• Welcome to the Chronicle Forums.
    Please complete your profile. The forums and the rest of www.chronofhorse.com has single sign-in, so your log in information for one will automatically work for the other. Disclaimer: The opinions expressed here are the views of the individual and do not necessarily reflect the views and opinions of The Chronicle of the Horse.

Announcement

Collapse

Forum rules and no-advertising policy

As a participant on this forum, it is your responsibility to know and follow our rules. Please read this message in its entirety.

Board Rules

1. You’re responsible for what you say.
As outlined in Section 230 of the Communications Decency Act, The Chronicle of the Horse and its affiliates, as well Jelsoft Enterprises Ltd., the developers of vBulletin, are not legally responsible for statements made in the forums.

This is a public forum viewed by a wide spectrum of people, so please be mindful of what you say and who might be reading it—details of personal disputes are likely better handled privately. While posters are legally responsible for their statements, the moderators may in their discretion remove or edit posts that violate these rules. Users have the ability to modify or delete their own messages after posting, but administrators generally will not delete posts, threads or accounts upon request.

Outright inflammatory, vulgar, harassing, malicious or otherwise inappropriate statements and criminal charges unsubstantiated by a reputable news source or legal documentation will not be tolerated and will be dealt with at the discretion of the moderators.

2. Conversations in horse-related forums should be horse-related.
The forums are a wonderful source of information and support for members of the horse community. While it’s understandably tempting to share information or search for input on other topics upon which members might have a similar level of knowledge, members must maintain the focus on horses.

3. Keep conversations productive, on topic and civil.
Discussion and disagreement are inevitable and encouraged; personal insults, diatribes and sniping comments are unproductive and unacceptable. Whether a subject is light-hearted or serious, keep posts focused on the current topic and of general interest to other participants of that thread. Utilize the private message feature or personal email where appropriate to address side topics or personal issues not related to the topic at large.

4. No advertising in the discussion forums.
Posts in the discussion forums directly or indirectly advertising horses, jobs, items or services for sale or wanted will be removed at the discretion of the moderators. Use of the private messaging feature or email addresses obtained through users’ profiles for unsolicited advertising is not permitted.

Company representatives may participate in discussions and answer questions about their products or services, or suggest their products on recent threads if they fulfill the criteria of a query. False "testimonials" provided by company affiliates posing as general consumers are not appropriate, and self-promotion of sales, ad campaigns, etc. through the discussion forums is not allowed.

Paid advertising is available on our classifieds site and through the purchase of banner ads. The tightly monitored Giveaways forum permits free listings of genuinely free horses and items available or wanted (on a limited basis). Items offered for trade are not allowed.

Advertising Policy Specifics
When in doubt of whether something you want to post constitutes advertising, please contact a moderator privately in advance for further clarification. Refer to the following points for general guidelines:

Horses – Only general discussion about the buying, leasing, selling and pricing of horses is permitted. If the post contains, or links to, the type of specific information typically found in a sales or wanted ad, and it’s related to a horse for sale, regardless of who’s selling it, it doesn’t belong in the discussion forums.

Stallions – Board members may ask for suggestions on breeding stallion recommendations. Stallion owners may reply to such queries by suggesting their own stallions, only if their horse fits the specific criteria of the original poster. Excessive promotion of a stallion by its owner or related parties is not permitted and will be addressed at the discretion of the moderators.

Services – Members may use the forums to ask for general recommendations of trainers, barns, shippers, farriers, etc., and other members may answer those requests by suggesting themselves or their company, if their services fulfill the specific criteria of the original post. Members may not solicit other members for business if it is not in response to a direct, genuine query.

Products – While members may ask for general opinions and suggestions on equipment, trailers, trucks, etc., they may not list the specific attributes for which they are in the market, as such posts serve as wanted ads.

Event Announcements – Members may post one notification of an upcoming event that may be of interest to fellow members, if the original poster does not benefit financially from the event. Such threads may not be “bumped” excessively. Premium members may post their own notices in the Event Announcements forum.

Charities/Rescues – Announcements for charitable or fundraising events can only be made for 501(c)(3) tax-exempt organizations. Special exceptions may be made, at the moderators’ discretion and direction, for board-related events or fundraising activities in extraordinary circumstances.

Occasional posts regarding horses available for adoption through IRS-registered horse rescue or placement programs are permitted in the appropriate forums, but these threads may be limited at the discretion of the moderators. Individuals may not advertise or make announcements for horses in need of rescue, placement or adoption unless the horse is available through a recognized rescue or placement agency or government-run entity or the thread fits the criteria for and is located in the Giveaways forum.

