Heart Like a Dog

The Good, the Bad, and the Oh My God of living with dogs!

Delilah Goes to Tufts

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In June of 2018, at Delilah’s annual exam, our vet discovered an arrhythmia affecting all four chambers of Delilah’s heart. (You can read the posts about it HERE and HERE.)

We were lucky enough to get an appointment with a cardiologist within a couple of weeks. Despite echo cardiograms (EKG’s) and Holter studies, the cardiologist could not find the cause of the arrhythmia.

All suited up with a Holter Monitor.

The cardiologist said it could be a small, unseen scar on her heart, but she also said we might never know the reason for the irregularities.

The treatment plan for Delilah was medication. The initial medication was Soltalal, which reduced the occurrence of the irregularities, but they were still occurring.

The cardiologist then added Mexilitene. Both the Mexilitene and Soltalal is available at our local pharmacy.  The Mexilitene is very expensive (over $200 at the vet’s office for a 30 day supply, but our local pharmacy could fill it for about $95 {the last time I bought it, it had gone down to $75} there is also an online pharmacy out of California that fills it for about $95.)

The next EKG showed the irregularities while decreasing, were still occurring.

At this point I became concerned that the Cardiologist was missing something. I spoke with my vet and inquired about getting a second opinion. I explained how the other cardiologist in our state required you drop your dog off and that I wasn’t comfortable with that and she said, “Then take her to Tufts.”

And so I did.

I have to confess, I’ve always been sort of in awe of Tufts. I mean, anytime someone in my area has an animal that needs specialized care, they go to Tufts.

I’m not sure what I expected Tufts to look like, but I was still surprised. Upon arriving I realized, it looks like a University Campus. (Because it is bozo!) There are houses, cottages, barns, pastures and this amazing hospital.

I had given myself an extra half hour, so we arrived in plenty of time. I parked the car and went in to scope it out, leaving Delilah in the car.

Tufts Veterinary Hospital

A portion of the front desk area. I should have taken photos BEFORE bringing the dog in.

I checked her in, then went out, took her for a walk around to sniff and do her business and then brought her in to settle on one of the many couches. I tried to get her to sit with me, but she chose the floor instead.

Tufts

Delilah poses patiently for a photo at the front desk.

We didn’t have to wait too long before were brought into a small room by a very personable vet tech. She asked a lot of questions and then left us while she went to get Dr. Karlin.

I loved Dr. Karlin. She was super nice. She looked at Delilah’s records, listened to her heart, then asked if she could do an echocardiogram. The room they use for the test was small, so I was asked to wait in the exam room. Delilah seemed very comfortable with both Dr. Karlin and the vet tech, but I was told if Delilah seemed at all concerned, they would come get me and we would squeeze into the room.

Delilah was back in less than 10 minutes and then Dr. Karlin and I discussed what’s going on.

In the six-minute echo, Delilah showed no irregularities, this was good, (I still have concerns because her arrhythmias tend to show up more during the night, but without running another Holter monitor, there’s no way of knowing.) Dr. Karlin said the only change she would make to Delilah’s meds, were a different strength of Soltalal, which would be easier to administer. We had 80 mg that she was getting ¾’s of, (about 60 mg, twice a day) which was changed to 120 mg which could be halved. Otherwise it was stay-the-course.

The Inside of Tufts Vet Center

Delilah watching who knows what, while I consult with the cardiologist.

She did advise me that Delilah was still at risk for a fatal heart event, but that was something we already knew.

Dr. Karlin was kind enough to let us out the side door, so I didn’t have to deal with the waiting room full of animals.  I walked Delilah about, put her back in the car and went to pay my bill. The bill came to $507. Now some people would say we spent a lot of money and found out nothing new.

I disagree. For me it was confirmation we are doing everything we can for Delilah, and my friends, that takes a heavy burden off my heart, and that is something I am truly thankful for.

Today is the Thankful Thursday blog hop hosted by our friends over at Brian’s Blog. Hop on over and say hello.

Brought to you by Brian’s Blog.

Holter Monitor – Take 2

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DISCOVERING AN ARRHYTHMIA

For those who don’t know, our vet discovered a heart arrhythmia at Delilah’s annual exam in June.  Since early July, she’s been seeing a cardiologist.

At the first visit, the vet did an ultrasound and recommended Soltalol to help control the irregularities. At the next visit, they increased her Soltalol and at the recheck, they repeated the ultrasound which showed her irregularities were down to six beats in a four minute period. The vet was over the moon with this, but  a Holter Monitor study was recommended to see what was happening with her heart in the other 1,436 minutes of her day.

Does this Thundershirt make my butt look big?

We had the first one completed in August, and you can read about that HERE.

Because we had a problem with that first test, we repeated the Holter study on the 11th of October. Last Thursday we got the results of the test and it’s not good.

In a 24-hour period, Delilah had a total of 9,549  Ventricular Premature Beats and 1,162 Supraventricular ectopic beats. That’s almost one every minute!

