Rappie

It can take a while for the pupil to return to normal size, particularly if there have been several doses applied and maximal dilation of the pupil occurs. It's usually a couple of days but 1-2 weeks is still normal. It lasts longer in pigmented irises (brown eyes) as well Generally you apply atropine every few hours until the pupil dilates and then stop, reapplying if the problem you were treating (like an ulcer, or acute uveitis) is still present and the pupil starts to constrict again. That is just generally, it depends on the formulation and the specific condition. The drops that you were given were probably something different like tropicamide which only lasts for a few hours. Atropine is used for it's long duration of effect.

There will be individual variation in what can be tolerated as far as fat content, and sometimes it can be the fact the food is just 'different' rather than necessarily higher in fat. There can also be underlying factors like breed (CKCS are prone) or concurrent conditions or medications that result in higher fat levels in the blood. RC Hypoallergenic is contraindicated for pancreatitis - it is good for elimination diets for suspected food intolerances or IBD but from memory still has a moderate to high fat content of around 20%.

Generally speaking the fat content should be 10-14%, but in cases where dog have had severe or chronic pancreatitis I would aim for <10% fat. There are specific very low fat diets such as the Royal Canin Gastrointestinal low fat, and others like Hills r/d etc. You might find with some hunting around that there are other weight management diets that will fit the criteria. It is certainly possible to feed a home prepared diet but obviously some more care needs to be taken to ensure the rest of it is balanced. Lean chicken, beef or kangaroo can be used as starting points but the specifics about ingredients will depend on if there are any underlying conditions like food sensitivities or inflammatory bowel disease etc.

No problem :) It's welcome (and relevant :laugh:) distraction.

Kirty, in cases like this if people aren't sure what to do I try good pain relief (as generous doses if needed) for a couple of days. If it's enough to make him feel comfortable enough to 'enjoy' himself then good, if not then we consider other options - but it is always up to the owner to make the call as they live with and love their pets day in day out. It's ok to have them on pain relief if it truly does make a difference to their quality of life. If he thinks he's ok, it's not time for times sake.

Prednisolone is the only thing like prednisolone, and it is probably the most flexible as far as control over the dosing. For all it's downsides, a very lose dose, given intermittently (say every 2-4 days) probably has less of an impact on the liver than daily antihistamines, or other medications for atopic allergies such as cyclosporin. That is at least the case in a dog with a 'compromised' liver - I'd normally recommend an antihistamine trial etc first, but in your case I would aim for the least treatment in general, with the least impact. Add as many supportive treatments as are possible and effective, such as moisturising treatments, omega oils, medicated shampoos where required etc to limit systemic medications in general. If the bile acids went down after introducing the diet and supplements that is great :) They probably wont ever return to normal because the liver is not normal, but the ALT will typically increase gradually over time. Edit to add: If she has any blood tests while on prednisolone, there will probably be an increase in the level of ALP - which is steroid induced but doesn't reflect damage as such. It will stay up for about 3 weeks or so after the meds are finished.

Short term use of prednisolone shouldn't cause too much of a problem. Long term use can certainly cause changes in liver metabolism. As for the prednisone / prednisolone - they are for most purposes the same. Prednisone is metabolised to prednisolone. As for the ALT elevation, it is to be expected with microvascular dysplasia but it is important to keep in mind that the 'numbers' reflect the increased activity of that enzyme in the liver and not the function of the liver. In some cases certainly an increase in ALT will reflect damage to the liver cells in the form of acute toxins etc but not always. Specific testing with paired bile acids would be required to assess the actual function of the liver. Sorry this is so brief, if you have further questions just ask - I'm in the middle of a pre-exam study period :laugh:

Glad to hear there is some improvement even if it is mild. If an MRI is not an affordable option, then I would still suggest a consult with an internal medicine specialist. They will be able to suggest the most likely causes and best treatments after a consult. If you've got a neurologist nearby (there aren't many in Australia!) then all the better.

I have no particular interest in who, was jut wondering whether they were comments from a breeders or someone with a veterinary background.

Out of curiosity what is the background of the person giving that comment?

How low is his heart rate and temperature? Any change in his respiratory pattern or abnormalities on a neurologic exam? Has his blood pressure been measured? I would be suspicious of a neurological cause - and if there are behavioral changes then it is suggestive of a brain lesion whether that be from trauma (even severe concussion with the lump on the head), infection, inflammation, ischaemia, neoplasia etc. An MRI and possibly a CSF tap would be required to identify those things and if treatment is having no effect then I would get the opinion of an internal medicine specialist to try to narrow it down sooner rather than later. Edit to add: A thorough clinical exam should provide more clues about whether vestibular syndrome is likely ie whether there is nystagmus (eye flicking) or strabismus (change in eye position), change in postural tone and reflexes in addition to the obvious signs like a head tilt and circling.