5. Do not post copyrighted photographs unless you have purchased that photo and have permission to do so.

6. Respect other members.
As members are often passionate about their beliefs and intentions can easily be misinterpreted in this type of environment, try to explore or resolve the inevitable disagreements that arise in the course of threads calmly and rationally.

If you see a post that you feel violates the rules of the board, please click the “alert” button (exclamation point inside of a triangle) in the bottom left corner of the post, which will alert ONLY the moderators to the post in question. They will then take whatever action, or no action, as deemed appropriate for the situation at their discretion. Do not air grievances regarding other posters or the moderators in the discussion forums.

Please be advised that adding another user to your “Ignore” list via your User Control Panel can be a useful tactic, which blocks posts and private messages by members whose commentary you’d rather avoid reading.

7. We have the right to reproduce statements made in the forums.
The Chronicle of the Horse may copy, quote, link to or otherwise reproduce posts, or portions of posts, in print or online for advertising or editorial purposes, if attributed to their original authors, and by posting in this forum, you hereby grant to The Chronicle of the Horse a perpetual, non-exclusive license under copyright and other rights, to do so.

8. We reserve the right to enforce and amend the rules.
The moderators may delete, edit, move or close any post or thread at any time, or refrain from doing any of the foregoing, in their discretion, and may suspend or revoke a user’s membership privileges at any time to maintain adherence to the rules and the general spirit of the forum. These rules may be amended at any time to address the current needs of the board.

Please see our full Terms of Service and Privacy Policy for more information.

Thanks for being a part of the COTH forums!

(Revised 1/26/16)
See more
See less

Dog in crisis, looking for ideas

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Dog in crisis, looking for ideas

    Firstly, THIS DOG IS IN ICU.

    Secondly, it's not my dog--I'm just trying to get some ideas for a friend.

    The dog is a spayed teenaged Golden Retriever.

    Here's what I have from the owner:

    Thursday I took her to the vet and she had a growth removed from her foot – they cut and cauterized. She was very strong and difficult to hold down, hence why I am so baffle that Saturday night things changed so quickly.

    I could not get her to go outside before bedtime. I thought she was just being stubborn so I got her leash and decided to take her for a walk. She did got up and proceeded to go for her walk, however, she was moving very slowly. We got two houses down and she went laid down in the neighbor’s lawn and would not get up. I loaded her in my vehicle and my nightmare began. Her blood sugar was at 47. She was not walking because she was so week. She had an elevated temperature of 104 and no signs of infection. She took a turn for the worse at about 3:30a and would not even lift her head.

    Her blood workup is good except for her glucose levels. There were a few that were a little off the mark but not concerning. She has had chest x-rays, adnominal x-rays, and on a drip – antibiotics, pain medicine and dextroxe. She has been on a drip since about 1:00am on Saturday and finally as of last night she her blood glucose rose to 65. She sat up yesterday afternoon and even tried to get up to go home but she is still too weak. At that time her glucose was only 56. (the nice increase happened between 4 – 7p last night). They are upping her dextroxe.

    They feel that she has a tumor that attacks insulin. It is possible it is not showing in the x-ray but will show in the ultra sound. If they do not find anything, is there any diseases that you are familiar with that would attack her blood sugar like this? Her temperature is back down to the high side of normal. The other weird thing is her mouth seems to be tender or else it is itching her. When she was not responsive and could not sit up (Saturday morning), if I touched her around her mouth she would paw my had away. Then yesterday she kept pawing at her mouth. I have had them check it 3x for abscess, bite, etc. Nothing has been found.

    I realize I may have to make a difficult decision today as I do not want her to suffer, but if they can’t tell me what is wrong I feel there is still hope. Unfortunately I am not at my regular vets as I had to take her to the emergency center. They seem to be really good and I don’t feel my dog’s history will shed any light. I had a full blood work done about six months ago since she was aging and everything was fine.
    Does anyone have any ideas?
  • Original Poster

    #2
    This is my best guess: http://www.vsso.org/Pancreatic_Insulinoma.html

    The emergency vet does not have the dog on glucagon or diazoxide. Results from the belly ultrasound should be forthcoming shortly.

    Comment


    • #3
      Isn't low blood sugar from too much insulin? I'm sorry to hear about your friend's dog, we've got a diabetic dog on 2x daily insulin and a restricted diet. Dog also has thyroid issues and is on steroids. He's running around like a 3 year old as as long as he's still happy, we're happy to keep him on them.

