Tuesday, November 26, 2013

5 Days Later

Some dogs moan when they get their tummy  rubbed, or when you nudge them.  This is not typical for Darby, she's not a moaner...but Wed. and Thursday (21st) she moaned every time I moved her.  My siren went off.

As I mentioned during my last post, I gave Darby her first PepsidAC on Thursday.  She was in severe pain from GI upset.  It could have been the piroxicam or baytril, or both.  Nonetheless, as Dr. Pam said, "we need to stabalize her".  Pepsid for 3-5 days then add on the Standard Process supplement.  It may take 3-4 weeks.  This Thursday will be one week.

Lesson:  There is a dosage amount and it starts at 0.25 per 1 pound.

We had a really tough Friday evening.  I had my neighbor Mary and Lydia here with us.  We all talked about what to do because Darby just did not look good.  She was sick, exhausted.  Was it time to let her go.  Cohesively we all agreed that we should try to get through the weekend.

She ate OK on Friday and Saturday evening, but had a little suprise Sunday morning.  Undigested food.  It was obvious that her gut was still so weak and irritated.

Puree and liquids Sunday, and monday.  She seemed to be getting better, more alert, staying awake longer.

Today, the little princess is coming back to normal.  She ate solid food, homemade of course.  Milestone.  


Sunday, November 24, 2013

The Holistic and Homeopathic Approach - Doctors of Vetenary Medicine

The approach to wellness is different for everyone.  My belief is that the body must be in harmony and in balance to be able to heal. So, with that being said, back in '09 I found a holistic doctor and a homeopathic doctor to help Darby.

It's cold in Texas.  41 degrees, gotta keep Darby warm.
Dr. Charles Loops became more prevalent in her treatment because of how gentle homeopathy was on the body. Dr.  Loops has been a doctor of vetenary medicine for 32 years.  Ten of these years he practiced traditional veterinary medicine or western approach, and the other 22 years he has practiced exclusively homeopathic medicine or the eastern approach.

After a 2 months of extremely potent chemo drug, I relied exclusively on Dr. Loops homeopathic approach.  It is an extreme commitment, but Darby is still with us today.  Dr. Loops has also been working with me on trying to find a solution, or remedy for her bladder issues, and her tumor. 

If you would like to learn more about Dr. Loops, visit his website.   http://www.charlesloopsdvm.com/

The other "eastern" vet on my team is Dr. Pam Montgomery.  When I went to visit Dr. Pam in '09, I was actively trying to figure out my strategy for treating Darby's lymphoma.  I saw her almost immediately.  Dr. Pam practices "Chinese" medicine (herbs), and she also does Acupuncture.  At the time, for some reason, I felt that the chinese herbs approach for the lymphoma was not the right approach, (she referred me to Dr. Loops) ,but I did rely on Dr. Pam for everything regarding nutrition. We talked about starving the cancer, and preparing her meals.  We talked about supplements: multivitamin, digestive enzyme, pro biotic, fish oil and antioxidants.  From 2009 to present, I have abided by her rules of nutrition, and thankfully, I have been able to keep Darby extremely healthy and strong.

Dr. Pam is now involved with Darby's bladder issues...and like she said, "we have a challenge ahead of us".  We have to rebuild.  Darby has been fighting this UTI / tumor issue for 12 months and we have to bring out the big guns.  During our recent visit, Dr. Pam couldn't prescribe much.  Darby is not stable enough and she needs to speak with Dr. Loops. The Piroxicam and the Baytril have irritated Darby so bad that we must get her tummy feeling better, and ensure that her digestive system is working properly.  Right now we must use the Pepsid to stablize, but hopefully we can transition off of it eventually.  Dr. Pam did prescribe, Standard Process Enteric Support.  This will help in the rebuilding process.  We expect to see results in 3-4 weeks.  While I am stabilizing Darby, Dr. Pam will work with Dr. Loops.  It is important for Dr. Pam to speak with Dr. Loops to ensure that the herbs she eventually prescribes don't interfere with the Lymphoma/tumor remedies that Dr. Loops already has Darby on.

