Saying Good-Bye

When I got up this morning, I found that Lexie's mammary wounds had bled through her doggy bed during the night.  I can't believe she even found the strength to get up, go down the front steps, and walk into the yard to pee, but she did.  She did it for me.  She fought so hard for me for so long, but she collapsed on the sidewalk before she could make it back into the house, and I knew at that moment that I wasn't going to make Lexie fight any longer. 

Justin sat with her and said his good-byes while I got ready to take her to Dr. Ellis.  Then, before I left, we held each other and cried as I thanked Justin for taking such good care of my Lou.  I told him how much she loved him.  It broke my heart to see him crying so hard for her, and for me, but it also made me realize just how lucky I and my girls are to have him in our lives. 

Unfortunately, Dr. Ellis wasn't at Animal Care Clinic today, so they sent us to Dr. Mark Ayers' office.  All of the staff and Dr. Ayers were so kind to me and Lou.  I'm glad that she was surrounded by so many kind, happy voices in her final hour.  I'm also so glad that I decided to stay and be with her while she was euthanized.  I put my forehead against hers and held her face in my hands as I thanked her for loving me and told her what a good girl she was.  She was peaceful, and I also felt at peace as I finally let her go.  I made her promise to find me again someday, though.  I have a feeling she will. 

Oh, Moomie.  I'm going to miss you so very, very much.  You'll always be my little turd, and I'll love you until my last breath.  Thank you for making me so happy for so many years. 

Regression and a Big Decision Today

Despite having a really good Sunday evening, Monday, and Tuesday morning, when I got home from work yesterday evening, Lexie had regressed.  She didn't want to eat anything, not even hot dogs, and she was very weak.  A little later in the evening, she finally went into the kitchen to drink some water.  She drank a TON of water, actually, but then she staggered into the living room and threw up all the water she had just drank.  Justin tried to tell me that she probably threw it up simply because she drank so much so quickly, but there was no consoling me.  I knew that none of this was good.

We decided to sleep in the living room with Lexie last night because she had started moaning and groaning a bit.  Mind you, Dobermans are known to be big whiney babies, especially when they're wanting some attention, and this is definitely true with Lexie.  However, Justin and I didn't sleep all night because we each took turns laying in the floor, spooning Lou and trying to comfort her.  No matter how much we cuddled her, though, she continued to moan and groan all night long. 

Finally, around 5:00 a.m., I tried to give her two Tramadol pills for pain.  She wouldn't open her mouth for me, but I managed to pry her jaws open just enough to slip the tablets into her mouth.  A few minutes later, she spit them out.  We did this a couple more times before she finally swallowed them.  I thought that the pain medication would at least knock Lexie out so that maybe Justin and I could sleep for a half-hour before we had to get up for work, but she still continued to moan and groan.

At that point, I felt that it was probably time to end Lexie's suffering.  It just so happens that she already had an appointment with Dr. Ellis this morning because she's supposed to have her stitches removed today (such cruel irony).  So, I texted Zach, Kristy, and my mother to give them all the heads up that Lexie may not be coming home from the vet today.  Zach and Kristy both came over to say their potential good-byes.  I asked Justin if he would be willing to help me take Lexie to the vet because I wasn't even sure at that point if she was able to walk.  She had barely moved a muscle all night long.  However, when I asked Lexie if she had to go pee, she actually sat up.  She even managed to stand up, although she was very unsteady, probably due to a combination of the pain medication making her loopy and half of her body being asleep from not moving all night.  Regardless, she managed to find her way onto the porch, then down the front steps and into the yard to pee.  She even got into the car all by herself.

Normally, I'd be very happy about those things, especially with Lexie getting into the car independently, but all it did was make me even more confused about what I should do.  On one hand, I know I'm going to have to euthanize her eventually, no matter what, and I certainly don't want her to suffer if she's in pain.  On the other hand (and I realize I'm probably just trying to convince myself of this), I keep wondering if her backslide yesterday evening and all the moaning last night were reactions to stopping her pain medication cold turkey.  (We stopped giving her the Tramadol after her Monday morning dose.) 

The reason I'm having such a hard time just "letting go" right now is because I want SO BADLY to be able to give her at least a few happy days after being fully recovered from her surgeries before it's time to finally say good-bye.  When I told this to Kristy this morning, she said, "But you have given her a LOT of good days.  She's lived a very happy life."  I know this is true, and Kristy makes a good point, but I just hate with all my heart the thought of Lexie going through all this pain and misery, all those trips to Ohio, those long, overnight stays at MedVet, and THREE surgeries, only to finally come home and be euthanized before her stitches are even removed.  I mean, what was the point of any of this?!?

People also keep telling me not to beat myself up and that I made the best decisions with the information that I was given at the time.  I know this is also true; however, that doesn't make any of this easier for me to accept.  It doesn't stop me from being SO ANGRY over the fact that I was told Lexie's abdominal ultrasound showed no signs of cancer, which was the reason why I decided to let her have the enucleation surgery in the first place.

Speaking of that, I sent Dr. Kennedy an email full of questions yesterday, to which he replied yesterday evening....from his iPhone.  I am now going to copy and paste the questions I emailed to him and his answers for you to read (I have not altered this text in any way, other than highlighting his responses):

1. Could you please tell me again exactly what Lexie’s cancer diagnosis is?  I tried to take notes while we were on the phone, but all I wrote down was “vascular and lymphatics,” “inflammatory mammary carcinoma, “Stage III,” and “50/50 it will return in 12-15 months.”  Obviously, I should have taken better notes, but I was in a combined state of shock and devastation at the time.

Mammary carcinoma

2. You mentioned on the phone that the size of the two mammary tumors removed during Lexie’s surgery were quite large, and you said this was “concerning.”  I actually have a few questions regarding this:
   1. How big were the tumors? Over five cm
   2. Why is the size of the tumors still concerning if they were removed? Because we could not take the amount of normal tissue desired to be sure all cancer was removed
   3. When you first mentioned the possibility of removing Lexie’s swollen mammary glands on July 7, 2012, because you said the tumors could be cancerous, I informed you that Lexie had just recently had an abdominal ultrasound, which I was told showed no cancerous tumors.  At that time, you explained that it takes billions of cells to form even a small tumor that is visible enough to be seen on an ultrasound.  If that is the case, and the two tumors removed during Lexie’s surgery were so large that you find them to be concerning, why weren’t they visible on her abdominal ultrasound performed June 20, 2012? The statement about the cells refers to x-rays. I do not know what to say about the presence of the masses at the time of the ultrasound. There is always some mixed inflammation. In these rumors and that might be why they were so obvious to me.

3. When you said that there is a 50% chance that another tumor will appear within 12-15 months, does that mean that the two tumors that were removed during Lexie’s mastectomy were the only cancerous tumors she had?

The only ones we could detect. It is likely that more will form in others glands or within our surgery site

4. You mentioned something about further tests being done on the tumors to see if any lymph nodes were also removed during surgery.  Could you please re-explain the reason for this?  Also, when do you expect to have the results of these additional tests? We submitted a mass of tissue. The lymph node should be in that mind of tissue. If the pathologist finds it he can assess any sites for metastasis (spread) as this will worsen her prognosis if found.

I do not know when to expect it back but hopefully by the end of this week

5. Does Lexie have a life expectancy given her recent diagnosis?

 Potentially as little as 5-7 months

6. Do you know of any current clinical trials for canine cancer treatments for which Lexie might be eligible?

 not that I'm aware of

I'm a little infuriated by his response to question #2c.  Why would he have answered my question about Lexie's abdominal ultrasound with information that pertained to X-rays?  I am 100% certain that I did not ask him about Lexie's X-rays because 1) her X-rays were not performed at MedVet; they were done at Animal Care Clinic in Huntington, and 2) When Dr. Kennedy called on July 7 to discuss Lexie's swollen mammary glands, I mentioned her abdominal ultrasound to him because it had just been performed at MedVet two weeks prior, and I was told that the ultrasound did not show any cancer.  I didn't mention Lexie's X-rays to him because they were X-rays of her chest, not her abdomen.

