DEXTER DID GREAT!! He is just coming out of anesthesia. I will make a more detailed post about the procedure in a few hours (because I’m still at work!) However, I just had a great talk with Dr. Eshelman (the surgeon from Alpenglow who did the procedure). But there are still some questions about exactly how he is recovering for the next 24hrs due to the paralyzing effect of the epidural that he received. For example, we have to see if he can urinate on his own later tonight, but if he can’t then they will use a urinary catheter to alleviate the problem. The good news is that the abdominal procedure and repairing of the herniated muscle on his right side seemed to do so much for him that the rectal exams seemed to indicate his left side didn’t actually need the same kind of surgery! So he had less surgery than they were originally thinking, but of course there’s still some risk; until he recovers from the medicine they don’t know if his sciatic nerve may have been affected which would give him functional problems in his foot. “It’s very rare, but it is possible,” as the doctor said. In any case, I will have one more update from Dr Collins (at LFAH who can give me more details and information on cost, etc), and I’ll do my best to write the specific muscle names and such so that way the information is shared. Thank you everyone!! I will keep updating at each step of the way! I love you all!
surgery
Surgery day pt1
Today is the day. I left Dexter at the vet’s office this morning and am now waiting to hear how he did in surgery. My nerves are fried!!!
He wasn’t too pleased to be at the vet’s this morning, no surprise. Here’s a pic of him in the crate and I’ll update with more detail when I know more information. Thank you everyone for your support!
Updated Goal and $3k reached!
The good news is that LFAH has hung up a flyer for SaveDexter.com and will be sharing on their facebook page! Yay! The bad news is that the final estimate for Dexter (including the neuter procedure and the blood work) has required me to raise the goal by $800. 🙁 I’m trying not to be discouraged, but honestly, if this issue with Squall had not just happened, I could have totally absorbed that $800 cost. Instead, I am paying back about $1800 over the next month just for Squall and it will be so challenging I may end up paying a few bills late in order to make it… (I should also note that the prescription diet Squall requires and the canned food that generally agrees with Dexter are not as cheap as they could be, despite my efforts to shop around when things are on sale.) The range for Dexter is $3,753-$4,792 and there’s no way for them to know where he’ll come in until the surgery happens.
If for some reason it’s lower rather than higher I will be able to use any remaining donation money toward paying off Squall’s procedure. Right now, it looks like I will be able to get Dexter’s surgery before I am caught up from that! This is good, because there’s still no guarantee how long Dexter will be ‘okay’. Every day that he has to try and go to the bathroom without this surgery is another risk of further injuring his herniated muscles (since he has to strain to go – even when it’s very soft, he still has to strain past the kinked up rectum area). I can visibly see his distorted rear end when he is trying to go 🙁
I’m trying not to be discouraged, though, since we just crossed the $3k mark! This is awesome!! I have gotten a few different messages with donations about other people having long haired miniature dachshunds (or just dachshunds in general!) and so I KNOW that your sharing HELPS!! Thank you again!!
UPDATE: New goal from updated vet visit
So, you may have noticed I REDUCED my goal to $4000! This is because I finally met with Dr. Collins again and he confirmed that they could provide me a discount compared to Alpenglow. The surgeon will come to their office and perform the procedure. So basically, Louisville Family Animal Hospital is the best vet I have ever been to in the 4 states I’ve lived in by FAAAR.
The bad news is that today I had an emergency with my cat, Squall. He has a urinary tract obstruction and, once again being awesome, LFAH will let me split the bill into a couple of payments, as he needs to be hospitalized, unblocked, monitored, on fluids, etc. for as long as possibly Saturday morning. This is HEARTWRENCHING for me as I now will be totally tapped out with contributing my own extra income to Dexter’s surgery. What kind of timing is this?!?! On the other hand, I’m just relieved beyond measure that I was provided that option today, and did not have to say goodbye to Squall just yet.
Thanks again to everyone for donating, please please keep sharing and if you come across $5 laying around, well… Ugh I hate asking for help! It’s so hard. Thanks again. Here is a picture of Dexter and Squall
Surgery Breakdown
The surgery is so expensive because for Dexter to have his best shot at recovery, it requires more than one procedure. I should note that I’m by no means an expert, but I will explain everything as it was explained to me, and hopefully answer a few questions about what is the plan.
