Posted By: Xfilefan
Chronos is in Serious Conditon - 02/28/07 10:57 PM
For any who attended either of the last 2 SGGAs...Chronos is the little guy who so graciously let me repeatedly put the E-collar on him half a dozen times or so in the SM table demos both years.
Now he's in trouble, but we think it's treatable.
I had him out Sunday, and he seemed fine. Last night, he came out a little before I left for work, and threw up. Then he peed, and it was the most neon yellow I can describe-think the gremlins in the posts yellow.
I had weighed him only a few weeks ago at 145 grams (down from 154)...BUT, we'd cut treats down for a few months, so that wasn't out of line. I stuck him on the scale last night and he was only 122 grams. Took him into brighter light, and could then see that not only was his pee extremely yellow, so were his hands, feet, nose, and ears. 10 pm. Okay..jaundice means the liver is involved-due to what was the question. So we gave him some metaclopramide (anti nausea), and I'd take him to my regular vet in the morning.
Got off work this morning, and took him straight from work in Park City to my vet in Salt Lake...who wasn't in today. They referred me to one in Centerville they send to when Dr. Harris is out (and I was very impressed by him)...and tacked on another almost 100 miles to an already nearly 100 mile drive. But Chronos needed to be seen TODAY, so off we go.
We got there, and they took us in, got Chronos' information, history, weight, and didn't have to wait long for the vet. (I'll be adding another option to the database for UT people). He really looked yellow under the exam room lights. Vet did physical exam, and got a urine sample-bright yellow-that they went and ran a urinalysis on. Extremely high amounts of bilirubin (indicating liver dysfunction). Next step was a blood panel-we had to find out what was going on on the inside. Vet put him under with Isofluorin....and he promptly vomited. They spent at least 10 minutes clearing it out of his mouth with swabs so he didn't breathe in any. They took blood from the vena cava in the chest (forgive me if that isn't spelled right-I'm pretty tired by now), I knew it could be done, but hadn't even seen it attempted before-that was interesting. He woke up, and instead of chewing on the towel, he tried to chew on his back foot as he came out of it. So I had to hold him wrapped in the towel until he woke up enough to stop that. I talked with the receptionist a bit while they were running the panel-took about half an hour or so.
First, I'm going to post the results. Items marked with * are elevated, marked with ** are dramatically elevated:
ALB 2.8 g/dl
*ALKP 496 U/L (liver enzyme)
*ALT 307 U/L (liver enzyme)
AMYL 467 U/L
BUN 13 mg/dl
Ca 7.9 mg/dl
CHOL 156 mg/dl
CREA 0.5 mg/dl
GLU 241 mg/dl
PHOS 5.3 mg/dl
** TBIL 18.8 mg/dl (bilirubin)
*NEUT 26% (white blood cells)-slightly elevated
**LYMPH 60% (dramatically elevated lymphocytes)
MONO 11%
EOS 2%
Base 1%
Urinalysis:
URO --
GLU --
Ket --
**BILI ++++
Prot 30
Sp Gr. 1.034
Now I'm going to attempt to re-explain this so it makes sense.
It is NOT Primary liver disease (what our Gim died of), because of the fact that the liver enzymes, though elevated, aren't 'dramatically elevated'
A small part of the liver is involved, including the bile duct (hence the bilirubin secretion)
Possibilities presented based on his history, symptoms, and test results:
Hephatic Lipidosis (sp?)
Bile stone, sludge
Iron storage disease (remote)
some blockage or dysfunction of the bile duct
cancer
The vet feels Hephatic Lipidosis is most likely (and I'll get to explaining what that is), though cancer and stones aren't ruled out.
This means he isn't processing fats correctly, and they are storing themselves in the liver, forming deposits and compromising function.
He starts the following meds today:
Amoxicillin
Milk Thistle (to improve liver function)
Metoclopramide (to keep him from throwing up what he tries to eat)
There are 2 others we can add if results are limited with this.
Dietary changes: no meats, limit fats, limit iron
This means no BML, because it has meat (chicken), egg, iron fortified baby cereal
We are going with Boost as a staple (it is a little lower in fat than Ensure-vet agrees), and along with eliminating green veggies, and NO more MEALIES, I have to go look up the rest of the fruit/veggie values. He can have an occasional little canned cricket, tho.
I am also to syringe feed him a few times a day to make sure he's getting enough calories-we need to see his weight go UP.
Now, vet wants to do a needle biopsy with ultrasound. That will look for things like cancer, stones, etc, and confirm (closer) the diagnosis with a glider safe sized sample of the liver). With almost $700 in vet bills between Feb 7 and 28th (today's was $273.77), I couldn't do it today. I'm going to have to try and scrape that together, and it will be an additional $300 (give or take)since vets got all but a couple tanks of gas worth of my paychecks this month. So for now, we're treating for what the vet thinks is most likely, and will go from there. My apologies for not managing to remember everything the vet said-a lot of it was rather detailed, and I think I'm too tired. We got out of the vets at noon (after 3 hours-the man is VERY thorough, and very gentle with the gliders), picked up his new staple food, dropped the blood results off at Harris' office, picked up a few extra syringes (and I gave him his anti nausea meds and a drink) and then home by 2:30 pm. (I left work with him about 7:20 this morning.
Know that if anything gets worse...we WILL be heading back to the vet no question, and immediate, and I just hope I can find a way to get what he needs for the testing.
I hope my little yellow guy starts to improve! As the vet said, this is very serious, and we could lose him (though I really hope not, as he has a chance this can be treated). He is such a sweet little guy. Keep him in your thoughts.
