Tag Archives: vet

Leo the Boston Terrier Medical Update: Pet Parent Warnings, Cushings, Medications and Second Opinions

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Leo the Boston Terrier Medical Update: Pet Parent Warnings, Cushings, Medications and Second Opinions

*AS NOTED IN PREVIOUS BLOG POSTS I AM NOT A VETERINARIAN OR DOCTOR OF ANY SORT.
**I AM A COLLEGE DEGREE HOLDING PET OWNER THAT BELIEVES ALL PET PARENTS NEED TO BE PROACTIVE, DO THEIR RESEARCH, FOLLOW THEIR INSTINCT AND ADVOCATE FOR THEIR PETS. IF IN SHARING OUR EXPERIENCES AND LEO’S STORY WE CAN HELP OTHER FAMILIES IT WILL MAKE US FEEL LIKE WE CONTRIBUTED TO THE WELLBEING OF THE PETS AND THEIR LOVING FAMILIES.
As most of you know Leo had an anterior luxation that caused acute glaucoma and had to have an eye removed in May of 2013. In October of 2013 we noticed some symptoms in Leo that lead us to believe he may have Cushing’s Disease. Symptoms at the time included: weight gain in belly, fur loss on lower back region, panting and a slight increase in water intact. We took Leo to the vet and expressed our concern stating that we thought he may have Cushings and requesting he be tested for it. At this point in time that vet told us that the symptoms Leo was experiencing were common signs of a thyroid issue. They tested his thyroid and told us it was low at which point he was put on Soloxine. A few months later we took him back in to the vet for bloodwork to see how his levels were and Leo was diagnosed with a non-specific liver and kidney issue as a couple of his liver enzymes were elevated and he had 3+ proteins in his urine. Leo was then put on Denamarin to assist with liver function. More time passed and bloodwork was done two more times by this vet, both times Leo still had elevated liver enzymes and protein in his urine. Finally, we were able to talk them into testing for Cushing’s Disease as Leo had an increase in Cushing’s symptoms. They ran the test and it came back negative for Cushing’s Disease. We then continued to monitor Leo’s liver and kidney function with no definitive answers as to what was going on, what was causing the issue or how to effectively treat the issues. At our final visit with this vet they diagnosed Leo with high blood pressure and attempted to put him on medication for that…at this moment I decided to follow my gut and seek a second opinion from a holistic vet in our area.
Upon meeting the holistic vet and having him examine Leo and go over all of his records he noted that Leo’s thyroid was fine and that he did not need to be on the thyroid medication Soloxine in the first place. When testing the thyroid there are three numbers that come back, many vets only focus on one of the numbers, but all three numbers need to be taken into consideration. Our new holistic vet explained that thyroid issues are often times over-diagnosed in dogs. At this point in time we decided to take Leo off of the Soloxine as he didn’t need to be on it in the first place and it was what was probably causing the increase in blood pressure for Leo. A month and a half after taking Leo off of the Soloxine we took him in to run blood tests and check his blood pressure. Leo’s blood pressure was perfect! Leo’s thyroid was perfect! A couple of Leo’s liver enzymes were elevated and Leo did still have protein in his urine. We put Leo on some Chinese herbs to help with liver function and decided to do more bloodwork the following month. The next set of bloodwork came back with Leo still having increased levels of liver enzymes and protein in his urine, Leo also had increased calcium levels. At this point with all of the bloodwork results all of the signs were pointing towards Leo either having lymphoma or Cushing’s.
As concerned pet parents we were not good with the idea of Leo having lymphoma, so we started researching Cushing’s again, at which point I made a few very interesting discoveries. The following is the exact (minus the blocked out names) email that I sent to our holistic vet sharing the information I found and seeing what his thoughts were:
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Dr. ___________________,
I apologize for the length of the following email, but also know that typically I am better at explaining things in writing than I am verbally…so it is a bit of a read, but I feel there are some good points. Goal is for Leo to be as healthy and happy for as long as possible. I know that there is a chance that Leo has lymphoma, but looking at all of his symptoms, etc. I feel that he probably has Cushing’s Disease.
The symptoms most commonly seen in dogs with beginning Cushing’s include:
Increased thirst and urination (which can lead to the symptom of incontinence): When monitoring Leo he does drink significantly more than our other two dogs. During daytime hours they drink nearly the same amount, but Leo is up at least three times every night drinking water. Leo also requests to go outside far more often than the other two dogs. We have been lucky thus far and not had any incontinence issues.
Increased panting: When first bringing up the concern of Leo possibly having Cushing’s with old vet I did inform them that Leo was panting much more than normal. Leo, at that time, could sit and just pant, even with no physical activity prior. Leo is currently not doing this anymore.
Weight gain in the abdominal area, in spite of a reduction in calories (pot belly): The main symptom noticed with Leo, other than hair loss, was that he was getting or had a Buddha belly that was mainly noticeable when he was sitting, but was also quite noticeable when he was standing (he appeared almost pregnant).
Thinning skin and change in the pigment of skin, from pink to grey or even black; bruising: Leo’s skin does appear to be thinning, especially in the belly and neck area. Leo’s skin pigmentation has also changed in his ears turning to the greyish black color.
Hair loss and dullness of hair: Leo has significant hair loss on his lower back. Leo has also lost much of the sheen of his coat.
Irritability or restlessness: We’ve not seen much irritability out of Leo as he is typically very good natured. We have noticed a lot of restlessness.
Increased hunger: No increase in hunger noted.
• Seems very tired and inactive: Leo does at times seem very tired, but still has a great amount of physical activity and enjoys playing. We associated his decrease in activity with an increase in age.
Gets skin infections: Leo is suffering from ear margin dermatosis that he has never had before, this is new to him.
Decreased Muscle and bone mass: Leo’s muscle tone is lacking compared to how it used to be, we just associated this with aging.
Much less common are symptoms of rear limb weakness and blood clots. Leo has shown signs of weakness in his rear legs. Old vet noted that he did not immediately move paw back when she curled it under and stated it was “nerve damage.” We have witnessed Leo having episodes of back leg shaking and this has been increasing. Noticed it for the first time about 6 or so months ago. There are times that Leo’s back legs or hind end will shake while he is standing, but this does also occur sometimes when he is in a seated position.

