Wednesday, January 20, 2010

If I Had A Dollar For Every Time I Said "Spleen" This Week...

(Contributed by Lori Whitwam)

WARNING: This post contains graphic pictures of a surgical procedure.

I wrote last week about the situation I was facing with the tumor we'd discovered in my dog Ozark's spleen. His surgery was yesterday, and that's the story I want to tell today. Even though I've worked in veterinary hospitals since 1998, and managed Whole Health Veterinary since it came into being in April of 2005, when it comes to my own dogs I'm every bit as involved - and worried when they are sick - as each one of you.

Being an "insider" in the veterinary business is a curse as much as it's good fortune. I know things, and over the years I've seen things. Sometimes cases go wrong for no reason, and illness (especially cancer) doesn't always follow the rules. On the other hand, I have access to specialists, and to knowledge of which many pet owners aren't even aware. In addition, we're a holistic practice, so our doctors think outside the box. I had the information and the resources to do everything in my power to stack the deck in Ozark's favor.

Another wonderful benefit of working for a veterinary practice (and being the one who makes the schedule) is that I was able to rearrange my work hours to allow me to care for Ozark. He received his pre-operation sedation at around 9:15 AM. The surgeon arrived around 10:30, and his surgery was over by noon.

Surgery always amazes me. Whether human or animal, surgeons are able to open up the body, take things out, put things in, rearrange various bits and pieces, then put it all together again... and the patient is still alive. Consider that one tiny wound from a gun or a knife or a pointy stick can be fatal within moments. A surgeon had better know what they're doing!

Here are some pictures from Ozark's splenectomy (removal of his spleen):

(Pre-operation. He's zonked on his sedation, and the IV catheter has been placed in his right foreleg.)

(On the table, shaved, anesthetized, waiting for Dr. Hammel. Vet tech Jenna is monitoring Ozark.)

(Dr. Scott Hammel, of Veterinary Surgical Specialists, begins the incision that will give him access to all the squishy, oozy stuff in Ozark's abdomen.)

(Dr. Hammel has located the spleen and brought it out of the body cavity in preparation for removal. The spleen should look like the part on the right. Sort of flat and dark red and mushy and shiny, like raw liver. The mass is the roundish area beneath the light-colored fatty material at the top left of the spleen as pictured. More pictures of the spleen coming up.)

(The spleen, again. The healthy tissue is the bottom - both right and left - and the tumor is the roundish area at the top-center.)

(Removing the spleen. What alarms ME is the incision visible above. Seems so... large. And look how thick Ozark's body wall is. Who knew there was so much meat on our canine friends???)

(Get that thing out of my dog, Dr. Hammel! Thanks!)

(A good shot of the spleen. If there's such a thing as a good shot of a tumor-ridden spleen. Doesn't it look like someone tucked an orange there in the top-middle part? The whole thing should be flattish and floppy, similar to a liver.)

(Since he was in the neighborhood, and because he's a skilled and thorough surgeon, Dr. Hammel also checked Ozark's intestines for signs of tumor growth. He checked the liver, too, and sent a small sample of that tissue to the lab, along with the spleen, to look for microscopic signs of cancer.)

(Getting that little bit of the liver to send off to the lab. The liver looked healthy, but there could be microscopic cancer cells sitting there waiting for a chance to cause trouble.)

(Everything back where it belongs - minus the spleen - and Ozark getting put all back together.)

Was I a nervous wreck? Yeah, pretty much. As soon as he was in recovery, we set him up in our healing and holistic treatment room, and I spent the rest of the day sitting with him.

One thing we learned is that Ozark is extremely sensitive to anesthesia. I'd expected him to be able to walk to the car with assistance around four hours after surgery. Dogs are way more resilient than we are. When I had abdominal surgery, I was in the hospital for 2 days and then spent three weeks in bed, whining. But at 6:00, six hours after his surgery, Ozark had done little more than flutter his eyes and move his head a few times. It was taking his body much longer to purge the anesthesia than normal.

Finally, we loaded him into the back of our Blazer, on a padded sled with blankets and heating discs, and my husband and I brought him home. He'd had his bladder catheterized to empty it, his temperature was steady and his blood tests looked fine. He'd had Reiki from both our technician Sabrina and Reiki Master Peggy Edman, and some homeopathic remedies. He'd mouthed some treats and swallowed some water syringed into his mouth. I knew what to watch for, in case of trouble.

So, we brought him home (dragging him up the stupid stairs in our stupid split level house on that stupid-but-handy sled) and set him up in our spare room on a dog bed and some comforters, with the heat discs to keep him toasty, and an afghan covering him. I slept on the futon, so we could keep him separate from the other dogs, and so I could keep an eye (and a hand) on him all night since the futon is so low to the ground. We had to turn him every couple of hours to keep his circulation going. It was an anxious night.

(Such a sweet, sad boy!)

But this morning, when my husband got up, Ozark stood. He went out on the deck and emptied his bladder, and ate some raw venison meatballs with medication in them. He's decided he wants to be with Brody, Darwin and me in the living room, so he's napping on a comforter across the room.

Now, if I can keep him from trying to sneak down into the basement family room to poo - which he wants very much to do, hating to do anything on the deck, which is his only other choice right now - at least until his incision heals a little, we'll be all set. His dog-brothers are behaving pretty well, and I'm keeping a close eye on him.

We should get the biopsy results Friday or Monday, then we'll know if we're likely out of the woods, or just starting a rough fight. Again, being part of the veterinary business and knowing the things I know is often helpful, and sometimes it makes things a lot harder. Until we get the report, I'll just hope. Really, really hard.

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