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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Fri Jun 22, 2012 5:35 am 
I am SO relieved you got a second opinion.


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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Fri Jun 22, 2012 7:45 pm 
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Another short update...

Got the 3rd opinion yesterday as well as I retrieved a copy of the biopsy report which is practically in martian even to those of us who might know a few medical terms. Anyway, #3 one wants to put a drain in before he'd do surgery. It would mean Eb being there all day, day after day for a week or so, or me coming in twice a day to have it cleaned out. I don't like either option at all given I have to work and Eb would be stressed to no end kennelled like that for several days. Once the lump and inflammation was down, he'd do an ablation. He was good, spent nearly an hour with me explaining options and things like equipment for surgery.

Now, first vet estimate $1000-$1500 depending on whether it's a full ablation or partial. Third vet $400 for the drain, $2400 for the ablation. Then I called the surgeon's office and asked what they might charge and they ballparked at $3000 if no catscan is needed (plus consultation fee of $150 just to look at Eb) and he has holidays so he'd have to do the surgery next week or not till the end of the July...

So I called the 2nd vet to see if they would do up a referral in case I want to see the surgeon and tomorrow it's a call to the first vet to ask some very straight questions now that I know a little more about equipment, side effects, etc. I don't have any belief that price dictates quality since my fav vet 6 hours away was fantastic and very reasonable so won't use that as any sort of gauge.

What I am finding interesting is being the cynical piece of work I am when it comes to vets, I actually have liked all 3 of these guys so far so didn't experience any feeling of manipulation or disdain I have some other times I've met new-to-me vets.

Anyway, the vet yesterday said she should be on pred for now along with the antibiotic the 1st vet put her on so as much as I hate pred, I am doing it to see if it will help get her in better shape for which ever vet we end up with. Poor thing smells so bad with all the fresh blood that keeps coming out of her and whatever this inflamation is coming with it. At least her bump is getting smaller as the blood is draining out, but boy what a smelly girl she is because of it. It seems no amount of cleaning that ear really gets it clean either and I was warned not to bath or get her ear soaking wet so it's a bit of a task.

No way around this I guess. We are up against a big deal surgery with some long recovery. First time in her 8 years she's ever had to deal with anything like this and she's handling it like a champ, no complaining from her, but I sure feel sorry for what she's in for.

Sure hope I can make the right decision for her.

JeanG


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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Sun Jun 24, 2012 10:12 pm 
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Well we are over another weekend. Eb is still bleeding a lot and if I push her bump at all, blood gushes into her ear. It is such a mess it seems like I am constantly dabbing her ear to mop things up. I got frustrated last night and decided it was best to just cut all the long hair on that ear off as it was just matted and hard and no amount of trying to clean it was making a difference. Tonight I noticed her gums are a little pale which worries me. She's also feeling the pred and is trying to lick any crumb she can find and drinking more today.

I did call my old vet yesterday thinking maybe he could either speak to me or if needed, make time to see us and the dog and I would be in the car in short order. Anyway, his office message says he retired 2 weeks ago...Words can not describe how my heart sank because if there is one voice I really need to hear it's his. So I am flying by the seat of my pants now I guess.

One thing I forgot to mention about that 3rd opinion is he did tell me the first vet is a very good vet with a lot of skill and experience. That helped some. I did try and call 1st vet yesterday but he wasn't in so I will be calling him tomorrow especially given the gums going paler.

In my mind now (after having a few talks with myself over the weekend) if he can get me to a comfort level I can live with (telling me how many of these he's successfully done and showing me he has some of the equipment I have learned helps minimize the risks with this surgery), I think I will let him do the surgery on Wed. A few reasons for my thinking are:
- Eb is a bleeding mess and waiting is not going to fix that given she needs something closed up to stop it. If it was going to heal on it's own it would have by now (nearly 11 days now).
- I've noticed an odd soft pouch sort of thing on her front chest and am wondering if she isn't bleeding into there too as it doesn't feel familiar and I could see gravity causing blood pooling lower (at least that makes sense to my non-medically educated mind).
- having him do it on Wed and me having 4 days off to watch her is the only thing that even comes close to working with my job and the couple of friends who have said they would watch her after that for me.
- push comes to shove, if he can do the job at half the price, that would make a huge difference to me and as much as I wish it weren't so, there are practical things I do have to consider when it comes to money.

One thing I can't get out of my mind is the vets who saw the biopsy results saying ablation is probably the only outcome given the situation with this lump. The only question seems to be whether it will be now or later and partial or total. The now or later seems to be the one thing I can control and so far I have to find out more about it given there is some inflammation there which may be the very reason timing is key. If even one of them had given me even the slightest hope there was another option, maybe I would put on the brakes but that didn't happen. What kills me is still not knowing exactly what it is and what has caused it. That may be something I'll know when it's over I guess.

