Wentworth's Mystery

Everything is a mystery with this one...if it's not his baffling case of epilepsy, it's something else!

Here's what we know, please chime in if anything sounds familiar or you see a correlation:

-Loose stools/diarrhea on and off for approx 5 days.

-Projectile vomiting this AM (6m-8am).  Lots of clear fluid/water in the vomit...never really seen projectile vomiting from a dog (usually see gagging, etc..before hand).

-Took to the vet immediately this AM after making sure he held his epilepsy meds down.  They diagnosed him with "gastrointeritis" after a fecal exam, giardia test, and regular physical exam, and found nothing wrong.  They gave him an anti nausea shot (Cerenia) and the following meds for me to take home to administer:: Fortiflora powder, Tylan powder, Cerenia pack.

-Upon arriving home, I immediately gave him his lunch (he eats 4 times a day to take with his epilepsy meds) and he sniffed it and walked away (VERY shocking for Wentworth - he ate his own vomit this morning - he eats everything all. the. time.).

-Went out to potty and noticed his (solid) stool had 2 dime sized spots of blood; looked like spots of grape jelly.

-Upon arriving home, he has been burping a lot, and as this happens he burps up water (?)  His stomach is also making monstrous noises.

-Called the vet about his annorexia (anorexia), bloody stool, and tummy noises, and she had me come get canned food and metronidozal.  Told me not to worry "yet."  That a small amt of blood is still ok with tummy irritations and to call back with a report tomorrow.

-Fed him 1/2 can of canned food with all the powders and meds in it and he took about half an hour to eat 1/3 of the half in his bowl.  

sigh sigh sigh.  Does anyone see anything here?  My vet is clearly missing something.  Only new things in our routine:  I moved 2 weeks ago, we upped his potassium bromide last week, and he recently (2months or so) began eating dog poop at the dog park (big fear here...).

Help!  He's lethargic and miserable, too.  What is my vet missing?  What am *I* missing?
Kate

[Ghilly]

Wow, Kate, I'm so sorry to hear that you're having all these problems with Wentworth!  It has GOT to be SO frustrating!

I wish there was some help I could offer you, but I have no idea of where to even start!

Not trying to scare you, but with all these recent developments today, have you looked at his gums to see what color they are?  Check them to see if they are still a healthy pink color, because with all the belching and vomiting and refusal to eat, I'd be afraid that he had developed bloat gastric torsion / volvulus.  Is his abdomen bloated at all?  It's the lethargy part that has me worried, in combination with all the other symptoms.  

I agree with you that your vet is DEFINITELY missing something, but WHAT?  Have you taken him for a second opinion?  Sometimes you get lucky and end up with a vet who has seen similar symptoms before and at least has a direction to go in for a start.  

Hopefully someone else reading here will have an idea for you.

Ghilly

[katew888]

He has pink gums and a normal belly :(  The thing is, he is ONLY vomiting a clear fluid, and it's so strange the way he vomits...almost like he's not ever expecting it to come up.  He's just walking along, and *splat* it comes out.  No gagging, no heaving...

I guess we will go in for a second opinion tomorrow.  There are 4 different vets at my clinic, so I'd assume ONE of them had a clue.  

What can I do for all of this dehydration that's bound to plague him after all this vomiting?  I would estimate approximately 30 little spit ups (about half a cup's worth each) since 4pm today (it's 9pm now).

[Jaybay]

Have they done any blood and urine testing?  With that kind of vomiting, I'm surprised they aren't at least considering pancreatitis.  An x-ray would be helpful to determine if he's eaten something that's gotten stuck in his intestines.  In my opinion, it's time for your vet to get off his rear end and start looking for a diagnosis instead of throwing meds at the symptoms.

You are right to worry about dehydration and if this goes on much longer he's going to need IV fluid support in the clinic.  When a dog can't keep down water, that's when you really start worrying.

Sometimes dogs like ice chips when they're nauseated.  You can even freeze gatorade or offer it outright as a temptation.  Keep the amounts low but frequent.

Get your vet on the phone and demand some testing be done today.  Enough is enough!

[peekawho]

The grape jelly appearing stools is VERY concerning to me.

Its a classic sign of an intussusception.  I had a dog misdiagnosed with gastroenteritis when it was really an intussusception.  I noted the red jelly stuff in his stool, but the vet thought nothing of it at the time, and I didn't know any better.

The stool is often described as appearing like "currant jelly" in an intussusception.  

Please read this.  And call your vet and describe the jelly like blood in the stool again.  Ask if you can have him evaluated for an intussusception right away, today..  Its critical that it be diagnosed IMMEDIATELY.  Or the bowel will die.  

