Drip, drip, drip

And the leaking continues...
Dr. Clark, the vet who performed the TTA surgery gave us a follow up call yesterday and now this morning. He is concerned about the leaking as well. Hallelujah! We are not being overly neurotic. Dr. Clark recommends that we up the antibiotics. Thankfully, I have a good storehouse of antibiotics so we are adding in SMZ and amoxicillin to the Doxy that Zane is already taking. There is also a bit of an odor to the incision site which makes us think even more that it could be getting infected. I got the go ahead to wrap Zane's leg to keep him from licking at it. We are to change the dressing each day to make sure that no pus starts draining. I am really impressed with the follow through from Dr. Clark. I have never had a doctor, let alone a surgeon, check in so often and I am very thankful for his thoroughness and caring.

A leaky Dane

This incision site is driving us crazy! On Friday night, it looked like part of it had opened up so we took Zane over to the ER. Last thing we wanted to see happen was this thing tear wide open again, especially in the middle of the night. So we wait our turn and the ER vet looks at us like we are nuts and says the incision is fine and all this bloody serum drainage is normal. Fine, with tail between our legs, we pay the $83 bill and head home. Ok, so maybe we are just a little overly concerned. The incision never drained or opened in the week following surgery but supposedly this is all normal now...
Now on Saturday morning when we get up and check the incision, all is the same. Later in the morning, however, we notice that the stitches have come unknotted and are starting to unravel. Back to the vets we go...got to hurry because they are only open half days on Saturdays. The vet throws in some staples and says not to worry. They waive the office visit fee and we pay $20 for the staples. In case you are keeping track, that is now $263 for the incision that won't stop draining.

1 week + 1 day following TTA Surgery

So this morning around 9:30, I take a peek at Zane's incision and remark at how great it looks. It's healing up beautifully and the edges are sealing up. We head outside for a potty break and some fresh air. Come back in a little later and Zane settles down for a rest while I hit the computer to check the morning mail. A few minutes later, I hear big, slurpy licking that can only belong to Zane. I walk around the corner to check on him and there it is, a big pool of blood sitting in a wide open incision. I slap a maxi pad on him and some bandaging and headed out to the vets. Since we had just been outside, he was still in his harness and I still had on my sneakers so we were able to make a quick getaway.
Once at the vets, they recommend sedating him so that they can clean out the incision and resuture it. All goes well and I bring a very groggy Zane home a couple hours later. The rest of the night is pretty quiet while Zane slept off the anesthesia. Cha - ching, there goes another $160.

Day 5 Post TTA

Zane is doing great! I am so pleased with how quickly he is recovery from his TTA knee surgery. Each day, I have seen significant improvements. Today, he is able to get up fully on his own to stand and walk. He has no problem getting on the furniture to sleep. I guess with 3 weeks of a painful leg, he figured out how to get on the couch without using the sore leg.
The swelling in Zane's leg has almost disappeared at this point. I was pretty fanatical about keeping cold packs on his knee for 20- 30 minutes every other hour. The packs would actually be hot when I removed them. His leg is still pretty red but it looks better every day. We have started doing very gentle range of motion exercises to keep things limber. He doesn't seem to mind.
Today, Zeke even tried to entice Zane into a game of chase. Thankfully, Zane didn't even attempt to get up. There was a lot of rooing and smack talking going on but that was about it. That will probably be my biggest challenge....keeping everybody from wrestling and chasing. For now, they are satisfied with mouth wrestling and stealing toys from each other. A couple times a day, I pull out a big bag of toys and everybody plays romper room style. The we pack up all the toys and end the play session with a cookie break. I think it keeps Zane from getting overly bored. He is always ready for a good nap afterwards.
Speaking of naps...Zane has been sleeping so well during the day that he has been restless at night. He gets up and wanders, which of course makes me nervous that he may fall. I always end up getting out of bed myself just to put him back in his bed. So Saturday, I called my vet and asked for a sedative. The rx said 1-2 pills so I went light and gave Zane just one pill at bedtime. What a sweet night it was! He only got up once and that was just to reposition himself on a different bed in the room. Yesterday, though, he looked wasted all day long. His eyes were so red and droopy. The effects of the meds lasted from 10:15pm to dinnertime the following day! Despite sleeping most of Easter Sunday, he did ok last night (without a sleeping pill) and only got up once to go potty.
The potty breaks in the middle of the night are a pain because we have to get him in his harness and put a leash on just to take him in the backyard. Otherwise, anything that catches his interest will cause him take off running. He will need to be leashed for the next 2 months to take potty breaks. The prednisone is to blame for these late night sessions because it causes the dogs to drink a lot.
At this point, I am looking into rehab for Zane. He can start in another 10 days. I don't think he will need much in the way of physical therapy but I just want to make sure he starts to use his leg properly. I know that he will love the underwater treadmill. He has always loved to submerse himself in deep water. At just 2 weeks post surgery, his orthopedic surgeon will have him start a walking program that involves 5 minute walks, 2-3 times per day. Zane will have a 4 week recheck and then xrays at 8 weeks to check bone healing.

