It’s taken all day for me to have the energy to write this. Today at the vet’s office Sammy had the same two procedures as the last visit; ultrasound, echocardiogram. Still no fluid was found in the pericardial sack however they drained 2.5 liters of fluid from her abdomen and chest cavity. That’s quite a lot.
So the vet sat us down and told us that she is very concerned that Sammy has a tumor on her heart. This is the same tumor that we felt probably wasn’t there. The problem is if it exists it is high up on the heart and can not been detected by the tests we have done thus far. The vet is only able to guess that is it there based on the return of the fluid yet not finding any in the pericardial sack. Following this? View the vet's letter.
Our options:
~ Opt for surgery. They would go in through the rib cage to investigate the heart and look to get a visual on the mass. If they found one, they would call us (during surgery) to discus options since most elect not to wake the pet from surgery. There doesn’t seem to be any type of mass that is operable.
~ Get a CT scan. That would be a non-invasive way to see if there is a mass, and as mentioned before, there doesn’t seem to be a “good” mass.
~ Do nothing. If we do nothing, she will continue to retain fluid. We can have the fluid drained again.
We are going to have the CT scan, and we will do it on Wednesday. We feel we need to have conclusive evidence there is a mass. Plus we are on some level still clinging to the hope that she doesn’t have a mass (yet then we have to do more tests to figure out what the issue is.) No one really thinks this is at all likely, but we still hold out hope.
Bottom line, barring a miracle, the best case scenario is she has a month to live. What we are likely to see is increased fluid, and increased difficulty breathing and a loss of appetite. At the same time she will not be in any pain or discomfort other than that associated with the fluid and breathing. This is so hard because her personality, vitality and spirit are as they have always been. She is playful, enthusiastic and energetic. It's hard to imagine she is so sick. I'm sure all this is confusing since previous posts indicated no tumor, no cancer in the lab results. All I can say is that the vet was clear with us that these heart tumors are sometimes hard to find and the cells don't always flake off into the blood.
Thanks again for all of your kind words. We are going to spend the next days with Sammy doing all the things she loves to do and spoiling her rotten. Though we feel the two years we have had with her is not nearly enough, we are lucky to have had any time with her at all.
Monday, February 27, 2006
Sunday, February 26, 2006
Incredible, Expanding Sammy
I don't know who this is harder on. Clearly Sammy is uncomfortable, she looks like she might pop at any minute. But this is torture for me too. Sammy has an appointment Monday morning for another exam and ultrasound. I was told to wait 'til then to bring her in. I'm at least thankful that the appointment is tomorrow and early. Think she really would pop if we had to wait until Tuesday.
She still has her personality though!
She still has her personality though!
Wednesday, February 22, 2006
Sammy is a puzzle
I don’t know what to think anymore. Sammy’s sonogram showed that there is NO fluid surrounding the heart. Really good news. It means surgery is not indicated and it suggests that she does not have a tumor on her heart (which in turn supports the conclusion that this whole situation is idiopathic).
Her ultrasound showed there is still fluid in her abdomen. This is puzzling news. When she came home a week ago, she really slimed down in the first few days, suggesting the fluid had dissipated. But then she has increased in size in the past few days, suggesting the fluid has returned. Since we now know that there is no fluid surrounding her heart that either means her abdominal fluid is the “old” fluid that hasn’t gone away yet, or there is fluid coming from somewhere else. They sent a sample of the fluid to a lab to see what it consists of.
She goes back Monday for another exam just to be sure that her heart stays stable. I still think (hope) she is constipated.
Her ultrasound showed there is still fluid in her abdomen. This is puzzling news. When she came home a week ago, she really slimed down in the first few days, suggesting the fluid had dissipated. But then she has increased in size in the past few days, suggesting the fluid has returned. Since we now know that there is no fluid surrounding her heart that either means her abdominal fluid is the “old” fluid that hasn’t gone away yet, or there is fluid coming from somewhere else. They sent a sample of the fluid to a lab to see what it consists of.
She goes back Monday for another exam just to be sure that her heart stays stable. I still think (hope) she is constipated.