Cushing’s is an over production of cortisol which is the stress hormone. Leo didn’t start showing any symptoms until October of 2013. In May of 2013 was when Leo had his eye removed, which could have been a trigger as he had been in a lot of pain prior to surgery and losing half of your vision, plus your depth perception, along with running into things, etc. has to be very stressful on him. The increase in cortisol can affect immune function, “trigger a glucose release from the liver” (thus making the liver work harder and I would assume knock liver enzymes, etc. all out of balance). “Cushing’s dogs get referred after a misdiagnosed liver disease. The liver of an animal with hyperadrenocorticism gets overtaxed from trying to process the excess cortisol in circulation throughout the body. This causes an elevation in the liver enzyme alanine aminotransferase (ALT) and the inducible liver enzyme, alkaline phosphatase (ALP).”

There are two major types that affect dogs:
Pituitary dependent. This form is the most common, affecting about 80% to 90% of the animals who have Cushing’s. It happens when there’s a tumor in a pea-sized gland at the base of the brain, called the pituitary.
Adrenal dependent: This type comes from a tumor in one of the glands that sit on top of the kidneys, called adrenal glands. About 15% to 20% of diagnosed dogs will have this type.

When we first took Leo to old vet with concerns about him having Cushing’s they diagnosed him with a thyroid issue and put him on Soloxine. The following are cautions linked to Soloxine:
Cautions:
Soloxine should not be used if your pet has ever had thyrotoxicosis, or an uncontrolled adrenal gland problem. Tell your veterinarian if your pet has heart disease, anemia, diabetes, or problems with the pituitary or adrenal glands. If you give your pet insulin or diabetes medication by mouth, dose adjustments may need to be made.

