Author Topic: Addie spay complications  (Read 21452 times)

Vet

  • Getbig IV
  • ****
  • Posts: 1679
  • Immortal
Re: Addie spay complications
« Reply #50 on: September 22, 2007, 02:35:24 PM »
"Spontaneous bruising is the major clinical sign."


I am thinking that this is actually a "bruise", and maybe because of her size and the area it is (the knee where the skin is stretched as she sits) maybe it opened?    Maybe Vet will have a thought?  I will be asking my vet when I see her later, he did say that it wasn't done in transport or when she was up and moving.  That was my first thought.  Moving big dogs can be dangerous to the dog and to the staff.  When they are knocked out they aren't as easy to move as a person.  Some vets won't do some surgeries on giant dogs because of the strength needed and the chance of harm to everyone.  At least I have had one vet tell me that.  The woman who did Emmett's neuter wouldn't do Addie's spay even though Addie is 40pounds lighter. She said it was just too much to move them and dangerous.  She did also have some arthritis in her wrists which also made working on a giant dog harder on her. 

Yeah,its most likely a bruise----its hard to say without seeing it, but consider the cage is probably metal (or coated wood) and even with a pad in it, if she rolls across the bone just the right way, considering her current condition, she's in a condition to develop these type of "cage sores".   Typically they start as a bad bruise, then the dog starts licking them, making them appear worse. 


To answer your other questions.... I doubt it if its anesthesia drug related.  I have no way of knowing for sure without knowing exactly what drug protocol they used (there are several considered "standard" for large breed dogs).  Thrombocytopenia is more associated with antibiotics and similar pharmaceuticals, not anesthesia drugs. 

Yes, this may be a lifelong condition.  Right now she's going through a bad spell.  She's got to get through this.   Events at a later time could trigger a reoccurance. 

Vet

  • Getbig IV
  • ****
  • Posts: 1679
  • Immortal
Re: Addie spay complications
« Reply #51 on: September 22, 2007, 02:37:41 PM »

Yes, that would be great, another obstruction.   :P


 I noticed on the Hematology report that Anisocytosis is checked (looks like a tv or tr ?)

 Would unequal red blood cells have any input on what is going on with her or point to a possible cause?


No, Anisocytosis just means red blood cells of different sizes.  I don't consider it an indicator of any specific cause, however it might help you figure out the exact cause of the problem----for example a dog with severe bone marrow suppression with thrombocytopenia may also show anisocytosis as a result of the bone marrow not producing redblood cells correctly either.   

Vet

  • Getbig IV
  • ****
  • Posts: 1679
  • Immortal
Re: Addie spay complications
« Reply #52 on: September 22, 2007, 02:39:46 PM »
:'(


Ok.....

explain this to someone that can't comprend this stuff....

Is Addie in trouble?  What's the seriousness?

I know it's not great....but just to what degree.










I know flower's vet may not have come right out and said this, but I will.  This is serious, very serious.   How she does depends on her response to the steroids and her degree of platelet destruction.   Does she have a resonable chance at survival?  Yes, but she's going to have some intensive medical treatment the next few days. 

Could things get much worse?  Yes.   

knny187

  • Moderator
  • Getbig V
  • *****
  • Posts: 22005
Re: Addie spay complications
« Reply #53 on: September 22, 2007, 02:44:13 PM »
I know flower's vet may not have come right out and said this, but I will.  This is serious, very serious.   How she does depends on her response to the steroids and her degree of platelet destruction.   Does she have a resonable chance at survival?  Yes, but she's going to have some intensive medical treatment the next few days. 

Could things get much worse?  Yes.   

 :-\

Vet

  • Getbig IV
  • ****
  • Posts: 1679
  • Immortal
Re: Addie spay complications
« Reply #54 on: September 22, 2007, 02:52:33 PM »

 I don't know if I can answer that right now.  After we see what the dexamethasone does and a transfusion if she does end up having that, a better prognosis could be given.  I am going to ask the vet just that question later, is she in danger and how real is that.  He has called her condition "fair" this whole time. I guess that means she hasn't entered into an actual crisis yet, but the results on her platelets show that she is heading that way. 

 I don't know what this means long term for her either? Will she be on meds? Is this a "crisis" of a disease and maybe she will never have another "crisis" present itself?

 She was healthy before she went in, so that is on her side.


