What Lynx said, exactly.
Bodies are complicated, and bodies are inconsistent. It would be SO much easier if bodies were like, say, cars -- a good mechanic can fix them, because they are made of metal and plastic and oil, and it's well known how they work.
But when you love living beings, it's not so easy, nor simple.
Sambucus - chronic sneezing mystery?
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LS in AK
- Upside-down & Backwards
So, after three and a half weeks without any word, I had horrible visions of my little boy's body moldering, forgotten, in some refrigerator up on campus and called the clinic for an update on his necropsy. Turns out he's been cremated and his ashes have been sitting in a box shoved, forgotten, in the back of a drawer at the clinic. Nice :/
Still no word on the necropsy results, either. I left a message for the vet, but have not heard back. Will probably have to track her down when I go pick up Sambucus's ashes when it warms up early next week, as it is still -22F today and I am feeling like too much of a wimp after a week of -40 temps. to go wait for the bus and run errands.
ETA, just checked my messages, and vet did call back (shame on me for not checking my phone before posting!) Copy of the necropsy is in the mail, so should get that sometime next week.
Apparently, they found a liver torsion/infection in my little boy. Never heard of this, so I will be trying to track Dr. D down for more info. on what was going on, and maybe how we could have detected/treated this. Will post when I know more.
Still no word on the necropsy results, either. I left a message for the vet, but have not heard back. Will probably have to track her down when I go pick up Sambucus's ashes when it warms up early next week, as it is still -22F today and I am feeling like too much of a wimp after a week of -40 temps. to go wait for the bus and run errands.
ETA, just checked my messages, and vet did call back (shame on me for not checking my phone before posting!) Copy of the necropsy is in the mail, so should get that sometime next week.
Apparently, they found a liver torsion/infection in my little boy. Never heard of this, so I will be trying to track Dr. D down for more info. on what was going on, and maybe how we could have detected/treated this. Will post when I know more.
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LS in AK
- Upside-down & Backwards
Called the clinic to leave a follow-up request, and looks like Dr. D will be back in on Monday. Hopefully, I'll be able to talk to her then. If anyone has any input on questions I should ask regarding detection, prognosis, treatment or anything else related to Sambucus' liver problems (even though he was not a candidate for treatment by the end), please let me know by Monday. Thanks.
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Talishan
- You can quote me
And not forgotten by any of us, either. I'm sure you'll feel a lot better when you have his little box in your possession.
Ditto Lynx -- I've heard of stomach/abdominal torsion but not liver. Liver infection -- question one, would it respond to antibiotics (at least any of the safe ones we can use on guinea pigs), and two, how would it be diagnosed? Bloodwork? Any other diagnostic that could be used?
Ditto Lynx -- I've heard of stomach/abdominal torsion but not liver. Liver infection -- question one, would it respond to antibiotics (at least any of the safe ones we can use on guinea pigs), and two, how would it be diagnosed? Bloodwork? Any other diagnostic that could be used?
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LS in AK
- Upside-down & Backwards
Thanks for the responses, Lynx and Talishan. Will add those questions to my list.
I was surprised to hear that his liver was messed up. I am wondering whether the torsion could have been a congenital problem? Or if I screwed up his care somewhere, and it was secondary to or a complication of something else? Dr. D did not mention any other significant findings in the phone message, but did invite me to call her back to talk about it. A copy of the necropsy is in the mail, so I can look at that when it arrives, too.
I am kinda glad they found something major, because Sambucus was definitely a very sick little boy between mid-October and the end of his life, but I am anxious to know what it all means.
Asked the Google gods for help this afternoon, and found some abstracts for a few promising papers I should be able to access through the university library. Liver torsion was mentioned in several of them, but only in rabbits, where it was described as a blockage requiring immediate surgery (remove the affected lobe) and was linked to symptoms of GI stasis and severe abdominal pain.
Sambucus did struggle with intermittent stasis/pain during November and December, but I thought that was due to the recurring bloat (which I thought was due to the ABs he was on, as well as a newfound sensitivity to veggies) and then the return of the cystitis/stones, as his symptoms were consistent with the initial bout of cystitis/stones. If we had not found and removed that first set of stones, I would probably be wondering right now whether that was ever part of the problem. If he had both cystitis/stones and this liver thing at the end, it would explain the rapid weight loss and incredible levels of pain.
Baytril was mentioned in one of the PubMed abstracts for treatment of a liver infection. Bloodwork was mentioned in detecting elevated levels of liver enzymes, and an ultrasound was supposed to show a liver torsion, but I am not sure how. I have some reading to do. Hope to have some good citations soon.
Will run all this by Dr. D after I get her input.
