CIMDA

Hi Sandra,

Welcome, but sorry you have to be here. My boy Bossdin (RIP) had SLO, amongst other things. He lost all his nails twice. The first time they grew back they were quite deformed, the second time they were all normal bar one that was a bit crooked.

I think he had a mild case of the disease as he never had to go on steroids and was only on antibiotics when necessary. He was on pain meds when needed, I kept a supply at home. I believe one of the reasons his case was mild was because I had access to the sea. The fresh salt water did wonders for helping to clean any infection and to dry and shrivel up the quicks. It was also great for helping a loose nail finally fall off, with little pain. If you don't have access to salt water try soaking his feet in a salt water solution or Epson Salts.

I maintained him on the high dose fish oil pills only. After he lost his nails twice he had more issues with nail bed infections (treated with courses of antibiotics.... if really bad and a brilliant cream called Neo-Topic) than he did with the nails actually breaking and falling off again.

Once the new nails grow in, it's important to keep them as short as possible. I learned to trim Bossdin's myself. Many people suggest using a grinder trimmer.....pedi-paws or something similar.... .. I brought one of those too, but he hated it. I had better success with the ordinary cutter type (don't know what it's correct name is). It was important to hold the nail firmly though, at the base, to help minimise any movement and therefore possibly discomfort.

All the best

Dee

Thank you Jo

Dee xox

Bossdin Update

God this is hard to write. He didn't make it. Insulinoma. He suddenly stopped eating and started throwing up undigested food on Sun 21 Dec. He crossed the Rainbow Bridge at 3.55 pm on Christmas Eve. I buried him in my garden on Christmas Day. Probably the worst day of my life.

I've written a blog about him and the details of what happened are on this link if anyone wants to know..... or knows someone else who has a dog also with a mysterious collapsing disorder.

Thanks to everyone in this group who helped me, especially Jo, Sylvia and Penel.

https://bossdin.wordpress.com/2015/01/02/christmas-time-mistletoe-and/

Dee

Hi Jo,

And everyone else who had taken the time to comment.....  thank you.

I've been speaking to my vet and have Bossdin booked in for Wednesday 3rd Dec to have both an insulin/glucose test done, and then the cardiac holter monitor fitted. Vet said.... quite rightly, that due to the fact we would most likely have to sedate Bossdin somewhat to shave him and fit the holter leads etc, we might as well do the blood draw at the same time.

So everything going to plan I will give Bossdin his dinner meal as usual at 5.30pm on the Tue night, then starve him and take him to the clinic at 9.30am on Wed. By the time the sedation kicks in that will be about 16 1/2 hours with no food. I can't do it any sooner than that as the weather forecast for the next 5 days is terrible.... rain and hail (and yep it's almost summer here in NZ ha ha ha) and the holter monitor can't get too wet. Hopefully the forecasters will be right and it will be fine again by the Wednesday.

So all my fingers and toes are crossed that we may get some sort of answer soon.   

Jo said "That sounds a lot of money Dee.  You only need TT4, FT4 and TSH to get a good picture of the thyroid.  I would use the money on the insulin/glucose ratio test first."

Hi Jo,

Yes, the insulin/glucose test is more important.

Martin Referrals did get back to me (aren't they wonderful!!!!! ) and said this
"Dear Dee,
Thank you for thinking of us over here in the UK.

The Vet here has looked at your video this morning. It is difficult to confirm what is happening here as it doesn't present as a typical fit or heart problem. While the Vet doesn't think it is a seizure he cannot confirm it is a heart condition either.


To confirm whether or not it is a heart condition an ECG monitor needs to be fitted for him to where during an episode, this will record the electrical activity of the heart and help show if the heart is stopping or slowing down. We use Holter monitors here.

The vet recommended you ask to be referred to a specialist who would be able to investigate this further. We know of the University of Massey in NZ, but your vet may know of other centres. I hope this is of help."

