Daisy Mae - our sweet Daisy has crossed The Bridge

[doxiesrock912]

Green is better than red apparently in the case of poops. :-)

[goldengirl88]

You got that right! Do not want to see red ever!

[lulusmom]

Hi Valerie,

I haven't posted to your thread during Daisy's most difficult times but I've been following along and am so happy that your girl is doing much better. It would be really great if you could call the vet and ask him which treatment he is contemplating next. You are Daisy's only voice and he should not be too busy to answer a simple question so that you can familiarize yourself with the treatment before your meeting. If you post that treatment here, we can help you be much better prepared to advocate for Daisy during that meeting. How can you ask appropriate questions if you haven't done your homework, right? Consider all of us your personal tutor. :D

Glynda

[doxiesrock912]

Dr. Foreman's first priority is to get Daisy better, then regret and determine the new plan from there. They usually have the results of the ACTH one or two days later.

[lulusmom]

I understand that getting Daisy better is the first priority but you said he mentioned an alternative treatment for Cushing's going forward so why not find out what that is now so you can do your research and be prepared?

Glynda

[doxiesrock912]

Daisy ate breakfast but we had to syringe dinner. Strange thing is that her poops are a better color according to Dr. Forman when I described them to him yesterday. Hoping she is just having an off night.

Got the queen to eat ice cream and meat flavored baby food. It's something.

[goldengirl88]

Valerie:
Oh dear, I am just hoping that there is not some underlying issue going on with her. How is she this morning? Has she been acting like herself when the eating stopped? How about her poop, still good? Poor little girl had had enough of being sick. I hope it was just a one meal thing and not the start of something else. Blessings
Patti

[gatorgirl_bama]

Bless your heart Valerie. I know what a toll this is taking on you. Just wanted you to know I'm thinking of you and Daisy Mae. I wish I had advice to give, but since I don't, I'm sending love and prayers instead.

Donna

[flynnandian]

i hope to hear from you that daisy has her appetite back.
does she have a favorite food? maybe tinned cat food? or people food?

[Trish]

Hi Valerie

How is she doing today, sorry she is not eating. That is a worry.

She might be feeling off with the antibiotics, can cause dodgy poops too. Is Daisy up to date with worming? I would not do it while she was sick but just something that crossed my mind.

I guess we are still up in the air about what caused the symptoms she had before she crashed on the meloxicam and adequan so hope nothing there is still causing problems. Glad you are in close contact with the specialists so you can hopefully nip anything in the bug.

Hope Daisy is feeling better today xx

[goldengirl88]

Valerie:
How is Daisy, I am worried as I have not seen any updates after she would not eat? I am hoping the situation is better and that you two are just taking a break from it all. Blessings
Patti

[molly muffin]

Hoping Daisy is doing okay. Checking in on you

hugs
Sharlene and molly muffin

[doxiesrock912]

Today was Chris' birthday and we spent part of it at the hospital with my father. While I was waiting for an update on dad, Chris took Daisy back to Cornell.

She stopped eating period, got lethargic again, no vomiting but had two extremely loose poops outside and when I brought her inside and rinsed off her butt - it looks so sore and a drop of fresh blood dropped onto the kitchen floor mat.

Got the update on dad. Not pneumonia, but bronchitis and they are keeping him for at least tonight. I probably won't know anything about Daisy for awhile.

STILL haven't heard from the vet who gave her the NSAID shot and I'm ready to blow into his office like a whirlwind tomorrow.

I know that I don't need to ask, but please keep us in your prayers.

Thank you

[Tina]

Oh gosh Valerie, I'm so sorry to hear all of this from today. I'm glad they are keeping your Dad, I hope they get a quick handle on the bronchitis.

And poor Daisy. Is she getting oral clavamox? I wonder if maybe that isn't agreeing with her. I know it can cause nausea and gastritis, Jasper is still taking it and gets reglan along with it to help with the nausea. I wonder if she might have colitis now from all the stress. After Jasper's first Addison's crash, he ended up back in the hospital a couple of days later with HGE, and he had bright red blood like that. I am sure it was due to all the stress, and he had no cortisol in his little body to counteract it. It was very scary.

Do you have any news on Daisy? You are both in my prayers.

Big hugs to you.

[doxiesrock912]

Yes, oral Clavamox with food also Pepcid AC.
She hasn't vomited at all since being out of the hospital though.

Chris just got to Cornell with her and they're checking her over now. Looks like she's dehydrated again already.

[Tina]

Dehydration can happen very quickly with colitis, and especially if it is HGE. She will probably need IV fluids.

I think I may have read somewhere that clavamox may react with antacids.

[doxiesrock912]

Oh that's just great and explains the sudden downturn I think. Can you give me a link that I can share with the vet please?

Thank you

Cornell just called. They're concerned because Daisy's lungs sound crackly and she's breathing hard. Her lungs have been clear all along until now. She fought me when I fed her with the syringe and the ulcer medication has to be dissollved in water and given via syringe which she didn't like either. Could this have cause aspiration pneumonia? The other cause would be heart failure. Low estimate of $3500, high estimate of $5,000+.

This SUCKS.

[Trish]

Blardy hell, poor Daisy :(

Sorry to hear about your Dad too Valerie, gosh when it rains it pours sometimes. Thank goodness Chris was around to whizz Daisy to Cornell.

Was the blood coming from her butt, you said it looks sore so was wondering if it could be from skin irritation? I hope so, that would be better than fresh blood poops.

What did they say about her lungs, surely they can do an xray and see if it is pneumonia or her heart?

Have you heard any more yet?

xx

[doxiesrock912]

They don't see evidence of pneumonia or heart failure on the xrays. Possibility of having thrown a clot due to Cushings?

She's resting comfortably in an oxygen chamber.

I wiped her butt and it looked SO SORE so I'm sure that's where it came from.
She pooped very loose, dark brown stools earlier.

[Trish]

Well I am pleased to hear that the blood was likely from skin. :)

Are they treating her for a blood clot with anticoagulants?

[doxiesrock912]

They're not sure that's what it is yet. She's comfortable and they're giving her IV fluids and antibiotics and someone else (some kind of specialist) and Dr. Forman will look everything over tomorrow.

She got dehydrated and super lethargic again.

I expressed my concern over the number of medications that they sent home with her after the other hospital stay and how they might be affecting her appetite etc and they're going to see if any can be eliminated but said that all of these were being given during the last hospital stay and that she was fine with them.
I just don't know.

Now I have nothing left in the savings. The high estimate is $5,800.

[doxiesrock912]

I found this.

Symptoms and Types

Fatigue
Cough
Lack of appetite (anorexia)
Sudden difficulty breathing
Inability to sleep or get comfortable
Increased breathing rate
Spitting up blood
Exercise intolerance
Pale or bluish-colored gums

Treatment

Dogs with PTE should be hospitalized, primarily for oxygen therapy. If the dog is not receiving enough oxygen to its heart, lungs, or brain, the veterinarian will recommend rest in a caged environmentl this is generally due to hypoxemia or syncope. However, the underlying cause of the condition will be treated once your veterinarian has settled on a definitive diagnosis.

Living and Management

Unfortunately, this disease is usually fatal. Unless the underlying cause of disease is found and corrected, pets will often suffer a recurrence of PTE.

Your veterinarian will schedule weekly checkups with the your dog to monitor its blood clotting times, since anticoagulant medications can cause bleeding disorders on the opposite side of the scale. The new low-molecular-weight heparin anticoagulant medicines are much safer for use, but they are also more expensive.

Close supervision of your pet, and contact with your veterinarian will usually be sufficient, especially since your dog may need to be on anticoagulant medication for several months.

Doctor approved physical activity, or other physical therapy, may improve blood flow. Your veterinarian will be able to advise you on the appropriate activity for your individual pet's needs. The goal is to prevent future PTE in immobile dogs with severe disease.

[Trish]

Well lets hope it is not that then. I guess they will have done blood gases to see where her oxygen levels are sitting.

I wonder if they will scan her, chest and abdomen at some stage. Was she short of breath and panting before you took her in?

[doxiesrock912]

Not panting, breathing rapidly. Yes, bloodwork and she's in an oxygen cage.
Could this still be a part of the NSAID toxicity?

The symptoms are the same.

[Trish]

Well I guess it could be, what are her kidney tests like tonight?

[doxiesrock912]

I've only heard about the xrays. Dr. Forman is in tomorrow and I told them that I want a phone call from him asap in the morning.

My eyes are on fire from all of the crying. Poor Chris' birthday was today. He's such a good sport. I apologized for everything negative today and he said "It's ok. I have another one next year."

The cats sense that something is upsetting me. Annabelle Lee brought me a stuffed toy mouse. Dropped it on the carpet and meowed to get my attention. She's never done that before!

[Trish]

True that, about the birthday!! Well I hope Daisy has a settled night and you get some answers tomorrow. So hard when it is up in the air like this.

I cannot believe your prices, Flynn had an adrenalectomy and all scans and aftercare for <$5K... they are outrageous.

[doxiesrock912]

Yes, they are and they won't begin treatment until you pay the required deposit.
I had to drive to the bank and make a transfer through the ATM. Can you imagine?

[Trish]

No I cannot imagine, that is awful. I guess they sustain a lot of losses doing it the other way around. I just cannot fathom having to do that.

With the IMS, we have to pay before we take them home and they give you an estimate up front.

With my local vet, he knows us so well and knows we always pay that I just pay when the bill gets up a bit. Plus he is hopeless at sending the bills through on his computer system so they never ready on time. Suits me!

[Tina]

Oh my gosh Valerie, poor little Daisy. I am going to think positive and that it is not a PE. I hope it is not that. I wonder what has caused her to become dehydrated so quickly again. I hope her kidney values are all still ok.

As far as the clavamox being given with an antacid, I am pretty sure it was an absorption issue which would decrease the bioavailability of the drug. I am not sure where I read it, probably found it by googling clavamox. But that would not account for her current issues.

Valerie I don't know what to say other than I am so sorry for all that you are going through and I hope that she stabilizes over night and that they are able to shed some light on things in the morning.

I'm so glad you have Chris, he is a great support.

((Big hugs))

[doxiesrock912]

Trish, I'm trying to be positive but as I sat outside waiting for Chris to come and take Daisy, I had her in a small bed on my lap curled up in a blanket and all I could do was cry and tell her how much I love her and apologize for every time I've been impatient or frustrated with her. In my heart, I felt like I was saying goodbye and I pray that this is not the case.

Daisy looked up at me and I swear when I was crying the hardest, I heard her cry very, very faintly. Is that possible? Do they recognize the love in our voices?

Once again, I'm crying hysterically.

[Trish]

Of course they do, they do not just get love from a voice. They get it from our whole beings... Daisy would have always known you love her so that is a given!

[doxiesrock912]

I hope so. I've been so impatient lately, I just want her to get better and this rips my heart out. Not to mention that I haven't heard a word from Dr. Kimm during all of this!

I'm sitting in this house alone and I can't stop crying. The poor cats are perplexed.

I'm always the one who does everything for everyone and aside from Chris and dad, who for obvious reasons are not here with me, there is no one who I can call to come over. That's pretty sad.

[Trish]

Crying hysterically is not going to help and will give you a headache!! Big breaths and blow your nose!! She might just not be over the crisis earlier in the week and need some fluids and rest. So I am hoping for the best here and with Tina that I hope it is not a PE. They are hard to diagnose in dogs, so lets think the best until we know otherwise OK. Was the Dr tonight positive in tonights prognosis? Sometimes they say, it could be this, it could be that. But really sometimes with our doggies it can take a while to fully declare itself, like look at scan results where they say it could be intestinal thickening, could be cancer, could be colitis. They cover their bases, so lets be positive and send good vibes Daisy's way!

[Trish]

Ya know, I would not even be worrying about Dr Kimm right now. Especially if he is going through his own crisis as you mentioned. I thought you have always been happy with him and how he worked with IMS. I think he did his best with the information he had on the day. You need to keep your mind on the positives and not focus on negative energy...

[doxiesrock912]

God I pray that you're right and I'm overreacting.

Daisy is my child and the cats are too, but Daisy was the first MY companion and not for the whole family. She chose us and I don't want to fail her now, especially now.

[Trish]

You have every right to be upset for your babies, I just want you to be in reasonable shape when you go to her tomorrow, you can react however helps you get through this Valerie!

[doxiesrock912]

I'm applying for Care Credit right now.

[Trish]

Good thinking! Least that will give you time to pay it all off.

