As I've mentioned in previous blog entries, my Bart is in his twilight years now, and every day he shares with us is a blessing. While we made the decision to provide palliative care for however much time he has with us, we still see to his medical needs when there is a change in his day-to-day condition. On Monday we noticed he had started favoring his left front leg. I gave him some 'carry-up/carry-down' help to navigate the 11 steps between the basement/outside level and the main living area during the day. He was subdued but eating and drinking normally, so we chose to do 'watchful waiting'. In 24 hours he would either improve or need to see the vet, so we kept him comfortable and assisted him as needed.
Tuesday saw him even more lame, and on examination he cried when I touched his leg mid-shaft. I hadn't seen him drink any water since the day started at 5:30am, and the inside of his mouth was dry. OK, so the watchful waiting period was now over, and it was clear he needed to see the vet. I called at 8:15 am and was at the vet's office by 8:35 am. Luckily, one of the advantages of being long-time and active clients of the vet practice (is it really 25 years? And wasn't I just there with the puppy a few days ago?) is we are recognized when we call, and we usually get an appointment with the vet right away. Getting Bart out to the car and into the crate took a bit of doing, but with a towel sling supporting his usually weak rear and keeping his leg off the ground, we managed to negotiate the front steps and I got him loaded in without too much discomfort. On the drive to the office, the first of the maudlin thoughts started creeping into my brain. 'What if it's a pathological break to a leg bone from a lytic lesion? What if it's a sarcoma? What if it's a dislocated shoulder or an elbow joint that's become strained? Did he pull a muscle or tear a ligament? Am I ready to do surgery? Can he be treated conservatively? Am I ready to say goodbye to him?' On and on the thoughts circled my brain, Oy. By the time I arrived at the office, I had to sit a minute to compose myself before I unloaded Bart and we navigated in to meet the vet.
Tuesday saw him even more lame, and on examination he cried when I touched his leg mid-shaft. I hadn't seen him drink any water since the day started at 5:30am, and the inside of his mouth was dry. OK, so the watchful waiting period was now over, and it was clear he needed to see the vet. I called at 8:15 am and was at the vet's office by 8:35 am. Luckily, one of the advantages of being long-time and active clients of the vet practice (is it really 25 years? And wasn't I just there with the puppy a few days ago?) is we are recognized when we call, and we usually get an appointment with the vet right away. Getting Bart out to the car and into the crate took a bit of doing, but with a towel sling supporting his usually weak rear and keeping his leg off the ground, we managed to negotiate the front steps and I got him loaded in without too much discomfort. On the drive to the office, the first of the maudlin thoughts started creeping into my brain. 'What if it's a pathological break to a leg bone from a lytic lesion? What if it's a sarcoma? What if it's a dislocated shoulder or an elbow joint that's become strained? Did he pull a muscle or tear a ligament? Am I ready to do surgery? Can he be treated conservatively? Am I ready to say goodbye to him?' On and on the thoughts circled my brain, Oy. By the time I arrived at the office, I had to sit a minute to compose myself before I unloaded Bart and we navigated in to meet the vet.
The vet and I conferred about Bart, and of course he didn't cry for her when she examined his leg...Nevertheless, I agreed to x-rays and blood work and a little IV fluid to tune him up and I signed for the $425+ estimated bill (welcome to vet care in the 21st century...). I returned home to feed the rest of the crew and got a call from the animal hospital that the testing was done within 30 minutes. When I asked the Vet Tech what the x-rays showed, she gave me the typical 'The vet will talk with you when you get here' response. Oy. That's not the answer that inspires confidence, even if it's their standard response. I know they are not allowed to tell clients any diagnoses, but even a cheerful 'don't worry' would have helped allay my fears. Knowing it's hard to be sad when there's a puppy around, I scooped up Red and put her in the car to ride shotgun. I figured she'd at least be company if I had to drive home alone from the office. Again the thoughts circled my brain on the drive. 'Is it sarcoma? Is it time to put him down? Can we have a few more days, a few more weeks? Am I ready to say good-bye to him now?'
The vet brought up the xrays on the monitor in the exam room, and I didn't see anything obvious to the leg or shoulder or elbow-they looked normal to me. Good! The vet confirmed they were negative-YEAH! The only thing we both noticed on the film was that the shadow of soft tissue on the left leg appeared more swollen than the right. And, the vet remarked that he was running a fever of almost 103F but his lab work was fine. So, it was looking like he had a cellulitis of his leg from some unknown cause. At this point, treatment was IM and PO antibiotics and monitoring his food, water and exercise to assure he kept hydrated and comfortable. She felt that the antibiotics would reduce the pain and preferred to not give him NSAIDs like Previcox or Deramax since they would mask the effectiveness of the Abx treatment and could be risky if he didn't drink enough water. I paid the $500+ bill (original bill estimate plus $100 worth of Abx.) and Bart and I carefully maneuvered out of the office for the trip home. Red was happy to see us both, and I kept petting her and rubbing her ears on the drive home, and instead of all those 'What if...' thoughts, I concentrated on setting things up for getting Bart settled and comfortable.
Today I didn't need to make any life or death decisions.One day I will bring Bart to the vet and he won't come home with me. But not today.Today is a beautiful fall day, Bart sniffed the breeze and sat in the sun, and it was a good day. Thank you, G-d for another beautiful day with my Bart.
The vet brought up the xrays on the monitor in the exam room, and I didn't see anything obvious to the leg or shoulder or elbow-they looked normal to me. Good! The vet confirmed they were negative-YEAH! The only thing we both noticed on the film was that the shadow of soft tissue on the left leg appeared more swollen than the right. And, the vet remarked that he was running a fever of almost 103F but his lab work was fine. So, it was looking like he had a cellulitis of his leg from some unknown cause. At this point, treatment was IM and PO antibiotics and monitoring his food, water and exercise to assure he kept hydrated and comfortable. She felt that the antibiotics would reduce the pain and preferred to not give him NSAIDs like Previcox or Deramax since they would mask the effectiveness of the Abx treatment and could be risky if he didn't drink enough water. I paid the $500+ bill (original bill estimate plus $100 worth of Abx.) and Bart and I carefully maneuvered out of the office for the trip home. Red was happy to see us both, and I kept petting her and rubbing her ears on the drive home, and instead of all those 'What if...' thoughts, I concentrated on setting things up for getting Bart settled and comfortable.
Today I didn't need to make any life or death decisions.One day I will bring Bart to the vet and he won't come home with me. But not today.Today is a beautiful fall day, Bart sniffed the breeze and sat in the sun, and it was a good day. Thank you, G-d for another beautiful day with my Bart.
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