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Jabber's health Problems

February 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.

Thank You

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.

Jabber's Necropsy
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:

Jabber at homeJabber's 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.

JabberwockyWhy 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
Relaxing in the livingroomJabber's 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.)

Jabber's bladder
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.

Jabber in the yard, DecemberThe 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 here

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