Distraught with worry

[momofdecker]

Re: Distraught with worry

I don't know if the chattering teeth might mean something or not. Patty's Ali had a suspected brain tumor and Patty took video of her and has some posted on her thread. I don't remember any teeth chattering specifically but do remember Patty capturing eye nystagmus. Here is a link to her thread:
http://k9diabetes.com/forum/showthread.php?t=615

If you have access to taking video, it might be worth documenting some of what you are seeing at home. What I discovered was that there were things I saw on the video that I never saw in real time.

Here is a video of Decker and what we were seeing that caused us to schedule the neuro appt. Natalie and Patty, one of the moderators who is not as active these days, were wonderful in gently encouraging me to schedule the neuro appt. We knew going in that we didn't have a lot of money to spend on tests, however, one of our biggest questions was whether or not he was in pain. We honestly could not tell at home.

This video was about a week before his neuro appt. He barks at our other dog for a little over a minute before nipping at him to get a reaction out of him. Decker had little to no vision left. What I see on this video that I never saw in real time is that after I help him roll to his side, he struggles to get upright. Learning that his his lesion was a c1-c5 cervical (neck area) lesion, and looking back at this video, I can see the struggle as I know what to look for. What I saw in real time was a blind dog who still had the spirit to tease our older dog and who despite falling down got back up again and continued to wag his tail and want to play.

https://www.youtube.com/watch?v=yZT_-R7scOA


This was when I could tell for sure he was hurting. His movement was so slow and calculated. He had to really lift his feet to keep them from knuckling. His head is held low as that is where the lesion was.
https://www.youtube.com/watch?v=8Zg8bBFfIco

We tried NSAIDs (metacam) before steriods too. They did not work (didn't provide enough inflammation relief). This video was taken as we were in transition between the metacam and steroids. He'd been off anti-inflammatories of any kind. He still showed such spirit that there were times it was still difficult to tell if he was in pain. He had strong herding instincts and nipped when he herded. He also had an obsessive love of barking .
https://www.youtube.com/watch?v=bHjht2NOoBQ

This video was after about 10 doses of steroids. His front paw knuckling stopped and was able to stand upright. He still had some mild balance checks and the rear legs were still off a bit, but it was marked improvement. What I see in this video is that he licks his nose a lot. I now realize it was probably a sign of pain but never saw it in real time because I was focused on his legs and not looking at his face.
https://www.youtube.com/watch?v=uZT7wj1uad4

[clydesmum]

Re: Distraught with worry

MumofDuston, hello from another Brit-based member.

I've read you posts and it must be agonising to watch Duston going through this. I'm no expert on anything, and until my Clyde had a bout of colitis recently, diabetes hasn't been a problem for him. Two things, though. When Clyde was first diagnosed in December 2013 the vet couldn't get a reading, his levels were so high. He gave him an immediate injection of Caninsulin. A couple of hours later his teeth starting chattering and he was trembling (but small dogs tremble at the least thing). We gave him another shot and he seemed to settle and be more comfortable immediately. So I'm wondering if the teeth chattering could be a response to fluctuating BG levels?

As far as further investigations and MRI are concerned, if both the vet and the specialist are baffled I wonder if they could refer Duston to the Royal Veterinary College - specifically to the Queen Mother Hospital near Potters Bar. Our son's dog was referred there when he had a mysterious condition (which they diagnosed and treated) and because it's a training centre there is a lot of expertise. He was covered by insurance, but there may be financial help available where necessary.

Duston sounds a great lad, and I can understand how worried you are. I wish him well.

[MumofDuston]

Re: Distraught with worry

Momofdecker

It appears that Duston's teeth chatter with excitement (at breakfast and dinner time). Something to do with salivating perhaps..?? Or BG levels as clydesmum suggested..??
Currently his eyes are still (saggy and bloodshot but still). Let's hope they stay that way.
I can take videos on my phone and ipad so I must get in to the habit of recording him. Lately my hands have been full just holding him up
I've been watching him like a hawk. He does not suck his toys any more (he has always been like a baby with a dummy), he hasn't rolled on to his back for the last 10 days (he used to spend most of his time upside down) and he doesn't seem to be able to shake himself any more.
On the positive side, despite a bad morning (where his balance was very poor), we had a good afternoon and he wandered round the house slowly (wobbly) but unupported. This evening I drove him down to the park and he had a little stroll and a good sniff around. He lost his balance twice and landed in the mud but I don't think he really cared, he got himself up and carried on sniffing.
I am going to book the neuro appointment. I really need to know now what is ailing him so we know how best to care for him and prepare for whatever the future holds.
It was nice to see that Decker maintained such spirit. Duston has lost his. He was such a huge character so it is hard to bear.
Decker's movements appear so similar to Duston's, although Duston is less stable. I also don't feel that the Metacam made any difference.
The pain element is such a difficult one to gauge. Our vet has really put him through his paces - pulling, prodding, poking, twisting - not once has Duston squeaked, groaned, winced or even turned his head to show any signs of discomfort. However, his mood alone is very telling.

