My Lizzie Update Path Report
 

I talked with Lizzie's Doctor last night and as it stands she has just has the Chronic Rhinitis issues that are proving to be very difficult to deal with.

I got a copy of her report this morning and I am posting it here. This is all so frustrating. I just hope she has no headaches with this.

Monday, February 14, 2011

Dr. Sherry Woods
Tara Animal Hospital Inc.
611 Cheek Sparger
Colleyville, TX 76034
Fax: (817)485-7147

Patient Name: "Lizzie" Patient #: 2951
Client Name: Vicki Kxxxxxxxx

Laboratory Tests:
Histopathology - IDEXX Laboratory Services (2/8/11):

PRIORITY BIOPSY W/ MIC (1 SITE)
Test
SOURCE/HISTORY

Patient has displayed eight months of nasal discharge which varies
from clear to mucoid with some blood. There has been no response to
antibiotic treatment.

MICROSCOPIC DESCRIPTION

A number of tissue fragments are received. These contain nasal mucosa
with scattered areas of clotted blood and mucopurulent exudate. The
mucosal elements of cells are fairly normal although there is a mild
increase in stromal lymphoid cells and neutrophils. No microorganisms
are noted within the exudate.

MICROSCOPIC INTERPRETATION

Mucopurulent rhinitis

COMMENTS

Lesions are inflammatory and potentially infectious although no
microorganisms were identified. A silver stain has been requested to
check for the possible presence of fungi. This should be completed and
reported early next week.

Special Stain Results
Tissue sections stained with a silver procedure to identify fungi showed no organisms within the lesions. 2/14/11

PATHOLOGIST

R. GAYMAN HELMAN, DVM, PhD
Diplomate, American College
of Veterinary Pathologists
(1-800-444-4210 x76725)
E-mail: gayman-helman@IDEXX.com

Diagnosis:
chronic rhinitis

Recommendations:
Lizzie has not shown much improvement with Zyrtec 5 mg daily and prednisone 10 mg daily, and the prednisone side effects seem to bother her. The dose will be decreased to 5 mg daily, Zyrtec 5mg or Claritin 5 mg daily will be given, and owner is going to restart topical tobramycin with dexamethasone into Lizzie's nose. We discussed the positive aspects that she has no evidence of tumor or fungal infection, but this will be a chronic condition that can be frustrating to manage. Owner was asked to keep me updated on Lizzie's condition as we try to find a successful management plan.

Please do not hesitate to contact us with any questions or additional information you have regarding this patient.

Sincerely,

Erika Haschke Pickens, DVM
Diplomate, ACVIM
(Small Animal Internal Medicine)

Veterinary Medicine Specialists of Dallas/Fort Worth
2700 West State Hwy 114
Grapevine, Texas 76051
v 682.223.9770
f 682.223.9771

Have you put her on Ester-C ?

Yes, I did at your suggestion and so far no improvement at all.

I will keep giving it to her. I just feel so bad for her.

Have you researched the Tobramycin ? It is up to you but I would not be using that on my dog. The Vet put mine on the Clorpheniramine at the end & I added the Ester-C. I used them both for about a month then took him off the antihistamine. I was never able to put any meds in his nose as it was totally blocked with boogs & swelling so everything was by mouth. After the first month or 2 trying diff antibiotic he was put on Batryl after biopsy revealed that the other antibiotics were not rite for the specific bacteria he had developed and that was when he started clearing some of that ugly stuff out, he was also on Mucinex. I found that the antihistamine only made it thicker so it could not come out. When I took him to WSU they told me to not put anything up his nose as the vac caused a reaction & irritation & was trying to heel itself & when you put something in the nose it tries harder to heal itself causing more irritation. I believe they were rite because after the last antibiotic & mucinex cleared out the infection & boogs he took the Clortabs for about a year then I added the Ester-C and that's when he really started to improve. As vit is for immune system & it is an immune response to the vac.
Well, my feeling is that the meds in the nose are causing more of a problem but that's just my opinion and every dog is diff. Maybe the labs will shed more light on the problem.

Yes, I know what the Tobramycin is. It is eye drops with a steroid in it. It can be given as drops in the nose to help clear up inflammation. I haven't started her back on this as it didn't help the first time. Grasping at straws here.

So I guess I'll keep researching.

I know how you feel as it is awful seeing them go through this. I was told that this intranasal vac is known to have this reaction. My question is , WHY do they still use it then? They now have injectable vac & they developed it for some good reason. If the intranasal is so great then why spend the money to develope the injectable ? I know why , Do you ? I'm thinking your answer is YES.;)

Forgot to ask, what dose of Ester-C do you have her on ? You can give 500 mg per 10 lbs of body weight & she should be taking the highest dose rite now.
Also you can give that dose 2 to 3 times per day in the beginning.

You probably covered this in the past...but have you considered allergies? Even if she would test negative for allergies, sometimes the nose can still drip from being sensitive, but not allergic, to enviro/seasonal stuff.

Just thought of this too....my nose was dripping for almost a year, and I tested negative for allergies. They finally wanted an MRI and found a little maxillary cyst. It wasn't worrisome enough for them to remove. I actually think the cyst eventually drained on its own, bc my nasal drip finally just stopped.

I am giving her 250mg a day. She is now just over a 11 pounds. She has lost 1/2 pound. She doesn't need to loose weight. She hasn't been eating much, I guess if you can't smell and possibly taste since the taste buds must be off as well.

I guess I can up it to 250 mg 2X a day and see if that helps.

Yes you can up the dose as she's only getting half what she should be getting. Also you can give pineapple if she will eat it as it is a natural antihistamine & anti-inflammatory. Good for you , not putting the meds in her nose. I know how picky they get when they can't smell as my Captain would not eat anything for the 1 month of his reaction and try force feeding a wolfhound , Lol. Till one day I got an apple out of the fridge and apparently he could smell it because he went crazy for it , after that his diet consisted mostly of 2 bgs of Fuji apples a day for the next 3 months and it HAD to be Fuji as I tried a couple of times to buy diff apples that were on sale & he would NOT touch them so back to the store I went for the Fujis. Have you had her on Mucinex ? it's the best thing for thinning out those boogs so they will clear out. I figured you knew what the Tobramycin was for but I was talking about the side effects & adverse reactions. One is fungal infection. Have the done a culture on those boogs ? To be sure they are giving the rite antibiotic .