If you would like to learn more about Dr. Pam.  You can visit her website here:  http://www.vitalitypetcare.com/pages/resources.htm

I would suggest you read her Harvest 2013 newsletter.  It will blow you away.  http://www.vitalitypetcare.com/assets/pdfs/Harvest2013EducationalNewsletter.pdf

Same Day (11/23) later in the afternoon.  It's a little warmer.
Just a few days ago, we ran an urinalysis to see if Darby had any remaining bacteria in her urine.  Unfortunately, there were some "rods" present,  I don't know their exact complexity, but I do  know that it is a bacteria, and I know that they are very difficult to get rid of.  Typically we would not send off a free catch, but this one was a must.  Deep down in my gut, I know that there is a bacteria that is re-occurring, and this one might just be it.  I also asked for an ultrasound as well as blood work.  Thankfully, Darby's white blood cells (WBC) continue to increase.  When she was admitted to the hospital on 10/16, her WBC was at 0.98, keep in mind, the range is 5.5-16.9.  When blood work was run on 10/21, her WBC had increased to 5.65, and on 10/22 her WBC was at 6.85.

Overall, Darby is doing well, she is not in as much pain as she was on Monday, Tuesday and Wednesday.  She is eating, but still having some difficulties with nausea.







Saturday, November 23, 2013

Piroxicam and Baytril

I once read in a "Parents" magazine that animals are the best teachers of "COMPASSION" for our children.

What is compassion?  Compassion is the feeling of empathy for others. Compassion is the emotion that we feel in response to the suffering of others that motivates a desire to help.  In the context of being a pet parent, it is our responsibility to see the signs and get help.  They are not able to verbally articulate, so these cues come from their behavior, how are they acting, do they have a sparkle in their eye, are they sleeping more, I could go on and on.  At the end of the day, our job is to make things better. Now, to what measure? That is really up to  you.

Because I don't have any children, Darby, Duncan, Codie, and Birdie are my children. Duncan and Birdie are happy go lucky, and in good health.  My Codie, well, she is an old lady, but still going strong, and you know about Darby.  Darby is the reason for this blog.  She has provided an avenue for me to help others.  Although everyone journey is different, I hope that I can provide some insight and some clues to help you through yours.

Where we left off:
I loaded Darby up on Colostrum over the weekend, and it seemed to have helped, she had an ok Saturday, and a pretty awesome Sunday.  The spring was back in her step, she looked strong, she ate well, everything was looking up.  Come Monday, and Tuesday, I noticed that she did not want to eat.  Through varying degrees of enticement, I was able to get enough food in her so that i could administer her medication, but she needed more.  It was later that evening that I remembered an appetite stimulant that I had, so I gave her one.  Sure enough, she ate well on Tuesday a.m. and p.m.  However, something was not right, there must have been something else going on because she started to obsessively lick  her paws, she even started to lick her babies.  Darby usually exhibits this behavior when she is hurting or sometimes when she has an upset stomach.  I worried all night, regretting the appetite stimulate this evening.  I decided to let her eat on her own on Wednesday, but unfortunately she did not.  This was a huge sign.  Darby was not feeling well, something else was wrong.  I contemplated all night on what to do.  As Darby's mama, its my responsibility to gauge her quality of life, and assess her future.  My baby girl has a UTI that has not been controlled, and she has a bladder tumor.  These two combined are terrible, however, they are under control and under extreme supervision; therefore, there must be something that I am missing...How can I solve this problem? CAN I solve this problem?

I woke up early on Thursday, not feeling well, and I had also decided that I would let my baby go.  I called my mom, and she came over, I called my neighbor Mary and she came over, my roommate Lydia whom I had not seen all morning was also caught by surprise.  I just wanted to make things better for her.  I walked into Dr. Allen's office with the intent of saying good-bye.  He walked in and talked to me a bit, answered my questions, and if I decided otherwise, he even helped outline a "plan".  He left the room, I needed some time to think.  Then, an epiphany...the medicine, its the medicine.  There is something about this medicine that is not sitting well with her.  She has given me cues all along, I did act on them, just not in their entirety.  The first time I saw her getting irritated was 7 days into the Piroxicam, so we started her on the antibiotic, then next time I saw her get irritated was 2 days into the antibiotic. Darby was missing an antacid all this time.  PepsidAC had a tough job to complete.  Now for all the unwinding to begin. 


Saturday, November 16, 2013

My Inner Voice - She's Not Improving Fast Enough

I'm awake again, its 4 a.m. on Saturday.  Thankfully, I fell asleep relatively early.  I wish I could say that I see significant changes in Darby, but I can't, I do see some changes though.  For someone that expects things to happen relatively quickly, this is so difficult.  Six p.m on Friday was 48 hours since I first administered the antibiotic Baytril (http://www.drugs.com/vet/baytril-enrofloxacin-antibacterial-tablets.html).  The discomfort she was exhibiting on Tuesday and Wednesday afternoon have dissipated, however, there seems to be an added layer of nausea.  I am also afraid that this antibiotic is not working as well as I want it to (mind you she has been on at least 5 others this year, so resistance is my fear. 

