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  • Lola has been very sick

    Hello all

    This morning we made the decision (once again) to end Lola's misery and dug a grave in our garden before phoning the vet to come out (yet to do that part) but I just keep wondering if we are making the right decision after dicovering this fantastic forum.

    Lola's case is unusual in that she was diagnosed last July with Necrotizing Pyogranulomatous Liver Disease, apparently extremely rare, no known cause could be found so the treatment has been a bit hit and miss. She came within a whisker of death and despite her unbearable pain and suffering I am glad we made the decision to try and save her as we have had her an extra few months and mostly in relatively good health albeit she is on a huge amount of medication.

    Two weeks ago she was diagnosed with diabetes.

    Because of the condition of her liver, the vet has started her on very low doses of insulin, once a day. We changed her diet from Hills Science Heptatic food to cooked chicken with green vegetables and a small amount of brown rice. Week one she loved her new diet and although she was drinking and peeing continuously we had good days, bad days. Now she is getting very picky and refuses chicken, tuna, sardines, any vegetables etc. Finally she settled on ham and boiled eggs, not so great for her liver but we were deperate for her to eat as she has lost 30% of her body weight and is skin and bones and of course she needs food with her jab.

    For the last few days she has just been permanently asleep other than waking for very large drinks and peeing. We have seen a couple of moments where she wants to play when she sees her brother, Eddie, with his ball but it lasts seconds and she zonks out again. Yesterday her stomach was very distended (this could have been the liver condition as we have seen it before). The last three mornings she has violently vomited after eating, with severe shaking for several minutes after. Could the vomiting may be down to the large water intake after her jab?

    The vet thinks her reactions at the moment are down to her liver condition and her body shutting down but I am just not so sure. She is such a strong little dog and has endured numerous health issues throughout her life I just want to make sure that we do not deny her the opportunity to come through the early stages of her diabetes if we can find a way to manage it.

    Taking the liver condition out of the picture are her symptoms typical - weight loss, lethargy, vomiting, shaking, weak legs, spaced out eyes and groaning.

    This morning she wagged her tail for the first time in a week and I felt hope again but am I kidding myself and being unfair to Lola.

    Can anyone help please.

  • #2
    Re: Just dug Lola a grave - are we being hasty

    I'm here only rarely for now, but happened on your story of Lola. I don't think you're being premature. If it were me, I would be considering quality of life, and I believe that is exactly what you are doing.

    The experts will surely be along to give you some tips, before long. Whatever decision you take, I know you'll be welcome to post Lola's story, and I, for one, would like to read it.

    Tue, 29 Jan 2013 04:29:16 (PST)
    http://www.coherentdog.org/
    CarolW

    Comment


    • #3
      Re: Just dug Lola a grave - are we being hasty

      Sorry to hear Lola is so unwell.

      I understand where your coming from with regard to thinking about her quality of life but wonder if your vet has done any blood testing to see how Lola's blood glucose is doing. A lot of the sympotms your describing could be down to very high blood sugar?

      You know your dog better than anyone and if you have doubts then perhaps its worth pursuing some additional testing to see whats going on.
      Alfie- 11 1/2yrs. 8kg diagnosed June 2008. Insulin - NPH, Novorapid & Caninsulin - a work in progress! Dx left brain neuro focal lymphoma 4th Dec 2012, still fighting on!.

      Comment


      • #4
        Re: Just dug Lola a grave - are we being hasty

        From what you describe I don't think you're being premature either. My cat had cancer and I knew she was dying but she was still alive, still had life in her, but I still made the decision to put her down because her quality of life was so poor an would only get worse.

        You know your dog better than anyone, so you have to make the assessment, but a distended belly, constant sleep, refusing food. It may be time.

        You could try increasing the insulin, if you decide to wait. I recommend talking to your vet about being more aggressive with the insulin. Also, you can syringe feed baby food. All of this is upsetting to animals and, having done it myself with dying animals, it makes you wonder if this is a little too much cruelness to be kind.


        I wish you the best, I know how hard this is.
        Zoe: 12 yr old Black Lab/shepherd mix. Diagnosed 6/1/11. Currently on 15 units Novolin NPH 2x day, and hopefully as close to regulated as possible. Feeding merrick Grain Free Salmon and Sweet Potato. Weight 63lbs.

