Thursday, July 31, 2008

Home Cooked Meals

After consulting with the K9kidneydiet group, I've started cooking Scooter's meals, following the Fuzzer Food diet. I've come up with a recipe which includes ground turkey, broccoli, peas, carrots, and potato. Sometimes I'll add some garlic, an egg, or yogurt. This is the first recipe, and I'm sure I'm come up with others for a little variety. I have to add calcium citrate to balance out the phosphorous. She also is getting supplements that will continue every day - B Complex, Vit E, Fish Oil, and Glucosamine. She's still getting the Proin for incontinence. I've discontinued the potassium citrate since I've learned it doesn't do anything for stones, and it contains wheat and sugar. I'm also temporarily giving her Magnesium, Crystal Clear, and Acidopholis since she has a UTI and is on antibiotics (last day). I'm taking a new urine sample in tomorrow to be checked.

Tuesday, July 22, 2008

Latest urinalysis and diet

Scooter has been drinking a lot and peeing a lot lately. She is frequently having accidents when lying down. I take her out on average every 3 hours, and have been getting up in the middle of the night to take her out. Because of this I was thinking she probably had another infection. I recently bought some PH strips to test her urine, and it is still too acidic. This morning it was 6.25.

I took another urine sample in today to the vet for another urinalysis. The previous one on 6/23 came back clear. Unfortunately this one did NOT. Another roadblock!

The vet said she had a lot of pus and bacteria in her urine, and prescribed 20 tabs of Zeniquin (antibiotic). Curiously, it was $20 higher than the last time we got it in March. Total $119.00 ($77.50 for antibiotics, $41.50 for urinalysis).

The analysis on the stones came back on 7/3 as Calcium Oxalate.

As for her diet, I decided not to feed her the prescription diet and have done much research online to find something suitable. In the meantime, I have been supplementing her current diet with Potassium Citrate granules. I’ve joined an online group on Yahoo called K9kidneydiet, which has been very helpful, and led me to the diet I’m going to fed her.

I’ve decided to start feeding her something called the Fuzzer diet, which is essentially a low oxalate home cooked diet balanced with Calcium Citrate, and supplemented with B-complex, E, and Omega 3s, with the option of adding CoQ10, Magnesium, Lysmachia 3, Digestive Enzymes, Probiotics, and/or Glucosamine. No Vitamin C or D supplements allowed. The diet has worked for many dogs with Oxalate stones. You can find it here if you want to read more: http://www.b-naturals.com/newsletter/category/calcium-oxalate-uroliths/ .

Current diet - distilled water, Innova EVO kibble soaked in distilled water, EVO canned, mixed with low oxalate veggies/grains (will be changing to over to the Fuzzer diet and eliminate the EVO completely)

SUPPLEMENTS:

2x a day:

  • Proin for incontinence 25 mg
  • Crystal Clear 1/3 teas
  • Magnesium 50 mg
  • B Complex 50 mg
  • Flax seed - pinch or 2
  • Potassium Citrate granules (1 scoop contains 300 mg + 423 mg of essential fatty acids -will probably discontinue)

Will add soon on daily basis:

  • Calcium Citrate to home cooked foods
  • Vitamin E in dry form once a day (100-200 IU)
  • Omega 3 Fish oils (1800 mg)
  • Glucosamine

Wednesday, June 18, 2008

Vet visit and prescription food

Scooter is doing well and healing nicely. I went back to the vet today for a second bandage change. The vet also removed the staples from her belly, and said she is doing well. I have to bring her back either Saturday or Monday to get her stitches removed from her paw. On Monday I got the results back from the biopsy of the tissue that came out of her bladder. It was just polyps, no tumor! That was good news for sure. Still waiting to see the composition of the stones - whether struvite or oxalate, uric or whatever. Oxalate is most likely.

The vet said something on the phone about putting her on a prescription canned diet called S/O, which I think is from Walthum or Royal Canin. I found some info on it and it is a diet to prevent all types of stones, by limiting the minerals she isn't supposed to have and adding the ones she should have. Unfortunately, it also contains a lot of meat by-products, and looks like an unhealthy food overall. If I'm going to pay a lot for a food, I'd rather it have good quality ingredients in it. I would consider feeding it temporarily, but would have to talk to my vet more about it.

Thursday, June 12, 2008

Post Surgery Photos

I picked Scooter up today around noon. As soon as she saw me she started wining and crying, like she was relived to be out of there. She got up the steps fine, but I had to carry her down later because she just kept wining. She has about 13 sutures on her belly and a big padded bandage on her foot. I don't know what it looks like underneath, but I'm sure it's not pretty. I'm glad she's home and doing ok. She's not feeling too good, but she still has her appetite and is resting.