Clydesmum

Thank you for your welcome and kind words. What a tough time this is.
The information on the teeth chattering sounds very interesting. We're due to do a blood curve tomorrow so I will see if we have any chattering and do extra tests if necessary. It will certainly be worth having a look as his steroid dose is being reduced and it could be playing havoc with his BG.
We haven't seen a specialist yet. Our vet has spent a lot of time having telephone consultations with the neurologists at The Willows in Birmingham, along with various others. He tells me Duston's case has been discussed far and wide It looks like our next step will be neurology and further tests. He is not insured so I had better prepare the credit card for an onslaught
Thank you, Duston is a lovely lad - he is my 'one in a million'

[amydunn19]

Re: Distraught with worry

I hope neurology can give you some answers. I know it seems rather bleak now and it is very hard to watch them struggle, but we have seen dogs make some big comebacks. Duston seems to be fighting it, whatever it is. A little progress is still progress. I hope he gets stronger every day.

[momofdecker]

Re: Distraught with worry

I hope the teeth chatter is simply excitement over food - your posting that made me smile.

Love that he took a stroll and sniffed around.

There is absolutely nothing you've posted that would point towards this - other than your description of Duston's eyes. At one point in time Decker did lose his spirit. It was when we began to worry there was more than diabetes going on because even when his bg ran high - early on he was still full of his crazy self. He was dx. in November 2011. By March 2012 we started noticing small things - like when he did sleep he slept very soundly and it didn't take much to tire him out. By May 2012 he did nothing but sleep. He didn't sit. Didn't stand. Basically only moved to eat and potty. We tried to walk him but he'd foam at the mouth on a 5 minute walk. He was just incredibly weak, had lost muscle mass and that is when the front legs started to give out on him (but were not yet knuckling under).

Decker ended up being hypothyroid and to this day I still believe that the delay in that diagnosis is what ultimately cost him his life. Here is one more video - it was about a month after he'd been on his thyroid meds. I wish I'd had the forethought to take video of him prior to this but it had never crossed my mind. You can see how unstable he is in this video too. He had been shaved down in April and this video in July you can see how little his fur had grown in. You can also see that despite his diabetes going uncontrolled for about 6+ months - he was still a bit overweight. What is most notable, however, is the weakness. He was actually getting better when I took this video. He'd been much worse in May and June before we discovered the hypothyroidism and started him on the meds.
https://www.youtube.com/watch?v=PPhflYiVY1I

Don't know if it's worth asking your vet about checking for hypothyroidism or not. Most likely there would be some indication on blood work that would have raised a red flag - high cholesterol value, low red blood cell count, low white blood cell count, low platelet count. But your continued description of his eyes looking through you reminds me a lot of what we saw before we knew what was going on.

Offering continued prayers that Duston finds his spirit and you get your happy and energetic boy back.

[MumofDuston]

Re: Distraught with worry

We had no teeth chattering yesterday. In fact, we saw more of the old Duston yesterday than we have in a while. He took a toy from the toy box, cuddled and sucked it for a few minutes (that baby/dummy action I spoke about before). We had another wander over the park last night, just 5 minutes but he was happy with that. This morning, again, he was wrecked - tired, low mood and wobbly. This afternoon he's on his feet and wandering around. He sneaked out into the garden and got himself down the steps to have a wee on the grass. I had kittens..!! (Just a reminder not to trust my husband to pay attention to what's going on around him)..!! We had to go out earlier (which I was loathed to do), but he was pretty excited to see us when we got home. So much so that we had a bit of teeth chattering..!!
I spoke with our vet yesterday. He said that the teeth chattering was an intentional something or another (I can't remember), but it's all part of the neuropathy and I have to keep an eye on it. He has suggested that further tests with neurology would not be particularly beneficial. Between himself and the neurologists he has consulted with, they are sure Duston has idiopathic polyneuropathy. To pinpoint exactly what the root problem is, he would have to have tissue biopsies. I don't want to put him through that. An MRI might show something but if it does show any slipped discs, lesions, or tumours, what am I going to do..?? If it is something repairable it will costs thousands of pounds with no guarantee that he would be cured. We don't have thousands of pounds The vet has assured me that we are doing everything right for him and we couldn't do more. I know he's very fond of Duston so I think I'm happy to go with his thoughts. We're going to keep him on 4 x 5mg steroids a day, as he does seem more mobile since he started them. He is also going to have B12 injections regularly to try and combat any further neuropathy. The vet also said that he was clear of hypothyroidism and negative for all the extensive tests he has done.
Do you know if anyone has any experience of Serrapeptase..?? I stumbled upon it on the internet. Apparently it is a natural steroid and I'm trying to gather as much information as I can about it.
It's good to see bits of my boy coming back (if only fleetingly), but I'll take whatever I can.
Thank you both for your prayers and best wishes.

[Eddie]

Re: Distraught with worry

I'm glad he's showing a little bit of his old self. I do hope that progress continues even if it is painfully slow. These things do seem to take a long time to improve and you have to be extremely patient!

