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MD for Pets
MD for Pets, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 173
Experience:  Veterinarian specializing in Emergency & Critical Care Medicine
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My dog has been retaining fluid for over three weeks now.

Resolved Question:

My dog has been retaining fluid for over three weeks now. She has had blood tests done, X rays done and exams done and still nothing is showing up. She has been put on Cephalexin, Furosemide and Prednisone. She was doing great until she ran out of Cephalexin not even 24 hours later she was ballooning up again. So we have her back on Cephalexin. I am just sitting here wondering if I am doing the right thing by her putting her through all of this. Without answers I am pulling my hair out worrying that I am causing her pain just to lengthen our time with her.
Submitted: 4 years ago.
Category: Dog Veterinary
Expert:  MD for Pets replied 4 years ago.
Hi thereCustomer

I am sorry to hear about your dog. I have a few questions to help me best know how to answer you and help your dog:
- how old is your dog? what kind of dog?
- where is she retaining fluid? (chest, abdomen?)
- is she still eating, drinking, urinating, and defecating normally?
- does she seem like she is in pain or not herself?

Thank you for the extra information.
Customer: replied 4 years ago.

She is a 10 year old Golden/Lab mix. She is regtaining most of her fluid in her face and neck where when she is at her worst you cannot recognize her as herself. But she has also been retaining in her legs at times.

 

She is eating fine, but at times when swelling is in her lips she has to have the "puppy" size food or she cann't eat it. She is drinking a lot, but that is from the prednisone.

 

She is Urinating and having regular bowel movements.

 

She doesn't seem in pain, she seems to sleep more and is less involved, but she will still get up and play with the children for an hour or two in the evening and she still makes her nightly patrol of the house.

Expert:  MD for Pets replied 4 years ago.
Thank you so much for the extra information.

Based on the sounds of where your dog is accumulating fluid, it sounds like she has something called cranial vena cava syndrome, where there is something in the chest that is pressing on one of the large veins that drains the head, causing back-up of blood in her head and neck, and this leads to the swelling. Often, in our older dogs, this is caused by a tumor in their chest pushing on that vein before it enters the heart. It sometimes does not show up on x-rays and needs a CT scan to diagnose. This can be a very tough condition to treat, as you are unfortunately finding out first hand. There has been some success with an experimental procedure where a metal stent is placed in the vein to hold it open and allow the blood back to the heart. However, this is something that only a few veterinarians in the country can do. If you are near New York City, there are doctors at the Animal Medical Center that do this procedure, and if you are near Michigan, a veterinarian at Michigan State also does this procedure, should you wish to talk to them.

The fact that you are asking the question about whether or not to continue treating her tells me that you are doing the best possible thing an owner can do; thinking only of your dog and her quality of life. That is the best mindset to have in this situation, and very refreshing to hear an owner thinking only of their beloved dog.

When I counsel owners in this position, and when I was in this position with my own dog, here are some of the questions I ask (many of which it sounds like you answered for me above):
- does she do the things she loves still (play with the kids, go for walks, beg at the table)?
- is she still able to eat and drink (and does she still want to)?
- can she get around the house well enough withou her feeling frustrated?
- do you feel like she is still happy and herself?
- do you think she is in any pain?

Based on your answers, it seems like she is doing remarkably well given everything that is going on, especially since she will still play with the kids and keeps up her home patrol duty. And it is understandable that she has some trouble eating when the swelling gets bad.

I feel like you are in a situation where there are not right and wrong answers, just right and wrong choices for you and your dog. And by thinking exactly the way you are right now, meaning her quality of life is your biggest concern, regardless of which choice you go with, I feel confident that you will make the best decisions for her. As long as you feel she is happy, able to eat, tolerating her medications, is not in any pain, and is able to get around, I think it is completely reasonable to continue treating her. And if that means leaving her on cephalexin, that is ok. But, if you feel she can't eat (even canned food or ground beef and rice), is painful, is having any trouble breathing, or just isn't herself, then it is absolutely fair to consider putting her to sleep. As owners, it is one of the worst decisions we have to make and live with, but for our pets, sometimes it is the best one.

I hope this information helps you with a very difficult decision. Please do not hesitate to let me know if there is more I can do to help you.

Dana
Customer: replied 4 years ago.

I would like to thank you for your information. I was so hoping that you would tell me it was an infection or something, but deep down I knew. I actually live in Michigan, I'm not sure what we will decide to do, but if you have the name of the Doctor who does the procedure in Michigan I would appreciate it.

 

Other than that procedure you are saying that there is little we can do to keep her quality of life going for longer? This is my children's best friend and the neighborhood's best friend. With a waiting room full of dogs three differnt children entered at different times and they all were drawn to her, puffy face and all. So for the love she has given us we need to get as much information and make the right decision for her.

 

My only other question is as far as you know does this cancer cause them pain? I want to make sure she is kept as comfortable as possible. And this is a dog that has had children climb and pull on her and has never yelped. So I don't know how much pain it would take before she would let me know.

 

Thank you for your time.

 

Andrea

Expert:  MD for Pets replied 4 years ago.
You are very welcome, I am happy to help in any way.

Here is the website for the Interventional Radiology Service at MSU. The program leader was my mentor when I was there an an intern there, and is one of the greatest veterinarians and people I know. I cannot speak highly enough about him.

http://cvm.msu.edu/hospital/services/interventional-radiology/about-our-staff


There are different diuretic medications (other than lasix) which can be used. In addition, a lot of times with tumors there is some degree of inflammation, so increasing her dose of prednisone may be able to help as well (though can have its own side effects). Some people use non-steroidal anti-inflammatory drugs instead of steroids, since they have been shown to help with certain cancers, like carcinomas.

As far as pain, it is so hard to know. Our dogs are much braver than we are, and it sounds like your girl is an angel who would never complain. The way I deal with this is to use a very safe but effective pain medication (that can be used with many other medications and with many health problems) is called Tramadol. I would ask your veterinarian to prescribe you some to have on hand, and then you can use it if you ever even think she needs it. It can be used as needed, and the dose is very flexible. That way, if you even have a hunch she is uncomfortable, you can give her some knowing it is safe and can only help.

Please let me know if I can help in any other way,

Dana
MD for Pets, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 173
Experience: Veterinarian specializing in Emergency & Critical Care Medicine
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