# Big day for the Toby Dog tomorrow



## hotel4dogs (Sep 29, 2008)

We go back to the vet for our 3 week recheck after the bad blood/urine results last time.
Hoping for better results now that he's off the rimadyl. Please keep fingers crossed that the drugs were the worst culprit in the test values! :crossfing


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## Finn's Fan (Dec 22, 2007)

Fingers crossed here that the new blood tests are at appropriate levels for everything. Rimadyl or another NSAID are often the culprits, so here's hoping that was the case for Toby. Give that senior fella a smooch from me, please, Barb....the golden oldies hold a special place in my heart.


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## Dallas Gold (Dec 22, 2007)

Come on Toby! We want good blood results, like your younger cousin Toby (my little one) got this past week. Will they get the results by Wed or Thurs?


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## hotel4dogs (Sep 29, 2008)

yes, we should have the results by tuesday afternoon. Usually a 24 hour turn around time.
On another note....what are you doing home??????? Was it the weather??


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## Mad's Mom (Oct 28, 2008)

Fingers crossed and positive thoughts sent for good results on the bloodwork.


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## Oaklys Dad (Dec 28, 2005)

Toby will be in our thoughts tomorrow.


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## Sammie's Mom (Mar 20, 2009)

Good thoughts coming your way from Sammie and Me!!!


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## BearValley (Nov 30, 2008)

All of his girlfriends here are rooting for him. Hooray Toby!!

I studied for my last blood test and it really helped - I just thought that I'd mention it.


.


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## AmberSunrise (Apr 1, 2009)

Good thoughts coming your way from CT that the test results be good for Toby


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## hotel4dogs (Sep 29, 2008)

He's been studying for the urine test. He's out in the yard studying every drop of urine he can find.




BearValley said:


> All of his girlfriends here are rooting for him. Hooray Toby!!
> 
> I studied for my last blood test and it really helped - I just thought that I'd mention it.
> 
> ...


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## fuzzbuzz (Aug 3, 2008)

Fingers and toes crossed here. Good thoughts going out.


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## Dallas Gold (Dec 22, 2007)

hotel4dogs said:


> yes, we should have the results by tuesday afternoon. Usually a 24 hour turn around time.
> On another note....what are you doing home??????? Was it the weather??


I elected to stay home, which is what I wanted to do from the start, because I didn't want to board Barkley during his chemotherapy. It would stress him out too much--who knew a big old blizzard and whopper power outage would reek havoc on our weekend. When the power went out and the snow piled up I suggested my father in law go with my husband to New York (the hotel room was non-refundable) and I stay with the dogs at the father in law's house. It was a mini (and warmer) vacation, though I learned to shovel snow and to skid out of ice on his driveway! I'm perfectly happy to keep the dogs entertained (or not, as the case may be).


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## Penny & Maggie's Mom (Oct 4, 2007)

Good thoughts and prayers coming for good lab work!


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## goldencontriever3 (Nov 7, 2008)

Good thoughts for Toby tomorrow! Please keep us posted.


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## coppers-mom (Jan 9, 2009)

You and Toby are in my thoughts and prayers for good blood test results!


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## goldensmum (Oct 23, 2007)

Keeping everything crossed for Toby, hope the results are the right ones


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## Tahnee GR (Aug 26, 2006)

Good thoughts for Toby-hoping for GReat test results!


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## CarolinaCasey (Jun 1, 2007)

Hoping for good results!


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## hotel4dogs (Sep 29, 2008)

Thanks everyone, will post an update when I hear from the vet late tomorrow afternoon.
Other points of interest, the vet started Toby on Duralactin. He just started stocking it since it got such high approval at the veterinary pain management symposium he just attended. We'll see what happens.
As far as the mange, the vet says it looks no worse, so we're going to try going back to every-other-week with the ivermectin instead of every day. That will improve the quality of Toby's life a lot.
The lump in his mouth is no different than it was 3 weeks ago. We're still just going to keep an eye on it for now.


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## coppers-mom (Jan 9, 2009)

I sure hope Duralactin helps Toby as much as it has helped copper.

I sure hope the mange stays under control on every other week and I also shall hope and pray his lump is just one more thing to keep your eye on.

