# UPDATE - Merlin’s results are in - multiple problems



## cowpony (Dec 30, 2009)

Oof. Poor guy. That's a lot of stuff going on. Anything mention of lymph nodes in their exam?


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## 94Magna_Tom (Feb 23, 2021)

What is recommendation #1 looking for via scope and again via biopsy? Not sure I'd be on board with this one. 
Does his abdomen still hurt him? Does gastritis mean he has gas? 
I hope he's feeling better 😘❤


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## TeamHellhound (Feb 5, 2021)

94Magna_Tom said:


> What is recommendation #1 looking for via scope and again via biopsy? Not sure I'd be on board with this one.
> Does his abdomen still hurt him? Does gastritis mean he has gas?
> I hope he's feeling better 😘❤


Gastritis is an inflammation of the stomach lining. Enteropathy is inflammation of the intestines. Hepatomegaly is enlargement of the liver. Any and all of them can cause abdominal discomfort. 

I'm assuming they want biopsies to see if they can determine the cause of the inflammation.


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## MaizieFrosty (Apr 12, 2019)

I'm so sorry you and Merlin are going through this, Dechi  All of the vet's recs sound reasonable to me. Prayers for a full recovery and as little pain as possible for Merlin.


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## Dechi (Aug 22, 2015)

cowpony said:


> Oof. Poor guy. That's a lot of stuff going on. Anything mention of lymph nodes in their exam?


No, none whatsoever. I don’t think they looked that high up.



94Magna_Tom said:


> What is recommendation #1 looking for via scope and again via biopsy? Not sure I'd be on board with this one.
> Does his abdomen still hurt him? Does gastritis mean he has gas?
> I hope he's feeling better 😘❤


Thank you. The goal of the endoscopy is to find what is causing all those problems. We could go blind and treat, but we’ll never know if we hit the heart of the problem. This has been going on for a while, I know he hurts and on top of that he has a heart disease (EKG coming in december, we’re expecting worsening of the condition). So we can’t cure the heart but I’d like to control the abdominal pain at least.



TeamHellhound said:


> Gastritis is an inflammation of the stomach lining. Enteropathy is inflammation of the intestines. Hepatomegaly is enlargement of the liver. Any and all of them can cause abdominal discomfort.
> 
> I'm assuming they want biopsies to see if they can determine the cause of the inflammation.


Yes, exactly. And I think it’s a good thing because that means he will then be treated by internal medecins vets, who are specialized in complex cases. A regular vet isn’t the best in that case.



MaizieFrosty said:


> I'm so sorry you and Merlin are going through this, Dechi  All of the vet's recs sound reasonable to me. Prayers for a full recovery and as little pain as possible for Merlin.


Thank you. I also believe that’s reasonable. I wouldn’t feel comfortable not doing all of it. He deserves to be pain free.


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## PeggyTheParti (Sep 5, 2019)

This is a lot, Dechi.  I hope you’re doing okay. Poor little Merlin.

I imagine stomach pain could cause a limp. Or could it be a leg they drew blood from, or administered an IV?


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## Dechi (Aug 22, 2015)

PeggyTheParti said:


> This is a lot, Dechi.  I hope you’re doing okay. Poor little Merlin.
> 
> I imagine stomach pain could cause a limp. Or could it be a leg they drew blood from, or administered an IV?


I haven’t thought of abdominal pain causing a limp. He’s not having an episode right now though. The thing is I started carrying him like a baby when we went on our last walks because I saw a very slight limp. Just in case. Next time, he was limping more and today, he was walking on 3 legs almost the whole time. But he plays with Beckie in the yard multiple times a day, running at full speed…

So I’m wondering if he’s not faking it to be carried. He’s such a sucker for attention from me. I don’t know. Today I didn’t pick him up, even though it broke my heart. I have to see if he will stop doing it on our next walk. He never does it in the house either.

The limping started before the echo and he wasn’t sedated so I doubt it has anything to do with it.

As for me I feel sad and a little depressed, but it shall pass. Thank you.


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## DogtorDoctor (Mar 20, 2020)

Poor Merlin! He's been having a rough go of it. Hopefully you'll be able to get even more answers with the internist.

In general, radiologists list their findings from most important to least. I'll also go in order to make things easier. 

1) It appears as though your vet is trying to decrease possible stomach pain with the low fat diet and the omeprazole. Gastritis can definitely be painful, as can enteritis. Enteropathy is just referring to any disease (pathology) affected the intestines, and inflammatory conditions are oftentimes vague and intermittent. Think a bit like a colicky baby - uncomfortable and grumpy, but unable to tell you exactly why or where the pain is coming from.

The duodenum and the jejunum are the parts of the intestine closest to the stomach, with the duodenum directly connecting to it. The duodenum is quite short, while the jejunum is very long. Scoping the stomach (+/- a biopsy) would likely be the next best step for identifying disease at that location, but you would definitely need the specialist at that point. Some people would likely not choose to go to a specialist, in which case the diet trial and proton pump inhibitor suggested by your vet are good and safe things to try. Omeprazole can sometimes cause mild liver enzyme elevation, so don't be alarmed if you notice that on your next blood test, depending on when that is drawn.

