Debridement

The tail dock didn’t really heal closed. On Monday we took her in for her stitches removal appointment. They said ‘hm. leave in another week’. On Tuesday, she pulled herself out of her cage when the door was left open. 9 hours later, I realized she’d pulled her stitches out then, too. There wasn’t really any blood, but you could see disturbing white glints when you looked at the open wound. Emergency room and associated costs, ho!

They put in more stitches late Tuesday night.

Yesterday afternoon, I checked on her and some of the stitches had snapped. Gaping injury, disturbing glints of white, etc. Emergency room ho!

They kept her over night and installed special loop sutures so we could apply and regularly change a wet to dry dressing. I guess this is one of the problems with antibiotics! Antibiotics keep infection away but they /don’t/ stop tissue from dying. Dead skin doesn’t hold stitches well.

She’s also developed enough upper body strength/flexibility to get to her tail area without curling her back end around. So she’s in a cone collar. And she’s an angry, angry dog. She has come to TERMS with her handicap, and with having a human pair of back legs and she is READY to SCOOT AROUND so why are we keeping her down?

Dumb dog.

Pre-therapy!

Actual real blood freaks me out. When I was a kid, injuries in myself and others (other than scabbed knees) that bled caused me to panic. It was a nice controlled panic, a ‘run to an adult and weep at them’ panic, but still a panic. Now, twenty years of intensive menstrual therapy later, I’ve learned that blood isn’t always a Very Bad Thing. Sometimes it’s just a little badness.

All the same, taking Hannah outside to pee today was nightmarish. If I can go my entire life without again being sprayed by warm blood forced between sutures over an amputated limb by sudden movement and pressure on the nearby area, that would be nice. Maybe tonight I should tape a temporary bandage over her tail stub before we do a reprise.

Part of me, deep inside, is taking notes for writing. A lot of it is cross-checking things already discovered by heroes and heroines throughout the ages. The warm sticky splash. The way so little blood can spread so far.

After we’d taken her outside, I took a shower and then hid under the covers. When I got up a second time, the pad under her butt was covered in gore, but her injury itself was dry and clean. A pad soaked in blood didn’t bother me nearly as much. Thanks menstrual therapy!

Hahahahah. Hah. Hah.

I wonder why they dock both tails and ships?

My paid subscription to M-W unabridged is ambiguous on the matter. Apparently ‘docken’ or ‘dok’ was Middle English for tail…

Anyhow. Hannah has a docked tail now, just like many dogs do. She’s unhappy; if I were to anthropomorphize her, on the way home, she had a quiet breakdown over all the terrible things that have happened to her lately. She’s in her cage now. Her sutures are unbandaged and leaking mildly, especially when she moves or pressure is put on them.  When she inevitably tries to sit up, it’s going to be grim. Hopefully the longer we can keep her resting, the better.

A 24-hour vet after hours is… a raw place.  They try to keep things private at human hospitals but pets aren’t protected the same way. By the time we left, the score (counting Hannah) was 3 pets leaving alive, 2 pets… not. We came in alongside a pair of women with a tiny dog wrapped in blankets. It had stopped breathing on their drive there. They kept mimicking its final cries to the doctor as they tried to explain and understand what had happened. It was horrible and depressing and I had to press my face against Kevin to avoid hysterical laughter. They didn’t know what had killed it but they signed up for an autopsy to find out. They were shocked but calm, so calm I wondered if it was their own dog or a child’s. I’m glad they were calm, though, because otherwise I would have cried myself.

Right after them, another pair of women came in with a dog who was choking, or at least wheezing. The techs took him back and brought him out again five minutes later, with a stick that had been wedged in the upper part of his jaw. The vet didn’t even charge for that, and it balanced nicely against the tragedy 5 minutes earlier to prevent a wash of PMS-enhanced despair.

And finally, near the end of our relatively short wait, an exhausted man brought in his fading cat, carried in a cat bed, to be put to sleep. I think, balanced out, I’d rather be in his position than those women whose dog had died on the drive over. I’d rather make a decision than have a life slip through my fingers in the midst of desperate, frightened confusion.

The fifth pet had been hit by a car; her person was waiting when we came in. The dog survived with a limp and abrasions, and would be going home that night with the usual suite of medications. We talked to the woman some, and she clearly felt awful about her dog jumping the fence to get into the street, and frustrated at her inability to train the dog to stay out of danger. But I was a little jealous on Hannah’s behalf, all the same. A limp and abrasions. Poor Hannah.

But tail docking is pretty standard, even among adult dogs. And as I told the techs, I’m very happy to still have my dog with me. I think, once a bit of time has passed, she’ll go back to being happy to be with us, too. After all, she was just a few days ago.

Post #2: The one about Hannah.

