Tuesday, March 31, 2009

Spooky

On a Friday night in January a two-year-old Maine coon cat named Spooky presented for unknown trauma. She was an indoor/outdoor kitty and her owner had found her crying with blood on her fur and not very responsive. Spooky was in shock when she arrived at Friendship, so we immediately placed an IV catheter and started fluids to help support her blood pressure.

Spooky's injuries were consistent with being hit by a car. She had blood on her face from a laceration and a fractured canine tooth. On physical exam we could feel her small intestines under her skin, which indicated an abdominal wall hernia. In addition, she was breathing too fast and had muffled heart sounds, which meant something was going on in her chest cavity. X-rays confirmed the abdominal hernia. They also showed us that she had bruising in her lungs and blood around her lungs, plus a suspected diaphragmatic hernia--a tear in the the diaphragm allowing abdominal organs to move into the chest cavity. As one can imagine, with the severe trauma to her lung tissue Spooky soon developed difficulty breathing and was placed in oxygen.


We were now in a difficult position. With the abdominal and suspected diaphragmatic hernias Spooky needed surgery before the blood supply was restricted in any of the misplaced organs. If we did not correct this as soon as possible the tissue could become damaged and possibly die. But given the condition her lungs were in she would probably not survive anesthesia. All we could do was support Spooky with fluids, antibiotics and pain management while we waited for her to become more stable. Injuries such as pulmonary contusions often worsen over the 48 hours following a traumatic event. We hoped that she would improve but if she continued to decline and there is very little we could do to help her.

Over the next 24 to 48 hours Spooky condition worsened. Her red blood cell count began to drop, indicating she was bleeding internally, most likely into her chest cavity. Giving her a transfusion of feline red blood cells would have been the best option, but her blood type did not match with the donor blood available. We were able to give her an artificial blood product called Oxyglobin to help support her, but this would only last for 24 to 48 hours.

Thankfully she responded well and was stable enough to go to surgery the Monday following the accident. At surgery we discovered that Spooky’s abdominal wall was torn and shredded but no harm was done to the small intestines. We also repaired a large tear in her diaphragm where a portion of her liver had been sitting in her chest cavity. She recovered quickly from surgery and started eating a few days later.

Spooky was sent home later that week on oral antibiotics and pain medications. However, once at home she started favoring her right front paw which she had not been doing while in the hospital. Her owner brought her back in for an x-ray which revealed a dislocation of her right wrist, which on a cat is located above her paw. She was seen by our orthopedic surgeon Dr. Walker, who placed a plate across her wrist to fuse the joint together. Spooky breezed through surgery again and was home in no time.

Her right front limb was placed in a splint to prevent movement while the wrist healed. The splint required weekly bandage changes. Unlike humans, our pets cannot tell us when something is wrong under the bandage so we must examine the area frequently. We check to see if the splint has been placed too tightly and is restricting blood flow or if it has rubbed on the skin and created a bandage sore. If any issues are discovered, we address them quickly, before they affect healing.

Two months after the event she is still enduring the weekly bandage changes but is always in good spirits. Spooky is an amazing cat. We were all inspired by her composure and bravery though the multiple hospital stays and surgeries. She would sit in her cage like a queen and was always happy for a head scratch and some attention. In the first few days, we were concerned that she wasn’t going to pull through, but she never stopped fighting and proved us wrong.

Tuesday, March 24, 2009

Westin


My beloved dog Westin died early this morning a few months shy of her thirteenth birthday from complications related to her chemotherapy treatment. She had battled lymphoma for eighteen months and melanoma for eleven months. She had been diagnosed this month with an aggressive type of cancer in her liver called hemangiosarcoma. She had done so well with the treatments for her first two cancers I think she just couldn't fight anymore.

Westin was truly my best friend and constant companion, with her death I feel as if a part of me is missing. I know we had a wonderful life together and that I was fortunate to be able to provide her with the best veterinary care available. I want to thank everyone at Friendship not just for the loving care they gave her during her last few days in the hospital but over the past three years as well. A special thanks to the oncology team who were always available for guidance and support. If anyone is not familiar with the Rainbow Bridge please take a moment to read it as I know I will see Westin again.

Things have been a little sad at Friendship Tails lately and I apologize for that. I will be taking a brief break this week but please check back next Tuesday for a great story about a tenacious cat named Spooky.

Saturday, March 21, 2009

Sam Dies

Thank you to everyone who has offered support (financial and otherwise) for Sam.

Sam's family informed us that Sam died peacefully and suddenly at home early this (Friday) morning. As Dr. Hughes' post from yesterday indicates, he had been doing quite well in the hospital and certainly seemed to be anxious to go home. His owners were anxious to have him at home.

The cause of his death is unknown but the acuteness of his demise would indicate a vascular event such as a pulmonary embolism.

