Buford--post surgical update

The surgeon called a little bit ago and said that Buford did very well. Fortunately I have nothing new to report since the last update as nothing additional was found/done to him. He is going to be monitored very closely through the entire night as they need to make sure he does not have an abdominal bleed. He's on morphine (I could use some) and if he's stable enough he will come home tomorrow. I flat out told the surgeon that I'm in no rush to get him home if he's safer there. I'll pay the extra hospitalization charges to keep him there until Sunday just to make sure he's really ok the return home. He said he understood and that we would take it day by day.

Recap:

Gastropexy (stomach tacking)
Removal of spleen due to multiple nodules
Partial liver lobectomy due to the finding of a nodule
Tissue samples being sent for biopsy of stomach lining, intestines and the spleen/liver to UPENN
Clear evidence of esophagus damage from acid reflux (to be treated most likely with Prilosec)

Thank you all for being there for him (and me too).

Buford--surgery tomorrow

Things are not getting better and we may be facing the last option in assisting my boy in having a sense of a normal life. Tomorrow morning I take my baby to the Veterinary Specialty Center in Delaware where he will undergo some pretty invasive surgery. They are going to tack his stomach down (gastropexy), do a surgical exploratory, do an endoscopy and scope his esophagus as well as taking biopsies of his intestines. Here's why:

While the bloat symptom of filling with gas has remained under control he is still clearly experiencing bloating on a regular basis, meaning, after each meal. He paces, he licks the air, he hypersalivates, and he is very uncomfortable for 3-4 hours after breakfast and dinner. The suspicion is that his stomach has been doing a 90 degree twist most, if not all, of his life. And he is now at the point where it has become more and more difficult for his body to unflip his stomach back into a normal position.

**IF** this is indeed the problem (for there is no real way to prove the suspicion unless the internist was to catch an actual twist/flip on an xray) then tacking his stomach may just solve his digestive problems.

If this is not the answer to the problem....we may be out of options and I may have to face making that decision every pet owner prays will never have to be made.

What makes things harder is that he is active, alert, hungry, playful and energetic. He trots the entire way during his 30-40 minute morning and evening walks; he greats me happily at the door when I come home; he plays with Della....and the list goes on. How do you make a decision to end the life of a dog whose very soul has touched your own when he simply does not appear to be clinically ill, but clearly is medically?

I do hope that is not the road we will travel....I suppose I will just have to wait and pray he 1) survives the surgery and 2) the gastropexy works.

Buford: Two Week Update

Buford has had a very good couple of days, almost a full week of "good." Eating well, everything moving through his system properly, etc. I cut out the Carafate after the 2 weeks as instructed he seems to be doing well.

But just a little while ago he threw up for the first time in about 10 days. It was fortunately a pretty normal episode in that he got up off his chair, sat on the floor and threw up the biscuit he had just eaten along with just a some water/mucous. No bloating, nor trying to continue making himself vomit, no insanity like before---but:

This morning he had a problem eating breakfast. The food (canned Hills Prescription Z/D) was from a new case and was not the same rubbery consistency as previous cases. It was a little bit softer/mushier (it that makes sense) and it stuck to the fork more after putting it in his dish. The case was in the garage the last couple of days and it was warm in there but not hot. I put some cans in the fridge and we'll see what it's like at dinner. Perhaps the cold of the fridge will "stiffen" up the food a bit.

I mention this because as he was eating either the food got stuck going down or adhered itself to the inside of his palette. He kept working at it trying to swallow it, acting much when he used to get some peanut butter. Finally he stopped, drank some water and I fed the rest of breakfast to him using a spoon, trying to give him pieces he could just swallow without worrying about chewing, etc.

Following the little vomit episode he started coughing like he had been doing 2 weeks ago and did a short period of the gasping/gagging. I'm going to give him a dose of Carafate in a little while--he's sleeping at the moment, having finally calmed down. He wasn't frantic this time--but he did look extremely worn out. More worn out than he should after a quick vomiting moment like that.

I don't believe my baby will ever be "right" again, I do hope that we can continue to control these symptoms however--he has been so happy, playful and acting like he generally felt better this last week. It is very difficult to see him in distress--sigh.

