Persy’s health set-back – August 2003
Even MORE complications for Persy in March 2004 click here
***warning - there are some graphic photos (surgery) on this page***
Click here to read Persy's story thus far...
Persy, who had been shot in the jaw as a stray sometime during the spring of 2002 had been doing so well for almost a year! He’s gained 20 lbs since his teeth abscess crisis in the fall rounding out at a robust and muscular 85 lbs (up from his original 40 lbs), eating well, arthritis under control with glucosamine, sporadic irritable bowel issues – but becoming less frequent. All in all… leading a normal happy life. Until…
August 7, 2003 – A few weeks ago Persy began having
a pink membrane under his tongue fill with air like a balloon when he panted
really hard, it then deflated after he was quiet for awhile. I took him to the
vet (the one who did his dentistry on the abscesses and removed the loose bone
fragments) who advised that it was something to watch and monitor. If it were
to fill with fluid it would be a real problem and could become infected.
Well... the membrane had not deflated for two days and was becoming an angry red
color, so I took him to the vet this AM. It had filled with fluid. They wanted
to sedate him and examine it as under the tongue isn't easily seen - since he
really didn't want to participate in that kind of exam - even though he was
being a very good boy.
While in his mouth they had to perform an emergency procedure because the
change in the membrane under his tongue was due to lead fragments from the
bullet that were moving into his gland and forming into his ranula - a
pseudocyst that is associated with mucus extravasation into the surrounding soft
tissues. These lesions occur as the result of trauma to the salivary gland
excretory duct, although obstruction of salivary flow is implicated in some
instances.
This was all thick mucous inside the area, 2 inches long and 1 inch thick. To promote drainage, they "marsupialized" the area so it would drain into the mouth instead of forming another mass.
The alarming thing is that the vet removed the gland and x-rayed the gland
itself and it is full of lead from his original gunshot wound.
They also x-rayed Persy
and there are still some lead pieces in the tongue itself and some down in the
bone. His body is trying to expel the foreign objects, but they didn't have a
good place to go. I will bring in his original x-ray to compare where the
bullet fragments were and are now later today to consider removal of the
remaining fragments.
Right now Persy is still at the vet - he is drooling a lot of blood and may have
to stay overnight so he can be monitored. I knew that there would be
complications with his health, but I wasn't emotionally or mentally prepared for
it to be this soon. He has been through so very much!
Andi
August 7, 2003 – evening
- Persy's mouth stopped bleeding, so he was able
to come home with me tonight. He is drooling
(just drool now - not blood) up a storm, but he
has a very large incision under his tongue. He
is pretty quiet and a bit groggy from the
anesthetic tonight. I've been trying to get him
to eat ice chips, since he can't lap water very
well. Trying to have a quiet evening.
I was incorrect earlier in describing his
procedure. The ranula is the area of the
salivary gland - what was blocked with fragments
of lead - 3 the size of sunflower seeds + many
other smaller ones. The obstruction is called a
sublingual sialocele. They corrected it with
marsupialization of sialocele and ranula.
Basically they cut out an area (the mass with the bullet fragments) and left it
open to drain should any other fragments filter up they will come out
(hopefully) rather than causing another obstruction and pouched it.
In comparing the x-rays taken in June of 2002 to the ones taken today - the
fragments are moving around. They are lodged all over the place in his tongue
and jawbone. They seem to be moving upward and the danger in that is if one
were to move up into the TMJ joint of his jaw. That would require some surgery
at the U of MN. It would be impossible to remove all of the shrapnel pieces,
not only because they are so scattered, but because most of them are just too
small to find and they are stuck in the tissue, so it's not easy to get them
out. Even performing surgery with a microscope would be difficult because of
the geography.
So... our plan is to get him over this crisis. He's on some pretty heavy duty
antibiotics (again) for a couple of weeks and attempt to recheck the incision
in 10 days or so. Understandably, he is not too thrilled about having his
mouth probed any more. We will probably have to x-ray his jaw periodically to
check for more migrating pieces of lead. If the incision closes... I think that
would be a bad thing as another obstruction would be likely.
Looking at the x-rays, I just can't even understand how he lived through being
shot, having his jaw broken, being left to heal on it's own and the trauma it
must have caused his entire system. He is one amazing guy. It’s very difficult
for me to see him feeling bad. After all he’s been through, he should never
know another day of pain in his life.