Another Ultrasound for Sammy
Sammy is at the vet today for another ultrasound. She had gotten bigger in the past few days, but still not as big as she was when we took her to the ER a week ago. Over the course of this week I have become quite a bit more adept at the medical terms… though I’m sure I’ll still mess them up a little.
A week ago Sammy’s diagnosis was pseudo pericardial effusion; the cause was thought to be idiopathic. Translated, that means that the sack that surrounds her heart was filling with fluid and pumping the excess into her abdominal cavity resulting in a bloated appearance. The cause is of unexplained origin. The fact that she has again started to retain fluid does not change the diagnosis at this point. She will have another ultrasound this morning and a complete exam. If the vet confirms that she has the same condition as a week ago and does not see any signs of a tumor then she will speak with the surgeon about scheduling Sammy to have the pericardial sack removed. This would probably happen in the next day or so. She tells us that Sammy would most likely stay at the hospital for 1-3 days and then can come home – good as new. Removing the pericardial sack is curative for idiopathic pericardial infusion.
So now we steel ourselves for surgery on our precious Sammy’s heart. I'm still holding out hope that she is just really constipated.
A week ago Sammy’s diagnosis was pseudo pericardial effusion; the cause was thought to be idiopathic. Translated, that means that the sack that surrounds her heart was filling with fluid and pumping the excess into her abdominal cavity resulting in a bloated appearance. The cause is of unexplained origin. The fact that she has again started to retain fluid does not change the diagnosis at this point. She will have another ultrasound this morning and a complete exam. If the vet confirms that she has the same condition as a week ago and does not see any signs of a tumor then she will speak with the surgeon about scheduling Sammy to have the pericardial sack removed. This would probably happen in the next day or so. She tells us that Sammy would most likely stay at the hospital for 1-3 days and then can come home – good as new. Removing the pericardial sack is curative for idiopathic pericardial infusion.
So now we steel ourselves for surgery on our precious Sammy’s heart. I'm still holding out hope that she is just really constipated.
Monday, February 20, 2006
Sammy's Puffing Up Again
It saddens me to report that Sammy seems to retaining fluids again. Over the past few days she has (to our eyes) gotten bigger and when we took her over to visit my parents, they both thought she looked bigger too.
We can't figure out what the problem is. While we were going through our ER experience and ultrasound experience last week, ironically we were going through the same set of testing as another couple and their 9 year old mastiff. The short version of the story is that the mastiffs tests revealed a tumor on her heart and that couple elected to put her down. Sammy isn't acting ANYTHING like that mastiff... no lethargy, no vomiting, no dehydration, just bloating. Yes, they checked for Bloat first thing at the ER last week.
We will keep an eye on her and probably schedule an ultrasound on Thursday if possible.
We can't figure out what the problem is. While we were going through our ER experience and ultrasound experience last week, ironically we were going through the same set of testing as another couple and their 9 year old mastiff. The short version of the story is that the mastiffs tests revealed a tumor on her heart and that couple elected to put her down. Sammy isn't acting ANYTHING like that mastiff... no lethargy, no vomiting, no dehydration, just bloating. Yes, they checked for Bloat first thing at the ER last week.
We will keep an eye on her and probably schedule an ultrasound on Thursday if possible.
Wednesday, February 15, 2006
A Whole New Sammy
Sammy continues to get better and better. She was a bit sluggish yesterday, mostly napping and lying around. She made me a little nervous when up came her dinner two hours after she ate it. She did keep a couple of her cookies down though so that was hopeful. We wrapped her in a blanket in her bed (remember I said she was oddly shaven and there was a lot of cold wind last night). I woke up at 3:30 and she wasn't in her bed. I found her asleep in the Rumpus Room and convinced her to come with me back to the bedroom where she stayed the rest of the night.
This morning she was slow to get out of bed, but I think that was mostly due to having no food in her system. She enjoyed her walk as she always does. I gave her a small breakfast of rice and broth and she is a whole new Sammy! She pouced on the toy box, pulled out a toy, rolled on the floor with it and growled happily. She participated in a game of ball with Sophie and I and she has been wagging her tail like nobody's business. She is even begging to be rubbed. Now THAT is the Sammy we know and love.