The Morning After

He had a GREAT night!! From 10 PM - 3 AM he slept like a log--I'm not even sure if he changed position. Granted he was exhausted but I think it was also because he had gotten some relief from his problems.

This morning began at 5 AM because I need to leave for NYUCI w/mom by 8 AM. The schedule of digestive "assistants" that he is taking requires somethings to be taken 30 minutes before eating, some during meals and still another 30 minutes after he took his last medication. If you think you're confused you should see the notes I needed to write for myself.

Breakfast seemed to go well--again, not sign of bloating. Some "normal" post-meal belly gurgles, a regular belch and then some "posterior eliminations" (someone light a Febreze candle please).

It's about an hour now since breakfast was eaten--half of his old food and half of the new Hills Prescription Z/D (looks like there's nothing flavorful about it at all--poor guy)--and he's zonked out on his favorite chair in the living room.

Time will tell if we're doing the right thing but if all continues as the last 9 hours have gone then I'm going to allow myself to believe we're on the right track.

Return Visit to ER Clinic--Potential Relief

I know---it's getting old, but this evening I took the advice of Mary Tipping and took Buford back to the emergency clinic because things were "just not right" and I was a wreck. I called first, explained the situation--filling with gas/air to the point of bloat each time he ate ANYTHING--and they said to immediately bring him back for re-evaluation. I'm thinking "running out of money but what can I do? I don't want him to die because I was stupid."

We met with yet another doctor (4th one so far) who re-examined him, and reviewed his entire file from soup to nuts. It was perhaps the most exhaustive session I have yet to have with a vet. When all was said and done it was agreed that we're all just grasping at straws and guessing what could be wrong. Granted, he has early heart disease and I never would have known that if it were not for all the tests done these last couple days--but that did not explain all the gas he was getting. This doctor agreed.

So, we're treating him for three things: a possible gastrointestinal motility problem, a possible inflammatory condition of his gastrointestinal tract, and a possible reaction to his food and/or gastroesophageal reflux. Also knowing that something else could be in play, he will be seeing an internal medicine specialist as soon as I set up the appointment tomorrow morning.

We came home with Reglan, Carafate, Zantac and Hills Prescription Z/D food to go along with his Trilostane for Cushings and Enalapril for his heart. The way everything has to be given with regard to how often, how much, how soon before meals, how soon after meals, how soon after all oral medication....my head is still spinning! I had to write everything down twice to get it organized correctly and I'm still scared that I'll screw it up. Tomorrow I will pick up one of those pill boxes that spreads things out for a week, etc. YIKES!

**BUT** here's the GOOD news: we survived dinner tonight with ZERO bloat!!! Heck, the boy is so jazzed up with anti-this and anti-that it's a wonder his body even knows it ate food! But he's sleeping soundly on the couch right now and that's the best sound I've heard from him all day.

I hope we get through the night with ease as well as tomorrow morning's meal. I'll be a wreck all day because I have to take my mother to NY for her oncologist appointment, but he will be at his regular vet's for boarding and I'll make sure they know EVERYTHING that's been going on--I'll pay extra for someone to check on him every 30 minutes if I have to!

Things Not Good

Saturday night's dinner turned bad. While eating dinner, and mean WHILE eating, he bloated right before my eyes. It was so bad that he stopped eating. I raced over, yanked the bowl away and realized that he was trying to burp but couldn't. So I started rubbing and lightly patting his sides (like you would a baby) to help him. At first nothing and he was SO bloated that he couldn't breathe and started shaking. I truly thought he was going to either pass out or explode and I'm not exaggerating about the exploding part. FINALLY he belched so loud the it must have been heard down the street!

For the next hour he belched and passed gas on and off but eventually calmed down.

Breakfast: same thing but to a lesser degree. I gave him a Gas-X pill before he started to eat and helped him burp while he ate and afterwards. I denied him water for a full 2 hours after breakfast.

The weird part: he swallows tons of air ONLY while eating food, not drinking water.

