Wednesday, June 27, 2012

Pictures from the inside

Report from vet visit on Tuesday, June 26.  Summarized by foster person to Dr. Ryan Speltz and MWCR: 

This is my understanding of Milo's vet visit yesterday for x-rays of his chest in response to the continued coughing and exertion induced wheezing he's experienced.   

The x-rays showed that the lungs were clear of tumors and parasites although the bronchi were enlarged, you feel that this may be due to Milo's emaciated body condition.  

The issue appears to be at the tracheal area where his neck abscess originated.  Although originally reported to be the size of a soft ball, the area has reduced to the size of about a half dollar but contains hard scar tissue which seems to run very deep and may possibly be impeding the airway slightly upon exertion.  What is unknown is whether the issue might be improved with the use of antihistamine or with a decongestant.  What we do know is that stress exacerbates this condition with a series of wheezing/coughing - as evidenced from 4 am through 5 am this morning(!) following his day at the vet clinic.  

You had mentioned that a radiologist might glean more from the rads as the area in question is blocked from view by the scar tissue and a more trained eye may be able to provide more information.  I am unsure whether you were going to pursue this course of action or if the rescue needs to approve that action.  

You reported that his skin is looking good and ears are much improved.  Eyes seem to be a bit goopy, but it was decided to see where that goes as he has been on eye meds for several weeks.  

I've reported to you that Milo's drinking water becomes discolored after he drinks.  The other dogs will not drink from a bowl once he has, which tells me that there is some nasty stuff going on in his mouth.  Having been through this with Persy, my sense is that once Milo has completed the treatment of antibiotics in a week or so, his teeth issue will present and most likely compromise his health gains by abscessing.  Several dead teeth with that much infection in his neck, ears and eyes indicate to me that there will be a problem with those teeth.  I think it would be prudent to deal with that issue before it becomes an emergency.  

Milo has gained nearly 2 lbs which is very good.  

I know you reported that his personality seems happy and affectionate which is what I have found as well.  He's a very sweet guy for having been so very neglected for so long. 

I'm going to give Milo Benedryl at bedtime to see if he (and the rest of us!) can get a good night's rest. 

Please feel free to correct and expand on my report!

Notes on summary from Dr. Speltz:

I really would like to see if 2 - 25mg Benadryl help him with the cough.  We also know the cough is not related at this point also to infection while he is on meds of antibiotics too and its not responsive in the area of the cough with them.  This leaves me to believe his lab work monocytosis and cough is due also to the neck abcess that is healing but slowly and maybe the teeth but that might be a stretch.  The nonvital upper canines we will recommend removal at later time point if the board allows and his health continues to impove.

Overall the good news is the chest is clear, he is gaining weight, I LOVE his new attitude and personality showing and look forward to see how the cough does as well as what the body continue to strengthen and return to normal state over the next two months.

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