Wednesday, April 24, 2013

The Waiting Continues

2013 April 23 - 24

The Waiting Continues

On Monday, Dr Bennett called after Greyla's splenectomy was finished,but before she was fully out of anesthesia because he knew how worried we were. I was so happy to hear that she survived the surgery! My deepest fear had been that she would die on the OR table, and my extreme superstition would not allow me to voice that fear! They had removed the mass and spleen and ligated all bleeders. The mass was a whooping ten pounds! And as impressive as that is, the thing ruptured shortly after they removed it! Her liver looked "beautiful", to quote Dr Bennett. Her PVC, post surgery, was 34. Not out of the woods yet, but all in all, good news. 

[A splenectomy and removal of such an enormous blood-filled mass, is an equally enormous risk,especially in a dog who is broaching her 14th birthday. We were fully aware of the risks, but elected to do it anyway, because the alternative was to watch her slowly ebb away, in increasing discomfort, with the very real possibility that the mass would rupture causing her to bleed out and die. But the decision was not one we took lightly, for so many reasons, including the financial hit, with no guarantee of success. So, when Dr Bennett called, post surgery, my relief that she had not died on the table was palpable. Unfortunately, we perhaps failed to calculate the full cost of such invasive surgery on the sweet old girl, and we neglected to fully realize how long the recovery process would be.]

Later on Monday afternoon, Dr Person called to say that we should come out to Allpet around 7:30 to see Greyla and to decide where she should go for further post op care, since Allpet does not offer 24 hour monitoring. 

Seeing Greyla that evening, in her still anesthesia induced stupor, we knew that she needed much more care than we could offer her. Our choices were PVSEC or VCA Northview for continuing care. We opted for Northview, basically bc it was the closer place. Allpet kindly offered the use of their stretcher, provided we promised to return it. 

The drive to Northview, through the northern suburbs of Pittsburgh was stressful, but we arrived without mishap and Greyla seemed a bit more aware. They settled her into a double cage, with loads of quilts and blankets, and even a folded towel as a pillow for her head. She, for the first time since the surgery, lifted her head and looked at Raymond & me with possible recognition. The road to recovery was beginning. The doctor, Dr McKlveen, assured us that us that we would only hear from her during the night, if there was a problem, and/or Greyla needed a transfusion. She also told us that Dr Threadgill would be coming in at 7 and he would be in touch sometime around 9AM, to report Greyla's progress. We drove home cautiously optimistic.

Dr Threadgill did indeed call in the morning, around 8, with the update. Greyla was not yet able to stand or walk. Some of that inability may be a result of her old arthritic limbs and joints. She exhibited some abdomen tenderness. Her liver enzymes were down a tad. The white blood count was elevated slightly. Her pack cell volume was stable. She was alert, aware and responsive. We could visit around 11. She could probably be discharged when she was able to arise and walk.

Our visit to see Greyla went well. She was brought into the room on a stretcher, but was alert and responsive. After a time, we put the rubber backed rug we brought with us on the floor and coaxed her to try and get up, hoping the rug would give her purchase that the floor alone did not. Her initial attempt was a failed one, but her second try got her onto the rug, under her own power, where she walked a single circle, then laid back down on the gurney. It wasn't a lot, but for us it was an extremely BIG deal! We also offered her several varieties of wet food, but she wanted none of them. When we return to visit in the evening, we'll bring other things to try and tempt her to eat.

Upon returning home, we each set about our tasks for the day. Mine included at trip to the laundromat. AS I was finishing up there, my phone rang. It was Dr Threadgill. He reported that one of the techs told him that "his friend" was standing up in her cage & had made a couple of circles. They got her out, and the tech then walked her through the treatment area, out the back door and outside, where Greyla peed, then walked back! All on her own! No coaxing and no assistance! I was beside myself with joy! And, Dr Threadgill, bless his Tennessee heart, was too! He said, " I was so happy and I knew you would be too, so even though I'm almost ready to leave, I knew I had to call and let you know." I called Raymond & we were both happy! The plan was to visit sometime after 7:30.

We called Northview to be sure the timeframe for visiting was good and the tech we talked to suggested bringing any food we thought she would eat, regardless of it's nutritional value. So, on our way, we made a stop at McD's and got nuggets, which she usually loves, as well as a plain burger, to compliment the assortment of bread, treats and dog food we were bringing from home.

I was expecting Greyla to be similar to how she had been in demeanor earlier in the day, with the added benefit that she could get up and walk. So, when the tech walked her into the room to visit with us, although I was thrilled that she was walking, I was disappointed by her demeanor. She seemed dull eyed, compared to earlier in the day. There was no attempt to make eye contact. She whimpered. To me, her gums seemed pale. She had 2 small areas of fresh pale blood on her blanket. We offered food, she refused it. Although, at one point in the vista she opted to eat 2 or 3 very teeny bits of one nugget. When Dr McKlveen came in, I asked about her gums and the whimpering and the blood, and was told that her blood values were stable, the blood from the incision site was not a concern and that Greyla whimpered when she needed to go out to the bathroom. I do not think it was the Dr intention to be dismissive, but that was how I took it. The difference between Greyla at 8pm and Greyla at 12 noon was crushing to me. And had I had my wits about me, I would've shared the pictures I took when we visited earlier in the day with Dr McKlveen, and perhaps she would've seen it too.

We left and in the parking lot, I broke down in tears, yet again. This time tears of lose for what little progress had been gained and now seemed gone. Yes, I want my girl to be able to get herself up from a resting position and walk, but I want her to do it with a light in her eyes and spirit. 

So, we wait a bit longer…

This morning we got a call from Dr Sisk, the daylight Vet today, reporting that he is changing Greyla's pain meds to address her arthritis problems better. He said she is still able to rise and walk and go outside. She is still refusing food. He feels that she will progress, but due to her age it will be a long rehab period. We will visit around noon. We will allow her to stay until Dr Threadgill comes on duty at 7PM and reviews her condition. We will visit agin in the evening, talk to Dr Threadgill and depending on why he has to offer, either leave her another day, or bring her home tonight.

In either case, we will try and get some kind of ramp together this afternoon, because when she does come home, we're concerned about how to get her into the car, as well as in and out of the motorhome. 

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