Update on Nanook-How can you get 2 completely opposite diagnosis in the same day

[Rgeurts]

Morning all! It's been a very, very busy week. As some of you know, Nanook was sick again last Friday. After I posted, he threw up and was very bloated. I did not make it to the new vet (over an hour away) and instead, took him to the original vet as he looked like he was not doing well at all. They had me drop him off and leave him for the day. I asked that if any tests or treatment need to be done, please call me first.

They called me to come in and talk to the doctor, so I did. He went on to say that Nanook was in pretty bad shape but stable for the moment and said he needed to go to the hospital for overnight monitoring. They thought initially he had a twisted gut so they took x-rays. Turns out he had a bad bout of gas. Stomach was full, bowel was full and a huge pocket of gas in between. They also did chest x-rays and he pointed out a couple of spots and said his lungs were very bad, he could hear alot of lung sounds, which wasn't good and that it looked as though he had a bit of lung collapse. They also tested him for Pancreatitis, which was negative. The vet went on to tell me he felt very bad for us, he knew we spent alot of money and he was sorry. Then said no one at the clinic would "morally judge" us if we decided to euthanize him at this point. I was in tears, of course. He told me to stop the steroid completely because it was supressing his immune system too much. I told him I had read that was very dangerous, that he would have to be weaned off (he's on a 30mg dose 2x daily-60mg total). He just said "well, there is no right or wrong here. We have to do what's best for him. I don't know the outcome or effect but he needs to be taken off them for his immune system to recover". He also said again he didn't think it was Meningitis, just a case of juvenille epilepsy and he should remain on phenobarb. He said that after everything Nanook had been through he was afraid the lung infection was going to be his demise then hit me with an $800 bill.

We took him to the hospital to be monitored overnight. When we got there we had to pay their vet $150.00 for an "exam" fee even though we transferred him from the clinic to the hospital. He already had the IV and fluid bag and had just left our clinic and $240 to monitor him overnight.
I will say that I am glad their vet did examine him. He said that he thought clinically, Nanook looked pretty good and would probably feel better once he had a poo. So we took him out for a walk, he had a big poo and was alot perkier. We got back in to the hospital and the vet checked his respiritory and said he didn't hear the typical gurgling and crackle you would hear in a dog with acute pneumonia. He looked at the x-rays taken that day and compared them to the x-rays taken the last time he was in the hospital (a week and a half previous) and said it looked to him that there was improvement and he would equate Nanook's pneumonia with that of walking pneumonia in a person. He said he should be treated with antibiotics for 6-8 weeks to make sure it would take care of it completely. We told him our vet had said stop the steroids immediately and we were concerned with doing that. He said he would not stop the steroids, especially so abruptly. He said there was no evidence that it was hindering the antibiotic at this point and again said he saw improvement and the treatment should be at least 6 weeks. He said after the full course of antibiotics, if Nanook was not recovering from the pneumonia they may take a look at weaning the dose down at that point. He said we should consider weaning him off the phenobarb then said they would watch him overnight and if he was doing well, we could pick him up in the morning.

We called the next morning, he did great throughout the night (all he needed was a good poo). We picked him up then called the vet and told him that the vet at the hospital said he needs to remain on antibiotics for at least another month. He said he agreed completely and would call it in. I told him we had enough for that morning, and that was all and that we were heading out of town for a wedding and would like to pick it up on the way. He said he couldn't do it right away but would make sure it was at the pharmacy and if worse comes to worse, we could pick it up in the morning and he would only miss one dose
I told him that wasn't a good idea if his immune system was so supressed. He said it wouldn't hurt him. I called the pharmacy the next morning, no prescription. He had forgotten to call it in. I called the emrgency number (was a Sunday morn) and spoke with one of the girls from the clinic. They finally reached him at 3 in the afternoon and got him to call it in, so he missed a full day. That was the last chance. That is so negligent... I can't even begin to express how angry I was that he would put our baby in jeopardy like that. We have since transferred all of his, and Thorins, files.

We went straight to an internal specialist on Monday morning and told her about everything that had happened with our clinic, she couldn't believe it. She said it was good that we ignored his instructions to stop the steroid as that would have been extremely dangerous for Nanook. She also said she didn't agree that he has epilepsy and should remain on phenobarb and after weaning the dose for steroids down to a lower, steady level, she wants to wean him completely off the phenobarb and see what happens. She is doing it in stages because she said if she did them at the same time and he had another seizure, she wouldn't know if it was because the steroid dose was too low or he actually does need the phenobarb, which made complete sense to us. She was also very upset that Nanook went from Saturday morning to Sunday night without antibiotic. She said it's bad for any dog, but very bad with a dog that is as immunosupressed as he is. She thinks what he has is eosinophilic disease. She said they see it in respiritory but that it didin't show in the tests done on his lung fluid, but there were eosinophils in the fluid from his spinal tap. She does think he has it in his gut. She said if she were to try and explain what she thinks it is, the best she could do is Lupus in a human. She said his lungs don't sound bad to her and the x-rays do show improvement. She seemed very positive about his conditions/treatment and said it may be that he will have to remain on steroids very long time, possibly for life, or he may recover after these few months on steroids and be just fine. Even if we have to keep him on medication for life, we're ok with that!