This morning she was slow to get out of bed, but I think that was mostly due to having no food in her system. She enjoyed her walk as she always does. I gave her a small breakfast of rice and broth and she is a whole new Sammy! She pouced on the toy box, pulled out a toy, rolled on the floor with it and growled happily. She participated in a game of ball with Sophie and I and she has been wagging her tail like nobody's business. She is even begging to be rubbed. Now THAT is the Sammy we know and love.
Tuesday, February 14, 2006
No Cancer Detected
Good news! The Vet called to report that the cytology on Sammy's fluid showed NO CANCER CELLS. As you might imagine we breathed a huge sigh of relief upon hearing that news. She has to go back in for another scan in 2-4 weeks (presuming nothing else presents itself before then). Considering what happened to her, this is the best possible outcome.
Thank you all very much for your caring, concern and kind words. They really have meant a lot.
Thank you all very much for your caring, concern and kind words. They really have meant a lot.
Sammy is Home!
We just picked Sammy up from VMS in San Mateo. You can see they gave her a pretty bandage for where her IV used to be. She is a little groggy and oddly shaved but she is very Sammy.
We don't yet know the results of the cytology for the fluid that was removed - that should be later this afternoon so check back. The results could show evidence of a tumor or cancer that the vet was unable to see on the sonagram. Hopefully not, but even if there is no evidence of a tumor that isn't 100% conclusive at this point. We will be taking her back in 3 weeks for a follow up ultrasound. If they find more fluid, they will drain it and remove the sack that surrounds her heart that trapped the fluid this time. At that point we have to talk about exploratory surgery to see if there is a tumor that wasn't detected in earlier tests. The fluid in the abdomen should work its way out of the body in the next few days. Already I see most of it is gone.
We have been instructed to let her rest for the next 2 days then ease her back into her regular routine of activities. As you know, the hardest part of that will be getting Sophie to chill out for two days as Sammy has to be right on Sophie's heels at every moment!
For those of you interested in the report with all its fancy medical terms, I've scanned it for your reading pleasure. It is large enough to read at 100%. You might have to double click it to enlarge it.
We don't yet know the results of the cytology for the fluid that was removed - that should be later this afternoon so check back. The results could show evidence of a tumor or cancer that the vet was unable to see on the sonagram. Hopefully not, but even if there is no evidence of a tumor that isn't 100% conclusive at this point. We will be taking her back in 3 weeks for a follow up ultrasound. If they find more fluid, they will drain it and remove the sack that surrounds her heart that trapped the fluid this time. At that point we have to talk about exploratory surgery to see if there is a tumor that wasn't detected in earlier tests. The fluid in the abdomen should work its way out of the body in the next few days. Already I see most of it is gone.
We have been instructed to let her rest for the next 2 days then ease her back into her regular routine of activities. As you know, the hardest part of that will be getting Sophie to chill out for two days as Sammy has to be right on Sophie's heels at every moment!
For those of you interested in the report with all its fancy medical terms, I've scanned it for your reading pleasure. It is large enough to read at 100%. You might have to double click it to enlarge it.
My Courageous Sammy Bear
Though this is posted on February 14, it was all written on the 13th.
I noticed Sammy was bigger, as in she looked pregnant, this weekend. She was also heavier. But Sunday I looked at her and got scared at how large she had become. She looked like a barrel on stilts. I was afraid (unrealistically) that she would pop! We took her to the emergency vet, who took an x-ray and found that her abdomen was full of fluid. She took a blood sample and a sample of the fluid and really was not able to tell us what the issue was. She recommended we see our regular vet and get an ultrasound ASAP. I faxed all the information to Dr. Blount (our regular vet) Sunday. She called Monday at 8:05am to tell us she got Sammy an ultrasound appointment at 8:45am.