Being that Cushing’s Disease in dogs has two primary types: Pituitary dependent and Adrenal dependent and that the above states that Soloxine should not be used in cases where the animal has issues with pituitary or adrenal glands I question if Leo being on Soloxine when the Cushing’s test was done could have affected the test results.

Depending on your opinion I would really like to re-test Leo for Cushing’s Disease, or start to treat him for Cushing’s Disease to see if it would help him.

Sincerely,
Roxanne ______________
SOURCES:
http://pets.webmd.com/dogs/cushings-syndrome-dogs
http://healthypets.mercola.com/sites/healthypets/archive/2010/09/21/cushings-disease-caused-by-pet-stress.aspx
http://www.1800petmeds.com/Soloxine-prod10138.html
http://healthypets.mercola.com/sites/healthypets/archive/2010/09/21/cushings-disease-caused-by-pet-stress.aspx

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Our holistic vet received this email on Monday November 2 and by Friday the 6th we had Leo in testing him for Cushing’s a second time. As you remember from above the old vet tested him and it came back negative. This time Leo was not on unnecessary medication (Soloxine) that would skew the results. On Monday November 9th we received the call that confirmed that Leo DOES have Cushing’s Disease.
Leo has now started Vetoryl, one of the only FDA approved medications to help with Cushing’s…not a cure, but a help. Leo has only taken two doses so far.
Now our adventures in diagnosed Cushing’s Disease begins….we will be sharing Leo’s story along the way.

**PET PARENTS:  PLEASE FOLLOW YOUR GUT.  FOLLOW YOUR INSTINCT.  GET A SECOND OPINION OR EVEN A THIRD IF NEEDED.  DON’T BLINDLY TRUST A DIAGNOSIS IF YOU FEEL LIKE IT COULD BE SOMETHING DIFFERENT.  DO YOUR RESEARCH.  ASK QUESTIONS.  ADVOCATE FOR YOUR PETS–YOU ARE THEIR VOICE!!!

Leo the Boston Terrier with his sister Kuki and brother Doc.

Leo the Boston Terrier with his sister Kuki and brother Doc.

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Leo’s Enucleation Surgery from the Day Before to 2 Weeks Out

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Seeing a family member in pain is heartbreaking, doesn’t matter if it is a human or animal family member.  Having to go through surgery can and is very stressful…having a child/fur baby go through surgery can be even worse.   What is something happens?  What if something goes wrong?  What should I expect after the surgery?  What will the healing process be like?  Will my loved one be in pain?  These were just a few of the questions I asked myself, my husband and our vet prior to Leo’s enucleation surgery.  I spent weeks researching online and found a lot of technical information, but didn’t find very many personal experiences, so we decided it would be best to share Leo’s story and daily progress, in hopes that it would help some other families going through the same situation.

Leo’s Story:

Leo is a very happy, healthy and active 10 year old Boston Terrier.  Leo has never had any medical issues, well, an ear infection now and then, but nothing major.  Leo had only ever had one surgery in his life and that was when he got fixed.  On April 2nd I arrived home from work to find that Leo had something very wrong with his right eye.  Upon an emergency visit to the vet we learned that Leo had what was called an anterior luxation (to learn more I found this site very helpful:  http://www.eyevet.ca/luxlens.html).  This anterior luxation caused an acute onset of glaucoma because it blocked the flow of Leo’s eye fluids and was causing pressure.  We treated Leo’s eye with 2 different kinds of eye drops (Pred Acetate 1%  drops & Dorzolamide 2%…the first was a steroid to help with pain and the second is a glaucoma medication to help with the eye pressure).  Our vet explained that the drops would help for a while, but were not a long-term fix, she also explained that they could work for a few months or weeks and that eventually they would not help as his condition progressed.   We did a fundraiser to help with Leo’s surgery costs and as soon as we reached out goal Leo’s surgery was scheduled.  Leo was diagnosed on April 2nd and had his surgery on May 3rd.  During the month between diagnosis and surgery Leo’s eye was stable at first, but then did get much worse.  Leo’s right eye was clearly larger than his left, he struggled to keep it open, it was very bloodshot, it was pressure/touch sensitive, he was tearing excessively, and Leo could not see out of the eye at all.  Leo loves the sunshine and was not allowed to lay or play in it as it made his eye much worse.  Leo wanted to play, but if he got bumped he would yelp and run to mom for comfort.  We were very blessed to have such wonderful people help donate to Leo’s surgery so that he could get in to the vet and get the surgery done before being in more pain.