[peekawho]

If thats what he has, its a serious, dire, emergency.  

[peekawho]

And if your dog is getting into odd positions, like he's stretching repeatedly in an odd way, going down on his front paws in the "praying" position, rolling in an odd way, pacing repeatedly...these are signs of severe pain that often accompany an intussusception.  

I hope you see this.  Occasionally an intussusception can resolve on its own, but most often surgery is needed immediately!  Please let me know you saw this!  

[Ghilly]

Peek, you read my mind!   At this point, it most certainly DOES sound like an intussusception.  I am hoping that Kate has some news for us later today.  Not that I am wishing surgery on Wentworth OR on Kate, but it sure would be nice to at least have a diagnosis and a planned route of attack so that the two of them can get back to enjoying life again!

Ghilly

[katew888]

Thanks guys - reading this from my phone, FYI, in case there are errors.

We went to the er vet last night at midnight, he was just "regurgitating" too much. He's back at the vet now and they are doing everything: xrays, bloodwork, etc, etc. Sad that we had alredy BEEN to the vet with none of this done, but I will save that issue for a ranier day. His bloodwork looks fine, just has the normal elevations that a sick and dehydrated dog would have, pancreatitis was negative, his esophogus is enlarged and irritated, and the xrays are fishy and needing a second opinion...and of course he had a seizure while he was getting a pain shot. Nothing like another mystery to interrupt the already baffling and mysterious epilepsy.

Will report back later with news! And if that news is that he ate something again, well, I just don't know what to do with my "Hoover." I cannot for the life of me think of what he couldve gotten into this weekend, we were home together the whole time, and if he gets into things, there's usually VERY obvious evidence (he is not stealth or sneaky, there's always a trail behind his mischief). Sigh.

[peekawho]

They may need to do an ultrasound, if its a small intussusception it won't be seen on xray.

Oh, I hope he's ok.  I was beside myself when you mentioned the "jelly" blood in the stools.  

http://www.hhdane.com/medical/intussusception.htm

[katew888]

Ultrasound at 430 today. Then we should know.

Wentworth wins the "most expensive dog in the world" award.

[peekawho]

Not yet, he's  not.  

If he has surgery on top of all this, THEN he'll win the award.  I think I'm the previous record holder!

I hope its not.  My blood ran cold when you said about the bloody jelly in the stool.

Keep us posted!

[peekawho]

Kate, here's one more nugget of info, if it does wind up being an intussusception (I learned this too late, after my dog was already dead)

A barium enema is sometimes used first, before surgery.  Not only will it help diagnose an intussusception--sometimes it will actually cure it, if its not tos severe or the bowel hasn't completely died yet.
The thick barium will fill the intestinal walls and will actually sometimes push the telescoping part open.

Its sometimes tried if the owner can't afford surgery, too...as a last ditch effort.   Sometimes it works.  

[katew888]

VERY good to know.  The vet said that since the ultrasound is so late today and he's so dehydrated that she would wait for surgery tomorrow anyway, as surgery on a dehydrated dog is apparently a bad idea...maybe a barium enema overnight wouldn't hurt to try and prevent surgery in the morning!  I will see what the consensus on this is, thanks SO much.

[katew888]

Ol' W is in surgery. The Dr. said it couldn't wait based on the ultrasound. She's doing it herself because she couldn't bear the thought of passing him on to the overnight er doctor, so she's making up for the wasted trip we made yesterday for a diagnosis by working late into the night on my boy ;). Paws crossed that all goes well! Thanks to all for the advice and concern.

Kate

[peekawho]

Oh, Kate!  I am just reading this!  

Please update us this morning if you can.  I'm sending good doggy thoughts from my boys, and of course, good human thoughts from me.

[Jaybay]

Oh thank God he's in surgery!  Crossing fingers and toes for some really good news soon.  :-)

[katew888]

Surgery was finished at 10pm last night, and I transported him over to the ER for the rest of the night to be watched.  Doing well today, but he's having a few seizures, which is apparently typical for an epileptic after a major surgery.  He's also on some heavy duty antibiotics to prevent pneumonia/possible aspiration because of the 2 cc's worth of regurgitation that gushed from his nose uncontrollably during surgery  (he had a little green goo this morning so they were concerned).  If his seizures are still acting up throughout the day, it's suggested he spend another night at the er to keep a pair of eyes on him if I can swing it financially, so that's something we need to pray subsides throughout the day because honestly, I can't add another $400 tonight (last nights er cost) to the mounting $3k bill....but, best news is that he's fine so far.  Fingers crossed to keep any complications away from my boy!

[peekawho]

I'm so glad he's ok so far!  Those antibiotics are critically important, not just for the aspiration but because he's had bowel trauma.

