Please help sick dachshund: L'il Man
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L'il Man is a sweet 9 year old dachshund who belonged to my mother. She got him as a puppy in 2003 after the sudden death of my father, and he provided much comfort to her and was a source of joy that helped her to recover from the shock of my father's passing. Unfortunately, my mother was seriously injured in an accident in 2007 and passed away from complications in 2009. I subsequently inherited L'il Man, and his older brother and sister, Shadow and Delta.
On Thursday, May 30, 2013 L'il Man suddenly went from being his normal happy and energetic self to being on the verge of death in the course of an hour. I rushed him to my veterinarian, who noted that he was running an extremely high fever. They initiated therapy to cool him down and provide IV fluids and were able to stabilize him and sent him home with me that evening. However, that night his condition deteriorated again, and I had to take him to the local emergency veterinary facility, where they kept him overnight. On Friday morning L'il Man was transferred back to my regular veterinarian where he was scanned with ultrasound, and it was determined that he was suffering from acute pancreatitis, and gallstones were also noted in his gallbladder. That evening, while at home, his condition worsened again, and I took him back to the emergency center, where he has remained since, due to concerns that he might be having bile duct complications, and has been receiving additional testing and supportive care. On Sunday afternoon, a second ultrasound indicated that the gallstones may have migrated and were causing a bile duct blockage. Overnight his bilirubin level, which was already abnormally high, and liver enzymes levels rocketed, and a follow up ultrasound indicated that he was indeed suffering from a bile duct blockage. L'il Man is now undergoing surgery to remove his gallbladder, and to determine if there are any other underlying problems.
To date, I have spent approximately $12,000 on tests, treatment, and care for L'il Man, along with the costs of the surgery today, and I am hoping to re-coup some of them, as I am currently going to graduate school full time--funding my studies completely out of pocket--and will not be working until I graduate this December and re-enter the workforce in 2014. L'il Man also faces a stay in the hospital after the surgery is finished for recovery, which will add to the costs, and I anticipate that my funding goal level will evolve. I will provide redacted (to remove account, staff, and other personal identifying information) copies of his invoices as they become available--starting with those from my regular veterinarian:
His initial visit to my regular veterinarian on 5/30/13:
His follow up visit to my regular veterinarian on 5/31/13 (please note that I have broken out L'il Man's costs in the red circle from Shadow's, who also needed to go in that day):
His initial overnight stay at the emergency center:
As they become available I will post the bills from the veterinary emergency and surgery centers.
Thank you for taking the time to read this, and I thank you again for any donation that you are able to make! If you aren't able to make a donation, I would be highly appreciative if you could share this page far and wide.
Sincerely,
James Crookston
Update, 6/3/13 at 5 PM: L'il Man made it through surgery. Both bile ducts were obstructed, and the gallbladder had stones in it as well. The surgery team was able to flush the stones from the ducts into the gallbladder, and the organ was removed successfully. L'il Man is now resting in the recovery room and seems to be doing well. Now the long term process of restoring him to the happy energetic dachshund he was prior to this incident will begin.
Update, 6/4/13 at 7:30 PM: L'il Man had a mild seizure last night, which was most likely due to hypoglycemia. His IV drip is being supplemented with glucose. The veterinarian said that his liver enzymes are showing improvement, however there may be some concern about his kidney function.
Here are some photos of him and older sister, Delta from Thursday night and Friday night, before he wound up at the emergency center for full hospitalization over the weekend.
Thursday night (5/30/13) after coming home from the regular veterinarian, and before going to the emergency center later that night. The wrap on his leg is for the IV port:
Friday night (5/31/13), shortly before he had to go back to the emergency center. The IV port had been switched to his other front leg during his stay at the regular veterinarian that afternoon. You can tell that Delta is worried about her younger brother:
Update, 6/5/13 at 9:45 AM: The veterinarian said that L'il Man's liver enzyme levels have stopped improving--still not back to normal levels--and that he continues to show no interest in food, and may have vomited during the night. He is going to have to have another internal medicine consult, and remain hospitalized for possibly another 36 hours, which is going to add to the bills. If you can please donate, I would appreciate it!
