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Old July 28th, 2007, 01:19 PM
barryku barryku is offline
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10yr Sheltie with CHF is having diarrhea

My dog, Jimmy is having CHF and pulmonary hypertension. He doesn't eat by himself and started having diarrhea two days ago. I am very concerned how I can keep him up till his cardiologist appointment 9 days away.

Jimmy was diagnosed with congestive heart failure and pulmonary hypertension on Tuesday, and he is on Lasix and Benazepril for CHF and Viagra for pulmonary hypertension. He stayed overnight at the hospital for O2 therapy and got back Wed. night. The internist didn't feel comfortable with Jimmy's case due to the complexity of his illness especially pulmonary hypertension, and urge us to see a cardiologist. I had booked an appointment with the only cardiologist available in the entire SF bay area, but it won't happen until 8/6 as the cardiologist is out of office.

He started having diarrhea early Thr monring and last till Fri monring. I was fasting him with vegetable broth from Thr to Fri night. Since Jimmy had only one diarrhea early Fri morning, I gave him a few pieces of boiled chicken last night. Early this morning, his diarrhea came back again. Jimmy started to have dry cough about a month and half ago, and his appetite was declining. We took him to the family Vet two weeks ago when he stopped eating his dry food completely. He got a chest x-rays and blood test. The x-ray shows that he has dilated heart, and his heart rate reached 200. He is breathing a bit heavily. Our family vet put him on Lasix, Benazepril, and Hills dry k/d, but his condition didn't get much better after a week. That's when we were referred to the internist for a thorough checkup. Since Jimmy stopped eating his dry food two weeks ago, I tried cooking ground chicken/beef with white rice and it worked for about two days. I then had to force feed him with a syringe of liquified k/d which I blended with some water. It lasted for 4 days until we took him to see the internist. His stool was fine for the first 3 days of feeding k/d, and I noticed a bid diarrhea that morning before we went to the internist. I force fed him k/d Wed. night after he was back from the hospital, and next morning was when I found the serious diarrhea problem. He is drinking and urinating a lot due to Lasix, so I hope that wee keep him away from dehydration.
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Old July 28th, 2007, 01:36 PM
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I'm so sorry you dawg is so ill. Just an out-side-the-box question ... has your dog eaten chicken before for any period of time without digestive problems ? Hills k/d is not a kibble brand I would use regardless of what a Vet might indicate. Are you using any supplements or digestive aids, any holistic medicines along with the prescribed ones ? Does you Sheltie take any meds other than those you've listed ?
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Old July 28th, 2007, 01:58 PM
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Sorry to hear about the problems Jimmy is having. He is a medically complex dog and you must be exhausted with the stress of trying to keep things together. My only advice to you is that he needs to see a vet before 9 days. I would be very worried about dehydration, chemical imbalances related to diuretics, others meds and diarrhea. I am thinking he may need his electrolytes taken and possibly started on IV fluids. You are giving him complex care at home but, with the diarrhea and decreased food intake plus the diuretics, cardiac meds I think he needs to see the ER room asap.
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Old July 28th, 2007, 02:10 PM
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barryku,

Can you contact your regular veterinarian? Can she/he prescribe some antidiarrheal medications? Sometimes cardiac problems can manifest as gastrointestinal problems so I would at the very least call your regular vet and discuss the new clinical signs. A physical examination by your vet can help establish his hydration status.

As far as cardiologist in the SF Bay area - what about U.C.Davis VMTH (veterinary medical teaching hospital) - they have several cardiologists and residents there. They are one hour away from SF. Their main phone number is (530) 752 -1393. (That is where I went to veterinary school).