Kind Regards
Aimee Barber
Head Nurse

I am stoked they took an interest. My vets have been liaising with specialists at Massey Uni who also suggested the holter monitor. And my other vet (owner of the practice) emailed me last night with more details of how they will do everything they can to protect the equipment.... so I will do it if they still think it is worthwhile. I say that because I am unfortunately becoming more and more convinced it is insulinoma. So I will discuss with my vet about which we should do first.

Thank you again for suggesting them and for your helpful comments.

Dee

Catherine I mentioned that to both my vets about going to the golf course and they didn't respond so I took that to mean a NO.

Bossdin would not be any better at my home anyway. He always goes nuts when someone new arrives and it would take ages before he calmed down enough to be able to draw blood from him.

Boss isn't on Carprieve, I have that for emergency SLO problems and if he ever goes lame. He sometimes limps a bit now and again, but he has very tender/sensitive feet, and he has arthritis. He is on a very good green shell mussel pill for his arthritis.

You said : "I noticed with his previous results that his HCT and Platelets were on the slightly lower side......" what does that indicate? Thyroid problems ??

I will wait a day or so to see if my vet emails me back re my request for an eco-cardiogram. Then I will ring up and make an appointment to have another insulin/glucose test done. This alone will be another $220 odd but seems, unfortunately to me the most likely cause.... given feeding him honey can stop the collapse so quickly.

The full thyroid panel costs $400 + I was told when I asked about it.

Dee

Quote from: Catherine on November 23, 2014, 08:34:18 PM
What sort of things was your vet referring to when he said they could affect the thyroid result?

Have you had a biochemistry blood panel done on Bossdin recently? Or is it difficult to get Bossdin to have his blood taken? Along with the thyroid test it could rule out some things or throw up some answers. Things like the cholesterol, ALKP, ALT, GGT with regard to the liver as well as the Glucose you mention.

Hi Catherine, I can't remember now re the thyroid test but something about their general health. I've done two other post on here in the Endocrine diseases (hypothyroidism, Addison's) thread that explain more of Bossdin's symptoms and his blood results.  Yes it is incredibly difficult to get a blood sample, we have to sedate him and even then he can still get very worked up... and him getting worked up can affect the results my vet said. Hence I will only do a test if there is a really, really good reason cos the stress on Bossdin (and me) is enormous.

More Videos

This one shows Bossdin running on the golf course later in the afternoon of 2 Nov after he had that awful collapse in my house in the morning.  I took 3 separate videos of him showing how fine and happy looking he was. I only let him run one circle at a time and then force him to rest (but he doesn't want to rest).

https://app.box.com/s/zif4qjv89qssuxdyfvme

This one shows a more 'normal' collapse. There is no sound. This happened after he had intensely played golf for about 10 minutes, then had rested for about 5-10minutes. He was excited going down the path to meet the golfers as he knows what they are about to do.... Tee off, his most favourite thing. As soon as the video stopped he was perfectly fine again and did watch the golfers Tee off and he was fine.

https://app.box.com/s/ztv4ejo7ye8nkta37p6e

This one shows him collapsing after about 10 mins of playing golf with a nice guy who was hitting the ball just a tiny way so Bossdin could find it. Bossdin was on the long lead doing this cos I was aware it could cause him to collapse and needed to get it on video for Michelle (one of my vets). The crazy thing is sometimes he can 'play golf' for 1- 1/2 hours no problems at all and other times, all it takes is 10 minutes and he will collapse. I'm not letting him play golf at all now, he can only watch from a safe distance.

https://app.box.com/s/aff4jbkp9q2d6rlia4fu

From these two last ones, which are mild, I can understand why Michelle (vet) was pushing the MG idea, but it doesn't explain the changes in his mental state, or the blinking and heaving etc. And doesn't explain how he can still run flat out sometimes perfectly fine.

Again thanks all for watching, all comments are welcome.

