Appetite Satiated At Last

Joey looks up from reading his emails and comments, Monday evening, August 30, 2010

The update is late, but the news is good!  Your 'Long and Short of it All' host 'Joey' has eaten food and water for over 24 hours now without any vomiting!  He doesn't eat much - it will take a few days to get him used to food again, but he's eating enough to slightly form his stools, and keeping it down without the aid of any anti-nauseants. 

Dad had a ruff morning, hence the late update - it seems that Joey has developed some "sludge of the gallbladder and mucocele" which is potentially quite bad, and after reading about it on several veterinary sites, Dad went off the deep end a bit and couldn't handle another issue with the boy, and couldn't muster up an update.  But after taking the day off work at the last minute to talk to the internal medicine veterinarian about it, all is slightly better, as the vet doesn't think it is a huge issue, it has not led to mucocele as previously reported, and Joey should be able to come home tomorrow.  Let's repeat that:  JOEY SHOULD BE ABLE TO COME HOME TOMORROW!   Lesson learned (again):  stop reading about stuff on the internet and making assumptions about things you know nothing about. 

His pancreatitis is resolving itself, and his amylase/lipase values are both now within normal range.  The ultrasound shows a better picture of the pancreas.  The sludge of the gall bladder is evidently not surprising based on the shape that his pancreas was in.

And this will brighten anyone's day:  when we arrived at the hospital today, the vet tech was telling us that she went to Joey's pen and there was blood all over.  A scary thought, yes, but it turns out that he was wagging his tail so much against the netting on the side of the pen, that it has started to bleed!  He now has a little white bandage taped on the end of his tail, poor little man.  The vet tech said he chased it in circles for a while, but he didn't seem to mind it so much when we visited him today. 

Meanwhile, Maggie has been staying at a friend's house this week - what with Dad working all day and then visiting Joey in the evenings for several hours, that's a long time to be home alone by herself.  Tonight she's at her first (and probably last) agility practice and will do some "fun runs."  She's a gal on the go. 

Hungry Boy

Joey, Sunday, August 29, 2010

Today is the big day for your 'Long and Short of it All' host 'Joey.'  After resting his pancreas following the second bout of serious surgery-induced pancreatitis last Tuesday, he will be offered water and food today.  He's got to be able to keep the water and food down.  He finished his three-day course of TPN early this morning.  Next up is labs, and another ultrasound to look at that troubled pancreas.  Then he will most likely be offered some water, and then a small amount of food. 
And boy is this dog HUNGRY - which is a good sign.  He hasn't really eaten in two whole weeks, save for small amounts of baby food and a little canned food last Sunday and Monday.  When we visit him at the hospital he watches every single vet tech and veterinarian with great interest to see if they have any food in their hands.  He intently studies their every movement and facial expressions, head darting from side to side as they move across the room - DRATS!  - that crinkling sound is just another IV bag opening.  Oh, here they come with a whole bowl of food!  Eyebrows twitching, he wills them to step in his direction.  DRATS!  It's for the Labrador in the next bed recovering from surgery after swallowing a corn cob. 

You can do it Joey. 

Love Letters

This is just a sampling of the many Love Letters for Joey.  Thank you.

Love letters straight from your heart

Keep us so near while apart.

I'm not alone in the night

When I can have all the love you write.

I memorize every line,

I kiss the name that you sign.

And, darling, then I read again right from the start

Love letters straight from your heart.

Hello Joey and Maggie,

we went to the sea side the other day, when Lea decided it might be sweet sending some sunny fotos of Croatian cost line for Joey to have some sun...

we keep our paws crossed for Joey. We're keeping him in mind and share Maggie's nervousness end worries!

Lea hopes the sun will bring some smiles on Joey (cause she says he's cute:)

Good luck Joey, hang in there Maggie...

kisses to both...

I know where you're at right now.  My Poncho went in for spinal surgery almost 2 years ago and it was one of the most stressful times of my life! You are all in my thoughts tonight. Wish I were there to lend a hand to, in some small way, make life a little easier. It's a very good thing reading the blog, something I look forward to at the end of each day when I get home from work. Poncho's always in my lap at the 'puter, so he's kinda in on it as well.

