Diffusely Thickened Walls And Layering Bowel Loop

[charbess]

Pray her passing was peaceful--{{{{{hugs}}}}}

Well, we spent quite a bit of time alone with her first...I brought a "picnic lunch" for her, the rest of the chopped meat I had cooked up on Thursday along with a hard boiled egg and a piece of pita bread, all her favorites. She gobbled up the meat but passed on the egg and bread. Then we spent time hugging, kissing, crying and taking pictures. She looked so vulnerable...her little butt was raw from the constant leakage and the staff was cleaning her up every 30 minutes and applying cream. We had hoped to take her out for a short walk but when we saw her stretched out on the floor after her few bites of food we could not ask her to indulge us in the heat. She dozed on and off while we massaged her poor body and until the final solution was administered.

 

I have to keep remembering that when the dreaded "second thoughts" descend...We would not be able to attend to her like that at home without a great deal of stress on our parts. Selfishly, we did not want the additional burden of a $1500-$2000 colonoscopy or even an analysis of abdominal fluid to see what kind of cells were present and if she had septic stomach. That would have required the risk of anethesia (sp?) It would have made for a great learning experience and I envy the young vets there who have this exposure. The "old timers" are behind the scenes but the young woman vet who happened to be on emergency rotation when we came in Saturday morning could not have been more kind, compassionate and thorough. She took our questions to her mentors and we all got an education. We felt supported throughout this horrible ordeal. I told her never to quit her day job because she is a perfect companion and educator for those of us on this sad journey.

[Batmom]

Hugs to you in your loss.

 

Run with the angels, sweetest girl.

[charbess]

Charlotte has been gone 9 days now. Your messages of condolence and empathy mean so much and I thank you all.

 

I am now trying to decipher and understand what exactly happened...the vet at the ER was very patient and explained things to us but I must confess, I shut down after a while. I have been on websites for a week, trying to educate myself.

 

I gather "diffusely thickened walls" is a sign of trouble...did this cause the vomiting and severe diarrhea? Are thickened walls a symptom or a result? Would it heal itself over time, perhaps with changes in diet and meds or is it an auto-immune issue and this was the tip of the iceberg?

 

I am trying to equate this "condition" with humans...what would the treatment be? In the worst case scenario, would a colostomy be the treatment of choice?

 

As the vet explained it, if it was cancer and we chose to go the chemo route, they would first have to know what kind of cancer it was in order to use the correct drugs. That would involve a biopsy (surgery.) If it was not cancer but IBD the treatment would differ and involve trial and error for drug regimes and all the potential side effects.

 

If we had wanted to bring Charlotte home for a bit she would prescribe prednisone but that would involve experimenting with the dosage to see what worked with the least amount of negative side effects. As it was, she had put her on it the night before but there was still leakage from her bowels. There was no "quick fix.".

 

Of course I am second guessing myself here...did we act too fast in deciding on the euthanasia?. I just really want it explained to me in layperson's terms.

 

Any info would be very much appreciated. Thank you.

 

 

[Batmom]

Please try not to second-guess yourself. There is always a "what if ..." and nobody ever knows the answer to that. It's a rotten question to torment yourself with.

 

Thickened walls are a result and a symptom both. They're a result of some process, and they suggest (symptom) what the process is -- usually cancer or autoimmune disease, as your vets indicated. Which was it, and could it have been something else? You wouldn't know without doing a bunch more tests and probably a biopsy, and you might not know even then. Sometimes all the tests, including the biopsy, are inconclusive.

 

A dog with an enlarged spleen, fluid in the abdomen, and probable inability to absorb any nutrients from her intestines is a desperately sick dog. You did the right thing in letting her go.

[tbhounds]

Please don't second guess yourself-I under stand that's a normal thing to do but, IMO it doesn't help to beat yourself up. I think your vet explained things pretty well. Thickened bowels to put it simply are not healthy working, normal bowels. They are exactly what they sound like-thick and inflammed. Could it be cancer? Yes. Could it be inflammatory bowel disease yes. No way to know without doing a biopsy. If it was IBD you might compare it to the condition humans get-crohns disease. Honestly, whichever condition your girl had I believe it was bad. I agree-there was not going to be a quick fix. Listen, I think you need to understand-your girl was very, very sick. If you did proceed with treatment there was no guarantee she would respond. It would have been expensive, and she may have suffered terribly. It was her time to cross and you helped her with love and dignity.

