Sire: Ch Sunstrike Romeo | Dam: Ch Affaire's Taken By Storm v Blanton |
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Vienna died of pneumonia so virulent that her lungs completely failed. The sequence of events is documented here for informational purposes. Hopefully, this information may help save another Dane. 7/16/12 Monday Returned home from the San Antonio shows last night. I had to go immediately to Miami for 3 days due to work commitments, so Vienna was left in the care of a close friend with two dogs who we had also travelled with to the San Antonio shows. The friend called me and said she heard Vienna cough a couple of times and produce a small amount of clear mucous. She was taken to my regular vet the next day and we surmised it was probably a kennel cough picked up from the shows. We had been to the Dallas shows the weekend previous to the San Antonio shows, so it was no surprise to anyone. Her lungs were clear, she had no fever, her appetite and energy levels were all normal - all symptoms were from the neck up - possibly even allergies. She was sent home on cough suppressants and all the dogs were isolated to prevent spread of possible kennel cough. When I came home on the third day, she was very depressed "out of it". It was obvious the narcotic cough suppressant was making her way too groggy and lethargic, so I took her off it and she rebounded immediately. She would have a moist sounding cough 2-3 times daily and that was all; appetite and energy levels were normal. I pulled her from the Reliant Series of Dog Shows just in case. Friday - all is normal and she's bouncing around all over the place. I'm thinking whatever she had is finished and maybe if she continues I'll take her to the show on Sunday after all if she's asymptomatic still on Saturday. Unfortunately, my friend's dogs who were with us both of the previous weekends are now coughing, which confirms our supposition that there is just kennel cough being passed around at the shows. Her dogs were mildly sick one day and then felt fine afterwards but had a slight lingering cough - again the 2-3 times daily kind and not the typical constantly hacking kennel cough. * This paragraph is just for background information - this previous week probably had nothing to do the sequence of events starting on Sunday* 7/22/12 Sunday - Vienna wouldn't eat all her breakfast. NOT normal for this chow hound. She had eaten her dinner the night before, albeit slower than normal. She was somewhat lethargic during the afternoon and wanted to go outside and sun herself. She seemed to be breathing slightly harder than normal and her moist-sounding cough was back. I resolved to take her back to her regular vet in the morning. I was concerned, but not overly since her lungs had been clear earlier in the week and we were still thinking it was a mild kennel cough going around. By that night, she had spiked a 104.5 temp and was breathing heavily. I took her to the emergency clinic but they couldn't take her in and would not let me leave her or wait for an appt because the vet was going in for a long emergency surgery. I took her home and waited the few hours remaining until she could go to her regular vet when they opened. 7/23/12 morning Her regular vet, Dr. Fix, examined her, took a chest x-ray and called me to take her immediately to the ICU at Gulf Coast Veterinary Specialists (GCVS) in their Critical Care clinic. He started her on an IV, IV antibiotics, and placed a nasal canula to start her on oxygen. Upon admission to GCVS, her temp had gone up to 106 and she was very hypoxic. Her pulse ox was in the 80s. Diagnosis - bacterial pneumonia. I was told Vienna would need to be on oxygen for at least 3 days in critical care and I had to sign a DNR (do not resuscitate order). OMG They were astonished she had been able to walk in unaided, which I attributed to both her desire to please me, tremendous physical conditioning, and her will to live. 7/23/12 later morning These are the antibiotics she is being given: Amoxi, baytril, augmentin, and something else, I forget what it is. All are injectable. They placed another nasal canula to give her oxygen in both nostrils and placed a soft cone on her because she was trying to paw them out. 7/23/12 afternoon Temp is 103 now, pulse ox is 98/99 so that is looking better. However, her WBC (white blood cell count) is almost nil. Hopefully this is due to fighting infection in her lungs, but she is in sepsis. The next few hours are even more critical and they keep preparing me for the worst. :-( Vienna is exhausted but can't rest because she has to work at breathing so hard. They are going to call me tonight if she deteriorates further. 7/24/12 morning Vienna made it through the night and her temperature is normal. She is still struggling to breathe however and can't be off oxygen at all. They are going to run a respiratory panel of bloodwork to see if there is any viral component to her pneumonia. If she stabilizes they will do a lung wash to collect material from her lungs so it can be cultured and xrays again tomorrow. Small improvements. 