[Tina]

Hugs Valerie, I wouldn't have anyone to call to come over in the middle of the night either, don't feel bad about that. I understand how you feel about Daisy, Jasper is my child also.

[doxiesrock912]

Well, Care Credit is apparently experiencing technical diificulties and this is what I get when I click "Apply".

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I tried Internet Explorer and Google Chrome.

[doxiesrock912]

Thank you. HUGS.

Everything is piling up and there is no one in close proximity who helps me. Yet, they call me when they need something (usually a computer issue). I think that I'm going to start charging. Seriously.

Daisy and I had a connection from day one. There was no adjustment period. I have the same relationship with Gracie. Annie has taken awhile to trust me.


The chat person on the Care Credit websit said "it must be a technical difficulty" then they wanted me to take a survey. My response to that was "when your website works properly, I'll take the survey."

[Trish]

Leave it until tomorrow, probably just some glitch. I have no idea on that sorry. Can you apply over the phone?

[Trish]

Tina, you have all of us to come over in the middle of the night!!! Same as Valerie, we all look out for each other!

I wouldn't call anyone either, prefer to be stressed out on my own for some stupid reason! Works for me :)

[doxiesrock912]

I'll try again tomorrow.
Just called and Daisy is resting in the oxygen chamber. I hope that they let her keep her blanket with her.

I asked if I should get in the car and drive to be closer, and they said that they didn't think that I need to.

[Trish]

YAY well that is good news!!! Are you going to head up in the morning, or stay and see what is happening with your Dad and when he will be discharged>? Where is Chris? He is a gem!

[Tina]

Yes, we do have each other here, and that is a wonderful thing.

I know what you mean Trish, I typically wouldn't call anyone either. It kind of sucks for me, I have no family in town (other than my Nana in assisted living). So it would have to be a friend. As good as my friends are, they don't completely get it when it comes to my dogs. No offense to them, it is just different for them with their pets. So I am usually on my own, except for my friends on this forum of course.

[doxiesrock912]

Chris brought Daisy to Cornell for me because at that point, I hadn't heard from the hospital in regards to dad. I'll wait until I hear from Dr. Forman. I asked that he call me right away.

It's 4:15am. I'm going to try to get some rest.

Thank you for being here with me. XO

[doxiesrock912]

My best friend gets it but she got engaged recently and he moved in so she's been less accessable.

[Trish]

Hope you get a few hours sleep Valerie, its often times like this we run ourselves into the ground. Just a few hours can really make a difference, I sure hope tomorrow is a better day for you and we can hear some good news about Daisy. Nighty nite xx

[Tina]

Me too Valerie, I will be watching for updates tomorrow. And of course keeping the positive thoughts going for Daisy.

[labblab]

Val, I am so sorry that Daisy is back in the hospital! I am sending healing wishes to your little girl and will be anxiously checking back throughout the day. I will be hoping so much for good news.

Many healing wishes flowing to you, too.
Marianne

[gatorgirl_bama]

Sending prayers to you and Daisy.

[goldengirl88]

Valerie:
This just can't be happening to you, my God girl I wish I lived closer to help you somehow. I am so sorry you are going thru all this. I hope your father gets over this bronchitis quickly and glad there is no pneumonia. Poor Daisy, there is obviously something that is being missed that is the key to all this misery she has been thru. I am so glad Chris could help you with her. I am praying for all of you and say a special prayer for Daisy at nite with Tipper. God Bless You All.
Patti

[doxiesrock912]

Still waiting for Dr. Forman to call.
Applied for Care Credit and got approved for $8,000.

No new news on Papa either.

[goldengirl88]

Valerie;
Well that's not too bad lady for not working!! Thank goodness as you can make smaller payments and it will cover whatever is going on today. Have you heard any news from Chris? He is definitely going to make a good hubby! Take care of yourself, all this worry is going to get you down, and everyone and everything depends on Valerie.
Blessings
patti

[Woodydog]

Oh my word Valerie I'm so sorry to read this tonight. I hope that you have some better news later on. Sending hugs and strength to you both x

[addy]

Oh Val,

I am so sorry to hear Daisy is back in the ER. I am sending love and prayers.

[Harley PoMMom]

OMGoodness Valerie, I am so sorry to hear that sweet Daisy is having these issues and is back in the hopital, I know you are very worried but for right now she is where she needs to be and is getting the best of care.

We are here for you, dear Valerie, and are waiting anxiously with you. Sending healing, loving, and comforting hugs, Lori

[Budsters Mom]

Oh no! So sorry to hear that Daisy has returned to the hospital. At least she is where they can keep a close eye on her.

Sending healing energy and wellness thoughts to you both. Hang in there Valerie. I know this is hard. Xxxxx

Kathy

[My sweet Ginger]

Dear Valerie, I'm just so crushed over this and so sorry that you have to go through this again. It's just not right for neither of you.
Will pray hard for you and our little Daisy. Please, hang in there.
Many hugs. Song.

[molly muffin]

Dang! I can't believe Daisy has had a set back and in the hospital again. Poor little girl. She is trying so hard and I know she just wants to be home with you, but if this helps her and they can figure out a solid game plan to get her better, then okay, it's doable.

Valerie, you have us, we may not be right there in close proximity but we are never more than a finger tip away.

I'm so late in seeing this. :(

I hope by now, you have gotten some positive new for both Daisy and your dad. Enough of this, your family is due for some good vibes.

I'm sending every positive vibe I can to both of them.

hugs
Sharlene and molly muffin

[doxiesrock912]

Tina, you mentioned the Clavamox?
This might be what sent Daisy back to the hospital!

Dr. Forman is perplexed and I agreed to have another ultrasound done to rule out cancer or anything like that. I told him that she didn't stop eating cold turkey. She started to get finicky and then stopped so he's thinking that the Clavamox might be it. He also said that he wouldn't fault me if I decided to put her down. I almost flipped. I told him that I won't make that kind of decision without knowing what we're dealing with.

If nothing is found on the ultrasound, this also means that the meloxicam DID cause the first illness because Dr. Forman also said that the ulcers are healing already.

He wants to start her on Baytril instead of the Clavamox. She had that before for giardia and did fine.

[labblab]

Val, is she out of the oxygen cage, and are they now less worried about there being a respiratory issue, I hope?

[goldengirl88]

I am confused did I miss something here. I know I never read about an oxygen cage?? Is she having the ultra sound today Valerie? I am shocked at the Dr. saying he would not blame you for putting her down. Does he suspect something he is not saying? This is all a night mare for you Valerie, I wish I could help somehow. Blessings
Patti

[molly muffin]

Valerie. Big hugs.

They put her in an oxygen cage over night Patti.

Is there a reason that he would say that? Is she getting worse, or not responding to treatment or is there something else that makes him think that she can't be saved? I don't understand why he would say something like that.
Is it kidney? Liver failure or something dire they think they can't treat?

Valerie, take deep breaths. We're here.
hugs
Sharlene and molly muffin

[doxiesrock912]

Dr. Forman mentioned this before we discussed the possibility of Clavamox. Speaking of, I just looked this up and found that it shouldn't be given within 2 hours of an antacid and the same thing for Baytril so I call Cornell to discuss this!

I was not advised of this interaction and Dr. Forman didn't seem to know about this. What the hell? Shouldn't they know about medications that they are prescribing?

[goldengirl88]

Valerie:
I hate to say it but you seem to be a fix that I regularly find myself in. The one where you can only count on yourself and have to check and recheck everything everyone around you is doing! I am so sorry this is happening. Just thank God he did not graduate in my vets class, then you would really have a babysitting job. I am praying for Daisy the poor girl has been thru so much. Have you seen how she looks? I hope she still has her fighting spirit. Blessings
Patti

[labblab]

Val, are you sure you saw a specific interaction listed between Clavamox and Pepcid? I just looked myself and did not find anything. I think Tina is right that some antacids, like TUMS, can reduce the effectiveness of other drugs if given simultaneously and hence the general warning. But Pepcid is an entirely different class of antacid and I have found no issue about it myself in conjunction with Clavamox. There are several different classes of antacids and they do not all interact in the same way.

[doxiesrock912]

Labblab, here is the link http://www.petmd.com/pet-medication/clavamox

Dr. Forman agreed that the side affects are possible but rare.

I just got off the phone with Dr. Forman and I discussed the meds and asked that he be sure that they don't give an antacid within 2 hours of the antibiotic.

He saw chronic kidney disease on the ultrasound, distended gallbladder, enlarged liver, kidneys, something dark with the spleen and what looked like foreign matter or food in her stomach. Much of this consistent with Cushings but it appears that the Meloxicam did something bad all around.

He's doing blood work too but also finally admitted that he's very concerned about Daisy Mae and thinks that she might be failing.

I asked if the Meloxicam could've caused the kidney damage and he said it can cause damage but I think that there was already damage. He doesn't think that Daisy is going to die tonight but now I'm wondering why he didn't give any inclination of this earlier and I don't want her to die without me holding her.

She was very sleepy, breathing hard but not as hard as last night, her whole body was shaking rapidly too. She lifted her head though and was alert looking around and responding to my voice etc. She also seemed restless until I asked them to get her a larger bed and she stretch out nicely.

I don't know what to do.

They just changed her to Baytril. Should I give that a chance? Wait for the blood tests?
I don't to make this decision if there's a chance that she can pull through.

Bottom line. I don't want her to suffer of course but if there is a chance of recovery, than I have to give Daisy that chance.
Many of the symptoms that she's having point also to a reaction to the Clavamox which can be treated.

Correct me if I'm wrong, can't kidney disease be managed with food etc?

I have no experience to fall back on with this and I just need all of the facts so that I can make the best decision for Daisy. I love her so.

If she's not in pain, and there's nothing that they can do, can she come home?

[goldengirl88]

Valerie:
I am jut wondering what happened between the hospitalizations that now he is really worried. Is he giving you the whole picture?? I am crying typing this to you as I know you just don't know what to do. No matter what you do I am here for you, I can offer support and listen, I just wish I could do more. I truly don't know how you are handling all these situations. I am praying for you to have strength and to be able to make decisions. I know how I would feel if this was Tipper, so I am with you on whatever you do. I am praying for a miracle for Daisy. Valerie did Daisy have an ultra sound before this one? If so was any of this mentioned then? I hate to ask but, how is your dad? Does he know about Daisy? God Bless you Valerie, and may he give little Daisy a miracle.
Patti

[addy]

Val,

you need to know why the doctor thinks Daisy is failing- what is she exactly failing from?

1- what is the diagnosis?

2- can it be treated

3- how

4- what is the prognosis?


If it were my dog:


dont let them talk to you in general terms, make them be specific. Wait for the blood work- have them explain the ultra sound. Ask them to explain the blood work, make them tell you if there are any abnormalities, dont let them say "there isn't anything really there"

what stage kidney disease or is he saying that because "we see this in a lot of older Cushings dogs?"



are her kidney's failing?

[doxiesrock912]

He's saying chronic because he sees abnormal kidneys, enlarged liver, adrenal glands - all Cushings related. He said "I'm concerned that Daisy is failing. I don't expect her to die tonight." and then asked if I wanted bloodwork done to confirm. He still mentioned the kidney infection.

The thing is that Daisy has all of the symptoms of an allergic reaction to the Clavamox. She was very sleepy, more so than I've ever seen her but then she perked up and looked around laid her head in my hands, looked in the direction of every noise that she heard on the other side of the door. She was constantly trembling though. I don't know how to explain that. Fast, quick shakes of her whole body.

He changed the Clavamox to Baytril and the Pepci AC to another antacid.

Earlier today, before the ultrasound, he was talking about her coming home on Wednesday night if she improved.

Good question. I know that they did an ultrasound during the previous hospital visit and I was never told what they saw. I will ask this question for sure!

If it is the same, then how can he suggest that she's failing until the Clavamox is out of her system?

Patti, dad knows that she's back in the hospital but nothing more.

[Harley PoMMom]

Is Daisy's creatinine elevated? If not, has the creatinine been trending upward?

[doxiesrock912]

It was elevated on the last hospitalization but they got it within normal range before sending her home.
She looked bloated tonight but she looked that way at first the last time too and that subsided with treatment.

My concern is that both of these downturns in her health were due to reactions to medications, first the meloxicam. Now the Clavamox and/or Pepcid AC since I was not told to give the second two hours after the first.

If both ultrasounds are the same, what has changed between this time and the last?

I know that she has no problem with Baytril so that is what they're using now. When should we see improvement if it's going to happen?