Anyway, I know that what's done is done and that going over all the shoulda, woulda, coulda's isn't going to change anything, but I just feel so...wronged.  While I can accept that Lexie has cancer and will eventually need to be euthanized, possibly even today, I simply cannot accept the fact that the veterinarians at MedVet missed two Stage III mammary carcinoma tumors that were both over 5 cm in size, nor do I find Dr. Kennedy's reply of "I do not know what to say about the presence of the masses at the time of the ultrasound..." to be acceptable in the least.  I plan to call MedVet today to request a copy of Lexie's medical records, including her ultrasound images.  If another veterinarian looks at Lou's ultrasound and tells me that they do not see cancer, then maybe I will stop feeling so angry. 

In the meantime, Lexie is currently at Animal Care Clinic, and I am waiting for a phone call from Dr. Ellis so we can discuss Lexie's current condition and whether or not she should be euthanized today.  If Dr. Ellis tells me that Lexie's behavior yesterday evening and last night were a result of the sudden medication withdrawal or possibly some other explanation, and if she thinks that Lexie's still got a few good, pain-free months left in her, I will probably choose to bring her home.  If Dr. Ellis tells me that Lexie is in pain due to the cancer, I will not make my Lou suffer any longer.

So, What Now?

Just to recap, the following is a fictitional representation of the actual conversations I've had with veterinarians regarding Lexie since the beginning of June, 2012:

June 5, 2012 - Dr. Corbett:  "Lexie has an eye condition called anterior uveitis, but the good news is that she's not going blind!  Just give her these medications and follow-up in a couple of weeks.  That'll be $300."

June 18, 2012 [Lexie's eyes are worse] - Dr. Lilly:  "Lexie has glaucoma and she could go blind any minute!  Quick, you must rush her to MedVet!  Oh....wait....nevermind.  Dr. Corbett said to just give her these $100 eye drops, and then take her back to MedVet in two days."

June 20, 2012 - Dr. Corbett:  "Remember when I said that Lexie wasn't going blind?  Well, I forgot to mention that she could develop secondary glaucoma and potentially go blind within hours, which is what has happened.  So, we need to figure out what's causing her anterior uveitis because then we can possibly get rid of the glaucoma, too.  Cancer is one of the things that causes anterior uveitis, so let's rule that out.  That'll be another $700 for a chest X-ray, abdominal ultrasound, and blood work, please."  [An hour later.]  "Good news!  Lexie doesn't have cancer!  Therefore, this must be an autoimmune condition.  Give her these new meds and I'll see her again in two weeks."

June 21, 2012 - Lexie officially loses her sight. 

June 25, 2012 - Dr. Ellis:  "I've consulted with Dr. Corbett, and becuase Lexie's eyes haven't reponded to treatment and just keep getting worse, we both recommend enucleation."

June 29, 2012 - Dr. Ellis:  "There has been a surgical complication.  Lexie's blood won't clot.  She must have developed Von Willebrand's disease.  We're going to do a transfusion, but she's in critical condition."  [Two hours later.]  "The only way we could get the bleeding to stop was to pack Lexie's wounds with gauze, but she's now bleeding through those.  Therefore, you need to rush her back to MedVet tonight and pray she doesn't die on the way there.  You'll also need to pay a $1250 deposit when you get there."

July 2, 2012 - Dr. Corbett:  "Good news!  Lexie's surgery to remove the gauze was a success!  We're not really sure if she has Von Willebrand's disease, though, and we noticed an infection has started in her wounds, but we cultured the infection so we'll know exactly what kind of antibiotic to give her when she goes home."

July 3, 2012 - Dr. Corbett:  "Good news!  Lexie is stable and is cleared to go home!  That'll be $2300."

July 4, 2012 (14 hours later) - Lexie's stitches burst in her right eye, and she has to be rushed to the local Animal ER for an overnight stay.

July 5, 2012 - Dr. Lilly:  "Sorry I waited until fifteen minutes before we close to tell you this, but I don't want to stitch Lexie back up, so you're going to have to take her back to MedVet."

July 6, 2012 - Dr. Webb:  "We just got Lexie's cultures back and it turns out that she has TWO different bacterial infections, which are pretty extensive.  No wonder her incision pulled open!   I guess she wasn't "stable" when we sent her home the day after surgery, after all.  Anyway, we're going to need to keep her for another few days and then perform another surgery, but don't worry, we're going to do everything we can to keep the costs as low as possible for you."

July 7, 2012 - Dr. Kennedy:  "How long has Lexie had these swollen mammary glands?  There's a 50/50 chance that those are canerous.  Those are going to need to come off, too.  I don't have a cost estimate for you yet, but don't worry!  We're going to do everything we can to keep the costs as low as possible for you."  (I mentioned that Lexie JUST had an abdominal ultrasound and I was told that they did not show any cancer.)  "Well, it takes billions of cells for even the smallest tumor to show up on imaging, so even though it's GOOD that her ultrasound didn't show any tumors, that doesn't necessarily mean she's cancer-free."

July 8, 2012 - Dr. Sawyer:  "Lexie is responding really well to her new antibiotics, so we're going to push the surgery back until Wednesday.  I don't have a cost estimate for you yet, and I know we just tacked on another three-night stay to your bill, but don't worry!  We're going to do everything we can to keep the costs as low as possible for you."

July 10, 2012 (the day before surgery) - Dr. Sawyer:  "Dr. Kennedy told me to tell you that he was given permission to discount your services, and the cost of Lexie's surgery is going to be ONLY $1800!  That doesn't include the cost of her seven-night stay, though, which will be an additional $1400.  Don't worry, though!  We may still be able to get you more discounts!"

July 11, 2012 - Some random surgical tech:  "Ms. Bell, I'm just calling to let you know that we're getting ready to perform Lexie's incision repair and mastectomies now."  (I hadn't approved the mastectomies yet because I was told "there may be more discounts," which would be the deciding factor as to whether or not I could afford the mastectomies.  I raised a fuss, and they finally agreed to charge me "only" $1800 for all of Lexie's services over the last seven days, including the mastectomies.)

July 13, 2012 - Lexie comes home.

July 23, 2012 - Dr. Kennedy:  "I just got Lexie's biopsy results.  She has Stage III mammary cancer.  The size of the tumors worries me, though, because they were both pretty large.  There is a 50/50 chance that in 12-15 months another tumor will appear.  You can speak to Oncology about chemo options if you'd like, but they will charge you for the consultation."


In summary, I guess that cancer was the cause of Lexie's anterior uveitis after all, but here's my main question:  If Lexie's TWO mammary tumors were "so large" that Dr. Kennedy is concerned about metastases, then why didn't those two large tumors show up on her abominal ultrasound?  If I had been told on June 20 that her ultrasound revealed Stage III mammary carcinoma and that there was a 50/50 chance that I would have to euthanize her in 12-15 months, I'm not so sure that I would have chosen to have her eyes surgically removed, which would have saved her from having to go through THREE different surgeries and a very difficult recovery (not to mention the thousands of dollars for which I am now in debt).  It also would have saved her the stress and depression that has resulted from her sudden blindness. 

However, I also cannot say for certain that I would have chosen to put Lexie down instead of going through with the enucleation if I had known she had cancer.  It definitely would have been a very difficult decision, but you also have to keep in mind that, at that point, I wouldn't have known that so many other complications were going to result from the initial enucleation surgery (blood clotting issues, infections, two more surgeries, etc.). 