TTA Day

Zane and I left for Raleigh at 5:30 on Wednesday morning for Veterinary Specialty Hospital of the Carolinas. Dr. Clark has become the newest member of "Team Zane," our group of doctors that work to get Zane as healthy as possible. Dr. Clark briefly explained the procedure to me and what to expect regarding Zane's recovery.
Zane and I went out for a drive and then waited at the hospital for another hour or so until it was his turn for surgery. He made several new friends out in the waiting room: Rosie the Golden, Diamond the Lab, and Chin Chin the Akita.
It only took a little over an hour for the surgery. Dr. Clark gave me a call as Zane was coming out of anesthesia to let me know that all had gone well. The diagnosis for Zane included a ruptured cranial cruciate ligament and medial meniscal cartilage tear. He said that Zane could head home at dinner time if he was up to it.
I stopped by the hospital at 5:30 and the nurses let me know that he was doing well but that they were unable to get him to stand. They said that I could leave him for the night or try back later. I offered to get him standing if I could be allowed out back to see him. As soon as he saw me, he wagged his happy tail and started to get up. That's my boy! I headed back up front to pay the bill ($2100) while they cleaned him up for discharge. It took 4 nurses to walk him up front and get him in the van. Zane was great about it the whole time.
Zane was starting to get painful towards the end of the ride home. I suspect that his pain blocks were beginning to wear off. From personal experience, I know how rough it is when that transitions happens. He cried most of the night and we were up every hour or so to comfort him.
By morning, he was pretty sluggish and not willing to get up to go outside and potty. He refused all food and water. I gently "shoved"his pain pills down his throat to keep him on schedule. He takes 2oo mg of Tramadol every 8 hours. It is his only option for pain control since he is also on Prednisone (a steroid). I checked his temperature and he was at 103.3, with 101 being normal for him. I gave the hospital and call and talked to one of the nurses. Dr. Clark immediately called back and agreed that I should take him to my regular vet for sub Q fluids if he didn't start to eat or drink by afternoon. He even gave Dr. DeQuick a call to let him know Zane's status. I love that kind of follow through!
Zane and I headed back to bed to catch up on our sleep. At 11:45, Zane woke up and attempted to stand. He was ready to go outside! I got him saddled up in his harness and used the towel under his stomach to guide him and we headed outside. Thanks goodness for the ramp. Zane did his business and then came right back in. He collapsed as soon as he got in the doorway. I made him lunch and he happily ate it so I knew we were back on track.
Dr. Clark called again in the afternoon and I was able to give a much more positive report on Zane. Dr. Clark stressed the importance of not letting Zane stay down too long or we might risk him getting pneumonia. Yikes, been there before with Daizee Lu. Well, Zane must have heard him because he made it in and out several more times during the afternoon and evening.

Time for another roadtrip

Zane and I are all geared up for another roadtrip. Tomorrow we are heading to Raleigh to meet up with Dr. Clark of Veterinary Specialty Hospital of the Carolinas to talk about a TTA surgery to repair Zane's torn CCL. If all goes well, Zane will get this surgery in the afternoon. The TTA procedure uses titanium implants instead of the steel plates used in a TPLO. The procedures are quite different. The TTA offers a quicker recovery which is really important to getting Zane up and moving again. I'll post more about the procedure and add up some links soon. We will be spending the night and hopefully returning on Thursday afternoon.

Coming up to breathe...

Well, it's been a week since all hell broke loose. Zane is now walking again or rather limping, since his knee is still painful. Zane made steady improvements each day as the inflammation from the myelogram subsided. By Thursday evening, he was able to walk out to the backyard with assistance. By Saturday, he was able to walk around the yard on his own.

Some of the things that I have learned about caring for a dog with sudden medical issues....

1) Teach your dog to eat from a spoon or fork while he is healthy. When they are extremely ill and lose their appetites, they associate spoon feeding with especially tasty food treats from their humans. My dogs always know they are getting something great when it's on the end of a fork (like yummy scrambled eggs). Also, since Zane couldn't bend his neck, he had no way to get the food from the bowl. He had trouble chewing too so we relied on good, holistic canned foods. Another food we like is by Nature Balance. It's a semi moist dog food that comes in a long tube. It looks like summer sausage and is somewhere between a canned food and dry kibble. My dogs love this food. It smells great and is easy to feed since you can cut off slices for feeding. I will never be without this food in my pantry for feeding emergencies.
2) Build a ramp so you can get your dog in and out of the house without struggling up stairs.
3) Get a good harness like the Ruffwear webmaster. I should earn a commission on the sale of these harnesses since I am such an advocate for them! LOL We were able to lift Zane up and into a standing position with this harness. We could steady him while he tried to walk and offer him support so that he wouldn't fall over.
4) Keep dog diapers on hand as well as waterproof crib pads. They will save your dog beds and carpeting from the inevitable leaks. "Depends" also makes a disposable absorbent pad that you can place in the areas that the dog sleeps.
5) Crib mattresses can make a wonderfully waterproofed dog bed for a Dane. Cover it with a crib sheet and it will blend in with any decor. It's also cheaper than most dog beds ($40 in Walmart).
6) Just like with a newborn, sleep when the "dog" sleeps. For some reason, sick dogs seem to be more restless at night. The first night that Zane came back home, he was awake and trying to stand every hour. I eventually slept on his bed for a while with him!

