More on Billy -- this is getting really scarey

    • Gold Top Dog
    If circumstances were better you'd better believe I'd be there for that coffee... LOL
     
    My DH already thinks I'm nuts for driving to Kissimmee for a rescue pup ;party!
    Driving to Gainsville seems reasonable for a cup of coffee if it means meeting you in person.   [:D]
     
    Take good care of yourself and tell Billy he has a bunch of groupies rooting for him!
    • Gold Top Dog
    Callie, I keep you, David and of course Billy in my thoughts all the time.  I was anxious to read your report about the visit to Gainesville.  I'm sorry you had to leave Billy there, even though it sounds like a wonderful team of people are going to see to it that he gets the best of care.  I'm sure it broke your heart to leave him there, especially for several nights.  I think I would've had to sneak back in and set up a cot right next to him for the duration!  But the problem of having employers that need us at work each day really messes that up!
     
    I'm so unfamiliar with AIHA - it sounds so scary, but I'm hanging onto all the positive hope that is in Billy's corner - all the love from you and David, the tremendous vets and professionals you have, and the volume of vibes and prayers sent from here.  Precious Billy - don't give up yet - we're all keeping our fingers crossed for you!
    • Gold Top Dog
    I got a call from the University this morning pretty early from my “student” working with Billy and another one tonight from the vet working with him. 
     
    Billy looks better (he would with blood in him!!  that made such a startling difference last Friday!), but even WITH the transfusion it only went up to 20!  So, they're going to do another partial transfusion tonight and see if they can bring it up some more.
     
    They also started cyclosporine today (another steroid) and upped the pred -- they gotta get the immune system to STOP killing red blood cells and then they can begin the wean off.
     
    They found no cancer in the spleen and liver aspirates so no bone marrow draw RAH!!  The spleen and liver are both taking a big hit from the pred (the liver) and the spleen (the auto-immune stuff) but the fact that they are monitoring it is super.  The body has a whole lot to deal with right now, til we get him stable.
     
    They have found that he's 'positive' for anaplasma phagocytophilum which is a big mouthful for another tick disease in the Ehrlichea family.  Yes, it's found locally.  the treatment is the same, but they're waiting for the "PCR" (??) that will tell them if it's just residual stuff or if there is 'live' parasites there and IF so why hasn't the doxycycline killed it after almost 2 weeks on the doxy (it should be 'not' live and on it's way out by now).  Because he reacted so strongly TO the doxy (that's what started this whole decline) they don't want to switch drugs on him and rile everything up again.
     
     But the cute but encouraging thing was Eric emphasized that “the ricotta cheese thing WORKS LIKE A CHARM, and everyone has fallen totally in love with your dog in ICU!!!  He wolfed down his breakfast almost before it hit the bowl and he DOES love his yogurt and eats it off the spoon JUST like you said he would!!”.   He's apparently become the darling of ICU which is FINE with me.  She told me tonight that *definitely* if he runs out of either yogurt or ricotta cheese they will be after more of it for him!!
     
    For those of you who pray, I've got a specific for you … Dr. Goldkamp emphasized to me yesterday tho that dogs can seem to be totally responding to this and suddenly the body will throw a blood clot and boom, they are gone in a heartbeat.  (literally) Since I lost Polly to a stroke I know that can happen, but there#%92s something about the treatment for the IMHA that makes this sad but a solid possiblity.   
     
    When I spoke to the vet from Dr. Xie's team this afternoon she told me not only did they start acupuncture today, but they are changing Billy's herbal to one that is a heavier blood tonic.  In TCVM-lingo that's something to keep the blood from being sluggish and flow better.  I queried and that specifically addresses the clot-risk to keep the blood flowing properly and NOT prone to clotting.  She said YES and was happy that I understood the significance of this.
     
    I keep feeling in MY gut that this is a big deal -- this is where I'm focusing MY prayer for him - not only that the body respond as it should and stop killing the RBC but that the blood will flow properly and no blood clots.
     
    I#%92m trying not to get too over the moon enthusiastically, and yet we all know the benefit of encouragement and how well my dogs respond to it.
     
