Print

[Rudy]

Our 3 yr old Irish Setter, Rudy, was diagnosed with Blasomycosis June 13 and started on Irtaconozole the following day.  It had been since mid-April that there were noticeable signs that he wasn't his usual energetic self- he seemed unwell-not enthusiastic for his walks, eating less, lethargic... After a battery of diagnostic tests over a few weeks span, it was discovered/diagnosed last week at an emergency visit when his condition worsened; laboured breathing, limping, cloudy eyes, fever and no appetite,  It appears to be throughout his body- it is in his lungs, & since they found it also in his urine, it was concluded it was throughout his body.
He seems to be improving in some aspects i.e. eyes look normal, his respiratory rate is still high at about 63 beats/minute but it doesn't increase erratically up into the high 80's any more- even after limited physical movement and his breathing while still slightly laboured seems less forceful & less noisey & he is no longer limping. There are times that he is very alert and responsive and where he wants to go for a walk (which we keep shorter than he'd like) or wags his tail briefly when there's a visitor to see him but there are also times each day where he seems unresponsive or uncomfortable especially at night or after a good spell or a forced feeding.  We are hoping that since he is still alive and has had the mediation for over one week that this is a good sign.  It is his lack of appetite and refusal to eat that is causing us the most concern right now.  We have tried everything we can think from human food/meat, dog food and treats including homemade liver treats and rollover.  Neighbors bring in different samples of meat etc & we take turns feeding him when he becomes resistant to one of us.  He has lost 10 lbs in the last 3 weeks and today we have started to puree/blend his high calorie dog food from the vets mixed with chicken broth and feed him with a syringe vial that we squirt into his mouth.
Any suggestions on how to get him to eat or at least how to make sure he is getting enough food/nutrients?  We appreciate learning from other's valuable experiences.  We've tried the medication Mirtazapine to stimulate his appetite but with no success.  (Perhaps we need more than 3 days worth to work?)  He also has stopped drinking from his water dish but loves drinking lots of water with the syringe or sport bottle that squirts which I make sure is offered to him frequently & more often when he is up and about.
Sometimes we feel we're losing the battle but other times he shows signs of improvement in his energy/activity level that we wonder how we could ever think he won't make it.  It's the not eating that worries us the most right now.
Plus there's a funny crinkling noise when you rub along his ribcage/side chest area that sounds like crumpled tissue paper that you can hear if you have your ears close to his body.
Any information, advise, suggestions, words of encouragement or sharing of similar experience would be most appreciated.
Thank you,
Sheila & Paul for Rudy

[Cathy, Bailey and Duke]

It sound like you are doing all the right stuff! When Duke was at his worst, the only things he would eat were summer-sausage, salami, scrambled eggs.  I would definitely keep doing what you are doing with the syringe vial. Good luck and keep us updated!!!

[evayola]

I am glad that you found us here. I'm am sorry that Rudy was diagnosed with blasto. Great that you have Rudy on treatment and he is showing signs of improvement. We all have been in your shoes with the feeding issue, some worse than others. Since you are giving Rudy itraconazole are you making sure that you give the meds with a source of high fat (tbsp of butter or glob peanut butter)? That is most important. The itra was really hard on Marge because of that reason. We had to switch her to fluconazole so she could get her appetite back and the blasto had spread to her eyes. You are most definitely on the right track with your feeding. Our vet told us to feed Marge anything she would eat. She was eating all sorts of different things and usually wouldn't eat it more than once. There is a paste that I bought at the pet store called nutrical and it is very high calorie. I would squeeze it in Marges mouth and pretty much force her to swallow. Make sure you are keeping Rudy very hydrated. That's very important. We had to give Marge subcue fluids at home to help her out. There's a section on the site about what to feed a dog. Take a peek at that. Keep us posted and I will be thinking of you guys. Stay strong and stay positive. Your positive energy is key for Rudy, it sounds as though you have been doing a great job.
Eva

[Rudy]

We really appreciate all your encouragement and helpful advice.  It sure has been exhausting- an emotional roller-coaster and a process to figure out what is the best way to help Rudy recover and be well again.  Your personal replies have touched us in more ways than you know- we sincerely appreciate all your input & concern- it lifts us up and motivates us to keep going.  This website is very special.

I've been thinking it would be good to have a one page checklist of sorts that could be readily available to help with the management of blasto and that vets/ pet owners could easily access. (Perhaps a quick checklist already exists?)