We are gearing up now for the surgeries. I am looking to schedule surgery to repair the knee first. We feel it is important to get Zane walking on all four legs before we do the neck surgery. Zane can potentially have difficulty walking for 2-3 weeks post surgery (neck) and I will need him to help himself as much as possible. Since Zane will be down and out recovering, he won't be putting any additional stress on his neck. About a month later, we will go ahead with neck surgery. His knee can continue to recover while his neck heals as well. I am still searching for a local surgeon to perform the knee surgery. I would like to use a new technique called a TTA. It promises a speedier recovery..... You can read more about the procedure at www.ttasurgery.com

The MRI that didn't happen....

This week sure has started out with a bang. On Monday morning Zane had his first color echocardiogram. I felt that it was important to assess Zane's overall heart health before he undergoes anymore anesthesia. With two potential surgeries in the near future and a MRI, Zane will be "put under" quite a bit in a short time. The echo went well and there are no signs of potential problems. That was a huge weight lifted off my chest. I know that he is not out of the woods, however, as dilated cardiomyopathy can strike quickly and without warning even when there are clean echos. For now, I will focus my worries on other issues.

Zane was scheduled for his MRI to take place once we finished the heart testing. The Dr called me about 30 minutes after I left Zane and told me that he could not do the MRI as the gold beads were interfering with the imaging. I questioned him about this before we ever scheduled the appointment but he said that he had done it before. Dr. Durkes was adamant that a MRI could not be done on Zane. He said that the beads have a magnetic quality. Apparently, sometimes it works and other times it doesn't. Zane has over 300 beads in his neck so I would bet that caused quite an issue for the machinery.

Since we couldn't do the MRI we agreed to go ahead with the myelogram. We knew there was a strong chance that we would have to go that route in order to get the answers we need. Dr. Bergman told us that we would need to leave Zane for the night so they could monitor his reaction to the dye and make sure he got everything flushed out of his system. He cautioned us that sometimes a dog's Wobbler's symptoms could be made worse by the procedure but that it should clear up in a few days, with less than a 1% chance of a fatal reaction.
Dr. Bergman called us a couple hours later to let us know that all had gone well. He sees atrophy of Zane's spinal cord at C6-7 that he is very concerned about. The problems at C4-5 and C5-6 are not as severe but could get worse over time. He requested a radiologist to review the findings and offer a second opinion.

The following morning (Tuesday), Dr. Bergman called us as we were on our way to pick up Zane. He told me that Zane was doing much worse than the night before and that he could not lift his head or even sit up. He said that we could leave Zane there longer for follow up care or if we were up to it we could bring him home. We immediately elected to bring him home. I know strange environments can be very stressful to dogs. Danes are very susceptible to stress and can even bloat as a result. We felt he would do better at home. They wheeled Zane out on a gurney and as soon as he saw us he gave a little tail wiggle and sat up. We got him loaded into the van and headed home. He had not eaten at all while he was there so I stopped on the way to get him some extra tasty foods. He did not move for the entire hour that we rode home. I worried about how we would get all 132lbs of him into the house. He could not even sit up for more than a minute. He was dead weight to carry in. I have no idea how I got the strength to help Greg carry Zane up the front steps and into the house.
Zane spent most of the day sprawled out on his mattress in the living room. We could not leave him alone at all. He would try to get up and flop over if we were not right there to lay him back down. He was so pitiful and we wondered if he would ever get back up on his own.
I fed him canned food and warm broth throughout the day. We put him in diapers and spent the rest of the day cleaning up urine leaks and doing loads of laundry! All the other dogs were very quiet for the day and cautiously sniffed him whenever they passed by. Daizee could often be found laying nose to nose with her best buddy. I gave him 100mg of Tramadol every 8hours and 40mg of Prednisone once daily. I have learned that Prednisone should always be given in the morning to mimic the body's own natural cycle of cortisol production.

As if all that wasn't stressful enough, it rained all day. By early evening, a tornado watch had been issued for our area. The winds picked up around 7:30 in the evening and I started to get stressed/ panicked that something was about to happen. I have awesome intuition. It's generally pretty dead on. Within minutes of coming back into the house to warn my husband that large branches were dropping on the house, two 75' tall pine trees came crashing down across our driveway and landed parallel to our house. Our 2 vehicles were crushed. Our car is only 1 year old today and the van, well it's a '95 but it's like gold to me. I use it to do dog rescue and for transporting all 4 of my dogs. The "totaled" value of it is only $1500... but for the purpose it serves, it is probably worth more to me than the car. I can't exactly replace it with that kind of payout. So now I guess we will be car and van shopping very soon.

We headed off to bed with heavy hearts. Talk about having a bad day.....