UPDATE on Ruffin. Promising new leads.

New blood test for Ruffin last Saturday still shows high levels in liver enzymes so I have postponed the CT scan once again.

Ruffin has now been completely weened off prednisone as of last Friday. Per my Vet we accelerated the decreased dosage spending one week on 2 x 5mg then last week on 1 x 5mg. Our Vet said this may have been contributing to the enzyme spikes and masking the true problem. Hopefully the new blood test next Saturday will show some improvement.

In searching for causes of liver disease I came across a promising new lead: Hepatic Encephalopathy in Dogs, found on PetMD http://www.petmd.com/dog/conditions/endocrine/c_dg_hepatic_encephalopathy?page=show

The list of symptoms of Hepatic Encephalopathy almost completely matches what I have seen in Ruffin, INCLUDING BLINDNESS. 

I think this should be looked into further by our own Vet, Dr. Matt McGlasson, at Noah's Ark and I will be bringing Ruff there tomorrow (Tuesday) morning.

On the lighter side, I am once again convinced that the strongest vitamin in the world is LOVE.  Bessie has been actively fussing all over Ruff, as the photos show. And Ruff enjoys the attention and responds.

UPDATE Tuesday, February 28th:
It pays to keep all of your doctors in the loop. Late yesterday afternoon after posting the above Update, I sent a courtesy email to Dr. Haeussler, the Ophthalmologist, letting him know what I found researching liver disease and hepatic encephalopathy and he came back with a reply and recommended Ruffin get a bile acid assays (blood tests) to see if hepatic encephalopathy is the cause of his symptoms. And I'm glad I took the time to look up that test last night because it requires an absolute 12-hour fasting and then a two-part test over two hours. I dropped Ruff off at our Vets's office this morning and picked him up at 2 PM. It will take a day or two to get the test results.

 

Bessie's new toy

I found it almost impossible to get a good photo of Bessie's new toy that lights up when she bounces it. Using the flash wipes out the glow. So I have been trying to capture an image using the aperture mode only and I got one picture this morning that is fairly decent. The problem with aperture mode is it lowers the shutter speed and the picture looks shaky.

I don't know what is inside the ball that causes the lights to flash or how long the tiny battery will last but Bessie is having a ball playing with her new ball. She has already realized that if she drops it on the floor the lights flash on and off for a few seconds so she walks around the house carrying it in her mouth and occasionally I hear it bounce and then she picks it up again.

Bessie in her little house

Bessie is the only one of all of our 7 Rottweilers who enjoyed being crated. Now almost 3 years old (July 1st) she considers her crate to be a place to hide, stash the stolen contents from the laundry basket or a safe place to go to to just be alone. I call it her little house and it amazes me that she can still fit inside and turn around in it.

Yesterday I took Bess to Pets Supply Plus to buy dog food and because she was being very good on the leash I bought her some new toys. Two soft rubber balls that squeal when you squeeze them and flash bright lights from inside when you bounce them. I gave Bess the larger one because it is too big to roll under the furniture. Bessie carries it around the house and takes it inside her little house and talks to it as if it was a kitten or maybe an alien from outer space that she is interrogating. Whatever she is doing it sounds like a very worried cry.

The blue toy is actually glowing in the dark.

UPDATE ON RUFFIN.

Last Saturday Ruff had another blood test and there was still several abnormally high enzyme spikes in his liver. I postponed the CT scan again until next Tuesday with yet one, hopefully final, blood test next Saturday. He will also have his prednisone cut in half for the last time and will have 5 days of a single 5mg pill.

 

Ruff has made friends everywhere he goes

My Rottweiler Christmas cards have made Ruff and Bess both very popular. Especially to the local merchants who have actually met them. Some people seem to recognize me just because I had Ruffin and Bessie in the car. Two of their favorite spots are the drive thru windows at the bank and the pharmacy where the girls all come to the window and smile when they see them and give them treats. Yesterday I went to the local Kroger Pharmacy but had to buy groceries first so I had to leave the Rotts at home so I could go inside. One of the ladies who work there came over to ask where they were and I told her how sick Ruff was. 

Today I went back to the pharmacy to pick up a special order and that lady called me over and gave me a large pill bottle filled with biscuits to take home for Ruff. And sent along some prayers, as well.

So I printed out these two photos and will give them to her tomorrow.