I'm sorry you miss your girl so much--there's not a soul here on this forum that doesn't feel your pain. Maybe some day Charlotte will send you another girl that needs a loving home because I'm sure she believes you need to love again. Hugs

[charbess]

Thank you, tbhounds. I cannot reconcile the end result with the complete (to human eyes, anyway) lack of symptoms. She had, to our minds, recovered well from the dog attack in June...to us, it was a frightening event but one that had no lasting effects. Follow up exams to remove the drain and then the stitches went well; the vets were pleased with her progress, as were we. She exhibited no visible sign of stress...always happy and eager to go for walks, no skittishness in meeting other dogs, happy, happy, happy. We did notice a reluctance to come and sleep upstairs with us, as was normal for the entire 6 years we had her. But, we wrote that off to soreness from the stitches and the fact that it is cooler on the first floor, especially this year. .Made sense.

 

I have been fanatical in reseaching this but there is just so much I can comprehend without a medical education...it helps so much to have people available who can say, "been there, done that." Google just goes so far.

[charbess]

Please try not to second-guess yourself. There is always a "what if ..." and nobody ever knows the answer to that. It's a rotten question to torment yourself with.

 

Thickened walls are a result and a symptom both. They're a result of some process, and they suggest (symptom) what the process is -- usually cancer or autoimmune disease, as your vets indicated. Which was it, and could it have been something else? You wouldn't know without doing a bunch more tests and probably a biopsy, and you might not know even then. Sometimes all the tests, including the biopsy, are inconclusive.

 

A dog with an enlarged spleen, fluid in the abdomen, and probable inability to absorb any nutrients from her intestines is a desperately sick dog. You did the right thing in letting her go.

Thank you, Batmom. My peabrain can't take it anymore!

[Charlies_Dad]

As others have said, please do not second guess yourself. You made a decision based on love and while it is the hardest decision, sometimes a pup is just too sick and that is when we need to muster the courage to say goodbye. It is never easy and always harder when you just don't know what is wrong with them, terribly hard. I hope in time you will smile when you think of Charlotte as you gave her a great life and that is what was most important to her.

[MP_the4pack]

I have second guessed all my euthansia decisions (I have 6 at the Bridge) except one. And I waited way too long for her.

 

I think it comes with the territory. When you give them the kindest gift of all, you will always question it. People who don't care, don't have that problem. So it just proves how much you loved her.

[gryhndsr4us]

You gave your girl a great gift. You let her go without being selfish. You could have kept her around longer and run tests and she would have been sick and suffering. Instead you did what was best for her! More painful for you, but best for her. Don't second guess yourself, sometimes Google is not helpful!

[carronstar]

I am so very sorry.

Run free, Charlotte.

[charbess]

I will add Charlotte to the list of Bridge Angels for July. I am so sorry for your loss.

I would love to see this...where is it?

[carronstar]

Charbess -- the Bridge Angels list is in the Remembrance topic http://forum.greytalk.com/index.php/topic/299649-bridge-angels-in-july-2013/.

[Guest lynne893]

Charbess, I want to add my support for you.

 

Our dearest Timber had alimentary lymphoma, which took 7 months to diagnose because the various vets we saw insisted it must be a food allergy or IBD. My instinct told me it was something worse and finally a new (young!) vet did an ultrasound and discovered her many intestinal lymph nodes were swollen to the size of grapefruits.

 

We were told we had a month and maybe could have her live a year with chemo, which we couldn't easily afford, plus she was 9 years old, plus she HATED trips to the vet. We did prednisone for 3 weeks and then it was time when that stopped providing her comfort.

 

I know the second-guessing.... to this day, 4 years later, my heart really hurts..... we tried to do the "day too early rather than a day too late" approach with euthanasia. But I think I'd always second guess, no matter what route we took. It just plain sucks.

 

We're all here for you. Please know that. It just takes a lot of time to heal.... and someday, your heart will be ready to open your home to another hound again...

 

Godspeed good Charlotte. Hugs to you, Charbess.

Lynne

[KF_in_Georgia]

I cannot reconcile the end result with the complete (to human eyes, anyway) lack of symptoms.

 

I had a dog--Jacey Kasey--at her vet for a well-dog visit on a Tuesday nearly two years ago. On that day, she had complete bloodwork, and all the numbers were fine. Her platelet count was 200,000.

