Liver Ultrasound and Biopsy Complete! Annual Opthamologist Appointment Complete!

Last Tuesday, May 17th, Dinglehopper had an appointment with an Internal Medicine Specialist at the VEC. It was a bit weird to be back at the VEC after so long. Weird in the sense that it brought back all the memories of Dingle's knee surgeries... but good because we were able to not go there for years.

The Internal Medicine specialist was amazing. So amazing. Dingle has a bunch of good vets, but I think this appointment goes on my list of the best. She spent close to 45 minutes taking Dingle's history, consulting with us, explaining the possible liver problems, drawing diagrams of the liver and different conditions, etc.

I opted to stay at the VEC and wait for Dingle, rather than going home. I figured it would be better worth my time, as it can take me a while to TTC it to the VEC and back. I was wrong. I ended up waiting about 3 hours and then they came out and said that the ultrasound was done. I made the mistake of assuming he would be going right in to the ultrasound after his consult... and didn't think about other pets being 'in line'.

The biopsy had not been done at that point. The specialist said that Dingle's liver looked normal - it had good blood flow and there were no obvious problems (no shunts, etc). His kidneys also looked normal and with one possible liver condition she'd have seen an underdeveloped/small liver and large (from compensating) kidneys.

She asked me if I wanted to go ahead with the biopsy and when we talked out the benefits and risks we decided to go for it, so we could totally rule out any of the possible liver problems.

About an hour or so later the biopsy was complete. She took 2 pieces from the liver to snd away to the pathologist for testing. The specialist said that Dingle's liver had bled during the biopsy (which is common) and so they wanted to keep him overnight just to be safe which I appreciated because I am a worrier and would have been scared to sleep - wondering if he'd be bleeding badly internally and die (okay, perhaps I'm a bit more than just a worrier)

This is the sign that was on his kennel:



Dingle isn't totally blind and the specialist knew that, but she wanted the sign on just to be on the safe side. She didn't want anybody caring for him overnight to open the kennel and expect to him to step into his arms and have him miss. I appreciated the extra caution. Dnigle probably liked the extra attention.

Perhaps the sign on his kennel should have said "Caution: HIGH"



Dingle was drugged, which was good because he wasn't in pain. He wanted out of the kennel, but eventually he settled down and laid down:



I stayed with him for quite some time. By the time I left the VEC I had been there for about 7 hours total.

The next day Razzleberry had an appointment with Dingle's opthamologist - because the pigment in her eyelid was changing color. Turns out she'd been scratching the hell out of her eyes.

Dingle likes attention and so I decided to pick him up from the VEC after Razzle's appointment so that he wasn't interfering with Razzle's appointment by demanding to be held or in the spotlight.

By the time I got to the VEC he was ready to go - they'd checked on his liver throughout the night and that day and there was no signs of continued bleeding or fluid in the belly. Yay.

I paid my $2,423.18 bill and called a cab because I had had enough TTC travelling - especially because Razzleberry barfs like crazy from motion sickness.

Dingle was happy to get home, as was Razzle. She was sporting her new e-collar and seemed pissed. I kept thinking "welcome to Dingle's world":



He was also happy to get the bright pink bandage off his leg. He spent the next 30 minutes (following the bandage removal) licking his patch of bare skin.

After he was satisfied that his patch was clean Razzle and him curled up on the couch and slept:



Clearly they have bonded and love each other.

On Monday I removed Dingle's stitch. He had one small stitch, even though they didn't cut him open at all (but rather stuck a big needle through his skin and info the liver). I was not looking forward to doing it myself, but it was most of the way out and it was easy to do.

Since Monday was a holiday the specialist said it might take until Wednesday to get the biopsy results.

I called yesterday morning and heard back that evening. The results were in and I was thrilled that we got positive results. Dingle rarely gets good news.

HIS LIVER IS COMPLETELY NORMAL!

Yup, all healthy. I really couldn't believe it. Given Dingle's track record I was still (even after her saying on the ultrasound things looked good) expecting bad news.

So, since Dingle's bile acids have been high compared to most dogs, he's considered "abnormal, normal'. Any other dog the elevated levels may indicate problems, but with him they do not.

The plan is to put him back on the Zentonil (which he was on in September and October 2010) just to be safe. He will get it once a day, I think forever... I will have to double check that when Dingle sees the regular vet next.

Since his ALT was high in September we are going to check his liver values (not his bile acids, which are the most expensive tests) in 3 months. Then we will do it again in 6 months and then yearly with his shots/check-up as long as his ALT comes back normal.

We will only check the bile acids (since compared to the general dog population they will likely always seem abnormal) if he starts looking clinically unwell, which we think is unlikely.

Yesterday Dingle also had an appointment with the Opthamologist.

It was his annual check-up and we got more good news. Dingle's eyes look good (translation: as good as can be for a dog with KCS and PRA).

The vet thinks that Dingle's day vision has remained the same in the last year, which is good. Perhaps he may always keep some day vision. I believe his night vision is getting worse because Dingle has never been afraid of fireworks, but when we were out walking this weekend he seemed hesitant to move, with the fireworks going off. But we kept walking (with some resistance) so he could work up that confidence.