You know Toby is very close to my heart and his Mom is one special lady too.:


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## hotel4dogs (Sep 29, 2008)

Thanks! 
We're very anxiously awaiting these results, they're critical. If it's NOT the meds., I don't know where we go from here.
So we're hoping and praying the blood/urine values are better, and that the meds caused the bad values :crossfing



coppers-mom said:


> I sure hope Duralactin helps Toby as much as it has helped copper.
> 
> I sure hope the mange stays under control on every other week and I also shall hope and pray his lump is just one more thing to keep your eye on.
> 
> You know Toby is very close to my heart and his Mom is one special lady too.:


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## paula bedard (Feb 5, 2008)

Saying prayers & crossing fingers for good test results for Toby.


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## sammydog (Aug 23, 2008)

Fingers are crossed!


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## coppers-mom (Jan 9, 2009)

Good thoughts and prayers for you and Toby.:crossfing:crossfing:crossfing:crossfing:crossfing:crossfing


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## coppers-mom (Jan 9, 2009)

No update yet?
I'll keep the prayers going and my fingers crossed.


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## hotel4dogs (Sep 29, 2008)

The numbers were just about the same. So it's not the rimadyl. Darn, I had so hoped that that's what it is.
There was a little bit of good news, his hematocrit is back up to 38, which is within the normal range. My vet thinks that MIGHT have been the rimadyl, there might be some low level gastroinestinal bleeding from it. He says it's the NSAID least likely to cause that, but with Toby's chronic IBD his intestinal tract is constantly inflamed, so it might have caused minor bleeding. Since I haven't seen much difference in him without it, we're going to keep him off of it for now and hope that the Duralactin will help him out.
My vet did some research on liver toxicity of ivermectin, and thinks there's an outside chance that it might be causing the high numbers. But unfortunately, we have to give it to him for the mange, and the other mange treatments available are just as liver toxic if not more so. 
The urine tests were the same, and he thinks that's just plain age related although it might be from chronic irritation in his gastrointestinal tract, too. 
His breath is really bad, and we've found over the past few years with him that that indicates an overgrowth of small intestinal bacteria, so we put him on a round of antibiotics every so often to bring it back in check. I started them yesterday after his blood draw, because unfortunately, antibiotics ALSO cause his liver values to rise so I couldn't start them before. 
The current game plan now is to finish 2 weeks of antibiotics, then take him off all drugs, including the ivermectin, for 3 to 4 weeks and just let the mange flare up as it will. Then a blood draw, and see where we're at. 
If the values are still high, then, well, then who knows?
The good part in all this is that Toby has no clue that his liver is dying off. He feels pretty good, and is enjoying life.


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## coppers-mom (Jan 9, 2009)

I'm so very sorry that his numbers were not improved or at least not all of them.

I am glad that Toby feels pretty good and is enjoying life. Take a lesson form him and enjoy his company and try to live in the day with him.
I know - that's easy for me to say since it is not my dog, but it is still good advice - just hard to follow I know.:

You're both in my thoughts and prayers every day.


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## Dallas Gold (Dec 22, 2007)

I've sent you a p.m.....I'm sorry the news wasn't better for you both. HUGS to both of you. Toby is lucky to have you as his Mom.


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## GoldenCamper (Dec 21, 2009)

So sorry Toby's results did not come back better  But glad he is enjoying life



hotel4dogs said:


> but with Toby's chronic IBD his intestinal tract is constantly inflamed, so it might have caused minor bleeding. Since I haven't seen much difference in him without it, we're going to keep him off of it for now and hope that the Duralactin will help him out.


I ran across a post on another forum when checking out the benefits of Duralactin (I might start Tucker on this to help with his arthritis) and apparently Duralactin has helped out other peoples animals with IBD. Check it out, link below.

http://itchmoforums.com/write-a-pet-product-review/duralactinmicrolactin-t8379.0.html


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## CarolinaCasey (Jun 1, 2007)

Hope Toby gets things cleared up! Sweet white face- I loved his portrait in the other thread!


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## coppers-mom (Jan 9, 2009)

Is Toby going to be retested in 3 weeks? I hope he gets much better results after being off the meds for that long.

