Rocky Mountain Great Dane Rescue, Inc.

Reina bloated this evening and had to undergo emergency surgery. Luckily, her foster mom noticed the warning signs and acted quickly, getting her to the emergency hospital right away! She was retching and foaming at the mouth and clearly very uncomfortable and something wasn't right.

After we got her to the hospital, they did x-rays and confirmed that she was bloating. Reina also suffered from gastric volvulus and dilatation (GDV) which is a condition that starts off with distention of the stomach with food, water, or air due to excessive swallowing. Basically, her stomach twisted as it became distended, so the food, fluids and air could not pass in either direction.

Due to the twisting and displacement of the stomach, the blood supply may also be cut off and a portion or all of the stomach may die. The longer that the stomach has been twisted before treatment is provided, the greater the risk that the stomach will die. In Reina's case, upon further examination of her internal organs, her stomach and spleen both survived and neither were damaged.

Unfortunately, there were other complications though. Reina was suffering from a fairly bad case of Peritonitis, which is an inflammation of the thin membrane that lines the abdominal wall and covers most of the organs of the body. Essentially, she had free blood floating near her bladder. The doctor had to clean up the infection and repair some adhesions from the spleen which had somehow adhered to the body wall and was more than likely a complication from her previous spay surgery. Peritonitis can also be life threatening and Reina's surgery scar is almost twice what a normal GDV surgery scar would be.

As the final step, after the doctor repositioned her stomach, he tacked it to the right side of the abdominal cavity to prevent a future GDV, which is also known as Gastropexy.

Reina made it through surgery successfully, but the next few days will be fairly critical. She will need to remain in intensive care for the best chance for a successful outcome. She will receive intravenous fluids and antibiotics for at least 24 hours, and probably more since she underwent such a long and invasive procedure. They will carefully monitor her blood pressure and blood protein level.

She will be transferred to Fort Street Vet Clinic tomorrow morning. Please keep this sweet girl in your thoughts and prayers!

November 6, 2007

I just spoke to Dr. Bussellman at Fort Street and Reina is not doing very well. She has been on supportive care and strong pain medications all day, but she is very anemic and her PCV volume has dropped by 10, which means she has lost a LOT of blood. When the surgeon performed her procedure last night, he did not locate any natural bleeders, just necrotic tissue that he cleaned up. This morning there was what appeared to be normal seepage, but as the day has gone on, she has become more and more lethargic. Her heart rate is high and her pain scores are high. Thirty minutes ago she just had a major hemorrhage, which may indicate that she is bleeding internally now and having further complications. There are a number of things it could be and her spleen may have ruptured, but they aren't sure at this point and the doctors feel we need to give it more time before deciding whether or not to open her back up again. I will keep everyone posted as I hear more about her condition.

November 7, 2007

Reina made it through the night on supportive care. The doctor did not feel that it would be a wise decision to cut her open at this stage and the goal was to get her PCV count to stabilize and start going back up.

As of this morning her PCV is at 26, which is totally livable and should start climbing even higher soon. It typically takes 3 days to start recycling the internal blood in situations like this, so we are just trying to get to 72 hours post op. She is walking, eating, drinking, and looking much brighter today, so in many respects the doctors are very encouraged.

On a not so good note, however, her ECG is showing a secondary complication to bloat. When the stomach is turned over, toxins get released, affecting the heart. The heart starts racing and doesn't use the atria (upper two chambers of the heart) and it only relies on the ventricles (lower two chambers). To treat this condition, the doctor uses IV Lidacane to anesthetize the heart and to serve as a barrier to protect the heart. They are closely monitoring Reina with a wireless ECG. The range of dosage for Lidacane is 5-20cc. The doctors had to give her 18cc (which is very close to toxic) before it made any difference in her heart rate, but she is now stable and on a 10 hour bag at least. If it wasn't for her heart condition, she would be out of ICU and in the regular hospital, but unfortunately she needs 24 hour monitoring still and is still fighting for her life!

I will keep everyone posted. Keep her in your thoughts and prayers!

November 9, 2007

I am thrilled to report that Reina was released from the hospital and send home to her foster family last night! She showed wonderful improvement throughout the day and her PCV count is climbing and her heart rate is back to normal. She is scheduled to go in today to check her blood count and do another ECG, but everyone is very hopeful that she is on the road to a full recovery! Reina was thrilled to be home and followed her foster parents everywhere.

November 10, 2007

Reina is doing great! Her foster family is bending the rules a little and letting her do her recuperation on the couch! She is loving it! When she isn't leaning on you, she is curled up on the couch resting. She went to see Dr. Busselman for her ECG and blood test. He was so excited and relieved with her progress that he was almost in tears. He really wants her to avoid any kind of stress for the next 10 days, so he would like he to come stay at the vet during the days when his foster family is at work so he can keep a watchful eye on her. We are so grateful for the wonderful care that Reina has receive both at Fort Street and the Emergency Hospital!