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Chronic Tonsillitis: should I seek second opinion or pay for tonsillectomy?
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Member Since:
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26 August 2012 - 3:08 pm
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Hi everyone,

 Well Chloe has been off oral steroids for a couple weeks, and slowly getting off all medications.  She is still 'gulping', possibly slightly worse now that she is off steroids, but she is still eating/drinking/pooping/peeing/walking normally otherwise. She is just 'gulping' and licking her chops a little more than usual.  She is not 'frantic' like she was in May, but sometimes she looks uncomfortable and has mild 'episodes' of gulping again. She is a healthy dog otherwise.

Here's the thing: I've spent $3k on her foxtail/inflammation issue already: foxtail removal from under tongue (antibiotics, steroid shot), full body x-rays (no obstructions, everything healthy otherwise), endoscopy with tissue biopsies (no inflammatory bowel disease or cancer, only benign inflammation of stomach and tonsils, and tonsils looking scarred and slightly larger than normal) and for precautionary measures tried antacids (pepcid ac, prilosec), metaclopramide, sucralfate (possible ulcers), alprazolam (incase gulping was OCD development) for the better part of a month and a half.

She seemed to have slight symptom improvement with steroids, but long-term isn't possible since it can lead to other issues. I have tried looking up hollistic methods, but I am afraid of giving my dog something that is bad for her health. The only 'hollistic' thing I am doing that her vet is ok with is a small amount of raw honey with warm chicken broth. 

My thoughts on everything: Does she need to be on antibiotics if tonsillitis is bacterial related? She hasn't had her teeth brushed in a couple months (usually go to groomer for this, but she's been on so many meds I didn't want her to deal with potential stress, so I recently (today) started teeth brushing in case excess bacteria in her mouth is adding to the  tonsil issue)

Should I just pay for her tonsils to be removed? It would be another 2k from what I am estimating based on previous anesthetic/surgical procedures we've done in the last few months...Her vet seems to think this is the next course of action, but there is always the worry of 'what if this doesn't solve the issue'... I can't buy pet insurance at this point since it is considered a 'pre-existing condition' even if this surgery clears up her issue. 

There is a pet discount plan called "Pet Assure" and if I go to a different vet (that also has good reviews) I can get at least 25% off all procedures and costs. Wasn't sure if it would be worth seeing another vet or if Chloe's current vet would think badly of me looking for another opinion or a place where vet costs would be cheaper.  

I am just so frustrated this isnt going away.  My 'savings' are dwindling and my parents are not willing to 'pour more money' into a dog. Between amputation and this 'foxtail/inflammation stuff' she has cost well over $6k in 2.5 years. I know it is just money and I do have over 2k to spend on this procedure but I just dont' know if she will be cured.  I am a full time grad student and trying to get out in a year and there are not many paying positions offered. Really I need to focus on finishing school (also costly) so I can get out and get a real job asap. Sorry for the long post, just all my thoughts are confusing me and I needed to write them down. 

I have also looked at doggie 'grant' programs, but some require the dog be in 'immediate' danger (like will die in 10 days without X procedure that will cost $Y) or a waiting period. I dont know!!!!! 

If anyone has any experience with seeing multiple vets or financial difficulties or anything relating to the above, please let me know!

-Nicole and Chloe

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog

San Diego, CA
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26 August 2012 - 7:17 pm
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Gosh, I'm sorry you are having to deal with this. I never heard of a dog having to have it's tonsils out before. Before doing anything else, I think I'd definitely get a second opinion.

Do you trust your vet? Maybe he thinks this is the "next logical option" because he thinks you can afford it. I read an article once in a financial newspaper where they found that vets who thought you could afford the procedure only presented the most expensive alternative, but if you went in to the appointment with more of a "what are our options?" attitude (rather than a "I'll do anything for this dog!" attitude - which is really how most of us feel, so it's hard to come in w/ the former...) then they're much more likely to present you with various options.

Maybe you should post in "ask a vet"? Is this a common thing? Are there other alternatives?

Good luck and keep us posted!

Jackie

Abby: Aug 1, 2009 – Jan 10, 2012. Our beautiful rescue pup lived LARGE with osteosarcoma for 15 months – half her way-too-short life. I think our "halflistic" approach (mixing traditional meds + supplements) helped her thrive. (PM me for details. I'm happy to help.) She had lung mets for over a year. They took her from us in the end, but they cannot take her spirit! She will live forever in our hearts. She loved the beach and giving kisses and going to In-N-Out for a Flying Dutchman. Tripawds blog, and a more detailed blog here. Please also check out my novel, What the Dog Ate. Now also in paperback! Purchase it at Amazon via Tripawds and help support Tripawds!