[labblab]

Val, I think you can at least eliminate the Clavamox/Pepcid combo as the source of her new symptoms. As Tina said, I think the only issue in that regard is that some types of antacids affect the absorption of other medications if they are taken too close together. So the other meds may not be as effective, but the combo itself would not make Daisy sick. That's not to say that the Clavamox itself has not upset her GI system, however.

[doxiesrock912]

Ok. I just spoke with the nurse on call.

My conversation with Dr. Forman was at 6:06pm. Since then, Daisy has been on Baytril instead of Clavamox. She's out of the oxygen crate, out of ICU as of 7pm, and the nurse got her to go outside to pee. She said that Daisy reluctantly took a few steps too.

If she recovers from this without another hospitalization, I know that she can't take Clavamox or Meloxicam or anything in the family. I'm so confused.


Anyone with experience with chronic kidney failure, please chime in with feeding ideas, supplements, etc. If Daisy does come home, I want to keep her feeling well for as long as I can.

[addy]

Val, we are not there, you know Daisy better than anyone. It just feels like there is something else going on besides reactions to medications but we are not there speaking to the doctors or seeing Daisy.

Did you ask the doctor this question? You need to ask the doctor if this second incident could be related to the anitbiotic and if so how long would it take to see an improvement in Daisy? If you have to write things down, write them down when you speak to the doctor. If you need him to repeat something, ask him to repeat it.

I know it is hard to think when you are upset and really hard to then come here and write it all down so I know we here on the forum sometimes end up hearing bits and pieces of the conversation so we cannot follow along and give you advice.

When the doctor says he feels Daisy is failing is he saying just that her general health is not good because she is an older dog with Cushings and that the Cushings is causing Daisy lots of other issues?

Is Daisy mobile? Can she get up and walk on her own? Wait-0 we were typing at the same time- I see she got up and urintated

[addy]

Ok we were typing at the same time, I see Daisy got up and walked and urinated.

She is out of ICU.

[doxiesrock912]

Addy, I think a huge key will be to know how the ultrasounds compare to each other and what the blood tests indicate.

I spoke with the nurse tonight and asked if she's familiar with any pets reacting poorly to medications. She is and said that symptoms resolve pretty quickly within a day or two. The only thing they changed late tonight was to stop the Clavamox and give Baytril instead.

Dr. Forman did say that he believed the ulcers were healing nicely and the plan was to send her home Wednesday night. He commented that her stools were brown and not black tar anymore. Then he got the results of the ultrasound. How accurate are they in determining the stage of kidney disease? I'm guessing that the bloodwork will be more conclusive.

I asked the nurse if she thought that Daisy was in any danger tonight and she said no and that she was surprised that she looks better than she did late last night when Chris arrived with her 10:30pm.

I guess tomorrow will tell. By then she'll have the Baytril in her system and hopefully the Clavamox will be gone.

Before this ultrasound, Dr. Forman said that the Clavamox could indeed be the cause. It can make a dog not feel well and Daisy has all but one symptom of that.

I also asked the nurse if Daisy was still non-stop trembling tonight and she said no, it's off and on. She said that Daisy looks more comfortable overall.

[addy]

Ok good job, Val, then we wait for the results of the blood tests and we hope Daisy has a comfortable night and we will see what tomorrow brings.

(((((((((((((((HUGS)))))))))))))))))))))))

[doxiesrock912]

I forgot to mention that Dr. Forman commented that Daisy's stools were brown and not black tar. Overall, he seemed perplexed until he got the ultrasound. That is where the confusion lies for me too.

[molly muffin]

Valerie, I would want to know more about this kidney failure, the stage they think it is at and what her blood tests and urinalysis are showing in that regard.

Current levels of everything, write it down and get a copy and if they have done UPC's. Ask what stage it is at and if it is treatable. Others have kidney issues, that have had to be watched, Jasper, Flynn, Zoe did. But information is what you need the most of right now.

Also, what did was that showing in her stomach on the ultrasound. What do the intestines look like any IBD? Any fluid around her lungs, etc.

Gosh there is just so much to try and figure out and I think Addy is right, you'll have to make lists of questions for each item.

hugs
Sharlene and molly muffin

[doxiesrock912]

He thought it was foreign matter or food in her stomach. She's not one to eat things that she shouldn't so I'm thinking food?

He didn't mention anything abnormal with her intestines. Centered around kidneys, gallbladder, splean, and adrenals.

[molly muffin]

hmm... I hope that tomorrows blood test answer some questions and provide a clear direction on getting Daisy better.

Hang in there Valerie!
hugs
Sharlene and molly muffin

[doxiesrock912]

Thank you everyone!
I hope so too and that the CKF is treatable and that she has an appetite.

I am going to try to get some sleep and will check back tomorrow to compile questions before I go to Cornell.

[molly muffin]

Okay, I hope she is much improved in the morning.

Did you ever get an explanation about why the oxygen cage was needed? What caused the respiratory issue and how it resolved?

Do they think the dark spot on the spleen is significant and can they determine what that is?

Do they have the results back on the kidney tests? That seemed to have reacted more as a crisis last time (went back to normal with IV intervention) than chronic?

Just a few off the top of my head thoughts.

Get some rest
hugs
Sharlene and molly muffin

[Trish]

Hi Valerie

Crikey, what a day you have had. Hope you are getting some sleep tonight. Here would be my questions?

1. What is going on with her lungs? Is it serious? Is it PTE?
2. What is going on with her kidneys? A lot of dogs here, mine included have ultrasounds that show kidney problems. A lot are age related, specifically lack of cortico-medullary differentiation. On her reports it is noted she has been diagnosed with low grade renal problems previously Is that what they are seeing on the ultrasound? How bad is it? What are her blood tests for renal function like now? Do you think the initital renal problems she had last admission settled with rehydration then when she went home it deteriorated again - if in fact it has deteriorated significantly, but the numbers from the blood tests would show how bad it is now. If we get her kidneys right again (presuming they have gone bad now) what are the chances this recurs? How can a kidney infection that has not grown a bug be severe enough to cause this, or is it more likely due to toxicity meloxicam/adequan and now clavamox or general deterioration of her renal function as previously noted? Prognosis? I would not worry about dietary things for renal problems until you get a good handle on what is happening during these acute episodes.
3. Gut issues - I never realised she had a scan last admission. As you say, get comparison between the two scans and specifically on the kidneys, gut, spleen issues. Her gall bladder is not causing issues is it? How does he know it is ulcers and not something else causing the blood?
4. Infection? Is her blood work showing signs of this? Cultures?

That's all I can think of right now, hope that helps. And I REALLY, REALLY hope to read some good news tomorrow! Big hugs for you Valerie and Daisy too! xxxx

[gatorgirl_bama]

Valerie,
Sending lots of love and healing prayers for you and Daisy. I don't have any good advice that I can share, but I just want you to know I'm here and thinking about y'all. Please take care of yourself so you can take care of Daisy.

Donna

[goldengirl88]

Valerie:
As I said previously I would get the scan before this and the current one and have the Dr. compare them with you present to see what has happened that is different. I believe that can help unlock the mystery of all these different issues going on and the Dr. going in all different directions with his diagnosis. It is too confusing and needs simplified. I would want to know the current diagnosis after the comparison, if there are any changes what he thinks was the cause, what is her prognosis, and what your options are for treatment if any.
My questions are:
What is the breathing issue and what is the mechanism causing it?
What is going on with her kidneys is she in renal failure? Is so and this was seen on the last scan, why was it not brought up by Dr. Morgan so it could be addressed?
What is the issue with the spleen? Is there a growth, is it looking suspicious, or what? Was that on the last scan?
What caused this leakage of stool? Normally the cause of this is a miscommunication from the brain to the colon. If she has back problems this could be compromising her spine, nerves etc. which could cause this. Doxies are known for back issues. Could the previous Dr. have hit a nerve when he gave her that Adequan in her joint which is not recommended??
Is there something going on with her gut causing this? I would compare the scans to see.
I know everyone has different opinions on this, but I think we are all unified in one respect and that is that there is something more than drug reactions going on here. I would want him to show me both scans and point out any changes. I pray you can get thru all this, and that your dear father is getting better. Prayers are going out to you and Daisy Mae. Blessings
Patti

[labblab]

Good morning, Val. Like everybody else, I'm surely keeping all fingers crossed for a better report!

In order to help make comparisons to any new info we get today, here's a repeat of Dr. Morgan's thoughts re: abnormal lab results in January:


...based on her previous diagnostic testing (ACTH stimulation test, chemistry panel, urinalysis), we do not have control over her Cushing's with this dosage of trilostane. We are seeing a gradual improvement in the the control based on the serial ACTH stimulation testing, but we are not in our target range by a long shot.
Yes, there are many diseases that cause liver enzymes to increase. The way to prove that Daisy's are elevated due to Cushing's would be to biopsy her liver, which is an anesthetic procedure with a lot of cost and certain risks associated with it. I can absolutely guarantee that the Cushing's is at least playing a major role in her liver enzyme elevations. I also think that it is likely playing a role in her gall bladder dysmotility. Similarly, I can guarantee that the Cushing's is playing a role in the protein loss that we are identifying on her urinalysis. Also similarly, the only way to prove that this is the only issue would be to obtain a biopsy of the kidneys--also costly, and potentially more risky that biopsying the liver. The most cost effective way to determine how much of this is the Cushing's and how much (if any) is something else is to control the Cushing's and monitor the protein in the urine and the liver enzymes. My feeling is that all of this is Cushing's associated.
There was one bloodwork change which bothered me more than the others, which was the increased potassium level. This is suggestive of a low aldosterone level. One cause of a low aldosterone level is Addison's disease. However, Daisy Mae's high cholesterol [I bet Dr. Morgan instead meant "cortisol"] levels rule out Addison's disease. Therefore, this may be primary hypoaldosteronism (meaning that only the layer of the adrenal gland that produces Aldosterone is dysfunctional), or it may be a condition called hyporeninemic hypoaldosteronism, in which the low aldosterone levels are being caused by decreased production of a hormone called renin by the kidneys. I suspect that later differential, but certainly either is possible. Neither of these is a reported side effect of trilostane therapy, and neither is it a reported consequence of Cushing's disease. However, it may be that chronic protein loss through the kidneys (which can occur due to Cushing's) may be damaging the kidneys, resulting in low renin production and thus a low aldosterone level. The way for us to best diagnostically evaluate this problem would be to run an ACTH stimulation test looking at cortisol and aldosterone levels at the same time, and also to run a renin level. However, the other way would be to try to better control the Cushing's and re-evaluate the amount of protein loss through the kidneys and the electrolyte levels...

And then, here are Cornell's previous discharge summary notes re: renal status:


On 5/22/14 Daisy Mae was diagnosed with a Acute Kidney Insult with bacteria in her urine however urine culture did not detect aerobic bacteria growth. She previously had evidence of low grade chronic kidney disease (with right sided-pyelectasia). We have been treating Daisy Mae for likely kidney infection (pyelonephritis) however NSAID renal toxicity is possible.

Here's an article discussing the significance or lack of significance of seeing pyelectasia on ultrasound (the term refers to enlargement or dilation of the renal "pelvis"):

http://europepmc.org/abstract/MED/21322393

[goldengirl88]

You are the best Marianne!!

[doxiesrock912]

You guys are amazing!
I'm also wondering why Dr. Morgan didn't take some kind of action on this before it got this bad.

Daisy was on Urisidol, Tulane powder, and Trilostane. Nothing else until the hospitalization.

[goldengirl88]

Valerie:
We are all in this with you, so we are doing whatever we can to help, as we all want Daisy better. Don't feel alone we are right there with you. Blessings
Patti

[labblab]

You guys are amazing!
I'm also wondering why Dr. Morgan didn't take some kind of action on this before it got this bad.

Daisy was on Urisidol, Tulane powder, and Trilostane. Nothing else until the hospitalization.
Val, I am guessing it is because up until now, there was no clear evidence that Daisy's kidney issues could be better treated by anything other than lowering her cortisol level. Since her urine sample didn't grow an identifiable infection, we've not gotten any new info there. And it sounds as though it would still take a kidney biopsy to accurately identify whether something else is going on in addition to the Cushing's changes, and that is an expensive and fairly risky procedure. In retrospect, biopsy info sure would be nice to know. But I'm not sure whether Dr. Forman would recommend it, even now, due to possible risks to Daisy.