These are the email updates that followed…
Sammy's ultrasound revealed that she has a lot of fluid in the sack surrounding her heart and essentially the heart has been pumping this fluid into her abdomen. That's why she was so big.
She is going to have a sonogram of her heart this afternoon to determine the cause of the fluid. It is expected to be one of two things:
1. A tumor on her heart. If this is the case we will have some big choices... We can put her to sleep today, we can take her home and spend some time with her, we can drain the fluid and spend more time with her, or we can surgically remove the tumor and have maybe 3 months with her.
2. a spontaneous and unexplained event in which case we drain the fluid and it is likely she will not have the problem again. As you can imagine, we are hoping for option 'B'. The odds are literally 50/50.
I’ll let you know more when I know more.
UPDATE 1
The vet just called. She does NOT see a tumor on Sammy’s heart at this point or any cancer. She is going to drain the fluid and call us this evening with an update. We are still not out of the woods as this procedure has some serious risk, but this is REALLY great news. Sammy will have to stay overnight at the vet’s office.
I’ll let you know more as I know more. WHEW!
UPDATE 2
The vet called this evening to tell me that they removed 150cc’s of fluid from around Sammy's heart. That's a lot. Dr. Joe says that's almost 2/3 of a normal glass of water. She came through just fine and she enjoyed going for a walk (no great surprise there). She is going to stay overnight at the vet’s office so she remains calm and the doctor will call us in the morning with an update and to discuss the plan for follow up treatment. They are sending a sample of the fluid through various lab tests and we should know the results in the afternoon sometime.
Whew.
I noticed Sammy was bigger, as in she looked pregnant, this weekend. She was also heavier. But Sunday I looked at her and got scared at how large she had become. She looked like a barrel on stilts. I was afraid (unrealistically) that she would pop! We took her to the emergency vet, who took an x-ray and found that her abdomen was full of fluid. She took a blood sample and a sample of the fluid and really was not able to tell us what the issue was. She recommended we see our regular vet and get an ultrasound ASAP. I faxed all the information to Dr. Blount (our regular vet) Sunday. She called Monday at 8:05am to tell us she got Sammy an ultrasound appointment at 8:45am.
These are the email updates that followed…
Sammy's ultrasound revealed that she has a lot of fluid in the sack surrounding her heart and essentially the heart has been pumping this fluid into her abdomen. That's why she was so big.
She is going to have a sonogram of her heart this afternoon to determine the cause of the fluid. It is expected to be one of two things:
1. A tumor on her heart. If this is the case we will have some big choices... We can put her to sleep today, we can take her home and spend some time with her, we can drain the fluid and spend more time with her, or we can surgically remove the tumor and have maybe 3 months with her.
2. a spontaneous and unexplained event in which case we drain the fluid and it is likely she will not have the problem again. As you can imagine, we are hoping for option 'B'. The odds are literally 50/50.
I’ll let you know more when I know more.
UPDATE 1
The vet just called. She does NOT see a tumor on Sammy’s heart at this point or any cancer. She is going to drain the fluid and call us this evening with an update. We are still not out of the woods as this procedure has some serious risk, but this is REALLY great news. Sammy will have to stay overnight at the vet’s office.
I’ll let you know more as I know more. WHEW!
UPDATE 2
The vet called this evening to tell me that they removed 150cc’s of fluid from around Sammy's heart. That's a lot. Dr. Joe says that's almost 2/3 of a normal glass of water. She came through just fine and she enjoyed going for a walk (no great surprise there). She is going to stay overnight at the vet’s office so she remains calm and the doctor will call us in the morning with an update and to discuss the plan for follow up treatment. They are sending a sample of the fluid through various lab tests and we should know the results in the afternoon sometime.
Whew.
Wednesday, February 08, 2006
Denver for the Day
I don't want to sound like I'm from the 1800's (though sometimes I feel that I am) but it amazes me that I can, and have on several occasions, commuted to Denver for a day's work. I caught the 8:05am flight out and was home by 7pm. It just seems like a commute like that would involve a longer day. Granted I only worked for around 4 hours of that day and spent 6 ish hours traveling, but it is still remarkable.
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