Good luck
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Old July 28th, 2007, 02:12 PM
barryku barryku is offline
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Quote:
Originally Posted by mummummum View Post
I'm so sorry you dawg is so ill. Just an out-side-the-box question ... has your dog eaten chicken before for any period of time without digestive problems ? Hills k/d is not a kibble brand I would use regardless of what a Vet might indicate. Are you using any supplements or digestive aids, any holistic medicines along with the prescribed ones ? Does you Sheltie take any meds other than those you've listed ?
He had chicken occasionally in the past, and never had diarrhea after having it. Since his appetite is quite poor, I tried boiled chicken which is on the list of food the internist suggest to get him start eating. My feeling is that his diarrhea started two days ago has not recovered yet. He hasn't eaten much in the last two weeks and he has lost a lot of weight. I really want him to start eating something, so I think I need to get the diarrhea situation under control soon. He is not on any other holistic medicines since it's already hard for me to give them the other medication now.
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Old July 28th, 2007, 02:34 PM
barryku barryku is offline
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Quote:
Originally Posted by crazydays View Post
Sorry to hear about the problems Jimmy is having. He is a medically complex dog and you must be exhausted with the stress of trying to keep things together. My only advice to you is that he needs to see a vet before 9 days. I would be very worried about dehydration, chemical imbalances related to diuretics, others meds and diarrhea. I am thinking he may need his electrolytes taken and possibly started on IV fluids. You are giving him complex care at home but, with the diarrhea and decreased food intake plus the diuretics, cardiac meds I think he needs to see the ER room asap.
Thanks for your reply. My family vet suggested the same when I contacted him regarding Jimmy's diarrhea Thursday morning . Jimmy was pretty stressed out from the hospital stay, and I wasn't too happy about the treatment he got there either. Since it's Sat already, so most likely I will have to send him to the same hospital which opens 7 days. I don't really want to send him back to the same place if possible. They gave Jimmy twice the dose of diuretic to clear the fluid in his lungs, but he didn't urinate much. I called the next morning to inform them that Jimmy will only relieve himself on lawn or grassy area, and the assured me that they would take him out to relive himself. Jimmy urinated for like half minute right after I got him out of the hospital.

Anyway, I will definitely get him to my family vet or other vet if he is not getting better this weekend.
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Old July 28th, 2007, 02:40 PM
barryku barryku is offline
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Originally Posted by Dr Lee View Post
barryku,

Can you contact your regular veterinarian? Can she/he prescribe some antidiarrheal medications? Sometimes cardiac problems can manifest as gastrointestinal problems so I would at the very least call your regular vet and discuss the new clinical signs. A physical examination by your vet can help establish his hydration status.

As far as cardiologist in the SF Bay area - what about U.C.Davis VMTH (veterinary medical teaching hospital) - they have several cardiologists and residents there. They are one hour away from SF. Their main phone number is (530) 752 -1393. (That is where I went to veterinary school).

Good luck
Thank you. I will try antidiarrheal to see if that works. I did call UC Davis small animal clinics before making appointment with Dr. Kienle, and their earliest appointment is 8/22. It's so unbelievable that there are so few cardiologists available here.
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Old July 28th, 2007, 02:59 PM
barryku barryku is offline
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Any good ER in San Jose area?

Does anyone know any good pet hospital opens weekend in south bay area other than the one on Thornwood? I may need to take Jimmy to an ER for IV fluid today or tomorrow.
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Old July 28th, 2007, 07:07 PM
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Sorry barryku can't help you with a Vet recommendation.

Have you tried a prebiotic like real yoghurt (I use a product called Bio-K) ? This will help settle his digestive tract and aloow him to gain more nutritive value from the food he is eating. If you can get him to eat, you might also want to add some pure pumpkin (the canned type but not the "pie filling") and psyllium (metamucil) to some broth along with shredded chicken (if you are going to boil it, do so in the broth so you retain a little more of it's nutritive value). Florazyme LP is another digestive enzyme which supports pancreatic function ~ you might also find this helpful.

In terms of rehydrating I use Pedialyte in similar circumstances. I know it's time for rehydration when I "pinch" my dog's skin and it retains the pinch for more than a few seconds or when I press on their gums and it stays white for more than a few seconds. If your dog is still interested in drinking on it's own, you can boil up a clove of garlic, with some ground meat or a meaty bone ~ he may prefer that to regular water.

