Ema Becomes Even More Complicated

Ema is waiting and seeing

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Today, Ema was supposed to be undergoing the procedure that we hoped would save her life. Instead, she is sitting here on my feet, as I write this. Ema, it turns out, is even more complicated than we’d thought, and it all has to do with doors.

Allow me to explain, as briefly as I can, and bearing in mind that I am a layperson, and not a veterinarian. This explanation comes to you courtesy of the very excellent University of Guelph Veterinary Cardiologists, Dr. Schuckman and Dr. O’Grady.

Picture your heart as two separate rooms, divided by a wall.

Each room has door leading into it. Ideally, this “door” should open fully, allowing blood to pass through it easily.

Ema’s “door”, however, does not open fully.

Ideal door and stuck door

Luckily, our “rooms” don’t really need their doors – it’s perfectly fine for the doors to remain wide open all the time, or to be non existent. In the balloon procedure, a catheter would be inserted into Ema’s neck, and fed into her heart. There, the balloon would be inflated, essentially tearing her door off of its hinges, leaving her ‘room’ wide open, and allowing her blood flow to move normally through her heart.

However, consider another option with doors.

What if, in addition to the door being stuck, it’s also in a frame that’s too small – much, much too small? In this case, even removing the door isn’t enough, because the frame just isn’t large enough to allow sufficient flow of blood into Ema’s room.

Ema's Door

This is, in essence, Ema’s issue. Removing her door  ( doing the balloon procedure to correct the pulmonary stenosis) wouldn’t be enough to improve her heart’s functioning to any serious degree. However, there’s another procedure that should be able to help her – a surgical correction.

The surgeon will, more or less, tear out Ema’s door frame, building her a wider one shored up with surgical mesh. Ema will then have a wider opening, and no stuck door.

Unfortunately, Drs. Schuckman and O’Grady don’t perform this procedure – they’re the “Balloon Team”, as they informed me. A Cardiac surgeon is needed to perform this, and Guelph only has one at the moment, and she happens to be on holiday until November 8th. Even then, she apparently hasn’t done many of these procedures (do I even need to mention that it’s a rare and complicated surgery, done only by a handful of people in North America? That should go without saying, since this is Ema we’re talking about). So, there’s a chance that Dr. Bisson, Guelph’s Veterinary Cardiac Surgeon, might be more comfortable referring us to a Veterinarian who has more experience in performing this surgery. This will mean sending Ema to perhaps Purdue, Cornell or Ohio State.

So, we sit and we wait. We wait for the Cardiac Surgeon to get back from holidays, then we wait for her to look at Ema’s file and decide if she can perform the surgery. Then, we either wait for a referral to another vet, at another University. Then we wait for a surgery date.

In the meantime, Dr. O’Grady said quite succinctly that “Ema is on a crash course with death”. He was frankly surprised that she’s doing as well as she is, and has survived for as long as she has. He asked, tentatively, if we could possibly tape one of Ema’s seizures – he’s never actually seen one himself, and it would be a great teaching tool for students at the university. Ema had another one this morning, and while I’m all for increasing the pool of knowledge among Veterinarians, grabbing a video camera is not the first thing that comes to mind when your  puppy falls to the floor, goes rigid and then screams in terror.

Financially, we should be OK. This new procedure shouldn’t cost much more the balloon procedure does, but it carries with it both better success, and greater risk. If Ema survives the surgery, her recovery success rate is as great as 95%. There is, however, a 50% chance that she won’t be able to survive the surgery. I’ll take those odds, because without the surgery there is a 100% certainty that Ema will die, and that it will be a slow, painful and terrifying death.

I’m not thinking about that right now, however. I’m just watching the clock and waiting, and so is Ema.

If you would like to read the actual veterinary report written by Dr. Schuckman, please click here to download the PDF.

Breeders Big Book of Scary Stuff, Chapter 915

Teddy says "How could anybody not want to do everything possible to save me?"

Teddy says "How could anybody not want to do everything possible to save me?"

I’ve always joked that someday I’m going to write a book titled “The Big Book of Unbelievably Scary Shit That Will Inevitably Happen to You if You Breed Dogs Long Enough”. If I ever do, this incident will be chapter 915.