[doxiesrock912]

Alright, I copied all questions into a word document which I will bring with me and email a copy to Dr. Forman to complete as well. Stay tuned and THANK YOU.

[goldengirl88]

Valerie:
Could that be the key to all this that her cortisol levels may have changed the way things now look on her scan? I would ask DR. Forman that too. Blessings
Patti

[doxiesrock912]

Thanks Patti!

[Woodydog]

Valerie

Just to let you know I,m still here sending hugs and strength to you Chris and the lovely Daisy :) Hang in there you are doing wonderful

[doxiesrock912]

I recorded the conversation with Dr. Forman today with all of the questions.
How do I share it with all of you please? Try this. You probably will have to download the file and listen to it using Windows Media Player of whatever MAC uses.

https://drive.google.com/file/d/0B440mY1nZfEyanN5ZFNxVURaRUE/edit?usp=sharing


I have running around to do. Dropping the car off at the dealers, dad comes home tomorrow and wants to take the ride to visit Daisy.

I promise to come back online tonight though. One of the techs promised that she would continue to try to hand feed Daisy. She got her to take one bite and then opened her mouth, which Daisy wasn't fighting her on! So, still praying and I can't thank each of you enough for sharing what you know.

[doxiesrock912]

Dr. Forman gave Daisy calcium tonight. She ate 1/8th of a can of wet food from the tech's hand without trying to spit anything out. They're going to do this every 4 hours.

When a dog looses their appetite for a length of time, do you have to sort of jump start it again?

[molly muffin]

One of the symptoms of kidney disease is loss of appetite. Toxins build up in the system, because the kidneys aren't filtering out the toxins. I don't know that in the case of Daisy it is a matter of jump starting the appetitie, so much as it is, just trying to get the kidneys to work as well as possible. This would help her to get her appetite back.

I listened to the recording twice. stage 3 kidney failure, is fairly serious. There is no cure, but the question is going to be, is it manageable at this stage, can they get her stable enough to go on. I think that Dr. Forman, whom I liked quite a bit in his answers, is waiting to see what the renal tests show tomorrow.

Remember that before creatinine starts to show elevation, there has already been a good deal of kidney damage, approximately 75%.

We aren't talking cushings here, we're talking kidney issues. I completely agree and we always say, do Not give cushings medications to a sick dog for exactly the reason Dr. Forman mentioned, it can make them worse. So, if they can get her stable, then maybe can look at cushings treatment again, but for now, this is all about the kidneys.

So, loss of appetite is a major component of kidney failure, as is dehydration.
That she will eat at all is a good sign. I'm hoping for them to get her to a point of stability, where you can mange her kidney issues and keep the deterioration at bay for as long as possible.

I'm not trying to be a pessimist here. It's just that it is a whole new reality.

What did you think Valerie after talking with Dr. Forman?

Sending big hugs
Sharlene and molly muffin

[goldengirl88]

Hi Valerie:
I have to say I was not exactly thrilled with the answers you go from Dr. Form an. For many of the questions I thought he skirted the issues. Really the only thing I felt he was clear on was the kidney issue, bun creatinine issues. I was surprised he did not feel her cortisol being uncontrolled could have caused a lot of the changes seen on the latest US. We all know you do not treat a sick dog with trilostane, but will this high cortisol cause further problems with her kidney values. Nothing was mentioned about the spleen either?? I don't know how the others will feel, but I am just hearing a diagnosis of stage 3 kidney disease, with no clear understanding of the other issues. I want to see what the others gleaned from this? Blessings
Patti

[molly muffin]

I thought the spleen issue was seen on the other ultrasound as a smaller spot and they would likely have to do further imaging to get a clear view of it. (that was what I took from Dr. Forman anyway) Not sure if he thought that it was a blood clot (as he does think clots are occurring) or something else.
He did say in relation to the cortisol that it is likely a contributing factor to have uncontrolled cortisol for any length of time, he mentioned years, but it is not the underlying cause of the kidney failure, or he didn't think it was the cause.
I do think he concentrated on the kidney disease but I think that is because kidney failure is what is the main concern and life threatening at this time. That has to be stable first before they can look at the cushings. What bringing the cortisol down now will do, is Maybe in 3 - 6 months, it will help to decrease the size of liver, adrenals, maybe GB. But the kidney disease and this is another component also effects the intestines, or can effect them and he feels that this is so in Daisy's case.
Sure you want to bring the cortisol down and if Daisy reaches a stage where she is stable enough to do so, then they can restart trilostane. It could actually have worse consequences to try and start her now while she is so sick.

That is what I took from what he said. I don't think he skirted the questions, I think he answered straight forward enough with the information that he has available now. Of course they will know more once the renal tests are back to see what is happening now. Is she getting the bounce back or not.

For instance, not sure exactly when these labs were drawn, if it was when Daisy first went in and they want to see what was going on when she came into Cornell or were they taken after she had been on treatment for this occurrance and they want to see if she is responding. Do you know Valerie, which it is?

hugs
Sharlene and molly muffin

[doxiesrock912]

Labs were drawn when she first went in and yesterday.

[molly muffin]

So they should then have a comparison to see how she is responding to treatment this time around. We know she responded well last time before she was sent home, so the hope is that she will respond well this time too.
We are all hoping for that Valerie.

hugs
Sharlene and molly muffin

[goldengirl88]

Valerie:
Were you satisfied with the answers? Was anything discussed about the shaking even though it stopped? Was it from pain or what ? I do not understand if Dr. Forman said she would be treated with meds and diet changes, why didn't Dr. Morgan do that?? Maybe it would not be as bad now?? Blessings
Patti

[Harley PoMMom]

Val,

I'm at work so I can not download the file but I will when I get home. If kidney disease is suspected, what is her phosphorus level because if this is high she needs a binder, also an elevation with the phosphorus causes inappetence.

[flynnandian]

ian's mother was diagnosed with kidney failure at age 13.5
she was slowly losing her appetite too.
she lived another 8 months on a powder called ipakitine.
you have to mix it with her food.
it is made of calciumcarbonaat and chitosan.
i think this is probably what they are giving daisy too.
it binds phosphates. it worked well for her.
it gave her her appetite back.
it does not cure, but it slows down the kidney disease.
maybe you can ask for some when daisy is released from hospital.
i hope she will recover from this soon!

[addy]

Hi Val,

So it seems we still wait for the blood work. Here are links for you if you are up for it. I cant imagine how worried you must be. I also am providing the links for anyone else wanting to read about the different staging of CKF


http://www.iris-kidney.com/_downloads/003%20N378.008%20IRIS%20Website%20Treatment%20Reco mmendation%20PDFs%20DOGS_041113.pdf

http://www.iris-kidney.com

Getting Daisy to eat and fluids are key as we all know.

I think Sharlene is right, no Trilostane right now. I agree with Dr. Forman on that.

It felt weird hearing him read my questions:o:o:o

Lori we are waiting yet for the renal panel I think

[doxiesrock912]

Daisy's body temp had lowered and she was chilly. The shivering hasn't come back since the Baytril kicked in, at least that is what I think. Not when I visited today and still not shivering each time that I checked in tonight.

Maybe the Baytril is having an effect and not upsetting her stomach like the Clavamox?

I am curious to know if the bloodwork was done before the Baytril was started, might that make a difference? They also changed antacids from Pepcid AC to something else.

She ate again at midnight, a few tablespoons this time wilingly. Sleeping comfortably. I will ask about ipakitine when they call tomorrow.

Dr. Forman gave her calcium tonight. What would that do?

I like Dr, Forman and if Daisy survives this, he will be her new IMS.

I was surprised when he said that he didn't want me to make the big decision yet and that we should wait for the blood test results. The tech that I spoke with tonight said that Dr. Forman was pleased with what he was telling him.

I had dinner with a friend of mine tonight, he said a special prayer for dad and Daisy which I thought was sweet.

[Tina]

Valerie,
I wasn't able to download the audio file for some reason so couldn't hear Dr Forman's responses, but I sure would be interested. I am anxiously waiting for the results of the bloodwork too. I hope the kidney values are showing response to treatment. I am very happy to read that she is eating a bit, I think that is a good sign and hope her appetite continues to improve. Sending continued positive thoughts for her recovery.

Hugs,
Tina and Jasper

[doxiesrock912]

Tina, I can email you the file if you'd like me to. Windows Media Player will play it nicely.

[Tina]

Oh, yes, you said that. I tried it on my iPad, duh. :o Let me see if I can get it to work on my laptop tomorrow and I will let you know. Thanks Val.

[Trish]

Hi Valerie, I just listened and I think Dr Foreman was great, I can see why you like him. I think he have very good answers to your questions. It was weird to hear our questions read out word for word, we really were fluttering around you today!! :) I think he is being very sensitive about your financial situation as well and going over the tests that could be run, but recognising the expense and weighing up the benefits.

So the kidney and bowel issues are the priority, I totally agree with Dr Foreman, Addy and Sharlene that Cushings should on the back burner for now. There is time to deal with that later once we get this acute episode and especially the renal function under control. I did think of another question.... (maybe for tomorrow) do they think this renal dysfunction is a continuation of the previous CKD or is this more an acute kidney injury. I think the staging may be slightly different for the different types.

I am pleased Daisy is taking in some food tonight, that is a good sign. Is she on IV fluids still? Calcium is not metabolised properly with renal failure, neither is phosphorous which Lori mentioned. So I would imagine they are monitoring that and supplementing as necessary.

Vets should not comment negatively on the previous care of their colleagues. They comment on what they see before them and treat accordingly, well that is what I think anyway. Professionals should never run down others as they never know when that is going to turn around and bite them on the butt, like when their conversations are recorded and then placed on the internet for anyone to listen too!!

I like how he was very reassuring that everything is being done to give Daisy the best chance and how you have done all you could, that should give you some peace of mind. I thought he was very professional and I hope you have a better understanding of what is going on. xxxx

[labblab]

Val, thanks so much for providing the audio link, and I agree with what the others have written about both the situation and Dr. Forman. Like Trish, I am still wondering about this part of things:


I did think of another question.... (maybe for tomorrow) do they think this renal dysfunction is a continuation of the previous CKD or is this more an acute kidney injury. I think the staging may be slightly different for the different types.
I wasn't exactly clear about that, either, but this may well be because Dr. Forman just does not know himself. It might take a kidney biopsy to truly determine the answer, and that is not a procedure he would recommend due to the risk. And at this point, the answer may not make all that much difference, anyway, since she's already on an antibiotic to cover an infection, the renal dietary/drug intervention right now would be the same, regardless, and he's recommending resumption of Cushing's treatment once she rebounds sufficiently.

One thing I hope you can feel better about is that it doesn't sound as though he thinks the ball was dropped by not intervening back at the time of the first ultrasound. As he said very simply, "There was no need." Apparently there has been no big change in the actual nature of the chronic issues imaged on the previous ultrasound, it is just that the issues have worsened since then and for whatever reason, Daisy's renal function is now at a point where there is clinical significance and it has to be addressed. Not every dog would have progressed in this same way, however, and in the absence of observable lab abnormalities of blood and/or urine (which we now have with Daisy), you would not have cause to directly intervene. (This last part is me talking, and not Dr. Forman, but I think this is what he was getting at).

So for right now, we concentrate on helping Daisy rebound, and I am sending tons of healing wishes her way!!

Marianne

[goldengirl88]

Valerie:
It seems Daisy is still a fighter and she has no intention of giving up, she is a tough little girl for sure. I am hoping with the focus being on the kidneys that she can get straightened around and gain her strength back in the coming weeks. I guess you will be changing her diet? Even though Dr. Forman said there was no need to intervene with the kidneys before, I can't help but wonder if a diet change would have helped her?? That being said Tipper and I prayed a special prayer for Daisy last nite and we will continue to do so. God Bless Daisy Mae
Patti

[labblab]

Patti, here's a link to a very comprehensive panel discussion re: the timing and reasons for dietary/drug intervention in dogs with renal disease. It focuses on proteinuria as a treatment prompt, but it does a good job of discussing treatment intervention in renal disease, in general.

https://www.idexx.com/pdf/en_us/smallanimal/education/proteinuria-round-table.pdf

Marianne

[doxiesrock912]

Dr. Forman is off today so I spoke with Dr. Broussard. He wants to run labs again since starting the Baytril to see if there's improvement. If not, and she doesn't improve within a few days, he doesn't believe Daisy's quality of life will be good. We all know what that means. He pointed out that she's sleeping alot and I noticed that too.

However, he is surprised that she's eating. It seems that the calcium helped with that.

