Friday, March 7, 2014

In like a lion...

They say "March comes in like a lion and goes out like a Lamb," but I'm okay with a little less lion and a whole lot more Lamb. Lamb the dog, that is. 

If you know me or follow me then you are subject to my gazillion daily posts about my three dogs...but what you may not know is that Lamby has given us quite a scare these past few months. In December of last year, we were on our way to David's parents' house to decorate the tree when I noticed that Lamb was ADR and showing signs of labored breathing. When we got to the vet,* they put her in oxygen and then I was hit with the fact that she might be going into heart failure. (Lamb was diagnosed with a heart murmur about 1-2 years ago.) She ended up staying overnight and getting both an echo and abdominal ultrasound the next day. The echo did show signs of further heart enlargement but no heart failure. The abdominal ultrasound was unremarkable.

Lamb had been seeing Dr. H previously for her heart condition, and her lab work indicated hypoalbuminia, which we were unable to determine the cause of, after running a number of tests. She has also had chronic intermittent vomiting and diarrhea, which has increased significantly in the past year. The diarrhea has gotten increasingly worse in the past few months, and she has lost close to 25% of her body weight. A week after she was hospitalized, we were at David's parents' house again, celebrating and early Christmas, and woke up to what I can only describe as "vomit-arrhea." (If you don't know what that is, then trust me, you don't want to know.) After speaking to Dr. K about previous tests we had done, and her current condition, I decided to pursue further tests, specifically to figure out if she might have atypical Addison's. A few weeks later, results came back. They were negative.

While I was glad Lamb didn't have Addison's, I was disappointed in not knowing what was wrong. Over the past year, we had done many tests (Bile Acid, Fecal Protease, food trial), in addition to radiographs, ultrasounds, and bloodwork, and ruled out numerous diagnoses. The last thing on the list was Inflammatory Bowel Disease (IBD). "The most difficult part of diagnosing IBD is eliminating other possibilities" ( Well, we'd done all that. The problem was, "if all screening tests fail to reveal an underlying cause for the recurrent gastrointestinal signs, IBD is suspected and biopsy of the intestines is required to make a definitive diagnosis. Obtaining biopsies involves anesthesia and either surgery or endoscopy" ( Surgery requires anesthesia. Lamb has heart disease. Anesthesia could be hard on her heart.

I considered treating Lamb for IBD without doing the biopsy, but after speaking to both her rDVM and Dr. H, and considering Lamb had done well with anesthesia at her dental earlier in the year, we felt like she would do well during the endoscopic procedure. So it was settled. I scheduled her for an upper GI endoscopy with biopsies. I fasted her the night before and dropped her off at the hospital early in the morning. 

We never did find that ketchup packet again. Guess we'll see it on "the other side." (Ew.)
Before noon, I got a call back from Dr. H. Lamb had a lot of food in her belly in addition to a ketchup packet. "A ketchup packet?!" "A ketchup packet. Heinz 57." They decided to wake her up from anesthesia, keep her overnight while continuing to fast her, and then attempt the endoscopy again the next day...which I agreed to. She did well overnight and the next day they attempted the procedure again. Afterward, I got a call saying that Lamb was doing well, but after getting samples from the duodenum, her BP and heart rate started dropping, so instead of continuing and getting stomach samples, they decided to wake her up. Luckily, the doctor felt the samples she got would be sufficient...and thankfully, they were.

Yesterday I met with Dr. H before work and she confirmed that the biopsy results are indicative of mild IBD. At this point, she suggests we continue Lamb on a hypoallergenic diet and B12 supplementation, as well as add in a corticosteroid (Dexamethasone) and immunosuppressant (Cyclosporine). I will be monitoring Lamb closely for any signs of heart failure or reactions, and will recheck her albumin level and weight in a week. Lamb started the Cyclosporine last night and the Dexamethasone this morning. She also made it outside to go to the bathroom (#2) today, which is fantastic. I am glad to be off this weekend so I can monitor her closely. (Hopefully this means I will not have to bring her in, which defeats the whole purpose of being off work.)

The plan is to attack the inflammation with the Dexamethasone and Cyclosporine, possibly switch her to Budesonide, and maybe even wean her off steroids altogether (if possible). (Budesonide is also a corticosteroid, but it is largely broken down by the liver soon after absorption, so systematic side effects are minimal.) That being said, good thoughts and prayers for Lamby are greatly appreciated! I'm praying the steroid doesn't give her heart any trouble and that it will really start helping with her IBD troubles!

Lamb has a special birthday coming up next month. She will be turning 10! I can't believe my two little dogs have been with me for almost a decade. To celebrate Lamb and the start of her recovery, I want to end this post with a little Q+A and list of fun facts about my little hairless dog.


the Bride

*I have been blessed to work at a specialty/ER vet hospital for the past 4 years. I love knowing that I can take my dogs in at anytime and get them the best care possible.

