Sundae

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LAWomans
"Live Long and Prosper"

Post   » Fri Sep 14, 2007 3:52 pm


Update on Sundae.

I took him to Dr. Kanfer 2 weeks ago because he was dragging one hind leg. He didn't have any symptoms of a stroke, just was weak in his right hind leg. He was still eating, peeing, pooping, etc. He had a fever and she said he probably had an infection in his mouth, which smelled bad. She prescribed Baytril and Doxie since they are the best antibiotics for bone and muscle infections. Sundae tolerted them very well. No soft poo or loss of appetite.

Then Dr. Kanfer mentioned he may have scurvy. Given his past history he probably didn't get sufficient vitamin C since he wasn't eating much and the previous owner obviously didn't supplement him. I had been giving him some C in his Critical Care but not enough.

I started him on 1cc of vitamin C twice a day and I swear it was like a miracle drug. He can walk normally again and has been slowly gaining weight. He is trying to eat more pellets and hay along with his syringe feedings, so his mouth doesn't seem as sore.

This makes me wonder if scurvy has been a problem all along and that his teeth are secondary because they were too sore to chew hay and pellets, so developed hooks.

He is still too emaciated to have his teeth done and he has to gain more weight before Dr. K will do them.

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snowflakey
E's Moriarity

Post   » Fri Sep 14, 2007 4:43 pm


Poor ol' Sundae. I'm so glad the vit. C is working its magic. I hope he's feeling a lot better.

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Mum
I GAVE, dammit!

Post   » Fri Sep 14, 2007 5:03 pm


This makes me wonder if scurvy has been a problem all along
This is highly unlikely as you know. He had several months here with plenty of C.

It will be hard for Dr. K to do a proper diagnosis without either seeing that xray or redoing it.

Ignoring that mass on the xray makes no sense to me.

Have you even reminded Dr. K. of the existing xray showing a mass?

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LAWomans
"Live Long and Prosper"

Post   » Fri Sep 14, 2007 5:30 pm


Mum, I'm confused. You told me many times that I don't need to feed extra C unless a pig is sick and that pigs don't really need much and can get what they need from the greens. How much extra C was Sundae getting?

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Mum
I GAVE, dammit!

Post   » Fri Sep 14, 2007 5:44 pm


Sundae came in with no signs of scurvy. I gave both pigs 50mgs of C daily for the first week they were here, just in case (as I do with all new pigs.) This was back in March. I continued to give Sundae 50mgs of C for several months.

In addition they had plenty of fresh veggies, giving them adequate C.

I'm sure he's had adequate veggies since he's been with you, and I wonder whether the addition of extra C was coincidental with his recovery or whether he has developed an absorption problem.

Scurvy, as a main diagnosis, is not where you want to go, and I'm really surprised that Dr. K. even made this suggestion, given his history.

Without all the facts, Dr. K cannot of course make a proper diagnosis. I suspect that she has forgotten, or been told to ignore, the xray I had taken showing the mass. This really isn't fair to either Sundae or to Dr. K. now that Sundae is coming up with other issues.

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Lynx
RESIST

Post   » Fri Sep 14, 2007 5:57 pm


It was likely coincidental that you saw improvement (normal improvement or something else you did caused it).

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LAWomans
"Live Long and Prosper"

Post   » Fri Sep 14, 2007 7:14 pm


Dr. Kanfer has been informed about the mass, but we both decided it was in Sundae's best interest to treat his symptoms, including his enlarged heart. He had the teeth problems and bumble foot in March when she first saw him. Who knows when the scurvy started. I don't know how long it takes to develop. All I know is that he is so much better with the added vitamin C, which is the only thing we changed. He really can't eat enough greens to get it from them, although he does try.

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Mum
I GAVE, dammit!

Post   » Fri Sep 14, 2007 11:24 pm


He had the teeth problems and bumble foot in March
She must be thinking of another pig - he never had bumblefoot, or any other issue regarding his feet.

Teeth issues were the least of his problems, and were ruled out on his examination with Dr. K. in March. Prior to that visit he had seen Dr. Beeder, and neither of these issues were present in that visit either.

He was eating plenty of greens for the 4 months he was here (along with pellets and hay), so I can only assume that the teeth issues arose more recently. Appetite, or the ability to eat, was not one of his problems.

As I have told you several times, Dr. Beeder did not diagnose an enlarged heart. It was my impression from looking at the xrays that it was enlarged, but I have never put a pig on heart meds without having an xray confirmed by Dr. Ridgeway.

As I said before, it's only fair to both Sundae and Dr. Kanfer that you get a new xray so that a reasonable diagnosis and treatment plan can be made.

Treating his symptoms is clearly the right thing to do, however, I have the distinct impression that you have Dr. K. struggling for a diagnosis, rather than looking at the existing xray or informing her that a mass has been seen.