So that is the way I am thinking at the moment. Who knows, this time tomorrow I may be swinging in another direction again. I so wish I could be certain of what to do.

JeanG


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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Sun Jun 24, 2012 10:23 pm 
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Hi Jean,
I hope by the time you read this that the vet has had a chance to look at Eb "in person." Her continued bleeding and paler gums are worrisome.

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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Mon Jun 25, 2012 5:57 am 
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Thinking about you Jean. Please update when you can.

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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Mon Jun 25, 2012 3:22 pm 
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Like you I'd be worried sick. I'd go with my gut on this one. The continued bleeding and somewhat pale gums would cause me to react. I know you will do what is best

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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Tue Jun 26, 2012 6:51 pm 
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Jean...

There is no hurry if quality of life is not impacted.... but you now describe an issue that is in need of being addressed. My thoughts and prayers as you make your decision for Eb's health care. Please continue to keep us posted!

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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Tue Jun 26, 2012 10:02 pm 
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So, t'is the night before surgery and my little furface is sleeping peacefully sprawled on the carpet as per usual. I don't mind saying I'm a little nervous, but I am trying not to think about it much so she doesn't pick up on my angst.

We saw vet #1 again yesterday. He had called me in the morning to talk as vet #3 had called him to discuss things. I was half way between pulling my hair out (as I thought I'd been clear that I didn't want #1 knowing I was getting other opinions until I told him myself but apparently I wasn't) and feeling some comfort that the two of them apparently chatted it out quite a bit and it sounded like they were putting their heads together making a plan for this dog that would be the best approach.

By the time we got to his office at the end of the day, Eb was really smelly and oozing from being at the daycare all day (they do well but weren't exactly into cleaning her and I can't say I expected them to, but a little bit might have been a nice touch given they've been pretty good about watching out for her while she's been living with a collar (blow up type)). Her gums were back to normal pink so that was a relief. That chest lump I noticed was more my paranoia and imagination than anything to worry about.

The vet took a look at the ear then said it really smelled like yeast to him and most definitely needed to be taken care of now because it was still oozing so much blood and obviously from the smell, some bad things that could spread. He didn't expect to see it still so messy at this point, but it just hasn't clotted like he thought it would. He also wants it stopped lest she end up with a spread of yeast that would weaken her a lot (seems she has a really strong immune system which is why this thing is a little odd in how it's arisen and stayed where it is so far because I guess most dogs would have been appearing very ill while she just wasn't appearing bothered at all).

So, more super antibiotic type things for the yeast are added (stopped the pred which I was happy to do) for a couple of days, and when we got to hard facts, he told me he had cleared his entire morning Wed for Eb after the 'vet' chat. He also explained he has the same sort of equipment and made me feel a little better telling me how much experience he had doing this kind of surgery.

As we stand, he'll actually start on her with a large cut as if doing the full ablation, but won't know what he is going to do until he flushes out the mess (which he said may take a few rounds of cleaning with that do-dad they use to flush ear wax etc out of the deep canals) and can really take a look at everything inside and out of that canal including that lump. He wants to see if this is just a result of yeast or if anything else is at work too (I guess that means taking some tests for determining medicine later too). Basically it's either:

Option 1= putting in some drains if there is still just too much stuff going on and get it all cleared up before going to the next step (the ablation). That means another surgery to follow.

Option 2= getting that lump and all it's nasties out as well as either a partial or full ablation and we let her heal up while giving her more antibiotics and hope that's the end of it.

So I basically will have no idea of what is happening until he's finished the procedure.

What surprised me a little is he told me he will do the drain (if needed) for half price ($150 - $200) and the ablation for his original quote of $1000 - $1400 with a guarantee that all costs, visits, etc. to do with this (like follow up) will not exceed $2000. Now that is something the other vets never mentioned but I thought it was a pretty decent proposal to come out of a vet (or at least what I think of most vets).

Bottom line, we do what is best for Eb while trying to keep her stress and pain to a minimum. We both agreed my impatience to just get it all over with would not come into play (mostly because I just am so worried about how I will take care of her if we have to do option 1 because I have no way to take time off or anyone who would be able to help after a second surgery given holidays and such...and mostly because I tend to be impatient when left hanging like this.). Option 2 does work like a charm when it comes to days I have off and friends who have offered to watch her for me after but no can do for a second surgery if it's in July that's for sure.

I expect I'll either be a bit of a stressed some-sort-of-zilla or a bumbling basket case tomorrow at work while I wait. Here's hoping I can stay calm and the morning goes fast and I can just avoid my boss who annoys me on a good day with her less than charming personality (I've worked for a lot of very nice people in my life but this one has taken the prize for examples of how not to manage people).