All right. For the squeamish, I’ll just say that Hannah injured her tail and thus it’s getting amputated tonight. Other than the tail injury, the doctor thinks she’s doing very well, and possibly even getting some sensation back (althought not any useful sensation)– and the tail amputation will make managing her condition significantly easier. In the medium and long-term. In the short term, keeping her from sitting on the stump is going to blow.

So it sucks to cut off her beautiful tail (although it’s not beautiful anymore and wouldn’t be again), and I cringe a lot at the thought of it, but it’s okay. It’s a side-effect of her condition and not a sign of more problems to come. Or so the doctor’s convinced me.

I wish the nightmares would stop, though.

Dante is very affectionate today.

Click on for details about how the injury occurred.

Continue reading Post #2: The one about Hannah.

The act of observation changes the observed?

Whee. Now when I do research on Hannah’s condition, my own blog comes up on the first page of results for various different queries. That’s a good reminder to take it easy and not focus on it too much! But I did discover a different kind of injury: Fibrocartilaginous Infarct/Ebolism, which seems to fit the situation and symptoms, although was not, of course, the exact diagnosis. Unfortunately, the major prognositcation is still based on deep pain awareness. However, I feel a little less like Hannah’s situation is something from bizarro-land.

She seems more mindful of her rear end. I’d like to say this is a good sign. but it may just be her learning that she has these parts she can’t feel anymore and being more alert for people messing with them. She still only has a reflexive, not conscious, reaction to toe manipulation. She hasn’t been drinking or peeing very much the last 20 hours or so, which is a bit worrisome, but there’s been a little movement in both directions. I think I’m going to start adding some water to her dry food in the evenings.

*

In other news, I’ve played most of the first Phoenix Wright game (and enjoyed it), and returned to Dwarf Fortress. I’ve also started the Fantasy Harvest Moon game.

The Phoenix Wright game is not high art, but it does a great job of conveying fascinating little plots via nothing but dialogue and extremely limited art resources. It requires a healthy distance from any prior understanding of the justice system, though. I spend a lot of time shrieking during the investigation phases, when witnesses won’t talk to me, when accidental deaths are still considered murder, when as a defense attorney I’m treated like the enemy of the state, when I have to not just prove my client’s innocence but prove somebody else’s guilt– although I suppose that last gives me both the fun of defending the innocent and the aggressive pleasure of prosecution. Nothing like making a ‘witness’ break down in tears or scream in rage, right? The structure of each case is a bit repetitive so far but if you play the cases far enough apart that doesn’t seem like a big deal.

State of the Hannah

We’ve mastered expressing her bladder. Well, I have. She finally pooped, and shaving her rear end was a good idea but it wasn’t awful, in any case. She hasn’t been eating very much, but she’s always gone through cycles of not eating very much, and she’s overweight in any case.

She continues to be alert and interested– still basically Hannah on the top half, although Hannah on a very hot day, Hannah upset because she can’t run to the window or go upstairs with us. She always heads to the stairs when we bring her inside. Baby gates might have to serve double duty…

As far as I can tell, she’s the largest living parapalegic dog on the internet. And truly, her size is the biggest problem if she doesn’t recover– I can see why so many people say caring for their tiny wheelchair-bound dogs is easy. It really, really would be.

I rub her legs and move them a few times a day.  I turn her over, and believe me, that’s a pain in the ass.  She never let me pet her this much when she was mobile. 🙂 I might try combing her soon. Is that cruel, to take advantage of her disability to inflict something she hates on her? Well, probably not, since it’s almost certainly a healthcare task now, but I know I’m going to enjoy it. I love her fur. Muhahahah.

On a more serious note, I’m still hopeful, but I’m trying to keep myself aware of all the possibilities. Well, really, hope is harder for me than despair, so it’s more correct to say, “I’m maintaining hope even in the face of the possibilities and the potential choices that, frankly, haunt me.”

I haven’t made a move on my shared Dwarf Fortress game in days, but I did start playing Phoenix Wright at  Raymond’s urging– a DS is more portable than my laptop. But never fear, Dwarf Fortressers! I shall play on.

There’s so little out there to find

Hannah’s accident was so freakish. As far as I can tell, this sort of thing happens to small dogs, to daschunds mostly, and it seems like an accident but it’s really a degenerative disc disease that finally manifests.

Almost all the dogs with this kind of paralysis are small. And almost all of them require surgery to relieve compression. A bruised spinal cord (also known as a contusion, which took me a while to figure out) is weird. A bruised spinal cord that involves total paralysis and loss of deep pain perception is not something I can find any documentation of, at least in layman’s terms. The medical papers are in gibberish.

So, hey, I might as well keep documenting this.