 

What to expect & risks of surgery:

One very important thing to remember is that every dog is different and heals differently.  If you have a dog that is healthy, the healing process with probably be easier, quicker and will more than likely have less complications…BUT as with humans, every surgery and patient is different.  Enucleation surgery is a MAJOR surgery.  Our vet did Leo’s surgery in the early afternoon and actually kept him overnight to monitor him, they also kept him on an iv with pain medication and antibiotics, which we think was very helpful (stressed me out and made me worry when they said they were keeping him overnight, but it was for the best).

Due to Leo being a Boston Terrier we chose to have the prosthetic eye placed in the socket so that he would not have a large caved in area.  Prosthetic eyes can cause more complications, such as infection.  Dogs who do not have such large predominate eyes like those of  Boston Terriers, will do very well without the prosthetic…it is all your choice.  The great thing with Leo getting the prosthetic is that he does not have a caved in area and literally just looks like he is winking, which is a little easier on the humans in his life.

One of the big risks that comes with any surgery is infection, that is why your vet will prescribe you a course of antibiotics for your dog (Leo loved them because every morning and evening he got a “special” treat and he thought that he was getting spoiled).   When you go to get your loved one after surgery there WILL be a lot of swelling, this is normal, but is very hard to see (as soon as Leo came into the room I was in tears, not only because I missed him so much and was so worried about him, but the shock of seeing his surgery area and the swelling).  Our vet explained that there may be some bloody discharge or seepage from the surgery area and that is normal, but if it becomes an excessive amount to contact them immediately…we were very lucky as Leo experienced no discharge at all.  Your loved one will have an Elizabethan collar on (much better than a regular cone of shame) which is nice and soft.  This will help protect their eye area from being bumped  and from them scratching at it.

If you have other pets at home you may want to keep you loved one that just had surgery away from them in a nice safe area.  Leo got to spend a lot of time in our guest bedroom during the first few days after his surgery.  Other pets do not understand that your loved one just went through a major surgery and you do not want them bumping them, running into them or anything else along those lines…those first few days after surgery are very important in the healing process and keeping the pet safe from further injury is very important.  Leo’s first night home we had him sleep with his Elizabethan collar, he wasn’t completely comfortable, but we felt good knowing his eye was protected.

You may experience some swelling in the check area after surgery, Leo had swelling in his check the day after he got home, but by the next day it was gone.

There WILL be bruising.  Hey, it is a major surgery and bruising is to be expected.  Being that your loved ones eye area will have been shaved the bruising will be very visible, but thankfully will only last for a few days.

Leo only wore his Elizabethan collar for a couple of nights, and then we had him wear it during the day if we weren’t right there to monitor him, but he did very well with it off.  Make sure to keep a close eye on your dog to make sure they are not rubbing or scratching at the area, if they are you will want to make sure they continue to wear the Elizabethan collar.  Thankfully, Leo did not rub or scratch at the area at all, so that really helped his healing process.

Typically, if all goes well, the sutures will be removed 11-14 days after surgery.  Leo had two sutures that came untied, we just left them alone and we were reassured by the vet that as long as the eyelids were not pulling apart in the areas that came untied Leo would be fine.  Remember that your furry loved one also has internal sutures to help.

One of the things that we did not think about ahead of time was eyelid and brow movements.  When some dogs get cancer or have to have more of the eye area removed the vet will have to take out many of the muscles so there will not be facial expressions of the eye area on that side.  Leo, thankfully did not have cancer, so they only needed to remove his eye, which means that his eyelid and eyebrow both still work.  Leo’s right eye area still does the blinking motion at the same time his left eye does and his little eyebrows still move and are very expressive, which is wonderful, but just not one of those things that we had thought about ahead of time.  We love that he still is so expressive.