Slippery Elm is an herb which I find helps with diarrhea but, I've also used products like Fowlers and Kaopectate.

When you are providing him with food and liquids I find it's best to keep the portions small and give them frequently rather than freely. When you fasted your dog, you helped to slow down his digestive enzymes ~ which was what he needed. When you fed him, his system likely became flooded with enzymes and his digestive tract revolted. But as Dr. Lee and crazydays have mentioned ~ your dog is in a complex health situation. And I agree, waiting that long for a cardio consult is insane ~ keepus posted !
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Old July 29th, 2007, 02:30 PM
barryku barryku is offline
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Thanks mummummum, Dr Lee, and crazydays, Jimmy seems to be doing better except for the diarrhea. We just got back from the ER, Jimmy's hydration is good, and his kidney function is ok and wasn't affected by the medication. His heart rate and breathing actually improved. I am very happy that he didn't need an IV and can come home with us after the examination.

We got some anti-diarrhea medication for him, so hopefully we will see his diarrhea stop soon. The vet also suggested to give him easy digested food starting now since he is literally skin and bones. He weights 13.6lb from 14.2 since Wed. and he was around 18 before the illness. I will try mummummum's suggestion and give him som white rice and pumpkin later. I also got a bottle of Nature's Bounty's probiotic acidophilus. Hope it's close enough to bio-k. The doctor said I can give him half capsule a day.

The past two weeks have been really emotional, and I was worried sick yesterday. Although his illness is complicated and his condition is not stablized yet, at least we are seeing some light at the end of the tunnel:love: .

Last edited by barryku; July 29th, 2007 at 02:33 PM.
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Old July 29th, 2007, 02:37 PM
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barryku ~ you're a good Daddy who is doing his best.
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Old July 29th, 2007, 03:53 PM
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Hi barryku
What great news it is to hear that jimmy is feeling better than he was. Good for you for nursing him through this weekend!! Lets hope jimmy can stabilize with his weight. I would love it it you keep us updated.

You are doing a fabulous job big daddy!!!! Also, I would love to see a photo off him.
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Old July 29th, 2007, 07:09 PM
barryku barryku is offline
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Thaks for all your kindness. This is just a great forum, and I will keep updating Jimmy's status here. I hope this will be a story of recovery that will inspire others. Here's Jimmy I just snapped. He like to hind under a chair or table.


My current challenge is to get Jimmy interested in his food and eat enough of it. His appetite has been very weird the past few weeks. His family doctor said it's because his heart rate, and the internist said he chose breathing over eating, but I don't think they are correctly entirely. I am sure the initial declining appetite was probably caused by the illness, but he was and still is interested in eating. He likes all kinds of fruits, apple, peach, banana, strawberries, etc. I used to giving him or eating with him an apple or a peach, and he seemed to never have enough of it in the past. He was eating an apple with me just two days ago, and was happy with the first three pieces I gave him. After the 3rd piece, he just turned away his nose, and I couldn't get him to eat another piece. If I put it on my hand and sort of encouraging him to eat, he would sometime pick it up and chew for a bit and spit it out. This happened with his pumpkin rice today. He was excited when I gave him the first spoon. The second was okay, but not that enthusiastic. He also spit out most of the rice. I figure maybe he doesn't like hard food or something, so I cooked it longer to make the rice soft. He did like it better, but for only three spoons. I was able to give him another two spoons an hour later. I began to suspect that his bad appetite is psychological. Anyway, this is my current challenge with Jimmy.
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Old July 29th, 2007, 07:23 PM
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Liver. I've never met a dog that will turn down fried liver. I know I get "hero of the Day" in my house when I cook it (and I'll tell ya... takes all of my gag reflex suppression techniques to do so !!!)

