My 13yo Newfie mix , in the last 6 weeks he has lost weight about 7#, he would sometimes skip meals, even when we put the high value stuff on top. In the last 2 weeks he has had 3 episodes extreme lethargy after vomiting, these last about 48hrs and he will avoid food, he eventually drink some water, and after a few days get to his normal self. He went to the vet after second episode, where labs showed a microcytic anemia with Hg in the 10s,borderline low platlets, normal WBC. ALT and Alk P were 4-500s with normal Bili. Remainder of chemistries, amylase, lipase, FT4- all WNL. AFAST showed splenic lesions, no free fluid. A abdominal US was recommended, (that was scheduled 2 weeks out). This was a week ago, the Vet prescribed flagyl and probiotics. Leaving the vet he began vomiting in the car and and was again lethargic (his 3rd episode) when he began taking food and fluids we started the ABx, and started calling around to get him an urgent Abd US, which he got on Friday. The report was notable for a distended thick walled GB with organized non flowing bile sludge with hyperechoic mesentary, c/w decompensating gallbladder mucocele. Emergency cholecystectomy recommended. This was Friday afternoon, and the only place that had surgical capabilities was not open untill Monday morning. As he was otherwise doing
OK, I took him home and waited out the weekend. He remains on the antibiotic/probiotics, he has been getting small portions of rice and boiled ground turkey, carrots green beans.
I contacted the animal hospital this morning to get him evaluated for surgery ASAP. When I followed up they told me they reviewed referral and surgery was not going to be seeing him, rather a referral to internal medicine. I’m an internal medicine doctor, and from all the reading I have done this looks like there isn’t much in the way of effective medical management, in his situation. If he can’t get surgery then he has a terminal diagnosis, but what should be my expectations going forward, besides low fat diet is there anything else I should be doing. My thinking is next time he has an attack, that a visiting vet for euthanasia should be called, because if he ruptures his gallbladder, I don’t want him to suffer from bile peritonitis.