Hope Joey gets better quickly!  Turbo and Reilly are thinkin' about him! We Love all the hard work he and Maggie put into the blog....

Joey knows that he is loved more than anything in the world. I can't tell you how my heart aches for you, because I know exactly just how painful it is. It's a pain that will never go away, but when it's painful like this, you know what a special bond you share with your babies. Joey couldn't have asked for a more loving daddy. We are going to keep thinking positive thoughts of Joey, and wishing a miracle to happen soon... Please keep us posted on his progress. Be strong for Joey and Maggie.

Yours in doxie love, Chopper, BP, and Colt

Dearest Joey, our Mum here in England has just read out your latest bulletin... She and Dad are so so happy and we are both over the moon. Mum was really frightened when she saw the photos of you with Maggie, she said in your eyes you looked too too poorly and it reminded her of our brother Stanley on the day they brought him home (Stanley was lost to myelomalacia following back surgery). Mum says today you look like a different dog entirely, your eyes look good and bright and the old Joey spirit is shining through. Mum says that in your latest photo, you look like a dog that has turned the corner, and we are all so very pleased and proud of you little man. Good thoughts coming across the pond from England every day, Mum checks your blog several times a day for updates because of the time difference, and we don't mind telling you, you have brightened our Saturday evening so much. We love you little man xxxx And we say well done to your Dad, Maggie and your close friends who have kept the faith each and every day :0)

Much love,

Louie and Milo

Nikita sends big kiss to my little friend Joey. We love this site, we love dachshunds, here in Brazil we are called "linguicinhas" (I think it is the same as sausage) 

Woofs and Kisses ....

The Whirr of the Tail

Joey coming in back in the hospital after potty break, Saturday, August 28, 2010:  This is Joey's way of saying "Thanks!" for all the prayers and well-wishes that have been sent to him.

Guarded Optimism

Joey, Friday evening, August 27, 2010

Your 'Long and Short of it All' host 'Joey' continues to recover from his bilateral adrenalectomy and spleenectomy surgery.  Surgery took place Tuesday, August 17, 2010, and this is day 12 in his recovery.  He survived a pulmonary embolism post-surgery and is currently dealing with severe surgery-induced pancreatitis.  His pancreatitis spiked a second time a few days ago, and he was started on Total Parenteral Nutrition (TPN) to feed him and to allow his pancreas to rest.  He is on his second day of TPN therapy, which will run a total of three days at this point. 

And we've got good news to share!  Joey's internal medicine vet gave us a call yesterday, and with excitement in his voice, stated that he was very optimistic about Joey's recovery!  They ran another amylase/lipase, which points toward his pancreatitis, and one of the values is back to normal!  That's the first time one of those values has been normal since his surgery!   So, this is exciting news, but the real test will be whether or not he can handle some water which will be offered to him on Monday.  If he can handle the water, he will then be offered small amounts of food.  And if he can handle the food, he will soon come home!

So, obviously we're a bit guarded with this good news - the past few weeks have been a rollercoaster of emotions to say the least.  But we're remaining positive and aren't inviting the thoughts that everything isn't going to work out great when he is finally offered some water and food.  His pancreas will be fine and well rested.  It's simply got to be so.  This boy has had such bad luck thrown his way, that the entire universe has done a full 360 - and nothing but good things will be coming his way from now on.

And thanks so much for the continued well wishes, crossed paws, and prayers.  We know very well that it's all this positive energy coupled with a crack hospital staff that pushed down those values yesterday.  We're eternally grateful. 

We still read to Joey every night all of his comments and emails that he gets.  We're quite sure that the hospital staff have decided that we're certifiably insane for doing so, but so be it.  

More good news:  Joey now rests at the hospital in a playpen because he kept jumping down off his little cot.

