hello everyone, i have been following recent posts from email notifications after signing up on this thread in July. i got confused because i think there are two Melissa T’s? or maybe it’s just more symptoms of the ways my brain has been not fully functioning right from stress levels.
i am sad to hear about dogs and owners going through health conditions, trying to help, and sometimes, the help, the medicine, causes its own serious medical problems.
the thing that is most frustrating for me about this is the way that many vets, not all, are kind of in denial of the risks related to adverse effects. There should be informed consent when giving a medication even when risk is believed to be small. The risks should be discussed with the owner so that they can know the risks they are choosing to take in advance, not to overreact if risk is small but just to be aware because their individual pet is not a statistic but someone they know well. The owner is the one who is at home with the dog 24/7 and knows that dog individually, and in that way, even though the vet has the training and education and clinical experience, the owner has experience with their individual dog and can be in a better position to know when something just isn’t right.
i deal with this with my own doctors too. i always search for doctors that are openly cautious about medications, and when they recommend them, they also address the risks and say something like “if you see anything that concerns you, call me right away.” i have mostly had the opposite experience with doctors, because that is their training and they believe it is the best judgement and want to reassure patients that they know what they are doing. Some are better than others at being collaborative with patients and pet owners.
in the case of Galliprant, it’s so new, there isn’t a lot of clinical experience with it, so no vet should assure a patient when side effects come up after being on the treatment for weeks, that it can’t be the medication that’s causing it, especially a new medication, but all medications are always being learned about and while there are statistical generalizations from pharmaceutical company research required by FDA for approval, those are still generalizations, not absolute universal outcomes, there are a percentages of dogs that have had adverse effects, or effects that are not understood, serious enough to be mentioned. when 10% of those they studied get diarrhea and vomiting, my dog could be one of those, because they don’t know what the risk factors of that are or how to predict that in each case.
When my dog’s vet really pressured me to give him Galliprant in mid July when i posted here before, we didn’t know what was wrong with him or what was causing his sudden stiffness and difficulty moving. i read over one of the posts and i had written that she, the vet, had said that in addition to having a painful spine, he also had a distended abdomen. We talked about her doing an ultrasound, a technician came in twice a week, and i was planning on having it done the following week.
As it turned out, i took him for his second acupuncture treatment with the new holistic vet, for his back pain, and she examined him and said “no acupuncture today.” She commented on his distended abdomen and said she would like to do abdominal x-rays. she did and she showed me that his abdomen looked abnormal, there was detail you can usually see that was not clear on his xray. she went over some different possibilities of what might cause that, there were about 4, one was heart related but as she said, he had just had chest x rays and exam at the cardiologist a couple of weeks before and that cause didn’t show up. We all three, me, regular vet and holistic vet, thought the heart would be the most likely cause because he has advanced mitral valve disease. She said the only other possibility that wasn’t ruled out yet was cancer of the abdominal wall. 🙁 so, that seemed to be the most likely theory, and she said get him in to see an internal medicine doctor ASAP to find out what is going on.
i got an appointment for the next day at the specialty clinic with an internal medicine doctor and she did an abdominal x ray, she said it looked like the fluid in his abdomen was related to heart dysfunction. His cardiologist was there and took over and did full cardio eval and said Zack had right side congestive heart failure and pulmonary hypertension, severe, and he said he could remove the fluid from the abdomen which would make him feel better, so he did that and said they removed 800 ml of fluid. wow, that’s a lot. poor baby. no wonder he was having trouble moving around and eating his food. After the fluid was removed, he began to gradually get more normal, he was put on a diuretic, furosemide (Lasix), and also pimobendan (vetmedin) which is a dog medication for the heart (no human version). my memory is confused, think there were just those two. Either that week or the following week he started sildenafil which is better known as Viagra, which can be used for pulmonary hypertension to lower it.
