Hard work to make a miracle

Published 5:49 am Monday, October 25, 2021

It was a Christmas miracle.
I walked in the red room last year, just before Thanksgiving.
Tiger was pacing around the room and the owners were visibly upset.
Once a beautiful yellow lab, Tiger had been sent home.
The owner was somewhat incoherent, but I got the message that Tiger belonged to her husband who had Alzheimer’s. Indeed, I had written in the chart four years ago that they would be unable to comply with feeding recommendations due to the 82-year-old husband with Alzheimer’s disease.
The physical exam was not good. The nine-year-old yellow lab was thin, grade three of four tartar and his mucous membranes were white. There was very little pink that would indicate blood circulating. On top of that, Tiger seemed disoriented.
About the time, I finish talking to the owner and her son, I get the fax with blood work from the prior vet. The blood urea nitrogen, creatinine and phosphorus were all high. Whatever else Tiger has going on, he is in kidney failure.
I show them the gums and explain that kidney failure is just that, failure. I cannot fix kidneys and they will not fix themselves.
But they had heard this at the other doctor and what they are looking for is a miracle of sorts.
They want Tiger to live long enough that maybe his dad forgets who Tiger is. And while, I cannot fix Tiger there are several things that I can do to make his life better.
First, we needed a baseline of where Tiger is now and is there anything else going on. A CBC, chemistry, blood parasite profile, urinalysis, chest and abdominal radiographs start the diagnostics. After those results we did an ultrasound of the kidneys.
The primary purpose of kidneys is to filter and concentrate blood toxins into urine.
When the kidneys stop working, the toxins build up in the blood stream. When the toxins build up enough they affect brain function and cause disorientation and dementia.
Another function of the kidneys is to secrete erythropoietin which is a hormone that tells the bone marrow to make red blood cells.
Tiger’s BUN is 97. His phosphorus is 8.5. His creatinine is 6.6. But his real problem is that his PCV (packed cell volume) is only 16 percent. Normal is 37-55 percent.
He is positive for Lyme disease. His urine has blood and protein. Some pancreatic enzymes are also elevated.
With the owner’s understanding that the odds are not in Tiger’s favor, we start IV fluids, IV antibiotics and some vitamins.
Tiger’s overall attitude improves, but after a day or so he has had enough of the fluids and bites his line in two. At this point, we shift to subcutaneous fluids.
Since the treatment only takes half an hour, Tiger goes home to come back in daily for treatment. He has special antibiotics for the Lyme disease. I only send him home with a 10-day supply, because I am not sure he will live for the entire treatment.
In addition to reading up on kidney disease, I sit through an hour of continuing education to make sure that I am not missing anything that might help Tiger.
He also goes home on several medications. Epakitin is a phosphorus binder. It reduces the BUN in the blood. Azodyl is a probiotic that breaks down the urea nitrogen levels and keeps them from being reabsorbed. Tagamet reduces some of the stomach acid production and helps with the secondary gastritis. Medicine to help his blood pressure may be needed.
He also has a special diet that has less protein and therefore creates less waste products. The subcutaneous fluids are a form of dialysis.
Two weeks later, we repeat Tiger’s blood work. Tiger’s BUN is 33. His phosphorus is normal. His creatinine is 4.9. But his PCV is still only 20 percent. Normal is 37-55 percent. His pancreatic enzyme elevation is better.
We talk to the owners about starting Epoetin injections. They are very expensive. I cannot afford to stock them and they will have to be special ordered.
The advantage to the owner is that they are marked up very little, if any. The advantage to us, is that the owner prepays for the $500 drugs so that we have no risk. A low dose will be one vial per injection. Tiger gets three injections the first week and then once a week afterward. Tiger is doing so well that we reduce the SQ fluids to three times a week.
Two weeks later, we repeat Tiger’s blood work. Tiger’s BUN is still almost normal at 39. His Phosphorus is normal. His Creatinine is 4.3. But his PCV is 27 percent! Normal is 37-55 percent. His pancreatic enzyme elevation is normal.
But the biggest thing is that Tiger is acting normally. He even chased the deer out of his yard yesterday. He begs and sits for treats in my exam room.
The owners are beyond ecstatic!

I caution that he is not out of the woods and that he still has kidney failure. I also note that we could not have done this without them. Not only have they done all of his medication at home and brought him in religiously for his treatments, but they have allowed me to do any treatment or diagnostic that I suggested.
The other vet was not wrong. Most people would not have spent the $3,000 that it has taken to get Tiger to this point. Some would say they would, but then they wouldn’t pay for it, leaving the vet with big bills.
But in talking with the owner as I am feeding Tiger small treats, I learn the real source of Tiger’s miracle. The entire First Baptist Church of Greenup and Tom Melvin (pastor) have been praying for Tiger.
Not that I would discount the medicine and tests that we have done, but studies have shown that prayer does indeed help.

MJ Wixsom, DVM MS is a best-selling Amazon author who practices at Guardian Animal Medical Center in Flatwoods, Ky. GuardianAnimal.com 606-928-6566.