Bailey is going home today. I probably would have released him yesterday, but his owners wanted to make sure he was okay. Bailey is very lucky.
Bailey adopted new parents about a month ago. His new dad brought him in to see if he was okay. Bailey didn’t have a name yet and was listed as “Beagle” on his chart and in the computer. My best estimate was that he was about seven years old. He had a dead upper canine tooth and his incisors were short. The owners said he had a slight cough. He had no microchip. Oh, and he hadn’t been neutered and his testicles were soft (diseased). They didn’t want vaccinations, but he needed them. They agreed to the heartworm test and fecal (stool) analysis. He had hookworms which can cause a cough. We treated them so the other dogs wouldn’t get sick.
Then they agreed to vaccinations.
That is when I knew “Beagle” had a home.
At his recheck appointment in three weeks, Beagle still did not have a name. He had some vomiting, so we did some blood work. He was slightly anemic, but his white blood cell count and blood chemistry were fine. We discussed taking radiographs or x-rays, but they decided to hold off.
Eleven days later, his cough was worse. Thoracic (chest) rads also showed a large mass in his abdomen. (Good thing we included some of his abdomen. The owners weren’t sure when I told them that Beagle would need surgery and only had a 50/50 chance even with surgery. They took a moment alone to discuss Beagle’s future. When I returned to the room, the Mrs. Owner told me they had decided to do surgery. I reiterated that the prognosis was only fair and they both said that was okay and they knew I would do my best.
We scheduled surgery for the next day and started Beagle on IV fluids.
Later the Mrs Owner would tell me: “We didn’t want to tell you, but that night when we scheduled his surgery, well, we didn’t want him to die without a name. We went out and had a tag made with his name on it. We may have had to put his tag on his ashes, but we wanted him to have a name.”
Bailey did well with surgery. The spleen and tumor was 4 pounds and 14 ounces (in a 35-pound dog)! The only complication was that the tumor had grown very close to the pancreas. The pancreas is not supposed to be handled during surgery, but it is really bad form to leave larger arteries bleeding into the abdomen. I chose to gently move the pancreas and suture the splenic arteries as I removed the mass.
Bailey did great after surgery. He continued IV fluids for several days because of the potential for pancreatitis, but Bailey soon insisted that he was well enough for food. A couple of days later and I felt he was okay to go home. A recheck after a few days at home had a complaint that he was coughing even more than before. We added some cough suppressants, but I really wasn’t too worried about the cough. I did add some antibiotics. Overall, the owners were thrilled and said he was acting better than before.
A week later, Bailey was sick again. I thought he was in just for his sutures out, but his parents said he was coughing a lot and just laying around. We did some blood work, just to make sure everything was okay and “bam!” Bailey was in the hospital on IV fluids and antibiotics again. This time his white blood cells were sky high.
Thirty-six thousand is high enough that it has to be a closed cavity infection. We call an infection that high one of the six “P’s”: pneumonia (lungs), pleuritis (outside the lungs inside the chest), peritonitis (abdomen), pancreatitis (pancreas), pylonephritis (kidneys) and either prostatitis (prostate) or pyometria (uterus).
My first thought was to question my surgery. I knew it had been routine. No extra bleeding. No intestines that had perforated. A good, clean, sterile surgery. We wear caps and masks and use sterile gowns, gloves, and packs for every abdominal surgery, even the routine ones. For this surgery, I even had radiopaque sponges in case I lost one. (The radiograph was clear of any sponges left.) I knew I had done everything right. It wasn’t the right timing to be pancreatitis. It had to be the prostate. Bailey would need more surgery. The owners requested a microchip.
We started him on fluids immediately, but he didn’t look as good as I thought he should. By the end of the day, I decided we needed an ultrasound to go with the radiographs. There it was in an area behind the bladder. The prostate was very large with little fluid pockets. I tapped one of these with the benefit of the ultrasound and got back pus. No pus was found anywhere else in the abdomen. As Bailey was looking worse, I decided to inject antibiotics straight into the infected prostate. By nightly checks, Bailey was looking better.
The next day, I came in on my day off to do Bailey’s surgery. Removing the testicles decreases the abnormal levels of estrogen that causes the prostate to be enlarged. Hopefully, that will be enough to allow the body and antibiotics to clean up the infection. Splitting the pelvis to get to the prostate in dogs is not a fun surgery.
By the end of the day of surgery, Bailey is eating and licking the bowl clean. The day after surgery, Bailey is doing great. I am ready to send him home, but the owners preferred to wait on IV fluids one more day. They did admit that Bailey looked better than he had at any time since he adopted them. He is even coughing less.
I mentioned how lucky Bailey was to have found them. We did everything we needed, in the order and time that it needed, but Bailey’s care had added up to a significant sum. That is when Bailey’s mom admitted that they had named him the night before his first surgery, so he would not die without a name. Bailey may still have some issues and will die sooner than they will like, because he was not a new pup and even a benign cancer takes its toll, but for now, Bailey is living the life with a great family.
Bailey is very lucky. So are Bailey’s parents. Bailey is a good dog.