Zack gradually became more normal and is pretty normal now. for me, there was so much stress about giving him the medications, they definitely have potential adverse effects , the diuretic can damage his kidneys, etc, so i had to give it to him but not unambivalently, and my own stress level about everything probably played a part in me having a lot of trouble remembering which medication to give when, and also, i found sometimes i would give him a pill and later find it on the floor, and he would then not have that dose since i didn’t know which dose he didn’t swallow.
i got an app called Medisafe that someone told me about that helps me remember what time to give which pills. Gradually the level of crisis went down but for a long time, i was thrashed by it, and at the beginning of when Zack first got his symptoms, i went to a specialist doctor appointment for a spreading skin rash i had for many years, other dermatologists had not diagnosed what it was, and that day, right at the beginning of Zack’s crisis i was told i have a cancer, a cutaneous T cell lymphoma, and i was reassured that most people don’t die from it, and the treatments aren’t bad, and that day, i started having whole body light treatments three days a week, so that was going on while i was trying to find out what was wrong with Zack, seeing three vets, two of them multiple times, and also trying to research the cancer thing on the internet and not feeling very good about what i was finding, scary treatments. then i got my biopsy results, he had taken three biopsies and sent them to two top labs in other parts of the country and when they came back finally after two weeks, he said it didn’t show results that confirmed the cancer, and now they were calling it some unusual kind of psoriasis, and the treatment is the same so the light therapy continues, but that was a load off my shoulders, to help with trying to find out what was making my dog deteriorate with some mystery cause. it doesn’t mean i don’t have the lymphoma thing, but at least i don’t have to know that i have it for now. One of the lab reports said it was eczema and not the cancer, the other one just listed off a bunch of possibilities of what it was and did not include the cancer, or eczema either.
i only gave Zack the Galliprant one time. He had increased panting and it lasted all night when normally he would sleep throughout the night. Heart failure has panting as a symptom, but he had never not slept all night before, or since. i will never give him Galliprant again, partly because i don’t like any medication that is long lasting, Galliprant is 24 hours. i would rather give it more frequently, like 3X a day, i just feel safer that way, though not convenient.
If he gets osteoarthritis or other pain from the musculo skeletal system, that’s different, i’d have to consider it, but if i did give him an NSAID, it would probably not be a 24 hour one, and one bloody vomit, it would be back to the drawing board.
i don’t fault my vet for wanting to try Galliprant because Zack seemed to be sore and stiff, she gave me her best advice and she did not invalidate my concerns and i will continue to go to her if needed. But if i had it to do over, i wouldn’t have given Zack that one 24 hour dose, he didn’t even have back pain, it turned out. What he had, as far as i know, just guessing, could be made worse by Galliprant. So it’s good that i was so scared of it all along.
As some other people have mentioned, when a pet is sick seriously enough to need a vet, part of the stress for many of us isn’t just these helpless babies dependent on us to find solutions and get them better, but also it’s expensive, and that just adds to the stress. I have dog pet insurance for Zack, i pay $145 a month, and i paid a similar amount his whole life, even though he was healthy and rarely went to the vet, but i knew he had that mitral valve disease bred into him, his breed, almost 100% will get mitral valve disease and 50% die from it by the age of 5 ! 🙁 We have been so lucky, his wasn’t symptomatic until he was 11-12, and pretty mildly, until June of this year, he’s going to be 13 in a couple of weeks, i thought he wasnt’ going to make it that far when that vet said it might be cancer of the abdominal wall.
So, his vet bills for the month of July came to $2700 paid upfront as i filed a claim. they pay 80%, but it took a month and a half for them to pay it, yay, they paid the whole 80% but i didn’t know until then how much they would pay. So stressful. now i can pay off the Care Credit balance , relief.
it’s so good that there is a discussion site for this subject, because for the many who need meds like Galliprant in their efforts to help their dogs have good quality of life, it’s important to be aware of potential adverse effects and to know what’s going on, even when some vets insist it can’t be the medications. It’s discussions like this one that are informative in a way that isn’t learned in medical school, to help both doctors and owners work together even when at odds to have the best result.
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