Tuesday, May 24, 2011

Another One Bites The Dust

Once again, apologies for the doom and gloom. I had a great upbeat post planned about kittens but circumstances have interfered and I can't do it right now.

Several things to update and share. I'll try to make it chronological rather than in order of importance simply for the necessity of logical thought.

Friday was yet another day from Hades. I walked in to find a 1 year old MinPin flat out on the table. He had been dropped off for vomiting and bloody diarrhea. Immediately set to work on him, somehow got lucky and got a blood sample but couldn't get an IV catheter in therefore left my tech working on that while I ran the blood. To list the highlights, leukopenia (low white blood cells 3000), significant hemoconcentration (HCT of 70% - Yikes!!!), Azotemia (both kidney values elevated plus high phosphorus level of about 14), total protein greater than 8, and severe hypoglycemia (21!!). Dog was obviously severely dehydrated and in septic shock. Called the owner to verify they wanted to proceed with such a poor prognosis while administering glucose on the mucous membranes while tech still working on IV catheter. Owner wanted to try so I wound up doing a cut down (cut through the skin to gain direct IV access) and finally threaded a tiny IV catheter into the dog then started bolusing fluids and giving dextrose. This dog actually had a good outcome (I know, I'm being glass half empty but you'll understand later) since he held up his head by around 11 a.m. then was sitting up by 1 p.m. Told owner not out of woods but at least trying to respond. Owner kept demanding to know what caused; I got a little frustrated and told her there was no way I could prove initial cause beyond doubt, point was dealing with septic shock right now. I was told they had "nursed him since Wednesday giving Pedialyte that he kept spitting up...."

Next case that made me bonkers Friday was the stray dog that came in to have her skin checked. A truly wonderful owner who was a little down on luck having lost her job. Classic case of flea allergy dermatitis. I euthanized the dog. Not because of the flea allergies but because the first thing I noticed was that the dog's eyes were red. My exam revealed hyphema (blood in the anterior chamber) in both eyes, iris color change in both eyes, retinal detachment in the right eye, huge peripheral lymph nodes (all of them 4cm or larger and firm), harsh lung sounds, and a fever. With that combination of findings I was left with cancer, fungal infection, or tick borne infection as the top 3 differentials. The dog was also heartworm positive, incidentally. Given the cost of further diagnostics and treatment as well as the guarded prognosis for all of the above and the potential roller coaster ride, the owner opted to euthanize. She had found the dog 3 weeks prior; at least the dog had 3 weeks of having been loved.

Then is the prodigal. Friday, my dearest brother decided it would be a great idea to take off home (about 425 miles away) by hitchhiking. He's still not well although doing some better with the presence of food, sleep, and lacking drugs. He finally let us know that he made it late Sunday afternoon. I'm glad he's safe but now I'm worrying about what trouble he'll be in before long plus he had all of us worrying while he was impossible to reach and hitchhiking. If he would only cooperate long enough to get everything out of his system he might actually rehab.

Lastly is my cat. In my experience, when dealing with a true "old cat vestibular" patient (meaning idiopathic vestibular), they tend to improve fairly quickly as in 3-7 days. Even ear disease as the underlying cause usually responds that quickly. I know that technically, the texts say 2 or more weeks but that also includes the nasty causes and has not been my personal (anecdotal) experience. Here's another acronym for y'all - FIP. Feline Infectious Peritonitis. A truly nasty viral disease for which we cannot vaccinate and cannot treat effectively. The diagnosis equals doom / death.

My Crazy Gracie most likely had FIP. She showed slow improvement over the course of 6 days and I actually thought she was turning a corner Saturday when she took a few steps on her own. Then Sunday, she seemed a little worse and couldn't seem to pass the hard fecal material in her colon. I took her to the clinic and gave her an enema and continued to monitor / treat her at home. Around midnight, she began to cry and when I got her out to examine, her mucous membranes were white, her abdomen was distended with fluid and painful, and there was no urine since several hours prior. Rushed to the clinic, bloodwork showed severe anemia, azotemia, and elevated liver values. Radiographs showed free fluid in the abdomen (surprise, surprise), small bladder, nothing else significant and an abdominal tap showed straw colored fluid. Granted, I can't totally prove it and have to say presumptive FIP but it fits too well and I couldn't justify putting her through more to prove it. She was hurting and probably trying to quit anyway so I euthanized her. I thought about trying to do a transfusion and treat her but...it just didn't seem fair to her.

I don't think most of my friends understand how deeply I feel these losses. They mostly seem to think that since I have so many in my herd it's not the same as when someone only has one or two pets. They are like my kids, though. Each one is special and loved, just like a person that has several children - you love them differently but it doesn't mean you do not love them equally. Now I'm wondering about #3. It seems that all things happen in 3's so do I count Stormy from last October, Ellie, and Gracie or do I need to hold my breath for the next strike. There are certainly enough geriatrics in my herd to wonder.

With that, I'll close. Figured I would update everyone this way since I'm not really in an appropriate state to talk to anyone. Maybe I'll manage my great kitten post sometime soon if life will cut me a break long enough to catch my breath and somewhat recover!


Anonny said...

Nothing hurts like losing a pet, and my heart goes out to you. You'll remain in my thoughts and prayers and hopefully turn the corner soon.

Sorry I don't comment more; I've been visiting regularly for awhile now and (dorky as it sounds) your updates are a treat for me.

Thanks for all you do. Please take some extra TLC for yourself in the coming weeks--we need some kitten stories. :)

DeniseL said...

I'm so sorry for your lose of your beloved Crazy Gracie. I'm certain you gave her a good life, as you do with the rest of your herd!

Stormy counts in the rule of three, so hopefully you will not need to fear the lose of another for a very long time. And most of us know, a loss is a loss - it doesn't matter how big or small the pack is - all our losses hurt.