WHAT IS A VENTRICULAR PREMATURE BEAT AND HOW DOES IT DIFFER FROM A SUPRAVENTRICULAR ECTOPIC BEAT?

The cardiologist’s office wasn’t much help when they called with the results of the Holter Study. They told me she’d had over 9,500 irregularities in the 24-hour study and suggested a new medication – Mexilitine (Mex-ill-ah-teen.)

“I have to warn you,” the vet tech said, “This medication is expensive, and it needs to be given every eight hours.”

She wasn’t kidding. To purchase the medication from the vet was $197 a month.

My initial reaction was, “We can’t afford $200 a month, and I don’t know how I’ll manage to give it to her every eight hours, I work.”

The vet tech told me of an online pharmacy in California that sold it for $95 a month, and she also suggested checking Walmart. Then she asked me if I had anyone who could come in midday to give Delilah her meds.

Honestly, WTF? Do these people think I’m made of money? A dog walker in my area charges $30 a walk. To my knowledge they won’t just pop over to give her a pill. I’d have to pay for a ‘walk’ and It would cost me $150 a week to have someone come in.

I asked about timing. “What if I can’t give it to her every eight hours?” Like what if I give it to her right before I leave for work, as soon as I get home and just before bed? I was told it would probably be okay.

Naturally I then asked if there wasn’t a less expensive drug we could use.  She said she didn’t think so, but she would check. I asked, “What if we can’t afford the new medicine?”

Delilah could collapse and die, or die in her sleep.

After I hung up with the vet tech and stopped crying, I went to the online pharmacy she recommended, (HealthWarehouse) and using their online chat, discovered I COULD get the medication for $94 a month, and I COULD put it on autoship. According to the chat rep, there would be no charge for shipping.

After I chatted with the warehouse, I called Walmart and it was $187. Then I decided to call MY pharmacy. The out of the box cost was $223, BUT they have a discount card that brought the meds down to $95.

The next step was getting Hubby on board.

Thankfully, I didn’t have to ask him if he loved Delilah $200 a month worth. He did whistle when I threw that figure at him, but then I told him how it came down to $95 and he was totally okay with it.

We then brainstormed on how we could possibly get her mid-day pill in and I think we have a plan. Once we get it in place, I’ll let you know how it works out.

WHAT THE HELL DOES THE HOLTER REPORT SAY?

I tried re-reading the Holter report, and googling the medical words, but I couldn’t understand it.

So I put a call in to my own vet.

I don’t know about you, but there is something so reassuring about speaking with my own vet. She did her best to put the information in such a way that I could understand it.

“Ventricular Premature Beats and Supraventricular ectopic beats.” – In English this says, some of the irregular beats are coming from the Atria (upper two chambers of the heart) and some are coming from the Ventricles (lower two chambers.)

Ventricular originates in the Ventricles and the Supraventriculars originate in the Atria. Ectopic means irregular. So basically all this report says is she has irregular heartbeats in both her Atria and her Ventricular chambers. Something we already knew at my vet’s office on the day of her initial exam.

(I’d finally calmed down after talking with the vet tech, but this could get me going again. WTF do I spend money on a specialist for?)

We still have no idea WHY her heart has these irregularities and according to both my vet and the cardiologist, we may never actually know.

We also talked about the timing of the medication and Dr. Soutter said, “Do the best you can.” The reality is I adore my dogs, but I have to work and there is no way around that.  She will get the medication three times per day, it just may not be every 8 hours.

WHERE WE ARE

There have been a couple of times when Delilah is feeling anxious. I can tell by the way she climbs into my lap. One night a couple weeks back, I could feel how fast her heart was beating. Hubby was gone, but I was fully prepared to take her to the emergency vet when he got home. After about 20 minutes though, her heart slowed down to a normal beat.

These episodes have me super concerned. My biggest fear is that she will collapse and have a traumatic event.

I know I can tell you this, because I know you won’t judge me, but I actually considered helping her to the Bridge.

When I tried to talk to Hubby he didn’t want to discuss it. He said, “She’s fine, just look at her.”

I mentioned it to my vet when we spoke. She told me she would never judge me for making a decision that felt right for me, but she really felt that if the Mexilitene works, despite Delilah being almost 13-years old, she still has some good time left. She also assured me if she thought Delilah’s quality of life was deteriorating, she would tell me.

Delilah started the Mexilitene last Friday, and she is seeing the cardiologist on Monday to have a recheck and see how the medication is working. My vet and I both feel a second opinion is never a bad idea, so I made an appointment for Delilah at Tufts. It’s not until early December, but that gives the Mexilitene some time to work.

HOW I AM

I am mostly okay. I have some good and bad moments, and I do worry a lot. When I let myself really think about it, or when I talk to the vet, I can get emotional and a little weepy, but for the most part I’m doing okay.

