Drake's Healing Progress - After Mass Removal From Both Left Legs

[Guest eaglflyt]

I'm continuing to pray and hope that Drake's legs are both well soon. Bless all of your hearts!

[Guest FLT]

Update: Took Drake to the vet this morning for his usual bandage change and wound check.

 

He had started to use his back leg much more over the weekend (the gentle exercise and the addition of Metacam to the routine seems to have done the trick there - the swelling is almost all gone, and it seems to feel pretty good). He'd been starting to limp more on the front, and I had hoped that was just that now he can put weight on the rear leg again that he was just able to favor the front again.

 

The vet unwrapped the front to find that the wound we've been treating is not changed.. he left the stitches in for a bit longer (it's been 2.5 weeks now, he said he'll have to take them out by about 3 weeks - so later this week) but was horrified to discover that we have a new wound some distance away from the original site. This has opened up a bit further "up" the paw towards the leg, and it is on the side of the leg. It was draining pus :-(

 

He cleaned out the new wound and took samples to culture, and wrote us a script for 3 weeks of Azithromycin again.

 

He said he really isn't sure why this new wound opened up, so far away from the original one. It could be that there really is cancer in the paw after all and it's ulcerating at a new tumor site.. it could be just that he's been wrapped up so long that he rubbed a new wound in it, or maybe he's just got an infection and it picked that spot to drain through.

 

I have to admit I am almost wishing we did the front leg amputation at this point.. it would be 4 months post surgery and Drake would almost certainly be fulled healed up by now, even if he would be a tripod.

 

I'll send a note to Dr. Couto giving him the update.. I really need us to get poor Drake to HEAL, damn it!

 

Drake is his usual sweet and loving self, and sends cuddles to all the ladies out there.

 

FL

Edited September 14, 2009 by FLT

[Guest eaglflyt]

I'm so very sorry! I'll keep praying for Drake and you. Bless his heart. I'm hoping that this is just maybe a pressure sore or something that can be treated ... and not the C word.

 

Give Drake lots of hugs and kisses for us.

[Guest boondog]

Poor baby. I think of Drake often. I wish he could catch a break.

[Xan]

Just catching up after a long family visit. Poor all of you!! Jeeper, Drake. Time to wrap this up, huh?

 

I was thinking before you mentioned wishing you'd maybe already amputated that it was a good thing you didn't, if he has such a mysteriously hard time healing. That would be a lot bigger wound to care for, if it wouldn't heal right. Maybe that's for the good. Maybe. Augh. Who knows? :

 

Hugs to you all for hanging in there!

[Guest Energy11]

Soo sorry you and Drake are going through all of this! Not fair! Not fair!

 

Hope the antibiotics helps, and he heals, heals, heals!

 

Love and prayers from us to you!

[Guest FLT]

Thanks everyone for your good thoughts, we really appreciate them around here. Would be nice if Drake could catch a break, eh?

 

Update: I told the vet tech who came out to take Drake back that I'd like the opportunity to see what's going on under the bandages since it's been a couple of months since I had my eyes on his foot. Dr. Prostredny took the bandages off in back (and found the stitches had pulled out this time) and decided to bring him up to a forward treatment room to wrap him back up so I could see what was going on.

 

The "new" hole was looking better according to Dr. P (it looks like a reverse ant hill almost - a tiny one) and "old faithful" was bigger than I expected, but has very nice looking healthy tissue in it. Still no skin growth whatsoever (grrr) but the skin that was pulled over and held by the stitches seems to have stuck a bit and narrowed the gap. Dr. P had been telling me it was the size of a dime, and now it's about half the width - but to my eye it's still the size of nickle if you shaved the edges down a little to make it a hair narrower side to side. I'm glad it's smaller, in any case. Additional benefit of having him wrap it in front of me is that I'm sure I could do the same bandage job if necessary - I know what he did and how tight he pulled each layer.