Time is the Wisest Counsellor of All

We're having a bit of a writer's block today, we're not sure where to start or where to finish.  Joey was very sick when Maggie went and visited him in the hospital, which was the primary reason for her visit.  We can't bring ourselves to go into the sordid details, but suffice to say it was almost all over for him.  The docs did an ultrasound of his pancreas to get a better picture of what is going on, and the result is that his pancreas is "really messed up" as a post-surgical complication.  There is a possibility that his pancreas may also have a blood clot which has lodged there.  Hopefully by not allowing food and water, his pancreas can rest and heal itself.
Joey has not really eaten anything since Monday a week ago (the day before his surgery), so he is obviously very weak, and restricting food at this point (not that he would keep it down), is not an option, so he has been started on TPN, Total Parenteral Nutrition, or intravenous feed.  In order for this to happen, Joey had to have a central IV line placed in his jugular, and the line goes very near his heart.  It could become infected, or it could make him throw another clot, but it was his only option to administer the TPN.  They tried to access a large vein in his hind leg instead of running the risk of the jugular access, and then the tube would run far into his body, but the short little legs of a Dachshund would not allow the tube to be placed.
And so it's another wait-and-see adventure for Joey.  He is doing better than he was when Maggie visited him, so all the prayers and well-wishes are working, and so appreciated.  Now we wait and give him time for his pancreas to heal.  The doc said we will know more in two or three days, and gives him a 60-70% chance of pulling through this complication.  We're banking on those odds coupled with all the good will in his general direction that he will heal. 

Dad's Little Angels

Cell phone photo:  Maggie and Joey, August 25, 2010

We took Maggie to visit with Joey at the veterinary specialty center last night.  It was a nice visit and they sat together for a good hour or so.  Joey rested his tired little head on his sister.  Joey is not doing well.  The surgery-induced pancreatitis is getting the best of him.  We haven't given up hope yet, but will know more after we discuss his options with his internal medicine vet this morning.  Thank you for keeping him in your thoughts and prayers.   

The Never Ending Story

And so the saga continues.  First off, thanks again for all your love and support for your 'Long and Short of it All' host Joey in his recovery after his bilateral adrenalectomy, and the complications which ensued.  Honestly, it means more than you'll ever know.  We wish his story would have had a happy ending by now, but a week after his surgery, it goes on.
Yesterday was another ruff day.  After being discharged from the veterinary specialty center on Monday, when he was eating and doing fine, he wasn't in the best of shape just a few hours afterwards.  We should have recognized this fact when he refused to eat a small piece of cheese which was offered to him when we stopped at a friends house, before he even came home.  From yesterday's update, he had vomited several times at about four in the morning on Tuesday, and so off to the local veterinary emergency clinic he went.  He received fluids while there, and we then transported him to his regular vet at about 9 AM (not the specialty center where he had his surgery).
Once at his regular vet's office, he didn't seem much better.  He was salivating when he was removed from the car, pointing towards the fact that he was still nauseous (he was on meds to help prevent him from vomiting), and that he was probably also dehydrated.  He was withdrawn and looked quite depressed.   After spending a good hour with his regular vet, we discussed the fact that Joey has really hardly eaten anything in a week's time, and it didn't seem like he would be magically better by 6 PM that day when Dad could pick him up from work, and he wasn't well enough to be left unobserved at his regular vet's office overnight.  If he would need Total Parenteral Nutrition at any point soon, that was something which was beyond the scope of the regular vet's practice. 
So, after visiting two vet offices in the morning, it was off to the third, back up the veterinary specialty center for Joey, where he has been admitted again.  The thought is that his digestive tract has been out of commission for so long, that it doesn't really want to move the food through, so he has been started on a medication to help with that.  His pancreatitis is probably flaring up again as well, but his amylase/lipase values really haven't changed. 
He was running a slight fever last night.  This morning he is "OK."  The good news is that his labs look good, he has had no vomiting, and that he has drank a little water and kept it down.  But he will not eat.  Hoping to have a better update tomorrow.

Dachshund Relaxation: Veenershnitzel Glide

Featuring 'Phyllis' and 'Rhoda,' fine swimming canines.  By vimeoer Vyusher La Kali.