 

That Thursday night she had diarrhea. By Friday morning she was in the hospital, with a platelet count of 17,000. We fought for four days--probably one day too long--before we put her to sleep on Monday. She was 8 years old. It was immune mediated thrombocytopenia, which has a better than 50-50 chance of survival. She was just on the wrong side of the numbers. We never found what caused it: ultrasounds didn't show cancer, bloodwork didn't show tick-borne diseases. She just--got sick. Went from perfectly well to slow-motion dying in less than 48 hours. And she was never well enough to come home: she couldn't eat, and all her meds had to be given by injection or IV, so she spent her last four days in the hospital with strangers.

 

I wound up incurring debt which is still impacting my finances two years later, and I lost my girl after watching her be miserable for four days. She was nauseated and lethargic for 3 days; by the 4th day, she was starting to show signs of pain, and that's when I let her go. If something like that happened to one of my current dogs, I wouldn't be able to foot the bills. Fighting for Jacey as long as I did means I've jeopardized my ability to care for my other dogs in an emergency. But if I could go back to two years ago and get another shot at it, with a possibility of a different outcome, I wouldn't change what we did for the first 3 days; she deserved a chance. General opinion is that IMT either responds to meds in the first few days--or it doesn't respond at all, and if we'd kept going after that Monday, it would have piled up more debt and made her suffer longer before she died.

 

So it's possible to go from healthy--no symptoms visible and perfect labwork--to dying in less than 48 hours. And it's possible to lose a much loved dog despite odds in her favor and excellent veterinary care--and still not know exactly what caused the death. But it also would be possible to fight too long, to put your girl through too much pain and meds and labwork, and still lose her. You gave your Charlotte the peace she counted on you to give. You were the one she trusted to do what was best--and you did it.

[charbess]

I am so sorry for your loss.....had to let two of our precious greys go in the past two years....intestinal cancer in our boy Mesa, and lymphangiectasia in our girl Merrie.

 

Caring thoughts are with you.

May I ask what diagnostic tests you had done to discover intestinal cancer and what treatment did you go with?

[charbess]

Charbess, I want to add my support for you.

 

Our dearest Timber had alimentary lymphoma, which took 7 months to diagnose because the various vets we saw insisted it must be a food allergy or IBD. My instinct told me it was something worse and finally a new (young!) vet did an ultrasound and discovered her many intestinal lymph nodes were swollen to the size of grapefruits.

 

We were told we had a month and maybe could have her live a year with chemo, which we couldn't easily afford, plus she was 9 years old, plus she HATED trips to the vet. We did prednisone for 3 weeks and then it was time when that stopped providing her comfort.

 

I know the second-guessing.... to this day, 4 years later, my heart really hurts..... we tried to do the "day too early rather than a day too late" approach with euthanasia. But I think I'd always second guess, no matter what route we took. It just plain sucks.

 

We're all here for you. Please know that. It just takes a lot of time to heal.... and someday, your heart will be ready to open your home to another hound again...

 

Godspeed good Charlotte. Hugs to you, Charbess.

Lynne

Thanks so very much, Lynne. May I ask what symptoms Timber was exhibiting for the 7 months it took to get the correct diagnosis?

Jean

[Guest lynne893]

Goodness. I have to recall. Mostly, her poops went from normal to runny, mucous-y, sometimes with some blood, and sometimes totally encased in mucous like a hot dog is encased in skin. It's hard to describe.

 

Also, she lost so much weight. And her appetite was lessened. I began cooking chicken and rice and even then sometimes she'd turn away.

 

Lastly, at the outset of the 7 month period, she had severe subcutaneous (under the skin) bruising that looked like a big blood clot under her skin. It covered a third of her abdomen. I do believe that was the first symptom of the lymphoma but I didn't recognize it at the time.

[charbess]

Goodness. I have to recall. Mostly, her poops went from normal to runny, mucous-y, sometimes with some blood, and sometimes totally encased in mucous like a hot dog is encased in skin. It's hard to describe.

 

Also, she lost so much weight. And her appetite was lessened. I began cooking chicken and rice and even then sometimes she'd turn away.

 

Lastly, at the outset of the 7 month period, she had severe subcutaneous (under the skin) bruising that looked like a big blood clot under her skin. It covered a third of her abdomen. I do believe that was the first symptom of the lymphoma but I didn't recognize it at the time.

Thank you for the reply, Lynne.

[charbess]

Thanks for sharing your sad story, Lynne. I am a bit more at peace that we didn't go for any heroics in treatments.

Sure do wish our pups could talk to us...

[charbess]

Thank you so very much for the reply, KF. So many people have told me we did the right thing by her and in my heart of hearts I know we did but that nagging feeling of "are you sure, are you really sure you didn't do it to save yourself aggravation and money and inconvenience?" is making me my own worst enemy.