Here are some post surgery photos:

Wednesday, June 11, 2008

Surgery

We decided to go ahead with both surgeries. I took her in this morning around 7:30, and she was done by 1:00.

The vet took another x-ray of bladder, which showed the stones had spread out, which confirmed that the previous x-ray was a collection of small stones congregated in one spot. Besides the stones in her bladder, she had an area of inflamed and irritated tissue, blood clots, and thickened tissue. The vet collected cells from the area for a biopsy to rule out any cancer, but is optimistic it is not. She is sending the stones for analysis to the University of Minnesota, since they offer free analysis. I only have to pay shipping and handling, but it will take 3 weeks. She is confident that the stones are the calcium oxalate type anyway. A quicker analysis would cost $120. After the analysis we will talk about her diet, but for now she suggested I increase her water intake and feed canned food, which I have already started to do.

As for the tumor on the toe, she took off the tumor and only one toe. She also took off that nasty mole on the same foot that she is always licking. She said she couldn't leave it there in good conscience. So I guess that was a freebie. I was actually thinking about asking her to take that off anyway, but didn't want to spend more money. She'll have a padded bandage on her foot for a few days. I'll have to bring her back in on Saturday morning to get the bandages changed.

She'll have to take an antibiotic for a week, and Tramadol for pain. She also wants her to continue taking Piroxicam. The vet is also writing a prescription for a pain patch that she may or may not need that I can get filled at Giant.

She is resting at the vet's office now on morphine and will stay overnight. The vet will call me in the morning with an update and let me know when I can pick her up.

Tuesday, May 20, 2008

Vet Costs and Photos

Photos of her tumor:



We've spent $1253.39 on this since March 6.

Do we have real concrete answers? No. Do we know what we're going to do? No. If we end up doing surgery for the bladder and the foot, it could add another $1300 to the total. It makes it even harder to decide since Scooter is almost 13 years old, has arthritis, cloudy eyes, and other lumps all over her body that we don't know about. But she appears to be healthy otherwise. I want to take care of her so she feels better.

Update:
The biopsy confirmed the tumor is malignant - a spindle cell tumor, slow growing, unlikely to spread, but likely to grow bigger. Quote for surgeries to remove tumor, toe amputation, and bladder surgery is $1600-$1700. I've consulted with the other vet at Del Ray (Dr. Mixon) and Brianna's vet friend Jen Pacey to discuss other options and opinions, but it's looking like surgery is the best option.

Latest Vet Visit

Scooter has been actually doing pretty well since the last post. She finished up her antibiotics and incontinence medicine (Ppa) a few weeks ago, and then I started her on Acidopholis and a herbal treatment for humans called Ultimate Urinary Cleanse. She is still taking Piroxicam once a day. I've also been giving her a little plain yogurt and flax seed with every meal. I took a urine sample in on May 16, and the results showed that she had no sign of red blood cells, although she did still have white blood cells and crystals. So there was some improvement but there are still signs of activity. The vet recommended I see an internal medicine specialist to get another diagnosis and she would fax over all her info including the sonogram and x-rays. I mentioned we never did x-rays for her, and she said we should do that before seeing the specialist.

So today I took her to the vet for x-rays and blood work/health profile ($200).
The blood work will show how healthy her organs are and if she would do well with surgery. Tom met me there. I was glad to have another ear to hear the vet. She said the x-ray looked like it could be an oxalate bladder stone. She wasn't 100% sure that's what it was because it appeared calcified or speckled, but it did appear in the middle of the bladder, where stones usually appear instead of the wall of the bladder, where tumors like to attach. A bladder stone can cause secondary infections like the UTIs she has been having since it irritates the walls of the bladder. From what I read, calcium oxalate stones cannot be made to dissolve over time by changing to a special diet (as can be done with struvite or uric acid bladder stones). Also, if they are left there, the urinary opening may obstruct as the dog attempts to pass the stones.

She recommended surgery to remove it, which they could do there, and it shouldn't be as complicated as a cancer case would be, or as expensive, but still about $900, which we could pay for in 2 payments. When/if she did the surgery, she would remove the mass and nothing else. It would then be sent to be biopsied. If it was just a stone, then that should solve her problems. If it ended up somehow being cancer, there wouldn't be much more we could do for her without spending thousands more dollars.