With all of that said, I strongly doubt that I would have chosen to spend so much money just so Lexie could spend her final days adjusting to sudden blindness.  If I had chosen to euthanize her a month ago, I would have at least been at peace knowing that Lexie lived a very full, VERY happy life up until that point.  As it stands right now, I simply don't know how well Lexie is going to adjust to being blind, or how much time she has left.  So far, she's had a difficult time with both recovery and adjusting to blindness.  Her appetite is poor, she's weak, she rarely looks happy, and she has no energy.  If these things don't improve before the time comes when I have to make the decision to put her down (whenever that may be), I will always regret with all my heart that Lexie spent her final days being scared, sad, depressed, weak, in pain, and blind. 

So, what do I do?  I have had several people ask how much her chemotherapy treatments would cost and suggest that I try to do another fundraiser to pay for it, but my heart and my gut are both telling me not to do that.  For one, it took everything I had in me to swallow my pride and ask for donations the last time, and now I just feel horrible that so many people gave so generously to help save Lexie's life, only to find out later that she has cancer.  Besides, Lexie has already been through SO much, and I'm not sure how much fight she's got left in her to go through chemotherapy treatments.  For that reason, I feel like I'd rather just try to make her as happy as possible for as long as I possibly can, rather than keep driving her six hours back and forth to MedVet for however often she needs chemo treatments.

The travel that would be involved is actually another reason why I don't feel like chemotherapy is the best option.  I have already put a TON of miles on my little Prius, and I even had to buy new front tires before our last trip to Ohio because the ones I had been driving on were so bald.  Not only that, but traveling that far that often is just grueling for both us and Lou. I'm not saying that it wouldn't be worth it if it meant saving Lexie's life, but the fact of the matter is that there is no guarantee that her treatments would be a success.  I'm also not even sure that Lexie would be able to receive her treatments on the weekends, as most of the specialists at MedVet only work Monday through Friday.  If that's the case, I definitely couldn't take off work that often. 

Pretty much the only way I would be able to even consider putting Lexie through chemotherapy would be if I won the lottery, or if some other lottery winner came to our rescue, because it would require Justin and I quitting our jobs so that we could move closer to MedVet, finding a place to live that would allow us to have three big dogs, and also being able to afford Lexie's cancer treatments, which I'm sure are very expensive.  Unfortunately, I don't foresee any of that happening, so I feel like the best option is to try to make Lexie as comfortable and happy as possible for the rest of her days here with us. 

So, on that note, I do have some good news in regard to Lexie's recovery.  Since she enjoyed her solo adventure to Justin's parents' house and the car ride home so much on Sunday, we decided to take her on another little adventure yesterday evening.  She got in the car all by herself, which made me happy, although she wasn't as interested in looking out the window this time.  She just laid in the back seat as Justin drove us down to Camden Park, which is on the other side of town, so that I could scout shooting locations for a photo session I've got coming up.  Then, we drove to Kroger's so that Justin could buy Lexie some hot dogs and baby carrots (she gobbled up a hot dog that morning, and baby carrots have always been one of her favorite treats).  While Justin was in the store, Lexie and I took a walk along the grassy edge of the parking lot.  It was a hot evening and she was panting, but I really felt like Lexie was enjoying her "adventure walk."  When we returned home, Lexie ate not one, but TWO hot dogs!  Justin had bought some vitamins for senior dogs while he was at the store, and he managed to get her to eat a couple of those,  and since we were on a roll, I decided to also give Lexie her "hippy medicine," AgariGold and mangosteen juice, which Dr. Wagner from the Integrative Medicine department at MedVet had given Lexie to help boost her immune system and energy levels.  (I'm going to seriously start looking into holistic cancer treatments for dogs, by the way.)

By the end of the day, Lexie was pretty tired, but she had a full belly and seemed happy, which is all I can ask for.  This morning, I was also very pleased because she seemed a little bit stronger than she had the day before.  She was more steady on her feet, seemed more alert, and even had a decent poop!  (It's hilarious how excited we get over Lexie's bowel movements these days.)  We've decided to try weening her off her pain medication again, too.  She didn't have any last night and seems okay so far, so I didn't give her any this morning, either.  Justin will check on her during his lunch break today, and if he thinks she could use some pain medication he's going to give her one pill instead of two.

So, basically, I'm going to try to stay focused on the positive things that happen day-to-day, rather than stay focussed on the fact that, oh my God, Lexie has cancer!  I'm still angry and heartbroken about it, and I probably always will be, but wallowing in sorrow isn't going to help either of us.  So, for Lou's sake, and for the sake of all the kind people who have been so supportive and encouraging, Justin and I are now going to do everything we possibly can to help Lexie fully recover from her surgeries so that she can continue to live the happiest life possible from here on out, even if it means feeding her hot dogs for every meal and driving her around the neighborhood for a couple of hours every evening.  :)

Making Momma Worry

Yeah, I'm worrying a little about my Lou.  She's not eating, she's losing weight, but she's also drinking a TON of water and peeing inside the house.  I thought her increased thirst and decreased appetite might be side effects to her Tramadol (pain medication).  We tried cutting back her pain medication for about a day, but then the following night I noticed she was trembling.  So, we decided we might be trying to ween her off the pain medication too soon and resumed giving her two Tramadol in the morning and two more at night.

As for her desire to eat, it's hard to tell if she's just being picky or if she's genuinely not hungry.  Justin and I ate dinner at restaurants almost every night this past week so that the girls wouldn't smell our food and think that they had any food options other than their own dog food.  Despite our brilliant plan, Lexie never seemed interested in eating her own food.  I got her to nibble some dog food a few nights ago, but it wasn't much, and I didn't see her eat again for two whole days afterwards.  Obviously, this started to worry us, so Justin and I decided last night to give into Lexie's "hunger strike," if that's what it was, to see if she'd eat some people food.  If she turned her nose up at the people food, then we'd know there was a more serious problem happening.

Well, after Lexie anxiously gobbled up an entire package of faux crab meat and two slices of American cheese last night, we've determined that she does still have an appetite after all.  Now, the question is how do we get her to start eating dog food again?!?!  We've thought about buying some canned food and mixing it in with her dry food, but you have to remember that Jocie and Sam are going to want to eat the canned food, too, and canned food is more expensive than dry food.  Therefore, we're kind of afraid to "spoil" them on canned food, as well.  Lexie HAS to eat, though!  She's lost so much weight that I noticed her harness is actually falling off of her now.  She also seems kind of weak on her feet.  

Then, there's the issue of Lexie using the dining room rug as her new toilet.  This is infuriating me, but I have no idea what to do!  The couple of times that I've actually caught her peeing on the rug, I've told her "no," rushed her outside, and then praised her like crazy when she finished peeing in the grass.  I just feel bad yelling at her too much because she drinks a TON of water, so I know she must have to pee a lot, and we're not there at all hours of the day to let her out every time she needs to go.  I'm just worried that maybe this amount of thirst, especially coupled with a decreased appetite, could possibly be a sign that something isn't right.  On the other hand, I'm also worried that she might get into the habit of peeing in the dining room whenever she has to go instead of trying to hold it until I can take her outside.

UUUuuuuuuugggghhhhh!!!!!!  

On a better note, her incisions are looking fantastic.  The swelling over her right eye is looking better and better every day.  Here is a comparison of how she looked Monday compared to how she looked yesterday:

You can see how much the swelling has gone down, and also how her eyes are kind of "sinking in" now.  I just wish I could be happier about the healing progress, but for the time being I'm just too worried about everything else.  She does have an appointment to have her stitches removed this coming Wednesday, though, so I plan to talk about all these concerns with Dr. Ellis.  

Will This Ever End?

I swear, if you look in the back seat of my car right now, it looks like I have murdered an animal.  My car is covered in fur and spots of blood, which you can see in this photo.  Bless her heart, Lexie licked that seat almost the entire way to Ohio last night.  Anytime she leaves a spot of blood on the carpet, a pillow, the car seat, or even my leg, she immediately tries to clean it up for me. 

