June 23, 2013
After a quiet Saturday night and no further "alligatoring" incidents, our girl was given clearance to come home. We were cautioned to expect that she would need to be in the oxygen kennel most of the time, but apparently Puff did not read the memo.
Aside from the sheet of discharge instructions, our conversation with the head of internal medicine (a geriatric specialist and newly volunteered for our Paws To People Advisory Board) sent us home with this summary: "You know her better than we do and she instinctively knows what she needs. Watch and pay attention to what you see and hear. If Puff is not coughing and wants to come out of oxygen, let her. If she is out and starts coughing or struggling, then it is time to go back in. The goal is to wean her off as much as possible. As the meds kick in she will need less and less time, but it might be that she will always need to have oxygen as a backup plan." He did suggest that she sleep overnight in oxygen with as much humidity as we could conjure here in the desert.
Using this advice, we let Puff socialize and spend time with the pack. She rested and was content to just be in the room with every one else. Steve had anticipated that the excitement would tire our girl, but she lasted about three hours before the coughing started up again and she started to droop. Then it was time for the oxygen kennel.
Puff hates being kennelled; she was a breeder in a puppy mill and the idea, I think reminds her too much of her past. But we insisted and she eventually accepted and laid down to nap...helped by the fact that Nuka was sleeping in front of the kennel door with Oso next to her and Quinn across the room. YoYoMa slept in the safe haven cave right next to the oxygen crate.
White Dog is having a little difficulty with Puff's wet hacking noises wanting her to stop and WD growls in distress that her sister is "locked up." To avoid stressing Still Another White Dog we are trying to keep some distance between the two Kansas girls.
Puff will see Dr. Julia Tuesday and the hospital will send all of their notes and her chart over for her review. For now, Puff has gone from a maintenance dose of prednisone to a full fledged 10mg., is taking an antibiotic, a cough suppressant, and a drug to open her airways.
The vets at the hospital believe this weekend's crises was a result of Puff's collapsing trachea and bronchial stem (effects of her heart worm battles). The collapses are a slow disintegrations and she is not in a life threatening situation but they do make her an easy target for flair ups of inflammation caused by allergies, pneumonia, or upper respiratory colds (hence the antibiotic). The swelling closes off passages that are already compromised by the slow collapse cutting off Puff's ability to breathe. They believe, and previous discussions with Dr. Julia concur, that Puff's condition is still medically manageable with medication and now, with possible oxygen therapy. None of us feel that surgery to insert a tracheal shunt would be a good choice for our girl, except as possibly as last resort when all else has failed.
The likelihood is that SAWD will stay at a higher maintenance dose of prednisone than before and will take the cough suppressant as needed. Dr. Julia may recommend some daily time in the oxygen kennel or may indicate that our girl, like her momma who has sleep apnea, will need to sleep oxygenated.
All of that said, we are glad that Puff will recover and more than anything, all of us, are glad our girl is home where she belongs. Thank you so much for all of your prayers and power of the paw and healing energies. Here at White Dog Ranch we know with certainty that Puff's being home was in no small part due to your caring connection.