Fiona was surrendered to FBV on a very cold February night, from an owner who loved her very much but could not afford the cost of her suspected diagnoses/treatment of a liver shunt.  Luckily, the liver shunt was ruled out when Fiona was spayed.    That was very good news!! Other than luxating patellas in her knees and her breathing difficulty, Fiona was in good health.  To correct her breathing, while she was being spayed, we had her palate trimmed and saccules removed.  After the surgery, she continued to be very mucousy sounding, still having problems breathing at night, and she started regurgitating. I took her back in multiple times to be checked over, only to bring her home again when nothing could be found.  I suggested a barium swallow study but her surgeon felt it was too risky (aspiration pneumonia).   We were sent home with the thinking that she probably just needed more time to heal.  As the regurgitation continued, I introduced elevated feedings as well as satin balls, which ironically seemed to help the mucus as well as the urping.  We were  progressing okay, with limited bouts of regurgitation with this method.  However, she still had bad nights where she could not rest, she would lay down only to get back up again, only to do it over and over again all night.  I tried so many different positions and beds, trying to find something that would work.  Some nights were good, some were not.  I took her back in and we were transferred to the Internal Medicine Department.

They diagnosed her with oesophogitis.  I went home with a throat coating medication and an anti-acid.  Shortly after her last visit, she collapsed. It was a Sunday night, I remember as my dad was in town visiting for the weekend and he was to leave the next day.  She was doing the up/down thing in her bed, lay down, get back up, except one of the times when she went to get back up, she collapsed.   On her side.  It was not a seizure, she truly just passed out.   She was admitted via the ER to the Care Center Hospital and we put the pressure on them to figure out a reason for the issues.  Internal Medicine told us they thought she was hydrocephalic, that we should confirm it with a  CAT scan, and euthanize her while she was under if that was the case.   I disagreed.  Fiona’s appearance suggests a presence of hydro but her behavior does not; she’s smart, obedient, good memory, never shown signs of “strange” brain issues.  I wanted a second opinion from an actual neurologist before making that type of decision and the rescue agreed.

I took Fiona to met with a Neurologist, who ruled out hydro being the cause of her problem and stated  ” It looks like she has heartburn” when I showed the videos of Fiona trying to sleep.  The Neurologist referred us to an Internist , who prescribed a different anti-acid medication and suggested a barium swallow study.  We did it, and the study was pretty unremarkable, (her esophagus, larynx and swallowing function were all normal) although it did show the effort of her breathing caused her to “suction” liquids back into her esophogus from her tummy.   She suggested an upper Rhinoscopy and GI scope.  This would either confirm or rule out any other reasons as to why she was continuing to have the problems breathing/regurgitating.  When they placed Fiona under anesthesia to perform the scope they did a visual examination of her palate.  They called me to say her saccules were exverted, (which can happen again) and that her palate was still elongated.  It’s not uncommon for a dog to require a second palate trim and we were all excited to find a cause for Fiona’s issues.  If she couldn’t breathe correctly, it could definitely cause the GI issues we were seeing.

Her surgeon confirmed that the previous surgeon at the Care Center had done an excellent job on her surgery.  He then proceeded to remove the saccules, trimmed her palate, and cleaned up the edges with a laser, Fiona’s airway was nice and open!  She’d done well with the surgery and everything looked great.  However, when the time came to remove the breathing tube, Fiona could not breathe on her own.  They retubed her and then tried again later with the same result.  We all believed there was excessive swelling preventing Fiona from breathing normally.   At this point our options were to leave the tube in, which required sedation, or do a temporary tracheotomy, with no sedation and much more comfortable.  We decided for the temporary trach.  It was placed last week and she was given the weekend for the swelling to go down.  Our hopes were that with the additional rest, on Monday she’d be able to breath on her own.  I continued to visit her in the hospital and was very surprised to see how nicely she breathed with the temporary trach in.  I had been very concerned about it overall, but after I saw how well she ate, drank,  and slept, I was relieved.

They attempted to remove the temporary trach on Monday, but she could still not breath normally.  They placed the trach back in and called us.  They weren’t sure what was causing the issue, they thought perhaps neurological, so another discussion with the neurologist was had. The neurologist ruled it out.  So Fiona was sedated and it was found that her palate was full of edema (swelling, fluid). They had never seen anything like this in previous patients.  At this point in time, we really had two options, go back and try to retrim the palate, or place a permanent tracheotomy.   The surgeon and the rescue ruled out the additional trimming, it would get too radical, affect Fiona’s swallowing and increase her risk of aspiration.  Since we have no idea how long this swelling could last, (it could even be permanent) and the temporary tracheotomy is risky (pneumonia, requires ICU care), we opted for the permanent trach.  Her surgeons and doctors agreed that this would give her a very good quality of life, and once the initial healing is over, the care is minimal.  Placement of a permanent trach would also allow her to come home and recuperate with no additional surgeries required.  She will get a much needed break to be able to grow and mature like a puppy should.  The trach will be placed this evening, and if all goes well, she will be discharged tomorrow.  She will require monitoring by this vet while I am at work, which will be considered a non-medical half day board which should run us about $35.00 per day.  After the trach has healed and we are confident she can be left alone, we will discontinue this.

Through this whole ordeal, from beginning to where we are now, I’ve never questioned whether saving Fiona was right.  Fiona has an excellent quality of life.  She enjoys people, loves children of ALL ages, other dogs and animals.  She loves to play with toys and chewies.  She enjoys helping me weed and garden. (which equates to her stealing my tools, many of which are bigger than she is).  She loves car and stroller rides with her fur brother and sister, Henry and Maggie.  She likes to kick her fur brother Henry in the jowls and lick his face.  She loves Maggie but is very respectful of her as she knows Maggie really does not have time to be bothered by puppies.  She has a HUGE appetite, is not food or toy aggressive and is now crate trained and potty trained.  She is excellent in any situation and tolerates any procedure that is thrown at her without complaint.  Her favorite thing to do is cuddle with you, she will immediately request to be picked up by anyone she’s near.  It’s likely because of this she has   a fast favorite of all Vet’s employees.  If she EVER showed signs that it was too much or we felt that we were keeping her here for selfish reasons we would have stopped.  Plain and simple.  But Fiona is a FIGHTER, she is very special, and is still yet a very young puppy at eight months old…who has a long life ahead of her.  This surgery will enable her to enjoy it even more.  We  have consulted with individuals who have been through the same thing and have provided nothing but positive feedback that this IS a good decision.  I feel that it’s our job as a rescue, and my job as her foster mom, to get her over these bumps in the road on her journey to that very special foster home.

As everyone knows, quality care is expensive.  Fiona’s procedures and surgeries come at a true financial cost, one we must offset with fundraising and donations, so that we may continue to help other dogs, such as her, down the road.  Going forward we will continue to provide updates about how Fiona is doing and what she’s up to.  Don’t think for a minute that a tracheostomy will slow her down.  Short of swimming (she has a trach hole, not a blow hole, remember?) she will be able to all the things she did before and we will be sure to tell you about it.  We also hope this journey will also help other owners dealing with the difficult decision of a trach and provide our experience on how this hole (whole? hole? haha get it?) thing works.  With Fiona, it’s never a dull moment, and we  hope you will continue to follow her and provide your support, whether financial, or just a nice comment or get better soon wishes, we’ll take ’em!