Having a lazy day, ignoring the beautiful weather (I hope to go for a walk later, but when there's less sun so I don't have to slather on the sunscreen), counting my little dog's respiratory rate somewhat obsessively.
I didn't write about it at the time, but about two months ago, Nesmith went into a congestive heart failure crisis. He has severe mitral regurgitation and accumulates fluid in his chest. He was on a low dose of furosemide (Lasix), a diuretic, and enalapril, an ACE inhibitor, but all of a sudden they just weren't enough and he rapidly got fluid build-up in his lungs and had to be given IV or IM (not sure which, as I've been avoiding going to the vet for immune reasons) furosemide to eliminate it. Since, his doses for both meds have been upped and he's on pimobendan (Vetmedin), which helps his heart contract more powerfully and acts as a vasodilator so there's less resistance in his vessels.
He's a barfer, so sometimes I think he vomits up or regurgitates his meds without us noticing, but sometimes I think his body wants to be extra congestive-y or he might eat a little too much salt and gets fluid build up. Usually we just give him an extra dose of furosemide for a day or two and that clears it up. Today, he seemed like he's breathing a little harder and more rapidly than on days where I elect to give him an extra furosemide, so we called up Dr. J, who's been managing Nemma's case, and he said to just give him the furosemide a little earlier than I was planning on, keep monitoring him and call tomorrow with updates. It's nice to know that my instincts have been right about when I give an extra dose.
Ace, my childhood dog, died from congestive heart failure. He must have had right sided failure, as opposed to Nemma's left, since he had ascites (fluid accumulation in his abdomen rather than in the chest). I was 18 when he died, so I didn't know a hell of a lot about veterinary medicine at the time, but it's interesting what I've been deduce from my memories and stuff I've learned in school. But it's also hard having experience with congestive heart failure. Ace maybe lived 6-8 months after he was diagnosed. It's a hard disease to manage because usually the patient develops resistance to furosemide, which is one of the most powerful diuretics and one of the mainstays of treatment and you can't just keep upping the dose because it's hard on the kidneys. You can add on more drugs, but they can only do much.
I'm hoping Nesmith just barfed up his meds or a portion of them or that the nibbles of steak I gave him last night had too much salt for him to handle. His resting respiratory rate seems to be slowing dropping. We gave him the extra furosemide around 3:00 and it's nearly 6:00 now. He was between 32 and 48+ but he's more consistently around 28 -32 right now. Normal is anywhere below 20 breaths per minute. Stanley has been between 12-16 for comparison. Nemma's breaths seem a bit less labored too. Poor baby. I love him so.
At least I don't feel like we're at the point of doing too much to keep him alive right now. The vast majority of his days are good days. He follows me around the house, wagging his little tail, barging into the bathroom so he can stare at me while I pee, begging for food, etc. I don't think we got to that point with Ace, either. He was on his meds, doing well, and then, one day, he decided he didn't want to eat or take them any more. A day and a half later, my mom jolted upright form a dead sleep, checked on Ace, noticed he was gasping, and woke us all up. We had a few minutes of discussion, trying to decide if it was time to call our vet friend, Dr. B. She said she would come to our house, night or day, and euthanize him for us when the time was right. And then he died, after a few more minutes. It was a relief not having to make that decision, honestly. I've only had to euthanize 2 pets: a rat named Napoleon who developed one of those lightening fast growing tumors that started pressing on her spinal cord, paralyzing her rear end, and a leopard gecko named Pandora, who went into what we thought was rapid renal failure. Those weren't hard decisions. I knew there wasn't anything that could be done for either critter. But with heart failure...it's a slippery slope, to say the least, and I hope I don't have to make any hard decisions for a while yet.
Bless him. Dr. J just called to check on Nemma before leaving work. He's become my favorite of the four vets at that practice, both to treat my critters and to work with. He's a good doctor, a good teacher, and the only doctor who teared up at every single euthanasia I assisted him with. Plus, he has one of the best awkward laughs I've ever encountered.
OK...well this has been a too serious entry for my liking. I'll lighten it up with some goofball pics :)
One of my photo requests was pictures of me in silly hats and/or making goofy faces. This pic is from maybe a month ago when it was being ridiculously cold out and I felt like some foxy coordination:
One of my classmates gave me a care package with a silly fox hat (very warm and comfy!) and I have a fox scarf. Plus, I'm making my "feelin' foxy" face...or some such nonsense :P
And here's a cross-eyed fish face from today:
And me making a weird face while Stanley sits on my lap
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