      I beleive the thyroid is what triggerred his low blood sugar stroke incident, that may be worth looking into.
      Nudging "Almost Heaven" a little closer still...
      http://www.wvhorsetrainer.com

      Comment


      • #4
        PS, not a vet, just my wife and I are living insulin, diets, and doggie pills for our Barn Dog. Best one ever, by the way.
        Nudging "Almost Heaven" a little closer still...
        http://www.wvhorsetrainer.com

        Comment

        • Original Poster

          #5
          Yes--I believe there was just some confusion regard low glucose versus low insulin...the dog seems to be hypoglycemic and over producing insulin. My friend is very stressed and doesn't have a medical background...

          The latest I have from her is that the dog is improving and up this morning, with only some lingering wobbling in the hind end. They are going to reduce/remove her glucose drip and see if she can maintain. Ultrasound has been bumped back to the afternoon.

          I think it's curious that she's improved with only glucose and antibiotics. Does a insulinoma resolve in that manner? Could this be infection based instead?

          Comment


          • #6
            Good to hear. Sorry, i can't help on causes just have a very narrow perspective on diabetes and dogs, and a huge thumbs up for sick pups healing.
            Nudging "Almost Heaven" a little closer still...
            http://www.wvhorsetrainer.com

            Comment


            • #7
              Causes of hypoglycemia are NUMEROUS, including pancreatic cancer (insulinoma), liver failure, sepsis (overwhelming infection somewhere in the body), brain cancer/issues affecting insulin regulation, xylitol (in gum and sugarless things) toxicities, etc.

              In this case, I'd be looking at insulinoma first, but also heavily considering sepsis or liver failure...the latter 2 will definitely respond to antibiotics and supportive care. They should find evidence for or against insulinoma and possibly liver disease on an ultrasound. If there is fluid in the belly that shouldn't be there, they should sample it. Sepsis is a little more complicated to prove.

              FWIW not all places have glucagon for drips or diazoxide. I wouldn't put the dog on diazoxide until a definitive diagnosis of insulinoma is made. For keeping in the in the ICU, a dextrose (NOT dextroxe...eeeek sorry my internal spellcheck went crazy with that one) infusion should suffice. For what it's worth, dogs with insulinomas tend to do worse on dextrose CRIs since adding dextrose to the blood causes insulin release even further when levels of insulin are already high...kind of adding fuel to the fire. Those dogs I've managed with intermittent feedings and a little bolus as needed if clinical.

              With the mouth issue...I'd be really worried about what her calcium levels (ionized calcium, iCa, not total calcium) are. Dogs that have calcium imbalance can have facial itching or pain. The iCa level has to be specially done and won't be on routine bloodwork. They should be able to do it easily in the ICU though.

              Keep us updated, and it sounds like your friend's dog is being managed appropriately for now. I'm pretty sure the vets treating her DO have other differentials like those I've listed above, but are chasing the most likely diagnosis (insulinoma). Jingles!

              Comment

              • Original Poster

                #8
                Thanks, Pancakes--I will pass the info on to her. I really appreciate your expertise and ideas!

                Wouldn't liver failure be pretty apparent on bloodwork? Is there anything in particular that could cause calcium imbalance and the hypoglycemia?

                Comment

                • Original Poster

                  #9
                  Ultrasound is back: definite tumor in pancreas (I don't know how large) with potential lymph node involvement. Vet is also cautioning that there might be more that the ultrasound cannot see.

                  Dog is stable right now, and my friend is debating pursuing surgery and treatment, or just treating with prednisone, or letting her go.

                  Sad day

                  Comment


                  • #10
                    Oh, crap. Sigh. Hugs to your friend and megajingles to her dog. That sucks.

                    Comment


                    • #11
                      SO sorry to hear this, such a terrible thing to go through.

                      Jingles

                      Comment


                      • #12
                        Originally posted by Simkie View Post
                        Ultrasound is back: definite tumor in pancreas (I don't know how large) with potential lymph node involvement. Vet is also cautioning that there might be more that the ultrasound cannot see.

                        Dog is stable right now, and my friend is debating pursuing surgery and treatment, or just treating with prednisone, or letting her go.

                        Sad day
                        Oh poop. Surgery might be hard on her at that age. Definitely a hard call to make. If she's not feeling better in the hospital, or they can't get her on diazoxide and pred (you can get diazoxide from pharmacies special-ordered), then I'd let her go. It might be worth seeing how she responds, though. But I know how crappy this finding is and it's 100% a family decision where to go from here -- no right answers unfortunately.