I want to thank everyone who provided support for Sam - the doctors and technicians here at Friendship and the enitire dog loving community. It is a sad ending to the story but I think that we can be heartened by the way the community came together to help Sam and that he was, if ever so briefly, able to go home after some very severe injuries.

Peter S. Glassman, DVM
Director
Friendship Hospital for Animals

Thursday, March 19, 2009

Sam Day 8

Sam is going home today! He is eating well and able to control his urination. While he is still unable to stand or walk, he is getting stronger every day. Sam has a long way to go with weeks of physical therapy before he will be able to walk again. He still has no feeling in his left front limb, there is a strong chance he will not regain use of that limb. Caring for Sam is going to be a lot of work for his owners, but I know they are excited to have him home and grateful for all the help he has received. Over $6000 in donations were made to the Sam Moreno Fund at Friendship. The majority of this money was used to cover his hospitalization, daily physical exams, nursing care and medications. Friendship also donated a portion of the fund to Dr. Bush's BVNS Rascal Foundation who covered the cost of Sam's CT scan and MRI. Dr. Covert who cared for Sam during his first five days in the hospital and drove him out to Leesburg to see Dr. Bush should be commended on her dedication to seeing him through this taxing ordeal. His technicians did a wonderful job of keeping him comfortable and making sure he had everything he needed while in the hospital. The outpouring of donations and well wishes from members of the community illustrate how much we love our dogs. Thank you to everyone who helped in getting Sam back to his family.

Tuesday, March 17, 2009

Sam Day 7


Sam is doing much better today. He is eating very well and on all oral medications, including pain management. Since he presented to us a urinary catheter has been in place to control his urination. This was necessary due to the high doses of pain medication which made him very sedate. Monday night he was a little frisky and pulled it out. It has not been replaced in order to determine if he can control his urination, this is the last hurdle before he can go home. We do not expect Sam to regain the ability to walk while in the hospital. He will need weeks if not months of intense nursing care at home and physical therapy before this is possible, but I am sure that both Sam and his owners are anxious to have him home. He is stronger every day and everyone at Friendship is very pleased with his progress.

Monday, March 16, 2009

Sam Day 6

Sam ate this morning for this first time since his injury! This is definitely a step in the right direction. Once he is eating well we can transition him to oral medications rather than giving all his medications through his intravenous catheter. He still has a long way to go before he is able to stand or walk on his own, but we are very pleased with his progress.

Sunday, March 15, 2009

Sam Day 5

Sam seemed less painful today so we have started to decrease his constant rate infusion of pain medication. This is an important step because often dogs will not eat while on such large amounts of pain medication. It then becomes a delicate balancing act between keeping him comfortable enticing him to eat. He is not yet able to bear weight, but again we hope that once his pain medication is decreased he will start trying to stand. He seems to enjoy his bed which is in the middle of our treatment area. With all the excitement that is always going on at Friendship there is plenty of mental stimulation for him which is another stimulus to get up and move around. I feel in today's picture compared to yesterday's he is much brighter which is a good sign.

Saturday, March 14, 2009

Sam Day 4

Considering everything he has been through Sam is doing well today. He is still on a constant rate of intravenous pain medications to help keep him comfortable and broad spectrum antibiotics. We are now dealing with the secondary effects of a 100 pound dog not moving around very much and eating very little. From his extensive wounds and non-existent caloric intake he has developed low protein in his blood which is causing swelling of his limbs. We have him on medications to help counter-act this and are starting physical therapy to increase movement in his limbs. He remains unable to bear weight but his motor function has been improving daily which is a positive sign.

Friday, March 13, 2009

Charlie's Memory

For those of you who followed Charlie's tragic story I have some very happy news. Stephen Tschida of ABC 7, who has done a wonderful job of bringing both Charlie and Sam's stories to life, told me yesterday that he was contacted by a Chihuahua breeder who offered to donate a puppy to Charlie's owner. Dr. Minch called Charlie's owner yesterday to give her the good news and she is ecstatic. Since she has been having such a difficult time lately and we all loved Charlie dearly, Friendship is helping her by donating a puppy plan and new puppy essentials to her new pal. This will cover the cost of all his or her puppy visits, vaccines for the first year and fecal testing. We will also perform the spay/neuter surgery at no cost to the owner. While this new puppy will never replace Charlie we hope it will help ease the pain of losing him.

Sam Day 3

Sam has been doing well after returning from Dr. Bush's last night. We continue to manage his pain and treat him with broad spectrum antibiotics for his wounds and pneumonia. For the first time since the incident he ate a few bites of food this morning. He is resting comfortably while the inflammation in his spinal cord cause by the bullet fragment resolves which will hopefully allow him to walk again. Dr. Bush feels that he has a very good chance of recovering function in three of his legs. The bullet lacerated a nerve left front limb which may cause permanent damage, it is just waiting game now.