Photos of L'il Man at the emergency center on the morning of 6/5/13:
Update, 6/7/13: I spent extensive time in discussion with the surgeon who performed the gallbladder surgery discussing the results of the cultures performed on L'il Man's bile. Apparently the underlying root of all the problems is that his bile tract became infected with a species of Enterococcus (a type of bacteria that normally lives in the gut) that demonstrates much more resistance to commonly used antibiotics than normal, and the bacteria in the genus Enterococcus normally are resistant to several classes of antibiotics (please note that my educational background is in microbiology). The surgeon believes the bile duct obstruction made L'il Man susceptible to an ascending infection, where the bacteria traveled up his gut and into the biliary system.
The veterinarians have started treating him with chloramphenicol, which was the only antibiotic in the standard antibiotic test panel that the bacterial isolate from his bile showed sensitivity to, however, extended treatment with this particular antibiotic (and L'il Man may have to be on antibiotics for 6 weeks) may major risks associated with it in the form that it could trash his bone marrow. I am currently awaiting results of an extended antibiotic susceptibility test to see if there is another drug that could be used to combat the infection which has less systemic toxicity concerns. L'il Man's prognosis remains guarded, but my last conversation with the veterinarian who was on staff last night indicates that if L'il Man's bilirubin levels don't start decreasing, and he expresses interest in food (he's currently on a feeding tube) relatively soon that his prognosis will deteriorate to poor.
Update 6/7/13, 10:30 PM: The extended antibiotic susceptibility tests came back, and the Enterococcus isolate is resistant to every antibiotic tested except for chloramphenicol. The veterinarians have switched the administration of chloramphenicol back over to IV in hopes that it will get into L'il Man's system better than through the gastric route because his digestive system still isn't working properly.
Update, 6/8/13:
These may be the last photos I ever take of L'il Man. Based on discussion with the attending veterinarian when I went to visit with him this morning, none of the medications that have been administered to promote gastric motility have worked, and there is only one option left to try to get his stomach and intestines to process food. They've discontinued trying to administer nutrition and fluids through the feeding tube, and have switched back to the IV as the main means of administering his antibiotic, glucose, electrolytes, and fluids. I've authorized them to try the final option to kick start his GI tract, and if it doesn't work L'il Man is going to have to be humanely euthanized.
Update, 6/11/13: It is with a heavy heart that I have to report that the last ditch treatments were not effective, and L'il Man was humanely euthanized at 9 PM this evening. I held him in my arms during the procedure.
Thank you to everyone who has donated and/or expressed their support for me during this time.
L'il Man is a sweet 9 year old dachshund who belonged to my mother. She got him as a puppy in 2003 after the sudden death of my father, and he provided much comfort to her and was a source of joy that helped her to recover from the shock of my father's passing. Unfortunately, my mother was seriously injured in an accident in 2007 and passed away from complications in 2009. I subsequently inherited L'il Man, and his older brother and sister, Shadow and Delta.
On Thursday, May 30, 2013 L'il Man suddenly went from being his normal happy and energetic self to being on the verge of death in the course of an hour. I rushed him to my veterinarian, who noted that he was running an extremely high fever. They initiated therapy to cool him down and provide IV fluids and were able to stabilize him and sent him home with me that evening. However, that night his condition deteriorated again, and I had to take him to the local emergency veterinary facility, where they kept him overnight. On Friday morning L'il Man was transferred back to my regular veterinarian where he was scanned with ultrasound, and it was determined that he was suffering from acute pancreatitis, and gallstones were also noted in his gallbladder. That evening, while at home, his condition worsened again, and I took him back to the emergency center, where he has remained since, due to concerns that he might be having bile duct complications, and has been receiving additional testing and supportive care. On Sunday afternoon, a second ultrasound indicated that the gallstones may have migrated and were causing a bile duct blockage. Overnight his bilirubin level, which was already abnormally high, and liver enzymes levels rocketed, and a follow up ultrasound indicated that he was indeed suffering from a bile duct blockage. L'il Man is now undergoing surgery to remove his gallbladder, and to determine if there are any other underlying problems.
To date, I have spent approximately $12,000 on tests, treatment, and care for L'il Man, along with the costs of the surgery today, and I am hoping to re-coup some of them, as I am currently going to graduate school full time--funding my studies completely out of pocket--and will not be working until I graduate this December and re-enter the workforce in 2014. L'il Man also faces a stay in the hospital after the surgery is finished for recovery, which will add to the costs, and I anticipate that my funding goal level will evolve. I will provide redacted (to remove account, staff, and other personal identifying information) copies of his invoices as they become available--starting with those from my regular veterinarian:
His initial visit to my regular veterinarian on 5/30/13:
His follow up visit to my regular veterinarian on 5/31/13 (please note that I have broken out L'il Man's costs in the red circle from Shadow's, who also needed to go in that day):
His initial overnight stay at the emergency center:
As they become available I will post the bills from the veterinary emergency and surgery centers.