On The Road


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26 August 2012 - 7:46 pm
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Wow, that's a tough one Nicole, and an expensive situation. I can't blame you for having your mind going in a million different directions. I'm sorry she isn't all recovered yet. 

When we are at a loss as to what to do, getting a second opinion, or even a third, makes all the difference in easing our indecisiveness and reassuring us we are making a good decision. You might pay a little more up front for the extra consults, but in the long run it could save you a lot of money. You may want to consider seeing an internal medicine specialist if you haven't already, and possibly a holistic vet, to get some different perspectives.

I wish I could be of more help. Rest assured you are an awesome pawrent, we totally get that Chloe isn't "just a dog" and why you want to find a resolution to this. We hope you get some answers soon. Keep us posted.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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26 August 2012 - 8:43 pm
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Tomorrow I will get a quote from her current vet about a tonsillectomy.  I don't think Chloe is at that 'critical' point where it is a 'you must do this or your dog will be suffering' since she is otherwise fine. I think I am just a paranoid pawrent and just want her to not be in any discomfort.

She is currently seeing an internal medicine specialist and when I called the vet office, I found that her internship time there is up and she will be leaving that practice soon. I think I will keep Chloe on the prilosec and honey regime for a week (that is what the vet specialist recommended as her last 'medication tapering' since she was on so many different kinds), and then if things change or get worse, call another vet and set up a consultation with their internal medicine specialist.  No matter what, she will be seeing a different specialist since her current one is leaving.  

Part of me wants to stay with the current vet practice since they all 'work together', but they are more expensive and don't have low income help. And like you said if I get another opinion and they say the same thing, then that's what I will have to do.  

Overall as long as her gulping doesnt interfere with critical functions like eating and breathing, I'm not too concerned, but  it will always be something in the back of my mind. And I wonder that if I go through with more diagnosics and procedures whether or not this 'gulping' is a side effect from having acid reflux and therefore affecting the tonsils or if it is just the tonsils and removing them removes the problem.  I would hate to have it 'remove' a side effect but not solve the problem. Too many circular arguments in my head!

-Nicole

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog

On The Road


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27 August 2012 - 7:21 am
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I think you are being a great advocate for her, you aren't being paranoid at all.

It's always good when you have a trusted relationship with your vet, but there are times when a second opinion will really clear things up. You are not being disloyal or suspicious of your doc by seeing another one. It's to be expected in situations like this any any good vet will understand. You may not necessarily want to look for one that says "We help financially distressed people" but a practice that is willing to work with you by presenting a range of treatments. If you haven't checked this out already, I encourage you to read Dr. Kay's book. I have a copy I would happily send you if you'd like:

Dr. Kay’s 12 Things to Expect from Your Vet

Good luck today, let us know how it goes.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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27 August 2012 - 2:42 pm
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In response to Rene, I just bought the kindle version, and will read it later today thanks for the tip!  You certainly always have a good tip up your sleeve no matter how many times I come back to the forums...

Update: I got an estimate from the surgeon today, the tonsillectomy would be anywhere from $1500-2500.  It would depend on 'how she looks' to determine the actual cost (if anything unexpected arose). Even though my estimate was right on, I feel better knowing that cost range rather than perpetually 'wondering'.

The only other potential diagnostic tests her specialist and I discussed months ago would be a $1500 MRI (to see if there is an obstruction outside the esophagus or trachea causing the gulping) or an ultrasound (cheaper than MRI) followed by potential removal surgery if anything was found. Or possibly another upper tract endoscopy to see if things have changed (another $2000ish). More anaesthetic procedures are of concern to me since she is 11.5 yrs old... I'd rather keep trying non invasive route as long as possible.

Funny thing is that she has been gulping less harshly in the last 36hrs, but some days seem to be better than others, so I don't want to jinx it! I've also tried looking up youtube videos to see if other dogs in the world had any similar symptoms, but I couldn't find anything exact. Other dogs with acid reflux problems seem to have kind of similar symptoms (which was her preliminary diagnosis), so maybe her body is just taking a long time to heal internally.

Like I said, this is her last week of prilosec (different than just pepcid) and on Friday I will call to give her specialist the weekly update. Since she is leaving the practice soon, I have prepared a whole lot of questions for Friday (like what if situations). 