2) Mild and rather unspecific, but important for the diet change your vet recommended. Low fat diets are always best for chronic pancreatitis. On a quick little literature search just now, apparently around 60% of asymptomatic dogs presenting for necropsy had fibrotic changes in their pancreas. The important things to watch (besides his low fat diet) will be his digestive ability and water intake. Chronic pancreatitis can sometimes (rather rarely) lead to diabetes and exocrine pancreatic insufficiency (EPI). Signs of diabetes are increased water consumption, increased urination, and oftentimes weight loss despite having a good appetite. Merlin's bloodwork will test for a high blood sugar when your vet runs it. EPI is characterized by very light tan greasy stools, which is the body being unable to digest food. No easy/cheap test for this one (specialized blood test normally only at research hospitals), but it's also quite rare.

3) Chronic cholecystitis (as opposed to acute or caused by a mucocele) is a bit out of my wheelhouse, so I'd just wait for the internist's opinion on this one. 

4) The liver is a very sensitive organ, for all that it heals nicely. A biopsy (needle or otherwise) would give you better information on what is causing these nonspecific changes. Your blood work results will likely shed some light, but you can sometimes have significant liver disease without enzyme elevation. A biopsy is more invasive, but it also gives the best answers.

5) Here they mention that all lymph nodes in the abdomen were normal (unremarkable). I'm sure your vet felt for any enlarged external lymph nodes on exam, and didn't mention that they were normal.

I think your vet has made some very good recommendations. I know this seems like a lot (because it is!), but internists thrive on multi-system/organ diseases and are very good at finding out what's going on and how to treat it.

One additional thing to consider: I think Merlin's last echocardiogram was last year? If they do the endoscopy and biopsy, they will have to anesthetize him. It would probably be a good idea to repeat his echo beforehand.

My thoughts are with you during this difficult time! Let me know if I can clarify anything.


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## Dechi (Aug 22, 2015)

DogtorDoctor said:


> Poor Merlin! He's been having a rough go of it. Hopefully you'll be able to get even more answers with the internist.
> 
> In general, radiologists list their findings from most important to least. I'll also go in order to make things easier.
> 
> ...


Thank you so much ! I will keep this in my personal file for Merlin and re-read as needed.

Yes, Merlin’s EKG was September last year. His next one is mid-december. I would rather not wait after it to do the endoscopy and biopsy, if possible. 

I’ll be calling tomorrow so I have no idea when they can see him. I will make sure to mention his heart problems and give them a copy of his EKG. If they prefer waiting after his next EKG, then I guess we’ll have to. That’s a very good point. I wish I hadn’t delayed his EKG. If only I had known.


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## Dechi (Aug 22, 2015)

Thank you so much for your time ! I feel reassured about spending all that money to see a specialist. Poor Merlin has so many problems and life is not always easy for him. On top of all that, he also has severe GAD which certainly doesn’t help. 

I really appreciate you taking the time to answer. Have a good evening.


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## DogtorDoctor (Mar 20, 2020)

Dechi said:


> Thank you so much ! I will keep this in my personal file for Merlin and re-read as needed.
> 
> Yes, Merlin’s EKG was September last year. His next one is mid-december. I would rather not wait after it to do the endoscopy and biopsy, if possible.
> 
> I’ll be calling tomorrow so I have no idea when they can see him. I will make sure to mention his heart problems and give them a copy of his EKG. If they prefer waiting after his next EKG, then I guess we’ll have to. That’s a very good point. I wish I hadn’t delayed his EKG. If only I had known.


Depending on the specialty hospital, it may be possible to have an echo done by a cardiologist in the same building as the internist. Most/many specialty centers have multiple disciplines on site that work with each other as needed for patients with multiple diseases. Definitely worth a call, and let us know what they say!

Edit: And you're very welcome! I'm always happy to help when I can.  I hope y'all have a restful evening!


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## Rose n Poos (Sep 22, 2017)

This surely is a lot to get thru but as things are identified, ruled out, and treatment is put in place, you'll all feel better. 

Keeping you all close 🙏


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## WinnieThePoodle (Sep 1, 2020)

I don't have any advice sorry, but sending good positive vibes to you and Merlin and hope they get to the root of the problem soon ❤


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## fjm (Jun 4, 2010)

Oooff - that is a lot to wrap your head around. I have always suspected that Poppy's liver problems originated in chronic, never quite critical, pancreatitis, eventually affecting her gall bladder and her liver. It is excellent that you have a plan for the next steps that includes both immediate change of diet to make him more comfortable and the investigations needed to pinpoint the issue - it is so much easier to stay calm about things when you feel that you have some control. Hoping Merlin feels better very quickly with the omeprazole and change of food.


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## Minie (Oct 4, 2021)

Poor Merlin and you. I have no advice to offer, however prayers and hugs your way 🤗❤


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## Streetcar (Apr 13, 2014)

Sending love @Dechi ❤. Holding you both in my heart, and so happy for the wonderful medical support you have rallied for Merlin.


