One step at a time

On Monday, the veterinarian performed some acupuncture to try to kickstart Bravo’s liver function and appetite.

To start, I am beginning to feel like myself again. I think.

Bravo is doing OK. Not much better. Just OK.

He’s not in pain. He’s not uncomfortable. And, The Weed and I are doing our best to try to help him.

This is what’s making me feel a bit better. We are doing our best. Really.

We returned to the animal hospital Monday afternoon. The veterinarian who has treated Bravo for many years was available to see him and assess his condition.

She is a great veterinarian and very good with our dogs.

At this point, we have two theories about what might be wrong with Bravo.

1. He is having a toxic reaction to some medication he took last month to help with a bout of diarrhea. Apparently, some dogs can ‘overdose’ on Metronidazole. Bravo has been on this drug twice recently. In August and October. Bravo’s blood tests show highly elevated liver enzyme levels that came on quickly. This is a good indicator of some sort of reaction to a medication or chemical product. We are treating his liver condition with four daily tablets of Denamarin.

2. The vet felt a small, internal mass along Bravo’s right flank. This could be a concern or it could be more benign lumps in his body. Bravo has several lipomas, fatty, noncancerous tumors. He had a few surgically removed years ago. And, more have developed.

On Monday, the vet gave Bravo more fluids, a vitamin B12 shot, an antinausea shot, and she performed some acupuncture to try to jumpstart his liver function and appetite.

Bravo was his quiet self even when the vet inserted an acupuncture needle at the crown of his skull and The Weed told him, ‘Now, you have a nice hat!’

Last night, we started a new ‘appetite stimulator’ medication for Bravo. The newly released drug is called ENTYCE® and it has a pretty interesting story.

The drug went on the market in mid-October, presented by Aratana Therapeutics. It is a ghrelin receptor that mimics the effect of ghrelin, also called the hunger hormone. Like naturally occurring ghrelin, ENTYCE binds to cell receptors and affects signaling in the hypothalamus, causing the feeling of hunger.

To learn more about this drug, visit http://entyce.aratana.com. If nothing else, visit the site to see the clever marketing photo featured.

After Bravo’s first dose last night, we offered him a few pieces of chicken. He immediately ate the chicken. This was huge! He has been anorexic for days. (Yes. It is called anorexia when dogs refuse to eat.)

About an hour later, we offered him some more chicken and he ate about six pieces. After feeding him an unholy cocktail of baby food and canned dog food from a syringe throughout the day, seeing him readily eat on his own was encouraging.

Unfortunately, this morning, Bravo is back to ignoring food when offered to him. I am hoping once the ENTYCE is in his system for a few days, the medication will help him eat more.

So, where do we go from here? We are planning to monitor Bravo for the next week or so. See how he responds to the new medications.

If he does not respond, we can go forward with a costly abdominal ultrasound. However, if we do that and something is detected, like a tumor, we cannot treat it surgically. Because of Bravo’s high liver levels and a heart condition, putting him under general anesthesia is impossible.

In that case, we would focus on keeping him comfortable and letting him live out his days at home with The Weed, Rio, and me.

After sleepless nights and anxious days, I’ve come to terms with letting Bravo dictate what we do. The Weed has always said ‘Take it one step at a time.’

That’s what we’re doing. I just hope this is right for our Bravo.

While Bravo feels punky, his sister —Rio— is doing just fine.