What happened to Jake
Around 6:30 on Tuesday night I noticed that Jake had a rash. It spread across his chest and left little pin prick red dots all over his belly and the insides of his legs. There were red marks on the side of his head, the top of his head, the underside of his chin, he was red and spotty all over. I thought he had poison ivy, I took and posted pictures on flickr to see if anyone could confirm. I gave him a bath in case he still had something on him that was irritating him, but as he seemed to not be itchy and otherwise feeling well, I didn’t worry. Truthfully I worried more about catching poison ivy myself. We went to bed and the next morning he was his normal bouncy self. Still some red, but it was fading. There were a few new spots too, but I just figured it was part of the cycle. I went to work. I worried about him during the day, but when I got home he was normal, running around, eating and peeing and pooping, fine. We chilled.
Thursday morning I woke up and was getting ready for work when Jake barfed. That’s not atypical Jake behavior, he’s a barfy little guy. But he barfed what looked like a clear brownish reddish liquid. Blood. I sniffed it. Blood. We headed to the vet. At this point my best guess was that he’d eaten something (I thought a pork chop bone that he’d found in the yard) that irritated his throat and gave him hives because it was gross and dirty. Sometime I think I go to the vet too much, I don’t want to be an over-reacting doggy-mama. I was really expecting them to say that he was fine. I asked to see Dr. Gilbert b/c the asshole blond vet was on duty too.
Sidenote: He is the stupidest, most unfeeling assfaced fucktard. For one thing it’s clear he doesn’t like small dogs. I’ve seen him with labs and rotties and other big animals, and he’s all over them. Whenever he’s seen my dogs he’s been a stupid ass, talking in circles, nonchalant no matter the problem, refusing to speak clearly. It’s hard to explain but if you’re a mom and you’ve been to an asshole doctor w/your kid you would get it. He makes no sense, and he talks to me as if it’s my fault he’s making no sense. He’s also incredibly nonchalant, no matter what he’s telling you. This summer he recommened an operation on Bruiser (despite her advanced age and heart murmur) to remove a lump on her stomach that eventually went away on its own. He didn’t even know what it was, but he wanted to anesthetize her and remove it. He also said that they’d just “go ahead and do a dental” on her while she was out. He didn’t even LOOK AT HER MOUTH to see that she’d just HAD a dental. Ass.
Dr. Gilbert is the doctor who helped Princess B through her Xylitol poisoning, and I trust her, as well as respect the way she talks to me about what’s happening. We saw her and I pointed out the rash and then that he’d been vomiting what looked like blood. That’s when she explained that this wasn’t a rash, this was petechia. If you watch crime shows you know that’s what’s in the victim’s eye whites when they’ve been strangled. It’s itty bitty bleeding under the skin. For some reason Jake was bleeding internally, and from his stomach. She thought it might be poison, like he ate rat poison or the carcass of a rat that died of rat poisoning. She said that it was very serious, that I should be prepared that it was very serious. I prepared myself by starting to cry helplessly. She went to take some blood from him and she was gone a loooong time. When she came back she said she’d double checked her first idea in a book, then called a specialist vet, and now she thought it wasn’t toxin-related, but was an auto-immune response. His body was attacking his own platelets and destroying them, so his blood couldn’t clot anymore. They had to have the bloodwork to confirm one way or the other, but in the meantime she was sending us to Veterinary Specialty Services at 141 & Manchester. This is a full-fledged animal hospital with an ICU and all kinds of equipment most vets don’t have. They see patients by referral from a regular vet only. She sent us there, saying that we had “a few hours left” to start treating him. I was very scared.
We went out to the VSS place and saw Dr. Greer. She explained that she needed the bloodwork to confirm, but this was a classic presentation for something called immune-mediated thrombocytopenia (IMT). She said that there were many reasons that a dog could present with IMT, and explained the bloodwork, ultrasound and x-ray things they could do to try to determine why it was happening to Jake. She also said that in 75% of the cases, even with doing that extensive workup, they still don’t figure out what is causing it. No matter the cause, the treatment is the same. The tests she was talking about were $1200-1800. What did I want to do? Fuck. That’s one of those moments in dog ownership where you think the person talking to you is going to think you’re a dickhole. Luckily before I left the other clinic Dr. Gilbert had talked to me about this a bit and said that in her opinion the whole workup wasn’t necessary b/c the treatment really didn’t depend on the cause. So I said no to the full workup, and she said that she wanted to keep him there while they waited for the bloodwork results that Dr. Gilbert was running. I asked if they would be treating him during that time, or just observing him. She said just observing him. I told her that I would observe him at home then, until the results came back, that I preferred him to be with me if possible. She said there was a chance that he would need a blood or plasma transfusion if he’d been poisoned, and he’d have to come back to the hospital for that. If it wasn’t poison the treatment was long-term steroids, antibiotics and vitamins to get him stable and get his body to stop attacking itself. She said the survival rate for dogs with this condition was 50%, even with treatment, though she said she was very encouraged by how he was still eating. Jake was still staring at us, wagging his tail and acting like he felt fine. We determined that if it was IMT I could pick up the necessary drugs at the original vet (much closer to me) and I went home to wait for her phone call. She told me to keep him from moving much and/or further bruising himself. I tucked him in the baby sling and carried him around with me all day long.