After getting not 1, but 2 pieces of good news today Dingle should look happy. Instead he looked irritated when I took the picture below. He was mad because Razzle always jumps on the bed and steals his food. That little girl has quite the appetite.



Above all things are looking pretty good for Dinglehopper.

Hopefully we can continue with this lucky streak (and hopefully he will pass it along to Razzle).

The Liver Issues Continue. Next Step: An Ultrasound and (perhaps) a Liver Biopsy!

Last week we got the results from Dinglehopper's most recent liver tests. While his ALT and enzymes were within normal ranges, his bile acid levels (pre and post) are not. They aren't crazy high, but they aren't normal. The vet wanted to consult with a specialist and get back to me on what the next step was.

On Tuesday night Razzleberry had an appointment at the vet for her third and final set of boosters. Here she is chilling out, waiting for the vet:



Though the appointment was for Razzle, we spent most of the time talking about Dinglehopper as the vet had consulted with the specialists.


Our plan is for Dingle to see an internal medicine specialist at the VEC.

Yes, back to the VEC - where Dinglehopper had his luxating patella surgeries and was seen for various other issues when his normal vets were closed.

The specialist Dingle's vet spoke to said that we should do an abdominal ultrasound - to look for vascular problems within the liver. We also may be doing a liver biopsy, which would require a clotting profile prior to it. Poor Dingle. I hope that they can see enough on the ultrasound so that he doesn't have to be put under anesthesia for the biopsy and have to deal with the risks associated with that.

The vet said that while these tests may be expensive (I can only imagine - any guesses as to what the total bill will be?) in the long run it will probably be cheaper than doing the liver tests (which run about $300) every few months to monitor the bile acids. True.

I'm really hoping that there isn't anything really major going on with Dingle. I hope that we just have to do a diet change or monitor him occasionally.

Our appointment is next week - Tuesday the 17th.

Why Your Liver is Important...

Back in February when I was waiting for the results of Dingle's most recent liver tests I got an Email forward from my Grandpa (who is in his 90's and yes, uses the computer) about the importance of the liver.

Here are some of the pictures from that liver, which explain why the liver is important.

Again, these are from an Email forward - no copyright infringements intended:





















So those are the reasons I am hoping that Dingle's next liver tests (May 3rd) come back okay.

Luckily Dingle doesn't drink... so that's one thing he's got going for him.

Dingle's very happy with his new sister, Razzleberry, and I want him to be carefree - with no daily liver meds. The eye drops are enough medications as-is!

Changes

It's been a few months since I have last written. This time it hasn't been because I forgot. I needed some time to adjust to the craziness in my life - which has been full of changes the last 2 months or so.

But before we get into all of the changes, let's back track a bit.

Back in February Dingle went to the vet to get his liver re-tested. We had noticed elevations in his ALT back in September when he had his dental, but luckily the levels had gotten back within normal ranges after a month and a half on medication. Our plan, at the time, was to keep him off medication for a few months and see if those ranges could stay within normal without the liver detox meds.

The results from February's test came back and there were still elevations seen. Not extremely high that he needed medication again, but high enough that we were going to re-check in 2 months to keep a close eye on them.

Dingle was supposed to go on Tuesday, but we had to postpone. Last Friday morning I came home to dog puke everywhere. All over my couch, bed, floors... sooo much barf. He was fine (eating, playing, drinking, happy) when I got home but we decided to postpone the tests for two weeks just incase the massive vomit fest threw his system out of whack. Plus I didn't want to spend over $400 on extensive liver testing if there was a chance that his sickness or whatever made him puke (I think it was from chewing a stick that night) could lead to inaccurate results. Dingle's appointment is set for May 3rd.

Onto the changes...

Liver stuff isn't all that's been happening in Dingle's (and my) life. There've been a lot of changes since February. My 6.5 year relationship ended and Dingle went from having two doggy companions in the house to being by himself. He had Sasso (the pug/beagle mix) as a friend since Dingle was 5 months old. I didn't live with my (then) boyfriend at the time, but the dogs were always together when we were hanging out prior to living together.

I could tell that Dingle was very lonely, especially when I was at work and he was on his own for about 12 hours. As a side note I am kind of glad that his steriods (crotch meds) back in December made him pee so often that we needed to give him pee pads, because now being inside for 12 hours while I work he needs them. It wouldn't have been fair for me to expect him to hold 'it' all night if he needed to go.

The timing of the break-up 'worked out' I guess you could say in terms of Dingle getting a companion. A breeder I have known online (and met a few times), also named Michelle, had a litter of pom puppies. There were 2 in the litter. The breeder was planning on keeping 1 of them and at the time of my break up the second didn't have a concrete home in place. Dingle and I were chosen to be the new owners. Okay, maybe it was more like I was chosen.

On March 26th Dinglehopper and I welcomed the new puppy home.

Keeping with my past of crazy/unique/whatever pet names, I named the little girl Razzleberry.

Meet Razzleberry:



Or I guess I should have said "Meet Razzleberry... what you can see of her".