A long bad weekend

I wrote that Thursday afternoon I took Ruff to see the eye doctor and besides mentioning the importance of a CT Scan to locate the suspected tumor, Dr. Haeussler ordered a reduction in the prescription for prednisone from 2 x 20mg to 2 x 10mg daily with the anticipation of cutting it in half again in two weeks. The doctor also warned about serious side effects if the prednisone was suddenly discontinued so it had the be gradually reduced.

That evening Ruff threw up his dinner about 3 hours after he ate. 

After finding out Friday afternoon the CT Scan could be done locally at the Emergency Animal Hospital in Wilder, Kentucky they told me they had to have a blood test to make sure Ruff was healthy enough for anesthesia so first thing Saturday morning I took him to Noah's Ark, in Ft. Wright, our regular veterinary clinic.

Soon as we got home I gave Ruff a late breakfast and he threw up again a few hours later. Then in the afternoon I got a phone call from one of our Vets and she told me the blood test results shows an elevation in the Alanine Transaminase (ALT) enzyme in Ruff's liver. The scary part was when the doctor told me I should bring Ruff in on Monday for a sonogram test of Ruff's liver before I go spend $800 to a $1000 dollars on the CT Scan. The implicit advice was duly noted and I told her I would be there.

For the past few weeks the prednisone has made Ruff extremely thirsty and I have been taking him out every two hours to pee. Now through all the bouts of throw up his kibble has been accompanied with huge quantities of water, too. Saturday night Ruff was again unable to keep his dinner down.

This morning I took Ruff to the Emergency Animal Hospital in Wilder and the doctor gave him an anti-nausea shot (Cerenia) to make his stomach feel better and gave him an injection of fluids under his skin and another injection of of a steroid (Dexamethasone) because Ruff wasn't able to keep the prednisone pills down. I also asked the doctor to do another blood test to have something to compare with the one our Vet did. This new test showed the ALT enzyme to be 893, more than four times the normal range. And that is the critical part that must be treated.

After getting the phone call yesterday from our Vet I did several hours of research on liver disease on a few veterinary web sites and the one encouraging piece of information I read was the liver has great regenerative powers so with proper treatment Ruff could make it through this crisis. It also looks like the prednisone may have contributed to the spike in the ALT enzyme which in turn caused the vomiting.

I wish to thank everyone who wrote to offer useful suggestions and pass on good thoughts for Ruff's recovery. I can't begin to tell you how precious Ruff is to me (and Bess) especially after losing Grandpa Axl last month.

Please keep the prayers coming. 

MINOR UPDATE: 3 PM
Since the day 16 years ago when my first male Rottweiler Nikko had spinal cord surgery to remove a ruptured disc and was sent home the following day and got up and walked to the kitchen after my wife called me out for dinner, I have been convinced that food is the greatest motivator to a Rottweiler. This afternoon I saw it again but to a lesser affect.

After I brought Ruff home from the hospital I laid out an area rug on the kitchen floor for him to lie down on. He was acting very tired and lethargic and hardly moved at all. A little while ago I went out to check on him and he was still laying in the same spot where I put him after I put the rug down. I turned my back on him and opened a pastry box to have a snack and as soon as the top of the plastic container popped open Ruff jumped to his feet. I turned around and he was staring at me with a starving, hungry look on his face. Not to make light of a serious situation, whenever anyone is eating a snack he always has a starving, hungry look because that's the way he begs for handouts and treats. But is is comforting to know his body can react like it did. I realize he hasn't held any food in his stomach for three days but the doctor said not to feed him until 6 PM. Then I will boil up some ground sirloin and rice.

UPDATES, ADDITIONS AND CORRECTIONS:
MONDAY 11 AM
First the good news. I took Ruff to our Vet for his sonogram this morning and it came back normal. Dr. Matt McGlasson did recommend waiting a week before having the CT Scan to see that Ruff's liver problems get better. That will need another blood test on Saturday. I took home a bottle of Denamarin which is a combination of SAM-e and milk thistle extract to help Ruff's liver get better.

The correction is another good thing. I read the ALT Enzyme number value wrong on the tiny print out for the blood test done yesterday. It is 693 not 893. Then I got a copy of the blood test done Saturday at our Vet's office and read that the ALT Enzyme then was 573. That blood test also showed the ALP Enzyme was greater than 2800 which was the limit the machine could register. If it is any encouragement, both of these high values are indicative of the affect of the Prednisone.