Some ideas re care we have learned over this last week &/or are exploring right now:

-  there is a type of recovery dog/cat food available at most vet offices that is higher in calories and nutrition, even more than the Gastro, plus mushier so hopefully easier to feed.  (We're trading our Gasto for this AD kind today; also not sure why this wasn't recommended to us from the beginning.)

- medications can often be bought from a regular pharmacy much cheaper than the vets since human pharmacies are subsidized.  Our vet will fax in the prescription at least for some of the medications, other vets will not because they have told us that the meds are not quite the same

- while Itraconazole is noted as the drug of choice, we have been informed that there is more success with Sporanox.  If I understood correctly, it is pretty much the same drug but in capsule (time release format) vs capsule in powder form where all the dosage is at one time.  My husband found out Sporanox is available at our local Costco (we will still verify with our vet that it is okay & he will fax in the prescription)

-it is a good idea to give a liver protective med when giving Itraconazole.  Hepato-support is a natural vitamin that protects the liver that can be purchased from vets who are members of some kind of vet purchasing organization.  Milk Thistle does basically the same thing and cost approx $20 at Costco for 240 softgels of 150 mg each (thank you to our friend, Joan, who did the research and gave us a bottle)

-apparently there are some labs in Arizona or Texas where an antigen test can be done to find out the level of blastomycosis in their system.  If the # is in the teens, it is not too bad, in the 50's, for example, is a lot worse.  These #'s help indicate how long treatment may be required.  When the test result comes back as #1, then they are able to stop the medication

-we will be starting to use antacid (not sure if I have the correct spelling but anyway...)- it was suggested we can use pepcid to help protect the lining of the stomach which might help Rudy to eat since he might be experiencing pain when he eats (it seems he is very quiet and rests right after his feedings)

- certain vitamins help to prevent infection and boost the immune system.  We haven't researched this enough yets but our vet said it is okay to give Rudy a Centrum every day to start with.

- since we have used up all our pet insurance coverage and beyond, we have decided that our strategy for our next year's coverage (renewal date, luckily, beginning in two days, June 26) and any additional costs beyond will be focused on treatment as much as possible rather than more ongoing diagnostic testing so instead of testing his liver etc since he needs to be on meds, let's go if the idea that his liver is affected and his lungs are compromised and treat him with that in mind & to protect him as best as possible.

Again, we have only found out this info mostly in the last two days and need to verify a few things & continue to think things through as they come up but hopefully some of this helps someone to at least be able to discuss some of these ideas/options with their vet & others.

Again, thank you again for all your help:  it is true, Cathy, with Rudy too that he will eat different things than usual so I’ll try him on scrambled eggs even though he wouldn’t eat them when he was well and Eva, your ideas are extremely helpful- coating the pills with peanut butter or butter and the Nutrical.  We’ll keep the subcue fluids idea in mind and discuss with our vet if/when required.  I’ve copied the quote from David also to use as a mantra especially during the tough time. 

Warmest regards to everyone,
Sheila, Paul & Rudy

[carolh]

Hello Shiela, Paul and Rudy,

I like your idea of one-page compilations of helpful information.  What it lacks, though, is the specific support, the "life histories" of the dogs and folks on this board and the personal touch of support we give to one another.  Also, we all don't always agree....example, some on the forum think it is important to not feed junkfood and others say feed whatever you can get your dog to eat.  If you go the subq for liquids, check out what you can get from on-line vets.  My vet was charging $25 a bag for the sterile water and I got the exact same product from an on-line vet (Lambriars though I think they have changed the name now) for $3.  Since our cat used a lot of bags, this difference was significant.

Even though Rudy isn't eating well now, it does sound as if you are making progress against the blasto.  We have used AD from Science Diet with a dog who could not eat because of illness-- as others have said, effective for a short time.  I'm in the "try anything" camp if the weight loss is extreme.  Our hearts are with you.  We know that desparate feeling when our pets are feeling too ill to eat.  You're in a tough fight right now and we're with you.
Keep on doing all that you're doing.  Keep asking questions.  THere are people on this forum with so much experience and knowledge and wisdom.

Carol

[Rudy]

Thanks Carol for the info.  I agree this site is a crucial life saver for personal support and wealth of info.  Perhaps adding this forum/website on a one page checklist sheet would be a helpful resource. 

Just wondering if there is a timeline or benchmark for gauging how long before he'll eat on his own.  Does anyone have any feedback?  I'm sure each case is different but just want an idea of what I can expect.  Any input would be helpful.