I'll be thinking about you daily.::smooch:


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## sammydog (Aug 23, 2008)

hotel4dogs said:


> The good part in all this is that Toby has no clue that his liver is dying off. He feels pretty good, and is enjoying life.


I am sorry you did not get the results you were hoping for.  But I like the good part! I am sure you are spoiling that boy! I will be keeping you in my thoughts for the next round of testing... :crossfing


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## hotel4dogs (Sep 29, 2008)

thanks for all the kind words and good thoughts. We're going to wait 4 weeks, the last 3 of them off the ivermectin, and then check again.
After a conversation with Coppers-Mom, I've also decided to take him off the duralactin until after the next blood draw. No sense muddying the waters.


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## cangolden (Oct 12, 2009)

My prayers are with you and Toby, let's pray for better test results in the next few weeks.


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## coppers-mom (Jan 9, 2009)

So tomorrow is Toby's new blood draw isn't it? You will both be in my thoughts and prayers for good results.:crossfing:crossfing:crossfing:crossfing:crossfing

Hugs to you both (and Tiny and Tito and Pawmer too).


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## hotel4dogs (Sep 29, 2008)

Thanks so much! Yes, tomorrow is the day for the next blood draw. He's been totally drug free (except his liver supplements) for 3 weeks now, so the number we get will be a true reading of what's going on with his liver. I don't even want to think about it, it makes me feel sick to my stomach to think about if it comes back still high. 
I should have the results on Wednesday afternoon or Thursday morning at the latest :crossfing:crossfing:crossfing:crossfing



coppers-mom said:


> So tomorrow is Toby's new blood draw isn't it? You will both be in my thoughts and prayers for good results.:crossfing:crossfing:crossfing:crossfing:crossfing
> 
> Hugs to you both (and Tiny and Tito and Pawmer too).


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## Kelbys'Dad (Jan 19, 2009)

:crossfing:crossfing from both of us that Toby does well on his test.:wavey:


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## TucAl (Sep 1, 2009)

Al and I are praying for normal results!


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## BearValley (Nov 30, 2008)

C'mon Toby, study, study, study for that test PLEASE!!

.


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## Dallas Gold (Dec 22, 2007)

Toby, we are sending good wishes and hopes for great blood test results for you! Your family wants you to be healthy and live for many many more years!:crossfing:crossfing


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## amy22 (May 11, 2008)

I just saw this thread...I and sending good thoughts and prayers that Tobys numbers come back perfect...please let us know....


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## GoldenCamper (Dec 21, 2009)

I really hope the liver supplements are doing their job and the results that come back make you


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## mikeynote (Jun 30, 2009)

Fingers, toes and paws are crossed!!! Hoping for the best for Toby!!!


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## hotel4dogs (Sep 29, 2008)

welcome back to the forum my friend! :wavey:




TucAl said:


> Al and I are praying for normal results!


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## hotel4dogs (Sep 29, 2008)

*Toby update*

Well, I got the results from his latest blood draw and they weren't what I had hoped for. Now I don't know where to head next. Toby feels fine (other than his back end being weak), eats well, still wants to play. The high liver values show up on routine testing, not for any symptoms.
Here's the email from my vet. I'm looking for opinions as to what you would do. 
I emailed back and asked my vet what he would do if it were his dog, and the second email is his response.
Thanks for any opinions or suggestions. Crying doesn't seem to help.

Email 1:
"...Subj: Liver values
You aren't going to be happy.
Alk Phos is 187 (was 176) which is an insignificant change.
ALT is 423 (was 476 in Feb, 512 in Jan) which I don't think is an impressive improvement.
The microalbuminuria is still >30.
Overall, not worse, but not much better. 
Soooooo...
We can do more work-up, ultrasound would be the next step. Or...
Use the carprofen to keep him comfortable, use Ivomec when and if we need it. 
I would definitely add the Duralactin and see how he does. 
I would like to recheck the values 3 weeks after starting back on carprofen and the 
Duralactin to make sure they aren't shooting up.
Let me know if you have any ???'s..."