It will take time for  your dog to adjust to only having one eye.  Their depth perception will be off, it will take them a while to notice things on the side of their surgery.  Leo loves to beg for treats and we experienced him grabbing a treat and dropping it, but he could not see it because it landed on the right side so we had to guide him to it.  As with any major physical change it will just take some time to adjust.  Your loved one may also be a little jumpy and easily startled if they are approached from the side that no longer has an eye.  It will also take them a while to do the visual adjustment with the other eye so that they don’t get to close to or run into things on their surgery side.  Leo has come very close to running into a couple of corners.

Your loved one will want to be playing and back to their usual selves within a few days of surgery, but you as their human have to be the big meany that does not let them play as rough as they are used to…you are their protector.  Leo is highly active and plays very rough, so limiting his play was very hard.  Typically within about a month of surgery they area will be completely healed and your loved one can play at their normal rate.  We are choosing to keep a very close eye on Leo (no pun intended) and not let him play as rough as he is used to because now he only has one eye and we need to keep that protected.

Remember that your furry loved one will need extra love, tummy rubs and nom noms 🙂

Photos from the day before surgery through 2 weeks after surgery:

A few days ago I went back and was showing a co-worker Leo’s surgery photos and I was amazed at seeing how he healed…how you could see the healing from day to day.  I’ve taken a few pictures from each day of his healing process and put them all together in this one blog so you can see how much of a change there is…amazing!

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Leo-2 weeks Post Surgery

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Leo a full 2 weeks after his surgery.

Leo a full 2 weeks after his surgery.

The surgery area is looking great.

The surgery area is looking great.

Leo is adjusting very well to only having one eye.

Leo is adjusting very well to only having one eye.

Leo is loving being able to enjoy the sunshine again...even though today it is hit or miss here in  beautiful  Central Oregon.

Leo is loving being able to enjoy the sunshine again…even though today it is hit or miss here in beautiful Central Oregon.

You can see that his surgery area just looks like his little eye is closed, or like he is winking.

You can see that his surgery area just looks like his little eye is closed, or like he is winking.

And Leo is still very VERY good at begging.

And Leo is still very VERY good at begging.

Leo-13 Days of Healing & Sutures Out

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Leo did not want to get his picture taken this morning.

Leo did not want to get his picture taken this morning.

Leo leaving the house and getting ready to load up to go see the vet.

Leo leaving the house and getting ready to load up to go see the vet.

Leo's sutures.

Leo’s sutures.

We are at the vet.  Leo had 2 sutures that had untied over the last 13 days that the vet was able just to rub out...didn't even have to tug.

We are at the vet. Leo had 2 sutures that had untied over the last 13 days that the vet was able just to rub out…didn’t even have to tug.

Dr. Gayln Snair, Leo's wonderful vet, removing Leo's sutures.

Dr. Gayln Snair, Leo’s wonderful vet, removing Leo’s sutures.

Snip snip sutures out.

Snip snip sutures out.

Dr. Gayln explained that the little red/blood area on Leo's eye is just from where a suture was and is nothing to worry about.  She was able to touch and rub the area and Leo seemed perfectly fine and had no pain.

Dr. Gayln explained that the little red/blood area on Leo’s eye is just from where a suture was and is nothing to worry about. She was able to touch and rub the area and Leo seemed perfectly fine and had no pain.

Dr. Gayln giving Leo a nom nom...look at how big and happy Leo's eye is...he is a fan of nom noms and loves his vet.

Dr. Gayln giving Leo a nom nom…look at how big and happy Leo’s eye is…he is a fan of nom noms and loves his vet.

Dr. Gayln giving Leo some extra loving before we head out.

Dr. Gayln giving Leo some extra loving before we head out.

We got home and I tried to take a couple of more photos...in this one Leo is doing his snarly kisses at Doc because Doc decided the best thing to do was sniff Leo's nether regions and Leo wanted nothing to do with it.

