Tuesday May 4: This was really no different from most recent days: I had spent some time working in the garden, both in front of and in back of the house. At about 4pm, I was setting myself down to watch the Giants game. At about 4:30 there was a loud knock and my doorbell ringing. "Crap", I think to myself "just as the game is starting". I pause the game and go to answer the door.
On my front step is one of the contractors who has been working on my neighbor's house. He asks me: "you have dogs, right?" That is a question that you never want to hear from someone at your door. My heart immediately sank. I said "yes", and he then said "I think they got out, and one of them has been hit by a car". Danny. I knew it immediately, there was no doubt in my mind. Why I knew I can't tell you, I just knew.
At this point I need to backtrack a bit and describe where my house is situated: I live on a small 5 house court. The north side of my house borders a very busy town road (between 2 freeways and it connects to 3 towns). Not only is this a very busy road, but 4:30 pm is right in the thick of rush hour. The speed limit is 35 mph, and thank God, most often people do obey the speed limit.
I immediately went running out the door, in socks, didn't bother to put on shoes. I turned the corner onto Geary, and a block down I saw a crowd around a small red dog in the road. I could tell immediately that it was Danny, even though my vision isn't so great right now. As I was running past one of my neighbors (who I have only met once before, when I found a stray in my cul de sac); he started following me and asked "Do you also have 2 Yorkshire Terriers?" "Yes", I said, he had them in his garage, he told me, I could come get them later, that they had gotten across the road without getting hit (unbelievable!). He said that one was wearing a collar with the name Hillary on it and the other one was also a girl. That was Mini, I told him. I then had a moment of clarity, and screamed out "Wait! I have 3 Silkys, there is a boy named Bobby" He assured me that he and the other neighbors would look for him while I took care of Danny.
When I got to him, there was a small crowd around him. He was holding his head up weakly, in a daze, obviously in serious shock, and he didn't even acknowledge me when I called his name. I reached down to scoop him up, and the woman that was driving the car that hit him shouted "Wait, you don't know if his spinal cord is damaged." I told her that I realized that, that I was also an RN, and I could tell that if I didn't get him to the vet immediately he wasn't going to make it. I wasn't able to process this until the next day, but I felt so sorry for this lady. She obviously cared or she wouldn't have stopped, and I could see the horror in her eyes. If I knew how to find her I would apologize to her for having put her in the position to have to deal with this; it was unfair, and it was my fault. But that is water under the bridge, I have no idea who she is, and the bell can't be unrung. I do hope, however, that in some way she was able to deal with what happened. I also hope that somehow the universe lets her know how much I appreciate that she stopped and tried to do something to help while they were trying to find Danny's owner. By the way, that was major screw-up #2 in the situation: I didn't have Danny's collar on him, so there was no identification. None of my dogs are running around sans collar any more. I don't care if they are locked up in their kennels with three more locked doors before the street. This incident proves that even with all the appropriate precautions, all it takes is one human error to topple the house of cards. Had somebody not figured he was mine and come knocking at the door, well...it's an outcome I don't even want to picture.
I scooped Danny up, ran back to the house and put him in the van. Thank God I had left a big fluffy comforter in there, it was perfect. I ran in the house, grabbed my shoes and keys and went running out the door. Then I had a single moment of clarity, and ran to the dog room (which I built into part of the garage) to see if there was any chance Bobby was there. I couldn't believe it, he was. It makes sense actually, Bobby is pretty much of a chicken and not prone to running off on a whim. He was more than happy to stay put. So I locked the gate that I had so stupidly left open, closed the dog door to the run just for good measure, so that he was locked in a room until I got home, and then ran out the door to the car.
I didn't have enough clarity to remember to go tell the neighbor that I found Bobby, and he wasn't standing out there when I came out anyway, and I was losing Danny fast. Luckily, there is an emergency clinic 3 miles from my house, and I've been there once before, so I bypassed the regular vet that I use out there, who is one mile from my house and went straight to the emergency hospital. It was almost 5:00 anyway, and since the regular vet didn't have overnight staff, they would have likely sent me there anyway, if they could get him stabilized.
