April 2, 2007 — This week's DaDane
is a continuation of an educational article contributed by Zeli Schulte. She
is discussing the tragic loss of two of her Danes, Circe and Grendel, to hemangiosarcoma. Click
here if you missed last week's
installment, which ended with the following scene:
after returning home, I asked myself if we had made the right decision to put
Grendel through the surgery. After almost three days, she was still not standing
or eating. Did I sentence her to a long and painful death among strangers? In
my desire to save Grendel, had I instead created a creature of pain and suffering
who in no way resembled the girl I once knew? Was it better to die suddenly,
as Circe had, rather than to go through the misery Grendel was experiencing
now? Bret believed that over time, Grendel would improve and reach the point
where she could finally come home. Oh, how I hoped he was right!
weekend, and over the Christmas holidays, we commuted to A&M daily. We would
visit with Grendel twice a day, breaking for lunch and bringing back some
tasty goody from a nearby restaurant, hoping she would eat it. On one
occasion she did eat for us, but otherwise she continued to refuse food. The
vets suspected that the various medications they were giving Grendel (all necessary)
might be making her nauseous. They were also concerned because she was still
unable to stand. However, we did get some good news. Grendel's blood tests indicated
general improvement, plus she was producing urine. After her massive
blood loss during surgery, there was a real possibility that Grendel's kidneys
would fail. Luckily, the flow of urine, coupled with the data from her blood
work, demonstated that her kidneys were functioning.
Grendel remained in the ICU for six days. During that time, she was receiving
daily blood transfusions and being fed through a tube. On the fifth day, she
was finally able to stand with assistance. The very next day, she was beginning
to walk. The A&M vets were still quite concerned that Grendel would not eat
on her own. Nonetheless, they decided to release her into our care. They felt
that they had done everything that they could for her. Hopefully Grendel's
appetite would improve once she was home.
That first night
home was very challenging — for all of us. Grendel finally
ate something, but shortly thereafter she vomited and then refused food altogether.
(She even turned down cooked beef and liver!) Despite her nausea, Grendel was
incredibly thirsty. She would drink large
amounts of water at every opportunity. Per
the vet's instructions, we encouraged this as best we could. Grendel's increased
thirst was attributed to severe anemia from decreased liver function (as a result
of the surgical resection) or else to possible kidney damage from her massive
blood loss during surgery. Perhaps her insatiable thirst was due to a combination
of both; the vets weren't sure. Whatever the cause, it was something we all had
to cope with.
Our new routine
involved getting Grendel up every 45 minutes, both day and night, to urinate
and drink. Her abdominal muscles were still very sore after the surgery, so it
was difficult getting her settled back down afterwards. The entire process from
start to finish usually took around twenty minutes. Throughout that first week,
I would set the alarm and get up at least 9 times each night with her. During
the day, Bret and I would take shifts. our biggest problem continued to be Grendel's
refusal to eat. This was even more serious at home where there was no feeding
tube. Grendel was taking anti-nausea medication prescribed by the A&M vets,
along with Pepcid A/C to decrease her stomach acid. Nothing seemed to work. I
knew that if we could not get Grendel to eat in another 2-3 days, we would have
to return to A&M to determine if her internal organs were failing. If they
were, we'd be faced with another very tough decision.
Works a Miracle
was desperate so I called our treating vet for her input. She suggested putting
Grendel on Carafate, an ulcer drug that forms a protective coating over the esophagus
and stomach. With A&M's approval, we gave Grendel her first dose. The improvement
was almost immediate. Within an hour Grendel started to relax - for the first
time in 2 days. Then she ate some Canine ID, which unfortunately she later vomited.
However, after that, Grendel's appetite came back and she finally started eating.
She was given Carafate three times a day. It had to be taken about 2-3 hours
before any other meds and food. The time-frame was particularly important because
Carafate can block absorption of other medicines and food
After the Carafate
was introduced to her daily regimen, Grendel got much better. She was eating
with gusto and it looked like she was gaining back some of the weight she had
lost in the ICU. (We later learned she had lost around 15 pounds). The incredible
swelling in her limbs was finally going down. She had more energy, so we had
to carefully monitor any activity to make sure she was not overexerting herself.
Meanwhile, we continued to watch Grendel's abdominal incision for signs of infection.
The incision itself was still seeping small amounts of reddish fluid. Whenever
Grendel stood or walked, it was like a dripping faucet, but thankfully there
were no signs of infection. Our days and nights still required those exhausting
hourly water/potty breaks, but after two weeks Grendel was drinking less so we
were able to drop back to every 2 hours.
As Grendel's thirst
diminished, it became increasingly difficult to administer the not-so-tasty liquid
Carafate. We did our best. Two weeks after the surgery, we took Grendel to A&M
to have her stitches removed. I requested new blood work. It revealed that Grendel
was still very anemic. Our treating vet recommended Lixotinic, a supplement that
provides nutrients essential for the production of hemoglobin in red blood cells,
including iron, copper and B-vitamins. It would help Grendel get over the anemia
and recover her strength.
During her initial recovery, Grendel required around-the-clock nursing care.
Bret and I were lucky in that we are self-employed and live just five minutes
from work. At one point during that first week she was home, we had to
leave Grendel unattended for half an hour. Bret came home to find that she had
chewed off one of her toenails!
By the time Grendel
had recovered to the point where we could take her for short walks, we were finally
able to leave her unsupervised for an hour or so, with no problem. We still had
to get up with her several times a night, though, so she could drink and urinate.
All in all, I'd say Grendel really did quite well at home. She was showing improvement
every day. We knew the old Grendel was finally back when we noticed that she
was flirting and stealing bones from Grimm.