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A Digit Here, A Digit There

A medical diary
by Jan Rifkinson
August 2006

 

Tue 27 Jun '06  I had to take Truman to the vet yesterday as he had a funky looking nail which he had been licking for the better part of a few days. I was allowed to accompany him to the 'back' rooms to help control him for further diagnostics sans drugs. Two x-rays later, it was discovered that he, indeed, had a funky nail along with 'something' that had started to eat away at the tip of the aforementioned toe bone. 

After a lengthy conversation with Truman's primary care vet it was decided to put him on Bayatril (antibiotic) & to apply a Fentanol patch on his left rear hock to take the edge off the surgery to amputate that toe, scheduled for the following morning.  The decision was made based on the erosion of the toe bone & the fact that it would have been too iffy to get a good sample for pathology.  And the time loss could prove fatal if it was a fast moving cancer. 

As some Bouviers do, Truman reactions to the Fentonol was a lot of panting & hyperactivity. It was a bit difficult to calm him down but, as the evening wore on, he became more sedate on his own.

Wed 28 Jun '06  It was pouring rain this morning & no food or water for Truman. He didn't seem to care much. He was a bit 'edgeless' but was plenty alert to know something was up. He followed me around with his eyes.

Just before 9am, I covered him with a towel & piled him into the car to drive to the vet. I handed him over to a vet tech that we both know with a smelly tee shirt for his crate & instructions to call me in enough time so I could be there as he came out of anesthesia.

While under Truman will get x-rays to make sure that if that "something" is a form of cancer, that it hasn't metastasized to his chest. The toe will be sent to pathology for follow up.  Best case scenario: a virulent infection and a 11 toed Bouvier.  Worse case... well, I've already mentioned it.

Truman is scheduled first for surgery & it's now 11:35am & I'm waiting for the call, trying to keep busy, writing this, amongst other things..

11:55am, the vet called to say he removed the entire digit  (the bone looked 'clean' at the cut), the x-rays looked clear, Truman is still under sedation but they are cleaning his teeth. I can see him in 40 minutes or so.

The digit & some extra tissue will be sent out for further examination & I will ask the primary vet to confer w the oncologist who took care of Sabrina. It will take +/- a week for the pathology results.

Wed 28 Jun 06  12:30pm went to be with Truman as he came out of anesthesia. Had gotten morphine shot & he was on a pain killer drip (can't remember name). I sat in his crate, scratched his favorite place & kept talking to him. Gradually.... an hour or so later, he started to move around but was extremely groggy & didn't react to my voice or touch. I wondered if I was getting through. Finally, veeeery slowly, as he came out of anesthesia & didn't panic.

2:30pm, Truman was getting restless. We thought he had to pee. He couldn't hold his rear end up so we put a towel under him & helped him stagger outside where he did nothing. So we all staggered back inside where he flopped on the cold floor in the middle of the recovery area.

There he stayed for about 15 minutes, gathering his strength @ which point I helped him up (he was really in the way) & directed him back to the crate.

By 4:00pm I had to stretch my legs so I took a short break. When I returned, tech told me Truman had been very disturbed in my absence; normally not an issue but it indicated that my presence was definitely helpful.

4:30pm Truman was very determined to get up so I stood back to see how what/how he would do. He wobbled directly to the exit door which gave me a chuckle. I opened the door for him & he swayed his way thru the hallways until we got to a small waiting room where he collapsed in exhaustion. He took a little food by hand -- a good sign.

A few minutes later he gathered his strength again & lurched for the front door like a drunken sailor. Outside he headed for the car but got distracted & decided he preferred air conditioning so we headed back to the office. There he collapsed in the waiting room to the dismay of a few people waiting for their appointments. I had to explain he hadn't dropped dead, that he was just tired  & gathering his strength after having surgery, etc.

Don't anyone tell you that a Bouvier doesn't know exactly what it wants & has the strength & determination to get it.

Around 5:30pm Truman got it together again & sort of hopped-wobbled-lurched to the front door & headed directly to the car. So I picked him up -- all 110 pounds of him -- and placed him in the station wagon, ran back to collect my stuff & drove him home.

5:58pm At home he allowed me to help him out. After that he made the supreme effort to get into the house, across the lawn, up a few steps into the house where he collapsed in exhaustion. At least he was home & in the a/c again.

Overnight he drank no water but had a couple of nibbles on a soft biscuit. Around midnight he made an unsteady move to the kitchen (I sat w him until he fell asleep @ 2am) where he stayed until 4:15am @ which point he returned w a wet beard & flopped near the sofa where I was waiting for him. I stroked him until he fell back to sleep.

Thu 29 Jun 06  T didn't want breakfast but stayed w us in the kitchen. Still a bit unsteady but his eyes are finally clearing up from that confused anesthetic look. He has not whimpered or cried or panted in anxiety or pain so I didn't give him any pain killers. Around noon he barked once (very quietly) to let me know it was biscuit time so -- well trained as I am -- he got it. And then he decided to join me in my office where I got my first tail wag & a little kiss. That was a happy moment for me.

