4, 2002 This is the last DaDane of DaWeek page you'll see
that features Jabber, our seven-year-old Great Dane. He passed away
on January 15, 2002. As a final tribute to Jabber, I'd like to focus
on the health problems which led to his demise. Perhaps the details
of Jabber's journey will help someone else.
Before I get started, though, I'd like to thank the many people
who wrote to express sympathy. More than a few messages moved me
to tears. What struck me most was the number of loving references
to other companions that have passed on. Someone wrote, "The
worst part is that each one that has to leave brings back memories
of every one that went before." How true. I think people relate
to Jabber's story because in a way it is part of their
own story with their own dog. Wherever Jabber is right now, I've
been assured he is in good company. No doubt Jabber was welcomed
to the other side by many who arrived there before him: Marina,
Butch, Otis, Ruger, Willie, Runtly, Eddie, Claudius, Romulus, Petunia,
Sebastien, Lacey, Tucker, Ruffian, Gracie, Lannie, Hamlet, Bouncer,
Bunky, Belle, Apollo, Emily, Jake, Brutus, Kayla, Edison, Chancy,
Duchess, Hannibal, Lil, Hershel, Sami and Yukon. Surely he is enjoying
his new friends.
When I put together Jabber's memorial
page, I did not dwell on details of his health problems, which
were numerous. Now I'd like to talk about them. I suppose the best
way to start is by taking a look at Jabber's necropsy (autopsy)
report and working backwards from there:
Necropsy (click to view)
The report took
me by surprise. I had hoped to see a clear explanation for the sudden
failure of Jabber's hind quarters. I also hoped to learn the reason
behind the chronic E. coli infection in Jabber's urinary tract that
plagued us for 9 months. Neither answer was definitive.
I was not surprised by the opening diagnosis of "severe bilateral
degenerative joint disease, knees." We knew Jabber's knees
were arthritic, the right one particularly so after his failed TPLO
(cruciate) surgery last spring. I was very surprised, however, to
read about the "septic purulent synovitis" (severe infection)
in his right knee. We were completely unaware of that. Meanwhile,
the report's reference to degenerative disc disease was no shock,
but Jabber's actual symptoms indicated far more damage than was
found during the autopsy. Most of the report itself seemed to indicate
a fairly mild problem with his spine, but not all of the
report. The finding of "severe pachymeningitis" and severe
"mineralization of the ventral dura mater (pachymeninges)"
is not insignificant.
Jabber went down
I discussed the necropsy report in depth with Jabber's veterinarian,
Dr. Warren. She knows Jabber's medical history inside out. Without
her medical (and emotional) support I could not have kept Jabber
going this past year. Both Dr. Warren and I found ourselves disagreeing
with the following statement:"The severe lesions of the knee
joints bilaterally, as well as the presence of infection of the
right knee, most likely explain the inability of the dog to utilize
the hind limbs." Jabber had lived with damaged/arthritic knees
for almost a year. There was no evidence his knee infection had
actually ruptured, but even if it had, it is likely Jabber would
have been able to utilize his other leg. When Jabber finally "crashed,"
both of his rear legs were entirely useless. He could not not move
them. Dr. Warren and I suspect that something in Jabber's spinal
area broke loose or failed, resulting possibly in an embolism, thrombosis
or severe impingement of the nerve and that's what caused
him to go down. Although nothing of this nature was detected during
autopsy, it certainly could have happened. To us this seems a more
plausible explanation for his collapse.
Severe knee infection
knee infection was very serious and I saw no sign of it beforehand.
Jabber did not seem "sick" or in pain. Because he was
already unable to bend that knee, I didn't observe any unusual stiffness.
At some point, if undetected and untreated, the infection probably
would have entered Jabber's blood stream. It might well have been
fatal at that point. I asked Dr. Warren if the infection could have
been easily treated had we detected it earlier. If I understood
her correctly, the answer was more "no" than "yes."
The infection was encapsulated and pretty well isolated
from the regular blood supply. Regular oral antibiotics might not
have been effective. I asked Dr. Warrren where the knee infection
came from. I felt it may have been a post operative complication,
even though Jabber's knee surgeries took place back in March. Dr.
Warren's view was that the infection was not related to the TPLO
surgeries because of the time lapse. She thinks the Strep could
have been blood borne, possibly entering Jabber's bloodstream through
his mouth. She speculated that the infection began one to two weeks
earlier. The bottom line is we don't know exactly how Jabber acquired
infection and we don't know how long he had it but it was
potentially life threatening. (Note: At least one orthopedic surgeon
has stated that he disagrees with this theory and feels the infection
most likely resulted from the previous TPLO surgeries.)
The chronic E. coli infections that plagued Jabber after he had
his TPLO surgeries back in March were extremely frustrating and
very expensive to treat. I've lost count of the number of antibiotic
treatments Jabber was subjected to. If nothing else was to come
of the necropsy, I expected to find out why Jabber suffered from
these recurrent infections. I asked Dr. Warren about the "chronic
lymphocytic cystitis" which was cited in the report, and what
it means. Her answer was rather complex. If I understood her correctly,
the lining of Jabber's bladder did not have a normal mix of cells.
Normally the bladder wall is comprised of various cell types, each
doing its own job. Jabber's bladder wall was infiltrated with lymphocytes
the normal mix of cells was not present. Dr. Warren feels
this condition might have altered the permeability of the bladder
and its ability to benefit from the antibiotics. Possibly the E.
coli infection persisted because the bladder could not "absorb"
the antibiotics. She wondered if the cellular changes in the bladder
wall were the result of repeated infections or if Jabber was born
with an unusual cellular makeup of his bladder lining. Whatever
the reason, once the E. coli took up residence in Jabber's urinary
tract, it was almost impossible to treat.
liver and spleen
In the necropsy report, Jabber's spleen was characterized as "congested."
Considering what he'd been through in terms of infections, antibiotics,
etc., that's not surprising. Jabber's liver was deteriorating; presumably
it was damaged. I did not ask Dr. Warren to explain the nature of
the liver findings, so I am unable to interpret this aspect of the
report. I will revisit this with her at a later date.
Dr. Warren pointed out that Jabber's immune status has always
been questionable. At the time of his death he had multiple problems.
His was a complex case. Considering what he was up against, Jabber
did very well. He probably experienced more discomfort than he let
on, but he managed to make the best of his time with us. He enjoyed
his daily walks, his meals, his teddy bear and above all, he enjoyed
the company of his family. He experienced these simple pleasures
right up to the end. That's the most I could ask for.
If you missed Jabber's Memorial, and you'd like to see it, click
by Ginnie Saunders. All rights are reserved. No part of this web
may be reproduced or transmitted in any form or by any means
electronic or mechanical, including photocopying, recording, or by
any information storage or retrieval system without written
permission from Ginnie
Saunders. To learn more about copyright issues on the web,
visit the Web Law
PO Box 50314
Columbia, SC 29250