Please send Eb your good vibes and thoughts. I have a feeling no matter what option goes tomorrow she's not going to be very happy when she realizes that collar is on to stay for a bit and more pills to come. She's such a sweet spirit I just hate thinking of putting her through something like this...Okay enough of that or I will be sending her my worry and stress. Good thoughts only from me for now. Stiff upper lip and all that.

JeanG


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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Tue Jun 26, 2012 10:22 pm 
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Jean,
Thank you for updating. It sounds like the vets really do have your little girl's best interests at heart. I think you have a real professional there, in giving you a ceiling on the cost. I hope you are able to sleep some tonight. I'm saying lots of prayers for your sweet Eb and for you. Please let us know how it all works out.

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Cricket, home January 29, 2012
Maggie Mae, home September 1, 2014

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Feather: March 23, 1994 - November 17, 2011
17 years and 8 months of Love


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 Post subject: Re: Ablation or not?...update added near bottom of page
PostPosted: Wed Jun 27, 2012 4:25 am 
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It sounds promising, Jean, that the vets are making a plan for treatment of this issue. :th-up

I am still sending along best thoughts and sincerest prayers for you and Eb as you travel this stressful journey. :hp

Update us as soon as you can, please. :hi

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Wed Jun 27, 2012 7:18 pm 
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Okay,I've been exhaling for a couple of hours now. Eb had a total ablation and has a drain as well. I guess that is what you call a vet two-fer. He told me it took over 2 hours to get that ear cleaned and reemed (his term...not very poetic IMO) and removed and he threw in the skin tags I wanted off her too.

Apparently there was virtually nothing to save and the lump was even bigger than he thought originally (oh my, he's saving it for me to see...I hope I don't gag). He said he really was thinking cancer when he pulled it out, until he put it in some solution he sends them off for testing in and I guess it changed the look of it a bit or made it easier to see, because he said it really is just a massive lump of calcified inflamed tissue (probably from her seborrhea and a mild infection that has gone on for years... or at least that is how I grasped what he was trying to tell me on the phone. How a yeast infection can go on for years with no vet spotting it is kind of unbelievable, but I guess I have the example. We'll have to be triple alert with her other ear that is for sure or this could happen again he tells me.).

I am happy it's all been done so at least no more big surgery to have to look forward to and I can be home to watch her when she needs watching. That's a big relief.

He wanted to keep her at the clinic tonight but I told him that would be a no go with her separation anxiety as she will just thrash around, even drugged, if there are no humans around (and so would I knowing no one was there to watch her). About the time I said that, he said he had to drop the phone as a dog was escaping. When he got back on the line I mentioned at least it wouldn't be my dog, and he said it was. He had her by his desk sleeping it off and expected she'd be out another 2 hours but she just got up and bolted for the door. He completely underestimated her ability to get around drugged, so I said thrashing was not just an exaggeration of mine, she'd do some damage to herself if left alone. So he's taking her home with him tonight (I'm getting to like this guy).

He also didn't recommend I come and see her as he said having an owner come in when a dog is like this and then leave again just makes them basket cases. So I have no idea how little furface is doing really. I guess it's just a quiet night and then I pick her up after work tomorrow to come home and start her recuperation. We won't know about nerve damage for a bit as he said she needs to heal and have the swelling go down before we will really know, but he said he doesn't believe there was any nerve damage.

Now I guess all I have to worry about tonight is how I am going to cope here all by myself. Separation anxiety for me I guess and no warm fuzzy to cuddle up with to sleep. Kind of lonely around here without her. Guess I'll go break into the junk food as this seems like as good an excuse as any (at least that's my rationale for such things).

JeanG


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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Wed Jun 27, 2012 7:23 pm 
I'm glad it's over and you can breathe again. Best wishes for Eb's recovery!


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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Wed Jun 27, 2012 7:53 pm 
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Julie Hydro wrote:
I'm glad it's over and you can breathe again. Best wishes for Eb's recovery!


Me too!

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Maggie Mae, home September 1, 2014

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Feather: March 23, 1994 - November 17, 2011
17 years and 8 months of Love


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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Wed Jun 27, 2012 9:00 pm 
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I'm so glad this surgery is over. My wish now is minimal pain and a quick recovery

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Thu Jun 28, 2012 3:42 am 
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I'm so happy it's over too...I know you won't feel better till you see your girl! I pray for swift and smooth recovery!

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Thu Jun 28, 2012 4:16 am 
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:hp Jean, Sending you a huge hug. Things will be so much better now - for both of you! I hope Eb feels better really quickly, take care.

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Thu Jun 28, 2012 7:25 am 
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Ah Eb, way to go! Escape while drugged . . . that's no small feat!

I'm glad the surgery is over, and you no longer have to mull that over in your mind. Now you can focus on Eb and her recovery. Hugs to you both!

