I took Aurora, Darla and Widget back to Peak in Burlington last week. Our internist, Dr. Marielle Goossens, wanted the radiologist, Dr. Lynn Walker, to ultrasound Aurora's leg again to see what that clot in her artery was doing. That's Dr. Walker doing the imaging in the photo while vet tech Melissa holds Aurora.
Dr. Walker graciously took quite a bit of time to show me what she found and explain to me what we were looking at on the monitor. Knowing I was going to post this on the blog, she also helpfully labeled the image for us:
(Click on photo for larger image.)
Unfortunately, the clot is larger and longer than it was a week earlier. That's because as it creates a dam in the artery, the blood flow slows down as it hits the clot and starts becoming turbulent; as it backs up and the rate of flow decreases, some of the blood begins clotting and adhering to the original clot.
In the meantime, Marielle had also received the results of the tests she had run on Aurora, particularly the critical one checking her antithrombin value. As the Cornell lab report on Aurora's antithrombin value noted, "Antithrombin is the major naturally occurring inhibitor of blood coagulation." If you are deficient in it, you're at elevated risk of clotting. The normal range is 65-145%, and Aurora is at 49%.
As it turns out, the underlying cause of Aurora's antithrombin deficiency is kidney disease.
So ... she is now on additional medications for clotting and for kidney disease. We'll also be transitioning her over to a special kidney diet.
Over the past several days, the pain Aurora was experiencing from the clot has subsided, and though she sometimes walks with a limp in that rear leg, overall she seems to be doing much better. Alayne is taking her to our local clinic this afternoon for some blood work to check her kidney values.
In more depressing news, last week our oncologist, Dr. Kendra Knapik, determined that Widget is not responding to the vinblastine/Cytoxan protocol that we had resumed after she came out of remission. That is not what we wanted to hear, of course. Kendra started her on the first line "rescue" chemo drug called CCNU (Lomustine), which Widget has tolerated very well. Right now we are just keeping our fingers crossed.
And also last week ... Darla underwent the surgery on her mast cell tumor and the procedure on her now blind left eye. Instead of enucleating (removing) the eye, this time we elected to do an injection of gentamicin, which kills the cells that create the internal fluid that can no longer drain out adequately (thus causing glaucoma and then blindness). We have done this once before, more than a decade ago on a blind horse. Our view has been that if an eye is blind and chronically painful, it's better to get rid of the "hardware" once and for all. That way you avoid any future potential eye problems -- trauma, corneal ulcers, entropian, etc.
After some lengthy and helpful discussions with our ophthalmologist, Dr. Sarah Hoy, on the pros and cons of each method, we chose the gentamicin procedure this time. In large part because Darla was already going to have surgery on her leg to remove the tumor, we thought it would be easier for her to not have an eye removed at the same time. And on a human emotional level, I wasn't ready to see her missing an eye yet.
Sarah did her procedure first, and then our surgeon, Dr. Kurt Schulz, performed the leg surgery. Everything went well, and I was able to bring Darla and the other two girls home at the end of a very long day.
Here's Darla and Aurora the next morning:
2014 Shelter Challenge Underway
The first round of the Shelter Challenge for 2014 is underway and runs until March 30th. You can vote every day here. To search for us, type in our name, Rolling Dog Farm, and Lancaster, NH 03584. We've won thousands of dollars in the previous contests, so your daily votes do bring in serious money for our disabled animals!
Please note that I cannot help with technical or voting problems. I also do not have an "inside track" to anyone at the Shelter Challenge, and I don't know any more about the contest than anyone else does. So if you find yourself having issues, please consult their FAQ page here and their Rules page, which is a pop-up you can find linked on this page.
Thanks for your votes!