During my last post, I had mentioned that we really didn't know where the infection was, however, I think we have pin pointed it.  Since her sterile urine shows no signs of bacteria, however, there is obviously bacteria when the  urine exits the body.  The thought is that the infection is in the urethera.  This completely makes sense.  Her hind legs are shaking a bit, not as much as they were on Monday and Tuesday, but they are.  This leads me to believe that she is uncomfortable.

As an obsessive compulsive momma, I have consistently checked her temperature for the past two weeks.  I've even charted it.  She consistently stays around the 99 to 100 area...my 3rd sense told me to start checking more frequently.  Her temperature is  has been at 100.3 to 100.5, so it has increased the last two times I've checked.  Dogs normal temperature is 99 - 102.  Because I've sensed her discomfort, I have increased her liquids, and her intake of EverPup (www.everpup.com). As soon as my clock turns 8 a.m.  I'm headed to the sunflower shoppe to purchase some Colostrum. http://www.tbrlabs.com/product.php

"Bovine Colostrum provides instant antibody protection and destruction of infective bacteria, viruses, fungi and cancer cells. It is an old remedy that was relied upon before chemicals and antibiotics. Today the orthodoxy is in a losing battle with the infective organisms that have the capability of mutating, producing antibiotic resistant strains, and growing at faster numbers than the drugs can kill. It will always be so- this is the genetic code imprinted in the organisms that assure their survival. This is the beauty of Colostrum- the organisms have no time to reproduce. Colostrum’s healing affects are multifaceted. Recommend it in all ill animals and people no matter what the cause, in arthritic, allergic and autoimmune conditions. Colostrum comes in capsules or in loose powdered form.  (http://www.holisticvetpetcare.com/Bovine-Colostrum.htm)

This fight is tough folks.  I constantly step back and ask myself if I am doing the right thing.  Not only is it tough fighting the unknown, its tough not being the expert.  Although I am not the expert, I will compulsively ask questions and challenge the professionals to get the answers.  If for some reason I've received the information too late, I at least have it for someone else.

Thursday, November 14, 2013

NEGATIVE, NOT POSITIVE, NULL

I received a phone call from Dr. Allen at 5 p.m. today.  He said that the culture came back "NEGATIVE".  You would think this is good news, but, well, it's not.  It is not good news because, now we do not know where the infection is.  Like I told my mom, "its in a pipe somewhere", just don't know which pipe..

Regarding how Darb's is feeling.  Well, thankfully she is feeling good.  The past two nights were so difficult, and it was obvious she was not comfortable, and maybe in some pain.  Tonight, she is doing well.  She seems a bit tired, but she is doing well.  The antibiotics must be working.

THE PLAN:
Since Darby does not have infection in her bladder, but does seem to have an infection somewhere.  We are going to keep her on the antibiotics for a while.  Maybe take a little break, but continue the therapy for a while. She will also maintain her dosage of piroxicam.  I don't want to keep her on either of these two indefinitely, but I have to for now.  I eventually would like to give her homeopathic remedies as well as the holistic therapies a chance.  But I'm no fool, if I have to have her on them long term, I will just have to adjust diet and supplements accordingly.




November 14th - WAITING CULTURE AND SENSATIVITY TESTS

My Wednesday started early, 1:30 a.m. to be exact. The report that we received on Tuesday from A&M worked a number on me.  

As I had mentioned, the sample was sent via overnight on Monday for Tuesday a.m. delivery.  Hopefully they plated the the sample and started the bacteria culture and sensitivity tests. 

What is the culture? 
A urine sample is kept under conditions that allow bacteria and other organisms to grow. If few organisms grow, the test is negative. If organisms grow in numbers large enough to indicate an infection, the culture is positive. The type of organisms causing the infection are identified with a microscope or by chemical tests. 

Sensitivity, what is this? 
The bacteria are allowed to incubate for a day or two, and then the plate is examined to see whether the bacterial growth is inhibited (or not) by the antibiotics on each disk.

