Rickiesmom

Just got back from a great visit with Jaynie. She had her head up when I arrived, and was awake for much more of the visit than previously. Many kisses and a couple of good grooming sessions - acceptance of kisses managed by mom accordingly. Her kennel attendant somewhat deflated me when I mentioned her brightness, saying she hadn't seemed so bright this morning, but he agreed she did now. Her ID tag is taped to the back wall of her enclosure, and someone has drawn little red hearts all over it. To my surprise, there was a note posted on the wall also, that she was a lepto possible, and to wear gloves. I must ask Dr. Norris about this because the impression I got initially was that while she was a slight positive for 3 lepto strains on the titer test, he didn't think it meant much since she had been so recently vaccinated, and the test couldn't distinguish between antibodies due to the vaccine vs. an actual infection. She's down to 54.5 lbs. It looked like she'd eaten all the prescription food they gave her, but none of the rice mixed with cottage cheese. There was a note on her chart that she had eaten hand-fed scrambled eggs. I brought more scrambled eggs for her today, hopefully she will keep eating it. Toward the end of the visit it was time for her walk - and here is the pinnacle of the visit - she had perfect poop!! We'll visit with her again tomorrow. I told her if she kept up the good healing work, there were only two more sleeps and then she would be home.

So glad to read a promising update. Keep it up Lexi!

Continued prayers for your Lexi.

Dr. Norris called a little while ago. Everything on Jaynie's full blood and biochemistry panel is great except for the creatinine (down though, to 227) and her potassium is still not quite normal but getting close. He is pleased with the results, and says it is positive that her creatinine dropped even though they are reducing fluids. He'll call again tomorrow with another update. Assuming the trend continues, I think we're very close to bringing Jaynie home. At this time last week I was in countdown mode to Monday, not knowing if Jaynie would make it until her first appointment with Dr. Norris. Now I am in countdown mode to Monday to hopefully bring her home! What a difference a week makes! Rickie and Arlie are going to be very happy dogs this weekend because I am going to give them treats liberally, then give away what is left as most of our goodies are not suitable for Jaynie, who will for sure be on a protein-restricted diet. It just wouldn't be fair to give the other two things that she loves but can't have. I hope there are good-for-teeth things to chew on her allowable list!

Sending a ton of prayers for your sweet Lexi, that the plasma gives her what she needs and she pulls through.

Just back from a nice long visit with Jaynie. I love the stall where she is now - I can just hang out with her there as long as I want, out of everyone's way, and life just goes on around us. They had put an e-collar on her, as for the first time she started chewing her IV line - while it's too bad she has to have that thing on, hopefully the chewing is a sign she's feeling better. I left them with her bite-not collar when I brought her in last week, but her nurse seemed to think this was better. The stall is big enough that she still has lots of room to move around, even with this thing on. Her fluids have been at 3x. They dropped her down to 2x today, and seem to have decided she wouldn't pee as often because she was on a nice folded up comforter with a polar fleece blanket on top. Very comfy. Perhaps because of the nice bedding, she roached a lot while I was there, including a full flag-pole roach a few times, which made everyone who passed by smile. As she always does, she also slept a lot. I pet her the whole time, whether she's awake or not, but stopped when she launched into a big chase dream, complete with nose twitches. Somewhere in her imagination, her prey was going to be in trouble, and I didn't want to spoil things. Her bloodwork is good on the whole. I didn't see the report, but Becky, her nurse, said the urea was 7.x (I forget the decimal value) and her platelets are 191!! Her stubborn creatinine is still high, though slightly less so at 243. It's the number they are watching most closely as they drop the fluids. It's likely she won't be discharged until Monday, and that's fine with me. Much better they should drop the fluids slowly, and she should be in a stable state while Dr. Norris is off for the weekend. We can still visit every day. The idea that her kidneys might not function on their own really scares me, but hopefully the improvement in her blood values bodes well. And I told her firmly to get working on that creatinine.

Dr. Norris called early this morning. They are going to start reducing her fluids. The goal is to wean her off completely, and then make sure her kidneys can function without the support. He said he'd call again this afternoon when her bloodwork was back and I'll ask him about timeline for the above.

Just got back from the clinic. Jaynie's values are pretty much what they were yesterday, except her platelets are down to 123. Dr Norris said not to be alarmed, that they would move around a fair bit. Urine culture came back negative, nothing yet from UNC. He hadn't re-done the ultrasound since Tuesday, and said we could do one today and I could join him. He said the kidneys, while not normal-looking, did look better than on Tuesday. The spleen though, remains very enlarged. Her BP is good - it had been kind of high. They will run more complete bloodwork tomorrow, so we get updated liver and other values. He's thinking she can come home "soon". He wants to give things some time and then decide what to do, presumably based on how things are looking after whatever interval. It will be wonderful to have her home and I am sure she will be much happier. She's now out of the crates completely. They have a few "stalls" for lack of a better word - 3-sided enclosures with low walls - in the treatment area, and Jaynie is now in one of those. Much nicer - gives her a lot more room and she has more to look at. As a funny aside - she really enjoyed the ultrasound. She was in a padded V-shaped holder that kept her in a nice secure roach, the light was low, and she got a bit of a tummy massage. She actually fell asleep and I was so sorry she couldn't just stay there awhile. I always feel so much better after our visits.