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## ShamrockPoodle (Jan 22, 2017)

Hoping you can find treatment and food that will help him feel better. The report does look very thorough —and hopefully will lead to a good treatment plan for little Merlin ❤


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## Dechi (Aug 22, 2015)

fjm said:


> Oooff - that is a lot to wrap your head around. I have always suspected that Poppy's liver problems originated in chronic, never quite critical, pancreatitis, eventually affecting her gall bladder and her liver. It is excellent that you have a plan for the next steps that includes both immediate change of diet to make him more comfortable and the investigations needed to pinpoint the issue - it is so much easier to stay calm about things when you feel that you have some control. Hoping Merlin feels better very quickly with the omeprazole and change of food.


I just realized he is on a low salt diet because of his heart problems. Now he has to be on low fat food. I don’t think they make low fat, low salt diets. I’ll have to call the vet to find out which prevails, the heart or the stomach/intestines/liver ?

This is definitely complex.


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## Liz (Oct 2, 2010)

Dechi, I'm late to this news, and want to wish you and Merlin well. I hope your vet has more answers than questions, and more good news than bad.


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## Skylar (Jul 29, 2016)

Poor Merlin. I’m hopeful when you find the right food that he will be a lot happier. There is a lot going on in his results but they all seem to be pointing to digestive issues. 

Long before there was commercial prescription foods, I had my tpoo on a no salt, low fat diet for her pancreatitis. she lived til she was almost 20 years. The one time I fed her regular dog food she had another pancreatitis attack so I threw out her old food. I’m think the same may be true for Merlin, once you find a low fat, low salt diet that he will thrive. There must be one available. Or ask your vet for a recipe to home cook, cooking for a tpoo isn’t a lot of work. You can make batches of food and freeze. There’s tricks like using frozen or canned no salt veggies so you limit your work.


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## fjm (Jun 4, 2010)

I think the hepatic foods may be low in both salt and fat. They may also be too low in protein though, something my vet warned me about. I worked out that Poppy (just under 10lbs) needs 4-5oz of the Royal Canin canned Hepatic food and 2oz of plain cooked chicken breast a day, plus healthy treats and a vitamin B+E supplement, to get just the right balance of everything. One can feeds her for 3.5 days.


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## PowersPup (Aug 28, 2020)

It sounds like you and Merlin are in good hands. I hope you will soon find the root cause of his issues. In the meantime, you have a lot of people and poodles hoping for the best for both of you!


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## Dechi (Aug 22, 2015)

I called and made the appointment to see the internal medicine vet, in 3 weeks. Apparently they will do the endoscopy and biopsie right after the appointment. I’m hoping that’s the case, as this is both stressful and time consuming.

I also went to my local vet today and picked up his Omeprazole and the new food. I had talked on the phone with them prior to going and after verification, Royal Canin gastro low fat is best, as it has very low sodium as well. I bought kibble and canned food, as Merlin eats very little if he doesn’t have a little wet food and warm water mixed with his kibble. I started mixing it with his old food and he liked it very much.

Saturday we’re doing the full blood work.

I’m so glad I decided to get some insurance for the dogs a few years ago. Even though Merlin has exclusions for his heart and patellas, it’s still more than paying for itself. I don’t know how I would have been able to afford all this. And to be honest, I probably would have just gone with the treatment, without looking for the cause. Which is also okay but not knowing if there is an underlying illness would have given me a lot of anxiety.

I’ll keep you posted.


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## Mfmst (Jun 18, 2014)

My goodness, dear Merlin has come so far behaviorally and now this crush of health issues. Praying for a clear path forward with specialist expertise and a new diet that he’s eating without complaint. Hugs to you, Dechi and Merlin.


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## Dechi (Aug 22, 2015)

Merlin did not want to eat yesterday. Or very little. Today he wouldn’t eat until supper, then he threw up his undigested kibble. He is asking to go outside to eat grass. He has trouble falling asleep. I know he is hurting and not well.

I’ve called the vet clinic and told them what was going on. I think we should try another medication, and perhaps something different to help him sleep. It can’t be good for recovery to be in pain and not sleeping. I also told them about the limping, in case there is a link. The vet should call me tomorrow.

Tomorrow I’m also going to try to move his appointment in internal medicine sooner. It’s only in 2 weeks and since the meds aren’t helping, it’s a long time to wait.

Poor guy is not having it easy. :-(


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## Streetcar (Apr 13, 2014)

I am so sorry, @Dechi. Sending love to both of you 💗.


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## Dechi (Aug 22, 2015)

The vet called not long after I posted. She’s a young vet and she’s doing her best but she clearly is way over her head. She recommends Merlin continues to be seen in internal medicine after his endoscopy, as he is a complex case.

For now she recommended giving Omeprazole twice a day and giving gabapentin earlier, as she says it can take up to two hours to work. She will prescribe something to protect the intestinal mucosa, and something for nausea. As long as he eats, she says he can wait two weeks for his appointment in internal medicine. If not, then I need to take him to the ER if I can’t move up his appointment.

I had trouble convincing him to take his medicine in the Royal Canin low fat canned food. He ate it mixed with the kibble, but is very reluctant to take it on its own. I’m bringing back the cans tomorrow and asking for something else, as he will have more meds to take and I don’t want it to be a battle every time.