Email 2:
Hate that question. Mixed feelings. Since he is doing well, I probably would go the carprofen/ duralactin route. I might consider another diet trial assuming ibd still our main differential. Ultrasound would be nice, but I probably wouldn't pursue biopsy or surgery, so value of ultrasound would be to rule out cancer (which i have a tough time buying since we've been playing with these values so long). Like I said, mixed feelings... There's no right answer .


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## coppers-mom (Jan 9, 2009)

If crying would help, I'd be of some use.

If an ultrasound is useful only to rule out cancer, I wouldn't do it, but I like to hide my head in the sand too.

Are there any supplements you haven't tried? The only one I know of is Sam-E and Milk Thistle (Denamarin) and I can't vouch for how well it worked since we only used it a couple of weeks.

I am glad Toby is feeling and eating well.


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## Dallas Gold (Dec 22, 2007)

I'm so sorry about this.

If it were me I'd probably go with the ultrasound, and the results of that would dictate how I would proceed. It's a very personal decision of course and I'm one of those that wants to know everything I can beforehand, good or bad. 

Please give Toby a big hug from his GRF friends and also extra treats today. Big cyber hugs to you too.


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## AmberSunrise (Apr 1, 2009)

I'm sorry the results were not as hoped. I too would go with the ultrasound, to help decide the course of action would be best to take. 

It is a personal decision and a hard one at that. 

Thoughts and hugs coming your way from CT


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## paula bedard (Feb 5, 2008)

Sorry the news was not any better. Hugs to you and Toby as you decide where to go now. If he's feeling fine and eating well, then life good, right? I don't think I'd have the ultra sound, what difference will it make really? It doesn't sound like you'd pursue the results if a tumor is found.

I know I mentioned this before, but Sam's last months of his life were spent having a wonderful rejuvenation period. Prior to September, he'd been through bouts with diarrhea, increased weakness in his hind end and had been diagnosed with a neuro condition, his arthritis was flaring, and his last check up showed he too had elevated Liver levels. We were watching his levels and tweaking his diet to try to bring his levels back to normal before discussing the next step, an ultra sound and what it might find, a tumor.

When we returned from our vacation to the Outer Banks that September, Sam started feeling better, eating better, having energy and enthusiasm about life again. He had a wonderful Fall and early Winter. His liver levels were holding steady so we continued with the special diet and let him enjoy his good days. I had a feeling there was something going on underneath, but I also knew that I would not put him through any procedures at his age. So, we just enjoyed him enjoying life...and he DID!

At the end, Sam developed pneumonia. An x-ray at the ER Vet showed that he also had a large tumor next to his heart. He showed no outward signs of illness. No pain, no severe weight loss, nothing. He'd been a perfectly happy boy enjoying the gift of a wonderful rejuvenation period... until the mega esophagus brought on by the neuro condition caused him to develop aspiration pneumonia.

Sam's end came blessedly quick and without pain. He was great on Thursday, a little off on Friday, Saturday's trip to the Vet found the ME, pneumonia, and tumor, Sunday we said our goodbyes, and Monday morning we helped Sam to the Bridge. It was a shock for our family. We thought we'd have more forewarning before we'd have to say goodbye, but for Sam it was a blessing.

I hope this doesn't depress you...it's not meant to. I've been where you are and know what you're going through. Hugs to you and to Toby.


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## hotel4dogs (Sep 29, 2008)

thanks everyone, you guys are wonderful.
I'm going to take a few days to decide what to do. 
Toby feels wonderful. He plays, eats fine, constantly begs for treats, etc. He has no symptoms at all of any problems except for back end weakness, which of course is totally unrelated.
But his quality of life is great right now.


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## GoldenCamper (Dec 21, 2009)

I'm sorry the results did not come back better  Personally, I would have the ultrasound done, just to get an idea of what, if anything, might be going on inside. As long as his quality of life is good, enjoy every day! Best wishes from here for you and Toby.