Its going to be hard to control the seizures if his gut isn't working yet.  He'll have to have injections or IV meds.  

[Jaybay]

Keep the good news coming.  The next 24 hours sound pretty critical, and I have to agree with the decision to keep him overnight.

Our dog Maggie had an accident where she impaled herself on a plant stake.  It took 2 surgeries and several days in ICU to save her - along with $7,000.  Then there was Chica with a nearly $5,000 bill for TPLO surgery, and Travis at $10,000 in a failed attempt to save his life from pancreatitis.  I had to sell my car to help pay Maggie's bills, but it was so very worth it.  Think about the bills when this is all done.  You've come too far to stop now.  Later you can look at selling on ebay or having a garage sale.  :-)

[katew888]

He's at the ER tonight to monitor the seizures - he's had about 6 today.  Hopefully they stabilize soon!  Everything else looks good, according to all the vets (he's won the hearts of all 4 vets at the clinic, and of course the ER vets).He should be home by Sunday or so.  I think he's pretty sick of the routine, but just a little more time until he's home to snuggle in bed with me!

My boyfriend loaned me his dogs for a few hours this evening to keep me company, but they are so weirded out by Wentworth not being here, they will go back home soon; too much anxiety on their part.  They didn't even want to jump in the back of my car.  I suppose the smell of a medicated/sick Wentworth is pretty overwhelming and confusing to them in his absence.

Thanks for all the advice/concern/well wishes!  It's nice to have a little support system that understands; I was actually asked today if it's worth it to spend so much $ on my dog!!  Goodness yes, it is.  100%.

[peekawho]

Was it an intussusception, or some other type of bowel obstruction or twist?

Heck, yes its worth it!  Costco sells giant jars of peanut butter.  My dh and I lived on those for about a year, it seemed!  Anything to pay for our "boys" vet bills!

[katew888]

It was an obstruction: several things from the trash can and some plants (weird).  

Just got an update that he has a spot of pneumonia in his lungs, and that his belly has filled up with fluid, however an ultrasound showed the stitches intact and nothing leaking, so his body is just reacting strangely.  I'm told that it CAN be normal for the belly to simply react that way after surgery, so we'll see what else we can find out.  He also went from happy and bouncy this morning to lethargic and depressed at noon, so the Dr. is going to drain the fluid from his belly and see if he feels better after that...

I'm officially getting worried and think real prayers are in order.  Hearing that he is lethargic and depressed is NOT a good sign, as it takes a LOT to get my little man down and out.

[Jaybay]

I agree.  More prayers on the way!  The fluid is definitely worrisome - did the vet happen to tell you if it was blood or if they tested it for a specific bacterial infection?  Infection is always a worry when the intestines are opened up, but hopefully this one will be knocked right out with antibiotics.  

My abdomen swelled up like a pumpkin after resection surgery.  In my case it was just a matter of peristalsis kicking back in.  It actually took several days, and I had no appetite whatsoever.  Reglan (metoclopromadine) can help with that, and is commonly given to dogs with nausea.  Your vet may not want to give it so soon after surgery though in order to give the intestine tissues time to heal.

You are providing top-notch care for your dog.  Hang in there!  :-)

[peekawho]

More real prayers coming right up.  This is the first thread I've been checking each time I log on, I'm so worried.

I hope he's all right.  

[Ghilly]

Lots and lots of prayers going up for Wentworth!  OMG, I can't believe what he is having to go through!  But at least you finally figured out what the problem was and it has been corrected.  Now we all need to pray to keep W's guardian angels working overtime for the next few days.  Seriously praying for your boy to recover, Kate.  Thanks for keeping us posted.

Ghilly

[Misfits4Me]

I'm praying too, Kate.....COME ON WENTWORTH (Love that name)......You can do this!!!!!!.....Karla

[katew888]

He's coming home tomorrow!  They took out his catheter and he's off the fluids and taking medicine orally as of this morning, so if all goes well through the night, he's back to being mine, all mine!

Thanks so much to each of you...it is SO nice to have this little group to turn to.

Kate:)

[Jaybay]

WHO HOOOOO!!!!!  Now that's what I call FABULOUS news!  I'll admit I was extremely worried about Wentworth when you posted about the post-op issues.  Your dog obviously has a very strong will to live.  You are the best kind of pet owner - you didn't abandon your gut feelings early on, strongly advocated for your dog and saw this horrific event all the way through successfully.  Bravo!  :-)

[Ghilly]

Way to go, Wentworth!!!!!!!!  Kate, that's WONDERFUL news!!!!  I'm so happy for you both!!

