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

[jamngrey]

sending tons of wishes for good news for hyou and your pup

[Batmom]

CONGRATULATIONS on your exam!!!!!!!!!!!!!!!!!!

 

Safe travels, update when you can.

[Xan]

Yeay!! Good job!! :

 

Safe travels. We'll be on the edge of our seats for your updates!

[Guest FLT]

Update - Got into Columbus Ohio (Varsity Inn North) without a hitch, and immediately ran into tallgreydogmom (actually she spotted me - sharp lady that she is). I got unpacked and then she came in to visit with Drake (and me).

 

After not hearing from me because tallgreydogmom and I got chatting, boondog called me to make sure I'd made it (sorry again about getting distracted!)

 

boondog and tallgreydogmom had spoken with Suzie (sorry, not sure of the spelling of your name on here!) about coming over as well - so we all met up for dinner, and then those three lovely ladies petted Drake into a coma of bliss.

 

They are just all headed back out, and I'm going to get working on the paper that is due tomorrow by 11:59pm for my Developmental Psychology class (which is an online class - so I do not need to be anywhere for it in particular so long as I have internet access).

 

Drake's appointment is 8:30am tomorrow and tallgreydogmom said that Dr. Couto and Dr. Vilar were already talking about looking forward to meeting my crazy greyhound with the confusing issues, LOL.

 

I didn't bring my camera sync cable, so you don't get to see the picture of Drake with his Harem until after we get home. :-D

 

Look for another update sometime tomorrow.

 

Cheers,

 

FL

[Batmom]

Glad you made it!

 

Hope the paper writes itself (oh, why can't that happen, eh?).

 

Hugs.

[Guest boondog]

I was delighted to be part of Drake's harem for the evening. He is quite the handsome boy. It was great to meet him and his mom. Paws crossed for a good game plan from Dr. Couto!

[Guest FLT]

Update:

 

Took Drake over to OSU this morning and we were seen pretty quickly. Cindy (the Sr. Student working with Dr. Couto on our case) interviewed me about Drake's history and I gave her the FULL story (starting 2+ years ago), and gave her the copies of Drake's recent history from Dr. Prostredny's office that I had brought to bring their files up to date here. I also took all the empty (and semi-full) pill bottles that we've ever given Drake since surgery to make sure I didn't forget any of the drugs.

 

Drug Summary follows so I can keep track of it myself:

 

Prescribed on 5/22/09

Ciprofloxin 250mg - every 12 hours for 2 weeks

Cephalexin 750mg - every 8 hours for 2 weeks

Tramadol HCL 50mg - give 2 tablets every 12 hours as needed for pain

 

Prescribed on 6/11/09

Ciprofloxin 250mg - every 12 hours for 2 weeks

Trimeth-Sulfa 480mg - every 12 hours for 2 weeks

Tramadol 50mg - give 2 tablets every 12 hours as needed for pain (got a big bottle this time, to be used as necessary but we haven't needed too many of them)

 

Prescribed on 6/14/09

Azithromycin 250mg - one per day for 3 weeks

 

Also prescribed on 6/14/09 - but told not to start until almost done with the Cipro and Trimeth-Sulfa, so started on 6/23 or so

Doxycyline 200mg - every 12 hours for 6 weeks.

 

 

Then Cindy took Drake back with her to meet Dr. Couto so that the two of them could perform his physical exam. Cindy told me that she'd come and get me in about an hour after they had looked him over. It was actually only about 40 minutes before she came and got me, and brought me back to meet (finally in person!) Dr. Couto. I also got to meet Dr. Marin as well.

 

Dr. Couto said that he had also gotten one of their other surgeons in to look at Drake while he was back there. They all agreed that the front paw looks good - but are scratching their heads about why it isn't healing up. (I get the feeling they'd be happy with the progress he's made if it were just a couple of weeks, rather than a couple of months worth of healing post mass-removal). They also puzzled together a bit over the rear leg, but Dr. Couto thinks that one is a continuing infection in the rear leg.

 

The game plan for today is:

 

Put Drake under briefly to do a punch biopsy of the front paw to see what is growing back (this is good - I hoped they would do that!) Then they will also figure out a way to get a sample out of the rear leg, hopefully without popping open the incision again.. They tossed a couple of ideas around, and said they'll get creative and figure out a way to do something. (Mentioned a type of brush sounding probe that should fit through the existing pinhole that they could use to brush around inside the leg, and also something about maybe a small catheter and then sucking out some liquid as well.)

 

They hope to do it now (11am) - but if they don't have time they'll do it at 1pm. Hopefully they'll call me in just a couple/few hours and I can go pick up Drake this afternoon.

