I've been watching Billy for a few days -- it's been a tough fall because he's such an allergy boy and man, his skin has been seriously inflamed and it's kind of been one thing after another. Got another gonzo UTI last week -- and both the regular and holistic vet wanted to try herbals first (this is the IMHA dog and we really don't want him on antibiotics any more than 100% super necessary).
I have just had the feeling he wasn't feeling superb ... he's still happy, bright and his color is good .. but I just couldn't shake the feeling something wasn't right. He'd been on cephalexyn for the skin and that kicks the gut sometimes so about a week ago after he'd come off it one day when he sorta turned up his nose at ricotta cheese (which is what I put his meds in) I wasn't super worried -- but ... hmmm NOT a Billy thing to ever turn up his nose at food. He just doesn't.
Work's been a bear and I just haven't been able to get him to Dr. B (my regular vet) -- but I was feeling pretty sure we needed to do some blood work. He's still wolfing down his food and the tails waggin a zillion miles an hour.
Long story short, I had jury duty today and it ended early so since I wasn't expected back at work I grabbed the time and zoomed home, got Bilbo and off we went to Dr. B's. Me mostly saying "well, his eyes are inflamed and none of the regular stuff is working ... and I just don't think he feels good". I'd also had the girls collect a sample of urine as we came in (yes, I can actually get my dog to 'hold it' from the car "so the girls can take you and get a sample" -- he DOES hold it for me!! whatta dog! I can't just walk faster to get him in fore he pees otherwise)
Dr. listens to me and then Dr. B pulls out the stethescope to give a listen and the LOOK on his face. "Gosh -- I"m picking up about a grade 3-4 MURMUR here!! let's do that bloodwork ... NOW".
(one of the potential causes of a heart murmur that manifests suddenly is a seriously low hematacrit/pack cell volume)
took a couple of vials of blood and while that was working he palpates him and WHOA ... Billy's got a seriously sore area in the lumbar region ...l literally to the point where when Dr. B put a bit of pressure on it Billy almost collapsed.
heart AND sore back?
I told him I'd try Dr. D' (holistic vet who does both the acupuncture and chiropractic) and he said "I was just going to ask if you could get him in today and would she talk to me a minute???"
(Have I said yet in this post how much I love my vet??)
About now the bloodwork comes back and the first looks SUPERB. Pack cell was 44 (darned near perfect). But WHOA ... we've got a MAJOR uti going on despite the herbals ... there's blood in it, specific gravity is a *bit* low but it's also too alkaline. darn. So ... antibiotics for sure.
murmur + sore back + UTI
But he'd taken more blood so after some discussion we're both wanting to see more evidence that the kidney/liver situation is acceptable. Is the heart simply stressed by something else? This dog has NO history of any heart issues at all but he's been thru SO much with the whole IMHA treatment ...
So the did a complete CBC - as much as he could do in-house ... BUN/creat are FINE.
uh oh .... alt is VERY high.
For those of you who know such stuff ... in August his ALT was 23. Today it was 723 (yeah, a 700 point difference).
But the ALT/phos was still right on the boderline in the upper margin of "LOW". Meaning it was as absolutely high as that ratio *could* be and not be very serious.
Ao the ALT is *very* high but the ALT/phos ratio is ... kinda high but not dire.
Both of those are pointing to liver distress -- but it's the only value that IS high.
So now we've got these 4 disjointed things -- Sore Back + heart murmur + uti + High ALT.
So what's ticking off the liver? do we have an infection going on in there (yes, that can definitely happen and in a dog that has been THIS sick it's not unusual to see the body cycle inflammation from one place to another).
Sooooooooooooooooooooooooo Dr. B did an x-ray (to get at least some visual on the liver, heart AND back/lumbar area).
Darned x-ray looks GREAT. (so no obvious swelling/nasty stuff going on with the liver, no huge enlargement of the heart or such .. .and NOTHING looks bad on the spine at all).
he hands me Clavamox (which will help the UTI without ticking off the IMHA but will ALSO be a good solid drug to treat any potential liver infection).
He's talking to Dr. D's office as I'm racing out the door to drive back to Orlando so he can see someone at Dr. D's office to get both some acupuncture and chiro to try to settle the back down AND get some additional input diagnostic wise.
I've mentioned before -- the exam a 'regular' vet will give and the exam a holistic vet trained in TCVM will give are different. Neither bad nor lacking -- just somewhat different. the holistic vet will feel the pulse in various places on the body to try to determine potential trouble areas.
She needled him AND did some chiro to adjust the back (which was out in a pretty sore place) and those two relieved a LOT of pain I think. to add to the antibiotic, she gave me a liver supplement to see if we can support the liver while it is trying to recoup from whatever is going on.
Dr. D wasn't there -- this was the other vet in her office (whom I really really like a lot -- this wasn't an inferior choice at all - she's just not his 'regular' vet). He's got another appt on Tuesday.
Soooo now we hold.
A. I felt SUPER vindicated. this was one of those places where the dog had giving me just a little indication twice that the stomach was not 'ok'. he's eating lke a horse otherwise -- this was nothing super obvious other than the fact I KNOW this dog.
B. Yeah, he sure wasn't feeling 'great'. Had I just let this go, I fear this could have turned REAL ugly real fast. Certianly the UTI alone is a big deal. But the liver values are scarey as heck after what all he's been thru.
C. What's whacking out the liver? We don't know ... yet. It could continue to get bad. Sure -- we could have the beginnings of liver disease, cancer or 999 other things.
BUT I HOPE we have simply caught something 'early on' once again. It could be many things and altho my heart is beating a hundred beats a second still late tonight -- I'm also not gonna let myself get all bummed. The Alpha of all Alphas prodded me in the right spot to get me concerned and then I got a once in a zillion days chance TO get him to the vet mid-week (I've put in more overtime in the past month than I've done in 3 years)
So we've got this weirdo set of "clues" --
sore back (maybe just coincidental)
heart murmur
UTI
high ALT value indicating liver problems.
We'll see where we go now. Prayers and good thots pretty please?? And if anyone has any input let me know please. Some of this is likely simply coincidental ... and it may simply be that stress over everything else COULD be causing the murmur. But I'm all ears if anyone has any thots or ideas. thanks.