Anyway, I just got a call from Dr. Webb at MedVet (Dr. Corbett is in Cincinnati this week, but Dr. Webb works with her).  Lexie's incision sites did not bleed much through the night, which is good becuase it's a sign she does not have Von Willebrand's disease, but they don't know for sure if she has it yet because her test results still aren't back from New York.  Anyway, Lexie's bacterial culture did come back showing that she's got two different kinds of bacterial infections right now:  staph and serratia, which are resistant to the antibiotics she is currently taking.  I should also add that Dr. Webb believes that these infections may be the reason why Lexie's incisions are pulling.  So, they've changed Lexie to a more heavy-duty antibiotic. 

Meanwhile, Dr. Webb has consulted with their soft tissue surgeon, Dr. Kennedy, who will be repairing Lexie's incision.  Luckily, Dr. Kennedy feels Lou still has enough surrounding soft tissue to make it possible to re-close the wounds without having to perform a skin flap surgery, which is kind of an extensive (and I'm presuming expensive) last resort procedure.

I did ask Dr. Webb about Lexie's immune system because I know it has been weakened by the Prednisone (steroid) she was taking in the 1-1/2 weeks leading up to her bilateral enucleation surgery.  She had been prescribed Prednisone because it was believed that her original disorder, anterior uveitis, was an autoimmune disorder, and Prednisone's function is to weaken her immune system in order to get it to stop attacking her own body.  However, the ER vet on duty last night, Dr. Foust, explained that Lexie's weakened immune system could be a reason why she's having these post-surgical complications and not healing as quickly as we would like.  Therefore, I asked Dr. Webb if there was anything they could give Lexie that would help build her immune system back up.  Dr. Webb said I posed an excellent question, and she would speak to their Integrative Medicine department, which specializes in alternative therapies to compliment conventional treatments and veterinary medicine.  She said they may have some suggestions for improving Lexie's immune system.

On an up note, when I asked Dr. Webb about a cost estimate, she said that she didn't have one yet, but added, "I promise, we are going to do all we can to keep the cost as minimal as possible for you."  She said that I would probably still end up with a balance, but she said she was going to talk to Dr. Corbett and even Dr. Ellis to see what they could work out.  (I forgot to mention that when I dropped Lou off last night, Dr. Foust told me they weren't going to require a deposit this time, which was such a relief.) 

As I was writing this, Dr. Kennedy called.  He said that the fact that Lexie has a staph infection, which is quite extensive, in addition to the serratia infection, is a little concerning.  He said it would be prudent for them to treat this as an open wound for a couple of days in order to allow her new antibiotics to start fighting the infections while they also treat and clean the soft tissues of her wound.  That way they'll be as healthy as possible when she goes into surgery on Monday, or possibly Sunday.  He sounded confident, though, that Lexie is going to be okay when this is all said and done (if it ever ends!!!!).  I asked Dr. Kennedy if HE had a cost estimate, because Dr. Webb had predicted that Lexie would come home tomorrow, but now it looks like Lexie may not come home until next Monday or Tuesday.  Dr. Kennedy said he did not know yet what this will cost, but he said that they are still "working on it," and he'll call me later with an estimate.

Please continue to keep Lexie in your thoughts in prayers, especially for her immune system to regain strength in order to fight the bacterial infections, along with her new antibiotics.  As much as I love the doctors at MedVet, I'm hoping never to see them again after this next surgery.  *knock on wood*

This Can't Be Happening

I am typing this from my iPhone as Justin drives us BACK to MedVet in Ohio, so please forgive typos and formatting. Yes, you heard me correctly. Dr. Ellis wasn't at Animal Care Clinic today, and Dr. Lilly waited until 4:45 p.m. (I dropped Lexie off at 8:00 a.m.) to tell me that Lexie's incision needs to be re-opened in order to be repaired, and she basically refuses to do that because of what happened the last time Lou had surgery there. Therefore, the only option I was given was to drive Lexie back to Ohio so they can perform another surgery tomorrow. Another surgery, plus I'm predicting another weekend stay at MedVet equals another huge bill for me. Why is this happening?!??? And no, I'm not asking for any more donations. I'm not sure what I'm going to do, but I will figure something out. I'm just venting because I'm so incredibly frustrated and upset, which may be the understatement of the year.

Aaaand Back to the ER

I was right, Lexie must have busted some of her stitches earlier, and throughout the course of the day the rest of the stitches must have just worked themselves out, too, because around 10:00 p.m. I discovered that her incision was completely open.  Not busted wide open or anything like that, but it was obvious the incision wasn't being held together tightly and none of the stitches were visible at all anymore.

So, my only option was to rush her to our local Animal ER, and let me tell you, I am NOT happy with that place right now.  I called ahead to let them know we were coming.  Then, as soon as we walked in, I saw a puddle of pee on the floor with a yellow Caution sign sitting next to it (the puddle dried in the amount of time we were there, by the way, and no one ever even moved the sign, let alone mopped the floor).  Then, I told the girl behind the counter who we were, what was going on, and even told her I was freaking out a little.  She handed me a form and told me to fill it out, then she disappeared into the back somewhere for about....oh....I'd say at least twenty minutes!  For twenty minutes, my Lou sat in the waiting room just bleeding from her right eye while I nervously and angrily tapped my nails on the counter waiting for someone to come back and help us.

Finally, a different girl emerged from the back, but I don't even think she was going to help us until I said, "Excuse me, but I would feel MUCH better if someone would at least come take my dog."  Her reply?  "What's wrong with her?"  Unbelievable.

Well, that second girl did take Lexie to the back for me, but then we didn't see another employee for the next half hour or so, not even at the front desk!  Finally, a vet (at least, I hope she was an actual vet) called us into a room.  She said she already knew a little bit about Lexie's case because Dr. Ellis had called the Animal ER last Friday to see if they had plasma after Lexie's blood wouldn't clot.  She asked me if Lexie had any problems during her second surgery at MedVet, and I told her she didn't.  However, I added that we never really found out for sure if Lexie has Von Willenbrand's disease.

I guess for that reason, this vet said that she "didn't want to do anything that might cause all that to start up again," and told me she was going to put some ointment on Lexie's wound and then put a patch on it.  A PATCH!  I asked if she could at least put one or two stitches in it to close it up better, but she said that because Lou's surgery was two days ago, she'd have to re-open her wound a little in order to stitch it back up, which is exactly what she didn't want to do because she was afraid Lexie would start bleeding uncontrollably again.

So, I asked if they could at least keep Lexie overnight for observation because there's no way I'd be able to sleep tonight if I took her home with just a patch on her opened incision.  They said that was fine, so that's where Lexie is now.  I'm going to have to get up super early in order to go pick her up and take her to the Animal Care Clinic before I have to be at work at 8:30 a.m. tomorrow.

Will this ever end?????

Celebrating Red, White, and Lou!

I am so thankful that Justin and I were able to stay home with Lexie today because of the 4th of July holiday.  All of my friends are headed to a big cookout, and I have to admit that I'm starting to feel a little cooped up, but there's no way I'd leave my Lou today.

She's been sleeping most of the day because of her pain medication, but when she's awake she seems happy, despite how awful she looks.  I'm trying to keep her face clean, but it's a losing battle right now.  Her right eye is really worrying me.  I'm not a vet by any means, but it looks to me like she may have busted a stitch or two.  I tried calling MedVet, but they told me the ophthalmology department isn't in today, and Animal Care Clinic is closed today, too (i.e. the one downside to having Lexie's first day home fall on a holiday).  Yesterday, the veterinary ophthalmologist at MedVet told me that it's normal to see some bloody discharge coming from Lexie's eyes over the next several days, but right now it looks like it's just plain blood.  It's not gushing, though, and her incision doesn't look like it's bursting or anything, so I'm hoping to just wait until tomorrow morning to take her to see Dr. Ellis.  If it starts to look worse, I'll take her to the local animal ER tonight.  