The bruise was so severe that it separated his muscle and skin tissue, which allowed fluid to build up. That’s why his pre-surgery picture is so horribly swollen. The first procedure to reattach the tissue was to make two incisions on either side of his rectum and suture the muscle and tissue back together. He then had some drains inserted before being stapled up, to allow any excess fluid to be released. He didn’t really drain too much at this point, and they were removed within 7-10 days. The staples remained in for much longer. However, the tissue did not fully reattach. Since Dexter keeps having to engage the muscles whenever he goes to the bathroom, they did not herniate worse than before, but they did not fully heal.
This procedure he already had is what Dr. Eshelman of Alpenglow Veterinary Specialty and Emergency Center (where Dr. Collins referred me, in Boulder) described as basically step 1 of 3 options for dogs that have these perineal hernias. Step 2 is what he would like to do now, whereas step 3 requires a more extensive muscle graft, I won’t be trying to explain that here. Though I don’t know the name of this 2nd-level procedure, it is basically folding a muscle up and suturing it in place, sort of doubling up on the muscle that is in the perineal region. There should be NO loss of function or mobility from doing this, but it is more advanced procedure. I’ll update this post if I can clarify the name and terminology! It IS a standard procedure for dogs with this issue.
The second part of the reconstructive process is to give his “kinked up”, diverted rectum a chance to be normal again. The easiest way to describe this problem is basically that his poop doesn’t have a straight path to exit his body. There’s a small bend in the path, where it can accumulate or even get stuck, which is making his injured muscles struggle even more. Dr. Eshelman basically said that this isn’t totally uncommon when the hernias happen, because the dog is still straining to go to the bathroom, and sometimes in severe cases the contents of the abdomen even get shifted down into the rear end and require a lot of organs to be moved back into place.
Luckily, Dexter isn’t quite that bad. However, they do need to move his colon and bladder up inside his abdomen and ‘straighten out’ the kinked up problem he has now.
These two things put together will mean that Dexter can have the strength return to his body to go normally again, and also that no more feces can get stuck and built up inside his body.
Finally, the last procedure on the surgery list is to have him neutered. Statistically, intact male dogs have the worst recovery chance after this procedure. Dr. Eshelman said it was thought to be a combination of testosterone levels, colon size, and other various factors, but it isn’t completely understood why this is the case. However, the neuter is not expensive by itself and so I see no reason not to give Dexter his best shot.
Some surgery items have a price range in case something goes wrong or takes longer than expected. Below is a copy from the printed estimate I received.
Echo with consultation (The visit, plus the required cardiac checkup to make sure his heart is ready for a long anesthetized period) $497
Met Check (3 views) (An optional step to check out his lungs for pre-cancer signs, which IS optional). $0-247.75
Chem 27 w/CBC IDEXX (Blood work required before surgery, standard) $205.58
Nursing Care – Level 2 $32.91
Intensive Care – Level 2 $82.69
Fluid Administration – Additional Liters $36.09
Fluid Administration – 1st Liter $77.24
Overnight Hospitalization (1-2) – $173.18-346.36
Catheter-IV placement $66.13
Diazepam ML (2-5) $36.77-38.20
Hydomorphone ML $36.77
CRI set up $38.67
Fentanyl ML $36.77
Propofol Injection – MG (75-150) $38.60
Epidural administration $117.36
Anesthesia Monitoring & Equipment Use $298.60
Isoflurane First Hour $176.04
Isoflurane Additional Hour (0.5-1) $58.68-117.36
Cefazolin injection – MG $38.60
Cefazolin additional inj – MG (0.5-1) $0-27.25
Fluid Pump $18.09
Syringe Pump $18.09
Miscellaneous Anesthesia $50-100
Replacement Line/Ext $17.99
Laparotomy (The actual incision into his abdomen) $366.09
Perineal Hernia (The actual surgery on both sides of his rear end) $922.30
Orchidectomy – Neuter $223.91-410
Cystopexy (The surgery to move his bladder) $366.09
Colopexy (The surgery to move his colon) $366.09
Pack, Disposables, Room Use $500.31
Suture application (2-4) $34.76-69.53
Aerobic Culture and Sensitivity IDEXX (Lab test to see if he has any infection) $210.57
Miscellaneous RX (The drugs I’m sent home with) $94.18-163
Recheck Exam (The follow up 8 weeks later. The only part I don’t need up front!) $55
This donate button goes directly to my PayPal account. All funds will be used toward the surgical costs for Dexter.