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## hotel4dogs (Sep 29, 2008)

after a lot of thought, some of it even rational (liver transplant did cross my mind), I think I'm going to wait until after the next blood draw (3-4 weeks) to decide what to do.
My thinking is this....his quality of life is excellent, he eats well, plays, etc. My vet doesn't *really* suspect cancer, because Toby has had an elevated liver enzyme (although not this high unless drug induced, his liver is very sensitive to drugs) for almost 4 years now. I think the stress of putting him thru the test might flare his mange, which, for the moment, is quiet. 
The ALT is the concerning value. It was 512 in January, 476 in February, and 426 this week. So the trend isn't up. I think I feel safe waiting another month to see if it continues the downward trend. THEN I'll revisit the ultrasound notion. My vet feels very strongly that a liver biopsy isn't a good choice for Toby, and he's NOT a candidate for surgery or chemo. So the test results wouldn't change anything that we are doing or can do for him.
We are going to adjust his diet, though, and see if it makes any difference at all. His asymptomatic IBD does cause his liver enzymes to go up, so if he's having an autoimmune reaction to one of the proteins in his diet that could cause a mild (although typically not this high) elevation of the ALT. That's what has happened in the past, anyway. It elevates it to about 300. 
Thanks for the good thoughts and the ideas. In another month, I'll be posting this all over again.....


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## Jackson'sMom (Oct 13, 2007)

Is Toby taking Duralactin now? My Jackson was on Duralactin for the last 4 years of his life, after his massively infected gall bladder was removed. Between the Duralactin and several other meds, and a low-fat diet, his liver values remained elevated but stable for the duration of his life. Duralactin is a milk protein, so I think it's pretty safe and without side effects.

Sending good thoughts for you and for Toby. My golden Toby was a very special boy, and it sounds like your Toby is, too.


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## Dallas Gold (Dec 22, 2007)

Barb, you really do have a lot of variables to consider with Toby and it sounds like you have undertaken a well reasoned approach to your decision. Between the mange, lack of spleen, immunity issues and IBD the decision is tough. I suspect your vet will agree your approach is a good one to take. I hope in one month you have more improvement especially with the dietary changes you are going to try.


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## coppers-mom (Jan 9, 2009)

hotel4dogs said:


> after a lot of thought, some of it even rational (liver transplant did cross my mind), I think I'm going to wait until after the next blood draw (3-4 weeks) to decide what to do.
> My thinking is this....his quality of life is excellent, he eats well, plays, etc.


I can sure understand the rational and irrational thoughts:doh:. the trend has been downward for his liver value and I hope that continues.

I am so happy his quality of life is still so good and he is feeling well. i just wish I had more knowledge and could make helpful suggestions.
the only ones I have are: Enjoy the heck out of him and the good times you are having.


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## Finn's Fan (Dec 22, 2007)

Barb, I think your thoughts about the next step are imminently rational. How wonderful that Toby is feeling good and his quality of life is excellent. Given his medical issues and what you already know you won't pursue, having everyone relax for the next several weeks and enjoy life seems a grand idea. Give the guy a smooch from me, please


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## hotel4dogs (Sep 29, 2008)

I have the duralactin here and ready to go, but I don't want to change 2 things at once in between blood draws. I added back his rimadyl, and we'll check in 3-4 weeks to see where he's at. The rimadyl does make a huge difference in his quality of life, so it was my first choice to re-introduce. The second one unfortunately will probably be the ivermectin if and when the mange flares up. Then probably fish oil, and finally the duralactin.


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## coppers-mom (Jan 9, 2009)

As you know, I am very careful about adding things to Copper's diet/regimen too. I agree to add back in the Rimadyl since you know it works well for him.

I hope you get some good weather and you and your crew can enjoy some special spring weather.


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## hotel4dogs (Sep 29, 2008)

Toby (and Tito) are anxiously awaiting the thirteen lined ground squirrels' reawakening from hibernation!!!


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## coppers-mom (Jan 9, 2009)

hotel4dogs said:


> Toby (and Tito) are anxiously awaiting the thirteen lined ground squirrels' reawakening from hibernation!!!