So, big questions for the vet tomorrow morning (always on a weekend folks, ALWAYS!) because this is scary stuff. I plan to break his dinner and breakfast up into 4 meals instead of two hoping that less at once will be easier on him.

I still think there is something else in play here. Yes we discovered the start of early heart disease and have him medicated for that----but this is too weird/odd to be JUST from heart problems.

Buford is Home!

The boy is snoring peacefully and calmly in his favorite chair next to the fireplace in the family room---you know, the $800 Thomasville chair and ottoman I purchased for myself a year and a half ago and have NEVER sat in.

DIAGNOSIS: moderate mitral and tricuspid valvular insufficiency. He is on 10 mgs of Enalapril to control his high blood pressure and ease the workload on his heart. This seems to have been causing all the coughing and gagging. The vomiting and bloating were just side effects of all the air gulping!

He needs to have his blood pressure, kidney enzymes and electrolytes checked in 7-10 days to make sure that the dosage is correct and not causing other problems. Then he gets to see his new cardiologist in 4-6 months. (I think that **I** better see a cardiologist after all this stress!)

He seems much more at ease and more in control. Earlier he had a small gagging moment but it passed quickly and without any negative results. I think it is going to take some time for him to totally stablize but he seems to be well on his way.

Good to have him home, that's for sure.

Buford--Heart Problems May Be The Cause

He's been at the VSCD in Newport for 24 hours....and since that time has undergone an abdominal ultrasound, abdominal xrays, chest xrays, and tons of blood work.  All of that revealed that for a Cushing's dog, Buford is rock solid healthy.  But it also revealed an enlarged left ventricular chamber as well as a substantial heart murmur.

This prompted me to agree (think more money now) to have him examined by the cardiologist who did an ultrasound on his heart.

Findings: His mitral valve and tricuspid valve are both not closing properly, his heart is overworking because of this and his blood pressure is elevated.  

He is being put on meds to 1) lower his blood pressure and 2) ease the workload on his heart. They believe this will ease the coughing and gagging that they feel is being caused by the extra stress on his heart as well as the enlarged left chamber that is putting pressure against his trachea.

**If his symptoms are not relieved by this treatment they will do a thoracic wash and see if there are lung problems.  This will not be done right now however--we are going to give the heart meds a chance first.

As long as he keeps food down tonight he will be released first thing in the morning.

A Buford Moment of Levity:  Prior to calling me this evening, the night emergency doc, Dr. Vicari, gave him some food.  She said she had to count all of her fingers to make sure she didn't lose any when he tried to snatch it out of her hands!  She was not angry in the least--she was laughing about it and added, "I think he's had enough of us and wants to go home."   Clearly the boy is not a happy camper!

Buford's Latest Battles

The boy is currently at the Veterinary Specialty Center of Delaware in Newport, DE. Initial reason: uncontrollable coughing and gagging causing swallowing of air and bloat episodes. All of this was preceded the day before with a 7 hour vomiting/bloating/de-bloating night and a day spent at his regular vet on anti-vomit meds, fluids, etc. He came home from there and later that night it all started again but worse.

Honestly we're not completely sure what we're dealing with yet. Buford has NEVER been a healthy hound--never, and he's been with me since he was 7 months old. However, he is a sweetheart and deserves as much care as I can possible get for him--so race to vets and I done and will continue to do because THAT is how I am. (can you tell that others have been passing "judgment" on me lately?!)

Ok, back to the situation:

Today he is being seen by an internist, his x-rays will be reviewed by the radiologist who has done his previous ultrasounds over the years, and we will most likely do another ultrasound next week (no appointments available until then). His upper abdomen is tender and slightly swollen--docs are unsure as to whether this is just the trapped air he has gulped into his entire GI tract or if the pancreas is at all involved.

The other "not normal" thing is that he has developed a slight cough over the last few weeks. Nothing regular, usually happens after drinking water--you know, you don't think anything of it because you're thinking "slow down pal, you'll choke." But that cough has returned and precedes all of his gagging episodes. This is another flag that we want to try to find the cause of--it's not normal and could be the indicator of a larger problem.

We just got the Cushings under control and now something else is in play. My poor boy just doesn't get a break.