The other thing that's worrying me a little is that Lexie hasn't peed all day.  She went out this morning without any problem, but she didn't pee.  For the rest of the day, anytime I've tried to let the girls out Lexie will walk to the back door, but then refuses to come outside.  The last time I tried to get her to go out, just a few minutes ago, she actually started trembling as Justin and I tried to coax her outside.  I'm not sure if it's the temperature that's making her hesitant to go out (it's almost 100-degrees today), or what.  I'm hoping she'll go tonight when it's cooled down.

In the meantime, I've decided to put Lexie's inflatable collar on her to prevent any further damage to her incisions.  (I still cannot believe she was sent home without an E-collar!)  She has been pretty good about leaving her stitches alone, but every now and then I'll catch her rubbing her face on the carpet.  I'm sure those stitches are itchy and uncomfortable, but I'd just rather be safe than sorry.  My poor Lou.  I'll be so glad when she's healed so I can stop worrying!

She's Home!!!

 I don't even know where to begin.  I am so overwhelmed with emotions right now!

First of all, I got the call from Dr. Corbett saying that Lexie could come home around 10:00 a.m., but I had a few reports I needed to get done at work before I could leave.  I was also crossing my fingers that Justin would be able to take off work early, but by 2:00 p.m. he texted to say his chances of leaving early didn't look good, so I decided to go by myself to pick up Lou.  After all, Dr. Corbett had told me that she thought Lexie would be fine riding in the back seat by herself during the trip home.

So, I arrived at MedVet around 6:30 p.m. this evening, and the first thing they wanted to do was settle my bill, the total of which was significantly higher than I had been anticipating (over $3500!).  However, you guys aren't going to believe this:  I learned that not only did Lexie's local vet donate a large sum towards her MedVet bill, in addition to the generous donations I have received through my and Chad Dressen's blogs, an incredibly kind woman from Canada, named Wanda, whom I have never even had the pleasure of meeting before, had also called MedVet and offered to pay the balance!!!!!  

I.  Am.  Speechless.

Stuff like this doesn't happen in real life, does it?!?!?!  It doesn't!  At least, not in MY real life.  I am still in shock.  I just happened to be standing at the front desk when the billing assistant called Miss Wanda to get her credit card information, so I asked if I could speak to her before the billing assistant hung up.  I'm so glad I was able to thank Wanda myself, although she may not have understood me through all the tears.  I am also  hoping that Dr. Ellis is in the office tomorrow so I can thank her, as well.  I mean, seriously?!?!?!  Seeing so much GOOD and kindness in people has truly been the most beautiful, amazing experience of my life.  It has definitely made me want to strive to be a better human being, and I can only hope many other people who have been following our story feel the same way.  You guys have been nothing short of incredible, and I cannot thank you enough.

Speaking of incredible, Lexie is home!!!!!  In fact, she's laying beside me on the floor as I type this blog.  Justin and I are already so impressed with how well she's adjusting, too.  She's actually getting around BETTER than she was right before her bilateral enucleation surgery.  I wonder if maybe she was depending a little too much on being able to distinguish shadows and light, because now it's obvious she's using her senses of hearing and smell a lot more than she was a week ago.  She's also not walking directly into things like she used to.  She ALMOST walks into things, but as soon as her nose gets really close to the wall, chair, door, etc., she kind of pulls back and changes direction.  Since being home, she's already located the food bowls and had some dinner, she drank about a gallon of water after finding her water bowl all by herself, and I even walked into the foyer at one point to find her cleaning Sam's ears!  She is definitely the same ole Lou she was before this whole ordeal began last month, and I can't tell you how happy that makes me.

The one thing that is kind of worrisome is the fact that she's bleeding a lot from her incisions.  The vet tech at MedVet told me that this is normal, and even brought in the ophthalmologist on duty to confirm this for me.  He said that, as long as the fluid coming from Lexie's eyes was just bloody and not actual blood, then it was perfectly fine.  However, since we've gotten home, I swear it looks more like blood and less like bloody fluid coming from her eyes.  She looks just like a crying vampire from True Blood!  I'm applying a cold compress, like the vet at MedVet suggested, but I just really wish her eyes weren't bleeding at all.  It makes me nervous.  In fact, I ended up asking him if they could wrap Lexie's head like it was when I brought her in on Friday, just for the trip home.  Poor little thing.  She looked like I had kidnapped her.

Other than that, though, my Lou is home and is doing so well!!!!!   Yaaaayyy!!!  Her eyes do look a little funny, like Dr. Corbett had warned me, but I can't help but think she looks adorable.  I was afraid she'd look sad all the time without having any eyes, but she really doesn't.  I mean, come on, that smile is pretty undeniable.  :)  She's also been giving the MOST hugs!  In fact, she hasn't really wanted me to leave her side since I picked her up.  During the first few minutes of the drive home, she kept resting her head on the console between the two front seats just so she could be closer to me.  She didn't look comfortable, though, so I pulled over and brought her up front to the passenger seat beside me.  I laid the seat all the way down, then stuffed a big comforter in the floor, just in case she fell forward at some point.  She curled right up into a little ball, though, and slept as I pet her the whole rest of the way home.  

I am just so relieved to have her with me finally.  If her eye incisions keep bleeding like they have been tonight, I'll probably have Dr. Ellis take a look at her ASAP.  So, I'm not 100% comfortable yet, but I definitely feel a LOT better now that she's home.  :)

Back to Ohio

Just about an hour after I posted my last blog about Lexie having Von Willenbrand's disease, Dr. Ellis called to tell me that not only was Lexie starting to bleed again (through all the gauze that they had packed in her wounds), but her latest blood work indicated that she DOESN'T have VW disease. Therefore, Dr. Ellis recommended we rush her back to MedVet in Worthington, Ohio to see another specialist who could hopefully diagnose the reason why her blood wasn't clotting. Dr. Ellis gave me another option of letting Lexie spend the night in our local ER for observation, but she was worried that Lou might not make it through the night. Because Justin had agreed to make up the hours he'd taken off work to be with me that day, he wouldn't be able to go to Ohio with me. So, I called my brother, Zach, and thankfully he agreed to go with me. I was terrified, however, to drive Lexie 3 hours to MedVet in her condition, and even Dr. Ellis said there was a chance Lou might not make it there. However, Dr. Ellis said that she felt the risk might be worth it because the specialists at MedVet would be much better at diagnosing her.

I should probably back up a little bit and explain that the issue was that Dr. Ellis and Dr. Ayers had to pack Lexie's eye sockets with gauze in order to slow the bleeding after her enucleation surgery, which means the gauze still has to be removed. So, the worry is that even if the bleeding stops right now, it could possibly start again when the wounds are re-opened and the gauze is removed. Therefore, we need to find out what's preventing her blood from clotting so we can fix it before unpacking her wounds.

Ok, so Zach and I went to pick up Lexie from Animal Care Clinic. I was afraid of how she'd look, but it was actually much better than I had expected. Dr. Ellis had wrapped Lou's head and eyes really well, and Lexie was even up and moving around. She was still my Lou, too, which pleased me more than I can even tell you. I had expected her to be this pitiful, lethargic, bleeding, dying, Franken-Dobie, but she wasn't anything close to that. I sat in the back seat with Lou as Zach drove us to Ohio. I am usually very careful about the speed limit, but I told Zach I didn't care if he got pulled over because we were racing against time at that point. 

Well, wouldn't you know that apparently the Storm of the Century just HAD to come through Ohio and WV right at that moment? Although we lucked out and only drove through heavy wind and some rain, the rest of Ohio was hit HARD. During the entire drive through half the state, we saw downed trees, branches, and the majority of towns we drove through were without power. The whole time, Lexie was so good. She just laid down beside me and slept most of the way. She was breathing pretty hard, though, which worried me, and I kept a close eye on her breathing the entire time. Then, when we were about an hour away from MedVet, we hit stand still traffic. After about 30 minutes of not moving, I started to panic, but then we finally started to move again. Just as we were about to take the exit to 270 toward Columbus, the exit was shut down! We ended up having to re-route through some town that had a billion stop lights, but the power was out so we had to do a four-way stop at every single one! I seriously thought I might have a heart attack at that point. 