There are photos to share of his surgery and the pieces of lead that I took home
with me - will get to that stuff next week maybe.
Thanks again for your kind thoughts. Persy appreciates it!
Andi
Saturday, August 9, 2003 update
Persy seems to be doing very well. He is still
drooling like crazy, but no blood, which is
good. Because he had that section cut away (the
tube of the salivary gland) he is going to have
to figure out what to do with the new area where
saliva is arriving in his mouth - back to the
rag next to the water bowl. He has been more
successful with drinking water, but still wants
to "suck" on ice cubes. He rests them inside
his mouth which makes me think that things are
still uncomfortable for him. I've been giving
him Rimadyl for pain. The inside of his mouth
is a mess - very hard for me to look at.
Persy is eating well and went to the park this
morning and although he didn't do much chasing,
he did bark at several bicycles that rode by -
so he is definitely on the mend. Got lots of
pats from the humans.
He will be visiting the vet again next week to
see (if he'll allow them to see) how the
stitches and wound are healing. I think my vet
now has my numbers on speed dial....
I finally felt comfortable leaving him. Left
him a bit yesterday and didn't feel good about
it, but Tasha had a therapy dog visit this AM at
a rehab center and I felt fine about leaving
him. WHEW!!
Thanks for all of your kindness.
Andi
Sunday, August 9, 2003 Update
Thought things
were going great w/ Persy, but he is now bleeding slightly from his mouth
incision area. Of course I can't really see what is going on and don't want to
probe too much since he gets very sensitive about that and I don't want to "ruin
him" for the vet to do the poking. Shoot. He was drooling a bit of blood, but
I can see it in his mouth too.
It's not bleeding enough to take him to the emergency vet, but I'm not happy
about him bleeding at all. I will contact my vet in the AM.
Other than that he seems to be in good spirits, eating well and back to his
happy personality.
Andi
Tuesday, August 10, 2003 Update
Persy went to see the vet
late yesterday afternoon. He was NOT going to cooperate and stick out his
tongue for examination so it was necessary to put him under for a thorough
exam. They used fast/short acting anesthetic so Persy was only under about 5
minutes all told. I was able to sit with him on the floor while all of this
went on.
The good news is that things look good. My vet had been afraid that there was
something stuck (like food) in the incision. I had been smelling a mildly
rotten smell on Persy's breath. Not nearly as bad as when his teeth abscessed
last fall, but mildly reminiscent. That scared me! On top of having him bleed
on Sunday evening, we all felt it best to see what was happening in there.
The wound is open - as it should be, and the flesh is granulating (it's
healing). So things are good. There was no necrotic tissue present. But the
wound needs to be cleaned daily, so now I have to try to persuade Persy to let
me squirt a wash into his mouth twice a day.
Persy is still uncomfortable as the vet said it's like having 2 inch canker
sore in your mouth, but he's doing better.
Thanks again for all the well wishes and your concern and support.
I know it's difficult for any of us to see their dog in any pain or discomfort,
but for some reason it's doubly hard to have anything be wrong with Persy. He
is so very trusting and such a good patient (except for the dislike of mouth
probing). By all rights, he should never trust a human again. The fact that he
seems to trust everyone he meets is a miracle.
The vet gave him a shot of painkiller "for the road" so Persy had a very
enjoyable evening last night....
Andi
August 17, 2003 – update
Persy had a good week after our scare and is doing very well. He even got a bath on Friday. Since he had been drooling so much, his fur had been a MESS. Please send good thoughts Persy’s way for no more complications!
Because these are foreign objects, his body was trying
to expel them,
but they couldn't get out so his body formed the mass around them.
The mouth changed VERY quickly - like over a 2 day time period.
Until then, the area (membrane) had been pink and was inflating with
air when he exercised which would then deflate after he stopped
panting. I had been checking the membrane situation daily for any
changes and I check his mouth periodically for bone fragments coming
out of the bullet wound. I have to pull his lower lip down to see
the bullet wound hole.
What happens in the future is a "who knows?" situation. The bad
thing is that the bullet fragments are all on the move upward from
last year June. If one lodges up in the TMJ joint of his jaw it
would mean surgery at the U of MN under a microscope. Since there
are so very many fragments and they are all so minute, it would be
impossible to get them out. It's like trying to find rice grains in
a sand box with a tweezer.
Hoping that the channel created in his mouth for saliva will expel
any more fragments.
Andi