"And, when you want something, the entire Universe conspires in helping you to achieve it." -The Alchemist, by Paulo Coehlo

Sunday, September 25, 2011

Good days

This past Wednesday at work was a good day. We had 2 Great Dane patients, both post-op GDV surgeries, one an example of everything that can go wrong, and the other an example of everything that can go right. GDV stands for "gastric dilatation and volvulus". Also known simply as "bloat". It is a common problem in large-breed and deep-chested dogs, where their stomach dilates and flips over on itself, cutting off circulation to the intestines and the stomach itself. It is a MEDICAL EMERGENCY!! The only way to fix it is surgery. Expensive surgery at that-the bill for the Great Dane with complications was at $12,000. Yes, 3 0's. The one for the surgery without complications was at $5,000. And note: we are not an expensive hospital, but we do provide the ideal in terms of care; there is no cutting corners when the pet's life is on the line. If the client can't afford bloat surgery, the dog must be put down. It is a slow, excruciatingly painful death otherwise. This is why everyone should have their pets insured. Especially if the pet is a dog. Especially if the dog is a purebred. Especially if it is a large breed dog.

Venus was a 130 lb Great Dane who walked in the door and at first hand, did not appear to be a bloat after all-her belly did not appear distended. Radiographs proved otherwise-her stomach had distended cranially (in the direction of her head), under her ribcage. This is why she didn't have the classic bloat presentation of hugely enlarged belly. Her insides were going crazy, too-she was already throwing some pretty scary arrythmias when we hooked her up to the EKG. Venus was one tough cookie-it was pretty amazing that she was still standing. She immediately went into surgery. Her stomach was dark when they went in, meaning that circulation to it had been cut off for awhile. It became pink after being untwisted, but whether or not the stomach's capacity to function fully had been compromised was something we'd find out later. She was in surgery for a long time; my shift ended before she came out of surgery. I returned to work 2 days later to find Venus lying on her side on our orthopedic mats, with an oozing incision site and her hind legs swollen to dramatic proportions. I was shocked to see her this way. Her body from her incision back was one giant bruise, all the way to her tail! This was highly unusual and a sign of very bad news. As the next week and a half progressed, Venus continued to have a very hard time getting up to go for walks-it took 3 people to get her up to go outside, and to get her to switch the side she was lying on because she continued to be laterally recumbent (we rotated sides to prevent bed sores, just like in people).  Bloodwork indicated a failing liver that was getting worse, delayed clotting times (her blood was taking a long time to clot), a low platelet count (this can prevent the blood from clotting entirely, hence the bruising) and low blood protein (the cause of all that edema/swelling). The doctors thought she might be going into DIC. (DIC = disseminated intravascular coagulopathy. Also known as Death Is Coming. There is no coming back from it; it is a death sentence). I very sadly said my good-byes to her at the end of my shift Saturday night, thinking that she would not be there when I came back to work on Wednesday.

On Wednesday morning, when I came back in to work after 2 days off, Venus was lying on her orthopedic mat like a sphynx, head up and front legs stretched out in front of her, all the bruising done.  On Saturday, we had thought that surely she would die on her own. The owner wanted to give her one more chance; the doctors changed the antibiotics Saturday night, and everyone continued fighting to keep Venus alive. On Monday, her bruising was halfway gone. On Tuesday, Venus had ripped out her IV catheters herself, and out of the blue started eating on her own. On Wednesday she was wagging her tail at us and the surgeon and criticalist declared her ready to go home. It was amazing. Venus was amazing. At the end of the day, I was massaging her legs (the swelling was almost completely gone) and she lay her head in my lap. I was almost moved to tears. What a dog! "You have no idea just how incredible you are, baby girl." I told her.

 Nikkita was the other Great Dane in hospital that day. She was a harlequin color with black-rimmed yellow eyes. A beautiful dog. And so very, very silly. She had come in Tuesday night for the same problem as Venus-GDV. However, her surgery was uneventful and 7 hours post-op, she was already bright and wanting to move around. You would never have guessed that she had just had life-saving surgery. She was my favorite patient, though at times she made me want to bang my head against the wall! I took her on myself because the other technician working with me is new to the hospital and ECC, and I didn't want him overwhelmed. Nikkita was young, less than 3 years old, and oh so goofy. She kept turning and turning in circles tangling up her IV line and the lines of her telemetry pack into one giant knot. By the 3rd time I went to untangle her, she knew she was to lie down and stay still while I undid the 5 million lines. This was the story of my life that entire day. By the end of the day, she would melt against my legs when I went to do her treatments, and slide onto her mat, exposing her belly for a scratch. It was a good thing we were relatively slow, and I actually had time to do this every 5 minutes! That is a LOT of untangling when your shift is 12 hours long. She eventually relaxed and would sleep for an hour or two at a time. By the end of the day, the criticalist said it would be okay to discontinue the telemetry, since her EKGs had been normal pre-, intra- and post-op. She also gave the thumbs-up to discontinue her IV fluids once her current bag was done, as she had been eating and drinking well all day long. Yaaay! No more lines for her to get tangled up in! Nikkita is probably one of the best recoveries I've seen so far from a GDV surgery. You can't beat a recovery like this! That girl was bright and alert, going outside for her walks and wanting to go and explore (the surgeon said we were to keep walks short the first day, of course). She made all of us laugh with her silliness. I gave her a big fat kiss on that gorgeous face at the end of my shift.

