treat a semi-pro golfer. The guy came in asking Joe to help him get ready for a tournament. This is huge for Joe because he has always wanted to work with athletes (golfers in particular), so if he can help this guy, that will be a huge jump in the right direction.

I have been sending out several resumes each week, for jobs that I'm very interested in, and haven't heard anything back. It's a little disappointing, but I know me not working right now is for a reason - if I was working, I couldn't be home with Ava, and I would be even more worried that I already am. Once she is better, the right job will present itself, I'm sure.

So, not all bad news. :) Hope everyone else is doing well.

Friday, September 4, 2009

Good Thoughts for Ava, Please

Thursday night Ava's ear started bleeding. She was under a blanket and something scared her, so she tried to get out and the blanket was tight around her, so she freaked out and when she finally got out of the blanket, one of her ears was bleeding. It really scared me, but I figured it was just a bloody scab. I cleaned her up and we went to bed.

Friday morning I woke up and went to the bathroom and found a blood spot on Ava's pee pad. I of course thought it was a bladder infection (ala Sophie) so I came out and checked on Ava in her bed. The whole left side of her head was bloody! The ear must have been bleeding all night - there was blood everywhere! Oh, it was so awful. So, I got a wet rag and a little doggie shampoo and cleaned her off the best I could. It didn't look so bad with all that blood gone, but I was still freaked out. Her ears just look so terrible and are so painful to her.

Right ear

Left ear

Later that day her ear started bleeding AGAIN and I decided I had to take her in. I thought I was probably overreacting, but I didn't want to chance it. And thank goodness I trusted my instincts. The doctor I saw was new to me, but he is the one who owns the practice. I really like him and he seems much more knowledgable. Unfortunately, he didn't have good news.

First of all, he is very concerned that there hasn't been any improvement in the ring worm, and he did another culture to see if he could find out anything more. We should hear back from that on Tuesday.

More importantly are the problems with the tips of her ears. He said they may be getting necropic because they are very dark in color and hard to the touch. He is worried that by her scratching at her ears that she has caused some blood vessel damage and that there is a lack of circulation. He commented several times that if it is what he thinks it might be, they may have to amputate her little ear tips. How horrible is that?? Her poor little ears!

So, he sent her home with a plastic collar so she can't scratch her ears anymore and some antibiotics in case there is an infection in those open sores. We have to take her back in on Tuesday to reevaluate and we need to monitor those ear tips to see if they get darker or harder or cold to the touch. That means the tissue is dead and they'll have to cut. :-(

Our poor baby girl!!

She really hates that cone, but she is dealing with it as best she can. I just sit with her and try to make her comfortable. She eventually snoozes off, which is good.

Anyway, please send good thought out for her. I really, really don't want to have her go through surgery!

Thursday, September 3, 2009

Jackson Watching Out For His Little Sister

Jackson is so sweet. He went outside and was just laying on the deck with his head up watching Ava. He looked my way when I brought out the camera, but he was looking right at her. They are quite the pair...

Tuesday, September 1, 2009

Trying to Make Ava Comfortable

It seems like my job lately has just been trying to make my poor Ava girl comfortable during the day and night. Her ear infection isn't going away and her poor ears hurt her so much that I just try to do everything to make her at least somewhat happy.

Today she wanted to go out onto the deck, so I set a camping chair out there for her to sit on. She just didn't look comfortable, so I brought her bed out and put it in the chair. She loved that, but then the sun moved and she was in the shade and started shaking, so I brought out her blanket to cover her up.

Seriously, how crazy am I??