Update on Ruffin's eyesight problem

I took Ruff to see the Ophthalmologist today and after a few tests he confirmed what I had noticed, that Ruff's eyesight has gotten worse than it was on the last visit two weeks ago. He stressed the importance of the CT Scan as being the only way to know what's going on. 

There is a new wrinkle to this problem. Since the first visit I have been taking Ruff outside on a leash to guide him. I have also been talking to him to have him follow the sound of my voice. But lately it appears he is suffering from hearing loss, as well, and either he cannot hear me or he cannot locate the direction my voice is coming from. He darts his head up and down and side to side when I talk to him. The only thing he responds to is when I touch him on his head or on his nose with a piece of food. And of course, he enjoys hugs, kisses and ear scratches. 

I mentioned the hearing problem to the doctor today and he said it may indicate the tumor is on his brain affecting both his eyesight and his hearing. 

I talked to the veterinary hospital that does the CT Scan and they said it would require sedation and take several hours from start to finish. This poses a problem for me since this place is an hour's drive away and I will need someone to stay with my wife for at least 5 hours. 

One good thing I learned today, if you can call it that, when I spoke to the place that does the CT Scans they told me that the tumors can be treated with 2 or 3 sessions of radiation instead of surgery. In spite of the cost of the CT Scan, I ruled out surgery anyway since Ruff is more than 10 years old. I didn't ask about the cost of the radiation treatment but if its anywhere near what it costs for humans it is not affordable.

Please say a prayer for Ruff. He is more important to me now than ever before.

UPDATE: 9 PM Friday.
Just found out tonight that an emergency animal clinic 20 miles away has acquired their own CT Scanner only 3 months ago. I am thrilled at the prospect of being able to have this done locally since I won't need to find anyone to come and sit with Jacqueline. Instead of a 5 hour round trip it now should take only 2 hours and I will be taking Ruff in for the scan on Tuesday afternoon.  

Prayers seem to be helping already.

 

Important information for all dog owner's. Euthanasia drug found in dog food.

Yesterday, USA Today ran a story from the Detroit Free Press about some Evanger's dog food being recalled because it was found to contain a drug called pentobarbital. This drug is used by veterinarians to euthanize animals. I did some cross checks on a few links referred to in the story and came up with some very disturbing news. Here is the original story from USA Today.

From USA Today

Euthanasia drug found in dog food prompts recall

Zlati Meyer, Detroit Free Press 
DETROIT — Evanger's is voluntarily recalling some of its dog food after a drug that is used to anesthetize or put down pets was found in it.

Pentobarbital was found in one lot of the dog food; five dogs got sick and one died, according to the Wheeling, Ill.-based company.

Fifteen states are affected by the Hunk of Beef Au Jus recall. The 12-ounce cans were  manufactured June 6-13 and sold in stores and online in Washington, California, Minnesota, Illinois, Indiana, Wisconsin, Ohio, Pennsylvania, New York, Massachusetts, Maryland, South Carolina, Georgia, and Florida.

As a precaution, Evanger's is recalling Hunk of Beef products manufactured the same week, with lot numbers that start with 1816E03HB, 1816E04HB, 1816E06HB, 1816E07HB and 1816E13HB, and expire June 2020.  The second half of the barcode on the back of the label says 20109. The ill and deceased dogs ate from the 1816E06HB13 lot.

The U.S. Food and Drug Administration is distributing information about the recall as well.

All Evanger’s suppliers of meat products are USDA approved, the company said.

"We feel that we have been let down by our supplier, and in reference to the possible presence of pentobarbital, we have let down our customers," the company said in a press release on its website, adding that it's the first recall in 82 years of manufacturing.

Evanger's said it has terminated its relationship with that supplier after 40 years, though that company services "many other pet food companies."

Read the rest here: http://www.usatoday.com/story/news/nation-now/2017/02/06/euthanasia-drug-found-dog-food-prompts-recall/97570032/  

It was the last sentence quoted above that prompted me to go to the original story on the Evanger's dog food web site. The lengthy company explanation contained a remarkable statement to explain how the euthanasia drug pentobarbital managed to get into their dog food.