It just goes to show, as Jaybay said, go with your gut.  If you feel like something's not right, chances are it's not, and don't stop looking until you find it!  Wentworth is very lucky to have such a dedicated and loving Mom!  Kudos to you, Kate!

Ghilly

[peekawho]

My heart was in my throat until you posted this!!  

You are my hero.  You did what was needed for your dog, even though it was a HUGE financial, emotional, and physical ordeal.

You ROCK!!!!  

I'm so glad he's recovering.  I was soooo worried!

[katew888]

Ok...how worried should I be that he just vomited up his dinner (approx 20m after eating)?  Today was his most active day since the surgery, we got to see his two sisters and he played - no rolling around, but some jumping and running.  Also gave him a full can of food rather than a half can, so maybe that's it?

I let him eat it back up since his epilepsy meds were in it...gross, I know, but I I don't want to overdose him by giving him more.  Plus I see it as a good sing that he wanted to eat it again and wasn't shying away from it.

Obvs I will call the vet in the morning, but any thoughts??

[Ghilly]

I would think there might still be some leftover effects from the anesthesia, and since he did have surgery on his intestines, it stands to reason that there might even be a bit of inflammation there after all he went through.  I think  you're smart to call the vet in the morning, but I wouldn't panic yet.  

I would try to keep him as quiet as possible for the rest of the night, only because you don't want him vomiting TOO much since it could damage the stitches if he heaves too much.  Remember, he doesn't just have stitches in the skin and muscles, he had his bowel cut into as well, and you don't want him damaging that.

I agree with you that it was a very good sign that he wanted to eat again, as gross as his choice of what to eat was.  :)

Ghilly

[peekawho]

I agree.  A one time puke in a recently critically ill post op dog might not be unexpected.  

Keep us posted with the updates!  You're both in my thoughts every day!

[katew888]

I was paranoid :)  It looks like it was just a case of an overly active day for him when he wasn't *quite* ready for it.  We're just taking small walks now rather than visiting our sisters, as that kind of excitement wore him out too easily - he thinks he can play harder than he should.  I think the full can of food put him over the top after that.

He's thrown up one other time, yesterday morning, when I started to mix his regular food in with the canned food, so it's obviously just a tummy adjustment, as he has been fine since.  

The only thing I'm struggling with is how much energy to let him exert?  He's an insanely excitable dog (we joke that his only emotion is "wildly happy"), but he seems to tire pretty quickly on our walks, and I'm not sure how far to push him.  I don't want him to just sit around feeling weak, I'd like to build his endurance back up, so any advice on that?  Just walking further and further each day has been my routine thus far.  Not sure when to let him see his sisters again since that was a lot of excitement for him the other day...

My only other (mild and slightly crazy) issue is that I don't really ever want him to leave my place ;)  It's completely "Wentworth proof" now and I fear that anywhere else in the world that he goes is full of things that he can get into that will hurt him.  How on earth am I ever going to have children one day when I'm this protective over my dog!

[peekawho]

Kate,

Hopefully, your children won't eat from the trash, or devour your socks!!!

I think your exercise plan of walking a little more every day is fine.  Small, frequent meals also.  

What a good dog momma you are!  

[ginger899]

I've been kind of 'lurking' on this thread, biting my nails for Wentworth, but not able to give any more than everyone else has already said. Poor Wentworth's drama has been so fast-paced. All I can say now is GOOD OLD WENTWORTH for being such a strong fella! And GOOD OLD YOU for looking after him like you have. This is all very happy news

[Jaybay]

After our dog's impalement episode and two bowel surgeries in one day, we were extremely lucky to get her back home in just under one week.  The surgeons was emphatic about keeping Maggie on a leash until her staples were removed 10 days later.  Her incision was huge - from sternum to genital area and easily 70+ staples.  Wentworth needs total supervision with a leash or a crate to ensure that staples or stitches don't pop open and the intestines fall out.  Crazy as it sounds, it does happen.

Go easy on the food for a few more days.  Too much too soon and it will just come right back up.  When the intestines are traumatized, they can take quite a while to resume the normal ryhthmic action that passes food and waste through the body.  That's why a large meal will come right back up - the body isn't quite ready to move it on down the line.  Small meals three or four times a day would probably do better than the usual once or twice a day feedings for the next few days.

I can't tell you how worried I was when you first posted about Wentworth.  Great job for you and Wentworth both to have gone through such a trauma and already coming out the other side!  :-D

[peekawho]

I was told to blenderize our dogs food for a couple weeks after his surgery, but he lost over 4 feet of intestines, and was septic.  We mixed small amts wet/dry, and soaked in chicken broth til soft, then put it in a blender and fed it 4 or 5 times a day.

He was on house arrest, and short leash walks only for a good while.