The Good, The Bad, and the Hopeful

Addie getting her IV treatment

Addie getting her IV treatment

The Good

Last week we realized that Addie had not had a blood test in over a year.  Honestly, we had only requested one test since we moved to Costa Rica.  So, since we were taking her to the vet to have her skin condition evaluated we figured we would also have blood drawn.  Her test results were pretty good.

Test Results Normal Range
BUN 26.1 8.8 – 26
Creatinine 1 .5-1.6
AST 59.3 8.2 – 57

Two categories are “above normal” but only slightly.  In comparison to her past 3 blood tests she is actually much closer to the normal ranges now.  Yeah!

The Bad

This past Sunday she was having a much harder time getting up than normal.  However, she was eating normally and we felt that this was a good sign.  Eventually though, she wasn’t even able to stand on her own.  By Monday morning she was much worse and we sent a text message to our vet asking for an appointment.  Unfortunately he was out-of-town but he did put us in touch with another vet in Tilarán.  We took her in first thing Monday morning.

We never know what to expect when Addie has to take an emergency trip to the vet.  On several other occasions we have rushed to the vet thinking “this is THE trip”.  We never want it to be but it is hard not thinking about that outcome as she is lying in the back of the vehicle in bad condition.   By the time we arrived she could hardly raise her head and her breathing was very shallow.

During the exam the vet even said “I am not optimistic at all about Addie’s prognosis”  but then again, we have heard comments like that on several other occasions.

The vet decided to insert an IV for hydration, to administer some pain medication, and to take a blood sample.  Later that day she called to tell us that Addie needed to stay overnight BUT that she was recovering faster than anticipated! The diagnosis was Ehrlichiosis – a tick disease that can be deadly if not caught.

By the time we arrived the next morning she was still doing well.  She had vomited the night before but did manage to keep a small amount of breakfast down.  She could also get up on her own so we walked her across the street to the park to urinate (for about 2 minutes!).  It was quite a scene: I was walking Addie slowly across a busy street, Rob was trying to keep the IV in her paw from tripping her, and the vet was following with a bag “just in case”.

Although she was doing better she was not ready to go home just yet.  The vet kept her until about 4:30 that afternoon in order to administer more medication and to fully re-hydrate her.   At that point she felt that Addie would do better at home than in her office.  (As a side note:  many vets here in Costa Rica work in conjunction with a feed store.  Addie’s hospital room was a crate tucked in between pallets of grain!).

The Hopeful

Since her return home, she has been picky but is eating her full amount of food.  She has been taking her medicine and getting up on her own.  She is still very tired but has improved over Monday.  She has a follow-up appointment tomorrow, and we are hopeful that she will continue to improve.

At this point the main concern is liver and kidney function as those two organs are typically the most effected by the disease.  This is worrisome because those are the two organs we worry about most given her age and cancer.  BUT as we showed at the top of the post, her blood tests last week were good.  We hope when the new results come in that the ranges will still be close to normal.

At this point only time will tell for our Addie Girl who apparently over the years has bartered for a few extra lives from some of her cat acquaintances… 🙂

Speechless

Addie enjoying the outdoors!

That’s what we are this afternoon… speechless!

We had Addie’s blood tested again today – 2 months since the last test.  Here are her results by month:

Test July, 2011 Sept, 2011 Dec, 2011 Jan, 2012 March, 2012 Normal Levels
ALT 93 129 190 224 93 < 120
ALP 93 119 200 220 <140
Glucose 94 98 87 89 53 75 – 125
Protien 6.9 6.3 7.2 6.5 5.5 – 7.6
Creatinine 1.7 1.4 1.5 1.9 1.1 .4 – 1.4

We don’t have comps for ALP or Protein, but her ALT, Glucose, AND Creatinine all went down.  WAY DOWN!!  They are not perfect, but they are astonishing to say the least as they had been trending very rapidly in the upward direction. We had been very concerned as they pointed to either liver and/or kidney failure.

So… the question we asked was why the drop?  There really were only 2 things that have changed in the past 60 days:

  • We added the Chinese herb Shu Gan to her diet.
  • We moved to Costa Rica.