Not to mention that it's incredibly good for him at this time.
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Old July 30th, 2007, 06:15 AM
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Wow- Jimmy is one sweet looking dog! Seriously, what a beautiful coat. He looks like he would be a great friend! I really wish you both the best!! Good luck on the nutrition end of things.
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Old July 31st, 2007, 12:31 AM
barryku barryku is offline
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Jimmy is doing great today. He had pork-rib porridge with pumpkin for both breakfast and dinner. It took four times to finish breakfast and two for dinner. I am quite happy that he was eating despite that we had to hand feed him. Jimmy had much better energy today than the last two weeks, and he even played with his dinosaur a bit. Here's a picture of him with his toy,


The porridge can last for another two or more days, so I am wondering what else I can mix in other than pumpkin before he gets tired of it. Although he wasn't picky on food in the past, and had been on Canidae and Wellness Senior for several years, I am not so sure now.
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Old July 31st, 2007, 08:48 AM
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He is catching a second wind!!! Looks great. I hope he continues to improve!
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Old August 13th, 2007, 11:04 PM
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Some updates

We went to the cardiologist a week ago and not much news beside the existing diagnosis. The cardiologist said we need to monitor his weight and tailor the medications as needed. Jimmy had been doing well for two weeks until last Saturday. Although it took three or four times for him to finish the rice/meat I cooked for him, and I had to wait for an hour or so between each feeding, I was still pretty happy about his progress.

He stopped eating the rice last Saturday, and I have been trying to find something to entice him to eat to no avail so far. He still eats his treats, yogurt, and cooked liver, but it's just too little. Besides, I really want him to eat the real food with good nutrition. Earlier this evening, I tried "doggie oats" in Dr. Pitcairn’s Complete Guide to Natural Health for Dogs and Cats. Unfortunately, he wouldn't touch it at all. I am sort of running out of ideas now. Since he has been drinking quite often the last couple of days, I was a bit concerned. We took him to our family Vet today and did a blood test on liver and kidney function. Our vet said his heart rate is much better now. That's a good news and I need more news like that. We will have the test results tomorrow, and hopefully nothing else is wrong with him. I am keeping my figures crossed.
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Old March 30th, 2008, 09:25 PM
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Jimmy crossed the rainbow bridge earlier today

Jimmy died on my lap in my arms this morning on our way to the emergency room. I am very proud of owning such a brave and great boy.

Jimmy, doctor said your prognosis won't look good, and those dogs with the complication of pulmonary hypertension on top of CHF don't live over 6 months. You didn't just live 6 months; you live a full 8 months. It was easy to take care of you like you were before the illness till last night except for the first two weeks. I divided the food into 3 to 4 batches, so you didn't have to take all at once because I know you didn't like it. You always ran and hid from me whenever you heard me preparing you dinner. Still you took it like a champ after I found you every time even last night when you were so ill. I thought you were going to make it this time after you finished you meal with no hassle, but I guess you were just strong and didn't want to disappoint me. You were restless last night, and couldn't stay lying down in one place more than a minute, and I suddenly realized why you eyes look dull yesterday morning. You didn't sleep at all the night before, to be exact, you probably stood up most of the night. I tried to hold you in various positions for you to rest without causing you any pain, but couldn't achieve it. My heart was broken, and I knew something went terribly wrong this time. We decided to take you to the emergency room around 6am, and you were breathing very difficultly in my arms when we drove you to the hospital. Seeing you so painful, I was so afraid that you would have to go through a similar ordeal like the disaster 8 month ago when you stayed there overnight, I said to you, Jimmy you can go now if you don't want to stand the pain anymore. Dad will always love you. Minutes after, you were gone. How kind of you, you didn't want me to worry about more than a night. I am glad that I told you how much I love you no matter what happens before the trip.