I'd be suspicious of a partial or slow moving obstruction in the absence of other clues like abdominal pain, temperature, diarrhoea etc. If there's been a weight loss of 1.5kg over a few days I would suspect a lot of that to be fluid that is not being replaced.

Christine Hawke at ARH or Nadine Fiani at SASH are your options for referral.

Dave73, I'm glad to hear that there is no spread and that you've been given a plan. I know it seems like a drastic solution but most often the humans have a harder time dealing with the prospect of their pets having a limb amputation than the pets do adjusting - especially with a hind limb. A little while on "training wheels" and they adapt pretty quickly I'm also really glad that you're comfortable at SASH - having confidence in the specialists is vitally important.

In this case Aliwake, I had assumed that ChequeredBlackDog was referring to an adult canine tooth in a young dog - hence the reluctance to remove it.

It sounds like a tooth that definitely needs some attention, but in a young dog if there is some way of leaving the tooth in situ and 'making it' work that is preferable. Removing lower canines is also something that I'm not entirely sure even the dentists enjoy doing :laugh: There are two main referral options in Sydney - Nadine Fiani is a specialist at SASH (North Ryde) and Christine Hawke is a dentisty consultant at ARH (Homebush).

It might be worth getting a referral to see a veterinary dentist to see if there are any options that are not extraction, such as crown reduction or orthodontic work.

I think one distinction to make is that with specific joints it is the anatomy of the joint that leads to degenerative arthritis due to abnormal wear, not that the hereditary factor is the arthritis per se. The other thing is that rheumatoid arthritis is more common, or at least more commonly identified in people and there are genetic / hereditary factors that make some people more susceptible.

It should be enough to start with :laugh: We can get a basic urinalysis done with 1ml but more is ideal. Always have to be careful saying that, some people dutifully wait until their dog fills an entire jam jar

For most things not fasted is fine but lipaemia (fat in the blood) an interfere with some measurements. If it's in the morning then dinner and no breaky is fine.

It's obviously difficult to determine without examining the mouth, but if there is significant tartar build up on the upper carnassial tooth I'd have a reasonable index of suspicion for a slab fracture causing a problem as well as the loose teeth. In answer to the question about whether the loose teeth need to be removed - yes. The provide access for bacteria to cause infection within the jaw bone, prevent the soft tissue from healing and generally cause pain and discomfort. Dogs and cats are very stoic and will continue to act normally even with significant amounts of dental pain.

It looks like an excellent resource for owners of pets with cancer

Rappie, this dog's infection is nasal, not ear, so bulla osteitis or osteomyelitis should not be be the problem. Quite right - I didn't look at the original post closely, evidently I thought this case was the dog with chronic otitis with vestibular signs one that was posted around the same time originally. Apart from the anatomical location though the purpose of the broad spectrum antibiotics is the same, there is often bony destruction and a predisposition to secondary bacterial infections (including pseudomonas) associated with nasal aspergillosis. As with your experience, long term +/- high dose broad spectrum antibiotic treatment can be used to reduce bacterial load prior to treatment with other more specific antibiotics.

I'm glad his condition is improving. It is difficult when your treating vets don't agree - in this case you've got two different approaches, not just two different opinions. The ACTH results are too high, they aren't 'good'. Cephalexin is a 'little gun' as far as antibiotics go, it's very useful and commonly prescribed and although it probably won't have any effect on the pseudomonas it will help to clear up any other infection, and it is also useful for treating osteomyelitis (which is likely to be present if you've got a middle ear infection and bony reaction in the bulla). As far as time - resistant pseudomonas infections take time to develop and in a case like this where you have limited options, then taking a little time to 'optimise' the situation while monitoring closely seems sensible, particularly if your next step is amikacin (a 'big gun').

Dave, I know from experience that 'tough' guys have squishy hearts too Once you've got the results from the biopsy then you will be in a better position to pursue your options. If you do go to SASH, the team there are exactly that - a team, and different specialists will weigh in with their opinions if needed even though one specialist might be managing the case. Unfortunately cancer can be one of those things that just happens, and when it does, it can absolutely suck. It may not make you feel any better but in all likelihood there is very little that you could have done to stop it happening, but you've done the best thing you could and let the investigative process start quickly. Hopefully you'll get some more person experiences but if you need any other general information just let me know.