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Monday, August 29, 2011

Talked To The Vet...

We're calling this thing a draining tract just because we don't know what else it could be. It ruptured sometime last night/this morning and is oozing, just like the really big mass did before the surgery.


Doc is still pretty confident this is all from a foreign body getting into Reyna and he was concerned this could happen, but he really doesn't know the best route to fix things. He had three suggestions when we talked a few minutes ago.

1 - Wait it out and see what happens with it. Try some different antibiotics in case some bacteria has worked its way in (after all, its essentially an open sore at this point).

2 - Do a second surgery with a board certified surgeon who is skilled at working around the femoral artery and the inguinal blood vessels. Surgeon would also do a culture, histopath, pathology, etc. Major down side to this is that the surgery would be 2 to 3 times the cost of the first surgery. Did I mention I'm still paying for the first surgery?

3 - Take an x-ray of the fistula tract. Inject dye into the system and see where it goes. Doc said its possible to have a foreign body enter in one place and drain somewhere totally unrelated. Problem is that the fatty tissue in the area of her draining tract doesn't react perfectly to the dye and can make it hard to get an accurate reading with the x-ray. This option also involves specialists and would be very expensive.

We're going with the wait and see with new antibiotics route, since thats the only option I can afford. The antibiotic Doc wants to use has been reported to cause problems with black and tans (GSDs, rotties, dobies, etc) so I have to take Reyna in this afternoon for a couple of tests to she if she's predisposed to the problem. If not, we give the meds a try and hope the problems don't occur. If she is, the next choice is a hideously expensive antibiotic.

Gotta stop and buy goats milk on the way home, since I'm sure the antibiotics will make her sick.

Sunday, August 28, 2011

Not Again

Interestingly enough, the sore near Reyna's incision that we were concerned about early last week appears to have healed up. But then this thing showed up yesterday (possibly the day before; I was busy and forgot to take photos, but I know it wasn't there on the 25th):


In case you're confused about what you're seeing, all the light pink skin on the right is healthy. The darker area left of center is the scar from her surgery earlier this month. The big red ball on the left is bad. I sent a couple of pictures to Dr. Lapham last night and got a response a little bit ago. He wants me to call him first thing in the morning - he thinks it's another draining tract that could be ready to rupture. I don't know what we're going to do. I still owe on the last surgery. Dog forbid he says she needs to go to the vet school, because that will cost a fortune. Another night of worrying ahead...

Friday, August 26, 2011

A Smidge Creepy

I was outside playing with the this morning pups when I noticed four areas of this on the ground below the tree:


I looked at the tree to see what might be causing this mess, and I saw this:


And this:


They've already stripped three branches almost completely bare. When I went out this afternoon, the leaves they were sitting on when I took the photos were gone.


At this rate, the tree is going to be completely naked in a week. Unless the hurricane gets them tomorrow....

Tuesday, August 23, 2011

Birthday Fun

My birthday present from Mary was "Paint Your Pet" night at Wine & Design. The idea with this event is that you send them a photo of your pet, they put it on a canvas, and then you paint it (with help as needed).

I used a photo of Duncan taken in 2009. I didn't do Reyna because a friend of mine who is an actual painter is doing Reyna's portrait for a belated birthday present. Here's the photo blown up for painting (the wrinkles are from adhering the paper to the canvass, not from the actual picture).


I will admit to finding the whole process very stressful. Up until I hit a certain point, anyway. All of a sudden, I was able to relax and just paint without worrying about exactly how it looked. Which is good, cause Duncan has some seriously complicated coloring when you're trying to paint it just right. I joked to Mary that if I ever decided to paint Belle, she'd turn from a tortoiseshell into a completely black cat....



Mary painted her shepherd, Bruno, and I think she did a lovely job.


My expectations for this project were fairly low - I really just wanted to be able to recognize what I painted as a dog. I was very excited when a couple of other folks could tell that I'd painted a German Shepherd. You know, considering the last thing I painted was the catiary, I think I did a pretty good job.


Maybe we'll try Kodiak next month...


Poor Pup Has No Luck

The red spot near Reyna's incision that we were watching has turned into a small open sore. It has a well-defined firm round shape. Dr. L said this is what he was worried about and he's hoping this is the last bit at the inguinal canal working its way out. We're not going to do anything yet, just keep a close eye on it and see what happens over the next few days.