So I guess what really bothers me is that one vet would have us considering euthansia, then hit me with an $800 bill even after I told them to call me prior to doing any tests, which he did not, and within the same hour another vet who seemed to think he just had a bad bout of gas and needed to poo, then should be fine, while 2 days later the specialist agreed that his outlook was not near as grim as our vet had made it out to be. She was also asking us why he did the pancreatitis tests and seemed to think it was not needed at all. Who knows

[Love4himies]

Holy moly! Poor Nanook and your poor wallet

Geesh, even I know you never stop steroids cold turkey unless it was life or death Glad to hear you transferred his files

Eosinophil cells, aren't they normally related to allergies?

[mastifflover]

I am so sorry that you and Nanook are going through this. I hate to say this but your vet was taking advantage of the fact he knew you would do almost anything to save Nanook. If you did not authorize test you should not be paying for them, you asked to be called and were not. If you have not paid this whole bill yet I would seriously consider not paying the rest or in my opinion I would call the society that covers veterinarians and speak to them this seems unethical to me. Also the that you had to pay again at the hospital does not seem right. I know you have spent a small fortune and I think your vet was taking advantage of you.
I am very glad to hear Nanook is doing better. Good vibes coming your way for both of you

[14+kitties]

to you for all you've been through. Poor Nanook. Did they say the bloat is something you will have to watch for with him now?

[hazelrunpack]

All I can say is I'm sure glad you found the internist, Robyn!! I'm glad he's feeling some better. I hope the new vet can get him back on the right road!

[ScottieDog]

Keeping Nanook in my thoughts. Not having definite answers is so hard. Your sweet guy sure has a fighting spirit. Try to stay strong.

[Rgeurts]

Originally Posted by mastifflover

I am so sorry that you and Nanook are going through this. I hate to say this but your vet was taking advantage of the fact he knew you would do almost anything to save Nanook. If you did not authorize test you should not be paying for them, you asked to be called and were not. If you have not paid this whole bill yet I would seriously consider not paying the rest or in my opinion I would call the society that covers veterinarians and speak to them this seems unethical to me. Also the that you had to pay again at the hospital does not seem right. I know you have spent a small fortune and I think your vet was taking advantage of you.
I am very glad to hear Nanook is doing better. Good vibes coming your way for both of you

Thank you for the good vibes
I will be contacting the AVMA to report him. The fact that I now feel he took advantage of us is bad enough, but the negligence and borderline incompetence is the worst part for us.

Originally Posted by Love4himies

Eosinophil cells, aren't they normally related to allergies?

I don't remember exactly what she said, but she did say Eosinophil cells are typical of an allergic reaction. The fact that they showed up in his cerebral fluid means that he has swelling and what they call meningoencephalomyelitis or EME, and idiopathic as they don't know the cause, which is good in a way. If it were infectious he would have a lesser chance of recovery. She believes it is an autoimmune disorder and called it eosinophilic syndrome (or something like that). She said they often see the eosinophils in the respiritory tract and the gut as well, which would explain the bloat, gas and diarrhea. She said she's quite sure if they did a stomach biopsy, that's what they would find and said the best way to explain is to equate it to human lupus. She said the transtracheal flush did not show any eosinophils though, which I'm sure is a good thing. We really did like her alot. She was so caring, and gave him lots of loves while she was checking him over... and said we had already done enough tests and spent enough money so she wasn't going to request anymore diagnostics, at least for now. She said it would be great to do an MRI and would be very interesting for her to study, but then said she wouldn't recommend it as it would have no real value to him at this point, it would just be more for her curiosity lol.

Originally Posted by 14+kitties

to you for all you've been through. Poor Nanook. Did they say the bloat is something you will have to watch for with him now?
She wants us to keep an eye on him. She thinks he may have food sensitivities and had us put him on a simple diet (switching food slowly) and something he has not been exposed to. We chose the Wellness Simple line, duck and rice. Hopefully it will help him She said he cannot have anything raw, at all. I guess because of his immune system and the possibilty of parasite infection and bacteria. She's hoping the prednisone will help with his gut also and if there are eosinophils, it should.

Thanks for all the good vibes everyone, hubby and I appreciate it!!

[luckypenny]

Wow. Poor Nanook. And poor you . I really hope things turn around for the better really soon, you all deserve it .