The Big News: Slightly Dampened

Yesterday was an exciting day in the recovery of your 'Long and Short of it All' host 'Joey,' and his continued recovery following his bilateral adrenalectomy and the complications which ensued.  Dad went back to work because he's gotta pay that vet bill, when he received a call about 11 AM that Joey is ready to go home!  So, it was a day earlier than expected, and off to the veterinary emergency center we went.
It was exciting to bring him home and let him see his littermate sister 'Maggie' again, and do you think she was excited?  Not so much.  A couple of sniffs, and a few tail wags; she was more excited to see her Dad walk through the door honestly.  Joey gave her a few good sniffs as well.  We had planned on capturing the big reunion on video, but couldn't find the camera at the moment, and thank goodness we didn't, cause it was a real snoozer.
Joey settled in well, and went straight for the rug in the kitchen next to the door with the sun blaring in so he could take a much-needed sun bath.  "Aaaaaahh," he most certainly thought.  He rested there for about an hour.
Meanwhile, Dad started thawing some chicken breasts, cooked them up, and added some rice.  The vet said that he could start back on his raw food upon discharge, but we decided to keep his food bland with the cooked chicken and rice.  Dad offered Joey his evening metronidazole for his diarrhea issues in a small hunk of nice organic swiss cheese, only to have Joey turn up his nose at his favorite dairy delight.  And so he was pilled.  He did eat about 1/4 cup of the chicken and rice though, and was drinking well. 
Afterwards, he had some lap time at the computer while Dad stroked him and read him all his most recent comments and emails.  He enjoyed this immensely, and was happy and content to be home.  He did surprisingly well at bedtime, and just sort of knew that he wasn't allowed to sleep in the big bed tonight; both he and Maggie were to sleep on their own bed in the bedroom - don't want to risk him sleeping funny next to Dad, and then having issues with his incision, or for some reason deciding to jump off the bed without using the stairs, which could also damage his incision.
Sleeping was peaceful until about 4 AM when Joey vomited three times.  And so, after a telephone consult with the veterinary hospital where he was, it was off to a closer emergency vet for some supportive care.  He will have bloodwork drawn, and he will be started on an IV again to get him some fluids.  Dad will transfer him to his regular vet at 9 AM to be monitored while Dad is at work. 
Hopefully this is just a bump in the road on his continued recovery.  It was so nice to have him home for a while though.  Expecting that he can come home again tonight.

The Road to Home

Cell phone photo:  Joey gets temporarily disconnected from his IV's and oxygen to go outside Sunday, August 22, 2010

We've got more good news for your 'Long and Short of it All' host Joey's recovery and the beginning of the Road to Home.  He has been completely weaned off his fentanyl drip, but still has his fentanyl patch which will help provide pain control when he is discharged.  On Saturday, they attempted to remove his oxygen, but it was not successful; his breathing began to labor, and his pulseox showed low values.  This was a bit of a frustrating setback.  But the good news is that he kept the water down that he had on Saturday, so they offered him some baby food on Saturday night, and he was able to keep it down as well. 

On Sunday, they removed his catheter, and he has been able to go outside to go potty!  He does have some diarrhea, but it is being managed.  They also removed his heart monitor.  We were able to feed him his baby food on Sunday morning, and he ate about a half jar for us.  About noon on Sunday they attempted to wean him off his oxygen again, slowing it down rather than completely removing it, and things were looking good.  But he couldn't stand that itchy tube in his nose anymore, and about 6 PM he yanked it out.  They monitored him to see if it needed to be put back in, but apparently Joey knew it was time for it to come out, and his pulseox has remained very good.  So he is now officially off his oxygen!  He also ate some canned dog food last night, and has kept it down.  His amylase/ lipase values (which point to his pancreatitis) continue to be high, but the fact that he is keeping his food down is very positive. 

This morning's update notes that he is doing "very very well."  Pulseoxing well, vitals normal, eating  and drinking great, no vomiting.  The vet tech took him out to go potty, and he's too exhausted to walk back in the building by himself, so he is pretty weak.  He did walk back in the building for Dad and his friend on Sunday, but he was no doubt showing off for Dad.

On Saturday night a friend said that we need to set a date in our mind for him to come home.  So, we set the day of Tuesday - thinking that things will continue to resolve through the weekend, he will mostly just be monitored on Monday, and he will come home Tuesday.  We told the veterinarian this on Sunday, and she sort of looked at us with a blank stare.  We did ask the vet tech this morning if she knew when he might be able to come home, and she said "I keep hearing Tuesday around here."  So, obviously he won't be coming home until he's ready, but we got the rumor going. 

