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.

Pee Pads, Not Just for Peeing

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We’ve been having a problem with someone peeing in the house.

It started the week of Christmas. I was on vacation that week and our walking schedule was off. We walked later in the morning and earlier in the afternoons to take advantage of walking in daylight.

The morning walks were around 6:30, while the afternoon walks would start around 3:00 pm and finish around 4:00 pm, then dinner was at 7:00 pm. Delilah as you know, being pure Lab, gets super excited for food. In fact, she jumps like a jumping bean when I bring her her food.

At some point during the evening feeding time, or directly there after, one of us would notice a big puddle on the floor. I say puddle, because it wasn’t like she dribbled a little, it was like she emptied her bladder. One night, she actually squatted in front of me and peed.

WTF?

We started trying to be super conscious of letting her out BEFORE we fed her and it seemed to get better.

But then the last couple of weeks, every night when I got home, there’d be a puddle somewhere.

It’s not like she was peeing in the same spot because she was marking something. It was more like she was sleeping soundly, got up, realized she had to pee and made a beeline for the door, but couldn’t quite make it.

Sort of like a toddler when they are being potty-trained.

Delilah, like many spayed females, has a problem with urine leakage, so she takes a low dose of Estrogen to help strengthen those weak pelvic muscles. This has worked wonderfully for her for the past couple of years.

After about the 5th day in a row of a puddle on my rug, as well as countless loads of laundry washing urine drenched towels, I called the vet.

The vet wanted to do a urine culture to make sure Delilah didn’t have a urinary tract infection.

Since it was mid-week, I couldn’t get a sample to the vet until last Saturday. I really wasn’t concerned because Delilah had a huge problem with UTI’s a couple years back and at that time her symptoms were frequent squatting and she wasn’t doing that.

Using my PNS (Pee Ninja Skills) I obtained a sample last Saturday and dropped it off. Dr. Soutter called mid-morning and said under the microscope it looked good, but there were a few white cells in there and she wanted to culture it.

Dr. Soutter called on Monday to say the culture had grown something, so she put Delilah on the antibiotic that kicked her infection to the curb the last time she had one.

Since then, I’ve had her on the antibiotic as well as a low dose of Gabapentin (to help dull that urgency to go) and knock wood, we haven’t had any incidents in the house, BUT we are being hyper-vigilant AND Hubby has been able to get home an hour earlier than someone usually does, so I’m not really sure IF we’ve gotten to the root of the problem.

Monday I will stop the Gabapentin since she will have been on the antibiotic for almost a full week.

I know, none of this is smiling material, right? What’s the point of the post, Jodi?

Well….the biggest problem we’ve had is trying to determine WHERE Delilah would have her accident, SO I started leaving pee pads in random spots in the house.

Apparently, SOMEONE thinks pee pads are comfortable to lay on.

I had no sooner laid that down, then he laid down on top of it. Of course, that made laugh. Dude it’s not a mat!

What did your pet do to make you laugh or smile this week?

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.

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