Just got back from seeing Dr. Walthall, and it was a busy morning for Penny. A little confusing, too since Penny is a new foster with a new rescue group for both me and Dr. Walthall; we're navigating the waters together, but it's a tad uneven while we work things out.
First off the good news. Penny's weight is up from the original 7.3 lbs she weighed when we picked her up from the clinic on Friday, July 29. She's now at 8 1/2 pounds. So that's the really good news. Like I expected, the muscle mass issue will just have to increase over time with good food since there's no way to really exercise her in this heat. Nothing insurmountable here...just time consuming.
Also, there is definitely not a heart murmur which is good news, since it was possible her congestion and breathing could have been masking one. Since the antibiotics have helped clear her up, Dr. Walthall said she can hear junk in the lungs, but the heart sounds good.
Now the not so good news.
A look at Penny's limp indicates a problem with her left elbow. Lots of grinding upon manipulation, that makes Dr. W think there was an old injury/trauma that's caused it. The current treatment will be Phycox soft chews every other day with a dose of Metacam once a day for pain as needed. Since there seems to be little pain involved with this right now, I will probably wait a day or two and see what happens with the Phycox supplement (this is a Glucosamine supplement). Once we see how this works we'll know more of the direction to take. There is an injection (Adequan) that can be given, but first we'd need x-rays to see just what is going on there. This isn't an urgent problem, so we'll treat the symptoms right now.
Penny's infection is just about cleared up. I have another 10 days of Clindamycin here, so she'll have a total of 24 days. That should take care of any lingering infection that may be contributing to her cough.
Which brings us to what needs to be done first and foremost...heartworm treatment. We know Penny is Stage 2 HW+ (adults, no babies), and she received her first dose of preventative on Friday, July 5. Dr. Walthall has prescribed her heartworm preventative every week or two weeks for the next 2-6 weeks and at least one follow up injection of immiticide. I'll get with Linne and we'll figure out how to tackle this. Penny will have to test clear before any surgeries are scheduled.
Once that's accomplished, the oronasal fistula and spay can be considered. One interesting thing to note is that just because there's a hole in the gum, it doesn't necessarily follow that there will be an infection. It's possible that Penny started with a URI, but because of the fistula, the infection settled in good in the sinuses.
Dr. W feels another vet could handle a flap surgery better than she could, but again, the heartworms have to be cleared up first. This makes sense, and Penny can always go back on Clindy for a while to clear up an infection if another one shows up before surgery is done.
I think this covers it for now. Once I get with Linne and we map out the heartworm treatment, I'll post another update. For now, everything else looks pretty good so we'll just keep on keeping on.