This whole issue leaves me totally confused. When you adopted Sundae you were well aware of his medical issue - and I gave you full access to the tests I had done at Dr. Beeder's office and to his health record for the period that he was here (at least 4 months prior to your adoption, as well as the previous year when he came into the rescue). It saddens me that these discussions have come to this point.

My only concern has ever been that Sundae receives the most humane care - which he deserves.

I, personally, am saddened that you seem to have another agenda regarding this whole issue. I can only hope that, in spite of this (whatever it may be), that Sundae continues to receive the best possible care.

As you know, I will happily take back any animal I have adopted out at any time.
Last edited by Mum on Fri Sep 14, 2007 11:47 pm, edited 1 time in total.

klynne

Post   » Fri Sep 14, 2007 11:44 pm


"it's only fair to both Sundae and Dr. Kanfer that you get a new xray so that a reasonable diagnosis and treatment plan can be made."

I'd have to heartily agree with this. Is money an issue? Not trying to be snotty, just wondering if that is why you've not already done the newer Xrays.

I'm getting confused at this point.

There is what appears to be a definite mass on the Xray that was posted before.

When I worked for a vet, and we knew a mass was involved, any deterioration such as loss of hind leg strength or mobility was always suspected to be related to that mass, either due to pain, mets from the mass, or organ system failure.

We ruled that out first, and attempted to treat the primary issue, rather than casting about for other issues. (Not that we didn't always do a complete physical exam, as well--we did.)

Yes, animals with tumors can and do develop concurrent issues. It's just you always have to keep the progress of that tumor first and foremost in evaluating everything else, and the animal's overall quality of life.

I'm not sure I ever saw your answer as to what Dr. Kanfer said upon viewing the Xray that Mum had done?

It seems that would be a good baseline, for a current Xray, and would help clarify things.

Please do keep us posted. I'm really attached to Sundae, feel like I know the little dude.

HollyT
Get on your bike.

Post   » Fri Sep 14, 2007 11:53 pm


Confused here too. I'm sure it's related to the tumor. Get another xray and see what's changed.

ChunkyPiggies

Post   » Sat Sep 15, 2007 2:19 pm


Growths/tumors can change VERY rapidly. Xrays sounds like a must at this point. An ultrasound by a specialized imaginary vet will also be helpful but expensive (because of the location of the tumor and the structures of concern in the area).

Piggie has a growth/collection of crystals that tripled in size and ossify in a matter of one week.

klynne

Post   » Sat Sep 15, 2007 2:47 pm


"by a specialized imaginary vet"

*sprflt*

Okay, I KNOW you meant "imagery vet," but I *like* your term so much better ;-)

Well, darn, when I saw the thread bumped, I thought we might have more news on Sundae.

I'm really interested in seeing the new Xrays, and hoping his mass isn't worse.

ChunkyPiggies

Post   » Sat Sep 15, 2007 2:55 pm


Oh darnit.. yes, I meant imagery.

Oh god... I had just sent out an email to half the class referring to our radiologist as an "imaginary specialist". AH!

klynne

Post   » Sat Sep 15, 2007 3:35 pm


Well, in fairness, our exotics vets around here are more imaginary specialists than real-life ones ;-)

(Wonder if your email will end up on one of those grammar error sites?)

Pigginess
You are my sunshine

Post   » Mon Sep 17, 2007 3:24 pm


I know that you are going to extraordinary lengths to save Sundae. However, given the fact that there was a previous diagnosis of a tumor and x-rays to support that I’m confused that this is not incorporated into the current treatment plan.

That tumor is likely the reason he is not gaining weight and also affecting all of the other current symptoms that you are addressing.

Personally I find it hard to believe that any reputable vet would choose to ignore the tumor and deal only with the current symptoms.

I recall you saying that you could get an ultrasound for a discounted price. I think the best thing for Sundae and to help Dr. Kanfer’s accurate diagnosis and treatment of him is to have one done on Sundae. It would be most helpful if Dr. Kanfer also had access to the previous x-rays that Mum gave you so that Dr. Kanfer could compare the results.

I hope you keep what is the highest and best good for Sundae as your foremost goal.

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LAWomans
"Live Long and Prosper"

Post   » Tue Sep 18, 2007 2:48 pm


I would like to thank all of you who really care about Sundae's well being. I know all of your kind thoughts and prayers are helping.

In all fairness to Dr, Kanfer, we were reading Sundae's file not some other pig's. In March, on his first visit, it specifically shows her drawing of his teeth and the hooks and that he had bumblefoot which was included in another drawing. There are two paragraphs of notes including that he was supposed to have supportive care until he gained enough weight so he could get his teeth done, which would have included syringe feeding him. It was noted was underweight but not emaciated like he was in July.

I told Dr. Kanfer about the x-ray and tumor when I first saw her and we have discussed it at every visit. She was not able to palpate it and still can not. We have discussed it at length and the treatment course. There is absolutely nothing that can be done for a tumor since he can not undergo surgery. Since I can't afford an x-ray at this time, we decided to treat his symptoms. He has had blood work which came back normal.