She doesn’t think the limping has anything to do with the rest of his problems, but I’m not convinced. I’ll ask the internal medicine vet.

His biochemistry came back normal, except for one value related to kidneys. She thinks it has to do with his cardiac problems. She said we could do a urinalysis to make sure the kidneys are okay. I said I would wait until we take care of the rest. The report will be sent to the internal medicine department so if they say we need to test I’ll do it then.

He is relaxing in his bed right now. I hope he sleeps.


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## Noodle_Poodle (5 mo ago)

My little mpoo had some stomach issues for the first few years of his life. He had a lot of trouble with diarrhea and some vomiting but more so the diarrhea. He also had bad gas and there were times I could tell his stomach was really upset. He’s not one to hide when he hurts. After quite a bit of investigation, my vet found some results similar to what you listed in the first paragraph of results. So I would essentially try a food for a while, wait and see if anything changed and if it didn’t he’d go back on the diet my vet suggested to calm his stomach. This was the boiled chicken breast, white rice and ~a tablespoon of plain yogurt diet. He’d stay on that until his stomach got better and then we’d try a different brand of food. I tried grain free and a bunch of other stuff. Eventually I found a brand that completely stopped the vomiting, 90% (at first) of the diarrhea and quite a lot with the gas. Eventually the diarrhea completely stopped and the gas got better by A LOT. I wish you the best of luck. I did spend probably the first 3 years of his life doing this though before we found what worked for us. It was a process but so worth it once we got it figured out! I hope you’re able to find what works for your baby!

My one piece of advice would be to try to treat your pup normally. Don’t change or overly baby because they pick up on it and it can very easily cause them extra anxiety, contribute to any possibly underlying neurotic tendencies and/or they take advantage of the situation, depending on the personality. I know it’s hard to do because you feel bad that they are hurting but it can really make things worse. Just continue to be gentle, kind and obviously don’t push for any activities if they aren’t feeling well. Best of luck ❤


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## Noodle_Poodle (5 mo ago)

Dechi said:


> The vet called not long after I posted. She’s a young vet and she’s doing her best but she clearly is way over her head. She recommends Merlin continues to be seen in internal medicine after his endoscopy, as he is a complex case.
> 
> For now she recommended giving Omeprazole twice a day and giving gabapentin earlier, as she says it can take up to two hours to work. She will prescribe something to protect the intestinal mucosa, and something for nausea. As long as he eats, she says he can wait two weeks for his appointment in internal medicine. If not, then I need to take him to the ER if I can’t move up his appointment.
> 
> ...


Have you tried pill pockets? They can work really well for some dogs and you can just break a piece off like clay and mold a pill into it because they’re usually huge. My poodle also was a BIG fan of pills molded into a small ball of Kraft singles cheese, haha. He would pick a pill out of any bowl of food but I could hide it in the more tempting treats. A lot of dogs aren’t fans of the low fat or kidney diet foods because they are bland but as long as they’ll eat it 🤷🏼‍♀️


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## Dechi (Aug 22, 2015)

Noodle_Poodle said:


> My little mpoo had some stomach issues for the first few years of his life. He had a lot of trouble with diarrhea and some vomiting but more so the diarrhea. He also had bad gas and there were times I could tell his stomach was really upset. He’s not one to hide when he hurts. After quite a bit of investigation, my vet found some results similar to what you listed in the first paragraph of results. So I would essentially try a food for a while, wait and see if anything changed and if it didn’t he’d go back on the diet my vet suggested to calm his stomach. This was the boiled chicken breast, white rice and ~a tablespoon of plain yogurt diet. He’d stay on that until his stomach got better and then we’d try a different brand of food. I tried grain free and a bunch of other stuff. Eventually I found a brand that completely stopped the vomiting, 90% (at first) of the diarrhea and quite a lot with the gas. Eventually the diarrhea completely stopped and the gas got better by A LOT. I wish you the best of luck. I did spend probably the first 3 years of his life doing this though before we found what worked for us. It was a process but so worth it once we got it figured out! I hope you’re able to find what works for your baby!


The thing is he has perfect stools. Nice and firm. Never any diarrhea. So I don’t think it has to do with the food. At least not directly. He’s also been on vet food for the last years mostly, and hypoallergenic food for the last year. He also doesn’t really vomit. He mostly chockes gags but nothing comes out. Tonight he regurgitated his dinner, all still undigested. This is the first time he’s done that in a long time.



Noodle_Poodle said:


> My one piece of advice would be to try to treat your pup normally. Don’t change or overly baby because they pick up on it and it can very easily cause them extra anxiety, contribute to any possibly underlying neurotic tendencies and/or they take advantage of the situation, depending on the personality. I know it’s hard to do because you feel bad that they are hurting but it can really make things worse. Just continue to be gentle, kind and obviously don’t push for any activities if they aren’t feeling well. Best of luck


Merlin has severe anxiety. He’s been diagnosed with general anxiety disorder. He is extremely anxious and it doesn’t take much to set him off. I’m used to that and our lives have to be re-arranged around that. My dogs are toys, but they are not babied. He is pitiful right now though and he is clearly hurting. He needs comforting and I try to give it to him, but even when he is resting on my lap, he cannot sleep most of the time. I suppose because of pain and discomfort.