                        Comment

                        • Original Poster

                          #13
                          Oh, Pancakes, that a bummer to hear it might be rough on her at her age. I was hoping it could be an option.

                          She is feeling quite a bit better in the hospital--she is up and engaged and was very, very happy to see her mom this evening. It sounds like she is still unsteady behind, but that is much improved over not being able to get up at all.

                          Comment


                          • #14
                            Originally posted by Simkie View Post
                            Oh, Pancakes, that a bummer to hear it might be rough on her at her age. I was hoping it could be an option.

                            She is feeling quite a bit better in the hospital--she is up and engaged and was very, very happy to see her mom this evening. It sounds like she is still unsteady behind, but that is much improved over not being able to get up at all.

                            I know But the pancreas is a delicate area anyway to operate around. It really depends on the type of tumor, the extent, etc. Definitely up to the surgeons and the vets working with her as to what her risk level is. But, like I said, I've seen people who opted not to go to surgery manage their dogs on oral medication and they did much better than expected. My last case had seizures from low blood glucose and his owners considered euthanizing him, but then he started to improve...last we heard, he's doing great.

                            It's not easy, but I'm thinking of her and hoping she improves daily!

                            Comment


                            • #15
                              Jingles for improvement. I had one that developed enteritis, we think from a pancreatic tumor. He got better, then worse, then better, then worse, till I let him go. Did not do anything aggressive in terms of treatment for a host of other reasons. Anyhow, hoping for the best in this case.
                              "One person's cowboy is another person's blooming idiot" -- katarine

                              Spay and neuter. Please.

                              Comment


                              • #16
                                Aw, shoot. I hope she can come home for a few good days. how sad.
                                www.ncsporthorse.com

                                Comment

                                • Original Poster

                                  #17
                                  Morning update: when they visited late last night, the dog was back in crisis and not being well managed. Her blood sugar was very low. The clinic had discontinued the dextrose drip.

                                  This morning, she is back on dextrose (I'm not sure if she's on a continuous infusion or boluses) and is bright and up and walking around--the clinic told my friend that she looks great.

                                  There does seem to be some sort of clotting disorder (secondary to liver disease?) that is causing lesions in the capillaries.

                                  Pancakes (or any other vets): I know you have a tiny amount of information about this dog, but do you think it would be possible to get her stable enough to at least go home for a little while? The emergency clinic seems unwilling or reluctant to get her on glucagon or diazoxide, which seems a little odd to me?

                                  Thank you all for your thoughts and well-wishes! It sure sucks when they get old, doesn't it?

                                  Comment


                                  • #18
                                    Simke,

                                    I'm so sorry for your friend, tell her we are rooting for her and the pup but remind her that second opinions are very very definitely an option!

                                    She should ask around (or her regular vet) for a specialist and find a way to either transport the dog or the records to get another view.

                                    That would allay lots of fears as to her current course of treatment.
                                    HaHA! Made-est Thou Look!

                                    Comment


                                    • #19
                                      Originally posted by Pancakes View Post
                                      Causes of hypoglycemia are NUMEROUS, including pancreatic cancer (insulinoma), liver failure, sepsis (overwhelming infection somewhere in the body), brain cancer/issues affecting insulin regulation, xylitol (in gum and sugarless things) toxicities, etc
                                      Pancakes, I just want to thank you for explaining medical terms.

                                      Its a pet peeve of mine when vets or docs throw around medical terms as if the general public has knowledge of them.
                                      On that alone, I just want to say, I bet your explanations help ease the mind of many of your patients. A vet at New England Equine is also very good at bringing medical terms into a human understanding...and she is board certified in Internal Medicine so has extensive education and knowledge, but thankfully doesn't feel the need to 'impress/intimidate' her clients.
                                      Its scary enough for an animal owner or person being thrown a diagnosis, add on terms that they might not fully understand and add to the stress and fear.

                                      I hope things go well Simkie for your friends dog.
                                      Good luck.
                                      save lives...spay/neuter/geld

                                      Comment

                                      • Original Poster

                                        #20
                                        Hey Chester's Mom,

                                        Yep, I've encouraged her to talk to someone else. CSU is right here, and their cancer center is very good.

                                        It's always hard for me in situations like this to know what the right balance is between helping and being supportive and potentially being perceived as pushy or stepping over the line.

                                        Comment

                                        Working...
                                        X