Oh, no one can access Dr. Forman's conversation without the link that I provided. No way would I share our conversation publicly. I did set the privacy settings in my Google drive that way.

[goldengirl88]

Valerie:
I am sure praying that your sweet baby gets better soon. You have both had an over load with all these issues. Is this Dr. not as optimistic on the outcome as Dr. Forman. I still can't believe all this has happened in this small space of time. Blessings
Patti

[doxiesrock912]

I know Patti.
Dad and I are waiting to visit her now.

[Trish]

How did the visit go? Hoping for some signs of improvement in Daisy and her latest blood tests. Hope you and your Dad had a nice visit :)

[Woodydog]

How is Daisy today, hoping for some improvement. She will be glad to see you and your dad :)

[doxiesrock912]

I wasn't thrilled with Dr. Broussard when we spoke this morning. He was doom and gloom and I felt like he wanted me to put her down.
Yet, when we met with him and he saw how Daisy's reacted toward dad, his tune changed quite a bit and he said "now THAT'S quality of life!" Followed by "give it more time". He wants to do another set of blood tests to see if there is an improvement now.

https://www.facebook.com/media/set/?set=a.802292413123024.1073741836.100000268197543&type=1&l=2afcd076ef

Dr. Kimm finally called and he wants to go after the manufacturer which I found interesting. I think that I'll set up a time to talk with him in person.

Daisy sought affection from dad! Something she hasn't done since she was hospitalized.

Dr. Brousseau doesn't believe this incident is related to the Clavamox. He still thinks that it's part of the Meloxicam issue.

[goldengirl88]

Valerie:
I hope you Dad if feeling better, and that he was happy to see Daisy. Take care of yourself. Blessings
Patti

[doxiesrock912]

Daisy ate from the techs hand again earlier tonight.
I just called again to check on her and the tech said that it looked like she was going to vomit at one point but nothing came up so I don't know what that's about. Sigh.....

Her temp is normal and they're obviously going to watch her.

Conversation with Dr. Broussard which again I made it so only people with the link can hear it.

https://drive.google.com/file/d/0B440mY1nZfEyc3RGbHM4WlVQRGM/edit?usp=sharing

[doxiesrock912]

Update again :-)
It's 2:45am and Daisy hasn't shown anymore signs of nausea. The doctor checked her over and didn't see anything worrisome. Her vitals are normal and they're going to try to offer her more food soon.

Praying that she takes it again willingly and that she can beat this. Poor babe is skin and bones. They did say that she enjoyed being outside earlier, walked in a circle to find a suitable spot to poop, did so with some trouble emptying completely which I wonder if it's due to her weakened state. It takes some effort to do that.

Worried mom is going to try and sleep now.
Hugs to everyone and I pray for good news tomorrow.

[Trish]

Hi Valerie, sounds like it is a waiting and hoping game. Sounds good that she has been eating tonight though. Hope tomorrow brings good news for you all, love the photos of your Dad with her, so sweet she perked up for him. He looks so concerned for her as you all are. Big hugs xx

[molly muffin]

Love the pictures with your dad. Those two obviously have a bond. :) Hoping she eats and can get her strength back.
Haven't had a chance to listen yet to the Dr. Broussard. Will do so today at some point :) Glad he isn't ready to give up yet. Remember, Dr. Broussard is maybe not as familiar with Daisy and family as Dr. Forman is? So, seeing them together, maybe he saw how hard she would try for her people.

hugs
Sharlene and molly muffin

[gatorgirl_bama]

Valerie,
Still have y'all in my prayers. The pictures of your Dad and Daisy are priceless.

Much love,
Donna

[doxiesrock912]

Yes, Daisy has always been the spoiled grand-dog :)

Dr. Broussard just called. Daisy had a few incidences of retching overnight but not much came up. Her temperature dropped so they gave her more calcium and she had some twitching again. She's back in ICU. He said that the bloodwork should be back within 3 - 4 hours and that he'll reevaluate based on that but he's concerned because we took one step forward and now two steps back.

I'm losing hope that my sweet Daisy Mae might not be able to recover from this. We need a miracle now.

[labblab]

Val, my heart is so heavy reading about this set-back, but I still hold onto all hope that Daisy will be strong enough to pull through. She is both a sweet angel and also such a brave spirit. No matter what happens, I know her spirit will always and forever be safe and protected. But I hope against hope that her body can rally again, too.

My thoughts and prayers are with you, your dad, Chris, and of course precious Daisy.
Marianne

[doxiesrock912]

Me too and I've been asking for copies of the blood tests since day one and still haven't gotten them.

[goldengirl88]

Valerie:
I have never heard you so defeated girl. This is a battle and you get ready to fight for your girl, you have gone too far to give up. Where is that spunky young lady I have known that can handle a multitude of things? Pick yourself up Val ,dust off and fight like HELL for your girl. I know better than this from you. I am praying for your precious baby Daisy Mae that she once again rallies and beats the odds. Blessings
patti

[doxiesrock912]

Patti, oh his I pray that you're right but Dr. Brouusard was not hopeful when I spoke with him this morning and I suspect that money is the reason that they have not been more aggressive with treatment.

I am going to ask about a transfusion or dialysis.

[goldengirl88]

Valerie:
Yes I think to see what options are open at this point if any is a real good idea. If they are not affordable or there are none may be another issue. You are a fighter Valerie and Daisy has your spirit. I sincerely hope that is enough to get her through. Blessings
Patti

[molly muffin]

Oh no I'm so sad to read that Daisy had a set back. She seemed to be rallying and I hope she can do it again. I know her spirit is strong, they just have to get the body able to fight this.

Prayers and best wishes for you and Daisy.

hugs
Sharlene and molly muffin

[spdd]

Lots of praying, wishing and hoping Daisy rallies. She's a fighter, and like Sharlene said has a strong spirit and will fight the odds.

[goldengirl88]

Valerie:
I am thinking of you and Daisy, and praying for a good report after your visit. Blessings
Patti

[molly muffin]

Checking in to see if you have had any news Valerie. How was her blood work? What do they think? We're all pulling for you and Daisy!!!!

hugs,
Sharlene and molly muffin

[goldengirl88]

Valerie:
We are all just wanting her to beat this, so I hope we aren't making you nutso by inquiring about updates. Blessings
Patti

[addy]

Thinking of you and Daisy

[doxiesrock912]

Hello my dears. Blood work (June 2 and 5th) and SOAP from yesterday.

VERY long day. Took dad's van at 12:30pm to pick up a head and foot board that Chris bought, then drove to Cornell for Daisy Mae, stopped at the house in Greenwich for a blanket to wrap the frame in so that we could then pick up an antique free standing coat rack/mirror that Chris won in an auction and then dropped all off in West Haven. Chris took us to dinner and then dad and I drove all the way home. Arrived at 10:06pm and probably clocked 200 miles.

https://drive.google.com/file/d/0B440mY1nZfEyTUl3M1dXVEVFSkE/edit?usp=sharing

https://drive.google.com/file/d/0B440mY1nZfEyTUl3M1dXVEVFSkE/edit?usp=sharing

https://drive.google.com/file/d/0B440mY1nZfEyRVZ4V0tmRUhxb1E/edit?usp=sharing

I asked Dr. Broussard about Epakitine. He didn't know what it was but he looked it up.

The plan is to increase IV fluids carefully. Because Daisy has a heart murmur, there is a risk of inducing heart failure. She wasn't as responsive today but she willingly ate treats from our hands! We didn't have to coax her or put anything in her mouth. I carried her outside and she LOVED sniffing the air :)

Dr. Broussard said that this is a continuation from the Meloxicam "acute kidney insult". That gives me a bit of hope as a chronic problem isn't correctable.

Please keep praying, we're not out of the woods yet. Thank you

[Trixie]

Just reading thru pages about what's been going on. I'm so sorry for little Daisy and for you too...this is a lot to go thru, a lot! I'm just tearful seeing the photos of your Dad with Daisy.
I see you just posted test results...I'm just hoping so much Daisy rallies from this.
Sending prayers and thinking of you.

Barbara

[molly muffin]

Okay, so, blood work is still all over the place, showing that she is a very sick little girl, however, having said that, acute I think while it means that the now is very hard on her, might give her the best chance long run.

I don't know, so maybe something to ask Dr. Broussard is about what kind of permanent damage does an acute kidney insult do? That might be a discussion that can be had, After she recovers from this. We're going to think as positive as possible.

You sure have had a long day. It is terrible that life doesn't stop even when in the midst of a crisis, so it just doubles everything.

Sending you big hugs! Hoping Daisy has a good night and you too.

Sharlene and molly muffin

[Sophies Mom]

Haven't been on forum for a couple of weeks. So sorry to hear whats going on with Daisy. Sending prayers your way.

[Trish]

Hi Valerie

Yes good question Sharlene, hopefully we will see it starting to right itself soon. That scan result shows a nodule in the adrenal too, I wonder if that is why Daisy has been so hard to regulate on the trilostane?? Something for the future too.

Hopefully you will be seeing more signs of improvement. The Cr had gone down a little on the latest results, so that's good news!

Hope you had a good sleep Valerie, sounds like a busy and stressful day yesterday, so I am sending good wishes for a better day today. xxx

[goldengirl88]

Valerie:
It sounds like there is more hope that this is not going to be an ongoing problem with Daisy. Is sure hope and pray that her little body has the power to over come this. I am glad you dad is with you that has to help a lot. Please get some rest so you can help Daisy battle this. It is heartbreaking to think of all she has been thru. Blessings
Patti

[gatorgirl_bama]

Thinking about you all.

Donna

[goldengirl88]

Valerie
Hoping you got rested up, and I am hoping for some encouraging news on Daisy
today. Blessings
Patti

[doxiesrock912]

Dr. Broussard is aggrevating me.
He said that Daisy is improving and eating but that they've had to increase fluids from 28ml an hour to 35ml an hour in order for her body to get rid of the excess phospherous and they've been supplementing with calcium as well. The problem that the creates is that the phosporous binds to the calcium and forms crystals.

Does anyone have experience with acute kidney trauma and is it possible with continued therapy that this can be reversed and that her kindneys can regain some function?

Dr. Forman hasn't responded to Dr. Broussard's email yet. He's out of town at a conference until Monday. Dr. Broussard admitted that this is more Dr. Forman's expertise. At this point, I feel like the expert is out of town and I'm paying for care that might not be optimum.

Her numbers are decreasing and she's eating, but at this point, what they're doing in the hospital can't be replicated at home.

I came across this.

http://www.dogcathomeprepareddiet.com/diet_and_chronic_renal_disease.html

[labblab]

Oh Val, I totally understand why you are upset and frustrated cuz I would be, too! I hope Dr. Forman will reply soon.

In general, I think it's possible to rebound from acute episodes, but a lot depends on the nature of the damage and the baseline health of the kidneys before the assault. So I just don't know what to expect with Daisy, although it seems as though Dr. Forman had not yet given up on things at the time he left. I really, really hope you can get his input very soon.

Marianne

[doxiesrock912]

Me too Marianne,

Dr. Broussard keeps talking about Dais's quality of life in once sentence than in the next I hear that she's improving. I don't believe that he knows enough about this and I'm getting frustrated. He said that he consulted with the critical care doctor and that they suggested increasing the water more, that's how we got to 35ml per hour, and that seems to be helping but at what point will the kidneys kick in and can they?

Of course, neither one of them has the expertise that Dr. Forman has.

[scoora]

Val, I'm sorry to hear Daisy is having these problems.
Prayers that she will be better soon.
Hugs

[addy]

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=726527

there are articles on DVM 360- here is one of them, Im at work so cant post links to them all- there another article about care

hang in there, Val

[goldengirl88]

Valerie:
I don't know to much about kidney issues, as I have not had to deal with any, but I am hoping Dr. Forman gets back to you quickly. I can understand your frustration with this. Are they messaging on his cell phone and he is not getting back? maybe he will have a break hopefully sometime today and call. I am praying for Daisy. Blessings
Patti

[doxiesrock912]

Thank you ladies.

Addy, that article is GREAT!

[Harley PoMMom]

Oh Val, I am sorry sweet Daisy is going through so much and I am keeping you both in my thoughts and prayers.

Unfortunately, as that article you posted states, renal damage is irreversible, however; there are things one can do to preserve the remaining kidney function.

I've read articles stating that CoQ10 can help with reducing the creatinine and BUN levels.