 

They expect the biopsy and culture results to start coming back on Monday or Tuesday. Because they've had great communications from the surgeon I've been working with in Maryland, they are very comfortable doing follow-up via him - so assuming all goes well today I can take him home. I could even go home tonight, Dr. Couto said - but I've got that paper due by midnight (and I didn't get much done last night) so I'll be staying here the night and will head home with Drake tomorrow. Besides which, I don't really want to drive so late if I can avoid it. I've got a headlight out, and I've been lax about changing the bulb.

 

So I don't know the big game plan yet - but at least we've embarked on trying to find out more information.

 

I really enjoyed everyone I met today.. they all are great, and very clear.

 

Oh, and the big communication back and forth with Dr. Vilar (by email AND phone because I wanted to make absolutely SURE that bringing Kaylee wouldn't help absolutely anything they had going) was still wrong. Dr. Marin was hoping I'd brought her so she could have taken her plasma for her greyhound database project. Grrrr... I really TRIED to find out if there was any reason at all to bring her, and I would have in a heartbeat! Oh well.. Dr. Marin can't take her sample via a remote location because it needs immediate processing, but she's going to give me info about a study at Harvard that needs healthy greyhound blood that can be taken off site and I'll at least help that group out.

 

If I come back for any reason, now I know to BRING her!

 

Oh, and in closing - they love Drake (of course) - he's a charmer :-)

 

Will update after I bring Drake back to the hotel later.

[Xan]

I'm sure your paper will be very clear and well-written. You write very well!

 

I'm cringing thinking about them sticking a brush inside that poor leg wound, but if it helps in the long run, so it must be. But glebhnlsnsz! So, we mostly have to all wait out the weekend to find out what they find out. That's why they call them "patients"; 'cause they have to be so patient!

 

Good luck getting your paper done. Don't forget to get some rest for the drive home!

 

[Guest FLT]

Well I was going to update an hour and a half ago when I had Drake back here - except he oozed through his front bandage before we got in the door and I noticed as soon as he jumped up on the (white linens) bed and left brown splotches.. so it was back to OSU for a quick bandage change and check.

 

He's fine though.

 

They weren't able to do the punch biopsies on the front paw because not enough tissue, so they snipped some out instead, and they removed a section of the tissue that was what Dr. Prostredny had been worried about as well to send.

 

They were able to suck some juices out of the back leg with a thin iv catheter type of tube, so they didn't need to open that up more than it already was.

 

I gave him a couple of Tramadol (it was left to me if I wanted to give them or not.. said he probably wouldn't need them - except he cried out when he changed positions and that's enough for me to give him some drugs.)

 

He's snoring now, and the bandage around his front paw is twice the size of the one before (extra padding to soak up the juices you know). They sent me out with some extra padding and wrap if I need to wrap right over top of what he's got now if he soaks it through before his next bandage change, and I have the option of stopping at OSU in the morning on the way out for another bandage change if I think he needs it.

 

Hopefully we can just hit the road though. :-D

 

Okay - NOW I really need to get cracking on that paper!

[Guest eaglflyt]

I'm hoping for excellent reports on the biopsied tissues and that Drake continues to heal. Get some good rest once you've finished your paper and have a safe drive home with your boy.

[Guest FLT]

I made it home safely with Drake at around 3pm today (a little over 7 hours again - not bad of a drive at all) but was so tired that I immediately went for a nap in my comfortable memory foam bed (Drake told me he had missed it too, and joined me).

 

His thicker bandages (and a bit of time) seem to have done the trick and he had not soaked through them in the night, so there was no need to stop at OSU on the way out so we got on the road very efficiently... which helped a lot.

 

Got up after our nap and tried to get the laptop up and running to find that my gently chewed cord (Chester had done that at least a year ago, and I've been nursing it along) didn't care for the trip and had died on the way home, finally. My laptop doesn't do well for long at all without a cord (it's older, poor thing) so I went out to Radio Shack (fail) and then Best Buy (win) for a new cord, and took myself to dinner while I was out.

 

I'm back now, and happy to report that the power cord fixed my woes, and the laptop is running just fine. Good thing too, I've still got 3 more weeks in my online Developmental Psychology class.

 

I'm loving the "no chew" bandages that OSU put on Drake. It is really nice to not have to muzzle him and so far he's respected them completely. It's like vet wrap, but with bitter apple built in to the wrap. Going to have to see if I can find it online to buy some to have around the house. If my local vet doesn't have the wrap upon request, I might put a small amount of it around their wrap on the front paw after each change. The extra money will be worth not having to muzzle because I prefer not to leave him unattended that way if I can help it.