I don't think DIC has been ruled out conclusively at this point:




DIAGNOSIS OF DIC

DIC can be difficult to diagnose because it can be triggered by many unrelated diseases, the clinical manifestations are variable, and there is quasi-consensus about what constitutes a definitive diagnosis. Diagnosis is based on the following criteria:

• Presence of an underlying disease known to be associated with DIC.

• Multiple abnormalities of the coagulation profile. Not all variables will be abnormal in every case. Some clinicians consider abnormalities in 3 of the following commonly available tests to be sufficient for a diagnosis: Platelet count; ACT, PT and APTT; fibrinogen concentration; AT-III concentration; FDP concentration; presence of schistocytes on a peripheral blood smear.



 :-\        http://www.vetcentric.com/magazine/magazineArticle.cfm?ARTICLE=Thrombocytopenia%3A%20When%20Your%20Dog%20Suddenly%20Starts%20Bleeding

Severe thrombocytopenia is much more common in canine patients than in feline patients. The disease has diverse causes, ranging from active bleeding during surgery to cancers to Rocky Mountain spotted fever. However, in dogs, the most common cause is the disease immune-mediated thrombocytopenia, or IMT. Unfortunately, mortality rates of patients with IMT approach 50 percent: death is caused by severe blood loss, especially bleeding into the gastrointestinal tract, or bleeding into the brain.

From what you've described, it sounds to me like she's going through an IMT crisis.  She may or may not be on medication long term.  SHe will require followup blood work to make sure her platelets are not getting destroyed.  There is a risk of another crisis at a later date.   Thats all part of IMT.  

I really don't know about DIC.  Thats getting into a realm of emergency and critical care and internal medicine I'm not up to date with.  Most of my patients won't get DIC--or its never been identified in these species positively.  They die first.    With dogs and cats there is such controversy about DIC, its a question I'd have to ask my wife (even though she's an equine surgeon, she's getting ready to sit for Emergency and Critical Care boards---she's way more up to date on DIC literature than I am).  Traditionally, I'd think if Addie was in DIC, she'd have not made it this long.   DIC is very, very bad.  Not something a dog lives for days with.  

Vet

  • Getbig IV
  • ****
  • Posts: 1679
  • Immortal
Re: Addie spay complications
« Reply #55 on: September 22, 2007, 02:59:04 PM »
:-\

Now lets not go and get all discouraged.  This is a condition that Addie stands a reasonable chance of getting through.   Its not a time to get depressed and focus on the negative.  When you consider the big picture of her condition, there are several positives----from her being alive this far post surgery, to a HCT in the 30's to her trying to eat a little.   She's sick right now, but she's still got a chance.  Its a matter of seeing how she responds to medication and how she does over the next couple of days. 


FLower, I don't know where you live exactly and I don't know your veterinarian, but now is a time that if that veterinarian suggests referral to a specialist or a 24 hour referral hospital, I'd strongly consider it.   The main reason being is the larger hospitals will have ready access to items like blood for a transfusion, inhouse laboratories for monitoring her clotting profile and platelets, and other things that may not be as readily available in a smaller hospital.   

~flower~

  • Getbig IV
  • ****
  • Posts: 3597
  • D/s
Re: Addie spay complications
« Reply #56 on: September 22, 2007, 03:11:11 PM »
allrighty.......  Addie did seem to be a little better today for some reason.  They had taken her outside and let her walk around a few minutes before I got there and the pressure bandage was off.

  She at first was not that interested in eating, but after some time with me sitting there she suddenly cleaned the whole bowl!!  :D     If anyone is considering cropping ears for looks consider this.... at one point I could tell Addie was getting over excited, she was starting to breathe more rapidly.  I put her head in my lap and started rubbing her ears and I could see and feel her calm down.  She relaxed, her breathing leveled out.   I think if given enough time she would of went to sleep.  When I had to leave she tried to hold me down with her head.   :(   The ears are very sensitive for dogs so consider that before you crop  ;)

 I asked the scale of 1-10 question and he said 7-8, so I think those are pretty good odds.  :)  He is going to check her platelets again tomorrow and make sure they haven't dropped further and hopefully they will be higher.  If she continues to improve and her platelets go up hopefully she will be able to come home on Monday.

 He thinks right now that this is an acute crisis brought on by the stress of the spay, not a chronic condition.  It is too soon to tell. 

 With Addie everything seems to be complicated and/or expensive.   :P


 Thanks again everyone for your good thoughts, experience (appreciated Vet),  and offer of money - lol.

