Piglet’s fever finally broke this morning with a 101 reading at 8 AM. The night had been rough with highlights including an episode of collapse and a 104.8 spike in his temperature early in the morning.
Today he spent the entire day in the oxygen cage at Miami Veterinary Specialists where he was under the care of Dr. Alvaro Larin. He looked positively healthy at times, especially when his stubby tail wagged like a windshield wiper on overdrive. But by 4:30 in the afternoon he was working hard to breathe. The 100% oxygen environment was no match for whatever was happening to his lungs.
At 5 PM I watched his ultrasound—Dr. Larin inserted a needle to extract lots of cloudy, reddish, viscous fluid. Under the microscope it looked like a big mass of white blood cells (inflammatory neutrophils), strands of mucus, occasional bacteria and red blood cells. All normal for a severe infection and an uncontrolled inflammatory process—except the mucousy stuff. Yuck. Where was that coming from?
Since we couldn’t see a mass (or anything else, except that pocket of fluid), Dr. Larin prepared Piglet (and his parents) for an exploratory surgery. By 6:30 PM he was under anesthesia and ready for what turned out to be a two and a half hour surgery.
By 9 PM he was out of the OR and the news was not good: Piglet had suffered a rupture of his esophagus. Lots of this critical digestive structure had died, leaving little room for Dr. Larin to maneuver. A repair was finally completed with a chest tube and stomach tube implanted for continued drainage and feeding, respectively.
This morning Piglet was standing up—but no wag greeted me at the large window of his oxygen cage. No doubt he’s uncomfortable in spite of the pain-relieving drugs administered throughout the night. But he’s made it this far; we can only hope his body works hard to heal itself at the site of the disaster in his esophagus.
We still don’t know what caused it—and we may well never determine what did it. Was it a toy or a treat that was lodged there? Or is it a cancer eating its was slowly through? Biopsies of the tissue will be back in a few days—maybe that will shed some light on the source, although we hope that’s not the case. Cancer would kill him. Trauma from a toy would not—as long as his repair holds.
Piglet will be fed through his stomach tube for at least four weeks. He’ll have to undergo future anesthetic procedures to look down his esophagus with an endoscope for visual inspection of the repair. If all goes well he’ll go home at the end of the week so his parents can take over the nursing care he needs.
Rare as Piglet’s condition is—at least we have some answers. I’ll give you frequent updates as his condition progresses.
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Wow, what a shocking turn of events! I'm glad Piglet is on the road to recovery, and hope his biopsy also turns out well.
Leigh-Ann August 15th, 2006 08:49:00 PM
I have a question (raising hand) -- when you did the needle biopsy, what area of the body did the fluid come from? Also, was finding the rupture in the esophagus just luck during the exploratory surgery, or had you already narrowed down the general area of the problem before the surgery?
Leigh-Ann August 16th, 2006 02:07:00 AM
Because we had no clue what was causing the changes to his lungs an exploratory had to be performed. Whenever you hear the term exploratory surgery it means we have to go looking for the source of the problem. A thorough search of his thoracic cavity (his chest) was the only way to find the leak. When we iunserted a needle it was into the chest next to the lung that looked funky on the X-rays. We removed fluid for culture and cytology (how I found all those white blood cells and goopy, mucoid stuff). The breach in his esophagus was leaking saliva into his chest, ultimately causing saliva to pool around his lungs. This accumulation of strange fluid led to the pneumonia. I hope that helps explain the sequence of events better.
Dr. Patty Khuly August 16th, 2006 06:21:00 AM
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