Hospitalization update

Got a call this morning from Dr. Michelle Evason, internal medicine specialist at Tufts, with an update on the Old Man. He's doing better this morning. The IV fluids have helped his BP and heart rate come back to normal. The biggest issue is that he is still bleeding out the back end. They have him on Anzement for nausea (stronger than the Reglan) and metronidazole (antibiotic, also known as Flagyl). Dr. Evason added Sucralfate, an ulcer medication that coats the intestinal tract to protect the wound from stomach acid and enzymes.

I must have misunderstood the doctor last night about the ultrasound. They don't do ultrasounds on the weekend, so the next big development will not be until Monday when they can have a look at the cause of the bleeding.

We'll go see him this afternoon after we take care of some things around the house. More updates to come.

Panic - Watson was admitted to Tufts ER

There was more retching and vomiting between 5-8pm last night. I administered more sub-Q fluid and then carried him out into the yard for a pee break. It had been 12 hours since his last urination and I took it as a good sign that he was hydrated enough to even have any urine. Unfortunately at 8:50pm, he had another vomiting episode and this time it was black. Yes, I said black vomit. I happened to be on my laptop at the time and quickly Googled the term. That was enough to send me into a panic.

I called my vet hospital to get the number of the ER, which is Tufts VETS (Veterinary Emergency Treatment & Specialties) in Walpole. Tufts VETS is affiliated with Tufts University Cummings School of Veterinary Medicine. He was very lethargic, especially after the black vomit episode, and had to be carried to the car. He had one more vomiting episode in the car. It's a rather long drive to Walpole from where we live (about 50 minutes) so I was thankful that nothing more dramatic happened.

Rich drove, and I am glad he did. When we got in the car, I was so panicked and upset that I couldn't remember how to get where we were going. I just kept imagining the worst and I knew in my heart that Watson, my best bubbe, was not coming home with us.

When we got to Tufts, he didn't even lift his head. Rich carried him, blanket and all, into the ER. The staff there was great from the beginning. They saw us carry him in and immediately got a stretcher to come get him. They prioritize their patients in the ER, so we got to go ahead of people who were waiting there for less critical matters.

Shortly after I filled out all the forms, a vet tech came out with a black trash bag and asked if we wanted our blanket back. I was confused as to why it was in a bag, but in my frantic state I said "sure". Well, I'm glad Rich clarified.... Watson had had an episode of bloody diarrhea all over the binkie. I was later told that it was mostly blood (again, I am glad the doctor waited until I was sitting in an exam room to tell me that since I would have freaked out earlier).

We waited for nearly 2 hours as they worked on him. When we were called in, Dr. Rutter sat us down very calmly and took a history. She then outlined his condition - he has severe GI distress, causes unknown. It could have been the prednisone; it could have been the foods he was eating (like beef and salmon that, although boiled, are still rich for a dog's GI system). His heart rate was 200 when he came in but after some fluids, it dropped back to a more normal 120. She said it's not a situation to lose hope over, but not to be fooled - he is very sick. But if we can get him through this, then there is a high chance that he can continue his chemo and have more quality time on this Earth. However, the most immediate battle is to find what's causing the bleeding and get it to stop.

We got to see him before we left the ER. He was in one of their big kennels, laying all flat against the floor. He had an IV in one arm and a catheter. His eyes were squeezed shut and he looked so very small lying there by himself. They opened the cage and I got down on hands and knees to give him a kiss. When I put my hand in front of his nose, he immediately opened his eyes and tried to lift his head. I put his little head in my hands and told him I loved him over and over. He looked so very exhausted... I gave him a kiss on the nose and said good night. They promised to call if anything were to happen. I asked that should he take a turn for the worst, that we have a chance to get there before we had to let him go. Thankfully, no call in the middle of the night.

He has an ultrasound and a consult with the internal medicine specialist today. They usually call before 12 noon, so I have the phone glued to my side. We will get to see him at some point, but there are no set visiting hours. We need to call ahead and make sure it's okay to come.