  Will get another update tomorrow morning after the platelet check, and be seeing her in the afternoon most likely. I just hope it does take another turn, it seems like every time I get better news and feel positive, something else turns up. 

  It's really weird with her not around.
  :-\



~flower~

  • Getbig IV
  • ****
  • Posts: 3597
  • D/s
Re: Addie spay complications
« Reply #57 on: September 22, 2007, 03:15:53 PM »
FLower, I don't know where you live exactly and I don't know your veterinarian, but now is a time that if that veterinarian suggests referral to a specialist or a 24 hour referral hospital, I'd strongly consider it.   The main reason being is the larger hospitals will have ready access to items like blood for a transfusion, inhouse laboratories for monitoring her clotting profile and platelets, and other things that may not be as readily available in a smaller hospital.   


 The emergency vet office did the clotting panel and have already been checked with for having blood, but thanks for the heads up on that.   He can do her platelets and crit in house, so that is good. 

 I think if she wasn't eating at all, or if she overall was worse (vitals,etc) then he would suggest transferring her there or I would.  If she takes a turn or something else presents it self then that definitely would be considered. 

~flower~

  • Getbig IV
  • ****
  • Posts: 3597
  • D/s
Re: Addie spay complications
« Reply #58 on: September 22, 2007, 03:18:37 PM »
Flower, if you need any donations to help with the doctor's bill,,let me know. ;)

  Thanks Jedi!!   :-*

  So far we should be good with the current plans and expenditures. Obviously this is more than I was in the spay budget which for a dog her size isn't cheap!   

knny187

  • Moderator
  • Getbig V
  • *****
  • Posts: 22005
Re: Addie spay complications
« Reply #59 on: September 22, 2007, 03:32:32 PM »


 I asked the scale of 1-10 question and he said 7-8, so I think those are pretty good odds.  :)  He is going to check her platelets again tomorrow and make sure they haven't dropped further and hopefully they will be higher.  If she continues to improve and her platelets go up hopefully she will be able to come home on Monday.

  :-\




is it

1 being bad & 10 being good

or

1 being good & 10 being bad

Butterbean

  • Moderator
  • Getbig V
  • *****
  • Posts: 19326
Re: Addie spay complications
« Reply #60 on: September 22, 2007, 04:21:08 PM »


 I asked the scale of 1-10 question and he said 7-8, so I think those are pretty good odds.  :) 

is it

1 being bad & 10 being good

or

1 being good & 10 being bad

From the smiley-face I think it' 10  being good.



Flower, thank you for the update and I'm so thankful it was a positive one!
R

ripitupbaby

  • Pros
  • Getbig V
  • *****
  • Posts: 6952
  • 2010 Olympia Pro Powerlifting Champ
Re: Addie spay complications
« Reply #61 on: September 22, 2007, 06:35:31 PM »
WOW flower...sorry you and Addie have to go through this.   :(

I hope that things continue to improve!!

 :)

:)

Lord Humungous

  • Getbig V
  • *****
  • Posts: 4673
  • REVOLUTION CALLING!
Re: Addie spay complications
« Reply #62 on: September 23, 2007, 06:56:48 AM »
Im glad things are turning up buddy! Please keep us posted!
X

knny187

  • Moderator
  • Getbig V
  • *****
  • Posts: 22005
Re: Addie spay complications
« Reply #63 on: September 23, 2007, 10:44:10 AM »
.

WOOO

  • Getbig V
  • *****
  • Posts: 18158
  • Fuck the mods
Re: Addie spay complications
« Reply #64 on: September 23, 2007, 01:54:45 PM »

~flower~

  • Getbig IV
  • ****
  • Posts: 3597
  • D/s
Re: Addie spay complications
« Reply #65 on: September 23, 2007, 03:16:00 PM »

 Today's Update:

  Platelets were up to 80,000 this morning- YEAH!!!   White cells are down so the antibiotics are doing their job, her crit is down from 32 yesterday to 30 today, but that isn't a cause for alarm at the moment.  No active bleeding from her incision or her knee (pic below).  Temp normal, other vitals normal.

 She ate with gusto and was standing when I got there.  Much more "peppy" today.  Was very content just to try and sit on me and then making do with her head in  my lap.  She will be in a small run over night and not the big cage to give her more room for movement.

 If her platelets have improved more tomorrow and everything else looks good she should be able to come home tomorrow night!!   :D  She will be restricted on her activity of course.  Her platelets and other stuff will be checked when she gets her sutures removed. 