 

He says there is now enough loose skin on either side that he could try surgically repairing it without needing to graft skin in from elsewhere - that he could just slide across the existing skin (after appropriate clipping of the hair off his leg again - poor guy - and de-germing) and seal it up. We'd have to put him under for this, but it seems like it might be an option now. I was anti-grafting (especially since it would have given us new hole(s) to heal elsewhere) - but I don't think I'm anti-sealing at this point. I think that 4 months makes it clear that this area simply does NOT want to grow skin. Going to see what Dr. Couto says, but thinking maybe next week sometime on that.

 

If it's cancer after all, this would probably be the wrong move - but it's better than doing nothing. If this doesn't take, and it pops open and stays open - it may be time to seriously consider amputation. 4 out of 5 experts thought cancer, even though Dr. Couto is the exception. Ugh.. I don't even want to think about that, especially after all this time (and $, frankly). Hopefully we can get this darn hole CLOSED sooner than later.

 

Hubby and I were just talking about how screwed we would be if this is still going on come January - I'll be entering the RN program at school and will no longer have the flexibility to take Drake to the vet like I can now. Please, please, please let us catch a break and get him healed up!!

 

Thanks to all,

 

FL & Drake (and Kaylee - who I'm told did fine in her dental and only lost another 2 teeth. She's waking up well and I can come and get her in about 90 more min).

[Guest Energy11]

Hoping you can catch a break! Being an ex Paramedic, I KNOW how intensive the RN program is! Love and hugs! Dee and The Five

[Guest eaglflyt]

I'm still praying for Drake's wound to close. At least it is progressing in the right direction, which is GOOD news! : ) I hope Dr. Cuoto can help you make the best decision concerning the surgical closure option. I've seen horses with leg injuries in a similar area that literally took months to close, too.

 

Prayers for all of you continue and I'm thankful that Kaylee's dental went well.

[Xan]

How's Kaylee's poor snoot? Happy's was so swollen after she had a bunch of teeth out, but she had a LOT of teeth out all at once. I hope she's feeling better by now, anyway.

 

Is there someone you could trust, maybe a close friend or family member, who could ferry Drake to and from vet appointments without charging you? Or even someone who wouldn't charge very much? Just in case?

 

It's hard to type with all my fingers crossed, but they remain crossed tight for Drake and you all.

[Guest FLT]

Hi Xan - Kaylee is doing well. She is much less tender than she was a few months ago when she had 16 teeth out at once! We gave her Metacam that time, along with the Tramadol to try and bring the swelling down that time. She's on Tramadol this time, probably more for my sake than hers.. I hate to have my pups uncomfortable.

 

If I had to, I could pay the dog walking service I use to take Drake to the vet for me It wouldn't be cheap, but it is certainly viable... and if my folks are available I might be able to get them to pitch in once in a while.

 

I'm just hoping that we sort this out BEFORE January!

 

Poor Drake has been doing a bit of crying out tonight when he puts weight on the front paw, so it's hurting more than it has for quite a while.. must be because the stitches are out and the secondary wound is sore (at least, that's my guess). He's already got Tramadol and Metacam on board though, so there isn't much more I can do for him tonight.

 

How's Kaylee's poor snoot? Happy's was so swollen after she had a bunch of teeth out, but she had a LOT of teeth out all at once. I hope she's feeling better by now, anyway.

 

Is there someone you could trust, maybe a close friend or family member, who could ferry Drake to and from vet appointments without charging you? Or even someone who wouldn't charge very much? Just in case?

 

It's hard to type with all my fingers crossed, but they remain crossed tight for Drake and you all.

Edited September 18, 2009 by FLT

[crazygang]

Hope Drake's surgery wound heals soon.......he is extremely lucky to have you caring and loving him the way you do...

 

 

[Guest FLT]

Update: Drake's original wound (from the surgery that was 17 weeks ago yesterday - shesh!) is looking about the same as Wednesday. The "bonus" wound is draining less and looks a little better. Culture came back showing a minor (or as Dr. P said, "pretty wussy") staph infection that was sensitive to Cephalexin, so we have discontinued the Azithromycin and are going to give 750 mg of Cephalexin 3x a day for 2 weeks.

