Remember my young Golden Retriever pup of last Christmas week’s posts? I hadn’t wanted to depress you horribly on your holiday and therefore refrained from reporting her euthanasia on Christmas Eve. She was succumbing to sepsis, the full-body infection I’d described to be her primary problem. She was suffering. Her chances were miniscule, at best. It was time.
In the hours leading up to her death, the microbiologists were hard pressed to confirm a specific course of antibiotic therapy except to point out what wouldn’t work (and on that score I had plenty of evidence already). She was so weak and was suffering so terribly that it seemed cruel to wait the extra two or three days the lab required for further studies on the resistant bacteria they’d isolated.
Sometimes, it’s better to choose a more humane route than to hold out hope for the possibility of improvement through future drug selections. Such a difficult choice—yet that’s what the family agreed to at once after witnessing her deteriorated condition in person on that morning.
It’s times like these when I abuse myself for being unable to do more. I wonder whether I’d given in too soon by persuading the family that waiting a few days more for the possibility of a glimmer of a thin slice of hope might actually be worth the suffering their pet was currently experiencing (if I could somehow even manage to keep her alive for that amount of time).
After receiving a call over the weekend confirming the isolated bacteria as a highly resistant strain of Actinomyces, it was clear that no amount of antibiotic therapy would have helped much—not without blowing out her kidneys. Only one antibiotic would have made the difference according to the lab’s studies: amikacin. After a week of sepsis it wasn’t exactly a drug I would have expected her to survive.
In the end I was relieved to have euthanized her earlier rather than waited to see how long she might survive until the lab came up with something tangible and doable—amikacin was clearly in neither category. Its profound effects on young, vulnerable kidneys are legendary.
As always, the microbiology lab was deeply interested in the case, wondering how she might have been inoculated with so vicious a strain of bacteria. When the patient’s condition was again described (kennel cough to pneumonia to metallic gastric foreign body and peritonitis to stomach surgery to retrieve the offending item), the microbiologist seized upon the beer-cap concept with uncharacteristic fervor: Did I still have the item? Had I disinfected it?
Turns out, it’s items like this that tend to inoculate susceptible patients with nasty bacteria we tend only to see from penetrating wounds. It seems the beer-cap (Coors Light, to be precise) is the prime suspect in this veterinary game of Clue.
Colonel Mustard with the beer-cap in the library (as if you needed another excellent reason to fear and loathe litter). And that’s all she wrote, folks. I only wish I had better news...
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What exactly did you mean by 'objects like this' ingested foreign bodies in general, or beer caps in specific? It makes me curious what about it introduces the bacteria.
thank you for waiting until after the holidays - I can't imagine how difficult it must have been for everyone involved (including yourself)
C January 2nd, 2008 10:12:00 AM
While not unexpected it is very sad news. I haven' t even heard of that particular type of bacteria. It sounded to me like you did the right thing even before I read the microbiology lab's findings. I'm sorry it wasn't a better ending for this poor pup but thank you for the update.
Jules January 2nd, 2008 02:33:00 PM
I'm sorry that you had to make that choice on Christmas Eve, but given the eventual lab result you did the right thing in not making the pup suffer more over the holidays.
jcat January 2nd, 2008 03:47:00 PM
C: "Objects like this" = dirty metallic objects soaking up soily bacteria. Rusty nails, dirty tin foil and other abrasive, ouchy sort of items are other good sources. All the yummies fit to enter the open maw of an insatiable retriever, in other words.
Dr. Patty Khuly January 2nd, 2008 04:55:00 PM
Dr. K. So sorry to hear the sad news. You are right. There is nothing good about the timing in this case. I can identify.
Marie January 3rd, 2008 04:58:00 PM
Sorry you had to go through this, but glad that your decision was OK, finally. I don't think I'd like that part of your job at all. Thanks for being there for our furry friends.
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