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## Dechi (Aug 22, 2015)

Noodle_Poodle said:


> Have you tried pill pockets? They can work really well for some dogs and you can just break a piece off like clay and mold a pill into it because they’re usually huge. My poodle also was a BIG fan of pills molded into a small ball of Kraft singles cheese, haha. He would pick a pill out of any bowl of food but I could hide it in the more tempting treats. A lot of dogs aren’t fans of the low fat or kidney diet foods because they are bland but as long as they’ll eat it 🤷🏼‍♀️


I used pill pockets for a long time with him, years ago. Until one day he decided he had enough and would not eat one more piece.

I like the Kraft singles idea. I have some in the fridge, I’ll try it tomorrow, thanks !


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## Minie (Oct 4, 2021)

Oh Dechi, so sorry for Merlin and you. You know Merlin and yourself best. If two weeks is too long a wait, then you are right! I read alot of pain in your descriptions of Merlin's reactions. Poor thing. It's difficult when you suspect the young vet is over her head. Do you have any access to a more experienced vet?


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## Noodle_Poodle (5 mo ago)

[


Dechi said:


> The thing is he has perfect stools. Nice and firm. Never any diarrhea. So I don’t think it has to do with the food. At least not directly. He’s also been on vet food for the last years mostly, and hypoallergenic food for the last year. He also doesn’t really vomit. He mostly chockes gags but nothing comes out. Tonight he regurgitated his dinner, all still undigested. This is the first time he’s done that in a long time.
> 
> 
> 
> Merlin has severe anxiety. He’s been diagnosed with general anxiety disorder. He is extremely anxious and it doesn’t take much to set him off. I’m used to that and our lives have to be re-arranged around that. My dogs are toys, but they are not babied. He is pitiful right now though and he is clearly hurting. He needs comforting and I try to give it to him, but even when he is resting on my lap, he cannot sleep most of the time. I suppose because of pain and discomfort.


The symptoms you mention remind me so much of a human problem called gastroparesis. I don’t really know much about it in relation to dogs though.

Oh, I totally think comfort is really important. Poor baby 😢
I’m sorry he’s having such a rough time. My little old man has CCD (dementia) and also has a very hard time sleeping. That’s always the worst because you know it’s not helping them heal to not get any sleep. Melatonin has helped my guy immensely but that’s because with dementia they stop producing enough melatonin and thus the sleep wake cycle gets really messed up. But he still wakes us up multiple times a night and needs to either potty or help getting back to sleep. There are nights where the only way he’ll go back to sleep is on my chest (while I’m sitting upright) or on my husbands lap, which makes sleeping for us hard. He also gets 2 drops of a local hemp CBD oil at night to help with his anxiety (another CCD symptom, he didn’t have previously). It does help some.

I also have the young vet struggle so I feel you there. He’s a nice guy but if I feel like he’s really inexperienced and if I wasn’t a person who goes out of my way to do a ton of research, my little man wouldn’t have most of the care that has helped him so much.

It’s so rough when they’re sick and you just can’t make it go away for them. I hope they’re able to figure it out for you guys. ❤


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## Dechi (Aug 22, 2015)

Minie said:


> Oh Dechi, so sorry for Merlin and you. You know Merlin and yourself best. If two weeks is too long a wait, then you are right! I read alot of pain in your descriptions of Merlin's reactions. Poor thing. It's difficult when you suspect the young vet is over her head. Do you have any access to a more experienced vet?


They told me the internal medicine vet had experience so hopefully it’s the case and he will be in good hands. The problem with my local vet clinic is they have a high turn over rate and most vets don’t seem to work full time. So even when I find an experienced vet I like and ask to only see her (only women work there), it’s not possible. Waiting time at other clinics is at least 3 months to get in and I’m not convinced it would be any better. So I’ve chosen to stick with that clinic. The vet Merlin saw I had never seen before and might never see again…


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## Dechi (Aug 22, 2015)

I got Merlin’s new meds : surnia, sulcrate, more gabapentin and omeprazole. The sulcrate make everything very complicated because it has to be given 2 hours in-between food or meds. I’ll do my best.

The Kraft single trick works so if he refuses the canned food I’ll use it. I brought back the RC cans and got some Hill’s instead, hoping he likes it more.

ETA : it’s « Cerenia » not « Surnia » lol…


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## Minie (Oct 4, 2021)

Gosh that's difficult. I'm glad the internal vet is more experienced. Praying for Merlin.


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## Dechi (Aug 22, 2015)

I thought we needed a picture of our boy… Taken just now.


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## Dechi (Aug 22, 2015)

For the first time in more than a week, Merlin played with Beckie outside today. On three occasions. Not as long as he usually does, but it’s still a good sign. He’s been on Sulcrate and Cerenia 2 days now so I guess it’s helping. I haven’t seen him want to eat grass today either.

This makes my day.


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## 94Magna_Tom (Feb 23, 2021)

Good progress.


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## Rose n Poos (Sep 22, 2017)

That's so good to hear .