By the way, the B12 that the neuropathy research related to was B12 methyl (as opposed to B12 cobalamin). I've no idea what the difference is but for Eddie we gave him the vet's standard B12 injections plus B12 methyl pills as well, in case the type of B12 was important.

Antonia

[MumofDuston]

Re: Distraught with worry

That's great, thank you Antonia. I have ordered some B12 methyl. I'll quiz our vet about the difference (we like to hurl questions at him to keep him on his toes)

We seem to be noticing that Duston is more like himself (more alert and less wobbly) in the middle of the day when his BG is at it's lowest. As soon as his BG is up, he is falling over, tired and (pretty much) out of it. I'm thankful we're, at least, having this semi-lucid spells as it was something we've been totally lacking for the past 6/7 weeks.

I've had 4 days without tears (yippee) and I seem to be gathering my thoughts about the whole situation and thinking about things more clearly. One day at a time, positive mental attitude and learning how to overcome obstacles. There's life in that old dog yet..!!

[Riliey and Mo]

Re: Distraught with worry

A couple of things that might help

according to the feed chart 44 kg dog would get 417 to 473 grams your feeding 380

injecting right after food is better than waiting 15 minutes. The wait can raise their bg

their is alread glucosamine and chondroitin in his food. You might want to stop the lintbells yumove

[MumofDuston]

Re: Distraught with worry

Thank you Riliey and Mo.

Duston is 40kg = 417g dry food per day (let's call it 210g each meal).
He has 1/2 can wet food per day so, proportionally, you have reduce the dry by 30g for each 1/4 can of wet = 180g. He has 180g of dry with 1/4 can wet morning and evening.

I had wondered about injecting sooner to see if it made a difference, but was a bit cowardly about doing it. I'll start doing that from tomorrow. Thank you.

We had only changed his food at Christmas (2 weeks after diagnoses) and the vet had suggested putting him on Yumove because his joints were also a bit dodgy. He had recommended his food too. He's still on the loading dose of 6 tablets a day..!!

[Riliey and Mo]

Re: Distraught with worry

A bit dodgy. I use this expression with my dog. A bit dodgy boy when he goes to bump into something

i just think adding extra g and c might cause a higher glucose just my over thinking.

the only time i wait to inject is when i think Riles will go low.
testing an hour and a half after will tell you whats going on.

one change, a day at a time eh

[Eddie]

Re: Distraught with worry

We inject as Eddie is eating (he is very fond of his food so usually he doesn't even notice) and it helps stop the food getting too much ahead of the insulin.

You just need to be sure that your dog will eat all his food before you inject. With Eddie this is just not a question - he would probably eat it three times over if he had the chance and if Duston is a typical Lab I expect he is similar! It's just a thought process to go through before you actually stick the needle in.

When Eddie was recovering from his neuropathy he ran out of energy very quickly - to the extent of being able to walk across the lawn away from the house but needing to be carried back because he just couldn't do it on his own (and he's quite an armful, even though he had lost a lot of weight). We found we had to pace him as he had no sense of what he could or couldn't do and he needed a lot of extra sleep for weeks and weeks.

I do hope you carry on seeing those little signs of improvement! Write it all down so you can refer back to it and see how he progresses.
Antonia

[momofdecker]

Re: Distraught with worry

Great update on the mobility progress. May the days ahead bring continued success!

[MumofDuston]

Re: Distraught with worry

Thank you Riliey and Mo for over thinking (it seems to have become a recent acquisition for me too)..!! I did a bit of internet research and found several sites with information that say Glucosamine can raise BG. I've pulled him straight off his loading dose (6 a day) and he's now down to 1 a day. The yumove has stopped him 'clacking' when he moves so I hope I don't have to stop it completely. I'll keep an eye on it.

Oh Antonia, one thing I can be thankful for is that his appetite hasn't been damaged in any way at all. If I lined up 20 dinners, he'd clear them all and enjoy the last as much as the first We are also finding that Duston tires easily. He is far too heavy to carry so we just stand with him (usual in the freezing cold) and wait for him to kick start back into life again.

He had a very sleepy day yesterday but sprang into action last night and thoroughly enjoyed the longest wander over the park that he's had for a long time.

I am taking one day at a time and writing things down as we go. I've changed his injection site, the time of injection after food, reduced the Yumove substantially and will be starting on B12 imminently.

I've got over the initial distress of thinking we would have to say goodbye to him. All your kind words and reassurance have made me appreciate that (although not great) it's not as bleak as I first feared it would be. Thank you

[Grayson]

Re: Distraught with worry

I'm also a 'Lab Mom', so I can relate to the never ending quest for more food! If Grayson ever shows lack of interest in eating, I'll know for sure he's sick. That enthusiasm for every meal - his, mine, & every meal consumed in his presence - is why I feel safe in giving his shot while he's eating. It's much easier to hit the somewhat stationary target, and prevents his food getting too much head start on the insulin. As long as Duston is a hearty eater, you should be safe to inject as he's chowing down. I'm glad he is showing signs of feeling better!