Roms Life, or, Thrombocytopenia Took My Best Friend
Continued from page 1
Anyway, I'm getting ahead of myself. Back to Thrombocytopenia. It's a relatively rare disease that, like in Rom's case, usually has an unknown cause. When their platelet count plunges like Rom's did, the main focus is to get the count back up to an acceptable level. The spleen can sometimes hold onto platelets, so the first thing Dr. Schawel did for Rom that first night at the emergency clinic was give him a shot of Vencrystine, which causes the spleen to release any platelets it's holding. [Some dogs with ITP eventually have their spleen removed, although we never got to that point with Rom.] Rom was also put on Cytoxin, which is a drug they use on humans with cancer, and Prednisone, a steroid that's used for many different things, but in this case it was to help stimulate his platelet production.
He spent the night at the emergency clinic, then I picked him up the next morning and took him to our vet for the day. They ran some more tests, put him on an iv, and pumped him full of Prednisone. That began our daily visits to vet for a check of his platelet count. We got to be very well know at the vet.
The huge doses of Prednisone caused him to retain a bunch of fluids and gain lots of weight (he ballooned up to 220 pounds!). Rom was depressed all the time and also got really weak and had trouble getting around. The vet assured me it was due to the Pred and that it would improve once his platelet count went up and we could cut the Pred dosage down.
Another side effect of the Prednisone is he leaked urine everywhere. His blankets were soaked every morning. Luckily, he was really good about napping on towels and blankets, so we put a plastic tarp down and put his blankets on top of it to save our carpet.
Eventually, after a couple of months and several thousand dollars, his platelet count stabilized at a low-normal level and we were able to start cutting back on his Pred. Once we got some of that out of his system, he started to feel better. He was able to move around a bit more and perked up a lot. I was so happy I cried when, in the middle of March, he started to wag his tail again.
Around that time, I switched vets to Dr. Lori Hageman. I had known her a little bit in college and found out she was working at a clinic nearby.
Rom continued to improve and was enjoying spring. He was never the same, but I used to joke that he was finally the dog I had always wanted - still Rom, but much more laid back. I could put him in a down-stay in the front yard and know he'd still be there later (which would never have happened six months earlier). We live on a very quiet court, with only six houses, and he was the neighborhood dog. Everybody loved him. He still had a little bit of trouble getting up, but I could take him on really short walks and he seemed to feel a lot better. He even ran around the yard with our other dog (his daughter, Albie) sometimes, although never like before. Things were looking very good.
Then on June 3, 1997 I was rubbing Rom's tummy and noticed what I had hoped to never see again - purple bruise-like splotches all over his stomach. I immediately took him to the emergency clinic and they confirmed that his count had dropped down to 35,000. The emergency clinic vet advised upping his dose of Prednisone to about 20 times what he was currently taking, and sent him home for the night. The next day, I dropped him off at Lori's clinic. She explained that it's much harder to get them into remission a second time and they don't usually have as much luck using the same drugs as before. Lori gave him another shot of Vencrystine anyway and tried him on a different drug called Imuran. It was obvious Rom didn't feel great, but he didn't seem to be feeling too terrible.
On the evening of June 10 (the day after Albie had a litter of puppies - Rom's first and only grandchildren), I called for Rom to come in for the night. He had been outside for several hours and didn't come when I called. I went out to the "doghouse" (our backyard has a 12 x 20 foot workshop with lights, carpet and insulation that we converted into a dog house) to look for him. He was lying on the couch out there, but wouldn't get up when I tried to coax him out. My husband came out and pushed him up so he was standing, but Rom just fell over when Bryan let go. It was around this point I started to get really worried. Between Bryan, me and two of our neighbors, we managed to get Rom onto a chaise lounge and load him into our pickup truck. I sat in the back with him on the way to the emergency clinic. We had called ahead and they were waiting outside with a gurney when we arrived. They wheeled him into the back, where they had already set up some blankets in the middle of the room so he was easy for everyone to keep an eye on. Dr. Schawel's diagnosis was septic shock and the prognosis wasn't good. Apparently, Romulus had had some kind of reaction to the Imuran, so although his platelet count was looking good, his white blood cell count was almost non-existent. With no white blood cells, he had contracted a mild bacterial infection that his body couldn't fight. His temperature was almost 106o when we dropped him off at the emergency clinic.
They didn't expect him to live through the night, but somehow he pulled through. I picked him up the next morning and drove him directly to Lori's for the day. He was hooked up to an iv for the day and put on antibiotics. Lori and I are friends, and she felt he would be most comfortable spending the evenings at home, so that night when I picked up Rom, she followed me home with his iv pole, monitor and a car full of iv fluid bags. She set Rom up in the corner of the family room. We got a crash course in how to change iv fluid and what the various alarms on the monitor signified, as well as a huge list of what medications to administer and when. That was a very long evening. I took him back to Lori's on my way to work the next morning and our routine had been established. He spent the days with Lori and the evenings in the corner of the family room.
It seemed like Rom was feeling a tiny bit better, but not much. He started eating again after a few days. Still, things were beginning to look hopeful. Lori began talking about writing an article for a veterinary journal since most dogs don't survive septic shock.
On the evening of June 24, Rom eagerly ate the chicken I cooked for him for dinner, then settled down for the night. He had begun to choose to sleep outside because it was too hard for him to go up and down the three steps leading to our house from the yard. When he slept in the house, he had to wake me up to go outside several times a night. Most of the time, after I let him out the first time, we would just make himself comfortable in his bed on the patio. I would leave the door open for him, but he usually spent the night outside. It was warm enough outside for him, and I think he preferred to sleep away from Albie's squawking new puppies. I got up and checked on him about 3:30 in the morning: he was awake and chewing on a bone. I sat out on the patio with him for a few minutes, then went back to bed.
The next morning I got up around 6:00 and went out to see Rom. Unfortunately, sometime between 3:30 and 6:00, Rom had died. He was lying in the same place he had been when I checked on him earlier, so I'm hoping he just went to sleep for one last time. I was right on the other side of the sliding glass door and I never heard anything, so hopefully it was quick and painless. I decided not to have an autopsy done - nothing was going to bring him back, and I didn't want to know if I should have done something differently.
I'll miss Romulus forever, but it's been a little over two months and it's not as painful to think about him as it used to be. Before he died, Rom had shown some interest in one of Albie's puppies, so we picked her to keep out of the litter (Rom has good taste in puppies - she was the one we would have picked without his help). The puppy's official name is California Belle of Romulus - Callie for short. She's three months old today, and lots of fun. We had been kind of disappointed Albie's litter had all girls, because we really wanted a male puppy in honor of Rom. So, in a moment of "weakness" we acquired Chase, a year-and-a-half old Harle who was a show prospect as a puppy but didn't mature with quite the correct confirmation. He's a great dog and a bundle of energy (he kind of reminds me of Rom in his younger years).
Romulus will always have a special place in my heart. It always seemed like he knew what I was thinking and he was always there for me. I'll never regret spending all the money we spent trying to save him - he was worth every penny. I wish things had turned out differently, but I feel honored to have shared four years of Rom's life with him.
Jennifer Saulsbury - Email
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