Dee

Hi Catherine,

Thanks for watching them and your comments, which are totally valid. I know I panicked totally in those videos because I knew I had to try to film the event, and found it all very overwhelming. I am a lot calmer when it happens outside because I'm so used to it now. The reason I speak so loudly is because the first few times it happened I really thought he had 'fainted' or was somehow 'drifting off' (if that makes sense) and I was saying 'stay with me, stay with me' to keep him conscious. And when he goes like that I've just kept doing it.  When it happens next I will en devour to let him lie down (normally I hold him up) and will be a lot quieter and calmer to see if that helps any.

Re the thyroid test, I've asked about that twice and vet, while not ignoring me, has tried to steer me in other directions because of all the things that can effect the result (and knowing I don't have endless $ to spend so have to spend them wisely).

After I had the abdominal ultrasound done and the insulin test came back inconclusive my other vet (the more senior and more qualified and owner of the clinic) sent me this:

2.    "   Liver dysfunction. More difficult to test in Bossdin as it involves taking a blood sample before food, then feeding and taking another sample 2 hours after eating.

3.       Insulinoma which is not yet giving us clear information on the fasting blood test. I think a 6 week interval since the last test and then repeating the blood glucose and insulin test together would help sort this out.

"So we need to think about the practicalities of doing these tests with Bossdin."

And therein lies the problem, actually trying to do the tests on Bossdin. But I will discuss these issues again with him. I feel now due to Sylvia's experiences I have to have another glucose/insulin test done.

I will put some other videos up of him having more 'normal' collapses, god what a thing to say.... more normal collapses.... where he isn't altered mentally.

Jo,

Thanks for that info, I had a look and watched a few videos on line but don't really think it fits as there doesn't seem to be anything about the dog having an altered mental state with that condition ?  The head nodding like that has only happened very infrequently. The eyes blinking generally happens if he has a really bad collapse.

Thank you both for looking and commenting I appreciate it.

Dee

This is another video (38MB) that shows him starting to do the 'heaving thing'.. you have to look closely at 54 seconds and at 1 min 40sec. You also see him become totally 'altered' for a brief moment... he starts nodding his head. That is not normal. I sent that to my vet and she said nothing!

https://app.box.com/s/lye1arl3j0zqdsbz5pth

Dee

I have managed to get the video of him having a bad collapse inside my house onto a cloud service. I have no idea why you can't automatically preview it, but you can download it (50MB) to your computer to view it. For anyone who wants to view it here is the link:

https://app.box.com/s/isebiroka4nujgm9b0gb

Thanks.

Dee

Oh my goodness Sylvia.......

Thank you for sharing your information. It's 7am here in NZ, I'm just having my first morning coffee and am taking deep breaths, trying to keep myself calm.

I have been writing a detailed diary and sending it to my vets (two who regularly see Boss) for the last few months. On 25 July Bossdin had a terrible collapse, witnessed by two of my doggie girlfriends. From that event, because he picked up when Wilma gave him some food I went home and researched hypoglycemia. It fitted. I started feeding him 3 meals a day on 26 July. I waited about 5 days before telling my vet of the remarkable change in him. Vet agreed it sounded like Insulinoma and that's why we did the insulin/glucose blood test and ultrasound.

Because they were clear I'd discounted that. Now clearly because of your experiences I need to reconsider this.... but...... doing anything vet like with Bossdin is incredibly difficult. Early on the vet asked me if I thought it would be possible for them to take blood while he was in a collapsed state. I doubt it!!! Depending on how severe the episode is, sometimes he gets very distressed and mouths me, two times, before the event happened he got so agitated and demanded to be 'free' ( I was holding him so he couldn't run) I was worried he might actually bite me so had to let him go. This was clearly because of 'it'. He would never in a million years intentionally bite.

I will have to ask about another insulin/glucose test. As mentioned previously, we have to sedate Bossdin to do that. I'm not aware of any specialists vet centres anywhere remotely near to me. My vets have been corresponding with a specialist at Massey University Vet School (not possible for me to go there, it's in the 'other island' of NZ) though. The specialist up there has viewed one of my videos ( not sure which one) and suggested the heart monitor.