        Comment


        • #5
          Re: Just dug Lola a grave - are we being hasty

          I don't post very often anymore since I lost my boy but your post begged for a response. I know the emotional rollercoaster you are going through right now.

          In his last few days our Buddy, he showed the same signs as your Lola and he too had a multitude of health problems to contend with. Wasn't eating anymore or the little he ate he threw up, even turned down filet mignon, went from 11 units of insulin down to 2-3 units, refused to go for his twice daily walks, which were pretty well the highlight of his life, was shaking a lot (which we were told was a sign that he could be in pain) etc. etc. My husband not believing that it was the end, brought him in for a complete blood panel which did not show any major problems and the results were pretty well the same. The vet suggested that his body was shutting down

          Despite those test results, we knew in our heart that he no longer had the quality of life that we all fight so hard to give our furbabies and we made the decision to let him go. It was gutwrenching and one of the toughest decision I have made in my life. We are now at peace with that decision.

          You know and love your baby and Lola knows that you will do what's best for her, listen to your heart.

          Good luck
          Louise

          Comment


          • #6
            Re: Just dug Lola a grave - are we being hasty

            Originally posted by dookie View Post
            Lola's case is unusual in that she was diagnosed last July with Necrotizing Pyogranulomatous Liver Disease, apparently extremely rare, no known cause could be found so the treatment has been a bit hit and miss. She came within a whisker of death and despite her unbearable pain and suffering I am glad we made the decision to try and save her as we have had her an extra few months and mostly in relatively good health albeit she is on a huge amount of medication.
            Not familiar with this condition, but the fact that she improved is encouraging. When you say "mostly in good health" does that refer to her quality of life? was she not in pain then?

            Two weeks ago she was diagnosed with diabetes.This could be a big blow for a dog trying to recover from what sounds like a significant disease above.

            Because of the condition of her liver, the vet has started her on very low doses of insulin, once a day. We changed her diet from Hills Science Heptatic food to cooked chicken with green vegetables and a small amount of brown rice. Week one she loved her new diet and although she was drinking and peeing continuously we had good days, bad days.
            Was the diet change just to accomodate the diabetes or was there another reason?
            Now she is getting very picky and refuses chicken, tuna, sardines, any vegetables etc. Finally she settled on ham and boiled eggs, not so great for her liver but we were deperate for her to eat as she has lost 30% of her body weight and is skin and bones and of course she needs food with her jab.Sometimes we are forced to give insulin without food in order to let the stomach heal. Obviously they don't get a full dose. If you decide to wait it out we can advise you how to do that.

            For the last few days she has just been permanently asleep other than waking for very large drinks and peeing. We have seen a couple of moments where she wants to play when she sees her brother, Eddie, with his ball but it lasts seconds and she zonks out again. Yesterday her stomach was very distended (this could have been the liver condition as we have seen it before). Since she hasn't been active I am thinking this isn't a gastric torsion
            The last three mornings she has violently vomited after eating, with severe shaking for several minutes after. Could the vomiting may be down to the large water intake after her jab?
            This seems to me to be one of the most pressing things, which I will address below.

            The vet thinks her reactions at the moment are down to her liver condition and her body shutting down but I am just not so sure.
            Not being familiar with the liver condition I don't know, but diabetes is a very significant disease. Without treating it there is no way she can climb the steep hill in front of her.
            She is such a strong little dog and has endured numerous health issues throughout her life I just want to make sure that we do not deny her the opportunity to come through the early stages of her diabetes if we can find a way to manage it.

            Taking the liver condition out of the picture are her symptoms typical - weight loss, lethargy, vomiting, shaking, weak legs, spaced out eyes and groaning.
            All of the above, except the vomiting and groaning could be attributed to uncontrolled diabetes.But the diabetes may have led into other conditions which would need aggressive care.
            This morning she wagged her tail for the first time in a week and I felt hope again but am I kidding myself and being unfair to Lola.

            Can anyone help please.
            At this point it probably comes down to three things:
            *wether or not her body is truly shutting down which is hard to tell
            *your financial situation and how much you can invest in her recovery
            *if finances are tight how much supportive care you can do at home.

            At this point I don't think there is a wrong answer either way you go, but I will offer what might help if you decide to try to pull her through this.

            The two additional things I am worried about are pancreatitis and ketoacidosis.

            You can get ketostix at the pharmacy and test her urine. Anything more then a trace is cause for an emergency trip to the vet's. This can turn deadly quickly.