Thank you for taking the time to read this, and I thank you again for any donation that you are able to make! If you aren't able to make a donation, I would be highly appreciative if you could share this page far and wide.
Sincerely,
James Crookston
Update, 6/3/13 at 5 PM: L'il Man made it through surgery. Both bile ducts were obstructed, and the gallbladder had stones in it as well. The surgery team was able to flush the stones from the ducts into the gallbladder, and the organ was removed successfully. L'il Man is now resting in the recovery room and seems to be doing well. Now the long term process of restoring him to the happy energetic dachshund he was prior to this incident will begin.
Update, 6/4/13 at 7:30 PM: L'il Man had a mild seizure last night, which was most likely due to hypoglycemia. His IV drip is being supplemented with glucose. The veterinarian said that his liver enzymes are showing improvement, however there may be some concern about his kidney function.
Here are some photos of him and older sister, Delta from Thursday night and Friday night, before he wound up at the emergency center for full hospitalization over the weekend.
Thursday night (5/30/13) after coming home from the regular veterinarian, and before going to the emergency center later that night. The wrap on his leg is for the IV port:
Friday night (5/31/13), shortly before he had to go back to the emergency center. The IV port had been switched to his other front leg during his stay at the regular veterinarian that afternoon. You can tell that Delta is worried about her younger brother:
Update, 6/5/13 at 9:45 AM: The veterinarian said that L'il Man's liver enzyme levels have stopped improving--still not back to normal levels--and that he continues to show no interest in food, and may have vomited during the night. He is going to have to have another internal medicine consult, and remain hospitalized for possibly another 36 hours, which is going to add to the bills. If you can please donate, I would appreciate it!
Photos of L'il Man at the emergency center on the morning of 6/5/13:
Update, 6/7/13: I spent extensive time in discussion with the surgeon who performed the gallbladder surgery discussing the results of the cultures performed on L'il Man's bile. Apparently the underlying root of all the problems is that his bile tract became infected with a species of Enterococcus (a type of bacteria that normally lives in the gut) that demonstrates much more resistance to commonly used antibiotics than normal, and the bacteria in the genus Enterococcus normally are resistant to several classes of antibiotics (please note that my educational background is in microbiology). The surgeon believes the bile duct obstruction made L'il Man susceptible to an ascending infection, where the bacteria traveled up his gut and into the biliary system.
The veterinarians have started treating him with chloramphenicol, which was the only antibiotic in the standard antibiotic test panel that the bacterial isolate from his bile showed sensitivity to, however, extended treatment with this particular antibiotic (and L'il Man may have to be on antibiotics for 6 weeks) may major risks associated with it in the form that it could trash his bone marrow. I am currently awaiting results of an extended antibiotic susceptibility test to see if there is another drug that could be used to combat the infection which has less systemic toxicity concerns. L'il Man's prognosis remains guarded, but my last conversation with the veterinarian who was on staff last night indicates that if L'il Man's bilirubin levels don't start decreasing, and he expresses interest in food (he's currently on a feeding tube) relatively soon that his prognosis will deteriorate to poor.
Update 6/7/13, 10:30 PM: The extended antibiotic susceptibility tests came back, and the Enterococcus isolate is resistant to every antibiotic tested except for chloramphenicol. The veterinarians have switched the administration of chloramphenicol back over to IV in hopes that it will get into L'il Man's system better than through the gastric route because his digestive system still isn't working properly.
Update, 6/8/13:
These may be the last photos I ever take of L'il Man. Based on discussion with the attending veterinarian when I went to visit with him this morning, none of the medications that have been administered to promote gastric motility have worked, and there is only one option left to try to get his stomach and intestines to process food. They've discontinued trying to administer nutrition and fluids through the feeding tube, and have switched back to the IV as the main means of administering his antibiotic, glucose, electrolytes, and fluids. I've authorized them to try the final option to kick start his GI tract, and if it doesn't work L'il Man is going to have to be humanely euthanized.
Update, 6/11/13: It is with a heavy heart that I have to report that the last ditch treatments were not effective, and L'il Man was humanely euthanized at 9 PM this evening. I held him in my arms during the procedure.
Thank you to everyone who has donated and/or expressed their support for me during this time.
Organizer
James Crookston
Organizer