I head off, and of course the traffic is terrible, barely going the speed limit. I get on the freeway, and it's moving well, but my exit is only a mile from where I entered the freeway. I exit the freeway, which drops me onto the street that the emergency hospital is on. This street is a major thoroughfare, and one not adapted to the traffic out here. I goes from one lane to two, to three, back to two...you get the idea. It was nearly at a standstill. The entire time from when I got in the car, I had been talking non-stop, yelling actually, at Danny, just trying to keep him conscious, telling him (me) that he would be ok, he just needed to hang in. He was slipping in and out of consciousness, and it was getting worse every minute. The hospital is only about a mile after you get off the freeway, thank God. It easily felt like it took an hour, but it was probably about 7 minutes or so (it would normally take no more than 2 minutes).
I 2-wheeled it around the corner into the parking lot, and shot out of the van like I had been shot out of a cannon. I picked Danny up off the floor in the back, and went running to the door. There was an older lady holding a 900 year old Pomeranian in front of me, and I'm thinking "crap, I need to just run around her". The minute that thought hits my head, she looks at me, grabs the door, and shooshes me in. I didn't know this at the time, but she was the receptionist, and though her old dog was not in the best of shape, he just came to work with her. After we get through the door, before I can say a single word, she unlocks the door back to the hospital area and sends me through. The minute I cross through the door, there is a vet tech waiting for me, like they knew I was coming. She grabbed Danny from me, and before she disappeared, all I could get out was "He was hit by a car!" I didn't need to tell her that, probably; she obviously knew that it was life or death, and with a young dog, more often than not if it's life or death, it's an HBC injury.
The receptionist tells me to go wait in the waiting area and in a few minutes a vet will be out to talk to me after he assesses the situation. I told her that my neighbors had 2 of my dogs in their garage, and they were looking for a 3rd, and I asked if I could please go tell them that I found the dog and also get the girls. She told me "no, you need to wait". I'm a little pissed at her actually, so I say, I'll leave a credit card with her (which I had actually forgot to pick up when I left the house), and she still insisted "no". I was getting really perturbed with her, and I think about just bolting and then coming back, but a cooler part of my mind prevailed and I stayed put. I was worried for my poor neighbors, looking for a not lost dog, but then I remind myself that I might be losing the dog I have here. I sat for what seemed like hours, but was probably no more than 20 minutes. I'm called back to an exam room, and the vet comes in, and the look in his face is one that, from being a nurse myself, is the face that you don't want to see.
He tells me that when they got Danny back there, he wasn't breathing. They put a breathing tube in him and were able to resuscitate him, but he was in severe shock, his blood pressure was almost too low to measure and he was not getting adequately oxygenated. By the road rash on the left side of his head, they were able to tell that he had been impacted on his right side. "Crap", I think to myself. "That's the liver, the stomach, pancreas, spleen and left lung". Not good, not good at all. He then tells me that with the force of the impact, he was very concerned about his spinal cord. He was not moving his rear extremities, had no pain response and was holding his right front leg stiff and extended straight out. He told me that considering the amount of shock, he really couldn't assess neurological damage for hours, even up to a couple of days. Then there was all the possible organ damage. I told him I was an RN, he could shorthand it, which he did, and then told me about all the possible organ damage, most of which I had already thought of. Then he told me "there is also a very strong likelihood of both spinal cord and hip injuries, possibly very serious, but until we can get him stabilized enough to shoot some X-rays there is really no way to tell".
Then he tells me "you have a few options here. The first one is the one that you don't want to talk about, and I'm certainly not suggesting it is what you should to, but I have to give you that option. Or we can treat him, try to save him and then assess injuries, likelihood of recovery and see if there are ones that we can't do anything about, and you then may still be back at the first choice". Then he says "right now, considering that I don't have that much information to work with, I'm going to tell you that at best we're looking at a prognosis of 50/50 that he can recover. It helps that he is young and was healthy, but still, the injuries appear to be very critical, and that is how I would list his status now: Critical." He then says "if you decide to have us try to save him, even in the best case scenario it's going to be expensive, likely very expensive, so consider that as well." With no hesitation I tell him "save my dog". He then tells me that he is going to write up an initial estimate that I will need to sign and leave a deposit on. The estimate would have minimum and maximum likely costs listed, and the deposit would be in the amount of the low estimate. He then told me that he should have more information in 3-4 hours, and he would call me back then. Once more, I said "save my dog", and he nodded his head and went back into the hospital area.
