ripley Posted October 25, 2007 Report Share Posted October 25, 2007 I think an atropine response test can tell you if there's a problem with the vagal nerve (which causes the syncope), so that might be worth investigating. I would also get an echocardiogram like others have suggested. I'm actually getting one for Yoshi next week. He has a low heart rate (48-60), but normal blood pressure, ekg, and bloodwork and no other symptoms. It's expensive, but will be worth it for me to know for sure if there's a heart problem. We also did the test for Addison's (ACTH response test), but the results were inconclusive (not normal, but not indicative of Addisons either). I think if your dog had Addisons and it was causing him to collapse, then he would also have abnormal blood work (i.e., imbalanced electrolytes). From what I understand, Addison's typically causes collapse by affecting the electrolytes (make sure the blood work included the sodium/potassium ratio). Let us know what you find out. I know how frustrating it can be to have all these tests done and still have no clue what's going on. Quote Link to comment Share on other sites More sharing options...
notailabigail Posted October 25, 2007 Report Share Posted October 25, 2007 Electrocardiogram= EKG, Echocardiogram= ECG I just happen to know this because I have had both done. Ekg is done with leads, and ecg is done using ultrasonography. The former takes just a few mins, the latter a lot longer- to get views of all the valves etc. Interesting, and confusing since when you google "ECG" you get a whole bunch of "electrocardiogram" results saying that it is called "ECG" or "EKG". Hunh. Quote Link to comment Share on other sites More sharing options...
kelpiegirl Posted October 25, 2007 Report Share Posted October 25, 2007 That's because electrocardiogram can be splelled either with a c or k- it is a german derived word. Interesting, and confusing since when you google "ECG" you get a whole bunch of "electrocardiogram" results saying that it is called "ECG" or "EKG". Hunh. Quote Link to comment Share on other sites More sharing options...
kelpiegirl Posted October 25, 2007 Report Share Posted October 25, 2007 I have had a test for vaso-vagal syncope- and let me tell you- getting an injection of Atropine ain't no walk in the park. I had a tilt table test done, and I was positive. The thing is, they strap you to a table, inject the A, and you and they watch your heart rate go up and up, and up... until, if you were like me, you bottom out and pass out. The nurses were excited that they had a "live one", and I just felt like a guinea pig. But, back to this Kelpie that has similar symptoms- exercise induced myopathy was the diagnosis. There is a vet in California I believe looking at supplements and diet change to help treat these dogs. This Kelpie was 6 before it showed up. I think an atropine response test can tell you if there's a problem with the vagal nerve (which causes the syncope), so that might be worth investigating. I would also get an echocardiogram like others have suggested. I'm actually getting one for Yoshi next week. He has a low heart rate (48-60), but normal blood pressure, ekg, and bloodwork and no other symptoms. It's expensive, but will be worth it for me to know for sure if there's a heart problem. We also did the test for Addison's (ACTH response test), but the results were inconclusive (not normal, but not indicative of Addisons either). I think if your dog had Addisons and it was causing him to collapse, then he would also have abnormal blood work (i.e., imbalanced electrolytes). From what I understand, Addison's typically causes collapse by affecting the electrolytes (make sure the blood work included the sodium/potassium ratio). Let us know what you find out. I know how frustrating it can be to have all these tests done and still have no clue what's going on. Quote Link to comment Share on other sites More sharing options...
Journey Posted October 25, 2007 Author Report Share Posted October 25, 2007 Thyroid Results are iffy... TT4 31 range 15-67 TT3 1.0 range 1.0-2.5 FT4 17 range 8-26 FT3 3.4 (L) range 4.5-12.0 T4 Autoantibody 19 range 0-20 T3 Autoantibody 4 range 0-10 TSH 22 range 0-37 Throglobin Autoantibody 5 range 0-35 - <20% Negative, 20-35% Inconclusive, >35% Positive Will wait to talk to Vet later today about results and schedule spleen x-ray (or whatever) and visit to UF for next week. Thanks for the info, ideas and thought everyone! Looks like he'll be holding down the couch for a few more days Karen ETA - appt at UF Monday, they have reviewed the file and actually want him scheduled with Neurology first. Quote Link to comment Share on other sites More sharing options...