Joey continues to enjoy all the comments and emails left for him, he is read every single one.  Maggie is chomping at the bits to see her brother again, although she also enjoys being in charge of the house and having Dad to herself.  She smells him on Dad when he comes back after vet visits, and she's a bit confused about the whole situation.  She even hesitates to go outside when a car ride is announced, but all will be normal for her again hopefully very soon.

This Thing Itches My Schnoz

Joey, Saturday morning, August 21, 2010

Nothing but more good news for your 'Long and Short of it All host!  Joey continues to mend after his surgery and post-op complications.  We went to visit him last night, and he was again fairly animated.  He was so overjoyed to get the lap again, which has been the center of the last few visits, along with reading him all his most recent comments and emails.  He just loves it.  His wonderful vet techs note that he spends most of his time in a deep sleep unless he has visitors.
He slept very well last night, so much so, that he appears to be in less pain, so they cut his fentanyl drip in half.  This morning they attached a fentanyl patch to his back, and will soon wean him off the drip completely.  They are also going to start weaning him off his oxygen, as his breathing is becoming fairly normal.  This couldn't come too soon for Joey because the tube in his nose and the stitches which attach the tube to his cheek are pretty darn itchy.  They are still restricting his activity though, so he hasn't got to sit out in the sun since Wednesday.  His vitals are all fairly normal. 
He also got to drink some water this afternoon - the first time in 48 hours.  We don't know today's status of his amylase/lipase values (which point towards his pancreatitis), but they must be pretty low if he was allowed to drink some water.  He may be offered some food today as well. 
Joey gets three visits from folks today - Dad came this morning, a friend came this afternoon, and Dad and a friend will be heading out soon for the evening visit.  He couldn't be happier - well, he'd be happier to be home, but hopefully that goal is coming soon. 

"No, really, my nose is super itchy."

Saturday afternoon snuggles with a friend

What A Difference A Day Made

What a difference a day made

Twenty-four little hours

Brought the sun and the flowers

Where there used to be rain

We've got nothing but good news to report on your 'Long and Short of it All' host 'Joey' and his continued recovery after his complex bilateral adrenalectomy, vena cava tumor removal, and spleenectomy.  His surgical complications have included a pulmonary embolism on Wednesday and identification of post-surgical pancreatitis on Thursday.    

Dad and a friend went to visit him last night, and got tail wags a-plenty.  Tail wags!  He wanted so badly to sit in Dad's lap, that he struggled to jump off his little bed.  The vet tech noticed this and said "It's OK if he wants to sit in your lap."  Really?  Can he?  What about all his tubes?  "He'll be fine," she said.  "Just be careful." 

So he was carefully placed on Dad's lap, and he was so incredibly happy.  He just sighed and rested his little head in the crook of an elbow.  We had placed all the comments and emails for Joey in a Word document and printed them off, and began reading them to him one by one by one.  He listened intently to each one with eyes wide open, eyebrows twitching every time his name was spoken.  His breathing was a little labored at first, but it began to slow down and became much more normal as Dad read on.  It was the most normal breathing we had seen from him since his surgery.  Finally he fell asleep.  We put him back in his little bed, and the vet tech taped all his comments and emails to the glass wall behind him, about a foot above his head.

This morning's visit saw him a little less animated than last night, but we still got tail wags and he got another visit to the lap.  Again, we read him more comments and emails which had been written for him.  He was quite tired today and closed his eyes while we read.  But the best news to report from today is that his breathing has continued to vastly improve, and the high lab values which pointed to his pancreatitis were reduced by 50%.  50%!  He may be able to try food and water again tomorrow night.

We'll continue to take every day and deal with every complication one at a time, but the last 24 hours have been heaven.  The emails and comments have meant so much.  Thank you.

Meanwhile, Maggie's new soapstone counters were finally installed today, and she anxiously awaits the faucet to be hooked up and the return of her brother so they can enjoy their new Dachshund jacuzzi.