What a wonderful girl Cora was. Thank you for letting those of us who never met her get to know her a little. My heart goes out to you at the loss of your special Cora.

Glad the vet doesn't think the lump is a concern! About his eyes - what can you do - does he need to wear doggles outside for example?

The latest update is *so* much better! I feel like I can breathe again, though we still have a ways to go. Jaynie's urea is now 9.3 - this is normal. Her creatinine is 277 vs the high end of normal (141) but this still represents a huge improvement over the worst reading which was 743. Now the most amazing part: her platelets are 161! I made him repeat it twice! I asked if he thought it was the doxycycline. He doesn't want to commit until the UNC results are back, but thinks its a reasonable hypothesis. The lepto titer results came back, and she's positive for 3 types, but he seems to think it's due to the vaccine. Her values were 1/100, 2/100 type of thing, and the way this works, the bigger the bottom number the more positive you are, so she's not very. He said the way to know for sure is to repeat the test in about a month to determine if there is an increase. Clinically he is still concerned at the enlarged spleen and the bright kidneys. I didn't have the presence of mind to ask him if they had rechecked these, or when they are going to - that will be on my list for the next call. He said she also seemed brighter, and also said what a sweet dog she is. We talked about diet, and I will bring in some better proteins than I have been - eggs, cottage cheese, and just in case she likes them, I'll pick up so Nilla biscuits. Although she's such a meat eater, not sure how much she'll like any of these things. He will also leave instructions to add more fleece pads to her crate - he said she'd look like a princess and they would make sure she couldn't feel a pea. I love this man. I was planning to change her collar today anyway since she's been wearing the same one since she was admitted, it will now feel like such a celebratory thing to do (it's a brand new collar). So many of you have stayed the course with me on this journey with Jaynie, and will share the joy and hope I am feeling. Please continue to pray for her and send your good thoughts. They are sustaining both of us.

Thank you for your kind offer. I actually have some of these from when Arlie first developed spay incontinence a couple of years ago - forgot about them as we haven't needed them in ages. That said, reading Batmom's suggestion, I had a blinding flash of the obvious: the clinic uses those fake sheepskin things. I will ask Dr Norris today to add instructions that they are to put 3 - 4 of them, one on top of the other, in her crate. That should give her what she needs plus simplify logistics for everyone, since they are using their own supplies and regular processes for cleaning, etc. Thank you everyone, for getting the juices flowing!

We had such a good visit with Jaynie last night. The clinic was fairly quiet and they brought her to an exam room with her IV pump and a blanket. We were able to cuddle for a long time and I think she enjoyed being away from the busy, noisy treatment area. I petted her gently the entire time, and she slept a lot, but in between gave kisses and wanted her belly rubbed. She even roached for a moment but it was very uncomfortable without real padding, either on her or the floor. She didn't want to get up when it was time to leave, and kept looking back at the door after she was taken back to the treatment area (I watched her through the window). It was so hard to leave. I wish she could be home where it is so much more comfortable and she would get better rest. In the meantime, I am going to try to be there for as long as possible during visiting hours, and take a bed for her, so that she can have more of these restful breaks. I would like to leave a bet or a pile of blankets in her crate so she has more padding, but it isn't very practical - because she's on all this fluid she sometimes pees in there. If anyone has any wonderful ideas about this, I would love to hear them.

Yes she is. What they didn't want to add speculatively was the drug for Babesia.

Spoke with Dr. Norris (internal med specialist). What they have so far is this: - ultrasound yesterday showed fluid in the abdomen which they sampled; it wasn't septic and today has largely resolved; he thinks it was probably fluid from the kidney therapy - the kidney cortex looked bright on the ultrasound, and enlarged; the spleen was also enlarged; this can be due to infection, scar tissue, a tumour... - the spleen is part of the lymph system so that it is enlarged is consistent with a systemic infection - the platelets are at 40; not materially better than they were and the pathologist at the lab confirmed the samples were valid He said the kidney values continue to improve. He's waiting for the lepto titer, and is going to take another sample for TBD testing which he will send to North Carolina. We are already treating for Ehrlichia. He doesn't want to add treatment for Babesia speculatively - want's the results back from NC. He's also running a test to check the protein in her urine. Results of urine culture are not back yet. Also doing a coagulation panel for bleeding disorders. He feels he's doing all possible non-invasive tests, and in the meantime continuing treatment. Although the samples would provide good diagnostic info, he's not keen to do a kidney / spleen biopsy "on a dog in renal failure with low platelets". His gut feel is that whatever is going on was smoldering before the spay, and also has in mind that first anaesthetic reaction after the dental, and that it is unusual for a young dog with good values going in to have a bad anaesthesia reaction. My sense is that he thinks in retrospect that might have been a sign of things to come. I asked about timeline. He said they will continue to treat her kidney issues until the values plateau. And for the rest, he hopes the tests and treatments they may lead to will help her. I asked about the causes of low platelets - he said it can be a bone marrow problem (not producing enough), consumptive (body consuming too many) or an immune disease. He wonders about the marrow because her WBC was also low. He mentioned a bone biopsy, but I think that's a possibility for later. Apparently the most common cause is auto-immune. So we wait for all the remaining results to come back, and pray there is an answer. If not, then he said we need to discuss "what's best for Jaynie and for you". So for now I am doing the only practical thing I can for her, which is to continue to bring her food (anything, they just want her to eat) and visit and tell her I love her.