I walked out of the exam room and up to the receptionist's desk, and before I could say anything she told me "you need to wait for the estimate from the Doctor, it should only be a few minutes, but you need to sign it and leave the deposit". I then tell her that I left my wallet at home, which I had realized a few minutes earlier, and again asked "can I please go deal with my other dogs and come back? I'll be less than 30 minutes, and you have my verbal authorization". She tells me "no, your other dogs are safe, just wait it won't be that long". Arrgh! I want to sock her, but I suck it back, and just remind myself that they must have a reason for the way they do things, and she was right anyway, my dogs were safe. It gave me enough time to realize that she wasn't the problem, I was, and the real problem was just me being irrational. I remembered how many times I had to be her when I was still working in the ICU, and had to occasionally gently snap people back to reality and get them to calm down and breathe. Then I look at her, and think "she is a really sweet lady, and she obviously loves that decrepit old dog of hers. I've been there with old decrepit dogs myself, and I know how endearing they are. So I sit and wait.
In about another 20 minutes (which seemed like hours), she called me to the desk and gave me the estimate. The low estimate was about $2500 and the high estimate was about $4800. I actually thought that wasn't that bad, and then she told me that the estimate was for the first 24 hours. "Crap", I think, "if he makes it, this is going to me more than a 24 hour hospitalization". Then I tell myself maybe not, then I realize that is a daydream, then I just tell my racing mind to shut up. I sign the paperwork, tell her that I'll call her back with the credit card number when I get home, which she says is fine, and I thank her and leave. I'm so glad I gave myself that little reality check before I went off on her. I'm sure she was used to it happening, considering all the crisis they deal with, but there was no need for me to do it. From that moment on, I will tell you that I can say nothing but positive things about everyone at the hospital, that place is amazing. I had taken Hillary there 2 years ago when she went into labor distress with her first litter, and they were really good and I liked all of them, but in comparison to this situation, that was nothing. Scary, but I didn't have the dread that I had this time.
I got back into the car, and my head flooded with emotions. I thought I was going to cry, pass out, throw up or some combination of the three. I just took a breath and drove back home. I really don't remember that drive, as is the case for a lot of the next couple of days. I got home and ran across the street, and went to knock on the first door. No answer; crap. I then turn around, and the guy next door is coming up. He says "you're the guy with the dogs, right?" I tell him yes, and he tells me "I'm sorry, but we couldn't find your other dog". I apologized and told him that I found him at the house, but I wasn't able to come back until now, that they wouldn't let me leave the hospital and I wasn't going to go look for him before taking Danny in. He says no problem, he is just glad that I found the dog. He then asks how Danny is doing. I can barely mumble "not good, but I won't know more for a few hours". We go to his garage, he opens the door, and I pick up the girls. They were a little wigged out, something I'm sure I didn't make any better, but I thanked him and left. The last thing he said was "good luck with your other dog, I hope he recovers". I thank him, and head home with the girls in my arms.
I drop them off in the dog room, realize that I need to feed them, and go in the kitchen. About 20 or 30 minutes later, I realize that I'm in the kitchen, but just standing there, blank, completely out of it. Tears are running down my face but I can't cry and I'm shaking like a leaf as I try to make their dinner. I never shake, I'm pretty steady-handed, so I know that I'm pretty messed up. I feed them, clean up and go back into the living room. I plop onto the sofa, and the Giants game is still on. I try to watch it, and then realize that I can't handle it. I try to find something to watch or listen to just to put some sound in the background, but I can't handle any noise. I sit in the silent room, try to read, and can't. So I just sit there, then pace around, then sit, pace, etc. for I don't know how long. At some point I get a call from the hospital.