I am happy to report that people have donated over $3700 to Sam's fund. This is a true testament to how much we love our pets; it warms my heart and is why I love coming to work every day. If you would like to donate you may call (202) 363-7300 and mention the Sam Moreno Fund. A sincere thank you from all of us at Friendship.

Thursday, March 12, 2009

Sam's Story

Friendship was mentioned in Thursday’s Washington Post and that night on ABC 7 (http://www.wjla.com/news/stories/0309/603179.html)
in regards to Sam a 2 year-old German shepherd who was shot by police during a robbery investigation. He presented to the hospital late Tuesday night in extreme pain with a bullet lodged near his spine and almost completely paralyzed from the neck down. He was started on aggressive pain management and antibiotics until he was stable for more aggressive diagnostics.

Throughout the day on Wednesday Sam owners worked desperately to find the funds to pay for Sam’s hospital expenses. The article in the Post reports that Sam needs an $1800 surgery to get better, this is not quite true. Sam in is critical condition, with many days in the hospital followed by weeks of physical therapy ahead of him, if he survives at all. His veterinary bills would be thousands of dollars and it is possible that he will never walk again.

During the day on Wednesday Sam showed some improvement by moving his hind legs, but he was unable to bear weight on any limb which made standing impossible. Despite use of the most aggressive pain medication we have in the hospital he continued to be in excruciating pain. At this point we recommended that Sam’s owners consider humane euthanasia given his poor prognosis and the extensive cost for treatment. They refused and continued to search for funds.

On Thursday, after exhausting all their options Sam’s owners could not pay for his hospital bills. At this point Friendship offered our Brudder Sullivan Fund to cover the cost of hospitalization and treatment pending a neurologic evaluation by a veterinary neurologist. Dr. Bush (my very favorite neurologist) of Bush Veterinary Neurology Services in Leesburg, Virginia agreed to examine him at no cost to the owner. Dr. Covert who has been caring for Sam since Wednesday morning took it upon herself to drive Sam over an hour away so he could see Dr. Bush. This is an example of another Friendship doctor going above and beyond the call of duty.

After performing a complete neurologic exam on Sam, Dr. Bush was hopeful and that a CT scan and MRI would give us a better idea of what type of damage the bullet had caused. Dr. Bush then offered to pay for these expensive diagnostic procedures with funds from his BVNS Rascal Foundation. The images below show that a bullet had shattered a rib head and a bullet fragment was lodged in Sam’s spinal canal. These results may seem like bad news but there is hope that Sam may recover and regain use of all four limbs.


Thursday night Dr. Covert brought Sam back to Friendship for continuing care. We are treating him with pain medication and antibiotics which will treat both his wounds and the secondary pneumonia that has developed. Friendship will continue to cover Sam's medical expenses and we have been receiving donations from our wonderful and generous clients. He has a long road ahead of him but with aggressive management we are hoping he will pull through. Please check back in frequently for updates on Sam’s condition.

Tuesday, March 10, 2009

Westin's Continuing Battle with Cancer


My dog Westin was diagnosed last week with a very aggressive type of cancer in her liver called hemangiosarcoma. This is a cancer of the blood vessels, it has a tendency to spread quickly and can be very difficult to treat. As with her two previous diagnoses of lymphoma and melanoma, the Oncology Department at Friendship has been amazing.


Dr. Chand Khanna--who may just be the most amazing person I have ever met--leads this team of dedicated doctors and veterinary technicians. In addition to being double board-certified in internal medicine and oncology, Dr. Khanna runs multiple labs at the National Institutes of Health and founded Animal Clinical Investigation. Through these organizations he performs ground-breaking research in both animal and human cancer. Equally important, he is a personable, compassionate and caring individual. His entire team--including doctors Tony Rusk, Alexandra Sahora and Esther Chon; his assistant Cindy; and the veterinary technicians Stuart, Tracey and Amy--understands what a scary time this is for your and your pet. Managing cancer is complex, expensive and at times confusing (even for me with Westin). Dr. Khanna and his team will go out of their way to answer all your questions and concerns and are always available to the emergency doctors at Friendship if something happens after hours. They do their very best to make treating your pet’s cancer as comfortable as possible for both you and your beloved pal.

Though most cancers in companion animals are, unfortunately, not yet curable, many are now treatable thanks to devoted doctors like Chand Khanna and organizations like the Morris Animal Foundation. We are making great advances in managing cancer in our beloved pets and one day we will find a cure. Westin has responded unbelievably well to her previous treatments. I know the next course of chemotherapy may be difficult for her but she is still a happy, active dog and I know she wants to keep trying. I treasure each day with her and consider myself blessed that she has Dr. Khanna and the Oncology Department at Friendship looking after her.