Caring for a Three Legged Dog or Cat

Hi everyone! (Warning:  LONG POST!)

Sorry its taken me so long to post and update, its been such a roller coaster of ups and downs I feel like I can finally breathe again. So glad Aubrey you have seen the story!  Ollie has been such a topic of conversation regarding Charlie's treatment since last Wednesday, I was hoping you would get wind of the influence you have had on Charlie's recovery.

Last Wed the trip to Friendship went well, Charlie was still a bit sloggy from the Ace the night before and calmly laid on my mother's lap the entire hour and 45 minute trip there through morning rush hour in DC (previously unheard of for him in the car).  Upon arriving, the office manager (who is more like an upscale resort's conceirge and so sweet with every animal that arrives), Dr. Glassman, and his 2 associate DVM's, all welcomed us at the intake counter.  After an exam that showed painful palpitation of his sciatic nerve area, Charlie had an ultrasound that determined both a large amount of fluid (seroma ) still in there, and an inflamed sciatic nerve.  He had an ultrasound-guided injection of a combination of steroid, lidocaine-like medication, and a neuropathic pain medication.  His antibiotics were extended for the fluid buildup still present.  Dr Glassman suggested we wait on taking his staples out due to some crusting that was visible at the incision (from the fluid previously leaking a bit) and hold off on Chemotherapy for at least a week.  The whole experience at this hospital is really beyond words.  The vets care so much and are so attentive to not only your pet but to you.  We were updated constantly of his progress, asked for our input, served beverages, and guided to a local eatery while we waited.  After the procedure, his sciatic nerve area was not reactive to palpitation but could have been due to the pain meds that were administered to do the procedure that were still in his system.  He came out a bit dysphoric and drugged and David the vet tech assisted with taking Charlie down the elevator and into our car in the garage and we were on our way.  He finally conked out again and slept the whole way home.

So we were cautiously optimistic until Charlie came out of his sedation and pain meds about 4 hours later and was really uncomfortable and back to "flipping" the stump again, trying to get at the area, crying a bit and breathing hard.  We got him back on his meds and tried to give Ace to allow him to sleep that night, but he was up every hour and continued to be painful the next morning.  Dr. Glassman emailed me when he landed the night before from a conference, emailed me again that morning and then called me.  We went over the options of either repeating the ultrasound to see if another area was inflamed, trying an additional antibiotic in case it's an infectious process, or possibly doing an MRI to see the nerves better.  An additional surgery was considered a last resort since Ollie has a subsequent infection from his surgery so close to the first one.  We were all so disappointed!  He conferred with the anestheologist that it was unlikely he would have a flare up and delayed response that you would see with an injection into a joint so it was unlikely this was temporary. So we decided to add the new antibiotic as a first course of action.  BUT, after sedating him with a bit more Ace that night, he had a great night and woke up the next morning with no flipping.  We were all shocked!  SO it really did seem like he was temporarily irritated by the injection and was on his way toward improvement.  Hope, once again! 

So now we are at friday morning where he goes to the oncology consult back at our Specialty practice.  The oncologist wanted start chemo right away, seemed to think the whole thing was more of an inflammatory process, and took Charlie in the back and did an ultrasound of the fluid and took a culture to make sure it isn't MRSA (we find out Tuesday).  She then handed him over to his original surgeon who apparently really manipulated the sciatic nerve area and we were warned he might be sore from it.  I was very upset about this as he was finally showing improvement and that area was already tender at this point from the injection; further, it didn't serve any purpose for Charlie and I can't see why it was done at all other than to satisfy his curiosity.  :/ The oncologist also said when she did the ultrasound and culture he seemed painful in the area of the fluid.  So, needless to say, within an hour of arriving home he was starting to flip again and most uncomfortable.  He continued to be painful, and that night we gave him his typical dose of Ace hoping he would rebound again.  Unfortunately the Ace had a reverse effect this time and he was up the entire night, dysphoric and in pain, until about 5 am after administering his gabapentin and he fell asleep and continued to sleep almost the entire day (but stopped "flipping' in pain again!).  Dr. Glassman emailed once again, (from his conference, on the weekend no less), that we could try Trazadone and he would see him Monday if needed for a repeat ultrasound.  I told him I really felt that he is improving, he just sometimes needs to be calmed and sedated, especially after painful consultations.

So last night we definitely didn't give him the Ace again and anxiously waited to see how the night would go, we have had so many sleepless nights, its worse than when we had twins at this point!  We took him for a short walk in the rain with our other Great Pyr to blow off any bad energy and move him a bit, then settled him between us on the bed and he had a great night!  And now I can safely say it has been the first 24 hours of basically no painful flipping of the stump!  I'm so scared to be optimistic but it really seems he is turning the corner.  Its a slow, day to day process, but he has been able to improve from this nerve block.  Friendship Hospital for Animals has been our saving grace.  As Ollie's mom said, the past 2 weeks post surgery and not being able to alleviate his pain has been truly horrible.  I think Charlie was just sensitive to the injection and/or the sciatic area being palpated so much for the first 24 hours and then would have improved there and then but had a subsequent painful visit with the oncologist and original surgeon 48 hours later and became painful again.  Really hoping this is it.

Thanks to all for your care, thoughts, and suggestions.  If you want to see his story posted on their facebook page, here is the link: https://www.fac.....38;fref=nf

Mary Beth, Charlie & Family