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Thu Jun 28, 2012 2:40 pm 
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Thank you so much, Jean, for this update and the positive news.

It's funny that sometimes our vets won't take our word about common behaviors of our dogs. :bang I don't have a degree in veterinary medicine but can predict very well how my own dog will react in almost every situation. :bg

Anyway, huge prayers for a quick recovery for Eb and sincerest thoughts for you. :hp

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Thu Jun 28, 2012 3:34 pm 
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I'm hoping for a quick and uneventful recovery. Please give the pup a snuggle from us when you can - and try and rest while she's resting since you are likely to be up and down a lot checking. I know this wasn't undertaken lightly and I personally think you are a wonderful example of thoroughly investigating a situation in order to make a decision in the best interest of our furbabies.

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Thu Jun 28, 2012 6:34 pm 
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Big sigh of relief, Jean. I'm glad it wasn't cancer and it sounds like the surgery was successful - despite Eb's attempt to run for the hills, LOL. She's a spunky little gal. I hope she will get a little better each day over the weekend. I say eat the potato chips (or cookies or pie) until you feel better.

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Fri Jun 29, 2012 12:28 am 
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Reminds me of a friend whose dog nearly leapt out of the vets arms literally minutes after a C-section, while she should have still been nearly unconscious! Glad to hear she came through the op, and I'm still she will recover just fine. :th-up

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Fri Jun 29, 2012 6:50 am 
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Just looking in to see how Eb is doing... hope she is now home recuperating!

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Fri Jun 29, 2012 12:52 pm 
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Thank you all for your thoughts and help. Eb is beside me snoring away. The vet warned me that her throat is a little swollen right now and the result is it sounds like I have a pug living with me (guess that would make her a Pucker?) who becomes a full fledged noisy snore factory when she's sleeping. I mean she snored before but they were nice little lady-like snores. These are something I'd expect from something like a rhino. Regardless, I am happy to hear her because it means she's home again.

The vet did save her lump for me. It had completely blocked the bend in the ear canal and the lower canal. It was the size of maybe a large grape. I won't describe how it looks as it wasn't attractive. He says it looked small because it was now drained of all the inflammation it held which had it swollen to the size of an egg before it came out (guess that is what changed when he put it in that fluid to send it off because the fluid didn't look very nice in that bottle when I saw it). It seems it was a slow build up of wax and her greasy stuff that caused a long slow inflammation and just has been getting bigger and bigger over the years (sort of sponge-like I guess). Again, no real signs all this time that there was a lot going on except some waxiness sometimes and a few polyps.

So lesson learned, even though she seemed fine and wasn't bothered, I needed to be really diligent with the ear cleaning solution and should have made sure the vets were looking way down deep once in awhile because we could have maybe been cleaning out that build up as we went along. Antibiotics might have held back inflammation but they wouldn't have done diddly for that greasy skin/seborrhea/buildup. I had no idea her greasy skin would lead to something like this. He's going to keep a closer watch on her other ear which he checked while she was out. He cleaned it a bit but says it also has quite a bit of build up and some polyps (from that stupid greasy skin seborrhea) blocking things.

For now we stay quiet. She's eating, drinking and sleeping. I'm watching her to keep her from rubbing off her bandages (poor thing has her whole head wrapped with a drain hanging out that I also have to keep working with to keep things flowing out. That's a new experience for me but not a big deal.).

So far she's been a real champ and not complaining or crying or anything. Her face is paralyzed on one side which means eye drops because she can't blink. He says it's all from swelling and should go away in a week or two. She's also been getting cherry eye too from the drugs relaxing her and that paralysis but they are popping back quite easily with a little massage.

Come Tuesday he'll be taking off the bandage and removing the drain and then I guess I'll see what she really looks like. He tells me all that will be different when it's healed is that when you lift her ear flap there will be no hole there anymore, just fur. She'll look perfectly normal to the casual observer. She'll be happy if we can take her blow up collar off as she'll have had that on for 3 weeks by then. I sure can recommend those things as she's been reasonably comfortable and able to move around without banging into things while still not being able to reach the incision. Well worth the money (which I will say varied around here with the smaller stores being about 30% less expensive than the big chains).

JeanG


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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Fri Jun 29, 2012 3:37 pm 
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Thank you once again, Jean, for this detailed update on Eb. :Clap

Poor Eb and poor you for having to go through all of this. :cry You are a terrific Cocker Mom for having the tenacity to get to the bottom of this issue with her and working through it with the vets. :joy

Sending prayers of healing for both of you. :hp

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 Post subject: Re: Ablation or not?...it's done....
PostPosted: Sat Jun 30, 2012 6:32 pm 
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I am so glad that Eb is home with you and on the road to recovery! I hope that all continues to go smoothly for her. I hope you never have to go through this again! Did the vet give you any idea what would be the best thing to use to keep her ear clean?

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