Recall Rocky and his problem? The crypto?
Well, he's been getting the fluconazole pretty close to every day. He hates it. He hates us. Well, he hates us because he believes that we're the reason for the nasty stuff being shot into his mouth with a syringe. Cold and nasty tasting. A refill was needed last week and the refill is from a different pharmacy. This doesn't need to be refrigerated and it would appear the taste isn't nearly so nasty. He's gotten five days of doses with hardly a blink. Instead of jetting out the door and away from us evil humans, we can put him back to the spot wherever we got him from and he lays back down.
The lump on his back is definitely smaller. But in the past two weeks, his foot blew up. Not literally, but figuratively. Then, last Saturday, it looked like a piece of it had been sliced off. Pretty icky looking. (The technical term we found out this morning is "granuloma".)
It didn't seem to bother him very much, not painful, he was walking and running on it, he didn't flinch when I put some Bacitracin on it, it didn't bleed, but there's something obviously very, very wrong. The only sign that it bothers him is he will shake the paw when he's walking. The only analogy I can think of is when you've got something stuck on your fingers and you try to shake it off. He does that with this paw. That only started yesterday. Monday, I call and make an appointment to see his doctor, who is the owner of the clinic. We were there this morning at 9:30.
He had gained a half pound since his last visit. That was good. But what wasn't good was that foot. The doctor said the lump on the back was somewhat smaller. That was good. But, again, that foot. Not good. The vet turned off the light and looked through a scope into Rocky's eyes. There are lesions. They don't affect his sight, but it's an indication that the fungus has spread. The good news is the weight gain, Rocky's heart and lungs sound good and he's in good spirits.
The vet said he's of the opinion that the fungus is becoming resistant to the fluconazole. That there's another one we can try, the same med that's in athlete's foot ointment. Terbinafine. He pulled in his Merck veterinary manual and looked up how this would work. The two meds taken together are synergistic.
Relating to the interaction or cooperation of two or more organizations, substances, or other agents to produce a combined effect greater than the sum of their separate effects.
"the synergistic interaction of mind and body"
So, Rocky will be getting a compounded (for those of you not familiar, compounding makes meds more palatable) terbinafine once a day and fluconazole three times a week. They're using a different company to get their meds from, no longer the rat bastards at Roadrunner Pharmacy, but one by the name of Diamondback Drugs. So, we wait for them to call us and we'll give them our credit card information and they'll ship Rocky's meds.
He also had blood taken for a antigen test to be done at an outside lab. This will give him a titer (the concentration of an antibody) of the fungus so he'll have a baseline for future information. If this combination of drugs works and there's a visible shrinkage of the foot problem, we'll know it's working. If there is no visible shrinkage, he'll get another titer test (in June) to see if he's gotten any better and take it from there.
The vet also mentioned the possibility that Rocky might need surgery to remove the toe, if it starts to bother him too much. He told us that the x-ray from last year (he pulled it up on the monitor) showed some deterioration of the bone. (We don't remember that being shared with us last year and I think it's something we would have remembered). But surgery is an option. It won't get rid of the crypto, but it will make Rocky more comfortable (if he needs it).
He kept repeating that we've done a good job. And he was really apologetic about the cost, he actually said that he wasn't trying to take advantage of us. We know that! We tried to stress that it's not a problem if it helps keep Rocky healthy and happy. If we can get him better, let's do it.
So, that was our morning. I took some pictures when we got home, just a warning, they're pretty high on the ick scale. But I know some might find them interesting. That pink area is just one toe. Clicking on a picture will take you to a bigger photo in my family album; clicking on that picture will open a larger photo.