 So it looks like the Dexamethasone yesterday and the pred this morning are working, her immune system is not destroying her platelets, and her body is producing them, so that is good.

We won't know whether this was an acute crisis or if it is a chronic condition.  It will be something to plan and look for if she ever needs another surgery or is injured in the future. 

  Thanks for all the support, encouraging words and information, it does mean a lot.   :D



Pics of her knee   :( (taken with cell phone)   :

Butterbean

  • Moderator
  • Getbig V
  • *****
  • Posts: 19326
Re: Addie spay complications
« Reply #66 on: September 23, 2007, 03:52:06 PM »
Thanks for the update Flower!  Wonderful news :D


Will you put anything on Addie's knee or leave it to heal on it's own?

R

knny187

  • Moderator
  • Getbig V
  • *****
  • Posts: 22005
Re: Addie spay complications
« Reply #67 on: September 23, 2007, 03:55:16 PM »
good news

 :D

WOOO

  • Getbig V
  • *****
  • Posts: 18158
  • Fuck the mods
Re: Addie spay complications
« Reply #68 on: September 23, 2007, 04:34:55 PM »
addie is october's dog of the month.

period  :)

JediKnight

  • Getbig IV
  • ****
  • Posts: 2081
Re: Addie spay complications
« Reply #69 on: September 23, 2007, 04:42:50 PM »
I agree with WOOO!   

ripitupbaby

  • Pros
  • Getbig V
  • *****
  • Posts: 6952
  • 2010 Olympia Pro Powerlifting Champ
Re: Addie spay complications
« Reply #70 on: September 24, 2007, 04:39:08 AM »
:)

CQ

  • Competitors
  • Getbig V
  • *****
  • Posts: 7018
  • TGT
Re: Addie spay complications
« Reply #71 on: September 24, 2007, 04:47:20 AM »
Hope everything works out Flower.

~flower~

  • Getbig IV
  • ****
  • Posts: 3597
  • D/s
Re: Addie spay complications
« Reply #72 on: September 24, 2007, 07:12:13 AM »
LOL @ Woooo & JediKnight   ;D


 It looks like Addie will be coming home today!!   :D    No recheck of her platelets was done because she is acting sooooo much better.  I guess they had her out and she had to go around greeting everyone in the office.   :)

 She'll get a warm bath this afternoon to clean her up after her ordeal (that will make it TWO baths this year for her!!!) and I should be getting her around 4:45, I have to call back around 2 and make sure she is still cleared to leave. 


  STella - I will probably just leave her knee alone. I could put raw honey on it to help healing and scarring, but considering the size of it and where it is I think that would just encourage licking by both her and the other dogs, in particular Tad!!   Since she is on antibiotics infection shouldn't be a concern, so I'll just keep an eye on it. 

It will be interesting to see the welcoming Addie gets.  I'm sure their will be lots of sniffing and checking her out.  Tad has been a snuggle whore in Addie's absence and has been shacking up with Bri most of the time.  :o  I even took a few pics but will have to make sure Addie doesn't see Tad's betrayal!!!

She will be happy to get some "solid" food, but I had ground up some extra chicken that will make up the majority of her meals for the next few days.  Missing a dog has really messed up my feeding system for meal times!!  I have had to think instead of doing it pretty much on autopilot. 

Keeping her calm and inactive shouldn't be a problem because she is a couch potato, but if she is feeling better she may have some pent up energy and just being happy to not be confined, so sparring with Briona will be out of the question.   

It seems the worst is over (paws crossed) and will have to see what future tests show about this incident, is it an isolated one brought on by the stress of the spay, or is there an underlying problem? 

     Thanks again and again for the support and positive words. 

Will post "back home" pics in the next few days.
   :D
   

ripitupbaby

  • Pros
  • Getbig V
  • *****
  • Posts: 6952
  • 2010 Olympia Pro Powerlifting Champ
Re: Addie spay complications
« Reply #73 on: September 24, 2007, 10:24:15 AM »
Awesome news!  Back home pictures are a MUST!    :D


:)

Laura Lee

  • Competitors II
  • Getbig V
  • *****
  • Posts: 9954
Re: Addie spay complications
« Reply #74 on: September 24, 2007, 11:56:34 AM »
Oh Flower, I just found this thread.  I went through a roller-coaster of emotions reading it too.  I am so very happy Addie is feeling better and on her way home today.

Give all your babies a big hug from all of us here, and from Rocky too  :-*
:D Weee