Wednesday, December 12, 2012

LiLi's near death experience - UPDATED with info and pics now

LisaJoy (Lili) ("Lee-Lee"): Hematoma of tongue & throat

I tried to chronicle the events here. I will continue to add updates to the description here. I can never give enough thanks to my friends and the veterinarians and staff that helped us. You are all life savers. Thank you for what you do.
Saturday, December 8, 2012

At approximately 9:45am, Lili went from happily playing, to crying and pawing at her mouth. As soon as I noticed her distress realized she appeared to be choking. I tried reaching into her mouth but there didn't seem to be anything I could remove. But clearly, there was something in there. I screamed, "she can't breathe, I have to go to the vet" picked her up and ran out of the house, down the stairs, out the gate, threw her into my car, jumped in, scratched my friends car backing out because there wasn't actually room between the cars for me to get out, and drove faster than I have have, my window was down, my seat-belt not on, I didn't stop at the stop sign, I did think to put my flashers on but I was driving around people on the wrong side of the road into incoming traffic and all I could think was that the vet (which is less than a mile from my house) was going to be closed. While I was driving she stopped crying and collapsed on the seat of my car - ( shook at her which caused her to leap into the back seat. We arrived to the vet and thank God they were open. I flew out of the car, grabbed her from the back seat, and left the doors open and the engine running and raced her into the hospital. 

Her tongue and throat were so swollen they were rapidly closing off her airway. Dr. Mary diagnosed the swelling as a hematoma, successfully re-establish an airway and place a small tracheal tube before sending us to Capital District Animal Emergency Clinic (1 hour away.) 

There they were able to place a larger tracheal tube that would allow her to breathe more normally. They sent us to Tufts University School of Veterinary Medicine (3 hours away.) Sometime such hematomas can take days to resolve and if that was the case she was going to need a feeding tube placed in her stomach to allow her to get food, in addition to the tracheal tube to allow her to breathe, and Tufts was the best place for that. 

Lili made amazing progress under the care of Tufts and her hematoma and swelling went down enough that by the end of the day on Sunday she was able to have the tracheal tube removed and she was able to swallow and eat and drink on her own.

On Monday they sedated her to examine her mouth more closely, to determine if there was a foreign body or something in there that caused the initial problem. They didn't find anything of consequence but they did note: "Under sedation we could see that the bleeding/bruise extended all the way to the back of her throat - she is indeed a very lucky dog to have been helped by [Borador Animal Hospital, PC] as she could easily have died." 

Lili continued to have bloody drainage coming from her mouth on Monday so they wanted to keep her overnight and most of the day on Tuesday for continued observation. I was able to pick her up on Tuesday afternoon. She continued to have the drainage from her mouth that night but by Wednesday the drainage seemed to have stopped. She is eating, albeit slowly and carefully, and drinking, and pottying. She is now scratching at the open wound in her neck with her hind feet which is a concern since they had to leave the site of the tracheaotomy open and allow it to heal on it's own. We have to be extremely careful while swimming, no bath, can't get area wet because she could aspirate water. Just be really careful. She can't wear a collar of course, we are using a harness, she needs to be kept separate from other dogs, and we need to try to keep her quiet and resting. She does NOT have a normal airway yet - she will not be not able to cool her self off by panting, she needs to be prevented from becoming riled up and excited. She is a very active little girl so this is going to be a challenge. I have to keep her neck as clean as possible, so I am keeping a very close eye on her with the scratching. I think it must itch as it's healing which is a good sign, hopefully. The doctor said it could take a couple of weeks to fully heal.

I know the million dollar question is: what caused this? I think we all want to know so we can prevent it from happening to our own dog. This basically describe swhat happened:  It was caused by some type of trauma most likely - perhaps a squabble with another dog, or chewing on a dog chewie - or who really knows. Seems to be a completely freak thing.

Here are the photos:

 Taken at Borador Animal Hospital right after they were able to intubate her enabling her to breathe initially. You can see the huge ball sized swelling under her tongue, the size of her entire mouth. 

Taken at Borador Animal Hospital right after they were able to intubate her enabling her to breathe initially. You can see the huge swelling of her throat.
 Right after Dr. Mary got a small tracheal tube into her trachea to allow her to breathe while we transported her to the emergency hospital. The swelling had displaced her trachea so much that it was difficult to find it beneath the hematoma.
 A photo as Dr. Mary stitches in the tracheal tube.
 Waking up from anesthesia after getting the initial tracheal tube at Borador.

 Waking up from anesthesia after getting the second tracheal tube at at Capital District Animal Emergency Clinic.

  Saying goodnight to before leaving her at Tufts.

Here she almost has her classic smiley face. Sweet darling girl, never stopped wagging her tail once throughout this horrid ordeal.
  On the way home, snuggled in the car with new toy Teddy Chance.

 On the ride home.

At home, trying to get her to eat a little. You can see on this side the swelling and bruising that is still present.
 Another view of the hematoma.
Settled into her soft crate with new Teddy Chance and with big Teddy Dog.
 LiLi had a tiny little walk this morning just across the road, where she posed herself for a few photos for all her fans.

 Then she came in and ate very well! ♥ ♥ ♥
My girls napping with me. ♥ ♥ ♥ LiLi looks a little uncomfortable in this pic but she settled in and we slept for a few hours this morning after she ate. She is really tired (and so am I.) 
 LiLi soaking up a ray of sunshine at lunchtime.

The underside of her neck, that lump is the underside of her throat, that's still the hematoma swelling, and then you can see the site of the tracheaotomy - they leave that open and let it heal on it's own. If they tried to stitch it, air bubbles could become trapped under the skin which is very painful. I think it is starting to itch so I am having to watch carefully so that she doesn't scratch at it with her back feet.

This post was written by my mom!  I'll try to be back blogging soon, though!  

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