![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
One of THOSE Fridays
Sep. 15th, 2007 01:42 pmAnyone who has worked in the veterinary or medical field knows what I mean: crises tend to clump together on Fridays, especially in the afternoons, and most especially when there's a long weekend, full moon, or some other special event.
Honey was leaving Friday PM for a Boy Scout camping trip, and I should have know better than to think it would be a quiet day.
It started with the migraine -- not in and of itself the end of the world, but definitely the cherry on top of the Totally-Sucks-Banana-Split-Sundae. When I'm in pain, all I want to do is sit quietly and do nothing more exertional than thinking. Instead, what I got was the health report, and rounds to do. OK, we can handle that; slowly, not rushing and thinking carefully.
Next came the phone call from $Boss who was upset about something. To resolve this needed a trip to another building -- a brisk walk across campus -- and lots of muscle activities for several hours. Along the way, I somehow forgot to eat lunch.
The crisis temporarily averted, at least until final resolution on Monday, I was able to pick up dinner and head home for a well-deserved meal. Only..not.
I arrived home to a very upset Honey and a dog who was not right. He couldn't stand up; had peed on the floor, and -- in her words -- his eyes were weird. I attempted to get him on his feet, with no luck; he was definitely not able to stand -- or sit up. Normally he prefers to lie on his left side, but at this time he was lying on his right side. Putting him on his left resulted in a flip -- rolling over his back -- and returning to a right side down. His eyes were drifting right and slightly upwards, and he had an anxious expression. He did wag his tail at me, and took treats from my hand, but I've never seen a dog eat anything while lying on his side.
My rule outs at the moment were (1) "stroke" (technically, infarct of some place in the brain); (2) idiopathic vertigo, (3) tumor, (4) middle to inner ear infection. The first three get the same treatment, so I started with intravenous valium, plus intramuscular steroids (prednisolone sodium succinate and dexamethasone). About twenty minutes later, he was sitting up, with his head tilted dramatically to the left. Later, about 2 hours after the treatment, he tried to stand; he managed to get to a high sitting position but couldn't go further. He did eat dinner while sitting up, tilted to the left.
Overnight I left him on his left side down, and flipped him onto his right this morning. I gave him his next dose of meds and went to feed the cats. He barked at me when I left the room; I came back to find him standing (!!) although still tilted leftwise. We "walked" out the back door, fell down the steps, did some pooping and "walking" through the grass, and then he got really tired. I had to push and shove him along, throw him up the steps onto the deck, and drag him inside. We were both worn out by the effort, and I eventually got him back to the bedroom. A little while later, he was standing again, and walked into the bathroom for a drink from his bowl. He drank it all, and moved to the toilet. I had to jump up and close the lid to keep him from doing that, and I let him put himself back to bed.
He's been mostly sleeping -- which is normal for him -- and hasn't eaten his food yet -- also normal -- only treats. We managed to scrape his scar on the elbow, so I had to rebandage his arm.
I'd called fellow vets last night, and both of them called back at the same time this afternoon. Three vets came up with three different diagnoses -- which demonstrates the art of medicine -- and we all agreed conservative treatment is the way to go. Can't diagnose what's going on without CT or MRI, and he's not a good candidate for anesthesia at this age. Besides, it won't change the outcome. He'll either continue to respond well to treatment (steroids) or he'll plateau. If I can't get him to recover quickly, it will be the end. We can't leave him lying on his bed all day unable to move around without assistance. After fourteen and a half years, he deserves his rest.
Of course, I have to keep him going this weekend, as Honey is not back from the camping trip until Sunday. We'll see how he's doing by Monday evening, and then make some decisions.
He's a good old dog. I'll keep him comfortable until she can make the decision to euthanize, and then we'll all cry as I inject him with sedative, anesthetic, and finally the euthanasia solution.
But it's a gorgeous day today, not hot at all; the wind is blowing and the time is just right for some painting and such. Oh, and the migraine is mostly gone.
Honey was leaving Friday PM for a Boy Scout camping trip, and I should have know better than to think it would be a quiet day.
It started with the migraine -- not in and of itself the end of the world, but definitely the cherry on top of the Totally-Sucks-Banana-Split-Sundae. When I'm in pain, all I want to do is sit quietly and do nothing more exertional than thinking. Instead, what I got was the health report, and rounds to do. OK, we can handle that; slowly, not rushing and thinking carefully.
Next came the phone call from $Boss who was upset about something. To resolve this needed a trip to another building -- a brisk walk across campus -- and lots of muscle activities for several hours. Along the way, I somehow forgot to eat lunch.
The crisis temporarily averted, at least until final resolution on Monday, I was able to pick up dinner and head home for a well-deserved meal. Only..not.
I arrived home to a very upset Honey and a dog who was not right. He couldn't stand up; had peed on the floor, and -- in her words -- his eyes were weird. I attempted to get him on his feet, with no luck; he was definitely not able to stand -- or sit up. Normally he prefers to lie on his left side, but at this time he was lying on his right side. Putting him on his left resulted in a flip -- rolling over his back -- and returning to a right side down. His eyes were drifting right and slightly upwards, and he had an anxious expression. He did wag his tail at me, and took treats from my hand, but I've never seen a dog eat anything while lying on his side.
My rule outs at the moment were (1) "stroke" (technically, infarct of some place in the brain); (2) idiopathic vertigo, (3) tumor, (4) middle to inner ear infection. The first three get the same treatment, so I started with intravenous valium, plus intramuscular steroids (prednisolone sodium succinate and dexamethasone). About twenty minutes later, he was sitting up, with his head tilted dramatically to the left. Later, about 2 hours after the treatment, he tried to stand; he managed to get to a high sitting position but couldn't go further. He did eat dinner while sitting up, tilted to the left.
Overnight I left him on his left side down, and flipped him onto his right this morning. I gave him his next dose of meds and went to feed the cats. He barked at me when I left the room; I came back to find him standing (!!) although still tilted leftwise. We "walked" out the back door, fell down the steps, did some pooping and "walking" through the grass, and then he got really tired. I had to push and shove him along, throw him up the steps onto the deck, and drag him inside. We were both worn out by the effort, and I eventually got him back to the bedroom. A little while later, he was standing again, and walked into the bathroom for a drink from his bowl. He drank it all, and moved to the toilet. I had to jump up and close the lid to keep him from doing that, and I let him put himself back to bed.
He's been mostly sleeping -- which is normal for him -- and hasn't eaten his food yet -- also normal -- only treats. We managed to scrape his scar on the elbow, so I had to rebandage his arm.
I'd called fellow vets last night, and both of them called back at the same time this afternoon. Three vets came up with three different diagnoses -- which demonstrates the art of medicine -- and we all agreed conservative treatment is the way to go. Can't diagnose what's going on without CT or MRI, and he's not a good candidate for anesthesia at this age. Besides, it won't change the outcome. He'll either continue to respond well to treatment (steroids) or he'll plateau. If I can't get him to recover quickly, it will be the end. We can't leave him lying on his bed all day unable to move around without assistance. After fourteen and a half years, he deserves his rest.
Of course, I have to keep him going this weekend, as Honey is not back from the camping trip until Sunday. We'll see how he's doing by Monday evening, and then make some decisions.
He's a good old dog. I'll keep him comfortable until she can make the decision to euthanize, and then we'll all cry as I inject him with sedative, anesthetic, and finally the euthanasia solution.
But it's a gorgeous day today, not hot at all; the wind is blowing and the time is just right for some painting and such. Oh, and the migraine is mostly gone.