Maizy Posted October 28, 2007 Report Share Posted October 28, 2007 Karen, I hope you get good results from seeing the neurologist. If everything checks out with the neurologist...maybe an ultrasound of the heart??? What does the spleen do anyway...I'm gonna have to look that organ up...how sad that I don't know what a spleen does. Anyway...good luck and I hope we hear good news from your end soon. Rachel Quote Link to comment Share on other sites More sharing options...
trailrider Posted October 29, 2007 Report Share Posted October 29, 2007 The T3 is too low for normal activiies. Since this is the active form of the hormone, it should be mentioned to have some replacement. The T4 is pretty well within range, so there may be some problem in converting T4 to the useful T3. That means synthetic thyroid would be no help, and T3 supplementation would be helpful - as cytomel or natural thyroid(armour) Quote Link to comment Share on other sites More sharing options...
Journey Posted October 29, 2007 Author Report Share Posted October 29, 2007 Thanks everyone for the good thoughts! Trailrider, I have the results from a Thyriod on him 4 years ago, that's why I said iffy on this one, things are off but ranges are different too...... Rachael, you and I both will get a crash course on the Spleen function I hear all about it but I don't know "what" it does exactly either. Off to UF in the morning and let me tell you this boy really stinks at "holding down the couch" much more of this and he may "eat" it Karen Quote Link to comment Share on other sites More sharing options...
Journey Posted October 30, 2007 Author Report Share Posted October 30, 2007 OK, here's the digest of today. He has a heart shunt. Yeah, ah sh** They are not sure where though. He's scheduled for a CT Monday, Angiogran if needed and if they can repair it with a "wire" instead of surgery they will. However, the CT is first so they can find it. We spent 9 hours at UF, they too were scratching their heads, even induced 2 episodes, the final test was a "bubble test" and that showed the bubbles going into the right side, out of the right side and then a moment later they were going where they shouldn't - into the left side. So, really no clue until the CT next Monday. Karen eta - on the paperwork it says - shunting of unoxygenated blood from right side of the heart to the left was seen. Quote Link to comment Share on other sites More sharing options...
Liz P Posted October 30, 2007 Report Share Posted October 30, 2007 Well, at least you know what is wrong now. Good for you for pursuing a diagnosis. It must be fairly small if they can't pinpoint it and he was healthy until now. Quote Link to comment Share on other sites More sharing options...
Journey Posted October 30, 2007 Author Report Share Posted October 30, 2007 Well, at least you know what is wrong now. Good for you for pursuing a diagnosis. It must be fairly small if they can't pinpoint it and he was healthy until now. Yeah, my concern now though is that it is getting worse. His BO is at 60. So, he's with me at work, in a crate. Everything is scheduled for Monday, Radiology, Cardiology and some other department. In looking trying to research this I found that UF is the *only* place that does this and they've only been doing it for a few years. He's going to get very familiar with a leash this week! This is going to be a long week. Karen Quote Link to comment Share on other sites More sharing options...
Liz P Posted October 30, 2007 Report Share Posted October 30, 2007 Yeah, my concern now though is that it is getting worse. His BO is at 60. So, he's with me at work, in a crate. Everything is scheduled for Monday, Radiology, Cardiology and some other department. In looking trying to research this I found that UF is the *only* place that does this and they've only been doing it for a few years. He's going to get very familiar with a leash this week! This is going to be a long week. Karen Yikes, that is low. UF is the only place that does what? Tufts repairs shunts and has several ways to do it depending on the severity and where it is. Quote Link to comment Share on other sites More sharing options...
Journey Posted October 30, 2007 Author Report Share Posted October 30, 2007 Yikes, that is low. UF is the only place that does what? Tufts repairs shunts and has several ways to do it depending on the severity and where it is. Sorry, in the SE that is. Not even the big specialty practices are doing this procedure. Karen Quote Link to comment Share on other sites More sharing options...
Lenajo Posted October 30, 2007 Report Share Posted October 30, 2007 What is BO please? Re the shunt: Do you mean he has collateral heart circulation that developed d/t a blockage, or something he has had for years? I would have guessed AV block as well. There was a run of this in obedience lines years ago. The dogs would get hyper or overexert and wham, they'd fall over in a faint. When they hit, the heart would restart and they would be fine again. Quote Link to comment Share on other sites More sharing options...