Finally, 4 hours after we left Huntington, we arrived at MedVet. When I got Lexie out of the car, I could see a spot of blood where her head had been resting. They took her straight back, though, so I was relieved she was at least receiving medical attention. However, I told Zach when we sat in the waiting room that I wasn't expecting good news.

 When we finally spoke to the vet on duty that night, Dr. Miller, I was both relieved and surprised when she told me Lexie looked good and seemed stable. She said she wanted to do a blood panel since Lexie had had a transfusion that day and keep her overnight for observation. Then, in the morning, Lexie would be seen by an internal medicine specialist who could try to figure out why her blood won't clot. It was after midnight at that point, and Zach and I were both too tired to drive, so we got a room at a nearby hotel.

I called MedVet first thing this morning and they said Lexie did well through the night and all of her blood work looked good. So, now I'm just waiting to hear from the other specialist after he has a chance to examine her. I'm crossing my fingers for some actual answers today.

Surgical Complications

If you're religious, I'm asking for prayers.  If you're not religious or of some different religion/faith, I'm asking for good vibes, VERY positive thoughts, chants, or whatever you can do to help my Lou survive this surgery.

Dr. Ellis called me a little before 1:00 p.m. to tell me that there had been a complication during Lexie's enucleation procedure, and I could tell by the tone of her voice that it was serious.  She said that Lou has Von Willebrand's disease, which is a blood clotting disorder found commonly in Dobermans.  Apparently, this blood disorder can develop at any time and is not always detectable on blood tests.  According to www.petmd.com, "Typically the platelet count will be normal (unless your dog has experienced recent, massive bleeding), and coagulation tests will show normal results."

Dr. Ellis said that they were having a hard time getting Lexie's bleeding to stop, but they had called in another local veterinarian, Dr. Ayers, to start working on her.  However, Dr. Ellis did not sound hopeful and even added, "I just wanted you to be aware of what's going on because it's critical.  Lexie has lost a LOT of blood, to the point that she's becoming weak...."  She told me that they were prepared to give her a transfusion if necessary, and told me to keep my phone close by.

I was covering the front office when I received this devastating phone call, and it was all I could do to try to hold myself together because there were patients in our waiting room.  Thank goodness my boss just happened to walk up front at that time, because as soon as I saw her I said, "I'm sorry, but I need to go."  I told her what was happening, and she said it was okay for me to take off the rest of the day.

I drove straight home, still trying to hold it together, because I felt like I was going to explode, and I didn't want to do that in the tiny waiting room at Animal Care Clinic.  Besides, they were still working on Lexie, so it's not like I could go back and see her anyway.  Luckily, Justin was home on his lunch break, and as soon as I walked through the door I cried, "She's dying!" then basically just crumbled to the floor sobbing.  Justin rushed over to me and helped me sit at the bottom of our stairs, then asked what was going on.  As I was explaining the situation to him, Dr. Ellis called back.  She said that they had begun a blood transfusion and would keep me posted.


Justin, unfortunately, had to get back to work, but he managed to work it out with his employer so that he could come home and make up his hours tomorrow morning.  So, we sat on the couch for what seemed like an eternity waiting for the phone to ring again.  I was in a complete zombie state at that point, just trying to block out all thoughts until I heard back from the vet.  


Finally, Dr. Ellis called around 3:30 p.m. to say that they had given Lexie about a pint of blood, but the only way they could get the bleeding to stop was to pack the wounds.  Dr. Ellis said that she was getting ready to call the local hospitals to see if she could get this stuff (she never told me the name of it or what it is exactly) that will hopefully help Lexie's blood clot.  They are hoping that it will prevent her from bleeding again when they unpack her wounds tomorrow.  


So, that's where it all stands at this point.  Dr. Ellis said that Lexie was resting comfortably, but didn't want me to come see her because she didn't want Lou to get all worked up.  She also said that she'd try to call me with an update later tonight, probably around 10:00 p.m.

Again, I'm asking for LOTS of prayers, good vibes, magic spells, good energy, etc. to help my Lou pull through this.  She's been with me through SO much, and I simply cannot imagine my life without her in it.  At least, not yet, and not like this.  

Background - Part Three to Present Day: The Enucleation Decision

When Dr. Ellis called me Monday afternoon, just as I was leaving to go pick up Lou from the vet, she reported that Lexie's right eye pressure was 46, which is the highest it's ever been, but surprisingly her left eye pressure was normal.  She said she spoke with Dr. Corbett, and Dr. Corbett said that there is only one medication left that we haven't tried, but it's extremely hard to find and it's very expensive.  Then, Dr. Ellis told me that, because Lexie has not responded well to ANY of her treatments, and because her eye pressures have continued to build and fluctuate, Dr. Corbett had advised enucleation, and Dr. Ellis agreed.  My heart sank.

When I arrived at the vet just a few minutes later, Dr. Ellis was waiting on me.  I could tell that she was truly sorry that we weren't able to save Lexie's eyes, but I know in my heart that we did all that we could do.  After all those trips to the vet in both Huntington and Ohio and all that medication, at no point did Lexie's eyes look like they were steadily improving.  One day they might have looked a little better than the day before, but then just as quickly one or both of her eyes would look much worse.  So, at this point, it just kind of feels like this is what's meant to be.  However, just as I was wrapping my brain around the concept of having Lexie's eyes surgically removed, Dr. Ellis said, "It's your decision whether or not you want to remove both eyes, or just the right."  


Whoa.  Wait.  What?


I have to CHOOSE whether or not Lexie has her left eye removed?!?!?!  I asked Dr. Ellis for her opinion, and she recommended that I have them both removed in one surgery.  She said with the way her eye pressures had been fluctuating, she was almost certain that Lexie's left eye would have to be removed eventually anyway.  She told me to think about it, though, and call her in the morning with my decision.  She said that Lexie's right eye was definitely causing her pain, so the sooner the surgery, the better.


I had read online somewhere that it's very important for owners of newly blinded dogs to stay upbeat because your sadness can make your dog even sadder.  So, the first thing I did when we got home from the vet was I went up to my bedroom and bawled for about an hour.  I couldn't stand the thought of my Lou never looking at me with those big, brown, sparkly eyes ever again.  Then, I started toiling over the decision to remover her left eye.  After all, the pressure in that eye had been normal, which meant it wasn't causing her pain, it looked a LOT better than her right eye, and I could tell she could still at least see shadow and light.  How could I possibly decide to remove her left eye when it looked so good and still seemed to have some function?

Regardless, I knew that the logical decision was to have both eyes removed at once since the chances are very good that her left eye would need to be removed eventually.  So, that night I made up my mind that I would schedule her for a double-enucleation on Friday (so I could be home with her over the weekend).  However, the decision didn't sit well with me all night and, in fact, I awoke at 4:30 the next morning literally in tears over it.

So, the next day I thought it over and finally decided that my heart simply would not let me live with the decision to remove her left eye for all of the reasons stated above.  If it looked as bad as her right eye and/or I knew it was causing her pain, it wouldn't even be a question, but as it was I decided I would let her keep her left eye until it became medically necessary to have it removed.  The moment I made that decision, I felt a million times better.

I continued to feel good about my decision, in fact, until yesterday.  I have been Googling all sorts of things regarding canine blindness, helping a dog adjust, enucleation photos to prepare myself for how she'll look after surgery, etc., and somehow I stumbled upon a blog, very similar to this one, written by a woman who's dog had undergone two separate enucleations.  She said that the second surgery was actually much harder on her dog because he had grown so accustomed to being able to see shadows and light out of his one good eye after his first enucleation.  Therefore, when he awoke to total darkness after his second surgery, it really freaked him out.