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## Dechi (Aug 22, 2015)

Today we went for a walk, even if it was raining a bit. Merlin had walked a little over 5 minutes yesterday without limping. Today he started limping after a while and I picked him up. When my arms hurt too much I put him down and let him walk 1-2 minutes. I went to pick him up again and he cried in pain. I wasn’t rough or anything. I immediately let him down, waited a bit and picked him up very gently. He was okay.

I’m starting to wonder if he has a mass or something that’s hurting when he walks. Maybe I put my hand on it when I picked him up. But wouldn’t the abdominal echo have caught it ? His appointment in internal medicine is in one week. I can’t wait.

I gave him gabapentin after he ate his dinner, to help with the pain. He’s okay now.

Notice he doesn’t have wet paws like Beckie…. He won’t be coming on walks anymore, until I know what's going on with him.


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## Rose n Poos (Sep 22, 2017)

This may not be the same but most of my poodles in my memory have a specific sensitive spot somewhere around where their side and abdominal area meet. If we happen to touch it just wrong, they cry or yelp in pain. They recover quickly and don't seem to have any further issue.


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## Dechi (Aug 22, 2015)

Rose n Poos said:


> This may not be the same but most of my poodles in my memory have a specific sensitive spot somewhere around where their side and abdominal area meet. If we happen to touch it just wrong, they cry or yelp in pain. They recover quickly and don't seem to have any further issue.


Oh really ? Would that be the sternum ? It happened as you describe. He was hurt and scared but it didn’t seem to last more than a minute or two. I was scared to hurt him though.

I’ll still mention it to the vet, as he’s having so many different issues it can be difficult to know what anything means anymore. Tamara, my late Chihuahua, had such a spot right behind the neck. She would scream in pain if you touched her inadvertently on this spot. I had forgotten about that.


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## Rose n Poos (Sep 22, 2017)

For mine it's been usually in the highlighted area, more toward the back end.


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## Dechi (Aug 22, 2015)

Rose n Poos said:


> For mine it's been usually in the highlighted area, more toward the back end.
> View attachment 498947


Ok, I see. It could still be it but my hands were definitely not near the back end but close to the front legs, where the chest is deeper. That’s where I always pick my dogs up.


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## Rose n Poos (Sep 22, 2017)

Good point. We don't actually pick up from the back either. It's more when trying to move them or even just a pet.

Can't think how it could have happened for Merlin but maybe it's a bruised rib?


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## fjm (Jun 4, 2010)

My small dogs give a squeal if I inadvertently pinch the skin when picking them up, especially the sensitive area around the arm pit - it can easily happen if they move at the wrong moment. And I am aware that Sophy tends to have a stiff neck, which can also hurt her. Always best to get it checked out, though.


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## Dechi (Aug 22, 2015)

Rose n Poos said:


> Good point. We don't actually pick up from the back either. It's more when trying to move them or even just a pet.
> 
> Can't think how it could have happened for Merlin but maybe it's a bruised rib?


It’s unlikely but possible. I’ll keep that in mind.



fjm said:


> My small dogs give a squeal if I inadvertently pinch the skin when picking them up, especially the sensitive area around the arm pit - it can easily happen if they move at the wrong moment. And I am aware that Sophy tends to have a stiff neck, which can also hurt her. Always best to get it checked out, though.


I could have pinched a little skin I guess, even though I didn’t feel it. I had gloves on. He’s 8 1/2 and never squealed when picked up before so it’s a little strange but again, not impossible.


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## Dechi (Aug 22, 2015)

This morning we went to the internal medicine vet. We were there for three hours. I don’t have copy of his file yet and so many things were discussed, and she was talking so fast that I’m sure I’ll forget part of what was said. But basically, she seems to have 2 possible diagnosis : inflammatory bowel disease or cancer.

We have decided not to do any biopsies before he has his EKG in december. We did a blood test including hematocrit (last time it was a little elevated, this time it’s normal), a test for Addison’s disease and x-rays of the lung and heart. We’re waiting for a specialist to look at them but she said his left atrium was definitely enlarged, and his lungs had signs of deterioration or other. I am to bring first morning urine to my vet for analysis, since one of the values of his echo was a little off. Just to rule out kidney problems.

She says licking the air is a sign of digestive discomfort. Unfortunately he is still doing it, but the other symptoms are mostly gone. I’ll keep giving him Omeprazole twice a day for now and Gabapentin at night, to help him sleep. We’re doing a large spectrum dewormer and I have a few days of Cerenia in case of nausea.

She will be talking with his cardiologist after his visit to find out if anesthesia for a biopsy is possible. Also to know if treating with cortisone is appropriate for him, despite his heart condition. She also wants to test him for heart worm because she wants to treat for possible parasites in the lungs, but doing so would kill the heart worms if he was infected, thus creating problems with his heart. I don’t remember this part too well so not positive I’m telling it how it should be.

So the plan is to keep him on his low fat (and low sodium) diet with his medication for now, and wait after his EKG to decide what we do. In the meantime, she will call me with the results of the tests and the lung/heart x-ray. If he deteriorates, I need to go back and we will adjust the plan accordingly. The drawback of waiting is that if it’s cancer, it will progress while we’re waiting. But…. I do not plan to treat him with chemotherapy or radiotherapy if that’s the case. Maybe certain dogs would do okay with that but for a dog with severe anxiety such as Merlin, it wouldn’t be fair. So I don’t think it makes a significant difference. If it’s cancer, he will be kept comfortable as long as possible but I won’t let him suffer. He’s been a good boy and he deserves to be kept pain free.

