The weekend of September 8th, we went camping at the Mt. Baker National Forest. It was a short, two-hour drive to get there. Upon arrival at a campsite, I usually put the dogs in the travel trailer for a few minutes while we get their pen set up; and  I was surprised to see that one of them had peed on the floor by the time I let them out. As the weekend progressed, I could tell that at least one of the dogs was drinking and peeing a lot; but I wasn’t certain which one. The urine in the pen smelled like infection – I have a nose for it…

But the dogs had a rowdy time, swimming in the cold river and going hiking in the woods. So, whomever was having a problem obviously wasn’t feeling too bad. The following Friday I had a vet appointment for Maggie, for a chiropractic adjustment from the holistic vet. I decided to wait ‘til then and have both of them urine-sampled for a bladder infection. The evening before that appointment, Gene picked at her dinner and seemed a little droopy, so I wondered if she was feeling off. Neither dog had a fever, however.

The vet did both urine tests, which came up inconclusive, other than noting both of them had dilute urine. While I was in the office, Gene peed on the floor (!); so we decided she was the one with the problem, and ran a blood test on her. It was also inconclusive, showing slightly-off kidney numbers and small white blood cell elevation, but nothing alarming. We decided to treat her with antibiotics as a precaution, thinking maybe it was a kidney infection. Her appetite came around, and she was feeling fine after that, so I assumed whatever was going on had resolved.

Recurrence

Fast forward to three weeks later, on Thursday morning, I noticed she was licking her back-end a lot. Her vulva seemed swollen. She’d just been in heat in August, so I wondered, could this be a split heat? But pyometra (uterine infection) also came to mind. She seemed to feel fine, so I resolved to scrutinize her after work. When I got home, I noticed right away her ears were droopy, and she  just had that “sick” look about her. I don’t know what it is, but animals  (and people) seem to instantly lose weight and look scruffy when they are ill (maybe it’s from dehydration?). I checked her vulva and saw huge swelling, and massive brownish-red pus exuding forth. Her muzzle was covered with staining, from licking the discharge all day. Arg, most definitely pyometra!

I quickly fed the sheep and hustled her to the emergency vet, fortunately only five minutes away. Pyometra is known to be very dangerous, and usually calls for immediate spay surgery. The risk of letting it linger is that the uterine wall can deteriorate, leaking bacteria into the abdomen, causing peritonitis (similar to the concerns of appendicitis in people). On the drive in, I pondered how much this might cost to do a spay in the middle of the night and if I had a limit… Gene was thrilled to be at that nice veterinarian place, where the staff patronize her with compliments and attention and treats. She wagged her tail and solicited petting from anyone who made eye contact. So clearly she didn’t feel too bad, despite having a raging infection.

Plan B

It was a long wait, but the vet confirmed this was definitely pyo. We weighed the options: his recommendation was surgery asap. Interestingly, he acknowledged that vets are now split about 50/50 on whether emergency surgery is the right option. Some choose to just treat with heavy antibiotics, and possibly spay later when the uterus is more stable. Immediate surgery overcomes the risk of the uterus rupturing into the abdomen, but that doesn’t always happen. The downside is that it increases risk of introducing bacteria into the abdomen as the uterine tissue is cut out. So, tough to choose!

He figured they’d charge $3-5K to do surgery that night: he said it would require shutting the clinic down to get enough staff to pull it off. We agreed to load her up on pain killers, antibiotics and fluids, and I’d find someplace to do the spay Friday morning. He wanted to do an x-ray and ultrasound, but I got him to admit we were already 99% sure what it was, and those diagnostics likely wouldn’t tell us anything new. In my three-hour wait in the lobby, I joked with the other emergency suckers that they should serve martinis, to make the expense seem less painful! The bill for that cursory exam, plus the drugs, was $560 (on top of about $550 I’d spend a month ago on the misdiagnosis!). Yay.

Decisions, Decisions

At 7am Friday morning, I left a slew of messages on all local vet voice mails, figuring they’d all start calling me back as they opened, and I’d just go with whomever called first and said they could take her. A huge, board-certified-surgeon place responded they could get her into surgery the moment I arrived, but they were non-committal on the price, whether it would be “daytime price” or “emergency price.” Soon after, the same clinic that saw her at night said they could fit her in (oddly, the day and night people are separate there, so the night people couldn’t tell me if the day people had an opening…). Two other clinics implied I’d be lucky to find anyone who could do surgery on such short notice on a Friday. I hesitated, wondering if I should wait until I heard back from a few more. But I worried I’d lose my chance, so I went with the big clinic close by.

While I was dropping her off, a spay-neuter clinic left a message that they could also fit her in. Darn that I missed it, as they are much cheaper; and I love the small incisions and quick turnaround of spay-neuter operations. Since that’s all they do day after day, their skill and speed is unrivalled, IMO. But Gene was already in the back getting IV fluids and drugs; so it seemed to late to switch gears. Big Vet made me sign a paper confirming I’d been given a written estimate, then after I signed, apologized saying they didn’t have it and would have to call later with a quote. Whatever, I thought, you already know you have me over a barrel. Two hours later I called them, and the most they could tell me was it would likely be $1200. I called Spay-Neuter guy just to see if I could still change my mind: nope, his morning surgeries were already done. But he would have only charged $300-500, which is closer to the price of a routine spay. Dang!