I'm providing a link to an informative article regarding proteinuria and kidney disease,and I hope you will find it helpful: PROTEINURIA AND RENAL DISEASE A ROUNDTABLE DISCUSSION (https://www.idexx.com/pdf/en_us/smallanimal/education/proteinuria-round-table.pdf)

I also belong to a Yahoo canine kidney forum and the folks there are very knowledgeable with all aspects involving canine kidney disease, here's their link: K9KIDNEYS ( https://groups.yahoo.com/neo/groups/K9KIDNEYS/info)

Hugs, Lori

[Trixie]

Just want to post re a positive story. A few years ago a small toy poodle in our building ingested a whole bag of raisins..she was about 12yrs old at the time. She had acute renal failure from the toxicity and the dog was in the hospital for days very sick and it was not looking good. Her kidneys were almost shut down. The owner was devastated but told me they were "flushing her out"...not sure what that was exactly.?? I wish I knew what they did to help her at the hospital...I just called her apt. but she is away right now. Anyway after awhile the dog somehow rallied and did pull through even though it was touch and go...she went on to live another 3 years too. Hoping there will be good news on Daisy and she'll fight this off. We're all pulling for her.

Barbara

[doxiesrock912]

Hi everyone,

Daisy stood up in her crate for Alex when she went to get her for our visit. She looks much better, was much more alert than yesterday and a lot less sleepy until the end of our visit which was longer than usual this time. Dr. Broussard said that she is eating on her own and when Alex stopped in to check in on us Daisy was interested in the salad that she was holding. her fur is shiny again.

When I took her outside she was more steady on her feet and peed a little which I thought was a good sign until Dr. Broussard said that she hasn't been able to fully empty her bladder and the nurses have been helping her :(

Finally, Dr. Forman responded with a few additional ideas and I'm praying hard for a turn around so that she can come home soon.

Here is today's conversation. https://drive.google.com/file/d/0B440mY1nZfEyR1Bnakd0TkoyT2M/edit?usp=sharing

Thank you all for your support and links. I'll be sharing some of those with Dr. Broussard as he's more than willing to learn right along with me it seems.

Barbara, that is the difference between an acute kidney insult and chronic kidney disease. It is possible for a dog to have early chronic disease which Daisy did and then have an insult which was the shot of meloxicam. Ideally, with fast treatment some damage from the acute insult is correctable depending upon what parts are damaged etc and if the body can compensate for the difference.

Also, when a dog has chronic disease (Daisy's was stage I and required no action at that time) the acute insult can make the chronic worse.

Now they are also exploring if we begin treating Cushings at 1/2 of the dose of Trilostane if that will help because it is likely that all 3 scenarios are playing a part in her inability to jump this hurdle.

That is my understanding of the situation anyway. Dogs can live with 25% kidney function with proper diet and medical management we're just having a problem getting Daisy to that point.

I've also read that recovery from an acute kidney insult can take weeks to months.

[doxiesrock912]

This is the therapy that Dr. Forman suggested and Dr. Broussard is going to try this before using Trilostane to see how Daisy responds.

http://relief.unboundmedicine.com/relief/citation/16189633/Comparison_of_the_efficacy_of_an_oral_calcitriol_p ulse_or_intravenous_22_oxacalcitriol_therapies_in_ chronic_hemodialysis_patients_

[molly muffin]

I'm thrilled to hear that she is being more responsive and interested in her surroundings. Crossing fingers that they can get her kidneys to respond well too.

hugs
Sharlene and molly muffin

[Tina]

Valerie,
I haven't been able to post on the forum the last few days because I've had a horrible case of tendonitis in one of my wrists and I'm on a hefty dose of steroids and pain medication. I'm actually home sick from work today I feel so awful but I just wanted you know I've been following along on your thread because I've been so worried about Daisy. I'm here, I just haven't been able to type/post.

I'm trying the voice text feature on my iPad right now so hopefully this will come out okay. I haven't checked out all the links for everything that you posted but my question is have they given Daisy a phosphate binder to try to get the phosphorus level down? I read where you mentioned that they increased her IV rate and the extra fluids definitely will help with that but from everything I've read it's my understanding that when the phosphorus level is up a phosphate binder is needed. Is that the calcium you mentioned? There are also aluminum-based phosphate binders that I read about. I wonder if that might be considered for Daisy if she's having trouble with crystals forming with calcium?

Just a thought I had Valerie. I basically wanted to check in real quick to just let you know that I'm here, praying hard for Daisy to pull through this and I'm thinking about you guys even if I'm not able to post much. I am encouraged that she's eating better and seems more alert. Take care and hang in there.

Hugs,
Tina and Jasper

[Trish]

Hi Valerie
Well that does sound positive with her feeling better today. Such a fine line to get all the numbers in check. Hope the new treatment helps x

[flynnandian]

the ipakitine i got for my dog is a phosphate binder. http://www.vetuk.co.uk/dog-supplements-cat-supplements-kidney-supplements-c-5_897/ipakitine-phosphate-reducer-aiding-kidney-function-p-657 this powder has a neutral taste and my dog had no problem with it.
dogs with kidney disease do not have a lot of appetite most of the time, so oral medication is not easy.
they also need pills sometimes against nausea. my dog ate well with those.
my dog also went from chronic 1 to acute in no time, but because of her age and quality of life i let her go.
my dog was 14, but daisy is much younger, so i hope she gets better.
but the fact that she is eating by herself sounds good!

[doxiesrock912]

Tina, she's low on calcium too so giving the calcium accomplishes 2 things, one is as a phosporus binder. The actual phosporous binder in Dr. Forman's opinion wouldn't make enough of a difference in lowering it since they wouldn't be able to give her enough.

Your ipad voice recognition did a great job! I hope that you feel better soon!

He's thinking that the uncontrolled Cushings might be having somewhat of an affect on her kidneys ability to filter since she's now been completely off Trilostane for 2+weeks.

Dr. Broussard has apparently been doing his own research and is going to try oral calcitriol instead of calcitriol pulse therapy because he thinks that this in combination with giving Daisy 1/2 of the total daily dose of Trilostane twice a day as well. They're hoping that by attempting to address the Cushings in part and continuing the fluid therapy, will tip her over into the right direction.

Poor thing is so weak. I took her outside twice today and set her down to pee tonight. She peed a little standing up which was discouraging then she squatted and peed much more :) Dummy me picked her up too soon apparently so now my clothes are in the laundry.

Ironically, while I was visiting Daisy tonight, a couple came in with a small dog who had cherry eye surgery and was taking oral metacam (sound familiar? sarcasm alert). Well, this dog started vomiting and they stopped giving him the metacam 4 days ago and the poor pup still isn't right!!!!

I will mention this to Dr. Broussard, Dr. Forman, and Dr. Kimm because maybe there is a bad batch or something but for a reaction that is supposed to be rare - I find it extremely odd that two dogs show up at the same veterinary hospital because they got sick from the same supposedly very safe pain killer.

Daisy is still eating on her own.

[doxiesrock912]

Ok ladies, stay tuned. I sent the link about aluminum phosperous binders to Dr. Broussard. He just emailed me and wants to run another idea past me.

He's improving my opinion of him :)

I think that I should ask him for a job as research assistant :) I'll give you guys a cut in the action. LOL

[doxiesrock912]

If all of the above don't work, Dr. Broussard spoke with the ER doc who first admitted Daisy and they think that an asophegial feeding tube might be a solution to get Daisy home and hopefully under control.

At this time, she is not a candidate for this because it requires a mild anesthetic and honestly, I hate the idea.

So, I know that I don't have to ask this but PLEASE pray super hard that what we're doing now works phenomenally and SOON.

I didn't realize this but they are already using an aluminum based phosphorous binder. He's also testing for Hypoparathyroidism and says that if that is present it means that her condition is chronic and that "we're screwed".

God I hope that she is NOT hypoparathyroid!!!!!

I just read this so it makes me a bit hopeful.

http://www.merckmanuals.com/pethealth/dog_disorders_and_diseases/hormonal_disorders_of_dogs/disorders_of_the_parathyroid_glands_and_of_calcium _metabolism_in_dogs.html

"Hypoparathyroidism is characterized by low calcium levels, high phosphate levels, and either temporary or permanent insufficiency of parathyroid hormone. It is uncommon in dogs, but can be caused by previous removal of the parathyroid glands as a treatment for hyperthyroidism or for a parathyroid tumor. Common signs of hypocalcemia include muscle tremors and twitches, muscle contraction, and generalized convulsions. Diagnosis is based on history, signs, low calcium and high phosphorus levels, and the blood parathyroid hormone level. Other causes of hypocalcemia must be eliminated.

The goal of treatment is to return the level of blood calcium to normal and to eliminate the underlying cause. If an animal is having muscle spasms or seizures because of low calcium levels, immediate treatment with intravenous calcium is needed. Dietary supplements of calcium, often along with vitamin D, are prescribed for longterm treatment.

Chronic kidney failure is probably the most common cause of hypocalcemia. However, the hypocalcemia that occurs with kidney failure does not tend to lead to the nervous system signs that are seen in hypoparathyroidism. Treatment usually involves dietary restriction and treatment to lower phosphate concentration in the blood."

Since she's been in the hospital she has developed intermittent twitches associated with low calcium levels but no seizures.


Dr. Broussard and I are fairly convinced that Daisy has an acute kidney injury and I just read that the fact that she's producing a lot of urine is a good sign. We may have to explore the option of a feeding tube in order to get her home and still be able to control the amount of fluids and food intake because it can take 3 - 4 weeks for kidneys to even start any possible repair process. I'm hoping that we see a big sign of improvement before we have to go down that road and that her low calcium is only a result of the high phosporous and nothing else. Crossing fingers and toes.

[spdd]

Hi Valerie, am checking in to see how Daisy is doing. She's a real fighter for sure.
A note about the Metacam. Keesh was on it for quite awhile... probably over a year, and then his wretching and vomiting started. This from a dog that could eat everything including a hot pepperoni every once in awhile from pizza. His gut has never been the same since Metacam and of course I pulled him off it. I went to the Tramadol, but as that isn't an anti-inflammatory I now use Previcox. He hasn't been sick on it yet, but I think the damage was done.

Hoping the kidneys heal soon, and I'm reading your thread daily. Lots of hugs from Keesh and I.

[goldengirl88]

Valerie:
You will be up for a DVM soon. I am praying this works well for Daisy and that she gets some nutrition. I go back to some of my earlier postings where I questioned if the uncontrolled cushings was partially to blame for this. I still in my mind think there is some connection like Dr. Forman. I hope the half trilo is enough to get her turned around to come home. The poor baby has been in a strange place for so long now, I know the traveling has to be hard on you too Valerie. How is you dad doing/ I hope he is healed form his bronchitis. God Bless sweet Daisy Mae, let her get well and come home with her mom.
Patti

[gatorgirl_bama]

Sending some love and healing prayers.

Donna

[molly muffin]

Hoping to hear there is some more improvement today and definitely no Hypoparathyroidism.

Will you find out about that today? Not sure how long it takes for those tests to come back.

I think this is a good team at Cornell that you have now. So I am hopeful.

hugs
Sharlene and molly muffin

[doxiesrock912]

Dad is doing well. I stayed in Greenwich last night and visited Daisy twice yesterday. I printed out the home made diets and am going to show them to the doc today because Daisy is being finicky about the commercial renal food. She's got to eat and drink more in order to come home.

Yes, I should find out about the Hypoparathyroidism today. I read more on this and it doesn't seem likely. She doesn't have the jaw symptoms thank God and believe me that little jaw is still strong. It was obvious when she clenched to keep us from hand feeding her. Hoping that I'm right on this.

I just called Cornell, Daisy had a stable night but for some reason they want me to wait until the blood results come in and talk with the doctor before coming in. Should I be worried or maybe they're really busy since they're the only veterinary practice around open on the weekends. It took awhile for someone to answer the phone.

[Woodydog]

Hi Valerie

Glad to hear your dad is doing well. Looks like Daisy is fighting hard to beat this which is great.

Sending more strength to Daisy, and you and her team :)

[Trish]

Hi Valerie, how is Daisy doing today, have you been in to see her yet? Hopefully small improvements each day :) x

[addy]

Hey Val,

I am just checking in too. Weekends can be hard, staff is probably smaller.

[doxiesrock912]

Daisy drank enough water while we visited that we were able to spend 3 hours together instead of one! She actually ate food too (k/d). Then she vomited a bit of it.I askd the doc if her stomach could've shrunk. She said absolutely so they're going to do smaller, more frequent meals.

