bonnie

Bonnie


8 week old "Bonnie"	16 weeks old "Bonnie"

A breeder contacted me to report that he had this sick pup in his latest litter that could not keep anything down?! ~ Being on benefits he could not afford a veterinary consultation, and wanted someone to take it off his hands. This poor little girl weighed only 2.5kg, and was a bag of bones, desperately hungry.

A friend drove me down to Gloucester to collect her, and on arrival we found that Bonnie was the result of a litter bred by these people ~ this was their second litter from the same dam in 6 months!!!. She was found to be living in filthy conditions in a downstairs toilet area. I could not wait for them to complete the adoption papers signing her over to me and get this poor girl away from these people who, to them, her life meant nothing.

On returning home I immediately phoned my vet Greg Firth who asked me to feed her a tablespoon of soaked biscuits each hour and try to determine if Bonnie was vomiting, or regurgitating. This being at 11pm on a saturday night, I was asked to persivere until 1st thing monday morning when Greg could see us both and try and determine exactly what Bonnie's problem was. Bonnie appeared to be managing to keep down a certain amount of her food served in these small measures but unfortunately took a turn for the worse as the month went on.

Later in the month Bonnie was admitted suffering from severe breathing difficulties. It was agreed that she should be X-rayed to determine if she should be allowed to continue this way. Waiting at home for Dr Firth to call was gut wrenching to say the least, but when the call came I was so relieved to hear that there was a possibility they could alleviate her distress.

She was diagnosed as suffering from pneumonia and persistent right aortic arch (PRAA). This condition blocks the entry of food to the stomach and, if allowed to go untreated, irreversibly damages the oesophagus.

Bonnie needed to undergo surgery which would hopefully correct her condition, but the chances of her surviving such surgery were slim, but both myself and Greg decided that being such a little fighter it was certainly worth attempting the delicate surgery needed to save her life.

Bonnie was admitted to intensive care where it was intended to feed her directly by a tube into her tummy in order to get her up to a weight that would give her at least a fighting chance of surviving her surgery.

From her case notes Monday 11th.
Admit to x-ray and assess if dog can carry on. Weight 6kg. Lat neck & chest radiograph: cervical oesophagus unremarkable with tiny pockets of air deligniating its course. Gross dilation of the oesophagus immediately cranial to the heart base with ventral deviation of the trachea. Oesophagus caudal to heart unremarkable. Findings consistent with Megaoesophagus due to vascular ring anomaly. Small degree of pneumonia present. Advise Baytril & feeding of semi liquid food little and often from a height till lung fields improve then general anaesthetic and scope oesophagus to confirm heart base constriction. Surgery if persistant right aortic arch confirmed.

From her case notes Wednesday 20th.
Poor nutritional state and some dehydration present. Elect to postpone thoracotomy but place gastrostomy tube for feeding/hydration ahead of thoracotomy. Weight 5.4 kg. Cannulate. Hartmann’s. General anaesthetic. Intubate O2/iso. Endoscope oesophagus: constriction 40cm from nose with pulsatile right oesophageal wall consistent with PRAA. Distal oesophagus unremarkable but proximal Megaoesophagus present. Left paracostal laporotomy for gastrostomy tube placement; stomach adhered with PDS to abdominal oblique muscles. Concentric purse string sutures of PDS laid in stomach wall and Foley (20FG) catheter passed through stab incision at centre of purse strings. Strings tied creating stomach inversion around the catheter. Muscle edges apposed with PDS and skin closed with Ethilon. Chinese finger trap suture tied to secure catheter to skin. Abdo wrap placed with Melonin, Sofban & Vetwrap. Inj. syn, Metacam, Pethidine & Tagamet. Pharynx cleared of fluid. Nasopharyngeal catheter with O2 supplied secured and endotracheal tube removed on recovery with cuff semi-inflated.

Bonnie was now in the care of the staff at the Park Veterinary Centre, Watford, and being fed through the tube into her tummy. Her weight and condition improved daily, and by the Sunday morning her weight was up to 6.3kg.
Talking through all the details again, Dr Greg Firth pointed out every possibility good and bad. There was an 80% chance of her not surviving the surgery, and only a 50/50 chance of a full recovery. Given Bonnie’s obvious will to live I felt obliged to offer her everything she required to do just that, and as the odds were in her favour the decision was made to go ahead with whatever surgery Greg could perform to save her. This was a very deserving puppy and expense was not even considered, I would worry about that when it was all over.

Monday 25th October, the big day. A call to the centre confirmed the surgery was to go ahead as planned. This was going to be a long day of waiting! ~ When Greg called me at 8pm to say that all had gone well it was as if I had won the lottery, but Bonnie needed another 24 hours of recovery to be sure of how well it really did go?!