Monday, August 22, 2011

Its That Time Again

Considering that I had to sit for two and a half hours at the DMV to renew my license, I'm really glad they gave me the eight year version this time. And that was at the DMV office that has a reputation of being one of the fastest in the area. I briefly considered leaving and coming back a different day, but I just knew that if I didn't get it done today, I'd suddenly be too busy to get it done by Wednesday, and Thursday I'd get stopped at some police checkpoint and be caught driving with an expired license. Cause that's just how my luck runs. I almost wish they were still doing the 5 year version - it'd be a lot easier to remember in connection with turning 40 than with turning 43....

Sunday, August 21, 2011

Fun In The Sun

The pups and I spent some time playing outside this afternoon. Reyna hasn't been able to get in her pool for quite a while, due to illness and/or injury, so I scrubbed it out and filled it up for her today. That made her a very happy pup.


Duncan never gets in the pool, of course, but he does like to hover around and wait for Reyna to get out so he can play with her.


Duncan really hates getting wet, but he loves to chase the water from the hose. Once Reyna was settled in the pool, it was Duncan's turn to play.



Surprisingly enough, Kodiak actually wasn't terrified of the water coming from the hose (although he was a little nervous about the hose itself). He didn't even seem to hate getting wet, he just wasn't interested in all that foolishness. He did enjoy teasing Duncan, though, when he got stuck in the honeysuckle bush while trying to dry his face.




And here's a little clip of Duncan playing with the water from the hose.



Its so nice to have Reyna feeling better and able to enjoy a little silliness outside.

Saturday, August 20, 2011

Freedom!

Yesterday, 11 days after her surgery, Reyna and I went to the vet's office to get the staples removed from her incision. I'm surprised we lasted as long as we did - I knew we'd never make it to day 14. I haven't seen this level of brattiness from Reyna since she was about 2. The only difference is that back then it was a teenage angst type of obnoxiousness, and now it's more of an unbridled joy sort of thing. Cute, really, even when she's flipping me the bird and bouncing just out of reach.

Reyna was a perfect lady while the tech removed her staples, and then she proceeded to maul Dr. L when he walked in the exam room. She wouldn't stop until she'd knocked his stethoscope off his neck and tried 3 or 4 times to tickle his tonsils. Its really a shame she doesn't like him....

Doc says his incision looks great, but there's a red spot that he's a bit concerned about. It could be nothing, just some irritation from the staples or Kodiak getting in a lucky blow. It could also be the infection trying to show itself again. We're not putting her on any more meds, but we are going to keep an eye on the area. If it clears up in a few days, yay, hooray. If not, we'll deal with it.

Reyna's staple-free incision:



5 minutes after getting home:



Saturday, August 13, 2011

Its Not Cancer

Just got a brief rundown of the biopsy results. Dr. L is out of town for the weekend, so we've been doing this via email and a call from one of his techs.

The histopath diagnosis: Chronic ulcerative fibrosing pyogranulomatous dermatitis/panniculitis. (Whatever the heck that is.)

The pathologist's opinion: Inflammation of this type could be initiated by infectious, foreign body, traumatic or idiopathic pathogeneses. There was, however, no evidence of predisposing factors such as visible infectious agents or embedded foreign debris discernible in the sections examined.

Dr. L's comments on the pathologist's opinion: Which in my mind backs up the likelihood of a foreign body penetration (stick/twig/sharp piece of something) causing damage with resultant ulceration/necrosis. Why it did not heal well with conservative therapy is anybody's guess, but I do wonder if I flushed out some material when I opened up the tract during surgery. If she heals well, that is the best answer of all. I will be holding my breath for the next few weeks as the tissues mend.

In simple terms - its NOT cancer.

They didn't find any microscopic particles of anything, but they aren't yet ruling out foreign body trauma. They have ruled out bacteria, fungus and other infectious agents. Now it basically comes down to how she heals. If Dr. L got rid of all traces of whatever object caused the damage (if it is foreign body trauma), she should heal nicely. If the infection comes back now that she's done with her antibiotics, then its back to the vet we go.

Sooooo happy its not cancer. Now that we’ve settled that, I’m not so worried about the other options. Reyna is feeling really great with that mass off her belly and the infection out of her system. Even one of the neighbors commented that she looks a lot peppier than she did before the surgery. The only downside is that she’s feeling well enough to be a total brat about her activity restrictions. She’s not at all happy that she has to be quiet for at least another 5 days. With luck, Dr. L will take out the staples and take her off restrictions when we hit day 10 or 11, rather than making us wait until day 14. Of course, that all depends on how her incision looks.