Dr. Kanfer diagnosed him with scurvy, and since he has responded well to the extra vitamin C, it would seem this is a good diagnosis. Because his case is so severe, the damage has already been done to his body and this can not be repaired. However, he is not in pain, gets syringe fed 3 times a day and is now eating some hay on his own. Scurvy takes a long time to get to this stage so I would imagine the person who adopted him was not following the feeding guidelines she was given when he was adopted from Cavy Love.


I hope this puts all of you who were concerned that we were ignoring the tumor, at ease.

We are doing all we can for Sundae.

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Mum
I GAVE, dammit!

Post   » Tue Sep 18, 2007 4:00 pm


In all fairness to Dr, Kanfer, we were reading Sundae's file not some other pig's. In March, on his first visit, it specifically shows her drawing of his teeth and the hooks and that he had bumblefoot which was included in another drawing.
She certainly said he had a couple of hooks, however this didn't seem to be the reason for his weightloss. The bumblefoot is a new one on me. If this had been the case you can be assured that I would have mentioned it in the thread. And of course I would have been treating it. Had I not treated it, and it was bumblefoot, it would not have healed on its own.
I told Dr. Kanfer about the x-ray and tumor when I first saw her and we have discussed it at every visit. She was not able to palpate it and still can not.
You specifically told me that Dr. Kanfer said he did not have any tumors - and, you have told me several times that you yourself do not believe he has one. You believe the xray I had done is 'bad.' Earlier in this thread you said:
Actually, he does not have a tumor or any growths,

Unless the mass is causing an absorption problem, you need to understand that scurvy is not an issue here. He was with me for 4 months, during which time he ate very well - and never, showed any signs of scurvy.

It concerns me that any vet would go in this direction, given the fact that for the past six months his diet has been excellent. If further bothers me that she wouldn't at least insist on seeing a previous xray so that she can see where this mass is.
It was noted was underweight but not emaciated like he was in July.
He was extremely emaciated when he saw Dr Kanfer in March (see the pictures earlier in this thread). He weighed 1lb 8 ounces. His weight fluctuated both up and down over the next 4 months, and when you offered to care for him when I was away in July his weight the day he left here was 1lb 6.7 ounces.

It's fairly obvious that you still don't believe there's a tumor involved here. This really doesn't matter, however - as I said before - it's very important that Dr. Kanfer has the full picture, including his previous xray, if she's to devise a proper care plan for Sundae.

To clarify - you have known since I have that Sundae has been diagnosed as terminal with a tumor. I have always told you that his time here is very limited, and that my plan was to give him the best supportive care possible. You took him into your care with this information made quite clear.

I'm disturbed by the veiled criticisms - or rather arrows - that are being shot in my direction, and I can only assume they come from some agenda which has very little to do with Sundae. However, the medical forum is no place to discuss this issue, so feel free to email me if you feel the need to expound further.

klynne

Post   » Tue Sep 18, 2007 7:01 pm


"I told Dr. Kanfer about the x-ray and tumor when I first saw her and we have discussed it at every visit. She was not able to palpate it and still can not. We have discussed it at length and the treatment course."

Okay, I am glad you came back to discuss this as we're all anxious to hear how Sundae is doing.

But, this is still confusing. You *did* clearly argue at one point in this thread (quoted above) that Sundae had no tumor. Now you say you informed Dr. K at the first visit.

If Dr. K knows about the alleged tumor, why would he/she then not want to see that Xray? This I totally do not understand.

"I would like to thank all of you who really care about Sundae's well being."

Do you truly think anyone reading this does not care about him?

Whatever else is going on with you, I do hope it can be put aside, for Sundae's sake.

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LAWomans
"Live Long and Prosper"

Post   » Tue Sep 18, 2007 7:04 pm


Mum, I want to apologize if I offended you or upset you or anyone else with my posts. I have a different philosophy about animals and health care and it came across differently than I intended. I didn't intend to point fingers or criticize. I thought I was just reporting what was said and observed.

I hope everyone will understand and forgive me.

I won't be posting about Sundae any more. If anyone wants to know how he is doing, they can e-mail me directly.

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Mum
I GAVE, dammit!

Post   » Tue Sep 18, 2007 7:15 pm


I have a different philosophy about animals and health care
I doubt it. My concern for Sundae, as I said when I gave him to you, was that having done the diagnostics my plan was to keep him comfortable for as long as possible.
I thought I was just reporting what was said and observed.
The facts here are in question. One thing is said and then another.

Bottom line, Dr. Kanfer needs to be aware of the existing xray. If she hasn't asked to see it, then she's not the vet I thought she was. A diagnosis of scurvy is always suspect, particularly as you and I both know that you and she said there are no tumors (based on your previous posts).

If any vet looking at a pig in this condition said there were no tumors, merely based on physical inspection, I'd be highly suspicious as to that vet's capability.

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