The Test of Time

When it rains it really pours as they say.  Visited with Joey last night and this morning, and about to head back up north to visit him again.  He's very happy when Dad and his friends come to visit, and we saw a partial tail-wag this morning.  He sits on his little bed all hooked up to tubes and such, and we sit on the floor next to him - he wants so badly to sit in his Dad's lap, he gets up and inches closer and closer with all the strength he has, but there are just too many tubes that keep him separated.  Maybe one day very soon.

Joey continues to be stable, which is the good news.  He is resting well, his blood pressure is good, his temp is a low normal, his heart rate is good, no arrhythmias, incision healing well. 

It's the surgery complications which continue to plague us to no end.  Yesterday he developed the pulmonary embolism, but the positive news around that is that it has not progressed.  It seems that when dogs get a PE, they often go downhill quite quickly, but the fact that he has remained stable is positive.  His breathing is still labored, but slightly better.

We tried to get him to eat last night, but he wasn't having it.  Canned dog food, an Ensure supplement, even chicken and gravy baby food, but he wouldn't touch it.  They tried to get him to eat later as well, and the smell made him vomit. 

He also vomited several times early this morning for no apparent reason, so they did some blood tests, and have determined that Joey has developed pancreatitis, another complication from his surgery.  He was hopefully looking at getting weaned off of his fentanyl drip soon, but pancreatitis is quite painful and he now won't be able to eat or drink anything for 48 more hours at least, and will remain on his fentanyl drip for pain relief.  It looks like he will remain in the ICU through the weekend.

All of this makes you rethink the decisions made to this point.  Other than his excessive water drinking, here was an outwardly heatlhy boy, albeit one who would not be healthy for long, and the decision was made to attempt to prolong his life, and was that a selfish decision?   Was that in his best interest?  It certainly seemed like the best thing to do at the time, but he is certainly not enjoying his time in the ICU.  If I knew what I know now, I would not have made the same decision.  But that's the feeling today, and maybe things will change.  Life doesn't hand you a crystal ball.

But we couldn't have predicted these postoperative complications, they are relatively rare, just like Joey's adrenal gland tumors which got us here in the first place. 

After long talks with his vet and the vet techs, and describing how overwhelming all this is, they offer good advice:  take one complication at a time and work to resolve it.  It's time that Joey needs right now.  Time.  He is just 48 hours post a complex surgery, he's a senior boy, and his body needs time to adjust and heal. 

And the most important thing they said, which was repeated by friends, as well as in the wonderful comments and emails here, is to remain positive.  Don't give up.  Because if Joey senses his Dad has given up, he will give up too.  He needs more time.

Off to see the J-Man.  We're printing off all the comments and emails that have been written for Joey, and will be reading them to him tonight.  He loves to hear his name, he will really enjoy it. 

A Little Pick-Me-Up

Sometimes laughter is the best medicine.

We can't think of anything that goes better with a Dachshund around:  Bounty Paper Towels.

Joey, Baby

Joey staring in his Dad's eyes, August 18, 2010 (photo by a friend)

We wish we had better news to report about your 'Long and Short of it All' host Joey - everything was going so well with his surgery and then postoperatively, all things considered, but later this morning he was throwing up, and the thing that we didn't want to happen during recovery has happened - he threw a blood clot which has lodged itself in his lungs - a pulmonary embolism.  The internal medicine vet suggested that we visit him as soon as possible, and we were out the door and at his side in record time (we were planning on a visit a few hours later).  At this point, the clot may dissolve and he'll get better, or it may build up and he'll get worse. His breathing is labored.

He seemed very happy to see Dad and one of his good friends.   He didn't wag his tail, but he perked up and enjoyed being talked to and stroked and massaged and kissed on.   We told him that great things await his return home:  car rides, walks in the park, laps, all his favorite food and treats, and that Maggie is lonely without him.  We told him about all the love and support that his friends from all over the world are sending him.

Heading back out to visit him again tonight.  He'll be able to eat tonight for the first time, and hopefully we'll be able to get some food down him, but when he was on a fentanyl patch before for back pain several years ago, he refused to eat, and we don't think he'll want to eat tonight with his fentanyl IV.  But we're hoping.  The vet tech did take him outside for a while about an hour ago.  He enjoyed basking in the sun with her - like most Dachshunds, his most favorite thing to do in all the world.