Now we're hoping he will opt for dinner. He's getting around better, hopping along. When he stops he picks up the surgical foot. He's more alert but still exhausted. The fentonol patch will stay on for 5 days.

I think tonight will be better. On Sat he returns to the vet for an inspection & change of bandage. That'll be my first look at his foot sans toe.

Fri 30 Jun   2 days post op Truman is still not himself but walking around with that stupid bag on his foot. I've been trying to keep him quiet but he is very restless. I heard a couple of very low whimpers so between that & his restlessness I figured he had some discomfort.  [CLICK ON ANY PHOTO FOR ENLARGEMENT]

Instead of Deramax (very strong), I gave him 2 coated baby aspirin to see if that would be sufficient. He continued with  erratic behavior most of the day, would stare at me from the hall or walk in, then walk out, lie down, then get up, would nudge me like he wanted something, etc.

I talked to him, petted him, put down fresh water, gave him some treats, asked him what he wanted as he's usually demonstrative, i.e. he will hit the door, walk to his water dish, treat box, etc.

He didn't want to go out, didn't want his water, wouldn't eat his breakfast, nibbled on his treats, couldn't make himself comfortable.  Because of all this weirdness he was getting plenty of attention so I started to wonder if he was 'playing' me. Never underestimate a smart Bouvier's human training methods.

Sat 1 July  (+ 3 days) Truman is different; he's more of a velcro dog. He has always keeps an eye on me but Sabrina always stayed 'in close' so he opted for higher ground, more of a general lookout. Now he's taken to following me around more (it seems since the surgery) & I don't know if that's because Sabrina isn't around any more or because of his surgery, etc. Whatever, it's interesting to observe.

Just before 2pm as I started to get ready to take him to the vet, he got a bit antsy, following even more closely until I asked him if he "wanted to go for a ride". Well, you would have thought this was better than baked liver treats so we rode over to the vet. T had no trouble getting in/out of the car, i.e. jumping onto the seat. However, once in the vet's office, he was *extremely* anxious but behaved.

While in the waiting a new vet tech came out to greet us. And with a file record in hand, she said cheerily "Hi! Who do we have here?... Sabrina?" After a pregnant pause I replied "Well if we had Sabrina here that would, indeed, be a miracle. She's dead." Suddenly there was silence, then profuse apologies we entered the exam room, off to a bad start.

They know me well enough to know not to say to me that they are going to take him to the back to do their work so everything possible is done in the exam room with me in attendance. In this case, I helped position him on his side w a "down" & "roll over" on the scale so the foot could be more easily inspected & re-bandaged.

I was surprised: the wound was dry, well sutured. He got some clean padding & a nice new, masculine blue bandage. 

It's been 5 days since the Fentonol pain patch was applied so that was removed. He is not to run & will probably take a good month or two to fully heal & may favor that foot for the rest of his life. That should be the worst thing.

Saturday (3 days post op) is the first day I can say that Truman is himself, i.e. I believe the anesthesia is out of his system...finally. He's happy, playful, still following me around.

Sunday, Jul 2nd. (+4 days) appetite normal, water intake, all bodily functions returned to normal. I will probably take him back to vet  on Fri for another checkup to make sure everything is still healing properly.

Truman is sleeping in the corner as I write this. He's had dinner & taken his pee so he's happy. Me, too.

Because the bandage was left on for too long -- 5 days --  Truman developed an infection around the wound. This really pissed me off as there was no reason for this to happen. A sample was taken for a culture. Then the foot was washed off, dried, an antibiotic powder was administered, the foot was bandaged &  he was put on a common oral  antibiotic. 

Two days later, the wound was washed & dried again, another helping of antibiotic powder was applied & and the foot re-wrapped.

Two more days, the wound was a little better but still slightly enflamed. The culture came back; the results showing that the bacteria(s) he had contracted were immune to the oral antibiotic that he was taking so that was changed.  The foot was treated as before.

Another two days, the wound seemed better but the antibiotic regimen was to continue for ten days.

July 21   -- 22 days post-op -- the sutures were removed & a looser bandage was place on his foot. 

Five days later, we had a final checkup & everything looked fine so, in the house, I took his bandage off so the wound could get air but when he went out, it was covered.

Aug 04, 2006. Hair is growing back, albeit slowly.

T looks pretty silly with one shaved leg but he he's not favoring his 3 toed foot. I've cleaned all the hair between his pads to make sure he gets good traction & no hair knots which would only complicate things. However, he needs more exercise so I'm going to start regular walks with him as he is less interested in roaming the property but I forget he's going to be 12 & needs prodding.

Otherwise my wonderful boy seems to be in fine shape.

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