My rambling thoughts: I keep going back and forth with trying to explain her behavior based on my limited knowledge and numerous vet visits (an online 'research'). My current line of logic (which tends to change with my mood it seems) is that she might have had some tummy issues in May, ate grass (and poo to get worms), then got the foxtail stuck under the tongue and in tonsils, which led to an endoscopy that revealed internal inflammation (possibly due to both acid/tummy issues and foxtail ingestion), and finally leading to a long recovery time for healing the inflammation and getting the tummy issues under control.  All of her other biopsy tests indicated no cancer or disease so I have no reason to believe otherwise.

I thought maybe her food was an issue, but she has been on this grain free food for almost 2 years (no recalls) and it doesn't have lots of fat or the controversial 'too high of protein' aka. too rich for older dogs (no idea what to believe on that front, but her food only has 25% protein thing rather than some foods that have almost 35%). I like that her food is salmon based so she gets the beneficial omegas etc... And the dog food advisor gives it 5 stars. To help mitigate large acid quantities produced in her stomach I recently started giving her 3 small meals a day with a little bit of mushy kibble, fat free chicken and brown rice.  Might add some canned pumpkin. I don't want to do an overhaul on her food just yet (aka switch) because I don't know if it really is her food or her age (and therefore would have acid issues on any other kibble). I also give her the same treats she has been given for over a year (trader joe's organic grain free chicken and rice sticks) and never give her table scraps.

I seem to write long essay posts...more for me to 'get out' my feelings than anything else. I know I have a blog for that too..sometimes this is just easier.

-Nicole

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog

krun15
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27 August 2012 - 4:30 pm
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Hi Nicole,

I'm sorry Chloe is having such a time.  I'm having a hard time imagining what you are talking about with her gulping. You sound pretty sure that it is a tummy issue, but here is a another idea-  has the vet(s) talked at all about it being laryngeal paralysis or a collapsing trachea?  I don't mean to complicate matters or put too many new thoughts in your head.  Tani has one or the other of those (need invasive tests to confirm one and I'm not doing that), when she has an episode she sounds like a duck.  I know, I know, she is a pug- but it is noticeably different.  In her case it is more of gasping than of gulping, and it seems pretty clear that she is not getting enough air.  So far I haven't done anything about it but get her weight down, and limit her activity when it is warm or hot and she has been fine.

Again- I'm not trying to second guess or give you more to worry about.  Before Tani had the first episode last year I had never heard of laryngeal paralysis (as a pug owner I knew about collapsing trachea), and Chloe's symptoms sound different.

I hope you can come to some resolution on Friday, let us know.

 

Karen and the pugapalooza


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27 August 2012 - 6:55 pm
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This is very odd!  Loki has stomach problems and must take pepcid as well as metoclopramide twice daily or he gags and urps up water but his tonsils are not enlarged.  Tonsils are lymphoid tissue and if they get smaller in response to prednisone then it sounds like it is indeed an inflammatory problem.  A tonsillectomy is not a routine surgery for a dog and may lead to post-op swelling or bleeding.  I would see what the second internist thinks.  I might be inclined to keep her on the antacid and give her a little more time to heal or even give another low-dose course of prednisone before I would go for an invasive surgery.

Pam

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27 August 2012 - 7:25 pm
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They are almost like weird hiccup/hard gulps. They are not hiccups though... She also tends to lick the roof of her mouth and then do this weird motion. 

This might be a better video, just put it together today, but this was taken July 25th. She gulps less now (I consider these 'episodes'), but it does tend to flare up more at night.

feature=youtu.be

She tends to lick and gulp more after she eats or at night when laying down, so I think she might have some stomach acid issues that irritate her throat causing the weird gulping? Though why her tonsils are scarred I do not know if it is from previous infections (no indicators from what I remember), from ingesting nasty foxtails, or from acid reflux irritation.    Chloe too was on metaclopramide 2x/day and that is also a possibility for going back on if necessary. 

Also, Pam do you know if it is OK to have a dog on prilosec long term if it does in fact help more than the pepcid? Or would it be best to switch back to max strength pepcid as an ongoing thing? I plan on asking her vet this question too before she leaves. I know that with humans prilosec is not good to be on long term due to the whole calcium deficiency thing, but wasn't sure if that was the same for dogs. Or if to counteract that to be on calcium supplement? 