I was surprised to hear that his liver was messed up. I am wondering whether the torsion could have been a congenital problem? Or if I screwed up his care somewhere, and it was secondary to or a complication of something else? Dr. D did not mention any other significant findings in the phone message, but did invite me to call her back to talk about it. A copy of the necropsy is in the mail, so I can look at that when it arrives, too.
I am kinda glad they found something major, because Sambucus was definitely a very sick little boy between mid-October and the end of his life, but I am anxious to know what it all means.
Asked the Google gods for help this afternoon, and found some abstracts for a few promising papers I should be able to access through the university library. Liver torsion was mentioned in several of them, but only in rabbits, where it was described as a blockage requiring immediate surgery (remove the affected lobe) and was linked to symptoms of GI stasis and severe abdominal pain.
Sambucus did struggle with intermittent stasis/pain during November and December, but I thought that was due to the recurring bloat (which I thought was due to the ABs he was on, as well as a newfound sensitivity to veggies) and then the return of the cystitis/stones, as his symptoms were consistent with the initial bout of cystitis/stones. If we had not found and removed that first set of stones, I would probably be wondering right now whether that was ever part of the problem. If he had both cystitis/stones and this liver thing at the end, it would explain the rapid weight loss and incredible levels of pain.
Baytril was mentioned in one of the PubMed abstracts for treatment of a liver infection. Bloodwork was mentioned in detecting elevated levels of liver enzymes, and an ultrasound was supposed to show a liver torsion, but I am not sure how. I have some reading to do. Hope to have some good citations soon.
Will run all this by Dr. D after I get her input.
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LS in AK
- Upside-down & Backwards
A Dooper update, for those interested in his liver issues.
Spoke with the wonderful Dr. D a few weeks ago (who was kind enough to call me from home after hours to answer my questions!) and she gave permission to post her comments from our conversation here.
Also received a copy of Sambucus' necropsy results in the mail same day. The pathology report confirmed cystitis along with 3 new bladder stones, each 4 mm in diameter. Everything else was judged normal -- except for Dooper's liver. One of the lobes was indeed found to be twisted, attached to the rest of the organ by a "thin fibrous strand." This lobe was also necrotic.
This necrosis, according to Dr. D, was the likely source of a systemic infection (sepsis) and gradual liver failure that would have eventually ended Sambucus' life even if he had not developed the new set of bladder stones. The liver torsion and necrosis also explained his rapidly deteriorating body condition and incredibly high levels of pain at the end of his life. In short, he was dying a slow, painful death -- until we mercifully cut it short.
When the liver lobe twisted, likely in response to Sambucus' first bloat episode back in October, when we discovered his first 2 stones, the tissue began to die, which led to probable organ compromise. Also, a lack of normal blood supply to that lobe caused toxins to be secreted into his system.
In order to treat the systemic infection, the source of it (the necrotic lobe) would have needed to be identified and removed. Dr. D mentioned she could have checked his liver during his cystotomy at the end of October, but neither of us suspected a problem of that nature compounding his existing bloat/sludge/stone issues.
The difficulty with detecting liver problems such as a torsion? Because the stomach and large intestines are in the way, the liver does not usually resolve well on ultrasound. Another option would be to do an MRI, but that would require advanced imaging equipment, and may be cost prohibitive.
For example, had we an idea of what we were looking for, we could have arranged with the local hospital for an MRI, but animals must be sedated for the scan. And, cost? $1000.
Other diagnostics, such as bloodwork, would check for elevated liver enzymes and white blood cell count, but that would not likely prove conclusive. While the liver is a resilient organ - it can apparently regenerate if problems are found and corrected early enough - it can be very hard to diagnose and treat when something goes wrong with it.
According to Dr. D, liver torsions are usually found upon necropsy. This was the first case she has ever seen in a small animal. Even if we had found the torsion via imaging diagnostics, she said prognosis would have been questionable, as she was uncertain of the best way to perform the lobectomy on a small animal. And Sambucus would have needed to be in much better body condition to undergo such a risky surgery.
In summary:
- Liver lobe torsion occurred as a suspected complication of bloat.
- Problem did not show up on x-ray or ultrasound. Bloodwork would have likely been inconclusive.
- Problem would have required risky, emergency surgery to correct.
- Euthanasia would have likely been recommended, even without compounding factors such as continuing bloat, stones, and cystitis as Sambucus had.
So, na-nite to my little boy. I am very glad now that I did not wait another day in hopes he would improve only to prolong his pain. Not only did he give me nearly 3 years of priceless companionship, but he will now serve to educate future veterinarians as part of the university's histopathology sample collection.
And his box of ashes is lying now on top of Crocus' box of ashes, because lying on his lady love is where he always wanted to be :)
Spoke with the wonderful Dr. D a few weeks ago (who was kind enough to call me from home after hours to answer my questions!) and she gave permission to post her comments from our conversation here.