Which one caused the positive effect?  We don’t know.  But we plan on staying in Costa Rica for a while, and we will definitely be ordering more Shu Gan!

Addie’s New Vet

Addie enjoying the Costa Rican sun..

Addie had her first appointment with her new vet in Costa Rica.  Nothing wrong, but we wanted to make sure and get her established with a vet right away.  We took in her 6″ of historical paperwork from both of her previous vets in Colorado including the last 3 blood test results.  The Dr. reviewed those, did an initial exam and verified that her ear infection she had the week before departure was indeed all clear.  She speaks wonderful English as she went to school and practiced in Texas prior to practicing in Costa Rica.  It is helpful that she speaks English well as our Spanish is no bueno!

She assessed that given Addie’s age and medical history, she is doing well!  The liver numbers are a concern being over 200, but she said she has seen a dog with ALT’s over 2,000 so that is encouraging and Addie show so signs of liver issues such as retaining water, yellow gums or yellowing of the eyes.  So for now, Addie gets 2 thumbs up!

And a great side benefit of this?  Addie’s initial exam and office visit cost us less than $14!  Back in Colorado, that type of visit is between $50 and $65!

Addie in Costa Rica!

Addie getting ready to board

We were pretty worried about flying Addie to Costa Rica with us.  She obviously has been through a lot, so adding the stress of a flight wasn’t ideal.  But we had consulted with both of her vets and they thought she would be fine.  We also made sure we took a direct flight to minimize the length of time she would be stressed.

Frontier Airlines was great. They did everything to make sure it was painless for everyone.  In the end, she came through like the trooper she is!  When we picked her up on the other end, she just gave me a look like “hey, what’s going on?  Can I get out of this plastic crate/box thing now?”.  She didn’t seemed stressed at all.  Finigan on the other hand was a whole other story.  Customs rushed him through very quickly due to his “stink”.

Addie helping Rob with the pool work

We are now settled in our new home in Costa Rica with a 6 month supply of all of Addie’s supplements.  They truly took up 1/4 of our luggage!  She is back on a routine and has a wonderful huge yard to sniff and relax in.  Her only trouble is getting accustomed to the very slick tile in the house, but she is getting her sea legs under her.

Rob had met in person with a local vet prior to my arrival with the dogs to make sure the vet could be on call if we needed.  That was nice to know.  We will be taking Addie in to see her next week just for introductions, pass along her 2 foot thick file, and see if she has any insights into Addie’s blood work.

And Yet More Blood Work

Addie after a recent snow storm. She loves the snow!

As the time gets nearer for us to depart the country, we worry more and more about Addie.  Because we will be flying next week, we had Addie’s blood work tested again to see if there were any improvements from a month ago, or at least hoped that the numbers had stabilized.  The results were not good at all.  Her ALP and ALT are still rising at an alarming rate.  See grid below:

Test July, 2011 Sept, 2011 Dec, 2011 Jan, 2012 Normal Levels
ALT 93 129 190 224 < 120
ALP 93 119 200 220 <140
Glucose 94 98 87 89 75 – 125
Protien 6.9 6.3 7.2 6.5 5.5 – 7.6
Creatinine 1.7 1.4 1.5 1.9 .4 – 1.4

After the last blood work, we did increase her Hepagin-C up to 4 capsules/day and added Sam-E at 400mg/day.  However, that has not seemed to help.  I have a call into the vet to see what recommendations he has.  It could very well point to liver damage/failure, but it could also still be a few other things such as thyroid or possibly Cushings though Dr. Friedly did not feel that Cushings was a possibility last month.

We are still also waiting on Addie’s MSU test results to come back.  That is a test for a thyroid issue which Dr. Friedly did not rule out last month.

In addition we found out yesterday she has a yeast infection in her ears, so she is receiving some nice ear cleanings 2 times per day.  She loves those!  NOT.

On the bright side, she doesn’t seem to effected by all of this.  She still likes to hang out with us continually, she still plays with her toys each day, and still gets super excited when we come home.  She also does not seem to be in pain.  She sleeps a lot, and does not have the energy she did even a year ago, but is that a health issue or old age?  We just don’t know.