 

Thanks again to boondog and Suzie for making me welcome to the Columbus area, and to tallgreydogmom for being such a good hotel neighbor.

 

Next bandage change is Monday afternoon (and my boss is going to just love me taking off early after being gone on Friday, LOL). Oh well!

 

Cheers to all,

 

FL

[Guest eaglflyt]

So glad to hear you made it home safely. I hope you enjoy your day tomorrow and that Monday's bandage change goes well.

[crazygang]

Continued well wishes for Drake...

[Xan]

Whew! Glad to hear you both got home safely, you got your laptop up and running (so we don't miss an update! ), and can happily enjoy the comforts of home.

 

What a brilliant idea, the no-chew vet wrap!! Never heard of that. Should be standard!

[Guest boondog]

I'm glad you made it home safely. Give that boy some scritches for me.

 

BTW, I saw the no-chew vet wrap awhile back on jefferspet.com.

[Guest FLT]

Thanks everyone!

 

I found the no chew in both 2" and 4" sizes at American Livestock - No Chew in 2" for a very reasonable price.

 

I already ordered a boatload of it (15 of the 2" rolls and 5 of the 4" rolls) - I figured I was paying for $7 in shipping anyway, so I may as well stock up.

 

Drake did finally seep through his mega bandages today, but I stuck a few pieces of gauze under the wrapped paw and put more "no chew" over the top (they gave me a partial roll of it that they didn't finish using on Drake and some of the padding materials they use in case I needed them - thank you again Cindy). Next vet appointment tomorrow afternoon at 3:45pm. It's so nice to be able to schedule in the afternoon and not worry about missing class. :-)

 

Thanks again for everyone's support. Drake and I both appreciate it.

 

FL

[Guest FLT]

Update: Drake was happy to see his ladies again today (the vet techs who all fawn over him), and his buddy Dr. Prostredny. His paw was looking good (still no real signs of actual you know, healing! but no worse than it's been or anything).

 

The back leg was closed up again, so Dr. Prostredny opted to leave it upwrapped. I sighed and said okay, we'll try it. Of course before we were home it was bleeding again. I'm going to call them in the morning and see if I should leave it open to infection (again - for the third time) or if we should wrap it back up again. I'm happy to wrap it at home, or can take him in.. whatever they want. I knew it was going to open up, but I really wanted to give Drake another try at keeping the rear bandage off. His poor leg looks so raw and battered from the constant bandages.

 

On the other hand, I must say that having seen it unwrapped again - I was VERY impressed with the look of that rear leg. It is no longer swollen larger than the healthy rear leg - and that's a BIG improvement! Last time it was unwrapped it was still almost twice the size of the "good" one.

 

I mentioned that Dr. Couto had suggested we consider using the sugar mixture that he's had good luck with for wounds that just don't want to heal on that big hole under Drake's front paw, and Dr. Prostredny poo poo'd the idea for a paw. I said that when Dr. Couto calls to discuss the results of the biopsies and culture (hopefully tomorrow??) that the two of them could discuss it and see what they can agree to. Dr. Prostredny is thinking graft is the only way to go to heal the paw at this point, and Dr. Couto was very confident that grafting would not be necessary.

 

Oh my two experts - how I loath watching you disagree over Drake. I just want to KNOW what to do! (Sorry - little pity party there for a second)

 

Fingers crossed that we hear about the biopsies and culture tomorrow.

 

FL

Edited July 21, 2009 by FLT

[Batmom]

Arrrrrrrrrrrrrgh. Hope you can get some usable answers on the biopsy/culture stuff.

 

I've had good success with things that need to be wrapped for a long time using SSD (silver sulfadiazine) -- keeps everything nice and moist *and* bacteria free.

 

Hugs and scritchies to you and Drake.

[Xan]

Silver or sugar. Or that special honey. It can't hurt, right? As long as you're waiting for your experts to duke it out? Just do it! You probably have sugar right in your cupboard!

 

Keeping fingers and toes crossed while we wait for biopsy results.

[Guest eaglflyt]

I hope they come to a good conclusion. I'm personally hoping for Dr. Cuoto to win out because grafting would require another surgery and also another site where they would take donor skin. Having horses, we've seen miraculous things heal given time and proper treatment. As long as the area isn't infected, or having a tumor recurrence, I really hope it will heal with Dr. Cuoto's suggested treatment regimen. If an attempt of this healing fails, you could always have grafting surgery done later. Just my thoughts.

 

I'm keeping Drake and all your family in my prayers. ((((Hugs)))) for all of you!