The vet tells me that they have been able to get him somewhat stabilized. They drew some lab work; his electrolytes were off, his liver values were starting to climb and his kidney values weren't that great either. His red blood cell count was also dropping, so they knew he had some internal bleeding but they wouldn't know how much until they repeated the test in a few hours. His blood pressure was somewhat better but still too low, so that could also be indicative of bleeding, but could also be just from the shock. They had taken some X-rays, and could so far tell that the bottom half of his right lung was collapsed. He also had 2 small hip fractures, and his right hip was dislocated; the head of the femur was not sitting in the hip joint. He said that all of these would likely heal without surgery, but there was one other thing that was even more troubling. He had a dislocation at the ileosacral joint. This is where the tail sets into the hips. The reason that this was so concerning was because there was a good chance with this injury that he could have spinal cord damage, and in that area were the nerves that controlled bladder and bowel function. If that were the case, then there was a chance that he would not have control of his bowels and bladder, and it would not return. They couldn't assess this for probably a couple of days, at least one day, so I really shouldn't make any decisions based on that information, but I did need to know that it was a concern. He told me that with all this information that he had now we were still looking at 50/50 odds. He was also at high risk for serious liver damage, but that was actually the best news, because if he could withstand it, the liver is the one organ that regenerates as long as you have at least 30% liver function. The other big concerns were bile duct obstruction, and most worrisome, pancreatitis. With injuries as severe as his, traumatic pancreatitis was always a substantial risk, and of course, it was very difficult to definitively test for. He then told me that they were going to try to get him more stabilized, run some more blood work and later on do an abdominal ultrasound and he should then have some more information. He told me that he would call me at least once more that evening, more if there were any concerns.
About 10 pm the phone rang and it was the hospital again. The vet told me that they did an abdominal ultrasound and that it actually didn't look too bad. There wasn't anything concerning in the findings. They didn't see any active bleeding, the other organs looked pretty normal. His pancreas looked ok, but an ultrasound wasn't very reliable as a diagnostic tool for pancreatitis. There was a blood test that they would do later on, and even though it was the best test, it was still not that reliable. They repeated a chest X-ray and they did see a little bit of fluid in the bottom of the left lung and a little in the right lung as well. Considering the extent of the trauma, that wasn't that bad. He told me again that he was still guessing that his prognosis was 50/50, but he was upgrading his condition from critical to very guarded. He told me that he was going to be on until 8am the next morning, and that as long as Danny was stable he wasn't going to call me until the morning. He told me to call him anytime if I was concerned, and I told him that for me, no news was good news, and I would rather he took care of the animals than to babysit me. I got the dogs, went to bed, and even though I didn't think I was going be be able to sleep, I tried. I had no interest in TV and I couldn't read. I decided to meditate; even if I wasn't successful, it was still better than not trying to slow my mind down and lay there with a racing mind. Unbelievably, I was actually able to meditate for 20 minutes, actually falling asleep toward the end of the session. I turned off the lights, put my head to the pillow and woke up the next morning at 6:00.
I got up, let the dogs out, meditated and then fed them. I wasn't hungry and couldn't force myself to eat. I had barely eaten since the afternoon before, and even though I tried, I still couldn't eat. I fed the dogs, and by the time I was finished the phone rang and it was the hospital. The vet, Rick, told me that Danny had been relatively stable through the night. His blood pressure was still low, and they had been doing pulse oxymetry (a non-invasive test for blood oxygen level) all night and his was low. Not critical, but low enough that they needed to keep him on oxygen. There could be a couple of reasons; it could be the fluid in his lungs and/or it could also be because his red blood cell count had continued to drop. The vet told me that they were getting close to the point where he would need a transfusion but that they were going to sit on it for a few more hours. He asked for my authorization for the transfusion, and I am pretty sure that I told him "anything within reason to save him". I did not want to save him if his quality of life would not be good. If he was going to be incontinent, crippled or even require lifetime intensive care, this was not a good life for a dog, and at that point I would surrender to the voice of reason and euthanize him. He told me that he was off for the day, but that the on-duty vet, Ben, would be calling me in the early afternoon with an update. He then told me that he still estimated his prognosis was 50/50, but he upgraded his condition to guarded. The one thing that they still could not accurately assess was possible neurological damage. He then told me "you could come visit him if you like", but I declined, as I did every time they offered, which was a number of times, at least 5. My stated reason was that I didn't want to stress him out by coming and then leaving. That was the truth, but at least very early on, I think at a subconscious level I knew that I wouldn't be able to handle seeing him in the condition that I was visualizing in my head.