Here is the full paragraph as quoted from the Evanger’s web site investigative report: https://evangersdogfood.com/news-events/pug-family-updates/

In our investigation, we spoke with many suppliers to learn how it could even be possible that an animal that had been euthanized could ever possibly end up in the animal food stream.  What we learned was that pentobarbital is very highly controlled, and that, if an animal is euthanized, it is done so by a veterinarian.  Once this process has been done, there is absolutely no regulation that requires the certified Vet to place any kind of marker on the animal indicating that it has been euthanized and guaranteeing that product from euthanized animals cannot enter the food chain.   This is a simple task, and goes a very long way to ensure safety in many areas.

Also contained in the investigative report on the Evanger's web site is this sentence:

Once we learned that pentobarbital was found in the stomach contents of the dog, we dug much deeper into research about the topic.  What we found is that the FDA knows, and has conducted research, on the use of pentobarbital primarily in dry foods.  The research can be found here: http://www.fda.gov/AboutFDA/CentersOffices/OfficeofFoods/CVM/CVMFOIAElectronicReadingRoom/ucm129135.htm

That report on the FDA web site was written in 1998.

Dog Food Survey Results - Survey #1, Qualitative Analyses for Pentobarbital Residue

Dry dog food samples purchased in Laurel, MD, area, March - June 1998

While it is almost 20 years old it does list the known brands of dog foods found at the time to contain the euthanasia drug. But there is no follow up info to find out what was done about it. 

What is most disturbing is the question raised by the news about what your local veterinarian may be doing with the dead bodies of animals they euthanize when the owner doesn't take them away for burial. I think this will lead to some very uncomfortable and difficult conversations with the doctors that treat our beloved pets.

Ruffin's eyesight problem worsens

On Thursday I have a followup appointment to take Ruff to The Animal Eye Institute with Dr. Haeussler, the Ophthalmologist. I don't look forward to this with any high hopes since the previous exam suggested that Ruff's eyesight problem was likely caused by a tumor pressing on his optic nerve and that would suggest surgery. But a tumor could only be confirmed after a CT Scan.

We had some false hopes that the Prednisone prescription was doing some good reducing the swelling after a few days but the hopes were dashed when Ruff's blindness condition worsened. Now he seems to be unable to walk through the house without walking into corners and getting confused. Bessie seems unable to recognize the nature of his problem and seems to want to make a game of it all. I am hoping this is some way that she is slowly learning how to help.

A few years ago my brother told me a story about two Labrador Retrievers he once owned. He said he found out one day that one of them was blind and it was only after the other dog had died. For some length of time the dog that could see was helping guide the blind one around and was doing such a good job my brother didn't notice. As I recall this story I realize that Bessie could possibly be of help but I don't know if she can do this intuitively.

I have tried to make things go as easy for Ruff as I can to help him get around without hurting himself. I have taken him out front on a leash because I found when he walked around he often walked into the bushes and got lost. The only place where I can let Ruff go out unattended is in the fenced back yard around the pool. We have a low deck outside the back door that has three steps down to the ground. I have noticed Ruff carefully feeling the steps with his front paw as he tries to go down the steps. So far he has managed to do this by himself but once in awhile when I try to guide him by his collar he freezes at the top step and is hesitant to walk down it.

If anyone who reads this blog has first-hand experience with a blind dog, please send me an email.  AbbyD@fuse.net

Thank you.

UPDATE 8:00 PM
I have gotten one reply about living with a blind dog and after reading it I realized my first mistake already, today. I mentioned I saw Ruff trying to get his footing walking down the short flight of steps off the deck. Once he found the first step he went down the next two pretty fast and leaped off the bottom step.

Inside the house he did something late this afternoon he has never done before. I went down to the basement and when I came up I turned off the stair lights but left the door open. The next thing I heard was a loud thump, thump, thump and when I ran to the basement door I saw him walking around downstairs. Apparently he didn't fall down the stairs because he wasn't hurt. He must have gotten his footing set on the top step and did a rapid walk/fall down the stairs. He must have memorized the proper gait going up and down the stairs that he got used over the years but today he did it very fast.

The unusual part of this near deadly accident was the fact that over the years, every time I went down to the basement Ruff would play a game with me and wait at the top of the stairs for me to come back up. I called him the toll collector because he wanted to get hugs and kisses before he would let me get past him. This is the photo I posted here back in October 2012. And who wouldn't want to sit down and give him a big hug and a kiss?

I also did a spot check of the other links I found but didn't see any mention of a two dog family where one dog helped the other. That is what I am hoping for as Bessie gets a little more mature and begins to realize what is going on.