Well, Snoopers and I are home and Amy is on her way back to Toledo and Ralph and her puppers. I am pretty sure she will be giving all her puppers big hugs when she gets home!
It was quite a roller coaster ride down there. Last night two students and a doctor saw Snoopy and while I was under the impression that we hurried on down there to do the tap and the ultrasound they informed me they were just planning on monitoring him - which kind of made me mad because it is not cheap to keep a dog in ICU overnight in a medical school hospital. Today a different student and doctor saw him and so we got conflicting opinions occasionally. I think are student is a little more optimistic in general than the doctor - she tried to tell us that it was because the doctor was more experienced but I have a feeling that this doctor goes with the worst case scenerio which may be good because obviously if your dog does better, you are happier. Anyway, we found out late in the day that they did do a tap last night and found that the fluid he is holding in his abdomen is from the cells leaking protein becuase the liver is damaged enough not to process so that does not happen.
The student said that they expected to see a very damaged liver but it looked as if only a part of it was damaged and the rest looked okay. She saw that as a positive sign that the changing of the meds would solve most of Snoopy's problems. But the doctor says the ultrasound isn't always accurate and although it looks good, it may not be. And the only way we will know how damaged it is and what is definitely causing the damage is an ultrasound. As Phred said they can't do the ultrasound until next Tuesday and that would cost $2000 - that is added to the $1400 vet visit we had today. And the biopsy may only show that what we have decided to do is the best plan anyway.
The only medication that they can change him to from phenobarbital is Keppra - the bad news it will cost $6.00 a day. We will be weaning him off the the phenabarbitol very, very slowly to decrease the chance of his starting more frequent seizures. He will be staying on the potassium bromide.
"Snoopy's incoordination and "drunkenness" may be a side effect of his anti-seizure medications, or it may be secondary to a process called hepatic encephalopathy. This occurs when ammonia builds up in the body due to a decrease in liver function and affects the brain causing a change in mental status. WE are starting Snoopy on several medications (Amoxicillin and lactulose) to help support his liver function. These medications decrease the toxic ammonia that builds up when the liver is not functioning. A low protein diet will also help decrease the ammonia that builds up in the body."
So we are now also adding other meds and changing foods which they fear may also make him have more seizures. One of the meds given in the dose the dr.wanted would have also cost us $6.00 a day! (I love Snoopy very,very much but there is no way I can afford close to $500 a month on meds and food. Plus the lactulose is the one that can cause the explosive diahrea ( it is also the one that would cost the other $200 a month.)
With two small children and 8 other dogs in the house, increased seizures and explosive diahrea will be most lilkely more than we can handle. And it does nothing for Snoopy's quality of life as more frequent seizures leads to even more frequent seizures. Some tough - almost impossible - decisions may be ahead for us.
So what we have decided is to take it day by day, week by week. I have paid for the first month's meds and we will be on a wait and see plan. How much it helps, how Snoopy handles it, how much stress it adds to our household, etc. If we can find some hidden stash of cash that can aid in his meds. (you know buried treasure or an antique thats worth millions or a lottery ticket by the way we never buy).
So that is where we are. Please pray for out big guy - the next weeks could be very difficult on him.
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