The surgery notes:
Left 4th i/c thoracotomy. Mediastinal pleura incised ventral to vagosympathetic trunk & ligamentum arteriosum isolated. Aortic and pulmonary ends double ligated with Vicryl and ligamentum sectioned between. Oesophagus freed from connective tissue adhesions to pulmonary artery and aorta. Foley catheter passed per os to facilitate dissection. Oesophagus completely freed and passage of catheter made possible unimpeded. Ribs exposed with PDS Cruciate sutures around adjacent ribs. Intercostal muscles apposed with Vicryl, serratus, scalanus, and lateral dorsi muscles each closed with Vicryl. Vicryl subcut suture and Ethilon skin sutures.
Chest drain anchored with Chinese finger trap & purse string suture laid (drain placed prior to wound closure). Pneumothorac drained, I/c nerve block performed with Intra-epicaine (total of 2ml inj). Foley anchored with CFT. 10ml Urograffin inserted into tube and radiograph taken; all contast in stomach without leakage.

AM Tuesday 26th October. With everyone expecting to find Bonnie feeling very sorry for herself, they were very pleasantly surprised to find a bright eyed, tail wagging puppy wanting her breakfast?!

An amazing recovery for such a young and weak puppy only proving to win more hearts of the staff at the centre.

Her gastrostomy tube was removed late Tuesday afternoon and she was able to resume feeding by mouth in an elevated position.

Bonnie came home on Wednesday evening. She was still bringing up a small amount after each feed, this was only to be expected with such a dilated oesophagus, but it is hoped that this may improve in time. At worst she may have to continue this elevated feeding for life, and continue with liquidised food, but for what little effort that takes I can’t see that being such a problem. Bonnie now had a lot of catching up to do with only weighing 6kg at 15 weeks old, but I am sure we will if it is up to her.

As an indication of how weak she was, and how drastic these procedures have been I am showing you these pictures of her taken Thursday 28th.

Monday 1st November
Bonnie has been brighter each morning over the weekend, and this morning she had a mad hour playing my other three dogs in the garden! ~ Here am I concerned that the others may play too rough, and it was little Bonnie that was doing all the chasing?!
All her morning meals were eaten with nothing coming back up, and that was with only a few minutes quiet time in her crate after each meal. Without the vomiting she is able to take full advantage of her rest and sleep, all helping with the healing process.

This afternoon we returned to the vet just to see what (if any) weight she had gained, and you can imagine my delight at seeing the scales registering 7kg.

Thanks to the veterinary and surgical skills of Dr Greg Firth, and the TLC from the veterinary nurses at the Park Veterinary Centre, Watford, Bonnie can now look forward to a brighter future.
Thanks also to Val O’Leary and Terrie Brown for all the fetching, carrying, and driving around they have done for me (or should I say Bonnie?) over the past weeks.

A special BIG thank you for the donations received towards Bonnie’s veterinary care from fellow Helpline contacts, and the Rocky Trust Fund. They certainly helped with the dent in my Visa card?!

I have received any number of messages of love and support for Bonnie, and I am sure that she was as grateful for all of their support and good wishes as I was.

Bonnie is now still eating a liquidised meal twice a day, and still in an elevated position. We just place her bowl on the breakfast bar and she stands on her hind legs with her front legs on a bar stool to eat her meals. She still occasionally has a few bad days where she is unable to keep her food down and we have to be constantly aware of the risk of bloat and this has been problem that has caused us to rush her to the vets on two occasions in the 21/2 years she has been with us.

To see her now playing with our other dogs and tearing across the fields with the grace of a gazelle she was certainly worth every ounce of effort it has taken to get her this far. There is no reason now that with good management why she can not enjoy a full and active life.

In Late July 2007 Bonnie suffered considerable weight loss and general deterioration of her coat and after a series of blood tests taken by our veterinary practice she was diagnosed as having EPI . Since being on the Pancrex powder her weight and general condition has greatly improved although she is still not achieved the weight she was maintaining before. With Pigs Pancreas being unobtainable due to the recent outbreak of foot and mouth we will have to continue with the Pancrex untill such times as slaughter house restrictions are lifted. Although the Pancrex can work out as an expensive way to manage EPI we are more than happy to absorb this cost having witnessed such an improvement in her general wellbeing and seeing her return to her energetic play with newcomer Tala and general playing with Bongo ans Kane. Having been through such a lot since birth Bonnie seems to take everything in her stride and has to be one of the most well known dogs in our veterinary practice. Bonnie tends to treat the veterinary practice like a home from home and is only too happy to return and meet old friends.

February 2009
Bonnie was rushed into the vets today with GDV She underwent a gastropexy and had a 20% chance of survival. Thankfully she came round from the operation bright as a button and was able to come home after she had eaten and drunk a little.

Bonnie became unwell overnight, vomiting quite badly and had to be rushed back to the vets this morning. On x-ray it was seen that she had ruptured her oesophagus beyond repair and we had to make the awfull decision to have her put to sleep. She could not have a peg tube inserted into her stomach for feeding and therefore there was no other way she could gain any nourishment. She would ultimately have starved to death.
We are all in a state of shock here and are finding it hard to come to terms with, after all this poor girlie has gone through over the years it is a crying shame that it has to end this way.
God Bless You Bonnie and thank you for the five years of happiness you gave us.
RIP