12 year old staffordshire terrier with intestinal issues possible lymphoma
Hello and thank you for look at my thread. I'm really hoping for some additional advice to help in making a big decision for a very loved family member.
Details:
-12 hear old neutered male Staffordshire
-always been sensitive to diet (any time he's ever gotten into any human food it resulted in a vet visit with antibiotics due to skin irritation)
-July 4th weekend (2016) is when the first big issues started. One day he wouldn't eat and did not look good, he started uncontrollably vomiting later that night with episodes of diarrhea so we rushed him in. He spent the weekend in the emergency vet which didn't end well (this particular company lied to us on multiple occasions, did not complete the tests they advised, and ultimately we got our dog back in real bad condition pumped full of pain meds for no reason). After the holiday weekend he went to his regular vet every day the following week. Between the Emergency vet and the regular vet he had many anti-nausea injection, metronidiza (sp?), prilosec, cdc blood work, fecal float, and was put on prescription food (EN). We where also giving him sub q fluids for the first couple days after the emergency vet. His blood test had come back very normal aside from dehydration from the vomiting/diarrhea. He started recovering pretty quickly, first drinking water, then finally eating again (EN and boiled chicken).
-From July ~8th to the start of this last episode (Nov 20th) he had been doing well. He had his days where you could tell he didn't feel real great, but he ate, drank, pooped, and urinated. His poop was very dark though, which is why we did the fecal float, and it didn't show any blood. It was chalked up to be the new diet and effects from the anti-biotics.
-Nov 20th at 6pm my beloved buddy started vomiting and it got bad pretty quickly. He first vomited his food from the day (he had been on 2 cans of EN plus ~4-8 OZ boiled chicken per day split into 4 separate meals). Within an hour he was vomiting blood in the same (horrible) emergency vet. They immediately tried to force us to leave him for the weekend again, we refused and requested out-patient care. They where NOT happy about this, but they agreed to give him the anti-nausea injection (cerenia), do x-rays, take urine for urinalysis, do blood work again, and send out pancreatitis test. They continued to try and force us to allow him to stay, we kept refusing. They first gave the anti-nausea, but then pumped him with pain meds before the x-rays(seems to be their standard regardless of situation, and reacted very badly to the one they gave him this time "hydromorphone"). At this point they gave him sub q fluids (refused to let us buy some even though they know we've given them many times before), famotidine (inject-able anti-acid similar to prilosec from what I understand?), and released him.
When we got him home in the middle of that night, he had appetite but would not drink water.
-Next morning Nov.21 we took him to regular vet. He drank one small drink before we left and that is the last drink he has taken on his own.
We've been spending most of our days at the vet doing more x-rays, then ultrasound, then barium x-rays, and that's where things got real scary.
The ultrasound specialist found a few possible concerns, but the vet was focused on the slightly thickened intestinal walls and the strange area within the small intestines that we had seen on the regular x-rays (very faint, they weren't sure if it was a mast or non-solid foreign object). The ultrasound specialist noted small amounts of fluid around this area in question. She also noted some sludge in the bladder and slightly enlarged prostate glands. Urinalysis and pancreatitis tests came back good from the other vet. The blood work also came back normal again aside from signs of dehydration. Our regular vet then suggested barium since we're still not sure what is going on exactly. Well, see attached images, the barium showed some very strange intestinal routing and what appeared to be some kind of blockage but didn't look like an object (at this point we where thinking tumor or mast of some kind). The vet decided to send him home overnight adding metoclopramide to his medications and return first thing next day (today Nov.23rd) for another x-ray. This was a small dosage to try and push some things through.
This morning he pooped once before we went in and the x-rays showed the intestines much smaller (normal size), the barium had passed the spot in question, and was exiting the track. He has pooped a couple times (small squishy brown/mixed barium turds) since then. He still won't drink, but is eating (now trying for 3 cans per day for this weekend to get overall health/blood sugar up in case of exploratory surgery next week). He is sleeping a lot, not real full of energy, but still very responsive, wags tail, and even wants to go on walks (we make them very short right now, but he lets you know he wants to stroll around).
Here is a list of all the medications he is currently on:
My vet (which I do trust and have a lot of faith in) stated she had never seen intestines that looked quite like these and that the routing was very strange. She is leaning towards exploratory surgery, but is really trying to determine the problem prior to surgery. After seeing the barium had moved through this morning, she was talking about the thickened walls and possibility of lymphoma. Us (the owners) are more concerned of his quality of life than anything, and fear a poor recovery if parts of the intestines end up needing removed. We also don't want to put him through the stress (he has pretty bad separation anxiety) of undergoing surgery without a prognoses. All in all we are on the fence weather or not to undergo exploratory surgery.
I GREATLY appreciate ANY and ALL advice/opinions/shared knowledge or experiences anyone is willing to give.
I wish I had pictures of the latest x-rays, but I don't. I could probably get the blood work from the emergency vet and post that if anyone thinks it would be helpful.
First of all, I am so sorry to hear about your poor dog. It sounds absolutely horrendous for you both.
My own personal opinion is that with a dog of that age to put him through such trauma is not in his best interests. I am sorry if that sounds harsh, especially at such a time when you are desperately worried about him. I have and have had dogs who suffer from SA, and I know how incredibly stressful and frightening it is for them to be separated from you - especially to have to stay in a veterinary practice away from everything they know and love. I cannot comment on the veterinary care or the treatment or the drugs as I am not a vet, all I can do is express my own personal opinion as to what I would do in the circumstances.
And that would be to spend one last day and night with him, and then with the vet's help, send him on his last journey over the Rainbow Bridge. I am lucky - when it comes to the choice between keeping an animal alive but in pain, discomfort and distress, or sending him off to eternal rest, I have no qualms in choosing the latter. And I feel exactly the same about humans - if I could have saved my very elderly parents the pain and discomfort they endured before dying by legal euthanasia, both my parents and I would have welcomed it with open arms!
All I can say is whatever path you choose, God bless and I wish you and your lovely old boy all the love and strength in the world. xx gnasher xx