Here are the answers to some common questions I get about Lamb (and the breed). 

What kind of dog is she?
Lamb is a Chinese Crested Hairless. In the Chinese Crested world, she is known as a "Hairy Hairless" because she has a little bit of extra hair.

How old is she?
Lamb will be 10 next month! Even though she is the smallest dog in the bunch, she is actually the oldest of the three.

If she is a Chinese Crested, why does she have hair?
A Chinese Crested Hairless dog will have "soft, silky hair on its head (crest), tail (plume) and feet (socks)" ( Lamb has extra (sparse) hair on her body, which I leave long. I also choose not to shave her snout.

What is a Powderpuff?
Noah is a Chinese Crested Powderpuff, and yes, him and Lamb are the same breed. The Chinese Crested comes in two varieties: Hairless and Powderpuff. The Powderpuff is the less commonly known variety, and depending on how they're groomed, can look like a Havanese, Shih Tzu, or a small Afghan Hound. (Noah and Lamb are not from the same litter.)

What is her grooming regimen?
Lamb is the easiest (and quickest) dog to bathe! I bathe her more often than the other two, but she takes no time to dry! She does have some skin problems, as many Cresteds do, but after bringing her to a number of dermatologists, we decided that her skin is not bothering her, so I don't do anything more than bathe her with medicated shampoo and occasionally apply lotion and/or sunblock if needed.  

Why does she wear clothes?
Umm, hello. She's hairless. Naked. She's cold! :)

Why does she look like that? She's so ugly!
Hey, I don't know. God made her that way. Why is your husband bald? :p

Why is she shaking?
Lamb shakes for a number of reasons. Usually it's because she's scared or cold.

Why is her favorite toy an iguana?
Both Noah and Emery have toys that look like them (I call them their Mini Me's). Noah has a small black and white stuffed dog and Emery has a small Golden Retriever stuffed dog. Let's face it. They don't make them like Lamb, so Lamb picked an iguana (Iggy).

Here are some fun facts about Lamb.

She's a clothes horse.
Lamb thoroughly enjoys wearing clothes. If she sees me take out a sweater or t-shirt, she gets super excited and sticks her head through the neck hole. Then she lifts up each arm to put through the armholes. It's entirely too cute.

She skips.
When you take Lamb on a walk, she gets so excited that she skips every few steps. Again, entirely too cute.

She likes being in a bag.
I am no Paris Hilton and don't carry my dogs in purses. Let's face it. Emery? In a purse? But the story with Lamb is that when my parents used to visit my brother in his old apartment they would sometimes sneak Lamb in to visit him. It got to the point that every time my dad brought out the gray duffle bag they used, she would hop right in. Hehe.

She's a cat.
David and I have decided that Lamb is actually a cat. She likes to rub herself on your legs (particularly David's), and furniture. She sleeps in sun spots. She jumps on you and walks on top of you like it's nobody's business.

She sings.
Lamb started "singing" to my dad's ringtone a few years back. And by singing, I mean howling. She also does this to sirens, other dogs howling, and incessant ringing phones or alarms. This gets Noah going. Noah howling keeps Lamb howling. It's an ongoing cycle. It's deafening. Cute at first, then deafening. They're known at work as the "howler monkeys."

She should have been insured.
Lamb broke her leg when she was a puppy. We think she did it digging or jumping. She had surgery where they placed a rod in her arm and she wore a cast (the size of her body) for weeks. Not long after, she had surgery again for a luxated patella. She has a heart murmur. Now she has IBD. (I don't wanna talk about it.)

She's quirky.
Lamb was a late bloomer. She never vocalized or tried to jump on furniture until much later in life. (And she learned those bad habits from a little black and white dog I know.) She's also very independent. Unlike the other two, she doesn't always follow me from room to room. If she wants to sleep downstairs by herself, she will. You may find her in the closet or the clothes hamper. Sometimes she randomly sits facing the wall or corner. She spins in circles when she's excited, about to lay down, or when has to "go." She holds her nose (and sometimes hind legs) when she sleeps. She particularly likes David when David doesn't particularly like her. She's afraid of loud things like yelling and thunder, but she's not afraid of the vacuum (unlike those other two wimps). 


Despite all her medical issues and those quirky, sometimes annoying, sometimes cute habits, I love my little Lamb. I originally got her as a companion for Noah, but she was quickly "stolen" by my mom, and tugged at the heartstrings of both my brother and Dad. My grandma met her for the first time this past Christmas, and she just fell in love! (Poor Noah was pretty bummed he didn't get all the attention.) She's one of those dogs that once you meet her, you just love her. I can't tell you the number of times a nurse or groomer has returned her to me, gushing about how much they love her. I also get the occasional negative comment here and there: about her skin, or about her breed...but I don't really care. I live by Lamb's motto: #NoHairDontCare :)


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