I have changed the food I'm feeding him and now he's getting lots more protein and complex carbs. I cook up chicken, no bones of course, potatoes and vegetables and he has that for his evening meal. Maybe I should give him that for his breakfast meal as well. He gets kibble or dog biscuits at lunch time. We always go out at about 2pm for his 'walk'. I had read about icecream but I can't carry that around with me on the golf course.... or wouldn't it matter if it was totally melted? Is icecream better than honey?

I will go now and find your articles on Freddie and insulinoma. Thank You !

Dee 

PS, just read your stories and on one page you say  "The signs/symptoms tend to be vague initially but  they become more severe and frequent as time progresses."

Yes, unfortunately this is the case with Bossdin. I restrict him severely in his exercise and we may go 8-13 days without any episodes. Because there have been no episodes I gradually let him do more of the things he loves (play golf with his golfing buddies) and then eventually we come unstuck again and have a period of bad episodes happening far more often.  If it is insulinoma, surgery is not an option for Bossdin.... the staying in hospital would be far too traumatic for him. Oh Dear!   

Wow Sylvia thank you so much for your input.....

And I'm so terribly sad to hear you lost your beloved dog in August. *hugs*

This bit you wrote:
"EXCITEMENT, exercise, weather conditions ALWAYS prove trigger factors in my dog"  YES! Same with Bossdin. I have been telling the vet for ages that the weather can often play a role in his collapses.

Crikey that is such scary information though, what you have been through and how long it took to get a correct diagnosis.

I have two good videos of him having episodes on my facebook page (they are hidden) I can't send them via email.... I've tried and tried to resize them down but they are still far too big. That's because the original file size is 400MB. If you could send me a friend request via facebook  Dee Sorrell in NZ I can let you see them.

The funny thing is though... after he had the terrible episode of 2 Nov in my hall way, we went to the golf course later that day and I took 3 other videos of him running around (and I mean running) totally normally. Did your dogs ever have an episode and then be perfectly fine and able to run like normal afterwards?

thanks so much for writing,

Dee

Thank you Jo,

I hope so too re Martin Referral's replying.

I'm going to ask my vets if we could put the holter monitor on him, then if one of them came with me to the golf course (I have suggested this in the past but they have ignored it) I'm sure he would collapse quickly as soon as he saw some players Teeing off. He gets so beside himself with excitement and joy at that part. They could see exactly what happened and then when he was over it, they could take the monitor off him .... thus preventing the risk of any damage to it.

For now I'm restricting him severely..... no watching Tee shots etc as he's had 'episodes' (or almost had them) these last two days.

Dee

Thanks for those contacts Jo, I will look at them immediately after posting this.

Insulinoma.....yep, been there done that. Starved him, took him for a short toilet walk on a really cold day before the blood test.... he collapsed..... 2 hours later we sedated him, took the blood sample, then I had a full abdominal ultrasound done looking for a tumour on the pancreas. Nothing showed up. Eventually the glucose/insulin test came back.... it had to be sent away.... and it was inconclusive at 50. And I've read if they don't do whatever it is they do to the blood samples quick enough it can give a not so accurate figure. So because the ultrasound was totally clear I don't think it is that.

I also wonder if....god forbid... he might be having faints and focal and complex focal seizures on different occasions. His symptoms and the different ways the collapses have presented actually suggest both could possibly be going on. But then, as I've previously said, to the best of my knowledge he loses muscle tone first......  god it's so complicated.... no wonder the cardic vets write how difficult it can be determining syncope from seizure.

I'm definitely going to push for a cardic ultrasound to be done.

Thanks again for your input, it's greatly appreciated.

Dee 

PS: Been on the Martin Referrals page from your link read this : "Opisthotonus is common with a more severe/prolonged syncopal episode (associated with cerebral hypoxia) and can mimic a seizure." Googled that..... and that is exactly what Bossdin did in the video I have of him taken on 2 Nov. I have emailed them, hopefully they will respond.