[Guest FLT]

Update via email this evening from Dr. Couto said "The biopsy is not back yet, but should be done by tomorrow. So far, he is growing a Staph sensitive to Clavamox, ampicillin, and a lot of other antibiotics, but NOT to doxy. There is another bug growing (enterococcus), and we'll have the sensitivity pattern by tomorrow. Please give us a call tomorrow PM if you did not hear from us. Let's wait for the other bug's sensitivity pattern before we change antibiotics. Hugs for Drake"

 

That's for the culture in the rear leg.. two beasties are growing! No wonder it keeps draining, poor guy.

 

Hoping to hear from him tomorrow regarding the biospies.

 

Re: putting on the sugar compound myself at home - I'm happy to do it, but I'm going to get the local support on board first. If I can't get him on board, I'll still do it - but I want to see what the biopsy results are before we mess with that foot. For now, bandage is fine. We'll have answers (fingers crossed anyway) soon.

 

FL

[Guest FLT]

Update.. Biopsy results are back. I'm cutting and pasting Dr. Couto's email below. - it's good news!

 

------------------------------------------------------------------------------

 

GREAT NEWS! NO TUMOR!

They will have the sensitivity of the "new" bug some time late this AM. More to follow,

 

Begin forwarded message:

 

> From: HIS@cvm.osu.edu

> Date: July 22, 2009 8:01:30 AM EDT

> To: couto.1@osu.edu

> Subject: RP_REP3

>

> OHIO STATE UNIVERSITY VETERINARY TEACHING HOSPITAL

> 601 VERNON L. THARP STREET

> COLUMBUS, OHIO 43210

> (614) 292-7284

>

> REPORT DATE: 07/22/09

> REPORT TIME: 8:01 AM

>

> CLIENT: FLT CLINICIAN: GUILLERMO C COUTO

VADDS CASE #: 09-16842

VETSTAR #: 000401969

> L - SEX: M

> BREED: Greyhound

> AGE: 7y 8m

> VISIT #: 0926968

>

> --------------------------------------------------------------------------------

> 07/17/09

> PROCEDURE 14:08

> --------------------------------------------------------------------------------

> HISTOPATHOLOGY-2 SITES

> PATHOLOGY # (BIOPSY): 09-1735

>

>

> Pathology Accession No.: 09-1735

> Clinic # 401969

> Owner: FLT

> Species: CANINE

> Breed: GREYHOUND

> Age: 7 Y 8 M

> Sex: MC

> Name: DRAKE

> Date Specimen Cut In: 7/20/09

> Surgeon/Clinician: G COUTO / C ADIN

>

> Clinical History/Abnormalities on physical examination/Pertinent

> laboratory data, radiographic findings, biopsy results/Clinical

> diagnosis/Operative procedure (excisional, wedge, needle, punch

> biopsy, other)/Organ and exact location from which specimen was

> removed/Size, color, consistency/Special requests:

>

> **SEE PATH AND MEDICAL RECORD FILE FOR BIOPSY REQUEST

> INFORMATION**

> Number of containers submitted from COMPUTER request form: 2

> Number of specimens submitted from COMPUTER request form: 3

>

> ******HISTOPATHOLOGICAL DIAGNOSIS******

> Complete cross-sections [ ] Margins only [ ] Other [X]

> Malignant neoplasm [ ] Benign neoplasm [ ] No evidence of neoplasm

> [X]

> Degree of differentiation: poor [ ] moderate [ ] well [ ]

> Completeness of excision: complete [ ] incomplete [ ]

> neoplastic cells within _____ microns of margin

> Vascular invasion: present [ ] absent [ ]

>

> Number of containers that ACTUALLY came over: 2

> Number of specimens that ACTUALLY came over: 2

>

> MICROPATHOLOGY AND SLIDE SUBNUMBER:

> Slide 1, "superficial biopsy".

> VADDS CASE #: 09-16842

> PAGE: 2

>

> Slide 2, "deeps snip biopsy".

> Specimens consist of kind and adjacent soft tissue characterized by

> widespread pyogranulomatous inflammation with numerous intralesional

> coccoid bacteria.

>

> COMMENTS:

> The findings are consistent with pyogranulomatous dermatitis and

> cellulitis. The coccoid bacteria present are interpreted as the

> underlying cause of the inflammation. No cellular atypia (neoplastic

> cells) were observed.

>

> PATHOLOGISTS: Aeffner (famke.aeffner@cvm.osu.edu)/Stromberg

>

> DATE REPORT COMPLETED: 07-21-2009

Edited July 22, 2009 by FLT

[Batmom]

YIPPEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

Holding breath waiting for sensitivity ...........

[Guest boondog]

YES!!!!

[Guest Energy11]

WONDERFUL!