Canine Vasculitis and Pentoxifylline-need advice

[ladyjane]

She is going to be fine!! Do your best to believe that!!

[Jenna AK]

Originally Posted by ladyjane

She is going to be fine!! Do your best to believe that!!

Yes Ma'am!
Well a bit of a setback, they didn't get the med there on time (we've had a raging snowstorm in town for the last 24 hours, so it had to be a dicey drive) so it looks more like first thing tomorrow, which is aggravating. But the vet didn't want to take a chance she'd react after they left the office and apparently didn't want her to have to be moved to the ER. Maybe he felt it would've been too stressful for her, or perhaps the ER has no room.
By sometime around 2 PM tomorrow we should be able to bring her home after they've watched her for several hours for any reaction. They'll start her on half the normal dose for a few days, then up it if she seems to handle it well. The pharmacy did give us enough for a month, but the vet says she may be able to come off it after 2 weeks. A bit of conflict there, but we'll firm it up.
She is also eating a bit more, which is encouraging.

Something I'd like to add for information's sake, there has been one big change lately that I mightn't have mentioned before. As of the last month or so, my OH has been bringing home dog treats we thought were safe since they were US made. These treats are Vitasnacks and Milo's Kitchen brands.
Jenna had never had anything but Zuke's before and not many of those. It was just easier to feed her home made food rather than letting her get a taste for 'sweets'.
However, I've just gotten a heads up that these treats may now contain hormones/illegal antibiotics from China. This is very discouraging because we assumed a US brand would mean safety.

IF anyone feeds these treats I would warn you to stop. It sounds like several small dogs have died stateside as a result of eating the Milo's Kitchen and as such, I'd just avoid anything like this is future to be certain. We can't know for sure this was what caused her troubles, but it seems a bit too coincidental.

Probably preaching to the choir here, but there you have it.

Thank you all again for your ongoing support. I'd be floundering without the advice I've found here.

[ladyjane]

Sorry there was a delay...hopefully the med is there this morning and they can get her treatment started...AND she can go home!!

As for treats, they scare me. I only use RX ones and also sweet potatoes for some of my pups. I think you are wise for avoiding those things ... yes, they could have caused her problems. At least, thank God, it sounds like hers is very treatable. Some pups have ended up very sick from renal failure due to treats. Scary, scary.

[Jenna AK]

Well Jenna is home. But I am not happy about her current condition.
When I took her in Friday, she had some reddened ears and trunk. Today she is red from head to foot and looks like she's received a bad sunburn. Her fur is falling out everywhere and she is not a big shedder!
They gave her one dose of the pentoxifylline this morning. Attending vet told me not to give tonight's dose, but to begin again tomorrow and then carry a twelve hour dosing schedule for the next four days, we'll see how she tolerates it. So far no vomiting or (apparent) stomach upset, but in my opinion I have a very uncomfortable little dog here.
She is still having the heavier breathing. It's not what I'd call labored, it is just the kind of breathing I see in her when she is distressed. You know how a dog makes that kind of nose whistle while exhaling? Well she's doing that almost constantly, which was about where she was the night before I hospitalized her, but then she was dehydrated. She's been on IV fluids for four days.
Speaking of that, she apparently has some edema in her abdomen. This is worrisome. Is this indicative of the vasculitis or are we possibly looking at lymphangiectasia? (They claim to have drawn her bloods and found nothing there to worry about, but in researching it, it looks to me like they have to take a sample of her bowel to be sure?)
Plus she has had a constant high temp of 102.5. Now while I know that's high end normal, she feels hot to the touch, which she normally does not...she usually runs cool. And her skin...it seems to cause her pain to touch her, but she doesn't want to be left alone either. She is just not herself. When I picked her up I hoped to see a little dog frantic to see her mum and all over the tech or doc who brought her out. What met me was a depressed looking dog who almost didn't seem to recognize me! Talk about a knife through the heart!
She has little to no energy, was very wobbly walking at first, and is rubbing her head and ears on anything she comes in contact with. Obviously itchy as heck but she's been given benadryl today so I can't give her anymore.
I basically got a 'polite' push off not just when collecting her, but now when I call to ask further questions. I am NOT a happy Yorkie mom at present.