I left the hospital with a smile on my face and was still thinking about these two while I cleaned Lily's stall. She had her dinner outside in the paddock, a nice change of scenery for her. She ended up being out for a total of 3 hours or so, which is a lot in the summer: days are too hot for extended turnout, especially in our turnouts, which don't have shelter from the blazing sun or the electric storms. I also get nervous with night turnout, as there is no one at the barn to check on the horses if something happens, and the turnouts are not large enough to keep the horses entertained; grass is scarce, and in the summer, we can also get lightning storms in the middle of the night. 2 horses died at the park in the same week due to evening storms at the beginning of the summer. My previous horse would get into trouble at night at this current barn-he tore down a fence board one time, another time he put a giant dent in the gate, and the 3rd time, he sliced both front knees open. After that, no more evening turnout. It still makes me nervous. So for now, while it's hot, Lily gets some late afternoon/early evening turnout between 5pm and 8pm. This is, of course, if it's not storming! You just can't win with Florida summers...

On Thursday morning, I took Lily down to the field to longe her for 15-20 minutes, as she had had 3 days off in a row and we had a dressage lesson that night. I wanted to get any extra energy out before the lesson, and it also gave her a nice break between the longeing and the lesson-lessons are an hour long and I knew she'd be exhaused by the end of it if I longed her immediately prior to riding.

She had one bucking fit at the beginning of the workout, then she settled in nicely. I had her warm up w/t/c without side reins, and then I attached them to her bit for another 10 minutes of w/t/c, using the entire field for the session. This is the nicest she has ever gone in side reins. She's starting to get it! She was even salivating a little with the bit!

 She was doing a nice medium trot when I took this photo. Now I just need her to be like this under saddle!

Cool down walk while still in side reins. She was overtracking by a good 6".
In the afternoon, I returned to the barn early to give Lily a snack before the lesson and to longe Bella, whom I hadn't worked in a week. We did some w/t/c, then I had her follow me around at a walk while I set up a bounce with the cavaletti. Bella thought she was done, and when I asked her to trot again, she gave me a whole lot of attitude, including a rear! I don't put up with her crap, though-I cracked the whip, growled at her, and got her going at a nice little canter. She popped over the bounce effortlessly. I had her do it 5 times in each direction, and then I walked her out before hosing her down and rushing to tack up Lily before Judy arrived.

The lesson went fantastic! Lily made progress, and Judy had us doing serpentines and spiraling in & out in both directions to work on getting her more supple. I could feel the difference in her with these exercises. Judy gave me homework-I am to warm up with spirals and serpentines every time I ride for the next week. We also cantered in the lesson, which I was a little apprehensive about, but Lily was an angel. Judy had me sitting back in the saddle in a more classical dressage seat-Lily tolerated it well! We reviewed lateral aids, as all I know is book-learned (I have been riding for 20 years, but in Puerto Rico we did not have dressage instructors; I had always wanted to learn because of its importance in the development of both the horse and rider.)  Judy was pleasantly surprised when she saw Lily execute a pretty decent leg yield. She came with this training; I just figured out that she had an idea what it was by playing around with the aids. As it turns out, I was doing everything correctly. Our shoulder-ins were also perfect, with the required 3-tracking. I was giving the aids backwards, but Judy told me how to sit to make sure I was doing my part correctly. I turned my shoulders, allowing my legs to turn in the same direction, and Lily did her shoulder-in just as well as when I had been giving the aids backwards. Gotta love my little mare!! I really like Judy's style of teaching-very low-key, relaxed, persistent, and patient. Very different from other instructors I've had in the past. Plus she isn't prejudiced against specific horse breeds, like some other dressage trainers in the area. 3 of us at my barn take lessons with her on our horses, all of us with non-traditional horse breeds (Crissy the paint, Big Boy the halflinger, and Lily the appendix) I still have a hard time with the sitting up straight-I have a bad habit of riding forward from so many years riding jumpers, so every time I take a dressage lesson, I feel like a beginner all over again. It's my favorite thing about being around horses, though-you really never, ever stop learning!

On Friday I rode in the afternoon. I set the cavaletti up as ground poles about 10 feet apart, so they could be cantered as bounces or trotted with 1 stride inbetween. We then worked on our homework after a nice long walk on a loose rein, and then lots of circles at a working walk. Lily's spirals at the trot were excellent! I took some video-will post it as soon as I have it edited. We then cantered around the arena and large circles in both directions, and then proceeded to trot the ground poles. I had her canter through the line once in each direction, but the ground was wet from rain earlier today, and there wasn't enough room to make the nice wide turns that I wanted, so we just trotted through a couple of times more. Lily did great. She's getting better with the ground poles-she used to be so apprehensive about them! We took a walk break with lateral work-leg yields and shoulder-ins in both directions, and worked on trotting some more circles. Our workout lasted about an hour, and then I took her down to the field to cool down at a walk. By then, dark storm clouds had rolled in, with thunder and lightning in the distance. The lightning sirens went off at the park as the storm got nearer, and we turned around after one loop of the field and headed back home. Riding past one of the barn driveways, the owner was fixing the giant pothole at the entrance with an excavator. It was extremely noisy as it pushed the dirt and gravel towards the pothole. Lily didn't even flinch and just walked on calmly past it. I love her!

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