Night of Unquiet

Big Vet ended up not being able to get to the surgery until after 4pm. He called beforehand with the dire comment of, boy, she’s one sick puppy, isn’t she? It didn’t really seem helpful at the time, since it was what it was: we’d missed the diagnosis before (and duh, both I and the vet should have triggered that frequent urination 6 weeks after a heat cycle is an obvious sign of pyo). But here we were, all we could do was go forward with the plan; why lament her odds and how long this infection had now been present? Besides, she didn’t seem to be feeling too bad when I dropped her off in the morning, she had been jumping on the cat at home. I reminded myself, my dogs are robust and healthy, they eat an amazing diet. Gene’s only been mildly sick one other time in her eight-year life and didn’t require treatment. She’ll probably going to pull through fine. What does this guy know?

In fact, the reality that she was only barely off her game with such a big infection is indeed  testament to her good health, and probably her diet. Most bitches are completely taken out by pyometra, and by this time, Gene had likely been weathering the infection for five weeks or more. Granted, the earlier antibiotics probably knocked back the disease, but still, she is one vigorous dog! I think that’s probably what confused us before, was that she didn’t act sick enough for pyometra.

It’s disappointing that her good health didn’t prevent the infection altogether. But I learned many years ago that dogs are unique mammals in that they lack the hormone which tells the body that its pregnant. So, unfortunately, the domestic canine uterus goes through the motions of pregnancy every heat cycle, pregnancy or not. It turns out this is why “false pregnancy” is so commonly seen in dogs. And it’s also why dogs’ uteruses literally wear out as they age, putting them at greater risk for disease. Though spaying is very unnatural, dogs are the one species where it’s probably warranted, to get this over-worked organ out of there before it causes trouble. And here it is, causing trouble; making me wish I would have spayed Gene before such crisis could occur.

The vet reported that the surgery went well, although her uterus was indeed filled with pus. He insisted on keeping Gene overnight. I hate that. I always figure animals are less stressed recovering at home. And I’ve interacted enough with the night shifts to know that they are usually staffed with rookie college grads with piles of book knowledge and little practical experience. Often there is enough chaos that they probably aren’t always watching the dogs in cages. Not to mention, it’s just extra cost.

I debated with the vet on this: explaining that I’m an experienced handler, I know my dogs well, and I’m five minutes away if something goes wrong. He countered that they could tell things I couldn’t (fair enough: but only if they are looking…). He said it would only cost $200 more. He also admitted Gene was stressed-out upon waking up, so they had to sedate her more to calm her down (which proves my point: she wouldn’t be stressing-out coming out of anesthesia in her familiar home environment versus in a stack of caged pets). But the guy pushed, I finally gave in. I worried all night, questioning my whole series of decisions and wishing I’d been more firm in my convictions.

All’s Well That Ends Well…

They called at 8am to say she was looking good and ready to go. I went to retrieve her immediately. The bill ended up being $884, and they didn’t explicitly charge me for the night boarding. (Maybe they sensed I was kibitzing with my dog show friends on Facebook all night about the price…) Her incision is pretty big, but maybe they have to make them longer when they are being really careful to extract the uterus without letting it tear and spill into the gut. I put the obligatory cone on her, which naturally made her insist she couldn’t walk and act miserable. A friend of mine on FB suggested making a “onesie” out of a t-shirt, something she’d done before with good luck. It was a great idea, I safety-pinned it up so Gene can’t lick her incision; but now she can go out the dog door, and still potty on her own since the back of the shirt is open.

And so, it turned out ok. There is still a small risk that the uterine “stump” could develop infection; but Gene is loaded up on double-antibiotics, anti-inflammatories, and pain killers. So she is likely out of the woods.

Missed Glory Day at Work

An ironic side note is that at my day job, one of my chief responsibilities is to usher the R&D organization through the Capability Model Maturity Integration (CMMi). Friday morning at 7:30am we had a video conference meeting with our appraisers to get the results of our last appraisal for level two; which I had anticipated we’d achieve. Thursday night, I concluded there was no way I’d be making this meeting, as I’d need to be finding a vet during that hour. So I sent some apology emails at midnight, knowing others would cover for me.

I went into work after I dropped Gene off, to find out yes, we had indeed gotten the certification. Everyone was saying Congratulations! to me in the halls, and I saw my email inbox was flooded with accolades from all over the organization and up the CEO chain. I was so tired and bleary-eyed it was hard to act excited. I took my laptop home and worked from there the rest of the day. What are the odds that rare time I’d have a veterinary emergency would be such an important day? Oh well! My colleagues understood and many had their own tales of dog emergencies. And, maybe for the achievement I’ll get a bonus equal to the vet bill!?! Open-mouthed smile

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