            I don't have a direct experience with pancreatitis but believe it can be quite painful and would account for the groaning and vomiting.

            Yes they can vomit if they have taken in large amounts of water.

            This would be my approach and it is extreme, but I think that is where you are.

            * test for ketones 1st
            *if no- trace ketones fast for 1 1/2 days giving either IV fluids at the vet or sub Q fluids at home if finances don't allow. I have pulled through 3 animals who were goners and subQ fluids were a big part of that.
            *Buy a blood glucose meter now and start testing. You may need to be more aggressive with the approach to the diabetes. having a meter will enable you to do that safely.

            Can you tell us wht your pup weighs and what insulin and how much you are giving.

            Giving you strength because either way this will be hard.

            Tara
            Tara in honor of Ruby.
            She was a courageous Boston Terrier who marched right on through diabetes, megaesophagus, and EPI until 14.
            Lucky for both of us we found each other. I'd do it all again girly.

            Comment


            • #7
              Re: Just dug Lola a grave - are we being hasty

              hi and welcome

              jesse came from the camp of quite ill i dont know how many times i counted her out and after awhile i stopped counting she just had such a drive to live

              i really change things up i went to one meal a day which settled her digestive issues because it gave a break from eating

              you can give insulin without food its usually best to start with a quarter of the normal dose given with food and a little bit more as more food is consumed so if you were giving 4 units at dinner time and she did not eat you would give her one unit

              home testing would really be needed at this time if am not sure if you are testing at home but i believe that would be your pups best chance at least as far as trying to keep blood sugar in a good range i can understand your vet only giving one shot but if blood sugar is wildly fluctuating from high to low well that doesnt feel good for the dog and you may have to give more than one shot as cebe said you do have to be more aggressive and see if you can stabilize things

              only you know what to do but there is always hope if you pup is willing
              Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
              Jesse earned her wings on 6/21/2021

              Comment


              • #8
                Re: Just dug Lola a grave - are we being hasty

                So hoping you can let us know what you decide, even if that is to not make a decision today.

                It doesn't take me long to get attached to animals, people and threads. Yours is just one of those that has struck a chord.

                worrying, Tara
                Tara in honor of Ruby.
                She was a courageous Boston Terrier who marched right on through diabetes, megaesophagus, and EPI until 14.
                Lucky for both of us we found each other. I'd do it all again girly.

                Comment


                • #9
                  Re: Just dug Lola a grave - are we being hasty

                  I too wonder how much lethargy is due to her diabetes. If she's running quite high, if there are ketones, etc.

                  It's definitely a choice that only you can make as you know your pup the best. I looked to my pup for when it was time and even then it was the hardest decision I ever made.

                  My friend Carla once shared this link that I saved a few years ago on quality of life. It's called the HHHHHMM scale http://www.homevet.com/pet-care-libr...uality-of-life? I hope it can offer some insight.

                  We are here for you,
                  Patty
                  Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~

                  Comment


                  • #10
                    Re: Just dug Lola a grave - are we being hasty

                    I'm so sorry that you are facing such difficult circumstances with Lola... I don't think any of us, from such a distance, can answer this question for you. You are there with Lola and are the only one who can look into her eyes and get a sense of whether she is mainly lethargic or whether she is in pain.

                    When a dog has a strong will to live, as it seems Lola does, I would lean toward giving her every chance to fulfill that wish UNLESS she is suffering from a great deal of pain. If she is simply tired, then that would move me to give her time to see if she can recover.

                    I know that it's extremely difficult to determine how much pain she might be in. That's where her eyes and demeanor have to be your guide.

                    When our dog was diagnosed with cancer, the vet suggested that we euthanize right away because things were only going to get worse, not better. But Chris had always had a very strong will to live and he wasn't in obvious pain at that point, just old and tired. We opted not to euthanize him, to let him play it out and only take that step when he was struggling. Two weeks later, he started bleeding internally. Still wasn't in pain, just extremely weak. But he was panicky because he couldn't stand up and walk to take himself to potty. That's when we felt that his quality of life was too compromised. And part of that decision was based on the fact that he had cancer and wasn't going to get better.

                    When you have a dog who has pulled through so many difficult circumstances by sheer force of will, I do think that should be a consideration in how you approach the decision.