We have to express her bladder. We tried it. We got a few dribbles, and weren’t even sure what we pressed to get those. It took two people. Now, she had a good solid expression before she left, at around 7:00. And she’s never been a big urinator. But bad bladder management can be fatal. As you can imagine, I’m nervous about doing it right. We’ll see how tomorrow morning goes. But while I knew already caring for Hannah would be a big task, I have a much more visceral sense of it now. She’s not a small dog.

I’m angry. I’m furious. I’m enraged that my dog ended up hurt in such an unusual, random way. I’m angry that her symptoms are so bizarrely extreme– loss of deep pain perception? (That’s when the dog doesn’t whine or bite in reaction to the skin between their toes being pressed on hard.) The recovery rate for that is incredibly low, after surgery. (But there is a recovery rate.) But surgery won’t help Hannah because what’s pressing on her spinal cord isn’t external. So what’s her recovery rate? Was it an insta-press-and-release that she’s now healing from? Or is it still pressing? What happened to her deep pain perception?

I gave her the prescribed medication, and I did it wrong. She may not have gotten part of the anti-inflammatory medication. Hell, she’s a dog. She may have the entire packet cached in her mouth.

Actually, the recovery rate thing above is a simplification. The recovery rates are based on how quickly a dog has surgery after losing deep pain perception. And that’s another reason I’m angry– if it’s fast, the recovery rate is very high. If it’s not, it’s low. But still possible. If her deep pain sense returns in two weeks or so, the recovery rate is higher. If not, it’s very low. But has happened. (I suppose that’s why the vet tech said 8 weeks…) But I’m angry because we did things right. We brought her in right away. We committed to the surgery right away. And yet–  surgery wouldn’t help! And if she had deep pain perception, the vet would have been pretty positive in his prognosis. And yet she doesn’t.

I’m so angry. My mother died due to complications from a cancer mostly contracted by old black men. Right now, I just want hope that my dog will be able to pee again on her own someday.

Hannah update, again.

Well, it turns out ‘no need for surgery’ just means ‘it wouldn’t help’. God damn it, why aren’t bruises on the spine less bad than compression?  A bruise sounds so mild. But stuff has to heal and enough nerves have to survive the healing process.

We have a carrier to make a dog suitcase– it fits under her hindquarters so we can carry them and she can walk with her front legs. We have some anti-inflammatories and some painkiller and some medication to make expressing her bladder easier on her.

And, if in 8 weeks, there’s been no improvement, we have the URL of a place that makes and sells dog wheelchairs. They think she’s lost deep pain, but maintains some reflexes, so the specialist figured it was a rough 50/50 chance of recovery– he’s seen some who have recovered and some that haven’t.

When she saw us in the consulation room, she freaked out– take me home take me home take me home, she whined throughout our consultation with the tech. She was better in the car, but still not happy. Now she’s in the cage, ears alert, looking pretty good. She ate a cookie and seems to be enjoying looking around, and is relaxed.

I hope she needs the painkiller eventually, though. (Because I hope she gets feeling back.)

Hm. She’s started whining. She might be realizing (again) just how limited her movement is. Poor girl.

Hannah update

The doctor called after the MRI and said he couldn’t see any reason  to do surgery, that her spinal cord was just bruised, and she could either come home or be cared for there. He’s a vet with a PhD, and a specialist in canine spinal injuries. And at first this was exciting good news.

But I’ve been reading about bruised spinal cords, and the care paralyzed dogs need. I haven’t been able to find very much about recoveries– possibly just because most dogs aren’t even diagnosed that far. And I’m nervous, and scared. When I called today to make sure she could come home, the tech said she was ‘fine’ but somehow I doubt ‘fine’ means actually fine.

In light of the reading I’ve been doing, ‘no surgery’ may just mean ‘nothing we can do’. I don’t know. I didn’t talk to the doctor myself. Kevin will be home soon and we’ll drive out there. Please everybody, keep your fingers crossed that I’m just being a worrywart, and Hannah’s being melodramatic. Or something. I’ll post more this evening.

There are no titles that convey the right thing.

Hannah and Dante were racing around the house up and down the stairs when Raymond let them in this morning. I was still in bed, Robin was asleep. There was a thump and Hannah started screaming. She couldn’t move the hind part of her body, including her legs.

It was a bad morning.

The current diagnosis is a badly herniated disc, requiring expensive surgery to repair. That’s a lot better than a fractured spine and a cheap euthenasia shot. But she’s only had x-rays and a referral to a specialist– she was waiting for the MRI at the brand new Kirkland animal hospital when we finally left. (Raymond and Jenna watched Robin while we were gone).

So if things go well, she might be home again with us in a few days, in need of physical therapy but basically healthy.  She’s 7 years old– really too old to race up and down stairs, but hopefully able to walk up them for years yet to come.

All I can keep thinking is ‘my poor beautiful dog’. I love her very much.