A couple of shots of her incision, taken this afternoon. No redness, no oozing. Paws crossed it stays that way. She's been really good about not licking, and I've been really good about jumping all over her if she looks like she's even thinking about licking.



Kodiak is still freaked out by Reyna when she's wearing her cone, which is generally when she's in her crate, and Duncan is clearly stressed out by all the drama....


Tuesday, August 09, 2011

Post-Op Pup

We all headed out early yesterday morning to get Reyna to the vet's office for her surgery. After dropping her off, the boys and I went to Suzie's for some distraction and then to Mary's to get comforters for Reyna's crate. While we were there, Dr. Lapham called to tell me Reyna was out of surgery. He gave me a rundown of everything he found (and didn't find) during the surgery. I sent him an email last night to verify that what I heard was what he actually said, and thankfully, he called again today to go over the information a second time.

He started the surgery following the duct, since that's where the infection was coming out. Dr. L said that now he thinks that wasn't actually a duct, rather it was a draining tract. He thinks this because it went into and under the mammary gland and then towards the inguinal canal, which isn't normal for ducts. The damaged area went deep into the tissue away from the nipple, and mammary cancer typically occurs closer to the nipple. He did do a mastectomy and removed that mammary gland, along with the lymph node, because the tissue in and around it was necrotic. He wasn't able to get all of the draining tract and surrounding tissue because it was too close to the femoral artery, but he feels confident that he got most of it.

Dr. L said that he's bumping cancer a bit lower on the list because the damaged tissue didn't have the typical appearance of cancer, but he's not ruling it out. He was hoping to find a twig or some other obvious foreign body, but no such luck. However, he thinks its possible that something got into Reyna's belly, created the draining tract and damaged the tissue and then worked its way back out, leaving microscopic particles behind that have prevented the healing of the wound. He's also leaving fungus on the list of possibilities. He's still saying pretty much anything is possible - after all, this is Reyna we're talking about. At this point, its really coming down to the biopsy results of the sample he sent to the pathology lab. He said further treatment will depend on the results and how Reyna heals from the surgery. He did mention that he's a bit concerned about her weight loss over the last several weeks, but without any other indication of problems he's going to attribute it to her immune system working over time. If she heals up and there's nothing left to treat, then she should get back to her normal weight. If not, we'll deal with it. He's still leaning towards Friday for the biopsy results, but it depends on the lab.

I was able to get Reyna yesterday around 5pm. The poor girl was still groggy from the drugs and had quite a bit of trouble walking. I couldn't help it, I just had to laugh. Here's Reyna in the exam room, waiting for the vet tech to go over the post-op instructions.


Crashed out in the crate after getting home.


And passed out on her bed later in the evening. I love how her tongue sticks out when she doped up like this. She's doing better today - her tongue's been in her mouth all day.


Here's a shot of her surgical site. There are more staples that you can't see from this angle, going down to the left along the curve of the darker area. I have to say it looks a lot better than the open wound did.


Reyna didn't want any food last night, but she's been eating, drinking, peeing and pooing normally today. She clearly feels fine, because she's been arguing with me all afternoon about needing to stay calm and quiet. I'm thinking its going to be a long 14 days....

Thursday, August 04, 2011

Happy Birthday!

My little Mycroft is 11 years old today. Happy birthday, sweet boy!



Monday, August 01, 2011

Back From The Vet

We ended up not doing any tests at the vet's today. Based on how the mass has shifted shape and location and because its not responding to antibiotics, the vet said the only real option is surgery to remove the mass and do a biopsy. Its possible the mass could be the result of a fungus or a foreign body entering the duct. The surgery will allow him to follow the duct to the mass and find a foreign body (if there is one) and do a lumpectomy. The biopsy will show if the mass is the result of a fungus. Unfortunately, the vet thinks the most likely cause of the mass is mammary cancer. If it is, the biopsy will tell us what type of cancer, and what we can expect. Doc said there’s three types of mammary cancer – bad, really bad, and really really bad. 50% of the dogs who have a lumpectomy are just fine afterwards and die years later from something unrelated. Of the remaining 50%, 25% may have a recurring tumor but no life threatening issues. In the last portion of dogs, its terminal. Doc is concerned enough about this that he's shifted his schedule to get her in surgery as quickly as possible. So, Monday the 8th is surgery, and we’ll hopefully have the biopsy results Friday the 12th. After that, we’ll see.

Back To The Vet

The swelling of Reyna's whatever-it-is still hasn't gone down at all. Dr. L wants to run a couple of tests to try and get a better idea of what it is, so we're headed back to the vet later today. Lucky us.