The bad news first. Elevated liver enzymes, low albumin and protein. Needs to start hetastarch therapy in the AM. We had the option to start it tonight or get transferred to NC State or VSH tonight for more diagnostics. He needs to stay calm and relaxed and staying at the ER was not helping. Too much yelping and screaming. Going to state is not really an option as I promised Nixon never again.

VSH is the best money can buy. Very few hospitals have the capacity that VSH has.

There is no mass felt but he needs an ultrasound first thing in the morning. He has been asking for high quality protein and that is what he will get tonight as per vets orders. No more previcox either so I hope he is not hurting too bad. He ran laps around the living room when he saw he was going for a ride. Like I said, mommy hunch. We could I've caught this earlier if I had questioned his weight on Wednesday. On the chart, they put 65 lbs. It should have been 56. Nope. He is at 70 lbs today.

Sally, we got sent home to keep him relaxed and quiet.  That wasn't an option at the ER.  I had the option to take him to VSH which is an amazing hospital, but it also might stress him out. He needs to stay off his feet to keep from stressing his wrist any further.

We'll probably head to his old vet an hour away in the morning because he is an internist and can do the ultrasound without calling someone in.  He still sees Nixon twice a year for his thyroid issues so we do stay in touch. 

My understanding is the therapy is given via IV and helps the blood reabsorb the fluid. 

He had a great appetite tonight when I gave him dinner.  When he heard the can of chicken breast open, he almost dashed into the kitchen but my husband encouraged him to stay put. 

Now Cookie is off her food too and I am not sure why.  She's do for her wellness exam this month anyway so I'll have a blood panel pulled on her too in the AM I think just so I can be sure that they're not being poisoned by something in the house.

Thanks for all the thoughts and prayers.  It helps so much to know we're not alone.

So Nixon went to an internist today who was not happy with anything the ER Vet did.  More tests needed to be run before doing an ultrasound.  I had Nixon fasting so we were able to do a bile acid test.  results won't be back until noon.  The 10th is also Nixon's ampuversary.  We're 23 months today!

The extra weight in his belly is impacting his balance.  I'll try to snap a picture of him so you can see what's going on.  His strong core is just blown away by the 10+ inches of swelling.  I measured his waist today and it was over 32 inches.  Poor boy.  But, he's moving a bit better and is on no pain meds right now.  We debated to give him tramadol but with his balance so impacted by 15 lbs of fluid in his belly, we decided to wait and see.

The bile acid test requires the dog to have fasted.  You pull blood, feed them, and then 2 hours later, pull blood again.  So, the woman who cared for Nixon today, I already forgot her name, was incredibly sweet.  When she brought a can of Venison out for him, he was all ears for her and licking his lips.  He ate the entire thing with great enthusiasm. 

He still had to pee on everything and socialize with everyone too.  He gave out lots of snuggles.  He was a bit stressed out and one of the cats took a liking to him and stayed with him a good portion of the morning.  Whenever Nixon needed to relax, he sniffed the cat.  I left my phone in the car so I didn't get any pictures or video!

So for the results of the test...this will check how his liver is actually functioning and if its recycling the bile like its supposed to.  If it isn't recycling, not much they can do for him.  If its recycling the bile, he has liver inflammation and then we have to figure out from what.  So tomorrow, he is probably getting an ultrasound, maybe a fine needle aspiration of his liver and/or lymph nodes, his abdomen drained (which worries me), and possibly surgery to go look at his liver and biopsy a piece of it.

After the fun today, we did swing by McDonalds and got a McDouble plain, hold the bun.  We grabbed one for Cookie too.  She's an absolute mess.  She hates being separated from Nixon.  We're checking to see if any friends can arrange a play date for her this week so she can feel special and just have fun being a dog.  Her bloodwork will be in tomorrow around noon too.