Now that brings funny pictures to my mind. I'll bet those guys have a blast with ground squirrels.:


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## Kelbys'Dad (Jan 19, 2009)

.......... sending good thoughts and a good ear scratchin' for Toby!:wavey:


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## hotel4dogs (Sep 29, 2008)

*slight but interesting change of plans*

Thought this might be of interest to some of the other senior dog people....my vet is adamant that I put Toby back on the Duralactin right away. That's very unusual for my vet to be adamant about anything in what we do with Toby.
He says that, according to the product literature, Duralactin "inhibits neutrophil participation in the inflammatory response". That might help with any part of the elevated liver enzyme which is caused by Toby's IBD.


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## clairer (Dec 27, 2008)

Lola & I are sending good thoughts..


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## Dallas Gold (Dec 22, 2007)

hotel4dogs said:


> Thought this might be of interest to some of the other senior dog people....my vet is adamant that I put Toby back on the Duralactin right away. That's very unusual for my vet to be adamant about anything in what we do with Toby.
> He says that, according to the product literature, Duralactin "inhibits neutrophil participation in the inflammatory response". That might help with any part of the elevated liver enzyme which is caused by Toby's IBD.


That is very interesting. I need to remember to ask my vet if Barkley can start this as soon as his final chemo session is over in 3 to 4 weeks. He is lactose intolerant so I'm not sure if the duralactin might cause those symptoms and smells...

Anyway, I really hope the addition of the duralactin will help with Toby's inflammation and elevated liver enzymes!


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## coppers-mom (Jan 9, 2009)

hotel4dogs said:


> Thought this might be of interest to some of the other senior dog people....my vet is adamant that I put Toby back on the Duralactin right away. That's very unusual for my vet to be adamant about anything in what we do with Toby.
> He says that, according to the product literature, Duralactin "inhibits neutrophil participation in the inflammatory response". That might help with any part of the elevated liver enzyme which is caused by Toby's IBD.


Goldencamper posted somewhere that Duralactin might help with IBD. It was a few weeks/month ago.

It sure would be wonderful if it (or anything else) helps Toby.:smooch:

I think I mentioned that it gives Copper major gas.:uhoh: Such a small price to pay for his improvement, but don't be surprised if it happens to you!


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## hotel4dogs (Sep 29, 2008)

as long as it makes him better, it's a very small price to pay!




coppers-mom said:


> Goldencamper posted somewhere that Duralactin might help with IBD. It was a few weeks/month ago.
> 
> It sure would be wonderful if it (or anything else) helps Toby.:smooch:
> 
> I think I mentioned that it gives Copper major gas.:uhoh: Such a small price to pay for his improvement, but don't be surprised if it happens to you!


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## GoldenCamper (Dec 21, 2009)

I will post that link again if you didn't catch it, the one saying its helps with IBD.
http://itchmoforums.com/write-a-pet-product-review/duralactinmicrolactin-t8379.0.html;wap2=

One websites description of Duralactin says it helps with IBD, must be catching on.

"Duralactin is an immuno-nutritional aid for the management of chronic inflammatory and musculoskeletal conditions, skin allergies, stomatitis, inflammatory bowel disease and bladder infections in dogs."
http://www.medi-vet.com/cat-PhyCox-6-9.aspx

The Duralactin site has the PDF's I'm sure your vet took a look at. I have read through them many times myself.

http://www.duralactin.com/techinfo.htm

I hope it helps Toby. FWIW, Tucker did not have a gas problem at all with it.


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## hotel4dogs (Sep 29, 2008)

Thanks Steve!


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## coppers-mom (Jan 9, 2009)

Hmmmm. Maybe something else is causing Copper's gas problems. It sure does offend my MIL, but I just ignore it. Copper is so impressed when it is a noisy one, that he looks back and checks it out.

thanks for the link Steve. Copper does have some skin infection issues so maybe it will help with that too.:crossfing

I hope all of our old boys do better and better. They all have such sweet faces. I lvoe them all.:smooch:


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## TucAl (Sep 1, 2009)

Been thinking about you and decision you had to make all weekend. I think you made good one - especially since vet is so adamant about the duralactin. I'm not familiar with it but I'll check it out to learn more -

Tucson (while always a "tooter") had really bad gas after his chemo - maybe he was on duralactin, I'm not sure. However, Al's face when Tucson did this was priceless! 

Hugs to Toby


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## Debles (Sep 6, 2007)

Sending good thoughts for Toby!


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