[evayola]

First of all, how is Rudy doing? Does he seem to be feeling at all better? It took us over a month to get Marge to eat on her own. And when I say to eat on her own I mean her actually getting up and walking to her bowl by her own will. Otherwise it was just a couple weeks that we really had to force her to eat. The other couple weeks was us coaxing her to eat and finding something that she would actually eat. She was hand fed the whole time. What I did that seemed to really help is making a food journal. I would write down how much she was eating, what she was eating, and what time. It was a nice piece of mind seeing that she really did eat more than I thought in my head. It was also good because I could see what time of day she was more willing to eat.

Eva

[Wilson3]

oooo please do NOT give antacids I do remember reading those are not good to give to dogs plus while treatment

Give plant Enzymes & Probiotics
Prebiotics are also good. These will help the stomach and help the absorption of food/meds and make the tummy feel better
 I am getting worried a vet saying to give antacids ...
wilson3

also wondering about the crinkling noise under the skin   is it still there? sounds like  he could have air under the skin. any puncher wounds anywhere?

[Wilson3]

here is a some good info about itra
http://www.marvistavet.com/html/body_itraconazole.html

INTERACTIONS WITH OTHER DRUGS

The use of itraconazole in combination with the antacids famotidine (Pepcid®), ranitidine (Rantac®), or cimetidine (Tagamet®), omeprazole (Prilosec®), or with the antibiotic rifampin will lead itraconazole to be less effective. If itraconazole must be used with these medications, it is recommended that at least 2 hours pass between the antacid administration and the administration of itraconazole.

Serious heart abnormalities have resulted when itraconazole was used with the antihistamine Terfenadine (Seldane) or with the intestinal motility modifier cisapride (Propulsid®). These medications should not be used with itraconazole.

The following heart medicines will be stronger in the presence of itraconazole and dosage may need to be reduced: amlodipine, digoxin, warfarin, or quinidine. A similar problem occurs with cyclosporine, an immune suppressant used in immune mediated disease, allergy, or after an organ transplant.


The all natural way works best...it really does

[Rudy]

It’s difficult for us to evaluate how well Rudy is actually doing; he seems much better: more attentive & at various times in a day more energetic and can go for a walk down the block which is longer than the shorter walks we normally take of 2-3 houses away from ours. Then there are periods every day or second day where he is more tired, breathing with difficulty and looking unwell. There are times where I get discouraged and think we’re not going to make it and take a small walk to collect myself, only to return home and find him content, breathing well with my husband boasting that Rudy had just finished a complete feeding co-operatively.

Yesterday, he ate a late night snack of dog treats, dental stick and chicken on his own!  He was truly hungry! We were amazed and frantically ran around the kitchen looking for what was would be best to feed him to take the most advantage of this special opportunity to put some weight on him. (Any suggestions for high-calorie treats or kibble that would be a change for him from the mushy stuff we use for force-feedings?) Now this morning he’s had a rough period: breathing strained, coughing again & we’re back to force feeding. 

The crinkling noise around the ribs has spread to his neck area also.  Rudy looks less bloated around the ribs but there appears to be what feels like a pocket of liquid by his right underarm.  The vet seemed less concerned after he checked him yesterday; he said it’s not as swollen as he thought it would be from my description over the phone.  It is emphysema. Our vet said to keep him out of the heat & humidity and restrict his walks to a few houses away even if he has more energy to walk further. 

He has lost another 6 pounds for a total of 18 in 3˝ weeks which is even more of a concern right now so we’ve increased the frequency and amounts of our forced feedings and making sure that he doesn't exercise or exert himself too much so he can hopefully gain weight and also heal.

We were also given an anti-biotic, Clavamox 375 mg x 2/day, for him; they found lots of bacteria of various sorts in his stool- he's developed a secondary infection. He still has a fever around 104 F (40 C) so we now also have meds (Celebrax 100 mg once/day) for that too.  The vet thinks that once his fever is down, he’ll also feel better and more likely to start eating on his own.

We are doing the vitamins B12, D, C (slow release) and pro-biotics.  (I couldn’t find the antacid- a good thing.)  We were starting to give him a multi-vitamin, Centrum 50+ (˝ twice/day) but now that Rudy is also getting 1-2 Ensure/day with extra calories, the vet said not to give the Centrum.

We’re looking at the fact that Rudy is still alive and becoming attentive/energetic for longer periods, plus the little big signs like the timing of our pet insurance coverage renewal making more funds available, that I was unable to find antacid, timely advice from friends and those with experience, plus the wonderful discovery of this message board and all your vital input you guys have been sharing as signs that we’re on the right path.