    But I also encouraged Eric that I know my dog, and I know how MUCH he loves people and loves to hear his name and for HIM it can make all the difference in the world of whether he recovers or not as to how happy he is.  So I told him to encourage anyone to ‘make nice#%92 to my dog who wants to and since he#%92s a list maker (he had three different notebooks yesterday and was busy writing every single time I saw him) that if he wants to keep a list of the techs, students, vets and “folks” generally who are nice to my dog I will see to it that they get mentioned in a thank you.
     
    He also put that bag of Newmans Own that I brought in with Billy#%92s stuff marked “PRN” (nurse lingo for ‘as needed by patient#%92) and everyone got a big kick out of THAT too.
     
    We aren't anywhere near 'out of the woods' yet -- it's still extremely touch and go, but I'm walking that line of realizing that odds may not be in our favor and he may not make it -- but then again, maybe he *will* and that's how I'm certainly praying and pushing all the positive good electrical stuff at him I can!!
     
     Sandra -- the liver takes a huge beating with IMHA in any event -- that was one of the results of Billy's aspirate is that the steroid is certainly taking a toll on his liver and they gotta watch that (cos the dose has to go up) - if he can just get THRU this the liver will regerate I hope. 
     
    But you make an excellent point -- one I want folks to walk away with even if they just 'lurk' on this thread.
     
    When your mature dog begins to do something out of the ordinary -- it's SO EASY to explain it away - "maybe he's finally learned ..." or "well it's hot so no wonder he's not as energetic" or "is he mad at me and not wanting to hang out with me on the waterbed at night or is he sick?"
     
    I think we are so often TOO quick to attribute things to behavior.  It's certainly true that often we don't WANT to see things -- because medical stuff gets expensive so if I 'see' something I might have to take him to the vet and we just can't afford that right now, or no I don't want to see anything bad because I can't handle more bad news right now ...
     
    so if we bury our proverbial heads in the sand often we lose that window of opportunity where something could be done.
     
    That's all I'm saying.  Someone emailed me the other day and told me they were taking their dog to the vet for a blood panel because "she just doesn't quite look right" -- RAH.  You catch things like renal problems EARLY and they can be treated and balanced.  It may take some diagnostic skill -- but having faith in our own knowledge of our animals  ... that's one of those 'hindsight' things Sandra is talking about.
     
    So if Sandra and I can give you the benefit of OUR hindsight so your dog doesn't have to get so sick -- it's worth typing.
    • Gold Top Dog
    and suddenly the body will throw a blood clot and boom, they are gone in a heartbeat.

    ....this will not happen...this will not happen...this will not happen.  Callie I completely believe in the power of prayer and I'm sending huge prayers that Billie is going to come home on Friday and you are all going to have a wonderful weekend.  We're all walking this road with you and feel your pain, fear, hope...all of it.  No doubt Billy has won over the hearts of all that are working with him and they will take good care until you can be with him again.  I can't wait to celebrate with you [:D].
    • Gold Top Dog
    Thats exactly what happened to my Kayla after she completely responded to her treatment for pancreatitis.  Her blood panel was back to normal and she was sent home... the very next night in the middle of the night it happened...
     
    All they could do was tell us its rare, but it happens.  Blood clots never even entered my mind - why did no one mention this was possible!?  Wouldnt have mattered I guess...
     
    I will be sending good vibes to you guys, and hoping with all my hope that Billy does not throw a clot.  Good thoughts only, he will be fine.  He'll be fine.
     
    BTW - does walking around help with reducing the possibility...?  I know they need to rest but on the same note may that help ensure the blood keeps flowing and no clots form...?  Just something I thought about on one of my many sleepless nights contemplating what I could have done differently.  If it does maybe they can walk him a little....??
    • Gold Top Dog
    Callie - believe me, I absolutely hear you about paying attention to small signs and not just explaining them away as behavioral, old age, hot weather, etc.  I think I'm very much able to tune into things like that.  In fact, I noticed Tonka swallowed saliva "loudly" once in a while (long before he really started failing), and I thought one side of his neck felt puffier than the other.  The problem was that everyone (a few vets, even DH) thought I was imagining it; they didn't hear or feel anything.  A year later, when he started with LP and eventually got calicified areas in his tongue and throat, I thought:  "I KNEW something was wrong there."  Yes, we can be very vigilant and try to get on things early, but sadly, we're often looked upon as being neurotic or something.  Unfortunately, I don't have enough knowledge to say, "I'd really like you check for XYZ because I noticed symptom ABC."  Often I could only point out a symptom, only to have it dismissed.
     