7/24/12 afternoon She is still in very critical condition but the infection is getting better. The pneumonia is not, however. She sounds even worse. Turn your volume up when you play the video in the link at the bottom of the page and you can hear what a struggle it is for her. They are hoping that she sounds worse because some of the mucous is being dispersed - moving up and clogging her airway on the way out - but it's just speculation until they xray her lungs again tomorrow and see if it that is the case of it they are filling up with even more fluid. She hasn't eaten anything at all since Sunday morning, but she was thirsty today and took some water I offered her. They gave her morphine while I was there to help keep her calm so she wouldn't panic because of the lack of oxygen. It's all hard to take right now. 7/25/12 8 am. The Dr. called and told me Vienna had taken a big turn for the worse this morning at about 6. She is having even more difficulty breathing and although she is on full oxygen, her pulse oximeter is below 90, which is terrible - a normal dog/person breathing that much straight oxygen would be at nearly 200%. It was 99 yesterday. They are doing coupage (basically beating on her chest to try to move fluid/mucous) and are going to xray now. They are going to change/add antibiotics if the pneumonia is getting worse rather than this being a mucous plug obstructing her airways. If the pneumonia is worse, she would have to go on a ventilator to have any chance at all of recovery. If that happens they would be able to do a lung wash to culture the lung material, but that would also significantly lower her chance of any recovery below what it already is. There is no way to physically remove the fluid in her lungs- I asked. She said the fluid is in her airways and can't be aspirated , suctioned or otherwise removed-it has to be broken up and reabsorbed. I may have to make a decision today but the Dr. is going to call me back with xray results and I'll know more then. It's a BAD day. 7/25/12 9 am. Dr.called again and her pneumonia has progressed and now there are air pockets forming in her chest cavity, possibly as an output of gasses from the bacteria. They are placing an arterial line in her rear leg to better track her oxygen saturation and changing her antibiotics. She is going downhill rapidly and they think her sepsis has spread further. I can see her after they place the line. When I got to GCVS, the Dr. said she now has Acute Respiratory Distress Syndrome. Basically, her body is reacting to the bacterial pneumonia and causing her lungs to seep fluid at the cellular level. Once this process starts to happen, there is no other treatment other than placing her on a ventilator for possibly weeks and continuing treatment in the hopes she would live. 7/25/12 10:30 am. I had to let Vienna go. She deteriorated extremely rapidly and was vocalizing in distress, as she couldn't breathe. Her oxygen level was 45 as determined by the cephalic line they put in - normal should be 99/100 and on the oxygen she was getting it should have been near 200. Her lungs were even more filled with fluid and she now had air pockets outside of her lungs which was probably from gas released by the bacteria growing. Being on a ventilator would not have saved her - the vet said the only other possibility to save her would be a lung transplant as her lungs are permanently scarred. Her lungs will no longer work. Vienna didn't respond that she knew I was there, but I was able to be with her as we gave her the final injection to let her go. 7/25/12 11 am. The Dr. did the lung wash post mortem in the hopes of finding a final answer to what caused her bacterial pneumonia and if we were treating her correctly. She said said her lungs were 70% full of pus and fluid. Results of the respiratory panel, cytology and culture will be back in several days. I have to highly commend the vets and staff at Gulf Coast Veterinary Specialists - they did everything possible to save her, gave me access to her, and kept me informed of every step along the way. A huge thanks also the my regular vet, Dr. Skip Fix and the staff at Nottingham Animal Hospital for their quick treatment and referral, and also their profound sympathy. 7/26/12 Dr. Lacaze from Gulf Coast Vet Specialists just called and gave me the preliminary results of what has come back so far from the lab work. This is the just the initial stage. Much more to come later and they will notify me as things come in. Respiratory panel: Distemper negative, canine influenza negative, bordetella etc. Basically all normal for any viral infection. We now know she had no underlying viral disease process. No kennel cough. Lung Wash: Massive bacteria and inflammation.Septic.Type of bacteria not identified yet, will take several days more for full results. Not a fungal pneumonia. All bacteria, which was severe and massive along with the severe inflammation. 7/29/12 Final Culture & Sensitivity Results: Bacterial pneumonia caused by: Klebsiella pneumoniae. Not an uncommon bacteria, but tough to treat. The antibiotics she was being treated with were correct, according to the sensitivity, but the infection was too overwhelming. Would she have had any different treatment knowing what we now know? No. Everything was done for her that could possibly be done and she was treated aggressively. The Acute Respiratory Distress Syndrome inflammatory response was what made the big difference - once that process starts, it's a quick and vicious downward spiral. Sometimes life just sucks.
Vienna's complete medical records from this incident are available for anyone to view in the hopes that maybe, somehow, someone will benefit. |
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Vienna's medical records related to this incident | Vienna struggling to breathe |
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