Rich had been so good throughout this ordeal. Although Watson is part of "our" family, he's really "my" dog. Watson would follow me off a cliff and he trusts me to do the right thing for him. I struggled with deciding on chemo or not, and now am faced with critical decisions that literally leaves his life in the balance. How do I weigh all that on a scale? Right or wrong? Through what scope do I make these decisions for him - love? Love is inherently selfish. Of course I want him here. I woke this morning to his empty bed and I wept even though I know he is alive and in the hands of top-notch medical professionals. Money? Rich and I have good jobs and, luckily, are spendthrifts. Watson's medical care will not put us in the poorhouse.

So how do I make these decisions for a loyal being who trusts and loves me unconditionally, but cannot talk and tell me what he wants. If someone has the answer, please tell me.

Can we just catch a break?!?!?

On the 40-minute drive to the vet's office, Watson managed to retch once but not actually produce anything. He was weak and a bit disoriented so I had to carry him up the front steps and into the exam room. In all, he's vomited about 8-9 times so far today. Dr. Delbecq, our regular vet, was working today; she usually has Saturdays off but had switched with her partner since his daughter was getting married today. Anyway, it was good that it was her since she's been his vet since we adopted him.

She ran an in-house CBC and his workup came back all in the normal ranges. Her in-house capabilities do not show individual breakdowns under specific categories like white blood counts, but the overall picture is that his blood is fine. And because I didn't actually see him ingest a rawhide or pork chew, we had to assume that this GI distress is just a mystery.

She took extra blood to send out to a lab for a full CBC; results will be back on Monday. She administered 300ml of sub-cutaneous (sub-Q) fluid while we were there and gave him an injection of 5mg/ml metoclopramide (Reglan) and 10mg/ml famotidine (Pepcid AC). She sent us home with fluid that I will need to administer tonight and tomorrow, as well as several shots of each of the aforementioned meds to get us through the weekend.

He vomited once more when we got back home, and now seems restless. He's lying in his bed but keeps lifting his head every 30 seconds. I'm not sure what that means, or if it means anything really. He still has a small pouch of fluid that has drifted to his left side, so that may be making him feel weird when he lies down.

So here we are with a beautiful Saturday almost at an end. I wish we could just catch a break so that I can catch a glimpse of summer before it's over. We lost our cat, Crusty, on June 29th, so it seems like illness has hung over our family for a few months now. Between the sick pets and trying to run a business, I feel stretched thin and nearly transparent.

Off to the vet's again

I called our local vet in Holliston and we have a 1pm appointment. I described the morning's activities and the consistency of his vomit (now a thick, mucous with a yellowish brown color) and she wants to see him ASAP. He's also not interested in drinking any water and I noticed that his nose is dry and his lips are more white than pink. Thankfully he is not running a fever so hopefully this is not a true emergency situation. More later when I get back......

Ick.

It was a rough night for all. Turns out that Watson's latest bout of lethargy and gastritis is a result of his scavenging a pork chew from the little basset. I swear I had picked up all the rawhides and pork chews, but he must have found a remnant somewhere. (Damn that hound nose!)

The vomiting began around 4am and has continued through the morning. From what I can gather, it looks like he may have swallowed a small piece that's been churning in his stomach all day yesterday. That would explain why he was not eating yesterday and I do regret giving him his usual dose of Reglan, which may have delayed the vomiting. Mind you, if he were not a cancer dog, I would be scolding him and telling him "TS for you; you did this to yourself!" But since he obviously has much bigger problems, I am only shaking my head at him and perhaps wagging a finger when he is not looking.

I've put a call into NEVOG to see how I should treat him. Judging from the smell, his stomach is quite sour at the moment. He's wanting water, but can only hold it down for about 30 minutes. Usually you are supposed to fast a dog who has stomach upset, but again with the cancer, I am not sure what I should do. I'm waiting for a call back from the vet.

And thank goodness for the little green Bissell. This mechanical miracle makes cleaning up all manner of canine fluids so much easier. If you have a pet, you must absolutely have one of these!