    As I've said before, you're so fortunate that you have such credibility with your excellent vets.  And it's SO awesome that everyone in Gainesville is rallying around Billy.  It's totally true that having everyone talk to him and treat him with such personal, special, attention will be to his benefit.  ALL of us, animals and people, have much better healing experiences if we have an outpouring of positive energy around us as we fight whatever illness we have.
     
    I'll be continuing my prayers and thoughts for all of you.  Bless that student who is showing such compassion for Billy.  You'll have all of them converted to the "cheese and yogurt" method of medicine administration!
    • Gold Top Dog
    Cathy you are hearing me exactly right -- you'll notice I said "the body" not "HIS ..." or 'he could ..."
     
    No -- he can't.  He's gonna stay golden and he's gonna get better.  My thing tonight is talking that blood into 'staying' --
     
    Loveyoukaykay -- He's getting exercise ... I can't worry about it because I'm 150 miles away. 
     
    The acupuncture and the herbals are gonna help with that SO much -- that's what they are targeting in fact .. "tonifying the blood" so it is "in tone" better.  A 'tonic' is a thing that stays consistent -- it doesn't over dose, it just allows an even-ness. 
     
    It was so strange and wonderful -- that conversation with the vet came to me mid-morning at work (sure, I was aFULLY concentrating on that agreement I was editing *sigh*) and my first thot was hmmm -- I need to let others know about this so we can be lifting this specific thing up!"
     
    Then at lunch it truly hit me "WHY did I even remember that??" -- so I thot hmmm, something that needs specific good thots and prayers! 
     
    So at least now we have a diagnosis!! (IMHA probably triggered by the tick-borne disease that's too long to spell that's related to ehrlichea).
     
    The biggies at this point are just two:
     
    1.  that his body will stop seeing red blood cells as the bad guys and quit trying to kill them.  The blood has to stay stable for at least two days for him to even possibly be in line to come home. 
     
    2.  that the blood will flow properly and without stagnation or any sludge or clots
     
    There is so much TO the blood -- I've sure learned a lot.  If any of you get Tufts "Your Dog" magazine there is an article in my issue that came today on Canine Blood Donors and how they are chosen and how the need for them has increased so strongly because of things like IMHA and cancer and owners who are more switched on and committed and willing to do things like that for their dogs. 
     
    Thanks again.  You guys have helped SO much.
    • Gold Top Dog
    Tracy -- I just re read what you posted -- make no mistake -- ME??? Have "credibiliy"??
     
    No -- I'm just a pushy broad who tends to get really ornery when someone tells me I'm nuts.  I'll say "No, I don't think so because ..."
     
    I may argue them into the ground -- it's just that at this point my vets have learned when to and NOT to argue with me.
     
    David reminded me tonight at dinner that the day 6 weeks ago that I ASKED for them to do that blood panel AFTER we thot we'd 'found' the problem was the ears (which could have caused the bit of nausea, etc.) -- David said to me "I KNOW YOU ... you felt foolish asking for that blood panel ... but you did ANYWAY and it saved his life!"
     
    So ... I'm a pushy broad whose husband sits next to me and says 'No, I've noticed nausea too'. 
     
    So ... what, now I"m inspiring other women to be pushy??  GO FOR IT! 
    • Gold Top Dog
    DH says the same about me but the word he choses for me is "nervy".  I dont agree with him, I just get things done.
     
    On the same note, he always says hes glad Im that way because I do get things done, and I dont get pushed around like he does, lol... and that came from his mouth not mine...[:)]
    • Gold Top Dog
    Still keeping Billy in my thoughts and prayers.
     
