Monday, February 15, 2010

Day 2, 2nd AM update from Soft Tissue Surgeon

Sitka is doing fine this am. Appears comfortable, still under narcotics. A lot of pain right now is associated with chest tube. Having something stuck in you is painful. Heart rate is normal and she is handling the tube ok.

Heart arrhythmia – this is what happening – some of the contractions that start on the top of her heart are not going to the bottom. “It is not worth worrying about”. Will look at it later if need be. It is the kind that they may do short term meds, but they think it will correct on it’s own. Doesn’t think it is congenital. Things it developed with the stress. They see with dogs who have this condition, it messes with the nerves around the heart and this can occur. He feels it will resolve itself.

He is certain of what the problem is. He is certain she does not have asthma. He thinks what happened is the Bulla of the lungs…. This is what inflates the lungs – he thinks one burst. When she breathes in, air would normally go into that sac (the bulla), but since it burst, air is going through it and surrounding the lungs. He said there are many cases of this involving Siberians. They call it spontaneous pneumothorx. Doing the suction pump, there is a 50% chance it could happen again. They find with Siberians that they leave them with the pump, and they never really get better. The way to fix it and not lead to a reoccurrence is to go in, find it, and fix it.

They did more xrays. There is no evidence of any tumor. They have ruled out cancer.

Next course of action. Tracheal wash. Flush solution down her throat and suction it back out and do a culture. Reason: Determine if she has an infection, which can cause a bulla to rupture. They are also doing blood work this AM and that will show the white blood count. He is not certain that the elevated white count on Sat night means an infection. It could have been stress. She may not have an infection, but they are going to 100% rule it out before going forward.

Next step is to do a CT scan of the lungs. Reason: they can pinpoint where the ruptured bulla is. Then they can go directly in and fix it. If nothing shows up on the scan, then they go in and do a thoracoscopy. They would stick a camera in and see if they see the rupture. To be sure, they also may put fluid into the lungs and see where the saline bubbles out. This would also show them where the rupture is.

All told – What they intend to do… if everything is as they expect, they will do the CT scan and the thoracoscopy 11-12. We should hear back from them around 12:15. He would let us know before they do any kind of surgery on her so we are in the loop.

Jeremy asked about surgery – what kind of procedure. He said it varies. It is as simple as slipping a wire in and repairing it. Sometimes they have to open an incision and fix it. He said it sounds more invasive than it is and amazingly dogs respond better to that surgery than humans do. Nothing we should be worried about if this is what they have to do.

Jeremy also asked – if able to repair the ruptured bulla – what are the chances we would go through this again – he said probably won’t. This is generally a onetime thing. Among dogs in general, the reoccurrence of this is 10%.

In terms of complications in surgery repairing the bulla – they look for risk of leakage after the surgery. Will need to monitor her for a while after to make sure. Also there is an infection risk after any surgery. The most common place they see ruptured bullas, is on the tips of the lungs. That makes for a less invasive surgery. Another complication – this is a delicate surgery but would have to put her under general aesthetic. They don’t expect any complications from general aesthetic from what they have seen of her, but there is always a chance.

In terms of the infection. Looked hard on the xrays. Usually the infected tissue will show up and they see no evidence of that yet.

Long-term prognosis – they feel they can fix this with surgery. He said at this point, the problem to figure out is why the rupture happened. He said it can be completely spontaneous. What can cause it is: a foreign object, he has seen them inhale a blade of grass/small pebble/etc and that cause an obstruction that messes things up. Sometimes it can be an infection. That will cause the tissue to be inflamed and cause a rupture. Another thing is you can get a tumor that causes it, but with her, they have ruled that out.

He said if there are multiple bursts, then they may have to take out a portion of one of the lobes of the lung. Each lung has three or folds of lung tissue that are fanned out. Sometimes if there is a large or bad rupture, you have to remove the lobe that it is on. No long term complications if this is the case.

13 comments:

houndstooth said...

We wish Sitka the very best! Hopefully things will start to get better soon!

Bunny and her Mom

Kayla and Maebe said...

We have our fingers and paws crossed for Sitka.

Our huMom's first husky, Rex, went through a very similar situation with the bullas. HuMom says it was furry scary but he got through surgery and recovery with no complications and never had lung problems again. We hope that Sitka's recovery is as successful and uneventful as Rex's was.

Hugs and husky kisses,
Kayla, Maebe, and their huMom

Marvin -The Hollow Hound said...

Thinking of you all, and all good wishes and healthy vibes being sent across the oceans to dear Sitka.

love and light, Marvin and Jeannie xxxxxxx

Jan's Funny Farm said...

We are sorry you and Sitka are going through all this. Warm purrs and tail wags.

Gus said...

We wish Sitka the very best...we hope this can be resolved quickly and simply, and you can have her home to love for a long, long time.

Lots of doggies are sending good vibes.

gussie

Steve, Kat, & Wilbur said...

We think this is a good update and we hope the next one is even better!

JackDaddy said...

Well, strangely that sounds like good news. Knowing helps!

I hope it's as minimal as possible!!!

The Army of Four said...

Sitka is where she can get the BEST treatment! We know you miss her, but hang in there. We just loved Kayla, Maebe, and their huMom's comment - that's so encouraging!
Sitka - if they let you read blog at UGA - we love you! Me especially. Ha roo roo roo!
Lots of love and a nose lick for your mom and dad!
Play bows,
Zim

Noah the Airedale said...

We were glad to read of Sitka's good progress. Sitka, you gave your pinkies a huge scare. Get well soon Sitka. We are thinking of you.

Noah Willow Tess & Lucy
xxxx

Cyber-sibes said...

We're keeping paws crossed - sounds like woo have a plan!

jack a-roo & moo too

Ozzie the OZmonster & Zowie said...

Oh you guys. I am just sitting here balling. My heart and vibes go out to you all. It breaks my heart to hear this. I know they are going to find and repair that tear and she is going to be good as new but it is so scary. Keep close and be positive. Those vibes are strong and she can feel them. We are all pulling for her.

All paws crossed,
Ozzie and Zozo

FurX4 said...

AWESOME NEWS!!! Webb Ranch is praying for all of you! May the doctors hands be guided by God and heal her!

Jake of Florida said...

We're sending you our love and best wishes for Sitka's recovery. Reading your story over the last few days, we realize what terror has been involved in getting her to the right vet and diagnosis.

We'll be back to see how she's doing!!

(Our human brother and sister-in-law are right thete in Athens so we'll ask them to add their healing thoughts to ours!)

Jake and Just Harry