We got home and I tried to take a couple of more photos…in this one Leo is doing his snarly kisses at Doc because Doc decided the best thing to do was sniff Leo’s nether regions and Leo wanted nothing to do with it.

Close-up of the little tiny boo-boo mark that Leo has.

Close-up of the little tiny boo-boo mark that Leo has.

As you can see, today was the big day, we went to the vet and had the sutures removed!  Leo did wonderful.  Leo loves his vet and all of the staff not only because they treat his so well and with so much kindness, but because they give him super yummy nom noms 🙂  Oh, and he enjoys being told how handsome he is.  Dr. Gayln Snair, Leo’s wonderful vet, was very impressed with how well Leo is healing.  She rubbed, pressed and petted the area and Leo didn’t show any signs of pain or discomfort.  Dr. Gayln explained that we need to give Leo another full week of healing and then he will be good to go and play like a crazy dog again…we are going to be very careful with Leo’s rough playing because we need to make sure the eye he has left is safe and fully functional for many more years (the rest of his life).

Leo-On the 12th Day of Healing la-da-de-da-de-da

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Caught Leo & Doc both early this morning and the flash got them...neither one of them were pleased.

Caught Leo & Doc both early this morning and the flash got them…neither one of them were pleased.

Leo enjoying quality time outside...the best part of this photo is that if you look very closely in the background Doc is running towards the camera.

Leo enjoying quality time outside…the best part of this photo is that if you look very closely in the background Doc is running towards the camera.

Leo is finally hamming it up again.  His eye is looking very good and we are very excited to get his sutures removed tomorrow morning.

Leo is finally hamming it up again. His eye is looking very good and we are very excited to get his sutures removed tomorrow morning.

Not sure what Leo was watching but he was in pointer mode...look at that little tail.

Not sure what Leo was watching but he was in pointer mode…look at that little tail.

Leo-11 Days Post Surgery

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Leo is now 11 days into his healing from eye enucleation surgery.  Leo is doing very well!  Yesterday I actually took the time to look at all of the blogs of Leo’s progress and am amazed at how he is healing.  Seeing how much the swelling and bruising has gone down and how quickly he has healed is wonderful.  Leo is full of energy and wanting to play…he gets to play some, but not nearly as hard as he is used to (will take a very long time until we let him play like he used to again…maybe never as our goal is to make sure his one eye stays safe & healthy).  Leo is loving being able to be outside and soak up the sun, prior to his surgery he wasn’t able to because the sun made his eye worse.  This Thursday Leo has a follow-up appointment with his vet to check on his progress and get his sutures removed…we are very excited to hear what the vet has to say.

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Leo-9 &10 Days Post Surgery

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This is how Leo spent much of his 9th day of healing.

This is how Leo spent much of his 9th day of healing.

You can see that the swelling is pretty much gone, very little bruising.

You can see that the swelling is pretty much gone, very little bruising.

Leo's eye is healing very well.

Leo’s eye is healing very well.

9 days into healing.

9 days into healing.

Top view...looking good.

Top view…looking good.

 

Sorry for combining days 9 & 10 of Leo’s healing progress…we can blame work and a tired Leo mama.   The photos above are from Leo’s 9th day of healing.  The photos below are from today, Leo’s 10th day of healing post surgery.

 

Leo 10 days into healing and wanting to play...I am holding his Hedgy down while he is trying to get it, just so I could get a couple photos.

Leo 10 days into healing and wanting to play…I am holding his Hedgy down while he is trying to get it, just so I could get a couple photos.

Day 10-Leo & Hedgy

Day 10-Leo & Hedgy

All of the kids out on the porch soaking up some sunshine.

All of the kids out on the porch soaking up some sunshine.

Leo is usually a ham, but I think he is starting to get sick of daily photos...look at that dirty look he is shooting me.

Leo is usually a ham, but I think he is starting to get sick of daily photos…look at that dirty look he is shooting me.

Both of us soaking up some love.

Both of us soaking up some love.

Leo 10 days post surgery and looking good.

Leo 10 days post surgery and looking good.