I am doing my best to document as much detail as possible in hopes of identifying some pattern - something that leads to resolving this for Pinuki. The day before doubling the dose of Doxy, I began giving Nuki 12mg Proferrin ES http://www.emedicinehealth.com/drug-heme_iron_polypeptide/article_em.htm. It is a heme iron polypeptide supplement used for iron deficiency anemia. I have been using it for some time. The day I doubled the Doxy, I restarted Pinuki on Tramadol, 75mg two times a day. The day after doubling the doxy, I increased the 50mg of Diphenhydramine HCL (a.k.a. Benedryl) from twice a day to three times a day.
So, after I got through panicking the other day, I reviewed all the possible causes for the event. I was reminded that iron supplements can decrease the absorption of drugs such as tetracycline antibiotics (e.g., doxycycline ), so I am now giving the iron at least two hours apart from the doxy.
I am continuing the medication/supplement regimen detailed at the beginning of this post. Currently, Nuki appears to be doing better. She had two bad days - meaning she bled more and longer than, she had for some time. Yesterday and so far today, she has bled minimally. She still sounds congested. I know it is time for her next dose of Diphenhydramine HCL because nasal discharge and congestion sounds have increased "significantly."
The doxy definitely seems to help. When I first started giving it to her, I assumed that meant she has an infection that is causing the epistaxis. When I asked Dr. Saylor about this he said doxy has anti-inflammatory effects and that could be an alternative reason why it works. Why would anti-inflammatory medication reduce epistaxis? I have been noticing the last few days, Nuki's gait seems "off." Too hard to explain. I might try to video tape it. "Structurally" she seems off. It seems like she is trying to compensate for the lipoma on the left side of her neck - something is "off" about her left side. I would love to consult again with Dr. Canapp http://www.vetsportsmedicine.com/about/staff_scanapp.html, the vet who did Pinuki's orthopedic evaluation, but I just cannot afford to. Drs. Saylor and Canapp know each other. Is it appropriate to ask Dr.Saylor to consult with Dr. Canapp in behalf of Pinuki? I don't always understand the etiquette involved with all this.
If you are reading this today, to your right is a picture of Pinuki that I took this morning.
