He's Hanging in There!

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!
Our Pond
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.

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...

     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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