We've been napping, both of us, this evening...I am exhausted and the stress is only making it worse. She has been a bit restless and has to go back to her bowl to drink and drink and drink. Not sure if she's hungry, will offer some of the hypoallergenic food in about an hour or so. But right now she's trying to sleep again.
Is any of this typical when it comes to treatment with pentoxifylline? She was definitely dizzy when we came home, she almost fell off the bed and staggered while walking. I'd hate to think she's in pain and they didn't give me anything to relieve that.
I don't feel we've successfully reached the cause of her illness and may only be treating symptomatically and not correctly either. Can anyone help me to determine if there may be somewhere else we need to look as far as what it is she really has? I realize that one dose of medicine is not a cure in most cases...but really, she WAS NOT THIS BAD when I left her! What would you think if she were your dog?

The big test will be when we have to get her to potty, or to eat. Right now I just know she is feeling pretty bad and that just hacks me off. Almost $1000 worth of treatment and separation for four days...this is not a preferred result!
I simply cannot afford to keep hauling her back and forth between vets if we are just throwing darts at a board. There are no specialists that I know of here (perhaps if alaskayorkie reads this he may have a suggestion?) and I feel like we are running out of time. She's been sick since the 11th. I don't know how much more either of us can take of this.
I will continue the medication for the trial period. She is supposed to be on this for a month. But do we have a month to wait?
Thanking everyone for reading and any and all replies.

[ladyjane]

What I do know is that cutaneous vasculitis can get bad really fast. When Dixie had it, I swore she was developing lesions and losing her hair while we were standing there watching her. The prednisone worked quickly to stop it, but she did not improve for some time. If this is that, then it makes sense it is worse because they had her for four days and as far as I understand they gave her nothing. Also, her skin would feel very hot in the areas where there is hair loss.

As for the abdomen...I don't know why you suspect lymphangectasia, but you are correct, to diagnose it a biopsy needs to be done. Has she had protein loss??

I just googled and found this place in your area....there is a Dr. Cook there who lives in Fairbanks and she is board certified. I really, really think you need a consult with a boarded internist ASAP. Of course, they don't come cheaply BUT the consult itself probably would be between $150 - $200 and you might not really need anything done. Just take all records with you if you go there so they have something to look at.

Internal Medicine Specialists at Alaska Emergency Clinic | Anchorage Emergency Veterinarian | Pet Emergency Treatment Inc.

[Jenna AK]

Thank you for your reply, ladyjane. I had no idea there was a specialist here in city. Perhaps this is who my vet consulted to get the diagnosis? I will have to ask him. No point in doubling up if this has already been done.
Yes, where the rash is the skin is hot and the fur is greatly thinned from just 4 days ago. But on the whole last night I'd have to say she was less fidgety than she was last week. She just does all that nose whistling and that concerns me because I don't want her to be in pain. Does cutaneous vasculitis hurt?
She would not eat last night but only drank water. Her poor leg where the IV was has a stiff bit of skin high up on the foreleg and a nasty hole at her knee. It must've been a big catheter. She wouldn't stop licking it.
I have to give her medicine with food. I fear I'll have to syringe it in if she won't eat on her own. Sadly this stuff has chicken liver in it and I know chicken was giving her a rash two weeks ago that didn't look quite this bad, but was still a rash, so I was worried the food had made her this way.
I don't know if they measured her protein levels. Would that show up on an abaxis blood test?
Can you please tell me more about CV ladyjane? Jenna cannot tolerate steroids. Will the pentoxifylline take care of this alone? Should Jenna be receiving something for pain or anxiety because she is a little stressball right now and I don't know for certain what is causing it. She also can't handle metacam.
Thank you.

[ladyjane]

I don't know if it causes any pain...I don't think so as my vet did not give me anything for pain and she is very good about giving pain meds out as needed. You could call your vet and ask about that.

You definitely have to get the medicine in her. I don't think I would worry myself too much about food allergies unless they were life threatening types...I don't think food caused this. Did you vet think so? You could ask him for an opinion on what to feed her. Maybe for now, you could just make some pasta or rice with some tilapia in it if you think chicken is an issue for her.

I don't know what to say about the steroids. I have never had a problem using them. Are you sure she cannot take them? Maybe it was just a fluke that she had an issue? I don't know. I do think that the pentoxifylline should work. I just have not used it myself.

Don't let her lick her leg! If you have to put an E Collar on, I would do that because she could end up with an infection. She has enough issues right now.
Try really hard to keep your mood calm when around her....if you are stressed out so will she be. Take some deep breaths!

Oh...and I asked about protein levels because that is usually the first clue that there is a protein losing condition. They will lost protein. I am sure that the vet checked them and they are ok. I just was wondering why you suspect lymphangectasia. Have you discussed this with the vet?

