| July
23, 2001 – For those of you following Jabber's
story, here is the latest news. Last Thursday I took Jabber to Charleston,
SC, to be evaluated by his orthopedic surgeon, Dr. Shealy. Jabber underwent
ultrasound. They examined his prostate, bladder, kidneys and spleen.
I expected them to find bladder stones. They did not. Instead they discovered
one of Jabber's kidneys is enlarged along with it's "plumbing."
They also found unusual masses in his spleen. It is possible that the
E. coli infection has spread to Jabber's kidneys, but I don't think
that would explain what they saw with the spleen. Another possibility
is hemangiosarcoma,
a deadly cancer. (Ironically, we lost our first Dane to hemangiosarcoma.)
A sample of Jabber's blood was drawn and sent off for analysis to help
determine a diagnosis. The report was due back Friday and Dr. Shealy
said he would call me with the news. I haven't heard from him. At my
request, his assistant faxed me a copy of the report Friday afternoon
but I don't know how to read it. (Some of the readings were high.)  I
expected Dr. Shealy to follow up with a call Friday afternoon or Saturday
but we haven't heard a word. I will try to reach him again today.
If the blood analysis points to hemangiosarcoma, I think the next step
is to do ultrasound-guided biopsies of the suspicious areas. I am not
sure what to expect if hemangiosarcoma is ruled out. Just prior to the
ultrasound exam, we discussed administering Amikacin to fight Jabber's
resistant E. coli infection. Apparently this can now be done through
a series of daily injections. Amikacin is particularly dangerous for
animals with impaired kidney function so I imagine we would need to
determine whether or not Jabber's kidneys could withstand it. At this
point I am not sure we'd want to put Jabber through it.
Now for some good news.
Both of Jabber's knees were radiographed and Dr. Shealy did a hands-on
exam. The bones in Jabber's TPLO leg have completely healed. You may
recall that Jabber has three plates and twelve screws in his right leg.
We were concerned that the three screws going directly into his knee
might give him trouble, but everything seems stable. Reviewing the films,
Dr. Shealy saw no new arthritis in the joint. Jabber still has very
limited flexibility, but Dr. Shealy told me the range of motion has
definitely improved since he was last examined. Jabber's other knee
is not doing as well. Before surgery we knew there was a torn cruciate
in his good (left) leg. My fear all along has been that the cruciate
would eventually fail due to added demands. So far that has not happened,
but the knee has lost approximately 15% of it's flexibility since March,
leaving it with a 30% motion impairment. We'll just have to live with
that. Obviously we can't consider doing any type of cruciate repair
on Jabber's left leg.
Jabber had a great weekend!
 This
weekend Jabber was feeling pretty strong. He can walk unassisted now
but he drags his right foot when he gets tired, so every morning I make
him a special bootie out of gauze, vet wrap and duct tape. This usually
protects his foot for the entire day – unless Jabber decides to
take a dip in the pond. (He has been wading more frequently now that
our killer swan is no longer with us.) On Saturday we decided to walk
over to the other side of the pond. When we got there, Jabber was still
walking strong, so I decided to see how far he could go. We walked all
the way around the pond! Our pond is large – 8 acres – and
it took almost 40 minutes to make it around, but Jabber managed to do
it without ever sitting down to rest. This was a tremendous milestone
because just eight weeks ago Jabber couldn't even walk outside for a
potty break unassisted. I figured he would be exhausted after his extraordinary
"hike" but Jabber was fine for the rest of the day and we
repeated the walk on Sunday. Three cheers for Jabber! He keeps hanging
in there.
Updates
I hope to update this page later today with news from Dr. Shealy regarding
Jabber's lab report. Stay tuned...
July 24, 2001 – Still no word
from Dr. Shealy despite the fact that I left another message yesterday.
Will try again this morning. Later – I left another message (my
third message) but Dr. Shealy did not call me back.
July 25, 2001 – Dr. Shealy would
not take my call this morning. (This was my fourth attempt.) The receptionist
told me he would rather I speak with his associate, Dr. Kaufman, who
performed Jabber's ultrasound last Thursday. So I asked to speak with
Dr. Kaufman. She was busy and could not take my call. I asked when I
could expect a callback because I had some errands to run and I didn't
want to miss her. "I suppose whenever she gets around to it,"
was the answer. (!!!) Six hours later the phone rang...
Whew!
July 25, 2001 – Dr. Kaufman
phoned at the end of the day and we discussed Jabber's case. She told
me that Jabber's bloodwork shows nothing remarkable. There are slightly
high readings of total protein and globulin. This might indicate inflammation,
but that could be expected after what he's been through. She explained
that the ultrasound revealed that both kidneys are actually normal in
size, but the "renal pelvis" area of one kidney is slightly
enlarged. The renal pelvis, as best I can make out, is sort of like
a reservoir for collecting urine from all parts of the kidney. It accepts/collects
the urine and channels it out to the ureter which then takes the urine
to the bladder. Jabber's enlargement is not significant enough at this
stage to be worrisome but it is something to watch. She also told me
that while Jabber's spleen is not as "clear" as one normally
sees – it has some density variations – she would not do a
surgical biopsy at this time because his bloodwork is normal. At this
point I think Dr. Kaufman considers the ultrasound to be a useful baseline
exam. There are some anomalies, but nothing to indicate anything seriously
wrong. It is possible that the E. coli has spread up to the kidneys,
but there are no strong indications that this has occurred.
Dr. Kaufman suggested we collect another urine sample for a culture
and sensitivity reading. This will tell us where we are right now with
the E. coli infection. Jabber has been off all antibiotics for three
weeks. His urine is actually running clearer lately. In my frustration
over not getting any information out of Dr. Shealy's office and wanting
to know something (anything!), I collected a new speciman early this
morning. By the time I spoke with Dr. Kaufman this afternoon, Jabber's
morning urine sample was already on its way to a lab in New York. The
results will be back next week. I'm hoping Jabber's immune system is
finally starting to take care of the E. coli, but that's a long shot.
Still, miracles happen.
Next
Installment
(See last week for more details about
Jabber's case.)
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