Colon Torsion

 

Wednesday January 24, 2007 was an ordinary winter day. That morning our 6-1/2 year old MAGDRL Dane Ambassador Jupiter (aka "Thief of Hearts"), wouldn't eat breakfast -- it happens sometimes. That night he vomited a few times, but it is not unusual for rawfed dogs to purge undigestible matter. I resisted the impulse to take him to the ER because his vomit was productive and he was gastropexied, but I made an appointment with our vet at Rocky Gorge Animal Hospital (RGAH) for the next morning. Jupiter is UTD on all shots, so from the symptoms it appeared that he'd picked up a virus.

Thursday January 25, 2007 at our vet's office, Dr. Wolchinsky immediately had upper and lower GI x-rays taken. They didn't show stomach bloat, but there appeared to be a tangled mass of crammed-up spaghetti below Jupiter's stomach. Something was clearly pushing up his intestines, so Dr. Wolchinsky sent us directly to Anne Arundel Emergency Veterinary Center (AAEVC.)

Jupiter 24 hours after surgery
Above, Jupiter 24 hours after surgery. He was in bad shape, panting, shivering, and filled with gas. He was so sedated that he hardly recognized me.

Dr. Krista Evans at AAEVC's Chesalpeake Veterinary Referral Surgery (CVRS) took more x-rays but couldn't see the source of the problem. Surgery was our only option. Once inside, Dr. Evans saw that Jupiter had torsed his colon (bowel/large intestine.) Colon torsion is a rare life-threatening emergency in dogs, and is about the worst place they can torse. A dog's colon  is only 1-1/2 feet long, and it doesn't take well to bisection.

Dr. Evans performed a 3 hour surgery to untwist Jupiter's colon, but unfortunately 6 inches was necrotic and had to be removed. The remaining 12 inches is the minimum a dog must have to absorb sufficient nutrients to live.

Although 90% of dogs with colon torsion die during surgery, Jupiter made it through. The next 72 hours are critical since most dogs that survive the surgery subsequently die from peritonitis, shock, or additional tissue death.

Improving after 2 days

Jupiter looked much better 48 hours after surgery. He ate and drank, and was starting to rebound.

I asked Dr. Evans whether Jupiter's Lapro-Pexy impacted the colon torsion. She said it's unrelated, that Danes most commonly bloat/torse their stomach, so gastropexy is the most prudent approach to extending their lives.

She also said that torsion can occur anywhere in their digestive tract because a Dane's organs have room to move around in their large body cavity. There is no known cause for colon torsion. Dr. Evans had only seen 4 dogs torse their colon in her 20+ year career. Three were Great Danes and only one survived.

Friday January 26, 2007 Jupiter looked like he was at death's door. He was panting and shivering, and he could hardly stand up. Thankfully there was no sign of infection and his temperature and heart rate were dropping back to normal range, but he was obviously still in trouble.  It was very upsetting to see him like this.

The late night update was better news. Jupiter drank water and kept it down, and he peed -- good signs!

Saturday January 27, 2007 VT Rachel reported that Jupiter drank more water and kept it down. When I visited him at midday, his chest has deflated some and his stomach was less noisy. He knew me, gave me kisses and nuzzled his head in my chest. He ate a couple of meat balls and wanted more. We spent 1-1/2 hours hugging each other and he was much less tired than yesterday.

Jupiter's 18" incision

Jupiter has a new 18" zipper from stem to stern! (The numbers on his groin are a tattooed ID that makes stealing him a federal offense under the Animal Welfare Act.)

All systems were registering normal, but VT Rachel reminded me that there's still the chance of infection. They will watch him around the clock for the next 24 hours.

Rachel said that Jupiter's surgeon Dr. Evans -- who was off for a few days -- called several times to make sure he was being monitored and asking for status. I can't say enough about the staff at both AAEVC and CVRS. They saved Merlot's life when she bloated last summer, and now Jupiter's on the rebound. PRIMO!