I also had her look at a mass on her back toe that just popped up recently. She said she could remove it at the same time as the bladder surgery, but if it ended up being cancerous, then she would want to amputate the whole toe, and not just the mass. She took a aspiration of it and looked at it under a microscope and said it was definitely a tumor. To find out it it was benign or malignant it would have to be send to a pathologist (another $150), which we did. That report will come back in 48 hours. The blood work in 24 hours. She has lumps and bumps all over her body now and who's to say they all aren't tumors? I didn't even have her look at the other bumps I've found.

She's going to give me a call tomorrow. So, now we have to figure out what to do depending on the results. We also would like to talk to a holistic vet they have at the practice to see what advice she could give.

Thursday, April 17, 2008

Info on bladder cancer

I found a very informative document on bladder cancer in dogs. The frustrating part is not knowing if it is bladder cancer. The only way to get a definite diagnosis is with a tissue biopsy, which is done through surgery, cystoscopy or even a urinary catheter, which all cost a lot of money. But according to this doc, a proper diagnosis is "important because the treatment and prognosis depend entirely on exactly what is wrong with the bladder. "

http://www.vet.purdue.edu/pcop/CanineUrinaryBladderCancer.pdf

Update

I'm starting Scooter on the Piroxicam today, and retesting a urinalysis in 10 days. Unfortunately since this drug is typically prescribed to humans, they don't make a pill in the size she needs. So everyday I have to open a capsule, take out the powder and divide it in two for her 2 doses. And then put it in a meatball or something. If she ends up having to be on this long term, it would be a major pain.It was that or have the manufacture make a capsule especially for her in the proper dosage which would cost a lot of money. Good news is I'm only paying $12.99 for a 20 day supply.

Wednesday, April 16, 2008

Scooter

I'm starting this blog mostly for myself to record Scooter's progress with this pain in the butt infection and mass in her bladder that may be cancer. For those that don't know Scooter, she is my 12 year old dog, who I have had since she was a puppy.

She has had recurrent Urinary tract infections (UTI) that responded in the past to antibiotics. This past infection involved a bit of incontinence and her licking herself a lot since it bothered her when urine would come out when she would lay down. I first took her to the vet March 6. Since then she has had 3 urinalysis’, 2 cultures, 2 ultrasounds, and been on several antibiotics (Zeniquin, Clavamox, then Ditrim). She was also prescribed an incontinence medicine (Ppa). The first ultrasound revealed a small mass inside her bladder. After a round of antibiotics, the second ultrasound showed the mass had gotten smaller, but the culture still showed her having an infection, so more antibiotics. The vet said she didn’t think it was a tumor, but perhaps just an inflamed or infected polyp. She didn’t mention anything about it being a stone. Her incontinence doesn’t seem to be a problem anymore. She isn’t licking much at all, and she seem overall pretty healthy and acts normal. The last urinalysis (4/14/08) shows that she still has an infection. I have already spent $850, and I still don’t know if it is even cancer or just a bad infection.

My vet is recommending I take my dog to a specialist to get a work up and another ultrasound for a possible surgery. The mass is located in an area that would be easy to operate on (end of bladder), but I don’t think I want to put her through surgery at this point in her life or spend the money (around $3000 for just surgery), plus chemo/radiation/meds if cancer. She said the most common cancer in the bladder is Transitional Cell Carcinoma (TCC), which is a very aggressive form of cancer, and from what I read, hard to get clean margins when operated on. If we went through the surgical treatment, there’s the chance it could come back if it was cancer. My vet also said a biopsy can only be done with surgery since a needle aspiration could possibly spread the cancer if that’s what it is. I got a quote from a vet specialist for a cystoscopy for $1200-$1500, which includes a biopsy which only identifies what the mass is.

My vet said if I don’t want to do surgery, then I should try Piroxicam for 2 weeks and then do another urinalysis. From what I know about Piroxicam, it is just an anti-inflammatory, but can shrink the mass. It is hard on the dog’s stomach so it should be taken with something to coat the stomach. She also recommended I do blood work for a health profile and to check the health of her kidneys, liver, etc. I asked about herbal/holistic treatments, which they have a vet on staff for, and she said we could have a consult with her as well, but said those treatments are pretty costly as well, more so than the Piroxicam. I have read good things about Graviola and PawPaw, herbal treatments which have shown to shrink cancer cells, with minimal side effects. I'm also thinking about giving her a supplement called Urinary Acidifier, which helps dogs who have recurrent UTIs.

So, it is frustrating because I don’t know for sure what it is (cancer or bad infection), so I don’t know what to do. I want to make a good choice. I think I'm going to just put her on the Piroxicam, and then maybe Paw Paw and the Urinary Acidifier, depending what my vet says when I call her back.