    {{Hugs}} to you, Callie & hubby.
    • Gold Top Dog
    No -- I'm just a pushy broad who tends to get really ornery when someone tells me I'm nuts. I'll say "No, I don't think so because ..."

     
     ;Probably comes from hanging around lawyers. [;)]  Cathy's right; it's not going to happen; there's too many good vibes heading to Gainesville. [:)]
    • Gold Top Dog
    Callie I am just seeing this I don't know how I missed it. Oh, honey I am so sorry that you, David and Billy are going through this. I will be praying for you and Billy a lot, and I will light a candle  tonight.
    You are in my thoughts and prayers.
    • Gold Top Dog
    Okay Callie - I think we all need our nightly update on Billie.  Hoping with all my heart that he had a good day and day after tomorrow, you can pick him up and bring him home.


    • Gold Top Dog
    Dang -- it's only 11:09.  whooo hooo!!!  Yes, I'm just really home and JUST setting down.  The words today are "very guarded optimism" -- VERY guarded.
     
    Today was a major 'hump day'.  Today was likely the MOST dangerous day for his treatment.  Because his "20" slipped to 18 by last night, they gave him another half unit of blood last night to bring the hematacrit up to 30.  Getting it to STAY is the big deal.
     
    Now, what's changed?  They doubled the pred and added the cyclosporin (*both* steroids -- and big doses) so by night it was 'in his system' pretty well.  It was 30 this morning which is where they thought it should be.  My student (and you'd better know I have already sung this kid's praises to the powers that be -- he's got heart and he's gonna make a GOOD vet in the coming years!) told me this morning this was a big risky day.  He also told me he'd written orders for the ICU techs to monitor him all the time.  And I know Eric spent a lot of his own time with Billy today.
     
    Then he did something SO special -- I was asking about Billy's mental state and Eric said it seemed good.  I told him I was concerned because Billy *does* have abandonment 'issues' and now that he was beginning to 'feel' better that COULD translate to Billy "why doesn't Mom come GET me - I'm *better*!!"  I said "If he were home I'd be reading e-mails to him and posts to him -- anything that had good words and HIS NAME in it"
     
    Eric says "if you have something you want ME to read to him, fax it up! I WILL!"
     
    I tell you -- these folks treat the whole dog -- they aren't just an "interesting case" -- and you betcha I did just that.  I cut and pasted together 4 emails that had been sent to Billy (yeah, my dogs DO get email and they LOVE to hear their names).  I also did a message of my own where I mentioned all the familiar dog names I could list (between this and my other board we've got some darned special folks and darned special dogs you know!!!).  You get a lot of "familiar name" mileage out of stuff like "Oliver's Mom, Tonka's Mom, Emma and Teenies Mom ..." so that was quite the paragraph of well wishes he got.
     
    Then about 4:30 the charge vet called me -- she told me right off "Eric and I read Billy's emails to him -- you guys are such good supportive owners".  And I'm thinkin, I bet this lady never dreamed when she went to vet school, one of her "therapies" would be reading e-mails to a patient!!
     
    The serious update tho is that as of 4:30 she said "Billy seems to be doing ... good.  I've monitored him all day and he continues to look .... good.  I see no evidence of back-stepping nor anything negative.  Of course he feels better because the blood has made him stronger, but I didn't see any evidence of decline BUT WE won't know til 8:00 tonight when we pull his blood levels.  The hope is that it will stay at 30 and not drop much at all.  We NEED that to stay there."
     
    I asked sheepishly if there was any way I could know what that blood value was at 8:00 and she said there really wasn't -- but that she WOULD be there, and she promised me if it fell more than a couple of points she WOULD call me. 
     
    **I have heard NOTHING**.  So this is pretty much a case of no news is really darned good news.  It's my sincere hope that it didn't fall at all. 
     
    What now?  She says IF IF IF his blood holds thru Friday morning without a drop of over 1 point a day, they probably will consider letting him come home Friday. 
     
    Big emphasis -- he is NOT out of the woods yet.  It's gonna be touch and go like this way past even him coming home.  Just about anything can send this plummeting so it's a big fat IF. 
     
