More complications for Persy!

Tuesday, March 1, 2004


Persy is having more trouble with his salivary glands... seems to be backing up into his throat area.  Said to be a non-painful issue at least.  The swelling had become about the size of a baseball/softball by the time we got to the vet on Monday.  The fluid was aspirated and sent off to be evaluated just in case (lymphoma has symptoms like this I guess).  Then 72 cc's of fluid (six large syringes) of fluid was drained from his throat area.  This could be a sialocele (again) or a mucocele - both would be caused by the trauma of the gunshot to the salivary glands. 

The danger is that the lower salivary glands are located in an area near the carotid artery as well as a delicate network of nerves and we don't know which gland is being blocked by shrapnel.  So... we are being referred to the U of MN Vet School for surgery and most likely will remove at least one gland.

Persy is on some pretty strong antibiotics and is eating well and seems cheerful, but really tired - going to be about 2 hours before normal.  I hope that I didn't make him worse by having him at Pet Expo, but he seemed to enjoy himself so much!  He gently demands that people stop and pet him. 

I'm a bundle of nerves over this one and I have a huge event this weekend for work (our presidential inauguration for Macalester).    Don't know when we take the next step at the U of MN since my vet is contacting them today about having him evaluated for surgery. 

If Persy's throat/neck fills with fluid we may have to go in to have it drained again.

I hope that there is a special place in hell for the person who shot him. 

March 4, 2004

 Persy's lab results came back and the results are somewhat optimistic.

Because of the type of cells involved they've determined that he has a salivary mucocele - which

is basically a leakage of saliva into the tissues around a ruptured salivary duct or salivary gland and the resulting inflammation. These can get abscessed at times and get pretty awful in a hurry. 

If a salivary mucocele occurs in the pharyngeal region it can lead to a harsh cough or retch and if it progresses it can lead to difficulty breathing.

The good thing is that there is no evidence of lymphoma.  Also good is that through the pathology of the fluid they've also determined that removal of the salivary gland should fix things.  (Amazing!)   There is no infection in the fluid.

On the not so good side is that there are several salivary glands which could be the culprit and determining that is complicated because of all of the nerves and carotid artery.  

I asked my vet what he thought the incision would be like and he thinks that it could be up to 8 or 9 inches long because of having to explore and removed the offending gland. 

Unless something drastic happens and we have to move up our appt. at the U of MN, I won't know anything further until March 24.  In the meantime, if the fluid builds up we'll just have to go to our vet and have it drained again.

Thanks for all of your kinds thoughts.  It's always been very emotional for me to consider what he has endured both before he came to rescue and after.  I feel very helpless  when these things happen and wish I could do more for him.

March 22, 2004

 We have a consult with the surgeon on Wed.  Since Persy's neck was drained on Monday (second time) it has not filled with fluid.  We are optimistic that perhaps a piece of bullet shrapnel was lodged in the the opening to the salivary gland and in the sucking out of the mucous and fluid was shifted aside.  I am keeping the appt. since I want this surgeon to be familiar with his case should we again have problems and also just in case she thinks that we need to go ahead w/ surgery.  Hoping that he doesn't need it at this time.

 March 25, 2004

 Persy is having surgery this afternoon at the U of MN.  They are removing one of his salivary glands, checking the bullet hole area and removing at least one canine tooth - maybe more - as his broken jaw made a mess out of his occlusion and it would be terrible to have a canine go through his mouth.  A dentist as well as an orthopedic surgeon will be in on these procedures.

He is staying overnight at the U of MN and I will pick him up in the AM and stay home with him tomorrow.

March 26, 2004

 Persy came home this morning.

He is in rough shape right now, but I'm so glad to have him home! He had to have the side of his head up to his eye and neck shaved for the incision, so the poor guy again has a really bad hair cut + he has about 6 inches of sutures in his neck so he looks like Frankenstein Collie.   I was trying really hard not to cry when they brought him out to me this morning.  He just looked so very pathetic.

Surgery involved both a dentist and an orthopedist.

I'll tell you what the diagnosis/surgery was:

"Examination revealed a severe over shot jaw with the lower right canine tooth contacting the hard palate resulting in a hole in the hard palate.  The upper right canine tooth was contacting the lower right canine tooth causing severe attrition and wear on the lower canine tooth, also causing the tooth to be pushed laterally.

The upper and lower incisor are worn but no pulp exposure.  The upper left canine has 6-8 mm pockets.  There are extra lower third molars on both the right and left mandible.  Fractured teeth include lower left 3rd and 4th molar, and lower left canine.  Furcation exposure of upper right 2nd premolar.

The crown of lower right canine tooth was amputated to eliminate contact with the hard palate and a pulpotomy procedure was perform to keep the tooth vital.  The lower left canine tooth had gingival flaps created on the lingual and buccal surfaces, the alveolar bone removed with a round bur, and the tooth was surgically extracted.  The socket was flushed well and sutured closed with absorbable sutures.

The lower left third molars were extracted and the sockets left open to drain. 

The left submandibular and sublingual salivary glands were removed and the cerivcal mucocele was suctioned.   The SQ tissue was closed with antiseptic vicryl and the skin with nylon.

Feed soft food for 3-5 days.  No exercise toys or chew sticks for 7-10 days.  Sutures in the mouth will dissolve on their own.  The neck sutures will have to be removed in 10-14 days.  Restrict exercise to house and short walks for 7 days.  Avoid using collar over incision for 10 days."

Since I cannot put a collar on him (stitches in the neck) he has to have a leash looped under his arm like a Ms. America pageant contestant.  Luckily he's not a puller on the leash or he'd slip out of it. 

I thank you all for your kind thoughts for Persy.  He has always been so patient and accepting of the surgeries he has undergone.   What an amazing dog he is.  Expensive!  But amazing.

He is obviously not feeling very hot.  Very tired and obviously in some pain.  He's sleeping next to my desk as I type, so I hope to give him a quiet weekend of recovery.   They gave him morphine overnight so he is a bit hung over.

March 29,2004

Persy is recovering nicely.  He is a bit itchy where they shaved his face and neck, but seems to be feeling more chipper than ever.  He still cannot wear a collar and I've been trying to keep his activity level down, but he is wanting more and more to run and play.   The fear is that if he is too active that he will burst the stitches in his neck which would be BAD.  We go back in a few weeks for a check-up.    Will try to post some post-surgery photos of Persy.  He looks like he has an asymetrical haircut.