Week 2: more issues, more questions...

Sorry I've taken so long to update; I didn't mean to leave anyone in suspense, but things have just gotten busier. Here's whats happened last week:



Day 9: Saturday 3/6/10

Woke up early, yet again. I planned on doing my usual routine of getting up, starting to thaw the dog food and going in the shower-all while the girls stayed in bed. But Heidi stood up when I got out of bed. "Do...you need to...go out?" I asked tentatively. She started dancing around like she had ants in the pants. I guess that's a yes. I picked her up to put her on the floor and she took off out my bedroom door. I started to put on my slippers and by the time I reached for my bathrobe, she was back. Apparently I wasn't moving fast enough. I hurried to follow her to the door where she sprinted outside. I watched her squat and pee...about 3 times. Then as soon as she came in, she hit the water bowl for a drink. Something was definitely off. I thought about how the surgeon said that we would check blood work if she didn't seem better by Tuesday, but this was different-she was getting worse. I decided to take her in and have the blood pulled, but first I fed her...and she ate! Yay! I brought her to work and the Dr. who's been taking such good care of us (and who diagnosed the tumor) pulled a health check and sent it to idexx. I worried all day what the results would be; she was drinking way more than she ever had. She said to stop the previcox (which I had don't the day before after she wouldn't eat breakfast-I know gastric upset can be a side effect of any NSAID and is not to be messed around with). I waited all day for those stupid results to come in, but they didn't get posted by the time I went to bed that night.

Day 10: Sunday 3/7/10

Finally, a day to sleep a little late. My schedule changed due to our shortness of help, so I was scheduled to work 11-7 (a "swing shift") instead of my usual 8-4. I woke up early anyway though because I wanted to see if the results had come in. When I got up, Heidi did the same pee-pee dance and ran outside. Then she drank. Dammit. While she was tanking on water, I turned on the computer and signed on to idexx. The results were in...but not at all what I wanted to see. Heidi's kidney enzymes were indeed elevated. Her BUN was 70 and her creatinine was 2.9. WHAT? Her levels were beautiful the week before-we had run them the day before surgery; her BUN was 15 and her creatinine was .7. WTF??

I started to get really upset; that numb horrible feeling was back. The feeling like something was closing in and the ice-ball in the pit of my stomach had returned. I decided to go into work an hour early to see if someone could go over the results with me. But even going in an hour early gave me some time to look things up on the internet...which scared me even more. I read on one of the sites that by the time the kidney enzymes were elevated there was already significant damage. OH MY GOD. What was I going to do when on top of just being diagnosed with CANCER, Heidi was in renal failure too?? Was it the anesthesia during the surgery? The previcox? The raw diet? Her Lyme's disease? My mind was reeling. I did all I could to not just call into work and demand to speak with someone; or even calling in and asking to be put on the emergency board as a patient and wait to be seen. But I knew it was probably busy, and I could just as easily speak with someone when they had the time. I had to try and remember what I had hear our Dr.s tell other clients-when they are in renal failure, they felt really crappy; like a terrible flu. Heidi was not behaving any differently other than drinking and peeing a lot. Good. Her spirits were OK. She seemed a little more, I dunno, depressed? But that was because she was wearing the cone just about all the time...I was pretty sure, anyways.

So I went in early to work, and I had been right.It was busy. One of the Dr.s did take the time to look over the results quickly with me, and gave me a plan for the day: they would run blood work in house (to make sure the results were right) and would check a sterile U/A as well. They did that later that morning, and then the surgeon came in to check on some other patients and looked at Heidi as well. She said we would still keep an eye on the black, dead skin flap and then she looked at the results of the in house labs. She said something was making her kidneys angry, and for now we would do sub-q fluids then (and the next day) and then recheck her labs on Tuesday. She was given the fluids and hung out in her crate. This went on all throughout the day. It was one of the busiest Sundays I have worked in months; we were 1 Dr. down (we usually have 3) so it was nuts. This was probably a good thing, because while I was focused on working and getting other peoples pets taken care of, I couldn't stress about Heidi. Well, I should say I couldn't stress about her as much as I would have had I been idle...

I went home that night praying this fluid therapy would work, and we wouldn't be looking at severe changes to her life as a result of kidney damage or failure. And of course I worried how this would effect my future medical decisions regarding her care and her treatment-how will we control pain? What if she needs treatment for her cancer? What about her arthritis when she is back to normal? What if she needs sedation because of another procedure? Because I didn't know what caused this, I didn't know how to prevent it happening again...if best case scenario, it was cured. Worst case is that it wouldn't be cured and I could make it worse...

Day 11: Monday 3/8/10

A day off. Because I was starting school the following Monday, they implemented the schedule change this week to make sure they stayed with the same pay period. I decided to just take it easy. Spend the day snuggling, watching movies, and prepare my questions and concerns for her kidneys. I was planning on going in for her fluids in the afternoon-when she had been given them the day before. I was just planning on going in and having the technicians give them (just like any other normal client). But when I checked Heidi's incision and skin flap (which I did several times a day) I saw something that made me even queasier than just the black skin: it had started to separate from the pink skin; the healthy skin that remained on the back side of the flap-the side of the flap that was attached to the rest of her leg, rather than the black part that was stapled. It was not only pulling apart, but there was yellowish goo that filled in the gaps in places. Ruh-roh. What if it was infected? I had paused in her course of antibiotics while she was not eating, so what if I had caused this too? I decided to call work and make a formal appointment; we could get her wound checked, I could get my questions and concerns addressed and she could have her fluids.