Reading this really made me doubt my decision to save Lou's left eye.  Was I really prolonging her quality of life, or was I just trying to avoid the inevitable for my own selfish reasons?  I fully admit that one of the main reasons I didn't want to have her left eye removed was because I wanted her to still be able to look at me with at least one eye, even if she couldn't really see me.  Again, I just couldn't stand the thought of her NEVER being able to look at me ever again.  However, I knew deep down in my heart that her left eye would have to be removed at some point.  I was even a little worried that her left eye might take a turn for the worse immediately after her right eye is removed, and she'd end up having back-to-back surgeries.

I went home from work yesterday toiling, once again, over this decision, but as soon as I got home I realized that the decision had already been made for me.  Lexie's left eye had gotten MUCH worse while I had been at work.  It is now just as cloudy as her right eye, bulging a little bit, and she was even pawing at her eye, which is a sign of pain.  I know this may sound awful, but I was actually kind of relieved to not have to struggle with this decision anymore.  Knowing my Lou is in pain takes away any other option, as far as I'm concerned.  Both of her eyes simply have to be removed.

So, now here we are.  Less than a month from the first sign of inflammation, it's the night before Lexie's scheduled enucleation surgery.  I'm still 100% certain this is the right decision, as her eyes both look really bad tonight and it doesn't even seem like she's seeing much shadow or light anymore.  At this point, I'm almost anxious for the surgery because I just don't want her to suffer anymore.  My hope is that once her eyes are removed she will be completely pain-free, and then hopefully I'll start to see her spunky little personality start to come back.  Right now, she's kind of depressed and obviously doesn't feel well, so she hasn't acted like "my Lou" in weeks.  I know it's going to take a while for her to recover from the surgery and adjust to complete blindness, but I'm fully confident in Lexie's ability to adapt.  In fact, I have a feeling this blind little Dobie is going to blow us all away with her amazing new abilities when it's all said and done.

In the meantime, I'm not gonna lie, tomorrow is probably going to be one of the toughest days of my life.  I will be dropping Lou off at the vet when they open at 8:00 a.m., then waiting on pins and needles while TRYING to work all day to hear how her surgery went.  I'm not sure if she's going to need to stay overnight, but thankfully my vet is open on Saturdays, so hopefully I can pick her up the next day at the latest.  I'm sure that I'm going to be incredibly sad and even a little bit horrified when I see her for the first time, but that won't stop me from babying the hell out of that little turd all weekend long.  In fact, I think I'll go baby her right now.

Background - Part Two: Blindsided By Glaucoma

After making the six-hour drive (round-trip) to see veterinary ophthalmologist, Dr. Corbett, at MedVet in Worthington, Ohio, Justin and I immediately began administering Lexie’s medications just as Dr. Corbett had prescribed:  three and a half antibiotic pills each morning, steroid drops in each eye every six hours, and her ibuprofen-type medication (I forget the name) twice a day.  We did this religiously for about four days without seeing any improvement in Lexie’s eyes, but I wasn’t really worried because Dr. Corbett had said we probably wouldn’t see improvement until after a week.

Then, on about the fifth day following Lexie’s trip to Ohio, Justin and I decided to take Lexie and her sisters, Jocie and Sam (see the Introduction section of my blog below), to visit his parents.  The girls had a blast running all over the fenced-in yard and exploring Justin’s parents’ home.  It was during that visit, however, that I noticed Lexie’s left eye was looking cloudier than usual.  Upon further inspection, I discovered the whites of her eyes were also extremely red.  I wondered if this was due to her blood pressure being elevated from all the excitement, and I hoped that the redness in her eyes would decrease after she went home, settled down, and had a good night’s sleep. 

Well, the next morning (Monday), not only were her eyes still very red, but her left eye had gotten even cloudier than the day before.  At that point, I felt it was time to call Dr. Corbett to schedule Lexie’s follow-up appointment.  After scheduling her appointment for that coming Wednesday, I spoke with one of the ophthalmology vet techs, and she recommended I take Lexie back to see Dr. Ellis, our local vet, to have her eye pressures read that day.  She said that what I was describing sounded like Lexie’s eye pressures might be building up, which is a sign of glaucoma.  Not only that, but those pressures can increase very quickly and cause Lexie to lose her sight within a matter of hours! 

I immediately called my brother, Zach, and asked if he could take Lexie to the vet for me after he got off work. He agreed, and about an hour or so later I received a call from Dr. Lilly at Animal Care Clinic, who was filling in for Dr. Ellis that week while she was on vacation.  Dr. Lilly said that Lexie’s eye pressures were dangerously high, and she told me I needed to take Lexie IMMEDIATELY back to MedVet in Ohio for emergency treatment.  She said she would call MedVet to let them know I was coming.  As soon as we hung up, I found my boss and tearfully explained to her that I probably wouldn’t be able to come into work the next day because I was about to rush my Doberman back to Ohio.  She said that was fine, but as soon as I got back to my desk I received another phone call.  Apparently, when Dr. Lilly called MedVet to tell them I was coming, she spoke with Dr. Corbett, who told her an immediate emergency visit was not necessary.  Instead, Dr. Corbett prescribed two new eye drops for me to give Lexie every eight hours, and I was to bring Lexie back to Animal Care Clinic the next day to have her eye pressures checked again.   If the eye pressures were decreased at that point, then it would be okay for us to just keep our Wednesday appointment.   Thankfully, the new eye drops were successful in bringing down her pressures, so that Wednesday Lou and I headed back to Ohio to see Dr. Corbett.

At this point, I was starting to feel like the butt of some sort of cruel joke.  Wasn’t it just a week ago that I had been SO happy and relieved to hear an that Lexie WASN’T going blind?  What was all this talk about glaucoma and having to lower her eye pressures so that she wouldn’t go blind within a matter of hours??!?!   Dr. Corbett never mentioned the possibility of glaucoma developing, nor did she tell me anything about this serious, sight-threatening condition!  Were there signs I could have been watching for?  Was Lexie at a greater risk of going blind now because I didn’t realize she was developing glaucoma? 

I was bursting with questions when we arrived for our follow-up appointment at MedVet on Wednesday, June 20, 2012.  Dr. Corbett was just as nice as ever and seemed genuinely disappointed that Lexie’s condition had taken a turn for the worse.  After examining her, Dr. Corbett explained to me that Lou had apparently developed glaucoma secondary to her anterior uveitis.  Here is what happened (at least, how I understood it):

Dogs have a sort of “drain” in their eyes, which allow fluids to, well, drain from their eyeballs.    If that drain becomes clogged for some reason, the fluid cannot escape and then pressure begins to build up in the eyes.   If that pressure builds up too high, it causes permanent vision loss.  That, in a layman’s nutshell, is glaucoma. 

Now, there are two different kinds of glaucoma:  primary and secondary.  Secondary glaucoma is when it develops due to another underlying condition, such as anterior uveitis.  In Lexie’s case, her anterior uveitis had caused her eyeballs to become inflamed, and the swelling is what caused the drains in her eyes to clog.  Dr. Corbett explained that if we could successfully determine the cause of her anterior uveitis, we could hopefully treat it, which would then get rid of the inflammation and allow those drains in her eyes to re-open; thus, also getting rid of the glaucoma. 

First thing was first, and that was determining the cause of Lexie’s anterior uveitis.  We had already ruled out an eye injury, and we had been treating her with medication as though the cause was either a tick bite or an autoimmune disorder, but we still hadn’t ruled out cancer, fungal infection, or disease of her internal organs. Therefore, Lexie underwent a chest X-ray and abdominal ultrasound, both of which thankfully came back completely normal.  As relieved as I was to find out she did not have cancer or anything else wrong internally, that only brought us right back to square one:  assuming her anterior uveitis was caused by a tick bite or autoimmune disorder.

Dr. Corbett decided to treat Lou much more aggressively for the next two weeks by adding an oral steroid, Prednisone, on a tapering dose, maintaining the antibiotics and steroidal eye drops, and also adding three different eye drops to treat her glaucoma, which were intended to help stabilize and maintain the pressures in Lexie’s eyes at a safe level.  Dr. Corbett told me that after two weeks of this aggressive treatment, we would have a much better idea of Lexie’s long-term prognosis, which we would discuss at her next follow-up visit. 