                    Again, I'm very sorry. And I agree that there is not a "wrong" decision here. Without a crystal ball, any decision made with love and Lola's character is a good decision.

                    Natalie

                    Comment


                    • #11
                      Re: Just dug Lola a grave - are we being hasty

                      Just wanted to note for everyone worrying about Lola that she does not live in North America so is in a very different time zone.

                      Everything here is crossed for good news for her...

                      Natalie

                      Comment


                      • #12
                        Re: Just dug Lola a grave - are we being hasty

                        Originally posted by k9diabetes View Post
                        And I agree that there is not a "wrong" decision here. Without a crystal ball, any decision made with love and Lola's character is a good decision.
                        This is all I could think of as well. I just don't know anything about liver disease. Thinking of you. Judi
                        Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.

                        Comment


                        • #13
                          Re: Just dug Lola a grave - are we being hasty

                          To everyone who has left me a message - THANKYOU - The hole in our garden is still empty! (Tara don't worry please)

                          I am new to forums so hope I am replying/posting correctly. Sorry for not answering individual questions, haven't quite worked that out yet.

                          Just to let you know I am a Brit living in Spain. My vet practice is fantastic and they love Lola but they are a little in the dark as to treatment due to her underlying condition, which is deteriorating. She basically has a tumour in the liver which is huge and destroying the liver. It's not cancerous but in a way if it were it may be better because at least they would know how to treat it. Lola is a 12 year old Parson Terrier, she was the runt of the litter and we fell in love with her when we bought her brother Eddie, she is the most adorable dog with immense character.

                          This afternoon we have seen a slight improvement, I have no idea why but she definitely has more life in her. We are due to visit the vet on Thursday to test her glucose levels and thanks to this forum I am more armed with information to hopefully ask the right questions.

                          My understanding is that the insulin treatment is at odds with her other medication so we are gradually stopping part of that to let the insulin take effect but by doing so we are at risk of her liver deteriorating quicker. We are under no illusion that one way or another she will not last years but if we can see a few more months with her that would be amazing.

                          She is not suffering, I have seen that in her before so know the difference, but she is so weak and I need to know is it the diabetes? Will she gain strength and weight once the right insulin level has been found?

                          In reply to Tara, it's not Pancreatitis for sure as I have seen the pain that causes which is horrendous, her ketones have not been checked and the vet suggested it may be a problem due to her breath. Her tummy is not distended today. She weighs 13lbs but I am ashamed to say I don't know how much insulin she is on but I will find out Thursday and let you know. She has dropped 30% body weight in two weeks, which is a particular concern of the vets and ours.

                          Our vets hasn't even charged for the insulin as I am sure they thought she wouldn't make it.

                          I will post again once we have seen the vet. Thanks again.

                          Amanda

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                          • #14
                            Re: Just dug Lola a grave - are we being hasty

                            A belated welcome,
                            And thanks for the update - watching and cheering you on.
                            Jj
                            Eddie is a 14yr old Rat Terrier Who is very well loved.

                            Love, Released and All promises kept. My Heart, My Heart, My Heart

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                            • #15
                              Re: Just dug Lola a grave - are we being hasty

                              .Amanda, you will find us to be a very inquisitive group. Just when you think you have given us tons of info we come back with more questions.

                              Can you find out what type of insulin and the amount? Then based on her weight we can ball park for you wether or not she might improve greatly when her optimal insulin dose was achieved.

                              The most common insulins are meant for twice daily dosing and even the long acting insulins usually work best when given twice daily.

                              If you can't do subQ fluids before your vet visit I would offer her small frequent amounts of water so she doesn't gorge on it and have it come back up. But if there are ketones present that needs to be very frequently.

                              I don't have any experience with ketoacidosis, but just want to stress that if she is in full blown DKA (diabetic ketoacidosis) waiting till even tomorrow to start treatment may be too late.

                              Here is a link from the home page that will explain it:

                              http://diabetesindogs.wikia.com/wiki/Ketones

                              I'm not sure if it would work the same in spain, but here I can go to my vet and get a bag of subQ fluids and a sterile line to give fluids at home. Or maybe they could call in a script to your local pharmacy.

                              Thanks so much for the update.

                              Tara
                              Tara in honor of Ruby.
                              She was a courageous Boston Terrier who marched right on through diabetes, megaesophagus, and EPI until 14.
                              Lucky for both of us we found each other. I'd do it all again girly.

                              Comment

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