This is very hard to think about but I have to be realistic. It’s a possibility.

ETA : we also tested for folate and B12. I don’t remember why.


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## Miki (Dec 25, 2021)

{{{{{{{❤Dechi & Merlin❤}}}}}}}


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## Asta's Mom (Aug 20, 2014)

Oh sweet little Merlin, so sad to hear. And dear you for your loving care. Sending best thoughts and prayers to you both.


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## Skylar (Jul 29, 2016)

(((gentle hugs))))


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## 94Magna_Tom (Feb 23, 2021)

Sending love and prayers💕.


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## Mfmst (Jun 18, 2014)

Poor Merlin. Sending love and support to you both. And big hugs.


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## Rose n Poos (Sep 22, 2017)

Holding you, Merlin, and Beckie close and sending prayers.


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## Minie (Oct 4, 2021)

Virtual hugs and prayers your way


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## Charmed (Aug 4, 2014)

Oh Dechi, I am so sorry to hear that Merlin has not been feeling well. I think you have the right attitude about palliative care if he does have cancer. My sister went the whole chemo/radiation/amputation and a prosthetic leg for one of her dogs. She said it was something she had to do, but never again. I had to laugh when you described Merlin's learned habit of limping to be picked up. One of my beagles used to do that; he was so pathetic looking, until you noticed that he had switched legs... and was cured if there was food involved. It does make it more difficult to tell when the little stinkers really do have a limp. What characters they are! I hope Merlin is feeling better soon. Try to get some rest yourself. Hugs.


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## fjm (Jun 4, 2010)

I hope you get a clear diagnosis soon, and a plan to help Merlin live his best life. I believe steroids are the go-to treatment for both IBD and lymphoma if you choose not to go down the chemo route for the latter - was there any discussion of them?


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## Dechi (Aug 22, 2015)

fjm said:


> I hope you get a clear diagnosis soon, and a plan to help Merlin live his best life. I believe steroids are the go-to treatment for both IBD and lymphoma if you choose not to go down the chemo route for the latter - was there any discussion of them?


She did talk about cancer treatment but I was overwhelmed and she was talking way too fast forme to grasp everything. She said that cortisone (is that a steroïd ?) was a treatment she used for certain dogs with IBD. She explained in details why it wasn’t her first choice but I don’t remember. She said she had good results with it but there are drawbacks to it which I also dob’t remember). Next time I’ll ask if I can record her.


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## Puppy Love (Aug 10, 2015)

It's difficult to remember everything, especially when there are so many possibilities being discussed. You are all in my thoughts and prayers and I hope you can keep little Merlin comfortable.


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## Streetcar (Apr 13, 2014)

You and Merlin are always in my heart, @Dechi 💓. I am so sorry he has this happening.


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## ShamrockPoodle (Jan 22, 2017)

Sending prayers and hugs for you and dear little Merlin❤


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## Dechi (Aug 22, 2015)

Thanks everyone for the support. It’s very much appreciated.


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## Kukla the Tpoo (11 mo ago)

I'm so sorry that Merlin is suffering. You and Merlin are in my thoughts.


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## Minie (Oct 4, 2021)

🤗 💞


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## Dechi (Aug 22, 2015)

Update : Merlin EKG has determined he can be under anesthesia. Now I have to decide if I will do the biopsy or not. I wanted to at first but I dislike the vet so much I want nothing to do with her anymore.

Not only has she cost me hundreds of dollars because she said the x-ray was done for the heart in her report and my insurance refused to pay (after she had told me it would not involve the heart, which was my condition for having it done, because as I mentioned to her, my insurance don’t pay for anything regarding the heart). I was very clear about that and we were doing the x-ray exclusively for the lungs. I have my regular vet taking care of the heart, and that’s all out of my pocket already.

She also seems to like doing lots of procedures. I feel like she takes me for an ATM. She wants to do another x-ray before the biopsy. Why ? He just had one ! Now that she has ruined it with my insurance, it means I’ll have to fight with them to pay the next one. Because of her carelessness. So no. I’m saying no.

So not only is she not trustworthy, but she takes forever to call for follow-ups (I mean, many weeks). She also takes weeks to send the reports, WHEN she does. I had to ask my regular vet to request Merlin’s EKG, after more than 2 weeks. And then she never called me to discuss the next steps, as we talked about (now that we know he can have the biopsy). I just can’t trust her anymore.

I will probably ask yo see another internal medicine vet instead of her. I’m still blowing off steam every time I think about it.


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## Dechi (Aug 22, 2015)

Here is our guy, happy after his grooming


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## Streetcar (Apr 13, 2014)

@Dechi , that vet would lose my trust, too. If she's that busy and takes weeks in between communications, how can she keep cases straight? And her mess up on the heart vs lungs seems worthy of a refund due to unrequested duplicate veterinary services. Not that you'll get one. Did she even bother to provide a report on his lungs? I hope I would have the nerve to insist on it, but honestly am not certain.

