Sleepy-Joe
Last night (Friday) went very well. Sleepy-Joe may not be rousing anytime soon but his seizures are being managed by the phenobarbital. The better news is that he is consistently being kept clean and there do not appear to be any new indcations of pressure ulcers with the frequent turns. He can still be roused, although it seems to be largely owing to food. With some dexterous hand feeding he will take chunks of wet low residue (he can't eat out of a bowl or really take them out of your hand because he isn't using his tongue and jaw effectively... the food will just smear, he starts choking and is a risk for aspiration), and there haven't been too many problems with his feedings. He really likes food, and its one of the few moments when he seems lucid, not to mention roused enough to push himself into a sternal position. Expressing him (coaxing actually) has also been very effective but it takes time. A bit of milking is necessary before he will release it. Because he is so heavy, I've been resorting to my little bag version of a bed pan. He's been kept pretty clean and although the urine is a little more concentrated than I would like, there do not appear to be any indications of a UTI. Best of all, most of his ulcers are healing remarkably well now that he is being kept clean and turned often. Also important, by clipping him the tissue isn't getting massicated by prolonged moisture. We can keep him dry much more easily. So he seems pretty comfortable for the moment. That's great news after seeing some other cases earlier this week.
On July 1st I talked with Dr. Sk about updates on Sleepy-Joe, Big-Snap and Sideways Sallie. The prognosis on Sallie is pretty bleak in the long run (inoperable lesion on her brainstem which is not responding to steroids and the owners have not opted for radiation therapy) with maybe two months tops before euthanizing she will at least have some reasonably good quality of life for the next month or so before she starts to go downhill fast. However, Sleepy-Joe is running, jumping, catching balls, and alltogether has undergone a radical turnaround. This is fantastic news, especially since it was never entirely clear what was wrong and interventions seemed to be a scattershot in the dark. So Sleepy-Joe is a major success story, and everyone is happy to hear that golden retreaver came back from the brink of death. Big-Snap will be permanently disabled, but he is doing much better. I had a chance to have a big talk with Dr. Sk and learned a thing or two (nerve root damage that wouldn't respond altogether well to medication and hot/cold pack therapy). So 2/3 good news on three serious cases (of the serious ones that stuck out in my mind).