I was very careful with the wording of my questions, but basically I told Dr. Corbett that when I left there the last time, I left under the impression that there was not any danger of Lexie going blind, so I just wanted to make sure that I had a full understanding about what was going on with Lexie’s condition so that I hopefully wouldn’t experience any further heartbreaks or disappointments.   Dr. Corbett never acknowledged or apologized for the fact that she did not at least give me a heads up about the possibility of Lou developing secondary glaucoma, but I did appreciate how nice Dr. Corbett was and how she made me feel as though she had all the time in the world to answer my questions.   I also felt confident that Lexie was receiving the best possible care at MedVet.

This time, as I made the three-hour drive back to Huntington from Worthington, I was relieved that at least Lexie’s condition wasn’t life-threatening and still slightly hopeful that her new aggressive treatment would cure her anterior uveitis and glaucoma, but overall I was just extremely saddened and disappointed by the fact that there was now actually a strong possibility that Lexie could go blind. 

Justin and I literally had to set alarms on our phones to remind us which medication Lexie needed at what time, but we continued to administer all of Lexie’s medications, just as Dr. Corbett prescribed, 24/7.  The cloudiness in Lexie’s eyes did actually clear up for a couple of days, which made me hopeful, but on Sunday night I noticed her right eye was starting to turn really red once again.  The next morning, her right eye was very cloudy, both eyes were extremely red, and her right eye even looked like it was bulging a little bit.  Even worse, it was obvious that she wasn’t seeing much more than shadows and light.  I called MedVet as soon as I got to work, and they advised me to take Lexie back to Animal Care Clinic to have her pressures read.  So, I left work, picked Lou up, and dropped her back off at Animal Care Clinic. 

Finally, just as I was leaving to go pick her up, Dr. Ellis called me.  I expected to hear a progress report on Lexie.  Hell, I was even expecting the report to be bad.   What I wasn't expecting was that Dr. Ellis was about to present me with the hardest decision I've ever had to make...

Background - Part One: It's "Only" Anterior Uveitis

It’s hard to believe it was only less than one month ago (the first week of June, 2012) when I first noticed something was wrong with Lexie’s left eye.   She happened to turn to look at me while her third eyelid was covering her eye, which was something I’d never seen her do before.    As soon as I jumped up to get a closer look, though, her eye went back to normal and she seemed to be perfectly fine.  I thought that maybe it was just a fluke, but it became obvious the next day that it wasn’t.   Her eyes were becoming increasingly red, so I made an appointment at the vet the next morning.  I thought that she was maybe having an allergic reaction to something, or perhaps had been scratched by one of the feral cats that sometime seek shelter under our deck.  I figured the vet would probably prescribe some medicine, which we’d probably have to give her for a couple of weeks, and then Lou would be back to normal in no time.

My boyfriend, Justin, and I took Lexie to see Dr. Ginger Ellis at Animal Care Clinic in Huntington, WV that Saturday.  I could immediately tell by Dr. Ellis’ concerned expression, however, that Lexie’s eye condition was something worse than I had anticipated.  She measured Lou’s eye pressures and was very relieved when her pressures were low, because she said that meant that this was not glaucoma.  After further examining her, Dr. Ellis said she believed Lexie had anterior uveitis, which is an inflammation that affects the front, or anterior, part of the eye.  She prescribed a steroid eye drop to give Lexie every six hours, along with an antibiotic, and told me that Lou’s eyes should start looking better by the next day.  If it didn’t, Dr. Ellis recommended I take her to the emergency vet, since it would be on a Sunday, in order to have blood work done because eye inflammation can also be a sign of something going on internally, like cancer.  I asked Dr. Ellis if we could just go ahead and do some blood work that day, just to save myself a little bit of worry.  She agreed, and thankfully Lexie’s blood work came back normal.

We immediately started administering the antibiotics and steroid drops to Lexie’s eyes as prescribed, but she did not look better the next day.   I didn’t rush her to the ER, though, because her blood work had come back normal at Dr. Ellis’ office.  So, I just continued to administer her medications over the next several days, thinking that eventually they would kick in and she’d start to look better, but she didn’t.  In fact, after a full week of treatment, Lexie’s eyes were starting to look worse.  Her left eye was noticeably worse than her right, but they were both very red, and she was holding them shut most of the time.   However, despite the fact that she was starting to actually look like a blind dog, she could obviously still see because she wasn’t bumping into anything, which I took as a positive sign.

At her follow-up appointment (one week after her initial diagnosis), Dr. Ellis frowned when she saw that Lexie’s condition had worsened, and after giving her a brief examination, she asked if she could refer us to an eye specialist in Ohio.  She said that she was afraid Lexie may be developing retinal detachment and could go blind very quickly, but because Dr. Ellis is not a veterinary ophthalmologist, she said she couldn’t really be sure.  That is why she wanted to make us a referral to a place called MedVet in Worthington, Ohio, which is a three-hour drive from Huntington.  I couldn’t believe we were actually discussing the possibility of my Lou going blind!  I was immediately in tears  because I wasn’t sure I would be able to afford any kind of extensive treatment that Lou may need.  Dr. Ellis and her assistant were both very sympathetic and talked to me about some possible financing options through Care Credit, if it came to that.  Her assistant held my hand and told me that dogs adjust very well to being blind, and told me about how her own dog adjusted very well after he had to have both of his eyes removed.  So, basically, I went home from the vet that day thinking that Lexie was most likely going blind, but still holding out hope that the specialist in Ohio would have better news for us. 

A few days later, my roommate, Ashley, accompanied me and Lexie on our road trip to see Dr. Corbett, a veterinary ophthalmologist, at MedVet.   (Thankfully, I have a very nice boss who allowed me to take some time off from work in order to make the trip to Ohio.)  I was very impressed when we arrived at MedVet because it was SO much bigger than the little old Animal Care Clinic back home.  It felt more like a hospital, which was comforting in a way. 

Dr. Corbett and her vet tech were both very nice.  After a thorough examination of Lexie’s eyes, Dr. Corbett told us that Lexie’s retinas looked fine.  She then went on to explain anterior uveitis to us, which was Dr. Ellis’ original diagnosis, but I still wasn’t 100% sure if Lexie was in danger of going blind.  Finally, I mustered up the courage to ask, “Just to be clear, are you telling me that Lexie is NOT going blind?”  Dr. Corbett replied, “Correct.  She is not going blind.”  Ashley and I both cheered, and Ashley immediately began texting the good news to all of our concerned friends back home as I continued to listen to Dr. Corbett. 

She explained that anterior uveitis can be caused by a number of things, including tick bite, cancer, eye injury, a disease of the internal organs, fungal infection, or it could possibly be autoimmune-related.  She was able to rule out eye injury during Lexie’s exam that day, and I could have paid to have blood work done that would have definitely told us if it was caused by a tick bite, but when Dr. Corbett said that we were basically treating her for a tick bite anyway, I decided to save some money and not order that test.  So, that left cancer, internal organ disease, fungal infection, and autoimmune disorder as the remaining possible causes for her uveitis. 

Dr. Corbett recommended we treat Lexie’s condition as though it was caused by tick bite or an autoimmune disorder.  If her condition worsened or did not improve after two weeks of treatment, then she would order a chest X-ray and abdominal ultrasound to look for cancer, etc.  So, I was told to continue giving Lexie the same steroid eye drops and antibiotics she was already taking, but Dr. Corbett increased their dosages and added another ibuprofen-type medication to her regimen.  She told me that Lexie wouldn’t look better immediately, but after about a week I should start to see an improvement. 

Needless to say, I went home the happiest dog owner in the entire world that afternoon because I had been told by an actual veterinary ophthalmologist that Lexie was NOT going blind!!!!

If only I had known the heartbreak that lay ahead…