Definitely insist on a different internist. Or if you have to, is there a separate practice? Specialist vets are not so common here, and that might be the same for you.

Good thoughts continue streaming to you, and Merlin looks so precious and proud after his groom 😍🤩.


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## Liz (Oct 2, 2010)

Agreed, Dechi. You and Merlin deserve a vet worthy of your trust.

Love seeing him relaxed and content.


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## The Popster (Feb 23, 2021)

Rose n Poos said:


> This may not be the same but most of my poodles in my memory have a specific sensitive spot somewhere around where their side and abdominal area meet. If we happen to touch it just wrong, they cry or yelp in pain. They recover quickly and don't seem to have any further issue.


!!!!! ... Yes, how strange, but that's so amazing, Poppy is the same I'm sure, on a 'few' occassions we have had a similar experience. Touch her in the same area and she emits a mini yelp.
We feel about gently, and find nothing, and she doesn't mind the feeling around.
I'm certain it's the same as you describe, not something that happens often but often enough for your comment to ring a bell.


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## The Popster (Feb 23, 2021)

Dechi said:


> Update : Merlin EKG has determined he can be under anesthesia. Now I have to decide if I will do the biopsy or not. I wanted to at first but I dislike the vet so much I want nothing to do with her anymore.
> 
> Not only has she cost me hundreds of dollars because she said the x-ray was done for the heart in her report and my insurance refused to pay (after she had told me it would not involve the heart, which was my condition for having it done, because as I mentioned to her, my insurance don’t pay for anything regarding the heart). I was very clear about that and we were doing the x-ray exclusively for the lungs. I have my regular vet taking care of the heart, and that’s all out of my pocket already.
> 
> ...


Two things , 1. Grrrrrrr.... this kind of situation, which we hear of all too often makes me so angry, vets and insurance maladministration, lacking in duty of care.
2. My heart goes out to you, just so unfair.
A ton of respect and love to you and Merlin.


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## Mfmst (Jun 18, 2014)

I am so sorry Merlin is suffering, and his vet has given you zero clarity - word salad of possibles and tons of potential tests. Hugs to you and hope a different vet will set Merlin on the correct medical prognosis path.


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## Rose n Poos (Sep 22, 2017)

It's so frustrating when you feel that a medical provider isn't a partner. Hope you find what you need in a provider and care asap! 

It may be too little, too late but I'd ask the vet who noted the reason for the xray incorrectly to send a corrected report to the insurance company to have those records corrected and to try to get reimbursed for all that. 
This is done with insurance claims for human health, so why not for our pets? It may come to nothing but could be worth asking. 

Merlin looks very handsome after his groom .


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## PowersPup (Aug 28, 2020)

Such a handsome boy, despite all the procedures and issues. I have no advice about your vet situation, but wish you clarity going forward.


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## Dechi (Aug 22, 2015)

Streetcar said:


> @Dechi , that vet would lose my trust, too. If she's that busy and takes weeks in between communications, how can she keep cases straight? And her mess up on the heart vs lungs seems worthy of a refund due to unrequested duplicate veterinary services. Not that you'll get one. Did she even bother to provide a report on his lungs? I hope I would have the nerve to insist on it, but honestly am not certain.
> 
> Definitely insist on a different internist. Or if you have to, is there a separate practice? Specialist vets are not so common here, and that might be the same for you.
> 
> Good thoughts continue streaming to you, and Merlin looks so precious and proud after his groom 😍🤩.


She did provide a report for the lungs and it was all clear. There are a few other practices with internal medecine specialists, but the one near me charges double the price so I’m not too thrilled about going there. This is already so expensive.



Rose n Poos said:


> It may be too little, too late but I'd ask the vet who noted the reason for the xray incorrectly to send a corrected report to the insurance company to have those records corrected and to try to get reimbursed for all that.
> This is done with insurance claims for human health, so why not for our pets? It may come to nothing but could be worth asking.
> 
> Merlin looks very handsome after his groom .


This is a long story and I didn’t give all the details. Before sending my claim, when she called me I told her about the mistake she made and asked that she correct the report. She said she could not, as the software does not allow it. So she added a small paragraph at the end of the report that stated the x-ray was done to rule out primary lung disease. The software automatically adds dates when the vet writes notes, so it was clearly showing that the note was written several days later. 

My insurance refused to pay so I filed a complaint, explained the situation and asked for a revision. They did and still refused to pay. I had to call them again and demand to speak to a manager to explain the situation. Nobody called me but after revision they payed 50%. I thought it was fair, since the vet had clearly stated the x-ray was for both the heart and the lungs.

I thought about calling the clinic and asking for money back to cover half of the price, but I think it would be detrimental to my mental health and would trigger too much anxiety and negative feelings. I would rather let it go, as long as I never deal with her again. I will definitely make sure to tell exactly what happened to the next vet and ask that they be very careful. I also want it noted in Merlin’s file that I do not authorize any testing or actions regarding his heart to be done by the internal medicine department.

Thanks everyone for your kind words. I’ll keep you posted ! Oh, and Merlin says thanks for the compliments !


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