At the late night update, VT Amy took Jupiter for a walk and said he peed forever. He's drinking a lot of water and beginning to eat more! Yeah!!!

Sunday January 28, 2007 the morning status report was so-so. Jupiter's bloodwork showed increased white blood cell count which means he's fighting an infection. CVRS will run more bloodwork and if the count hasn't dropped, they will put him on stronger antibiotics. That morning he had a bowel movement, ate and drank which are very good signs.

Jupiter outside AAEVC/CVRS

On our jaunt outside to potty, 60 hours after surgery Jupiter was alert and bouncy.

They had just drawn blood before I visited him in early afternoon. VT Rachel said he must be feeling better because he'd chewed out his IV. He bounced into the exam room and head-butted me in the stomach -- the most wonderful feeling in the world!

We went for a walk around the AAEVC/CVRS grounds and Jupiter peed a gallon. We came back into the exam room, and for the next 1-1/2 hours he laid with me on the floor while I did T-Touch. He got so relaxed that he fell asleep and dreamed, and also evacuated a huge amount of gas. I left the soiled sweatshirt that I'd worn the previous day for Rachel to put in his pen to give him comfort as he healed. Before I left, Rachel told me his white blood count was back to normal (WHEW!!!)

The late night update continued to be good. VT Tiffany said he was very relaxed, not chewing on his staples, and dozing off/on. Apparently the T-Touch and his "Mommy smell shirt" were just what he needed!

Jupiter and Dr. Evans

Jupiter peeked into the exam trying to find me. I was quietly standing right in front of him! Here he is with his surgeon Dr. Krista Evans.

Monday January 29, 2007 was a red letter day! Dr. Evans returned to duty and our Thief of Hearts was released from CVRS to recuperate at home. I gave Dr. Evans a big hug for saving our boy!

I talked with Dr. Evans about colon torsion because the symptoms are somewhat different than bloat. She said the symptoms are productive vomiting, refusal to eat, distended stomach, and general malaise. Unfortunately those symptoms mimic several other conditions, so her suggestion was to get the dog to a vet ASAP, then make sure they x-ray both the upper and lower GI tract.

I asked whether there was research on colon torsion, and she said it usually happens to horses, not to dogs (aren't Danes "House Horses?") She said that within the past 20 years, she'd only seen 2 - 3 papers written about this condition in dogs.

Jupiter went home with Clavamox (antibiotic), Reglan (anti-nausea), and Tramadol (pain killer.) He'll be eating home-cooked chicken & rice for the next week or so. His staples will be removed in 10 - 14 days by Dr. Wolchinsky at RGAH. We're praying that he continues his recovery and that we never see another episode of this awful torsion.

The veterinary staff that worked with us deserves HUGE KUDOS! If Dr. Wolchinsky at RGAH hadn't ordered the appropriate x-rays, and hadn't had his assistant Kathleen run out and catch me before I left their parking lot, the time wasted for me to return may have cost Jupiter his life.

Two weeks after surgery on staple removal day.

If I hadn't opted to have the skilled surgeons at CVRC perform the surgery, I wouldn't have lucked up and gotten Dr. Krista Evans who had performed three previous colon resections. There's nothing like having an experienced surgeon to tip the scales in your dog's favor. Besides being highly skilled, Dr. Evans is one of the most caring and diligent professionals I have ever encountered.

Besides the skilled veterinarians who worked their magic to save our boy Jupiter, I also want to thank my friends and family and all our MAGDRL friends, plus DanesOnline, MSN's Great Dane Room, and Leans'N'Slobbers members who kept our precious boy in their thoughts and prayers. I know that the power of our collective positive energy helped our Thief of Hearts survive. Thank you ALL!!!!

My dear friend and dog trainer Tressa Everts once said that only an owner knows when "their dog ain't right."  I would guess that the death rate is so high with this type of torsion because the symptoms are not significant until it's too late to save the dog. Thank you Tressa -- listening to that inner voice likely saved our boy's life.
 

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