Here is Dingle with Razzle only hours after she came to her new home. Unfortunately it's a crappy Blackberry picture:



I was off for 10 days after I got Razzleberry to be home with her and Dingle.

For the first few days Dingle wasn't sure what to think. I honestly believe at first he didn't want much to do with her because he didn't know that she was his new sister... he might have been wondering if this dog was going to leave too (like his other two friends/my exes dogs).

I got the pom mostly for Dingle. I'd be lying if I said I didn't want a second pom (or third, fourth, etc) for a long time. But seeing Dingle so depressed and 'needy', I knew he needed someone. The first few days Razzle was home I was worried that I made the wrong decision, but luckily on day 3, I think it was, Dingle started playing with the puppy.

Now, weeks later, they are best buddies. Razzle looks up to Dinglehopper and follows him around the apartment. Speaking of apartment - two weeks after Razzle came home I moved to a new apartment for a 'fresh start', so to speak.

Of course I worried about Dingle adjusting to a new place with his failing vision, but things have been fine. A bonus is that I no longer have a 2 level apartment - no stairs for me to worry about with Dingle or the new pup.

Dingle is a good big brother and spends hours play fighting.

When Razzle came home she was just under 2.5 pounds. Dingle is anywhere between 8 and 11 depending on the vet visit and particular weigh-in. At first I was worried that Dingle would hurt her, by accident, while playing. Now I'm not. She's one tough pup and she can hold her own. She clamps onto Dingle's face, bites him, etc. and he has never once gotten aggressive with her. He loves his sister.

Here's a video of them wrestling in one of the many dog beds that fill my apartment. It's not a particularly interesting video, just a few minutes of them doing what they do best. Dingle is making the high pitched noises, Razzle the Gremlin-like ones.



Razzle loves food more than anything in the world. I've been feeding Dingle on my bed (not the best idea, but whatever) and guess what the newly 3 pound Razzle did two days ago? Took a flying leap onto the bed for Dingle's food. I was shocked, even though my lovely Ikea bedframe isn't that high off the ground. But I'm not impressed with her newly aquired skill because being able to get on the bed means the possibility of falling off.

Luckily Razzle is in an exercise pen when not supervised, including when I'm at work. Now that we are somewhat settled in to our new home after the April 9th move we are in a routine. When I work they sleep at night, have a few hours of playtime when I get home and then we all sleep.

That's been the last few months in a nutshell. Remember, life can change so quickly...

Another New Bed!

Since November I have bought Dingle 3 beds.

He now has 4 beds - 2 in the bedroom and 2 in my work area, also known as "Dingle's area" as he's baby gated in there when we aren't home.

I am most excited about his newest bed. I saw it on the Southern California Pomeranian Rescue's Facebook page.

As soon as I saw it (with the cutest rescue pom laying in it) I went on EBay and ordered one for Dingle.

It arrived today.

Dinglehopper loves his new Sock Monkey bed:







The Sock Monkey bed stacked on one of his other beds:

Cold Weather

It's been very cold lately and Dingle hates the cold.

The other morning I took him out to go to the washroom and he pooped, but got too cold before he was able to pee. I kept encouraging him to go pee, but he just stood there staring at me, on two legs (because his paws were cold), half leaning on a snowbank for support.

Dingle's paws get very cold from the snow and sore from the salt. We've tried boots (at least 3 pairs that I can remember), but he refuses to walk... so it's a lose-lose situation.

I end up carrying Dingle back to the building a lot.

We don't have the heat on in our apartment because it's soooo hot in here.

The digital thermostat says 80 degrees. 78 if we have the livingroom window open (which we do often). The ventilation in here is so bad... while the rest of the apartment is sweltering the bedroom is cold (not cold enough that we use a little portable heater, though).

Dingle likes to snuggle up in our bed and keep warm, especially lately when it's been extra cold in the mornings:

"Why is there a pill in the bed?"

Just when I thought Dingle's crotch was back to normal it turns out it wasn't.

Dingle is on Clavamox, an antibiotic, as we believe he may have an infection causing discharge of the penis. Gross, I know.

So Dingle has been on Clavamox since last week.

A few days ago I made a comment on it seems like in the last 5 years Dingle's been on a bunch of medications. I can shake a pill bottle and Dingle comes running. I said that Dingle was so good with taking his medications.

Well, last night didn't Dingle prove me wrong.

As my boyfriend was going to bed he says "why is there a pill in the bed?"

He dropped it in my hand and sure enough it was one of Dingle's Clavamox pills.

I thought "little buggar - must have spit one out" and I thew it in the garbage.

Hours later I get into bed and by my pillow is a second Clavamox pill.

I have no idea when the pills got there - sometime in the last week.

When I give Dingle the pills I watch him for a minute or so to make sure he doesn't spit them out.

On the rare occasion when he's being feisty I put the pill in the back of his mouth and gently hold his muzzle until he swallows.

Yet somehow Dingle has managed to secretly hide away the pills, without swallowing them, until I turn my back (or he runs away)... when he then proceeds to spit them in my bed.

Oh Dingle.