Dr. Greer called around 2 or so, saying that he was not poisoned, he did have IMT and that I should give it about an hour and then go pick up meds for him at the original vet. I asked her if it was OK to leave him alone while I ran that errand and she said yes. Then the Dr. Gilbert called. She said Jake’s blood counts were “off the charts” and that Dr. Greer (who I’d just talked to) had told Dr. Gilbert that he needed a plasma transfusion. What? She didn’t say that to me. Dr. Gilbert said that his blood was not clotting at all, and that he had a much better chance with a transfusion and and overnight stay with Dr. Greer. She said that Dr. Greer said I refused to leave him with her. What? I never said that. I said I preferred to keep him with me until the diagnosis was finalized. I told Dr. Gilbert that, and what Dr. Greer had told me about him being fine to leave alone, which didn’t fit with Dr. Gilbert’s assertiont that he was about to drop dead of spontaneous bleeding any second.
Dr. Gilbert called Dr. Greer back, then called me back, acting as if I was trying to not treat Jake well. She said that he was going to continue to deteriorate without the treatment, that he had only a 10% chance of survival without the plasma. She acted like I was saying I wasn’t going to treat him at all - and all I wanted to know what was the fuck everyone was talking about, since they couldn’t get their stories straight. I said fine, I was taking him back to VSS if that was the case, and I did. They kept him overnight and transfused him with plasma. We’re actually very lucky that there was a facility with this capability here in the St. Louis area. The info I read about IMT recommended a plasma transfusion, but said it was rarely possible for financial and practical reasons.
I left him there Thursday afternoon, and they called me on Friday morning to say that he was responding very well to the treatment and was eating, acting like he felt well. I could pick him up at 4 p.m.
I did, and he looks good. Acts like he feels well. He’s on 4 medications, prednisone, doxycylcine (sp?) Vitamin K and Pepcid AC because the other ones may make him barfy. He has to go in early next week for blood work, I have to watch him for bruising, petechia, bleeding from any orifice, lethargy or vomiting. He’s going to be hungry, drinking a lot of water and peeing more in the house probably. I can deal with that.
The original bloodwork he had at the vet was $168. Seeing the emergency vet was $95. The overnight stay with plasma transfusion was $498. I had to go to three different pharmacies last night to fill his Vitamin K prescription, and a two-week supply of the pills was $80. I don’t know if I will have to refill those or not, or if I can get them cheaper somewhere. I don’t know what the rest of this bloodwork is going to cost in the upcoming weeks. Obviously I would pay all this and more, gladly, to make him better, but this does mean my Christmas vacation with Todd is now canceled. No biggie. I am gladder than I can tell you that I had the money to spend, I can’t imagine what it would have been like to have to refuse something he needed because I couldn’t afford it.
So that’s what happened, leaving out for the most part how I felt about it. Well, you can imagine. I cried so hard I was sick. I cried so hard that I had scabs under my eyes because the skin got so raw. I couldn’t sleep, I couldn’t eat, I couldn’t breathe without him. I can’t imagine the cruelty of taking him away from me, and I didn’t realize what this house would feel like with him not in it. He’s the goofiest, most joyous thing I come in regular contact with, and his pure glee at being able to run around and follow my every move with his big googly eyeballs is contagious. You can’t be as unhappy as my soul wants to be when Jake is around. The thought of anything bad happening to his innocent little body was devastating. I think it broke another part of me that couldn’t really afford to become any more fucked up. I feel drained, I feel dead inside, I feel raw and exposed and terrified and anxious. I still don’t know if he’s going to live. I still don’t know what caused this. So for now my entire being is holding its breath, pretending to be alive while we wait to see if we survive this.
Filed under: Demon Puppy, chihuahua | Comments (7)7 Responses to “What happened to Jake”
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You said something in your last entry that was very astute: all the worrying and fretting doesn’t make you any more prepared to deal with disaster. Don’t hold your breath, don’t try and protect yourself from more pain. You can’t. Be present with Jake, every moment you can remember to do so. Let the fear go for a while, and just love him. You can’t go wrong doing that, no matter what happens.
And I am sending many good karmic thoughts your way, and hugging all my own critters & kid.
