Joey's Big Checkup

We had no update yesterday because it was time for your Long and Short of it All host 'Joey' to have his 6-month checkup at the Veterinary Referral Center.  Regular readers will recall the tough times Joey had last fall.  Almost a year ago, on August 17th, 2010, Joey underwent a risky surgery to have both of his adrenal glands removed.  He had a tumor in each gland that was giving him Cushing's disease, and one of the tumors was so large that it was growing into his vena cava, and would have blocked it completely in about 3 months, and Joey would have passed. 
Although he had about a 60% chance of making it through this risky surgery, he sailed through.  They also removed his spleen, as they saw a nodule on there which could burst over time.  It was the surgical complications which almost did Joey in - a blood clot lodged in one of his lungs the day after surgery, and the second day after surgery, he developed severe pancreatitis as a result of the procedures.  Either of these events could have taken Joey over the bridge.
Every day was touch-n-go for him, but we continued to treat the blood clot, and he wasn't allowed to eat for almost a week because of the pancreatitis.  He started to eat a little again after a week, but the pancreatitis was just too much, and he was fasted for another week, and started on Parenteral Nutrition.  At this point, he simply had to eat and to be able to keep it down, or it would have been all over for him. 
But thanks to all the prayers and support he received from readers here, and from top-notch medical care in the ICU for 2 weeks, he's still with us today.  Dad is still paying off his medical bills, which totaled a nice new mid-size car, but it's priceless to still have Joey around today.
His checkup went very well.  His internest was happy to see how much muscle mass he has gained.  He actually needs to lose a few pounds, weighing in at 25 pounds, when he should be 22 or 23.  Dad isn't feeding him any more, but he is getting older, now that he's 10.5 years old, and could use a reduction in calories.  All his bloodwork came back great.  His alk phos is a little high, pointing to some liver failure, but the internest is not too concerned about it.  His Na/K ratio is good, a sign that his medicine for his Addison's disease (because he has no adrenal glands) is working well (he gets a monthly shot of a drug called DOCP). 
He is fairly stable on his daily prednisone dose, but about once every 4 - 6 weeks he seems to bottom out - he'll start vomiting in the middle of the night, and vomit up all his food and become very lethargic.  A boost in his prednisone seems to help him through the event.  Then we tinker with his dose by increasing it, but then he starts drinking too much water, so we decrease it again.  It's a catch-22.  Humans and animals generate internal steroids via their adrenal glands during times of stress - a fight or flight situation, an illness, or even a nail trim for an Addison's dog, can cause them to have such an event when the body needs more steroids. 
Joey will also continue on his ursodiol for his gallbladder sludge that he developed during the pancreatitis attack.  The vet asked if we wanted to do an ultrasound to look at his gallbladder, but at $350 for the procedure, not sure what we would gain. 
His heart murmur seems to have slightly increased to a 3.5 or 4.  We asked about a cardiology consult, but again, at $500 for the consult, we are going to wait a little longer, or perhaps until he shows some signs of CHF like coughing. 
So, all in all, Joey got a good bill of health yesterday.  If you saw him, you wouldn't know that he had any medical complications at all, he's such a happy boy, tail always wagging.  The bill came to a little over $500, but that included a vial of his DOCP ($160, which will last 4 months), and we had 2 new tumors aspirated, and they are both fatty, so nothing to be concerned about there. 
We just wish Maggie was doing as well in her treatment for Cushing's disease.  Our little girl just isn't happy, and seems to be losing that spark in her eye that we love so well.