Journey Posted October 30, 2007 Author Report Share Posted October 30, 2007 What is BO please? Re the shunt: Do you mean he has collateral heart circulation that developed d/t a blockage, or something he has had for years? I would have guessed AV block as well. There was a run of this in obedience lines years ago. The dogs would get hyper or overexert and wham, they'd fall over in a faint. When they hit, the heart would restart and they would be fine again. BO - Blood Oxygen or the proper medical term is Arterial Blood Gas PaO2 - normal is about 100 - he's at 60 The shunt is not genetic. The exact wording they are using is - "We cannot tell where exactly this shunting is occurring but it is not due to a ventricular septal defect or an atrial septal defect, but is believed to be due to a intrapulmonary shunt". And it's new as in he hasn't had it all his life. The Echo was normal, they did not find anything on the Echo, it was the Bubble Test that found the shunt. Not sure what you mean by "collateral heart circulation" but what's going in the right is also circulating back into the left no blockages found. Quote Link to comment Share on other sites More sharing options...
kelpiegirl Posted October 30, 2007 Report Share Posted October 30, 2007 Wow- if it were me, I would be saying "leave it to MY dog to have something this serious!" Did you mean CO- cardiac output? If that is the case, I would really become very comfortable taking his pulse, and finding out from your vet was is too low - of course you can only estimate with pulse. If you are at all concerned- get him to your vet. Quote Link to comment Share on other sites More sharing options...
Journey Posted October 30, 2007 Author Report Share Posted October 30, 2007 Wow- if it were me, I would be saying "leave it to MY dog to have something this serious!" Did you mean CO- cardiac output? If that is the case, I would really become very comfortable taking his pulse, and finding out from your vet was is too low - of course you can only estimate with pulse. If you are at all concerned- get him to your vet. All this dogs life it's been "only you....can figure that out, DO that!" etc..... Oh my vet is very much aware and if need be I can call him at 3 AM. He's actually surprised that UF found it much less in one day. Poor boy is getting used to me taking pulse and opening his mouth everytime I let him out of the crate! Quote Link to comment Share on other sites More sharing options...
Lenajo Posted October 30, 2007 Report Share Posted October 30, 2007 ok, I know it as ABO - and no it's not the same as cardiac output. CO is a volume, ABO is a percentage - the oxygen % thats in the arterial blood. You can have great co and lowsy abo. Collaterol circulation occurs in the human heart when the body develops other routes for the blood around a blocked area. It "shunts" around to put it in non-md speak. We create artificial shunts when they "bypass" surgically too. I've never heard of the shunt described in an adult just appearing. Not saying it can't - but what on earth caused the body to suddenly have a "hey, send the blood the other way" moment? A clot? Trauma? Just weird. Quote Link to comment Share on other sites More sharing options...
Liz P Posted November 5, 2007 Report Share Posted November 5, 2007 How is he doing? Quote Link to comment Share on other sites More sharing options...
Journey Posted November 5, 2007 Author Report Share Posted November 5, 2007 How is he doing? He's at UF now and will be till Wednesday. Plan is to do the CT tomorrow and depending on what that shows they will go in and do the Angiogram and place the coils. However, I won't know anything until tomorrow. They did say that they have never seen anything like this in an older dog, just in puppies. And wanted to make sure there was no trauma recently. So, no news till tomorrow, thanks for asking Liz. Karen Quote Link to comment Share on other sites More sharing options...
Journey Posted November 6, 2007 Author Report Share Posted November 6, 2007 Great news! And not so great.... He sailed through the CT and the Angiogram. No cancer, no masses, everything looks very good Not so good....they could not find the shunts, yes multiple. The vets feel that he has multiple micro shunts and that they are trauma related. I can only think of 2 trauma's - he dislocated his shoulder almost 2 years ago and a year ago last July he got behind the dryer during a storm. The dryer incident very well could be the trauma - he moved it off the wall, ripped 2 toe nails off, chewed though the washer cord, you get the point....he's storm phobic. During both procedures his blood oxygen was 100 - they had 3 anesthesiologists on him and everything looked perfect. So, he has no coils and he has to have a lifestyle change. No more stock, out alone in the yard, no more fetch games. They, the vets also feel the heat exacerbated the issue so he may be better in the cooler weather. I get to pick him up tomorrow afternoon The nerd also has his whole neck shaved....he'll really fit the nick name "chicken little" now! Karen Quote Link to comment Share on other sites More sharing options...
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