I noticed two weeks ago that Teddy’s hernia was larger than what I’d consider to be “normal”. I’ve seen quite a few hernias over the years, none of which have worried me – until this one. Concerned, I called my vet clinic (a fairly new clinic for us, I should add) and asked about having it corrected. They didn’t want to even see him – they told me that they NEVER correct hernias in a five week old puppy.

We’d had problems with Teddy’s umbilical since birth, a fact I attribute to the clinic not having clamped (or even tied off) the pups umbilical cords at birth. At two days, I was on the phone with the clinic telling them his umbilical was too open – they told me to apply iodine. At less than a week, I had him in the clinic, so that they could see his umbilical was so open you could see his abdominal wall.

Their solution? Liquid bandage. I was surprised that they didn’t want to stitch it – I even asked if they didn’t want to do a purse string repair. They told me no, that the margins of the opening were too healed over, and to leave it be.

Since I’m not a vet, I acquiesced to their professional opinions, even if I had some doubts.

Monday night after dinner, I popped in to see the pups, and found blood splattered all over the bedding. Teddy had two inches of tissue poking out of his hernia, and it was bleeding. As you can imagine, I panicked – wrapped him in a bandage, called the vet and headed for the clinic.

I arrived to see my least favorite vet – the one who has always seemed to have little confidence in his own skills. His reaction when he unwrapped Teddy’s bandage confirmed this – instead of looking at him like a diagnostician should be expected to, he grimaced and recoiled, not even examining the puppy beyond that cursory glance.

I asked him what he was going to do to treat it, and he responded “That’s intestine, and it’s necrotic. There’s nothing we can do”. I insisted that there had to be SOMETHING he could do, and he replied that I had to “think about the well being of the puppy”. I again said “I don’t even want to TALK about anything other than what he planned to do to fix his hernia”, and he again insisted “the prognosis isn’t good, and you need to think about what is best for this puppy” – basically saying, in effect, that we should put him to sleep, without even attempting surgery.

At this point Sean, who was thankfully there with me, yelled at the vet “If you’re not capable of fixing this, just tell us, so we can go someplace else where they can”.

Again, the vet said we ‘weren’t listening to the prognosis’, and again Sean asked him “Are you or aren’t you capable of fixing this?”. At that point, the vet reluctantly said “Well, you might as well take him someplace else”, to which I said we’d take him to the University, so please call there and let them know we’re coming. He agreed, but then told us “you have about an hour to get there, or it will be too late”.

Guelph is a one and half hour drive from the clinic we were at, so you can imagine our panic. Sue Simon can tell you – I phoned her from the road, to ask her help in reaching Teddy’s co owner, and was too incoherent to even talk. Thank God Sean was holding it together, and thank God Hope and Sue were there to help us.

As I took the puppy to the car, Sean stayed behind to make sure the vet called the University – a good thing, since he wasn’t exactly rushing to get them on the phone. Sean yelled at him to hurry up and call them, and said that if anything happened to Teddy, he’d better hope he had a good lawyer.

We managed the drive in an hour, and arrived at the small animal clinic at Guelph. They took a short history, and then took Teddy in the back for examination.

Five minutes later, we had a NEW answer – instead of necrotic intestine, Teddy had a little bit of fat hanging out of his hernia. Instead of a dying puppy, we had a puppy who was going to be just fine. In fact, we could have had the operation done at any skilled, experienced vet clinic, by almost any experienced, skilled veterinarian. When we told the veterinary surgeons at Guelph that our first vet had insisted that it was in Teddy’s ‘best interest’ to put him down, they were shocked. Even if it had been intestine, that fact that it was still healthy and pink, and that Teddy was alert and playful, should have been a sign that it wasn’t necrotic – and fixing it was still a relatively simple operation.

It’s this sort of blatant veterinary incompetence that scares me when it’s time to send my puppies home. What pet owner, with no experience, would have known enough to ignore a vet telling them to euthanize a puppy ‘for its own good’? Would a novice breeder know enough to be able to decide that their puppy was not even CLOSE to being sick enough to put down?

If I’d listened to him, instead of stubbornly insisting he was wrong, Teddy would be dead now.

French Bulldog Umbilical Hernia Repair

Teddy's umbilical hernia repair

Teddy is back home now – none the worse for the wear, and with his hernia fixed. We’ll be filing a complaint with the OVMA, and I won’t rest until the original vet is, at the very least censured.

If I have my way, he’ll be suspended.

More photos of Teddy, just home from the University, are here –