Creatinine and phosporous have gone way down but unless Daisy eats enough and drinks enough to keep them low, she can't come off of the IV fluids.Calcium is still low and they haven't received the results of the test for hypoparathyroidism yet. Tomorrow or Monday.

Today was the first day that she's eaten more than a few tiny pieces of treats that I brought in and she reach for the food! Exciting!

She's much more alert and interested in her surroundings, wanted to stand more than she has been, sit upright more rather than laying on either side, and took two or three steps for me outside.

I had a lawn chair in my trunk so I set it up in the parking lot and Daisy stretched out on me and we soaked up some sun.

It can take up to 8 months before a dog's renal system starts the repair process from an acute kidney injury.
Everyone was ecstatic that she ate and drank twice while I was there today.

[molly muffin]

That is truly wonderful news Valerie!! Sounds like she is really trying to eat and drink.

As we always say, baby steps will get you there, just maybe not as fast.

hugs
Sharlene and molly muffin

[doxiesrock912]

I was happily surprised Sharlene!

[scoora]

That's great to hear Valerie.

[doxiesrock912]

Thank you :)
I'm a very hopeful doxie mommy tonight. :)

[My sweet Ginger]

And you are a one devoted doggie mommy who's and would go above and beyond to give your pup a second chance in life. You are very admirable and inspirational. Daisy is one lucky pup and I truly hope she pulls through this and come home to her eagerly awaiting mommy and family. Like everyone said, baby steps as there may be a long road ahead back to recovery.
I'm praying that you will have another wonderful visit with Daisy today and get some good news on the lab.
Give Daisy extra hugs and kisses for me.
Take care of yourself and try to hang in there, Valerie.
Many hugs to you and Daisy. Song.

[goldengirl88]

Valerie:
Let the miracle of Daisy Mae continue! I am so, so happy to log on and read this. Everything seems to be looking more hopeful for Daisy. I am so glad you get to visit with her for that long. I often wondered what goes thru a dogs mind when they are sick and left in a strange environment. It is probably scarier for them than us. You have needed some good news and you sound like you are rested up and ready at it again like the Valerie I am used to. God Bless You All.
Patti

[gatorgirl_bama]

Valerie,
So glad to hear Daisy is feeling better. I'm sure the longer visits are helping her too. Still keeping her in my prayers.

Donna

[doxiesrock912]

Thank you everyone!
They put her back on antinausea meds for now because she vomits a little after eating. Poor girl's stomach is having to get used to food all over again I guess.

I'll know more after we visit her at 12:30.

[goldengirl88]

Valerie:
Keep your chin up Valerie it is going in the right direction. It probably is because she has not eaten real good in a while. Praying for you all.
Patti

[doxiesrock912]

Visited Daisy earleir today and she was alert but clearly not feeling well and wouldn't eat at all for me.

Cornell just called saying the she just crashed. They're doing CPR but suggest that it not be continued. We're 40 minutes away so won't be there on time but she tried so very hard and I'll always love her even more for trying.

Rest peacefully my sweetest companion. You will forever hold a special place in my soul.

My only regret is that I wasn't there when it happened.

[Harley PoMMom]

Oh no, Val, I am so, so sorry. Many loving hugs going out to you and sweet Daisy.

[labblab]

Oh Val, sending prayers to Daisy and you and your Dad and Chris. And saying a prayer for us all, because she is our girl, too. Fare thee well on your new journey, sweet little one. Fare thee well.

[My sweet Ginger]

Oh Valerie, I'm so very sorry.
You both tried so hard to fight this to the end and because of your devotion and love for her she was able to get the best care possible.
I hope you will be able to find some comfort in that.
I'm just so sorry she couldn't pull through but at least she is free from all the pain now.
Oh, how I wanted her to come through this. I'm so sorry Valerie and I appreciate you letting us know.
Daisy was a little fighter just like her mama and she was fighting so hard for you but probably the damage was too great for her little body to overcome in the end.
Fly free sweet little angel and please watch over your mama because it's going to be incredibly hard for her you not being here with her anymore.
Sweet little Daisy, we love you and we will miss you so so much.
Many hugs and kisses.

[molly muffin]

Oh Valerie. I am so sorry. My heart goes out to you and chris and your dad. I kept hoping she would pull through this, some how, some way. She was such a fighter and tried so very hard. The tears are just flowing as I know your heart and all our hearts are broken tonight.

Fly Free sweet Daisy, there will be many friends to meet you at the bridge.

love
Sharlene

[Trixie]

Val...I am so, so sorry that things took this turn. You did everything you could and I know above everything you didn't want Daisy to suffer. You were the best mom for this sweet little doxie! I know how deeply she will be missed by you, your dad and Chris. My heart is heavy for you Val.

Barbara

[gatorgirl_bama]

Oh Valerie I logged in to check on you and Daisy and this I not what I wanted to read. I'm so sorry sweetheart. She tried her best to hang in there for you as long as she could, but she was tired.

Please take care of yourself and your Dad. You're in my prayers. R.I.P. Daisy Mae.

Sending much love and lots of healing prayers.
Donna

[Tina]

Dear Valerie, I stopped in to check on Daisy as well and I am so incredibly sad to read this news. I just have no words right now, only tears. I am so very sorry. Many hugs.

[Budsters Mom]

Tears flowing. :o I am so sorry Valerie. Run free sweet Daisy, run free. The others will watch out for you now. Xxxxx

[Sophies Mom]

I've been checking in every night hoping Daisy would pull through this. I'm so sad now. My heart is so heavy. I know how much you loved her and you did everything you could for her. My thoughts and prayers are with you.

[doxiesrock912]

Thank you all. You have been such faithful friends to Daisy and I.
I sing your praises to family, friends and Daisy's vets.

They brought our sweet girl out to us wrapped in the blanket that she came in there with which was a surprise since they kept telling me to take things home so that they didn't get lost.

Dr. Broussard told me the other day that the ICU nurses loved Daisy so much that they wouldn't let her "graduate" to the regular ward. Many nurses told me of snuggles that they gave her because they just couldn't resist.

I had to ask exactly what happened when she passed. She got sleepy and fell into forever sleep. No seizures, no heart failure,no pain etc. Just peace and I thank God for that.

Tomorrow I bring Frontline Plus, Heartgard, and leftover food to Cornell to donate. They were so wonderful with her and fought hard alongside us.


Chris drove as I held Daisy love for the trip back to grandpa's house to her final resting place. All furry, feathered, and finned family members that have passed before have special places on the property of the home where they were all so loved.

Daisy rests wrapped in her daisy pastel blanket, with her favorite talking plastic ball that Chris gave her, a leopard patterned bone shaped pillow, her tags.....all swaddled together in a quilt that I made for her out of puppy patterned fabric.

Cornell gave me her paw print inked on paper and pressed into white clay

Rest peacefully my adorable companion Daisy Mae "monster" Howe. The pain that we feel is immeasurable but so are the love and memories that we'll hold forever in our hearts and souls.

https://www.facebook.com/media/set/?set=a.804673482884917.1073741837.100000268197543&type=1&l=557ea6d7db

[Woodydog]

Valerie

I'm am so very sorry I have no words only tears for you and the family

Run free little one xx

[Mel-Tia]

Valerie

I am sorry I haven't been posting but I was following along and came here first thing to see how she was doing, I so was so hoping she would come through this.

My heart breaks for you and the tears flow to read this update.

Run free sweet Daisy Mae

Mel
Xxxxxx

[doxiesrock912]

Thank you all.

Please visit this link. https://www.facebook.com/media/set/?set=a.804673482884917.1073741837.100000268197543&type=1&l=557ea6d7db

[Mel-Tia]

I am still here Val, you don't have to talk just wanted you to know your not your own.

I just looked at some of her pictures she's such a beautiful little girl

[Trish]

Hi Valerie

So sorry to read this news tonight, what a sweet wee girl. So sorry it ended like this for Daisy after you all tried so hard to save her. It sure sounds like it was a peaceful passing and for that I am thankful. I am going to look at the photos you have posted too. I will be here a few hours tonight if you want to chat if you cannot sleep. Just want to give you and Chris and your Dad a big old hug xxxxxxxxxxxxxxxxxxxxx

[Trish]

Awww I love those photos, when she was little she looks like she had two speeds... flat out or asleep!! Such a cute girl, her big floppy ears almost look too big for her when we was wee!! Just adorable. She sure had a lot of fun Valerie, I hope you keep these memories close as you go through these sad days x

[Trish]

Oh I forgot... my favourite is photo 285 :) absolutely lovely and I love it in black and white x

[doxiesrock912]

Thank you all so very much for being here for us always.
I'm not sure how to proceed from here, but Meloxicam has to be taken off the market for animal use somehow~

No one should ever go through what we have been through and Daisy's life never should've come down to this!!!! She deserved SO MUCH BETTER!

The specialists at Cornell definitely believe this was the cause of her rapid decline. Dr. Forman came right out and said that he "never uses meloxicam".

I don't want anyone else to go through this ever.

[doxiesrock912]

Trish, they don't have numbers for me so which one is it?
This still doesn't feel real. Tomorrow I'll go to Cornell to finalize the bill and get all of the documentation that I can.

I wonder how the dog that came in last night is doing after vomiting for days due to metacam? I'll have to see if I can find out.

[Trish]

Black and white one, with her laying down looking at the camera

[Trish]

https://www.facebook.com/photo.php?fbid=804685096217089&set=a.804673482884917.1073741837.100000268197543&type=3&l=557ea6d7db&theatre

They have numbers along the bottom of the box when you scroll through them

[doxiesrock912]

The photo was originally taken in color and then I made it black and white on the computer :)

She loved her blankets in true doxie style. I'm going to try to get some sleep while I can because I'm sure that there will be plenty of sleepless nights once real life sets in.

My favorite is the one where she's sitting on the floor in front of the bed with sunlight on her from the skylight above. It cascaded over every feature of her beautiful face and highlighted each feature.

https://www.facebook.com/photo.php?fbid=804677909551141&set=a.804673482884917.1073741837.100000268197543&type=3&theater


It's been 8 hours and 13 minutes since Daisy Mae left us. God this hurts every part of me.

[Trish]

I bet it doesn't seem real, hard to imagine she is gone. Do you need to go back so quickly, what about chilling out a few days and taking care of yourself. Can they not send a bill?

[Trish]

That one is gorgeous too, hope you get a bit of sleep. But please go with the thought that you did all you could for her Valerie, no one could have done more and many not as much as you did!! She was as lucky to have you as you were to have her, she is beautiful. Will be around if you want to talk xxxxx

[gatorgirl_bama]

Valerie,
I went to bed with a heavy heart last night, thinking about and praying for you. I'm so sorry this happened to Daisy. You're right, it shouldn't have happened at all. And I'm with Trish and wonder if chilling a few days wouldn't be best. Get yourself together, get your "ducks in a row", get your game plan down on paper, then go to Cornell with a clear mind as to what you need to do next.

The photo tribute of Daisy is just beautiful and I'm in tears looking at it. I know all too well how you are feeling now and every thing that is going through your mind right now. Losing your faithful constant companion, it's a heartache I don't wish on anyone.

Please know you're not a lone and we are all here for you any time you need us. I've ask Tippi and Tia to take Daisy under their angel wings so she's not a lone either.

Sending much love and prayers,
Donna

[goldengirl88]

Valerie:
I did not log on last nite and when I logged in this morning a deep sadness came over me as I started to read all of Daisy's posts until I got to the one that said she crashed. I am so truly sorry that this had to happen to your sweet girl. You went above and beyond to help her. She fought to the very end just like you. I am thankful to God that she went peacefully in her sleep. My Tipper is trying to comfort me as she sees the tears flowing. No one should have to go thru this, you have been thru enough lately. I am glad that Daisy will have a spot at your dad's house so she will always be near him too. Daisy will always be with you no matter what, so you can rest knowing you gave her every chance possible. In the end her frail little body could not take any more. I never ever thought it would come down to this. I wish I could change all this for you dear Valerie, as I would do it in a second. God Bless Sweet Daisy Mae I hope the others are running and playing with her and that she is pain free and looking down watching her mom.
Patti

[Squirt's Mom]

Dear Valerie,

It is with tears flowing that I come this morning. Each day I have looked in on this thread several times, praying our sweet girl would pull out of this and I had such hope as of yesterday. Reading your post from last nite is gut-wrenching. So very much was piled up against Daisy yet she fought terribly hard. I am so sorry she lost this final battle.