Exactly. It is a single facility but the staff that "owns" your dog depends on whether you are an ER case or a specialist case. Jaynie's ownership has now been moved to the specialist's staff, though I believe off-hours there is resource sharing. However, the specialist is now in charge of care instructions, which is huge.

I am feeling much better. Jaynie is not out of danger, but she is finally in the hands of someone I trust to pull her through if anyone can. No evening update from the clinic yet. Rickie has his final post-surgery re-check tomorrow at 12:15, so if not before, I will ask for an update while there in person. Thank you all for your support. It means more than I can say.

Just got back from the appointment with the specialist. I really liked him and feel Jaynie is in the right hands. I haven't seen the latest labs, but he did say her kidney values were improving. He doesn't know why they failed to begin with, but suspects a combination of some event (my word, I can't recall his) and dehydration. The "event" could be the post-surgical Metacam, a TBD, Lepto, or another toxin of some sort. He is going to get hold of the tick and lepto results as he hasn't seen them yet. He is also going to run a urine culture and ultrasound her kidneys. He is not yet able to say how much of her kidney function will return. To my immense relief he doesn't plan to biopsy the kidneys. My clinic didn't take a urine sample before putting Jaynie on fluids last week, so he is missing a test result he wishes he had. Also, since they had done bloodwork so recently (after the dental) no bloodwork was done immediately prior to the spay, so we don't have that as a basis for comparison either. The platelet issue is the other thing he will pursue. He is going to contact the lab to verify the accuracy of the results, and then take it from there. I think they had already sent blood over from this AM but the results weren't back yet. I may be forgetting some things, but the important thing is that he is good at what he does, and he's now on Jaynie's case. I believe he will be able to resolve this if anyone can. Not sure what the timeline is on all the above, but my sense is that a bunch of it will happen today, so I am hopeful I will get an update sometime later today. He said that he doesn't think she's in immediate danger and I hope he's right.

Finally talked to a vet. Jaynie's values aren't really improving and her platelets are down to 38 (normal range is 170 - 400). They are going to start her on Doxy speculatively. The basic tick panel is negative but it doesn't test for everything. On the platelets, he acknowledged it was a big drop from the already low 64 on Friday, but is not considering a transfusion at this time. The net of a much longer conversation, is that the ER vet doesn't want to do too much more, given that Jaynie has an appointment tomorrow AM with an internal med specialist - he is deferring to the specialist. More than ever, tomorrow morning can't get here fast enough.

I am with you all the way - nothing would make me happier than to have my girl at home. Unfortunately she's critical, and really needs the IV fluids, meds, monitoring and ongoing bloodwork being done to pull her through this. All her bedding is washed and waiting for her homecoming - it will be the occasion of great celebration. But we won't know when or how until (hopefully) tomorrow when we see the specialist. I am praying he can sort through this, figure out the cause, and get Jaynie on the road to recovery.

We had a long, if one-sided conversation during which that and many things were promised. Believe me, I am counting on the Fentanyl to dull her memory or I am in big trouble. And nothing would please me more right now!

Yes, poor lamb.

Nothing yet. I think there may be a shift change at 8, so with luck, if she was too busy to call beforehand, I may hear once she's handed off. I guess worst case I'll learn more tomorrow when I speak with the specialist, but I was so hoping to hear her values were improving.

I should have been clearer - she's receiving Fentanyl via her IV, there is no patch. In view of her kidneys, they told me that an opioid was a safe choice for pain management vs. other possibilities.

This visit was not encouraging. Jaynie was very lethargic when I got there. I didn't think she looked as good as she did yesterday. She lifted her head when she heard me speaking with the tech, and so I got down with her and spent some time cuddling with her and talking to her. She would only eat one or two small pieces of food. It made me so sad that when I finally was being given time with her, she wouldn't eat, whereas yesterday, when she was interested, I wasn't allowed to stay. Next visit I'll bring a few new things to see if a change will help. But the beef she wanted yesterday was of no interest today, and after one or two tiny pieces of boiled chicken liver today, that wouldn't do anymore either. No information on her labs as the vet was busy with emergencies - I am supposed to get a call by 8PM tonight. There was a sign on her cage to weigh her and measure her urine every 6h though I still don't understand that part, since I was allowed to take her for a short walk, and of course she peed. The one encouraging sign was that she really perked up on the walk. So for now we wait for the vet to call, and continue to count down to our appointment with the specialist tomorrow AM. I'll update again after the call.