Also received a copy of Sambucus' necropsy results in the mail same day. The pathology report confirmed cystitis along with 3 new bladder stones, each 4 mm in diameter. Everything else was judged normal -- except for Dooper's liver. One of the lobes was indeed found to be twisted, attached to the rest of the organ by a "thin fibrous strand." This lobe was also necrotic.
This necrosis, according to Dr. D, was the likely source of a systemic infection (sepsis) and gradual liver failure that would have eventually ended Sambucus' life even if he had not developed the new set of bladder stones. The liver torsion and necrosis also explained his rapidly deteriorating body condition and incredibly high levels of pain at the end of his life. In short, he was dying a slow, painful death -- until we mercifully cut it short.
When the liver lobe twisted, likely in response to Sambucus' first bloat episode back in October, when we discovered his first 2 stones, the tissue began to die, which led to probable organ compromise. Also, a lack of normal blood supply to that lobe caused toxins to be secreted into his system.
In order to treat the systemic infection, the source of it (the necrotic lobe) would have needed to be identified and removed. Dr. D mentioned she could have checked his liver during his cystotomy at the end of October, but neither of us suspected a problem of that nature compounding his existing bloat/sludge/stone issues.
The difficulty with detecting liver problems such as a torsion? Because the stomach and large intestines are in the way, the liver does not usually resolve well on ultrasound. Another option would be to do an MRI, but that would require advanced imaging equipment, and may be cost prohibitive.
For example, had we an idea of what we were looking for, we could have arranged with the local hospital for an MRI, but animals must be sedated for the scan. And, cost? $1000.
Other diagnostics, such as bloodwork, would check for elevated liver enzymes and white blood cell count, but that would not likely prove conclusive. While the liver is a resilient organ - it can apparently regenerate if problems are found and corrected early enough - it can be very hard to diagnose and treat when something goes wrong with it.
According to Dr. D, liver torsions are usually found upon necropsy. This was the first case she has ever seen in a small animal. Even if we had found the torsion via imaging diagnostics, she said prognosis would have been questionable, as she was uncertain of the best way to perform the lobectomy on a small animal. And Sambucus would have needed to be in much better body condition to undergo such a risky surgery.
In summary:
- Liver lobe torsion occurred as a suspected complication of bloat.
- Problem did not show up on x-ray or ultrasound. Bloodwork would have likely been inconclusive.
- Problem would have required risky, emergency surgery to correct.
- Euthanasia would have likely been recommended, even without compounding factors such as continuing bloat, stones, and cystitis as Sambucus had.
So, na-nite to my little boy. I am very glad now that I did not wait another day in hopes he would improve only to prolong his pain. Not only did he give me nearly 3 years of priceless companionship, but he will now serve to educate future veterinarians as part of the university's histopathology sample collection.
And his box of ashes is lying now on top of Crocus' box of ashes, because lying on his lady love is where he always wanted to be :)
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Lynx
- Celebrate!!!
Poor guy. It sounds like there really was little that could have been done - and even diagnosing would have have been just about impossible.
I don't know if you have the time to do a Records forum summary of this, but it might help people realize that this can happen and can, it seems, be an unusual complication of bloat.
I don't know if you have the time to do a Records forum summary of this, but it might help people realize that this can happen and can, it seems, be an unusual complication of bloat.
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LS in AK
- Upside-down & Backwards
Thanks, Lynx and Talishan. I actually suspect liver torsions may be more common than anyone may think at this point, considering mortality is not uncommon with bloat. Problem may lie in the fact that very few necropsies are performed afterward to check for these types of complications. Dr. D did mention during our phone conversation that this case was a good example of why necropsies are actually very important. I got lucky that the university was looking for specimens to examine and take tissue samples from for the new DVM program, and faculty were doing necropsies for free.
Writing up a summary for the records forum is definitely on my to-do list. It may just take me awhile to get around to it, as I have a heavy work load this semester. But, when I do, any suggestions on where should it go? We were dealing with simultaneous respiratory issues, sludge, stones, and bloat along with this liver thing.
Writing up a summary for the records forum is definitely on my to-do list. It may just take me awhile to get around to it, as I have a heavy work load this semester. But, when I do, any suggestions on where should it go? We were dealing with simultaneous respiratory issues, sludge, stones, and bloat along with this liver thing.
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Lynx
- Celebrate!!!
What you could do is a descriptive title, pick the best forum, and put links to the thread in related forums (there's a trick to doing this but I'm sure we can figure it out - I think it has to do with moving a thread out of one forum into another and leaving a link to the original post - might mean you have to move it to multiple forums to collect all the links to point to the actual thread).
SHOP AMAZON