My thoughts and prayers and tears are with you, Chris and your dad.
Our deepest sympathies,
Leslie, Trinket, Brick, Sophie, Fox and all our Angels at The Bridge



I ONLY WANTED YOU

They say memories are golden
well maybe that is true
I never wanted memories,
I only wanted you.

A million times I needed you,
a million times I cried.
If love alone could have saved you
you never would have died.

In life I loved you dearly,
In death I love you still.
In my heart you hold a place
no one could ever fill.

If tears could build a stairway
and heartache make a lane,
I'd walk the path to heaven
and bring you back again.

Our family chain is broken,
and nothing seems the same.
But as God calls us one by one,
the chain will link again.

--- Anonymous ---

[addy]

Oh Val, I am so very, very sorry. I was not expecting to read this.

I am just so sorry.

[spdd]

Valerie, I am so very sorry to read this about Daisy this morning. She really fought hard, and you did do everything possible for her. I take comfort and I hope you do too, that she passed quietly and painfully. If they only knew what a hole and vacancy they leave in our lives.
Lots of hugs going your way, and tears are plenty right now. Please take care of yourself and my deepest sympathy.

[Angelique (Maya's Mommy)]

Dear Valerie
I am new on the forum and have been following your thread hoping that your beautiful dog would pull thru this crisis. I am so very sorry for your loss. May she live forever in your heart as I know you will forever live in hers. She was so lucky to have you and to be loved so deeply. Be free Daisy Mae.
My deepest condolences
Angelique (Maya's Mommy)

[pansywags]

Valerie,

I'm so very sorry to hear about Daisy. I shed some tears for her this morning and I hope those are a few you won't have to cry. I wish you peace.

Sleep well, Daisy Mae.

[doxiesrock912]

Thank you all.
If anyone has any ideas how to go about getting this drug off the market for dogs, please let me know.

Another doxie will undoubtedly join our family, just not for quite some time.

I took some of your leads and let Gracie and Annie say goodbye to Daisy. Annie sniffed her gingerly and then mowed as she slowly rubbed past my leg. Gracie laid within a foot of Daisy just staring from me to Daisy. Then she went running around the house full force. That stopped with both cats fighting. Really girls?

I had texted my niece. She called dad crying.

I can't get out of bed this morning and it's pouring rain. The angels are crying with me.

[goldengirl88]

Valerie:
You did a good thing for the other babies in the house letting them say goodbye to Daisy. How is your dad holding up? I still am in shock and cannot believe this turn of events. Was anything said to you about what made Daisy crash so suddenly? Maybe Dr. Forman may have some insight when you are up to it. You are very brave, and strong Valerie to get back on here right away. I hope the hole in your heart will heal in time. You have had many issues these last couple months and certainly did not deserve to lose your baby. Again I am glad Daisy went over the bridge peacefully that is the one saving grace. Blessings
Patti

[Woodydog]

Hi Valerie

I looked at daisy pictures my she was beautiful. Please take time to rest before you go back to Cornell I'm sure they will understand. We will all be a around to help you through this, as you progress through the days ahead. Lean on us I know I wouldn't have got this far without leaning on the angels here after losing Woody.

Big old hugs being sent to you Chris your dad xx

[doxiesrock912]

I've already called Cornell and requested all of Daisy's records and I will pay off the bill completely too. I really don't want to go there later and make this tragedy new again.

Her personality was as sweet as those pictures make her look. She was exceptionally tolerant for a dachshund and so affectionate! That always amazed me. The never ending affection.

As Chris and I drove back to Greenwich without our Daisy with us, we smelled a skunk and Chris imitated the quiet, under her breath, two barks that always signaled that Daisy smelled it too. It was sweet of him but set me off into another wave of overwhelming sadness.

[Trixie]

hi Val,
In tears now going through all the great photos of Daisy. Trying to decide upon a favorite...but since all of them are cute and adorable it's been hard to choose just one.
Love her posing with the flag...but really they are all so good and I can feel how much you loved her just looking at all of those pictures and what a great life Daisy had with you, your Dad, all the family and including the cats...full of playing, being outside and great times! She was indeed a happy dog and that's easy to see from the photos.

Glad to read Daisy garnered special attention and snuggles from the people at Cornell...(who could resist that face and those eyes?). Knowing now that Daisy went off to sleep without pain and suffering at least will give you a little relief that she was not struggling...just fell asleep.
I'm so sorry this happened as it did..and I can only imagine how hard it was to face this rainy day today. I'm sure it's going to be very hard to keep from crying and having an aching heart......there's no words that can keep the grief at bay, but we're all here whenever you need to talk about Daisy. I'm going to miss her too!
xo Barbara

[molly muffin]

Valerie, I love all the Daisy photos too. It's hard to pick and choose. I think I like a two fold though, where she is running and playing, swimming, tugging and then the follow up of a whew, man I'm tired and out she goes, sound to sleep.
It's the perfect life for a dog (for a human too really).

You gave each other so much and that can never ever be taken from you

hugs and love
Sharlene and molly muffin

[mcdavis]

I just saw the news about your darling Daisy and wanted to tell you how very sorry I was. You have some lovely pictures of her - I love the one with one ear up.
I don't really know how you would get a drug taken off the market however maybe searching the internet to see if other people have reported similar experiences would be the first step.
Take care

[flynnandian]

i was away for a long weekend without internet and just saw the news about daisy.
i am sorry for your loss. she was a remarkable dog!
and i am glad that daisy is home, and i hope you can get some sleep tonight.

[doxiesrock912]

Thank you everyone.

One year, I used the photo of Daisy with one ear up on a birthday card for my mother that read "You're HOWE old?" Mom loved that card <3

Our last name is Howe.

I can't decide on pictures either.

[Trish]

Hi Valerie, hope you are OK. I would not plan on doing anything much other than getting myself through the days at the moment. I hope you have some time to just be..... bed is a nice warm safe place, so if you have to stay there a bit just do it xxxxxxxx

[mytil]

My deepest condolences Valerie!!!! I am so very sorry.

(((hugs)))
Terry

[gatorgirl_bama]

Sweetheart I just wanted to check on you this morning. The poem that Leslie sent to you is my favorite and I'm crying like a baby now.

For a while everything will make you think of Daisy and you will cry your heart out, but that's ok. When you're out grocery shopping, doing yard work, talking on the phone, some little something will pop up, and that's all it will take. Tomorrow will be ten months since I lost my Tia and last night while Sammy and I were eating (we eat in our recliners), Tanzee came to the side of my chair and slowly put her paws on the arm and looked at me with those sweet eyes and as I have many times before to my sweet angel Tia, I said "get down". At that moment and out of nowhere it hit me, I balled like a baby.

Daisy was your heart for so long and there's no getting over it. I'm just so sorry this happened to you, but just know we're all here for you any time you need us.

Sending much love and prayers,
Donna

[addy]

sending lots of love and hugs Val.

[goldengirl88]

Valerie:
I just wanted to tell you I have always loved the black and white picture of Daisy beside the bed. I think it captures every essence of her spirit. Just do want you want to Valerie and go where your heart tells you, this is a difficult time to say the least, just know I truly feel your pain. Blessings
Patti

[doxiesrock912]

Thank you Patti. I chose one of her resting and another of her playing.

[jxeno13]

Oh no!! Valerie! I'm just reading this!! I am so so sorry to read about your precious, Daisy Mae! :( My deepest condolences, prayers and thoughts are with you!

[doxiesrock912]

Thank you Jo Ann.

[goldengirl88]

Valerie:
You are so brave sticking with us during your grief. My hat goes off to you for how you have handled all this. Blessings
Patti

[lulusmom]

Valerie, I am so very sorry for your loss. Nobody knows better than Daisy what a phenomenal mom you are but I think your k9c family knows that to be true too. Your fight for Daisy is well documented here and I hope that helps you remember that nobody could have done more than you did for your baby girl.

My heart breaks with yours and my thoughts are with you during this terrible, terrible time.

Godspeed sweet Daisy.

(((Huge Consoling Hugs)))
Glynda

[Spiceysmum]

Valerie,
I am away on holiday and have only just found out that sweet Daisy has passed away. I am so very sorry, you both fought so hard and did everything you could possibly do. My heart goes out to you.
Linda x

[doxiesrock912]

Patti, I'm really not doing well with this at all. I got the piles of paperwork from Cornell and in them found a detailed report sent to Dr. Kimm telling him that she died and the details. It said that she "arrested suddenly" and that "moderate debris at larynx when intubated". Does that mean that she choked on vomit?!

OMG I just can't believe that this is happening and knowing that Dr. Kimm is aware that Daisy passed and STILL hasn't reached out to me is inexcusable!

I can't stop crying.

[Woodydog]

Valeria

Off course you can,t stop crying things are just so raw at the moment. It doesn,t necessary mean she choked on vomit, it could be anything.

Ive been where you are going over every test, hospital paperwork trying to figure it all out and I just couldn,t as like you I couldn,t make sense of it and was crasping at straws. Please take a deep breath sweetie and re read it all when you are in a better place thats what i did and it made sense then.

I don,t know why the Vet hasn,t been in contact maybe he is busy or maybe he doesn,t know what to say.

I,m around for a while if you want to chat x

[doxiesrock912]

The reports definitely say that Daisy had a kidney infection so that was her problem when we visited Dr. Kimm. Not her back.

Not only did he give her one medication that has warnings about giving to a dog with kidney, heart, or liver issues - bot medications have those warnings and he got them via injection back to back!

[Woodydog]

Can you write everything down in a letter to Dr Kimm, lodging an official complaint about the treatment that Daisy received, address it to the senior vet/owner, or if Dr Kimm is the senior one then address it to him.?

[goldengirl88]

Vale rice:
I am truly sorry for what you read in the paperwork. When you get to where you can tolerate more information, I would email Dr. Forman and ask him about what you suspect. You are still in such pain that I am not sure you should do it for a while. It just kills me that you are hurting. I don't want to speculate on what the report indicates, and I wonder if Dr. Kimm is with his daughter?? Maybe he has not seen all this yet? I am hoping that is the case. Vets seem to be reluctant to reach out to a client when their pet has passed. I don't know if that is their way dealing with their job or what. Most eventually make contact, sometimes with a card. I know you are feeling he should have called, maybe see if he has even been around in his office or not?? Do whatever it is that helps you get thru this. I realize thru the passing of many of our members babies that this mourning is definitely way beyond the scope of grief felt by typical pet owners. You have put your whole life into Daisy, cared for her every need, and loved her like no other. The daily care and devotion you put into a cush dog, will never he understood by anyone but another cush dog parent. I can see from the experience of others this is not one of those times where you pick up the pieces and go on, this is a very hard cross to bare. You have a lot of inner strength, and you will need it all to get you thru this. Blessings.
Patti

[doxiesrock912]

The more research I do, the more I find that Dr. Kimm is at fault. One Adequan brochure actually says not to mix with other medications, especially those that might cause bleeding or hinder clotting like NSAIDS. The meloxicam and adequan shots were given back to back.

Dr. Kimm was in the office a few days ago when I called and whomever answered the phone promised to make sure that he called me back. Didn't happen.

[goldengirl88]

Valerie:
That is my very favorite avatar! I typed you a long reply, and this stupid tablet would not work when I hit post!!! Anyway what I wanted to say was, I did research Adequan before letting Tipper have it. I did read all of the bleeding etc. I was very concerned when Dr. Kimm injected it into Daisy's joint in her neck as it is not approved for that. On the surface it seems Dr. Kimm was not as knowledgeable at using this as he told you he was. He is probably avoiding you and that is why no return call. He may be concerned you are pointing the finger at him, and does not want to have that conversation with you. I guess he is avoiding confrontation?? I hope you do get an opportunity to talk with him and get this off your chest, as I think this is eating away at you. Blessings
Patti

[doxiesrock912]

Yes it is Patti. Doing a simple bloodtest or a more thorough exam than assuming it was her back would have avoided ALL of this pain for Daisy, myself, and our family.

[scoora]

Valerie,
I am so sorry to hear about your sweet girl Daisy.
My thoughts and prayers are with you.
The pictures of Daisy are beautiful.
Hugs

[doxiesrock912]

Thank you. I just can't fathom not having Daisy's unconditional love anymore.

[molly muffin]

Sending love and hugs your way Valerie. :( I wish there was a magic wand that took away all the pain and only left the good memories and smiles of love.

hugs
Sharlene and molly muffin

[Harley PoMMom]

More loving hugs being sent your way.