Thanks,
Sheila & Paul

[evayola]

At least Rudy can take walks. Marge would not get up at all for a while. We would pretty much carry her outside to do her business and a few times she even peed on herself. So happy to hear that he had an appetite last night! It is definitely times like that that makes us happy to shove food in them. Rudy sounds like he is doing pretty well considering all that is going on. You just need to stay positive!

I am surprised that your pet insurance will even allow you to renew. Once our renewal time came, they sent us a letter saying sorry but we will be dropping you now since your pet has blasto. They knew the whole time and continued letting me pay our premium for nothing until the renewal time came and then she was dropped like a bad habit. Hopefully yours will cover Rudy.

Eva

[jefndebbacon]

Hi Sheila and Paul,

I used Canadae canned dog food for our Winter to eat. She loved this brand.  Plus, I gave her meds in sweet potatoes that I made each week and cut into pieces to give the Fluconazole.  Have had dogs who were suffering from cancer who would only eat liver or McDonalds' french fries!  We do what we can to keep them going.  Have to find their "niche." 

You seem to be doing everything right and I wish you the best. You are in my thoughts and prayers.  Keep us posted.

Deb

[Rudy]

Rudy had a rough day yesterday with grunting noises while breathing more labored than he’s had for a while.  It wasn’t as bad as at the beginning a few weeks ago but quite worrisome just the same. He looked so tired and worn out and was breathing with his head stretched out and his lower jaw extended as if trying to catch air.  We seriously contemplated taking him to emergency but decided instead to book a regular appt early next week to specifically get the vet we originally saw at emerg who made the diagnosis almost immediately. She has been the most knowledgeable; we feel most confident in her abilities/knowledge and experience and have decided to ask her to take over his care. It’s nothing personal re our vet or the other four we’ve seen at the hospital but we have the most faith in her.  We have to do what’s best for Rudy.

Rudy is a little better today; still heavy breathing but less than yesterday.  We were fearful and discouraged yesterday but today is a new day and believe that Rudy will have a good day with regular feedings, rest and love to restore him.

I’ll check out the Canadae canned dog food and I love the idea of sweet potatoes. 

Thanks,
Sheila & Paul

[evayola]

What temp do you have your house on? We had our house bone chilling cold while Marge was having labored breathing. Somewhere right around 58-60. We found that the cooler it was, the easier it was for her breathe. Maybe prop up a fan for Rudy? Some on here have tried some things to that extent. One even took their dog for a ride in the Jeep so she could hang her head out the window and get lots of air. Great that Rudy seems to feel better today. There are just so many ups and downs that you never know what to expect.

Eva

[Rudy]

Reply to Eva & Sandy (Beulah's owner):

Funny, we've been doing some of the things you suggested, Eva, before you mentioned them; reassuring to have the confirmation.  Paul has been taking Rudy for lots of car rides with all the windows down especially when his breathing is the worst and Paul invites him to "watch TV" in the basement where it is cooler.  I’ve also turned on the fan in whatever room he settles in to keep the air circulating.

To Sandy:  This is my first message board experience; I’ve never gone on facebook, chat rooms etc so I’m not sure how to sent/reply from message board via email but wanted to thank you for your encouragement and wish you the same. You’re definitely in our thoughts and prayers and we’ll keep track of Beulah’s progress/improvement from your messages. This site is not only extremely helpful but also the best place I’ve found where people really understand what you’re going through. 

Perhaps this will work for you with feeding Beulah:  We’ve learned that some foods are easier to feed when Rudy wouldn’t eat.  We discovered when our neighbor gave us special liver pâté that when we put some inside Rudy’s cheek, he couldn’t spit it out but would lick it.  The wet dog food we have now has a similar paste-like consistency so easier & more effective to use the same method than forcing food down his throat.  I’ve also used syringes (the larger the better: easier to fill and serve) with more liquid-like foods we’ve pureed. I soak puppy kibble (I think it has more calories?) and include some in the puree.  And every time before and in-between feedings, we offer him whole foods and surprisingly every other day or so, he’ll eat it on his own.  He’s always liked Dental Sticks so we start him with that.  It is true that different things work for different dogs and sometimes Rudy will eat one thing one day and not the next, at different times he’ll eat something he never would have before.  Sometimes we found someone else offering Rudy food has helped too.  We just have to keep trying and not give up. All the best and good luck; we’ll all be thinking about you.

Sheila & Paul