But I will see what happens and consult a second specialist if things digress (only to where it was in May, not to the point of no return). They have been steady for the last couple weeks (some days better with nearly no symptoms, some days a bit worse, but on average better than in May. Still going back and forth about whether it was significantly better on the steroids or only slightly since her condition varies slightly day to day), but not fully resolved. 

-Nicole

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog


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28 August 2012 - 11:22 am
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I have not used Prilosec for longer than 2 weeks at a time in dogs but I would ask the internist.  I do know that our local internist said that there was no problem with keeping Loki on Pepcid and metoclopramide long-term but I should wean off the Pepcid if I was ever going to try and stop it (rebound gastric acid reflux is possible if you stop cold turkey).

Pam

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10 September 2012 - 11:05 am
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Very strange, but someone took my dog video off of youtube and put it on this website below...under cancer gallery? I am confused...

http://firstpos.....9-1.html 

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog

On The Road


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10 September 2012 - 11:42 am
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Well, it's gone now, I get a 404. Very strange indeed.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

On The Road


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24 October 2012 - 7:23 am
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Hey Chloe, what's going on? I hope you're feeling better!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Beth & Tucker
14
25 October 2012 - 2:54 pm
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Hi Nicole,

 

My husband and I are going through the SAME EXACT THING with our 2 1/2 year old golden retriever! I feel so badly to hear that you're experiencing the same frustrations and worries but happy to finally (after months and months of searching and researching) find someone that's experiencing something so similar.

We have been to multiple vets and several internists/specialists. We too have spent over $2,000 - the only thing we have not done yet is the endoscopy because that would be another $2,000. His bloodwork is normal, Abdominal ultrasound is normal, everything else is normal. This all started in the beginning of June - he would continuously lick and swallow air and hack/cough like something was stuck in his throat (during the initial part of the "flare up"/"episode" he would actually throw up a big pile of white foam and then food from licking/taking in so much air). They first started him on Prilosec and Zantac but things got worse after a day of being on it - took him to the emergency vet where they found his inflamed and enlarged tonsils - they took him off the Prilosec and Zantac and put him on Clindamycin (antibiotic "that should kick any infection within 2 weeks") and Metacam (Anti-inflammatory/Pain Reliever for 5 days) At first he started getting better, then 3 weeks to 1 month later he had another episode - we brought him back in, tonsils still inflamed, put him back on Clindamycin for 4 weeks with the Anti-inflammatory), then another episode happened.....saw the internist who was just as frustrated and confused as us (especially because other than extreme salivation/drooling, his energy level was absolutely fine and he's always been a ravenous dog - everything else was completely normal but this hard swallow and drooling). She went out on limb and thought it could be Sialadinits - inflammation of his salivary gland - which was causing excess drool which was in turn causing him to swallow a lot more which would lead to inflamed tonsils....the only treatment for this though is Phenobarbital (that anti-seizure med)..needless to say this didn't do anything and after a month and half we're still tapering him off of this. (They also have to do bloodwork to monitor his liver function b/c of this med).

2 weeks ago we brought him to Angell Memorial in Boston - again, they were just as confused and frustrated. We bought a very large and expensive bottle of Metacam, the anti-inflammatory, which we were told to try it for about 4-6 weeks instead of 5 days to see if this would help (even though it wasn't addressing the primary cause - all of the vets we've seen have agreed that it's 99% not likely that this is just primary tonsillitis - something is causing it - they had him scheduled for a tonsillectomy but while rounding one morning the surgeons and doctors didn't feel comfortable taking his tonsils out since all of them thought that the main issue/problem would still be there even after taking them out...). Needless to say, it's 2 weeks later and Tucker is still doing the hard swallow  - I called the vet and asked if I could try the Prilosec/Zantac regimen for longer to see if that would help - my thoughts here were that maybe he's had such severe acid reflux that it's affected his esophagus and tonsils? As a puppy he would vomit in the morning if not fed immediately and frequently thereafter. 4-5 days into the self-diagnosed acid reflux treatment he developed bad diarrhea. I immediately took him off of the Zantac and the Metacam. I now only have him on 1 20 mg dose of Prilosec/day and back on pureed meals..... Not sure where to go from here - just put another call into the Boston vet to see if I could keep him on Prilosec long-term and what type of food they would recommend for acid reflux? (He's been on Science Diet Sensitive Stomach)  

Please let me know your thoughts and keep me updated on Chloe!!!!

Beth & Tucker

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25 October 2012 - 3:39 pm
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Thanks for the input Beth. Please consider registering so your posts do not require moderation.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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