Your 'Long and Short of it All' hosts Maggie and Joey relax on the porch, Tuesday evening, September 14, 2010
Joey continues to recover very well following his recent surgery and the complications which ensued. Today was his follow-up visit with his Internist, as it has been nearly 2 weeks since he was discharged from the doggy ICU, and he was due for his second monthly shot of DOCP, a drug which he must now have for the rest of his life because he doesn't have any adrenal glands.
When we walked into the Veterinary Referral Center for the 1 PM appointment, all the ladies behind the front desk got excited - "JOEY!! Joey's here!" They filed out one by one to get on the ground and greet him, and he responded with lots of tail wags. One cute gal said to Dad "Did you get your phone reminder about Joey's appointment? That was me yelling in the background at the top of my lungs that Joey was coming to visit!" We were ushered into an examination room like VIP's when the veterinarian's assistant came in and said "I saw Joey's name on the list today and told the doctor that I get to be the person to take his case. I had to see my Joey again, I missed him!" She carried him away to get his weight, and also took him for a short visit to all his friends in the ICU before coming back to the exam room. He weighs 20 pounds now, up two pounds since he was discharged. His normal weight is 22 or 23 pounds.
His Internist, Dr. Mordecai, came in the room, all smiles to see Joey looking so well. Joey hid behind Dad's legs and didn't really want to come out from behind them to see the doctor. Another vet tech came in the room to say hello, and Joey tried to escape out the door. "Not again, they're not keeping me this time," he must have thought. The good doctor sat on the floor with us to examine Joey which made him feel a little more comfortable.
He got his last dose of Plavix this morning, the anti-platelet medication he was on for his pulmonary embolism. It wasn't used to really treat the PE, but to prevent any other clots from lodging onto it if they were to break loose from either his incision or where his central catheter was placed in his jugular.
The vet also discussed an oral medication instead of the DOCP shot for his Addison's Disease, but the vet warned "if you were to miss a dose, you'd really be in trouble." Dad chose to keep him on the shot until things are a little more under control and to think about the oral medication later. So, he got his second DOCP shot. He will require electrolyte monitoring in 11 days, and again when it is time for the next shot so the dosage can be titrated if necessary. Essentially the shot regulates the amount of potassium and sodium electrolytes in Joey's system, and based on those levels, the drug is titrated up or down.
Dad also asked about the daily prednisone and the risk of ulcers - should Joey be on Pepcid or something for his stomach? The vet didn't think so - the prednisone is supplying what the adrenal glands would normally produce, so it shouldn't be an issue.
Then Dad asked about the surgery-induced pancreatitis - is pancreatitis going to be a lifelong problem for Joey? Again, the vet didn't think so - "We know that the surgery caused the pancreatitis, he should be able to go back on his normal diet in a month or so."
Dr. Mordecai carried Joey out to draw some blood to check his electrolytes. As the door closed, Joey's eyes stared intently at Dad as if to say "please don't leave me here again." Poor fella. All of his labs came back normal, with a lower sodium and higher potassium - still within normal ranges, but these values are expected with an Addisonian Dog.
The good doctor doesn't want to see Joey again until December so that he can get an ultrasound and see how his "gallbladder sludge" is doing, and to see if the ursodiol he is taking is helping to reduce it. His DOCP shots and titration can take place with his regular vet.
And with that, we were off to the exit - Joey prancing through the halls of the hospital as if he owned the place - head held high and tail wagging hard - much to the delight of the visitors and staff. Dad was proud of his handsome boy.