I think the worst thing was having to leave him in that place overnight. I somehow feel that as long as he’s physically with me I can keep him safe by sheer force of will, you know? Once he’s out of my sight there’s no one keeping him safe, but when he’s with me he’s OK. Nonsensical, but according to my Mom it’s the way she felt about me and my brother, so I guess it’s common.
The good news is, he’s acting totally fine. The bad news is that apparently doesn’t mean anything.
I’m so glad you have been able to afford his treatment. I’m wishing lots of extra money your way in case he needs anything else.
How are the little ladies handling this? Are they worried about him? Do they seem to understand what’s going on with him at all?
At the moment Bruiser has stolen Jake’s bone and is making him watch while she eats it.
He’s taken all his meds for the day, and seems to be doing OK. Thanks for the kinds thoughts, and please keep sending them. Hopefully the most expensive part is behind me, but I would mortgage my soul if I thought it would get him healthy.
I would also hit up Grandma and Grandpa, which is probably going to be easier cash than finding someone who’s looking for a soul like mine, anyhow.
How did he do the rest of last night? And how is he this morning? If he seems ok, then at least he’s comfortable, even if it doesn’t indicate anything for the long term.
You know, the more I think about those doctors messing around with you, the more it makes me angry. I don’t know anyone who is more dedicated to their furbabies than you are. Refusing treatment indeed. Maybe if she freaking TOLD you about the treatment. Maybe I just expect too much from the veterinary profession. No, you’re not dealing with human children. But if somebody cares enough to bring their pet to the animal ER, it’s pretty obvious that it’s someone whose ability to love a family member is not limited by their species. If you didn’t love him and consider him a family member, you wouldn’t have bothered to bring him there in the first place.
Also, I feel like the guy who doesn’t like small dogs should maybe re-consider his career choice as a general practice veterinarian. Perhaps he could specialize in equine medicine? They’re big. Maybe not, though. Horses would probably kick him in the head for being an asstard.
And yes, vets too are prone to the doctor’s disease of A) presuming you’re a mouth-breathing moron B) presuming you’re going to be irrational and C) presuming you can’t understand the facts that are being given to you. I think vets have an extra component in that they also are hesitant to say “This is what you need to do.” because of the cost factor. They leave it way too much up to the owner, who subsequently feels as if they’re not getting good advice because everyone’s reluctant to speak clearly. I think the subtext to their communication is frequently “How much do you love this pet?” Which I understand because there are people who wouldn’t/couldn’t pay thousands of dollars to treat a pet. But if they want to ask me how far I am willing to go, ASK ME ALREADY. Don’t give me options that I don’t know are options.
Give me your expert opinion, tell me the chances, tell me the alternatives, give me the information I need to help me make up my mind. Tell me what you would do if it was YOUR pet, if it was YOUR child. Instead they just shilly-shally around, talking in circles, never saying anything definite, until I think my head is going to explode. Hello? I come to you because you’re the expert.
I don’t know. I find the human doctors do that too though. Half the time I feel like they’re trying to leave treatment decisions up to me. They want me to decide, without them even weighing in. “Well, we could do this… or would could do that… It could be X or it could be Y… I could increase your medication if you want????” ARGH. I mean, I DO have the presence of mind to both question and argue with you if you recommend something that I don’t understand or don’t think is correct, but we can’t start that process until you STATE YOUR OPINION.
In this case I feel like Vet #2 (the specialist Dr. Greer) is clearly the one with the better experience, better equipment and expert knowledge of how to cure Jake. She is also a very poor communicator, unable to argue or disagree with me, unable to state clearly and strongly if she thought I was making a bad decision. She then presumed that because I felt one way when one set of facts were presented to me, I would feel the same way when another set of facts were presented to me. Vet #1 (Dr. Gilbert) knew that she needed an expert opinion when she saw Jake, wasn’t afraid to ask for it, wasn’t afraid to tell me what she’d do if it was her pet, wasn’t afraid to tell me that I was making a bad decision (which I actually hadn’t, it was just that Vet 2 presumed I’d made a decision I’d never been told about.) and not afraid to tell me what the potential consequences of that would be. That makes Dr. Gilbert a better vet, no matter that she has less experience than Dr. Greer, because you have to communicate well, you have to advocate for what you think is right. And even though I was upset at the time that she thought I would ever purposefully withhold treatment from Jake, unless she had said to me “You can’t do this, you’re lessening his chances for survival.” I would NEVER HAVE KNOWN that I was withholding a recommended treatment. I would have thought (and I would have been correct in thinking) that I was doing everything the “expert” told me to.
Communication. It’s all there is. Seriously. When I hear people railing about how accurate spoken and written word, nuance, clarity and concise thought are unimportant, I want to smack them. Clear communication is all we have in the world.
Bah.
I’m so relieved to hear he’s feeling better! I will keep sending love to you and him. And even the girls. LOL.