The Dr. (yes the same we had been seeing) really took her time and patiently answered my questions. She thought it was the previcox that caused the kidney issues; once they had flushed them out, they should return to normal. No more NSAIDS-EVER. We couldn't really discuss what would happen if they didn't flush properly-if the levels continued to be high-because she didn't know just yet (well, I think she did, but she didn't want to freak me out!) She looked at the wound and said it was normal it was separating: "remember, its just a big, ugly scab". The yellow stuff wasn't puss, but connective tissue. Yuck. But relief. Heidi got her fluids and we went home. More time spent worrying and thinking about the future...its scary when you don't have things to actually worry about. This was ridiculous!

Day 12: Tuesday 3/9/10

Finally, a day to get some answers! We hoped to hear from the surgeon about what to do in terms of the skin flap (aka "disgusting scab") and her kidney levels. I thought about it all day, but didn't really get any answers until the end of my shift. The Dr. had booked some time to see Heidi just about the time my shift was scheduled to end. But I had a problem with my cash report (as I was missing cash and credit card slips) and so took a while to really get finished so I could be with her. I was really angry; I tend to let little things completely send me over the edge when I get stressed out. Finally I went out back where a piece of paper was waived in my face by the Dr. who was now giving Heidi her fluids. The piece of paper were her results. Her BUN and creatinine were NORMAL. Holy CRAP!!! Two days of fluids and she had been fixed! I high fived the Dr. but immediately got down to business-I had found a small bump on Heidi's neck the night before and wanted it checked. I couldn't be truly happy until I knew this was nothing too. The bump was small, white and felt completely part of the skin. It had been there for a while, but I wanted it checked. It was nothing. Just a bump. Yay!!! Now it was time to be happy! I went home feeling better than I had in days! Well, a little less nervous anyways! The surgeons report was also pretty good; she said she would "debried" the wound (aka "pick off the scab") on Thursday and we would go from there. She might consider doing a second surgery to close the wound remaining (with staples and sutures) or she would do wet to dry bandages. But she wouldn't decide anything until her kidneys were better...truly better. That was good enough for me!

Day 13: Wednesday 3/10/10

Another day off! I decided to clean the house in the morning and a friend came over in the afternoon. It was again nice to not be as worried about everything. Well, I was almost less worried. Heidi had peed herself in my bed while sleeping. Hmmm...not something I was pleased about. Not because I minded waking up early (as Heidi had woken up to go pee at about 4 am-which made the accident even more puzzling) or because I had to wash my bedding, but because I had to put her in the tub. And I had to wash her very delicately to try and keep her wounds dry. She was not happy, but I couldn't leave her with pee on her skin and hair. That night my mom and I went to run some errands and I found myself at Petco looking at doggy depends. I didn't want Heidi to ear something all the time (the cone was bad enough!) but I wanted something to wick the pee away from her skin should she have another accident. I had her wear them that night, but they turned out to be unnecessary. OK. Well, I have a 15 pack of doggy diapers that I'll keep on hand. No big deal; better to be safe than sorry.

Day 14: Thursday 3/11/10

One more day to sleep in; well, sort of. I had taken some Tylenol pm to try and allow me to really sleep, but I was so worried about Heidi I kept waking up anyways. When she moved, I woke up. And put her out. Then I tried going back to sleep. I was groggy due to the meds but also the inability to truly get a good nights sleep for over a week. I had to go into work early again to see the surgeon. I had really only planned on bringing her in for a suture and staple removal, but the "scab picking" soon commenced. I thought I was going to PASS OUT. Seeing it peeling away on its own over the previous few days was gross, but seeing it peeled away from the skin and being able to see the inside of your dogs leg was really stomach turning. She decided to do a wet to dry bandage to peel away any ickies that were on the leg; and to soften the rest of the scab, because not all of it would come off. Well, at least if its bandaged I would have to look at it!

Heidi was still drinking a lot, so I planned on keeping an eye on that as well. But we figured we'd give it a few days to a week before rechecking her levels. She would need daily bandage changes for the next few days anyway, so shed be with me at work should I decide to check them at any time, or if I saw her behavior changing in any way. She went home with my mom that night (as I was working until 9, and knew shed be more comfortable at home) but I told her she couldn't really walk with her bandage; it went essentially from her arm pit to her wrist-covering her elbow, which impeded her walking. Apparently my mom thought I was lying though, because she said she was fine when I did get home! I think it was because the bandage slipped down and she could move freer...but she could have just been playing me!

Day 15: Friday 3/12/10

Two weeks. Two weeks since our lives were tossed about like a doll house in a twister. But things were calming down. Sure, there were still issues-including having to still have a consult at NEVOG, still keeping an eye on Heidi's pd/pu and daily bandage changes (which are now over the shoulder style, as the bandage kept slipping down which was not at all conducive to healing the whole wound!) I'm trying to keep focused on how different our future will be-I'm trying to focus on the positive aspects of that: pretty soon we'll be walking and hiking again, hitting the beach and our favorite spots in the mountains and kayaking. I'm trying to keep a level head and keep things in perspective. I know none of our lives will ever be the same again, but I have to try my hardest to make sure that I keep doing whats best for Heidi; for all of us.
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The last few days have been sort of uneventful; Heidi is still getting her bandage changes and is starting to get some spunk back. She hobbles pretty well when she wants to, and wants to play again. The surgeon said her leg looks good, and we may not have to go in and reclose; it may just heal on its own. We have the appt. with NEVOG tomorrow, and I feel good about it. Ive been doing a lot of research and feel good about the information Ive gathered, and the questions I'm prepared to ask. My next post will be up when I can type it, and I'll let everyone know how the consult went. This is the big one. This is where we'll get the answers...

Thanks again for your support through this difficult time...it really is appreciated!!!