April 27, 2009

April 27, 2009, 1 day short of 12 wks post-op, knee unstable again

We dropped Winston off at AMVS at 7:00am for his next surgery. I guess the silver lining for his lack of interest in food is that I don't have to feel guilty that he's hungry when we drop him off. Of course I still feel bad that he's going through this. Hopefully things will go well and they'll be able to close the wound today.

Winston is not normally a licker or a chewer on himself. We got lucky that he never did anything to himself with either of his tightrope surgeries. Towards the end of his 2-week e-collar stint on the second surgery, I watched him (with his donut e-collar on) reach around and nip at an itch on his leg "good" (left leg) right where the incision scar was. It was at that point that I realized that if he had been determined to get at his incisions, he could have done so despite having his donut on. My advice is to get the satellite dish style of e-collar.

They called in the afternoon to say that they were about to do his surgery and found him with no bandages on his leg. After looking around and asking around if someone had removed them, they figured that he'd eaten them. They took x-rays to confirm this (apparently there is something in the bandages that shows up on an x-ray) and luckily everything was still in his stomach so they'd be able to send a scope down his esophagus to pull them back out. There would be no charge for this and there would also be no charge for him to stay overnight at the hospital so they could watch him.

This is also a lesson to all of us... even when we think our dog is trustworthy (look what he's been through so far without ever doing anything like this), DON'T trust him. I have no doubt that AMVS will never trust another dog again and they'll ask that you bring your e-collar back with you each time. Since we were doing almost daily surgeries, I'd forgotten to bring it with me one time, and they'd told me that they had spares in the back. I got to the point where I just figured they would put one on him and stopped carrying it back and forth and Winston often had visitors while he was there, so they probably got to the point of trusting him since he was often being watched. That will teach us! Anyway, please don't hold it against them or think that they didn't provide excellent care, they did and they still do.

They called again when they finished his surgery to say that they'd been able to remove the bandage from his stomach and that they were still getting some gunk out of the fluid that they were flushing through his knee. They also said that they were still able to flush all 3 liters of fluid through the joint. I didn't understand the significance of this, but they explained that if it had healed enough, the fluid would be blocked from going into the joint, and would sort of "back up" or be really hard to push. Kind of like if you stuck a syringe into a piece of wood and then tried to push the plunger down. Either the fluid in the syringe would cause the needle to back out of the wood, or you wouldn't be able to push the plunger down at all. I guess that's what they're looking for when they determine if the infection has healed enough. So... we are going to skip surgery tomorrow, but we go get him then since they're keeping him overnight. And then we take him back again on Wednesday where hopefully they'll be able to finally close the wound.

Then... they had to tell us that today the joint wasn't stable anymore. I didn't know what that meant for long term prognosis. I asked if there was a chance that once his wound was closed up that the scar tissue would re-develop and hold everything together. I think I was grasping at straws. They had to tell me that there is a very small chance that will happen, but it's very unlikely that it will improve beyond what it is today.

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