 

I've been emailing with Dr. Couto as well, and he seems to agree that surgical closure of the hole (after the "bonus hole" heals up) is the way to go - so I'm glad to have both Drs on board with that plan. Will schedule it AFTER the extra hole is closed.

 

Glad to have a game plan!

 

Drake's next vet visit is Tuesday afternoon. Dr. P is out on Monday. We have the one after that already scheduled for Thursday afternoon, because we are taking the dogs and going to NJ to visit family for a long weekend and won't be around on Friday which might have been the next visit otherwise. If anyone lives in or near Wildwood Crest, NJ and wants to meet Drake and Kaylee please throw me a PM and we can hook up :-)

 

Cheers to all,

 

FL

[Guest Energy11]

Sounds like you are moving in the right direction!

 

Wish We could meet you for a play date, but, it might be a bit of a drive from the N. Ga. Mts! :-)) Good Luck and hang in there.

[Guest eaglflyt]

The plan sounds good and I'm sure it must be a relief to have both the vets agreeing on the next step. I'm continuing to send up prayers for Drake and you and your family.

[Xan]

Up ... down! UP ... sideways ... down a little ... uuuppp! What a ride!

 

It's good to know that Kaylee's pain will pass fairly quickly. And nice to know you've got a consensus on what to do about Drake's poor front paw. It's all good from here! And so say all of us!

[Guest FLT]

Time for another DOWN on the roller coaster of doom.. We are just back from Drake's latest vet visit and Dr. Prostredny says that the "new" wound now looks just like the other one did 4 months ago - ugly and "not right". He took a scrape sample of it today and we are sending a slide to Dr. Powers at Colorado, and a slide to Dr. Couto's team at OSU for review. It is possible that a negative result from the scraping will actually not mean anything because it might not have been a deep enough sample to really get the possibly abnormal cells - but it was easily done on the spot.

 

Now we wait.. again..

 

Next vet visit is Thursday afternoon,

 

FL

[Remolacha]

[pabozem]

FLT, I haven't been following this thread, and decided to click on it this afternoon. Read all 14 pages. All I can say is WOW. I feel for Drake, you and your hubby, and your bank account!

 

After reading about the suggestions for things to try to help the wound on his front foot, I remembered a post here on GT about a horse that had some horrendous injuries. For the life of me I can't remember what was used on his wounds, but it was a miracle worker. Maybe someone here will remember that story and chime in on the product.

 

Thank doG that Drake has you in his life. Give him a hug and ear scritch for me.

[Guest eaglflyt]

Bless your hearts ... yours, Drake's, your hubby's, and all those caring for Drake. I'm hoping for good news from the scraping and any future possible biopsy. ((((HUGS))))) I'm still praying, too.

[Guest BunnyBlab]

Like pabozem, I haven't been following this all along (I'm a newbie to GT), but read all 14 pages tonight. I can't imagine the decisions you've had to make. Obviously, Drake is one special and one very loved pup.

 

It's interesting to read you say now you should have done the amp 4 months ago, but you were only going on what you knew back then. There's nothing wrong with having lots of hope that it'll turn around in a few days. I'd be doing the same thing... So hindsight may be 20/20, but we're all just looking ahead and hoping for the best.

 

Drake and you and the DH are in my thoughts. I'll be reading, even if I don't have anything else to contribute to the discussion.

[Xan]

Holy smokes. Well, darn.

 

Okay, powering up the positive thoughts to an even higher level for poor Drake! Tomorrow's Thursday, so not much longer to wait for that, anyhow.

 

:bighug

[Guest FLT]

Pabozem and BunnyBlab - thank you both for reading the Drake saga, and for your good thoughts. Bunny - welcome to GT!

 

Update: The wounds are looking much the same today, and Drake had his bandage changed and our next appointment is scheduled for Monday.