    I'm still taking it day by day -- I absolutely have to.  I can't build myself up falsely.  If it bobbles a bit too much he'll be there at least over the weekend.  How much steroid can the body take?  Dunno.  And then even IF this all goes well and he comes home, the road is unbelievably long and dangerous.  Because every single time anything changes the body has decisions to make. 
     
    But he made it thru today and today WAS fraught with peril.  So it's very good that he made it thru such a dangerous day.
     
    Today was probably the most difficult for ME.  Yesterday I knew we were still diagnosing and beginning to treat.  Today was prayer and calm.  I got pretty wound about 7:45 and I had a talk with MY Alpha and reminded myself this is still a matter for constant prayer and good thots, not just "make it ok at 8:00".  Because it's that minute by minute stability that is critical.
     
    On the fun side, Eric told me this morning that Dr. Xie's folks were there early (doing acupuncture and brining the new stronger herbs to 'tonify the blood').  I figured knowing it was a Dr. Xie formula that it would be loose ground herbs which can be tricky to take.  They CAN be mega bitter and, of course, you don't want to depress the appetite. 
     
    Except when you have RICOTTA CHEESE to the rescue.  Eric was still giggling that he mixed the herbs in the cheese and "I don't think Billy even let it hit his tongue before it was down the hatch!!! That works SO well!!"
     
    He's also really super interested in how the Eastern medicine is augmenting and working with the regular "Western" veterinary medicine.  Like how the acupuncture and herbs are working to keep the blood smooth and unclotted and moving properly while the western med works to tamp down the immune system and make it behave. 
     
    Giggle note - my husband (the Scottish accountant, remember? *grin*) said to me tonight, "I guess I need to compose a message to send up to Billy to be read to him tomorrow, hmmm?"
     
    *wink* SOME miracles are more of a surprise than others!! LOL
     
    I do wish I could be more active -- but time is so precious right now, and my connection is being a p.i.t.a. -- David's installed a home network and for some reason it's like sludge.  Maybe IT needs a tonic, ya think??
     
     Oh and p.s. -- My little sarcasm of last night about being such a pushy broad -- I just want to make sure you folks realize, that part of my 'credibility' comes with experience.  And that's the big thing that a lot of you are missing.  Simply because not only am I  ... let's see, what's a good word ... "seasoned" (*grin* WELL seasoned), I also have this long history of having done sick dog rescue for a long time, so altho some vets may perceive me as a 'pushy' owner, it's also known that I've dealt with more than my share of health challenges in dogs and that experience brings some credibility.
     
    But I have SOOO been where you guys are.  And every time I have to encounter a new vet I begin again.  That's one of the reasons I was shaking in my shoes when I brought that yogurt in for Billy.  Just because *I* know it'll benefit him, doesn't mean that a bunch of techs and resident vets are going to take kindly to me telling them HOW to give my dog meds.  I'm the first to admit here that I'm fortunate this lead vet perceives me as a "switched on owner" rather than a p.i.t.a who is intrusive. 
     
    In honesty, learning how to 'say' things so an insecure vet doesn't take offense "Boy you are certainly right that ____________, but just as a thot ... would a culture and sensitivity test be helpful cos I'm definitely willing to pay for it  if that information might prove beneficial ... I know in the past ... blah blah ... but you ARE the vet".
     
    A mentor of mine told me once "If you sandwich one part of criticism or something negative in between two parts of PRAISE and positive it can make the negative far easier to swallow".
     
    Sometimes I almost feel manipulative, but then I realize my dog is worth it. 
     
    So we're guardedly optimistic tonight.  Every minute he continues and stays stable is a victory.  But he's got a pretty good shot since he's past a critical day, receiving superb vet care, but even more than that he's got the support and prayers and good thots from a bunch of really super people.  Thanks
     
     
    • Gold Top Dog
    Callie, prayers from here lifting you guys up.  Billy's in the best of hands - His hands!  As are you and David. Jezebelle said to tell Billy, "Hurry up and get better so you can go home. Mom's got Rockin' Raspberry waitin' for you!"