The positive thing that has come out of this is, I can now spell arrhythmia without looking it up, and without word underlining my mistake.

Non-Toxic Flea and Tick Prevention

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Living in CT, just 50 (ish) miles from where Lyme disease was discovered, you can imagine tick prevention is extremely important to me.

In my mind, ticks and fleas go hand in hand. They are both bloodsucking, disease carrying parasites, and I have no desire to have them on my pets, or in my house.

 

I stopped using a topical flea and tick preventative on my dogs many years ago. We did use it initially, but Sampson always cringed when we applied it, and then I started thinking about the fact, I was applying a poison to my dog, that was absorbed into his blood that was strong enough to kill a tick!

Have you ever tried to kill a tick? Yeah, it’s not like you can step on them and squish them.

The dogs and I love to hike in the woods, which, of course, are full of ticks. Additionally, due to all the wildlife in our area, we can pick up ticks just walking around the neighborhood.

Fleas

I’ve heard healthy dogs don’t attract fleas, and while most healthy dogs are unattractive to fleas, any dog can pick up a flea and bring it into your home. Once inside your home, fleas can lay eggs in carpets, upholstery, cracks in the floor, etc. They can lie dormant for months, and then a nice sunny day, those bitches pop up like you were playing Whack-A-Mole. Unlike Whack-A-Mole, you can’t just pop a flea on the head and think it’s gone. It can literally take you months…months!

Fleas carry diseases. I’m not going to go into them here, but if you are interested, you can read some of the diseases HERE.

Of course, we recently had a bout with Tapeworm, another really gross by product of the infamous flea. In that instance, I could not find evidence of fleas, either on the dogs or in the house, BUT, that doesn’t mean Sampson didn’t ingest a flea, or flea egg whether it was at the vet’s or outside.

Must. You. Go. There?

Ticks

As I mentioned, we live less than an hour away from where Lyme disease was first discovered. I want to vomit just thinking about these fat bastards, what they do and what they carry. Besides Lyme, they carry a number of serious  diseases, and while most are treatable, it’s just one more thing I don’t want to worry about.

I’m not saying ticks are BETTER than fleas, but usually when I find a tick, it’s ONE tick, and it’s easily removed. We have a small container filled with rubbing alcohol where nasty ticks go to die. It sits on the counter with our tick key, and is always ready when needed. I know some people who put the tick in tape, or a plastic bag with the date on it, in case they need to have the tick checked.

I like to prevent fleas and ticks, as opposed to treating for them, so this is how we do it.

Treating the yard.

Almost immediately upon moving to our home almost 11-years ago, I found a tick, attached to my stomach. We had just moved in, and a lot of items hadn’t been unpacked, so removal was primitive. (I think I held the flashlight and Hubby used a steak knife.) 🙂

I called for a professional service soon after. We used a traditional flea/tick service until about three years ago, that’s when I found Think Green, a professional service that uses a combination of essential oils to spray the yard. They come out four times per year at $95 a treatment. The bonus to this service is…my yard smells like a Tic Tac right after being sprayed. 🙂

So that’s what a Tic Tac smells like. I’m sure I’d love it, if I knew what it was.

Treating the dogs.

In addition to treating our yard, I use a non-toxic flea and tick spray on the dogs. I do this twice per day. Back in the spring, I was only spraying once per day, and there were occasions (maybe once per week,) when I’d find a tick on one of the dogs. Then I switched to twice per day, and that seems to have done the trick.

Ticks tend to thrive in the cooler weather of spring and fall, so we are heading into ‘tick season’ right now. Spraying the dogs twice per day adds more time to my schedule, but if it keeps them from getting ticks, and tick diseases, I’m okay with that.

When I look for a natural/non-toxic tick spray, I look for ingredients I can read and pronounce, (nothing with sodium lauryl sulfate in them.) It’s important to pay attention to the ingredients in natural products, as natural and non-toxic are not the same thing.  Also, some sprays use rubbing alcohol as a base, and while I’m okay spraying that on my dogs with thick Labrador coats, some dogs (especially those with thin coats) could have some issues with skin drying out, which could cause itching.

I typically rotate my flea and tick sprays, and one of my go-to’s is Pet Natural’s of Vermont.

I rotate my spray for two reasons. One, I don’t want Sampson or Delilah to develop and intolerance or have a reaction because I’ve used the same product too much. Two, I don’t want those fleas or ticks to get used to the smell and become immune to it. 🙂

The bonus for using a non-toxic spray, is I can use it on myself as well.

How do you keep your pets from getting fleas or ticks?

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This is part 4, in a series designed to help you make simple changes, that will help reduce toxin exposures for both you and your pets. If you’ve missed the previous installments, or are just tuning in, installment one can be found HERE, installment two can be found HERE, and installment three can be found HERE.

While researching whether it’s true a healthy dog does not get fleas, I came across this…Top 10 Flea Myths from Only Natural Pet.

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