[Dailydrool] Our Elsinore had a $350 tummyache

[Elizabeth Lindsey]

When I brought our Elsinore home from her surgery two weeks ago tomorrow, she had been given her first Cephalexin, Rimadyl, and Tramadol all on an empty stomach because she refused to eat during her overnight stay with the surgeon. Her appetite was nonexistent. She didn't want rice, scrambled eggs, dog treats, canned pumpkin, peanut butter, her favorite cheeses, and certainly not her kibble. She'd poke her nose into her bowl, stab at her food a couple times, and then push the bowl away with a look on her face that said she just couldn't face whatever was in it. The only thing I could get her to eat reliably was McDonald's double cheeseburgers. Because I wanted her to have *something* in her stomach to buffer the meds, that's what I fed her until the meds were gone. Her surgeon assured me that within a couple days of the last Cephalexin and Rimadyl, her appetite would return. 

Elsinore had her final Cephalexin and Rimadyl last Wednesday. It appeared as if her appetite might be returning on Friday, when I was able to get her to eat half a cup of kibble along with part of a double cheeseburger in her bowl. On Saturday I primed the pump again with another half a double cheeseburger and got her to eat three-quarters of a cup of kibble. On Sunday, however, she wasn't enthusiastic about the half a double cheeseburger and really not enthusiastic about her kibble. 

I caught her eating something out in the yard later that morning, but of course couldn't get to her in time to find out what it was. Maybe it was grass? Maybe it was something one of the neighbor's cats had dragged into (or pooped out) into the yard? By Sunday afternoon, Elsinore was self-segregating in the backyard and acting as if she didn't feel good. I brought her inside and locked her doggie door so I could keep a close eye on her, and she wilted onto a dog bed. Periodically she got up to walk around and stretch first one hind leg out behind her and then the other. I noticed she was yawning more, too. Last year, which featured three trips to the vet for inexplicable nausea, the vet said both behaviors are signs of nausea in a dog.

When dinnertime arrived, I tried to coax her to eat some warmed-up rice, but she looked as if the sight of it, let alone its smell, turned her stomach. She went back to stretching her legs. Then she started arching her back in a poor imitation of a black Halloween cat and looking as if she might consider throwing up. The bloat alarm sirens sounded in my head. We keep a symptoms chart on the side of the refrigerator for handy reference, so I immediately referred to it and went down the check list. Pink gums, yes. Licking the air, no. Panting, no. Retching, no. Restless, yes. Roaching, yes. 

I gave Elsinore a Cerenia tablet, which her vet prescribed last year for one of her three episodes, and then two 0.6 ml doses of simethicone. She didn't want the drops and did her agitated alligator impersonation by clamping her jaws shut and whipping her head back and forth. But I discovered I could get the dropper in between her teeth if I went at them from the side and squeezed fast. (I'll have to remember this for future difficult medication administrations.)

Then I called Drooler Kelly Jane Wilson and talked with her in what I hoped was a controlled panic about the bloat her lab and a friend's dog had had. She said the retching sound is distinct; it sounds as if it's coming up from their toes. Elsinore wasn't retching, distinctly or otherwise, so that was good, yes? By the time I got off the phone with Kelly Jane, Elsinore had gone back to bed, curled up in a loose, not tight, ball, and not shivering. She was breathing heavily but evenly in a sort of old-dog kind of way. I risked putting my head down to her stomach (she doesn't like to be messed with when she isn't feeling well) and heard loud gurgling, which my bloat information said was good.

She got up when it was time to put young Charlie outside for the final potty call of the day. After going out with him to take care of things, she hopped into her crate, which is her signal to me that I should give her a treat. So I gave her the usual bedtime treat and discovered that she still liked the *idea* of eating a whole lot more than the actual act of it. She left the treat untouched in her crate and slunk over to one of the dog beds next to my side of the bed for the night. 

This morning was her two-week post-surgery follow-up with her surgeon. The only thing I wanted to talk about, of course, was Elsinore's lack of appetite and frightening behavior last night. The surgeon was more interested in telling me about Elsinore's post-surgical progress and the cancer he found. He said there's a bit of a depression in her hip now where he scooped out what he could of the tumor (1 cm margins) and the incision scar will feel a bit thick for a long time, but all of her nerve functioning is what it was before the surgery and he's very pleased with what he was able to remove and how well she's recovered. There are still tendrils of the cancer inside, but it's going to take some time for the cancer to regroup and start to grow as a mass again. He's hopeful it'll take many months.

As for Elsinore's appetite, or lack thereof, he said to give him a minute and he'd send the oncologist in. The oncologist wanted to run blood tests, which came back beautifully normal. Which was good, except we still don't know what's been going on with Elsinore's guts. The oncologist said it could be a number of things: something she ate in the yard, the antibiotic having stripped out all the good bacteria in her gut, the antibiotic on an empty stomach immediately after surgery putting her in a cycle of nausea side effects/not wanting to eat/taking more antibiotic on an empty stomach. But at least we know she doesn't have pancreatitis. Or bloat. Or an intestinal blockage. And the surgeon and oncologist both said it's highly unlikely it's that cancer showing up in a different location. 

So $350 later, Elsinore was sent home with instructions to take Mirtazapine (an appetite stimulant), Cerenia, Pepcid-AC, and canned ID gastrointestinal food until her appetite returns. I gave her a Mirtazapine two hours before dinner, and oh did it work! She was antsy for dinner and ate her prescription canned food and rice combo with a gusto I haven't seen since before her surgery. She milled around our feet when Ken and I ate our dinner a little later, pestering for a handout. She joined us in the kitchen while I washed dishes. She asked to sit on the sofa with us and stayed on my lap for cuddling for half an hour. Her eyes seem brighter, and she's acting more animated than she has in days. As I write this, she's pestering to be put to bed so she'll get her bedtime treat. I suspect she'll actually eat it tonight. 

I'm feeling much easier about her. It's nice to have her "back" with us again at last. 

Elizabeth