Edit: Oh, and the reason the vet says it's not primary liver disease (meaning it's dying and too badly damaged to treat-terminal) is because he'd expect to see the liver enzymes much more elevated along with the other items, and they aren't.
Now he's in trouble, but we think it's treatable.
I had him out Sunday, and he seemed fine. Last night, he came out a little before I left for work, and threw up. Then he peed, and it was the most neon yellow I can describe-think the gremlins in the posts yellow.
I had weighed him only a few weeks ago at 145 grams (down from 154)...BUT, we'd cut treats down for a few months, so that wasn't out of line. I stuck him on the scale last night and he was only 122 grams. Took him into brighter light, and could then see that not only was his pee extremely yellow, so were his hands, feet, nose, and ears. 10 pm. Okay..jaundice means the liver is involved-due to what was the question. So we gave him some metaclopramide (anti nausea), and I'd take him to my regular vet in the morning.
Got off work this morning, and took him straight from work in Park City to my vet in Salt Lake...who wasn't in today. They referred me to one in Centerville they send to when Dr. Harris is out (and I was very impressed by him)...and tacked on another almost 100 miles to an already nearly 100 mile drive. But Chronos needed to be seen TODAY, so off we go.
We got there, and they took us in, got Chronos' information, history, weight, and didn't have to wait long for the vet. (I'll be adding another option to the database for UT people). He really looked yellow under the exam room lights. Vet did physical exam, and got a urine sample-bright yellow-that they went and ran a urinalysis on. Extremely high amounts of bilirubin (indicating liver dysfunction). Next step was a blood panel-we had to find out what was going on on the inside. Vet put him under with Isofluorin....and he promptly vomited. They spent at least 10 minutes clearing it out of his mouth with swabs so he didn't breathe in any. They took blood from the vena cava in the chest (forgive me if that isn't spelled right-I'm pretty tired by now), I knew it could be done, but hadn't even seen it attempted before-that was interesting. He woke up, and instead of chewing on the towel, he tried to chew on his back foot as he came out of it. So I had to hold him wrapped in the towel until he woke up enough to stop that. I talked with the receptionist a bit while they were running the panel-took about half an hour or so.
First, I'm going to post the results. Items marked with * are elevated, marked with ** are dramatically elevated:
ALB 2.8 g/dl
*ALKP 496 U/L (liver enzyme)
*ALT 307 U/L (liver enzyme)
AMYL 467 U/L
BUN 13 mg/dl
Ca 7.9 mg/dl
CHOL 156 mg/dl
CREA 0.5 mg/dl
GLU 241 mg/dl
PHOS 5.3 mg/dl
** TBIL 18.8 mg/dl (bilirubin)
*NEUT 26% (white blood cells)-slightly elevated
**LYMPH 60% (dramatically elevated lymphocytes)
MONO 11%
EOS 2%
Base 1%
Urinalysis:
URO --
GLU --
Ket --
**BILI ++++
Prot 30
Sp Gr. 1.034
Now I'm going to attempt to re-explain this so it makes sense.
It is NOT Primary liver disease (what our Gim died of), because of the fact that the liver enzymes, though elevated, aren't 'dramatically elevated'
A small part of the liver is involved, including the bile duct (hence the bilirubin secretion)
Possibilities presented based on his history, symptoms, and test results:
Hephatic Lipidosis (sp?)
Bile stone, sludge
Iron storage disease (remote)
some blockage or dysfunction of the bile duct
cancer
The vet feels Hephatic Lipidosis is most likely (and I'll get to explaining what that is), though cancer and stones aren't ruled out.
This means he isn't processing fats correctly, and they are storing themselves in the liver, forming deposits and compromising function.
He starts the following meds today:
Amoxicillin
Milk Thistle (to improve liver function)
Metoclopramide (to keep him from throwing up what he tries to eat)
There are 2 others we can add if results are limited with this.
Dietary changes: no meats, limit fats, limit iron
This means no BML, because it has meat (chicken), egg, iron fortified baby cereal
We are going with Boost as a staple (it is a little lower in fat than Ensure-vet agrees), and along with eliminating green veggies, and NO more MEALIES, I have to go look up the rest of the fruit/veggie values. He can have an occasional little canned cricket, tho.
I am also to syringe feed him a few times a day to make sure he's getting enough calories-we need to see his weight go UP.
Now, vet wants to do a needle biopsy with ultrasound. That will look for things like cancer, stones, etc, and confirm (closer) the diagnosis with a glider safe sized sample of the liver). With almost $700 in vet bills between Feb 7 and 28th (today's was $273.77), I couldn't do it today. I'm going to have to try and scrape that together, and it will be an additional $300 (give or take)since vets got all but a couple tanks of gas worth of my paychecks this month. So for now, we're treating for what the vet thinks is most likely, and will go from there. My apologies for not managing to remember everything the vet said-a lot of it was rather detailed, and I think I'm too tired. We got out of the vets at noon (after 3 hours-the man is VERY thorough, and very gentle with the gliders), picked up his new staple food, dropped the blood results off at Harris' office, picked up a few extra syringes (and I gave him his anti nausea meds and a drink) and then home by 2:30 pm. (I left work with him about 7:20 this morning.
Know that if anything gets worse...we WILL be heading back to the vet no question, and immediate, and I just hope I can find a way to get what he needs for the testing.
I hope my little yellow guy starts to improve! As the vet said, this is very serious, and we could lose him (though I really hope not, as he has a chance this can be treated). He is such a sweet little guy. Keep him in your thoughts.
Edit: Oh, and the reason the vet says it's not primary liver disease (meaning it's dying and too badly damaged to treat-terminal) is because he'd expect to see the liver enzymes much more elevated along with the other items, and they aren't.