 

The Histopathological results from Colorado University are back for the slide that was sent there and they say that because of the relatively low number of abnormal cells because of the superficial nature of the scrape sample they are not able to conclude anything, but regarding the cells that are there is that "a sarcoma of some sort is certainly a reasonable differential, especially in the absence of inflammation seen in this sample." They recommend taking a biopsy to confirm a diagnosis.

 

We are waiting on the results from Dr. Couto's team's review before we move forward with anything.

 

Dr. Prostredny really thinks that there is cancer growing - in part because of the lab results all along, but also because of the lack of healing in the original wound and because of the second hole that has appeared for no other apparent reason. Without the inflammation and with only the most minor of infections he just doesn't think that hole should have opened up and started draining without something going on below the surface. I'm inclined to lean towards amputation at this point, but want Dr. Couto's input before we go that route.

 

For those that can understand the lab-ese the description of the sample includes:

"Overall, the sample is of low cellularity. There are occasionally mesenchymal cells seen as individuals and in rare, small, loose aggregates. These cells display moderate anisocytosis and anisokaryosis. They often have plump, ovoid nuclei with course chromatin and occasionally have a single, prominent nucleolous. They have a small amount of basophilic cytoplasm and cells often have indistinct borders and are spinloid in shape. There is a thick blood background."

 

 

Now we are packing up the van and heading to the beach (oh joy - I hate the beach) to visit with family for the weekend. Back on Sunday night!

 

Cheers,

 

FL

[Xan]

Well, hm!

 

For what it's worth (probably nothing! But, nothing ventured, nothing gained!), when Brilly broke his toe, the constant bandaging caused sores that would not heal. It wasn't until we gave up on the bandaging altogether that the sores did heal. Could there be an aspect of this going on here? Such a constantly enclosed, probably humid, environment, with restricted circulation because of constriction of the bandage, seems like a good reason for the failure of the skin, all by itself. Could this possibly be the case? I know leaving it unbandaged hasn't been too successful (on the back leg, anyway), but maybe some open time, maybe with hydro-therapy, at this point?

 

Casting around for hopeful helpfulness, here!!

 

Hope your beach weekend was way better than you thought it would be!

[Guest FLT]

Dr. Couto emailed me on Sunday to let me know that they see the same things that Colorado saw in the scrape sample. We are faced with the choice of either putting Drake out and doing a full biopsy on the "new" wound to get results that may or may not be more definitive.. or to chose to move on with an amputation.

 

Because Drake's paw (update - today's bandage change visit) continues to show absolutely no signs of healing further after 18.5 weeks, I am reluctant to make a bigger hole in the second location for the biopsy. Dr. Couto said that amputation is more of a surgeon's call at this point, and the surgeon I have been using is very amp positive.

 

For us - we absolutely hate the idea of taking Drake's leg, but we feel that we have given him every opportunity to heal up without taking that measure, and it's just not going to improve without additional surgery. We were going to surgically repair the original hole until the second hole opened up. The only reason for there to be another hole is because of tumor. The infection that was cultured was so very minor that there was no way it was the cause of the additional ulceration.

 

I emailed Dr. Couto and asked him to see if the surgeons at OSU are willing to perform the amputation on Drake. If they are willing, we'll drive him there. If they are not able to do it there, I will allow Dr. Prostredny to do it here in Maryland. I will ask that the leg be studied to see what is in there for sure after the fact, just so we know.

 

Hopefully the healing issue is just related to tumor, and not an overall problem with healing. We won't know until we try though.

 

I discussed my concerns that he is favoring the rear leg and asked Dr. P if he feels that Drake would be okay as a tripod - and he feels that although there is some atrophy in the rear leg, and probably some chronic tendinitis at this point, that he would still do okay. The other issue is that some experts thought that he had cancer in that rear leg of course - and if that is the case we may well have future problems with local regrowth. Again, we won't know until it comes to that.

 

We will schedule another round of xray and ultrasound checks within a week of whenever we schedule the amp to double check prior that there are no changes on the internal organs before we start down the long tripod road.

 

Drake's next bandage change is Thursday morning,

 

FL