[Jenna AK]

One of the vets who saw her earlier last week had said she had a slightly low protein level and mentioned a protein losing enteropathy type of problem as a possibility. But we were hoping it was just due to the heavy vomiting she'd been doing.
She'd been on Medrol for three doses when she began vomiting blood and this was the vet who'd found blood in her stool and suspected an ulcer, adding sucralfate to her medications and taking her off the Medrol. A pity too as basically the med worked but it was too much for her wee tum.
The sucralfate gave her terrible gas and stomach cramps, she stopped eating and it went downhill from there.
She is still rubbing her face everywhere. I got her to eat a bit of the moist hypoallergenic food, watered down and syringed, but it's the kibbles she goes for. She had quite a few of those. Since they are new to her I didn't overdo, but she was happy to have them, that's the most animated I've seen her for food in a while.
We got the pentoxifylline in and I'm just watching to see how she does now. She is very stressed, understandably.
There is something hard on her leg, don't think it's dried pus but it looks a dull yellow-ish...I think it must be the adhesive they used to secure the catheter, and I was able to moisten and peel some off-it's like superglue!-but will call them to be sure that's what it is. The skin isn't particularly sensitive or sore but she just won't leave it and I don't have a cone or any vet bandage I can use to keep her from it. Guess we'll just be snuggled up all day while I manually restrain her from messing it up. This was a bulging area of skin yesterday it was like they'd had the bandage too tight.
Would it be advisable to use neosporin on it? The kind without pain relief?

[ladyjane]

I don't suppose it would hurt to put something on it, but make sure she is not licking it.

Hope she is doing better.

[Jenna AK]

She is resting, but still doing this 'distressed breathing'. The vet said it may be that the drug is making her nervous, hence the hyperventilation. But it seems a mechanical thing to me...like she has to work hard to exhale.
Her skin gets hotter while she is on the drug. As it wears off she cools just a bit.
I worry that she'll get dehydrated again with all this going on but they want me to keep up on the pentoxifylline.
I wish I lived closer to town so it wouldn't be such a worry if she suddenly needed to be seen.
Is there anything I can do to make her more comfortable? Maybe they should've given an anxiolytic?

[ladyjane]

I don't know....its hard to tell by your description. She could be just fine...
She really needs this medicine! I would do my best to try to relax about that part. As for her skin feeling hot, that is normal. As long as she does not have a temp I would not worry about that.

[bella_mia_hairy]

My Chloe had a bad case brought on by yearly vaccinations. She was on 6 weeks of prednisone, warning she had peeped accidents the whole time, it was a side effect of the steroid. Hope your baby gets well soon

[SusieQ36305]

So sorry for Baby Jenna and for YOU! You both are worn out and surely need a good night's rest. Will be thinking of you both and saying prayers.

[Jenna AK]

Well I can't be certain, but I'm afraid the dog food has once again set off her stomach because she is not interested in eating tonight again and will not drink water.
I have given her a little pedialyte by syringe because she won't even take plain water that way.
She is agitated and shivering again when awake. The distressed breathing has not really stopped since early this afternoon about an hour or more after her pentoxifylline dose.
Called the vet to check in and they said to withhold the med tonight and begin again in the morning if she is better, but if she is not she needs to return to the vets.
She has seen so many different doctors in the span of almost three weeks now that I have to wonder if any of them have a handle on this. I need to get hold of the vet who referred her to the internist but he is still out of town.
The food they gave me was not supposed to have animal protein in it, but it has chicken liver and fat in the ingredients and I'm pretty sure she can't tolerate chicken.
Outside of getting allergy testing at this point I don't see a proper way forward.
I don't mind continuing the meds if they are going to help, but she is not going to live very long without food and water.
I am confused, despairing and very, very angry.

[Jenna AK]

I'm sorry to post again but there appears to be no way to edit previously posted messages in this forum.
She has now had a bit of water on her own about 10 PM. So that's good. Any improvement is a plus. However she didn't like me much when I just had to syringe a little benadryl down her throat. Unfortunately she has problems with sorbitol so I can't use the children's liquid on her, so I have to crush the nasty tablets. Yuck.

She is very itchy in the facial area today. Other than that and a bit of trying to scratch her chin with her hind foot I haven't seen any other itching.
She does seem a bit more settled this evening, but no idea whether it's because she's just had stomach discomfort for a few hours from the food, or if skipping the pentoxifylline (which she was due for now) has made a difference.

Perhaps the dose will need to be further reduced or diluted if it is the med and just used over a longer period of time. If it is the food a simple change (again! Oi!) should make a difference for her. I really hope it is just the food. Will check in with the vet in the morning first thing.

Thank you all again for your continued prayers and vibes.