Just got this e mail - updated

[Sheryl]

I know you do...if there was a boat, we would both be in it!!

[fenn2006]

  totally and Nic  the funny thing is I bet our mutts wonder what all the fuss is about 

[Sheryl]

Hi,
 
A sample every 3 days varying times of day would be great, sorry its taken time to get an answer but this is an unusual case and the lab takes time to run the tests.
 
The results we had back today rule out kidney problems - there was nothing in the urine that was abnormal and the culture result was negative.
 
Basically we have now ruled out about 15 conditions that cause dogs to drink more than normal and only have 2 left:
 
1) Diabetes Incipidus (this is not the same as sugar diabetes that humans get) - it is a problem with the kidneys where they do not respond to a hormone called ADH which tells the kidneys to concentrate, or sometimes the body is not producing the ADH hormone at all.  Usually this is very easy to treat - they get eye drops a few times per day to give them higher levels of the hormone and you see a response the same day.
 
2) Primary liver problem - we can diagnosis this with the test that we need to repeat and by having a look at the liver structure with an ultrasound probe.  Our ultrasound probe stopped working over the Christmas period, we ordered a replacement on Friday and I am hoping it arrives today, as soon as it is in we can get her in to run the final tests.  The prognosis for liver problems varys with what specifically is wrong with it.
 
Normally it is better with conditions as these to get a diagnosis before treatment is started so that you don't miss anything, however it will take a few days for the lab test to come in again (usually 4 working days) and it is an option to start the diabetes drops and see what happens (if you think her quality of life is poor at the moment).  Have a think about it and if you want to start treatment let me know - I feel diabetes incipidus is the most likely diagnosis but the problem with this disease is there is no way to diagnose it so you have to rule everything else out first.
 
I hope the above helps, if you feel she has had enough and want to go with my gut feeling of a diagnosis of diabetes incipidus and start the drops with let me know.
 
Charlie Carnochan

I really want to go ahead with the drops but he seems to be telling me that he would prefer to do this liver scan and then try the drops.  We have waited this long that another few days isn't going to matter I guess.  I would hate to say yes, do the drops and forget the scan, just to find out it is her liver that is the problem.  Ye gads and little fishes

[*Jay*]

My vet suspected Brook had diabetes insipidus and I chose to start him on the tabs (hydrobendrofluazide if I remember correctly - the eye drops were not an option for us as it would be near impossible to get his muzzle on 3 times a day every day! lol) and the results were pretty instant. Had they not worked we would have done further testing but thankfully they did.  Big hugs for Holly 

[Beth]

Just wanted to tell you that i'm thinking of you.

[Magic Star]

It doens't really say a lot does it, maybe he will know more soon, thinking of you

[spanielcrazy]

Here's the way I read the second email:  He said normally you would diganose first before treating, but this isn't normal as you have a 4 day wait for the lab and who knows when for the probe.

He's suggesting that you can try the eye drops for the diabetes as you would see results within a day or  so according to Gill. He also did say that there was no test for it, so therefore, if the drops were to give results--that would be the diagnosis. I am assuming since he suggested trying the treatment on her that it will do her no harm if she does not have diabetes insipidus.

I would also think that if she shows a response to the diabetes drops, you may be able to forego the scan. The results would be back from the lab by then and you and he can discuss whether a scan or any other treatments or tests would be necessary.

I'd give it a go if I were in your shoes 

[louis mum]

Sorry Sheryl, only just got home from work, only just read this. As long as the drops wont do any damage if there are liver problems, I would have the drops. If any risk then i would personally wait.  Is this a normal veterinary practice Sheryl? I only ask because we were referred to the Small Animal Hospital run by the university of Liverpool as they specialise. Do you have such facilities where you are??

My heart goes out to you.  Thinking of you and Holly.

[Sheryl]

Is this a normal veterinary practice Sheryl?

I have no idea.   I spoke to Charlie today and she is booked in for the scan on Friday.  I know I could have gone for the eye drops in the meantime but speaking to him, he seems to want to do the scan and also the all day liver function test again simply because of the way Holly's gall bladder didn't respond to the high fat meal they gave her on the last test   Oh I don't know anymore, really I don't.  I thought what I was doing was for the best and now I think I made the wrong choice.  I know that the liver function results are 4 days to come back but I think that the ultrasound should be pretty obvious to see.  In that case, what I might do is wait until she has had the scan on Friday and if they see nothing untoward with her liver, then I will go ahead with the drops and if they do see anything that looks suspicious then I will wait for the function results before starting anything.  Poor baby.... and she is such a patient, regal old thing.

[jann]

  Poor you Sheryl, it's so hard to know what to do for the best isn't it?  I think you have to put your trust in your vet really though.

 I think you are doing the right thing for what it's worth, it's what I would do anyway. If she shows any deterioration between now and Friday then I assume you could start the drops ?

Thinking of you both 

[louis mum]

I think you are making the right choices Sheryl, its so hard isnt it.  With regards to the liver function tests, my Lou used to get rather stressed if left at the vets so we were allowed to take him in starved first thing in the morning, they took the blood straight away, we brought him home again, fed him as instructed and waited the time instructed then drove him back again to have the next lot of bloods doing. I dont know if that is an option for you, but it made it less stressful all round. 

[LucyJ]

No advice, but thinking of you and Holly 

[spanielcrazy]

  I thought what I was doing was for the best and now I think I made the wrong choice. 

I don't see this at all    There can be no right or wrong choice here as you don't have a diagnosis yet. If you and your vet are satisfied with what you are doing then that's all that matters. It sounds like you've made a good choice 

Hoping you can get some answers soon   [[[[hugs ]]]]

[*jean*]

It all takes time and patience.. Your vets seem a lot more helpful than some docs on the nhs.
 I hope it turns out to be something simple. how is she in herself?
 I wish you all the best and cyber hugs to you. Its AWFUL when you cany do anything you feel so helpless.
  cocker cuddles are good therapy! 

[Sheryl]

Aw thanks Jean and everyone else who has taken the time to write something for Holly.  She is ok I suppose.  She drinks, wees and sleeps but she is obviously in no pain so thats a blessing.  As I said before, she is very regal about it all.  She sits looking imperious but usually facing the wall as that is where she thinks we are   She is coping with the total blindness really well now.  These little dogs resilience is absolutely amazing   Last hurdle tomorrow anyway.  Either we will see liver disease or we will start drops I think.