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Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.
Thanks. I am running out NOW, but will be back online in about 75 minutes. Thanks
This has been quite an ordeal for you and Bingo. My first thought is to rule out myasthenia gravis, which you are doing with the acetylcholine receptor Ab test. Our other top differential diagnoses have been ruled out (heart arrhythmia, hypoglycemia and Addison's disease). Other possible causes might be a new electrolyte disorder (involving calcium or magnesium), toxin exposure, or a Neurocardiogenic bradycardia-related syncope (unlikely).
Will wait for you to return to continue our chat. I need to know what questions you have!
I am back Dr. Joey. I guess what I would like to know is what you have partially answered thus far...what do you feel could be some of the causes for this.
I am anxious for the results of the tests. The only other thing that my wife and I thought it could have been was Boric Acid poisoning. The vets...all of them, seem to think not. I questioned whether it could have been only because of the timing of things. I sprinkled the boric acid in my garage, around the bottom of the shelves, the inside perimeter of the garage walls and under my AVT trailer. My three young children think its funny to throw Bingo's food under the trailer so she has to crawl around and scarf it up. There was a decent amount of boric acid that I am certain she ingested. The signs and symptoms she demonstrated, leading up to the heart block diagnosis, were consistent with this type of poisoning. That is the only environmental change that we could possibly think of and now she has been away from that area of the garage, which has also been all cleaned up, for several days now, and things continue to evolve and deteriorate.
I did fail to mention the medication, which she was put on last night…Metoclopramide(10mg.) that I started this morning, about 45 minutes prior to her feeding. Interesting…she has only regurgitated 2 times since she woke at 5AM and also…I am feeding her while making her sit up, then I hold her to make her sit up for another 15 minutes… Anyway, now, she is making what sounds like very deep, long, loud burps…and then sometimes that is followed by her mouth filling with very thick & frothy, egg-white looking foam, which she then swallows. This is happening about every 20-30 minutes.
I agree with your vets that Boric acid is probably not the problem. It is a relatively safe product and only if a dog ingested a lot would I be concerned. A bit sprinkled or licked should not be a concern. Even if it caused a problem at that point, it would not lead to a persistent issue that lingered until now.
Agreed...as there wasn't that much injested...nor would it have carried over like it has.
Metoclopramide can occasionally cause some neurological problems but usually hyperactivity and agitation, although I have had patients that get very depressed/lethargic. So, it is a potential cause.
Hmm. Her 1st dose was this morning, so I haven't noticed those two issues, yet.
But metoclopramide is a very good choice when we are dealing with regurgitation because it tightens the stomach's sphincter which can help when a dog has esophagitis (this is the most common cause of regurgitation in a dog that does not have megaesophagus... and I assume she does not since x-rays probably have been taken a lot).
She could be treated for esophagitis which usually involves an antacid like omeprazole and then use of metoclopramide. Sometimes we also add in a protectant like carafate (sucralafate) in a liquid slurry.
I believe the regurgitation is partially, or mostly attributable to the incubation during her surgery, as it started post surg.
I've been giving her the Pepcid, ground up and sprinkled over her moistened food.
The intubation may have caused transient throat irritation but not esophageal problems. But if she had some regurgitation of stomach acid then she could have developed esophagitis. So, still circles back to esophagitis. The pepcid is an antacid. that is a good alternative to omeprazole.
yes. irritation from the incubation, but like you say, prior to the surgery, she had been vomitting forcefully for almost two weeks. I'm sure her esophegus must be raw.
how bout I get back with you as the test results come in? I don't belive there's much more we can discuss till then??
That sounds like a great plan. You can always reply to this question with an update at any point. However, we will no longer be in live-chat mode. But I will still respond.
does this service work that way, or is it a one day deal?
You can reply at any time at no additional charge and I have had conversations with some people that go months. My only request is if you can at this time submit a rating. It will close our live chat, but again, you can always return to the question and you can always post a followup. :)
Excellent. Thank you and I'll be back in touch.
He y Dr. Joey. Thanks for getting back with me. Bingo was diagnosed with Myasthenia Gravis and unfortunately contracted pnnuemonia over the last few days. Yesterday, we boarded her for IV antibiotic thereapy at the vet hospital. Last night however, she passed. Thank you for your help though, it was very appreciated.-Kevin