  • SENSITIVE: In this case, a clear, circular "halo" (technically known as a "plaque," or zone of inhibition) will appear around the antibiotic disk, indicating an absence of bacteria. The antibiotic has inhibited their growth and/or killed them, meaning that this particular antibiotic should be effective against the infectionn.
  • INTERMEDIATE: A somewhat cloudy plaque indicates that not all the bacteria in the area around the disk have been killed. This means that there are some members of the bacterial population that are sensitive to this particular antibiotic, but others that are genetically immune to its effects. If an antibiotic to which the bacteria show "intermediate" sensitivity is used, it is likely that the sensitive members of the bacterial population will be killed, and the resistant ones will survive, resulting in the selection of a population resistant to that particular antibiotic.
  • RESISTANT: In this case, the filter paper will have no discernible plaque around it, meaning that the bacteria are growing normally, even in the presence of the antibiotic. An antibiotic producing no plaque will most likely be ineffective against the bacteria. 


The Petri dish in the image above (shamelessly borrowed from the University of Wisconsin at Madison online Textbook of Bacteriology, which includes a more detailed explanation of the appearance of the halos used in bacterial identification), shows bacteria being strongly and moderately inhibited by most of the antibiotics (impregnated on circles of filter paper), but unaffected by the antibiotics on the disks located at 5 o'clock and 9 o'clock on the dish. 

In three to seven days after the sample is taken, the vet will receive the results from the lab, including the species of bacteria and the range of antibiotics to which the bacteria are sensitive (S), resistant (R) and intermediate (I). Again, "sensitive" means that the bacteria were inhibited or killed by that particular antibiotic, and this is what you want to hear. 

Continuance on Darby:  I saw Darby getting more and more uncomfortable, and really debated on putting her on an antibiotic prior to the culture and sensitivity test being complete.  She has been on at least 3 this year and obviously none were effective.  Dr. Allen suggested Baytril.  Because I want the tests to be efficient and correct, I decided to put her on an antibiotic that could possibly help her feel better.  We may need to change it but at least she is one one now. I couldn't have her continue with this for more than 48 hours, keep in mind we had a pretty big sign last Thursday when we put her on the Piroxicam.  So from Thursday to Thursday would have been 7 days, and adding another 2-5 days is a big deal. 

KNOWLEDGE IS POWER...LEARN AS MUCH AS YOU CAN!  



Wednesday, November 13, 2013

Another Sample for Culture - To A&M it Goes

We had a sterile sample taken on Monday 11/11 to be overnighted to A&M for culture...I need to know what the bacteria is...

Darby has been doing well, the Piroxicam seems to be helping, but we still don't know if this tumor is Transitional Cell Carcinoma or cysts due to chronic infection...Its a waiting game...

After a brief e-mail to Dr. Allen's office I receive the report from the Pathologist at A&M...It's complex, but pretty detailed...Now, I'm sick to my stomach.  My anxiety level is so high I can't think straight.  I'm sick with worry...

I pace back and forth as I chat with different friends.

My dilema:
- Darby's report shows bacteria...it shows a chronic infection...My friend Erica talks about exhausted neutorphyls.  These are signs that her body has been fighting something...
- Darby is only on a anti inflamatory / pain reducer, she is not on an antibiotic
- We have to wait 48 to 72 hours for the culture to grow bacteria

I'm nervous, I feel like I have no control.  How can I let her have this infection for another 48 hours.  How?  Can Darby hold up?  I'm watching her like a hawk now...obsessively compulsively watching her.  She is urinating more often, what does that mean?  She doesn't look right...the questions, the concern...I need peace to settle my fears...I need to TRUST.  The insecurity is overwhelming...

The questions going through my head:
  • How do I preoccupy my mind for the next two days?
  • She is stretching out on the bed, that's a good sign...
  • Do I take her to Dr. Allen's tomorrow for observation?...I'm sure they are sick of me by now.
  • Do I start her on an antibiotic before we receive the culture?
  • Is she OK?
  • What if they can't grow the bacteria, am I ready?
  • If I don't take her to Dr. Allen's, I'm going to ask my mom to come visit Darby at lunch...
  • For all I know, she is probably fine, and I am worrying for  nothing..
  • There is no way i can get back to sleep now (woke up at 1:30 a.m), waking up time is in 1.5 hours.
All I can say is that this is so difficult.  I don't want to give up on Darby.  I want to do as much as I can no matter what.  I'm thankful to have friends and family that will help me through this process.  I want to make sure that I am not looking at the situation through rose colored glasses.