We took you to the cremation place, and I am sorry that I had to leave you alone with only a few toys you loved. Dad promise you will be home soon once your urn is ready. I was looking around our neighborhood when we drove home from the cremation place, and it seemed I could almost see you and me walking down the street happily together. However, you were not home greeting me when I arrived home. I went upstairs and lied on the floor and listen closely, but I couldn’t hear the familiar ding ding sound coming from the name tag on your collar whenever you were approaching. I felt nothing on my back after lying there over ten minutes. Remember that you always came and lied back to back with me within minutes. You didn't just lie behind my back, you actually made sure your back touches mine. That was the best medicine whenever I felt down in the past 11 years and 3 months. I am already missing you and very very much.

It was a true blessing to have you with us through the happy and sometime difficult time over the past 3700 days. I don't know when I will be back to normal with your stuff in almost every corner in the house. Yesterday was a gloomy day, and the sky was still dark when we drove you to the hospital. Suddenly the sun came out in the day, and it was lovely out there, a perfect day to take you out for a walk. I think you were trying to tell me to be happy through the weather. Were you saying, hey dad it's a lovely day, just go out and have fun? I want to be strong, but boy you have set up such a tough example to follow. I was fully aware that you were still suffering during the time under that many medications. Both your heart rate and breathing never came down to the point I was hoping for, but you were always following us around the house gleefully, and barking with 3-year old force when you wanted to get a few pieces of the fruits I was chopping. That made taking care of you such an enjoyable chore. Jimmy, dad will try my best to be strong and happy without you around again. Right now, just rest peacefully.

Here are Jimmy’s medications and the daily meal in case anyone is interested,
* 6.25 mg Viagra twice a day for pulmonary hypertension
* 1.25 mg Vetmedin and 12.5mg * 1.5 twice a day

* Dr. Pitcairn's kidney diet without vitamin blended with vegetable broth ~ 120 ml every night

* Vitamin and supplements
* Vita-Dreams Daily Greens twice a day
* S Adensyl 100: once a day
* Vetri Science Cardio Strength: every other day
* 3V Caps: every other day
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Old March 30th, 2008, 09:44 PM
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I'm so sorry, barryku. Jimmy was a very lucky boy to be loved as strongly as he was by you.

Jimmy
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Old March 30th, 2008, 10:18 PM
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Jimmy was indeed very fortunate to have someone love and care for him as you do. I'm glad you were with him until the very end, what comfort you must have provided.

RIP Jimmy
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Old March 30th, 2008, 10:54 PM
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I am so sorry for your loss....


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Old March 31st, 2008, 12:59 AM
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How grateful you sound to have had this beautiful friend in your life, Jimmy will be with you always.

patti
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Old March 31st, 2008, 08:23 AM
barryku barryku is offline
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I wake up two hours earlier and said to myself, hey I slept 4 hour straight, I have moved on. Jimmy, don't worry about me and go do whatever you'd like or have to do. Minutes later, I was sobbing again. My eyes are sore from all the crying, I guess I am taking a day off from work today. I am writing down some of my thoughts here, so maybe this will help me to get that closure sooner.

I guess you are probably an angel that god sent to me eleven years ago. God will give you another assignment to go saving another lost soul or make another family complete. You probably won't be free to do so until god sees your job with me is completed, so I must move on. That's why I am telling you that I have, and you are free to go ahead for your new assignment. Seconds later, another same voice came back and saying, Jimmy, please come to see me from time to time, come to my dreams. I miss you so much, please let me hold you again. I hope that I can just thank all the kind words people put here and really move no, but it's just so hard to let go of you.

Jimmy, I found myself talking to you like crazy after you left. Just yesterday, I was folding my laundry and thinking these were done when you were still here and felt a bit closer to you. I started talking to an empty spot where you used to be and said, Jimmy stay there for a minute until I get these done. We will go downstairs and get you some snack.
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Old March 31st, 2008, 09:46 AM
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Hang in there, barryku... I know it's so hard.

Jimmy will hang around for a little while--you'll see him and hear him everywhere. When he sees that the happy memories are holding their own against the sad ones, he'll be able to move on. And it will happen.

We're here to listen if you need to talk.
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