I have to say here, I was really amazed by how consistent they were with keeping me updated. They called me every day, at least twice a day and usually 3 or more times without me ever asking. I was always told I could call at any time, but I never did. They did such a good job of keeping me updated that I never felt the need to check up on them. Also, it was more important to me that they take good care of the animals (and the owners that needed it) instead of me. I knew what the deal was, and there was nothing that they could say or I could ask that would make me feel any better. That said, the other thing that really impressed me is how good they were about really making me a part of the medical team. My opinions were valued, my questions were answered honestly and my concerns were always addressed. This is an expensive place, and you never want to have to use it, but if I ever have a really sick dog, even if it's the middle of the day and I can see my own vet, I'll never hesitate to go there. It is a very well-run hospital, and all the staff, from the vets to the techs to the office staff are all first class.
Late that afternoon the new vet called me to tell me that because he continued to not be adequately oxygenated, and also because his red cell count had dropped more he wanted to transfuse him, and I said go ahead. Otherwise, he was continuing to stabilize and now was moving all 4 limbs, though he was still holding the right front leg fully stretched out and stiff. That was promising, but they would still not know about any nerve damage from the ileosacral dislocation until they removed his urinary catheter, and that would not be until at least the next day (Thursday). He told me that he would call me again between 9 and 10 pm to give me an update before bedtime.
About 9:30 pm he called, and told me that he had given Danny a transfusion of 1/2 of a unit of blood, and his red cell count had improved significantly. His pulse oxyimetry reading was almost normal at 95%. A normal healthy dog would be 98% and above (the percentage of hemoglobin that is actually carrying oxygen). They were going to leave him on oxygen at least through the night and then reassess in the morning. Still, they were saying that his chances were 50/50, but upgraded his condition to guarded but stable. The reason that they continued to be so cautious about giving me too much hope was for a couple of reasons: First was that they still couldn't completely assess his neurological status since his bladder was catheterized and heavily narcotized (he was on a Fentanyl drip - a very strong opiate). The other reason was because the critical time period for internal organ damage to show was typically at 5 to 7 days post-injury. He could have too much damage to the liver, severe damage to the intestines, and stomach, he could be brewing a case of panreatitis, and this was the least likely, but he could also be brewing an infection. Despite this information, I was finally starting to feel hopeful. On the day of the accident, as I was driving him to the hospital, even though there was a huge cloud of dread over me, I still continued to tell myself (and Danny) that he was going to make a complete recovery. I told myself that all along for that matter, but by this point I was finally starting to believe it. I knew that dog better than anybody. I knew that he was about as strong a dog as he could possibly be, tough as nails, and perpetually happy. The way that I have often described Danny is thus: Every morning when Danny wakes up, it's the best day that he has ever had. Even as I was feeling more optimistic about his recovery, at that point a really big fear of mine was that this amazing spirit, this perpetually happy countenance, this incredible joie de vivre, would be lost forever. When I called my best friend Deanna the next day to tell her what had happened, she was devastated. Now I have to tell you, Deanna has never been a huge fan of the breed. She is not a hater, but Basenjis are definitely not one of her favorite breeds. When she could talk, she choked up and said "Oh my God, Parry, this is horrible. Danny is the happiest dog I have ever seen". And she meant not just the happiest Basenji, the happiest dog, period. In the last 2 years he has won over a lot of people, even non-Basenji people, because of his happy, silly, goofy, kissy temperament and his perpetually wagging tail, something that is not typical of the breed. I went to bed Wednesday night in a much better head space than the night before.
Thursday morning, the on-call Vet, Matt, who I had bonded with the most so far, called me to tell me that he was off oxygen and breathing on his own. He had held his red count through the night for the most part, but it was still on the low end of normal. He recommended that they transfuse the other 1/2 unit; it was already paid for anyway, and the better that he was perfusing (pumping well-oxygenated blood and getting it to the tissue), the quicker that everything would heal. I agreed, and he told me that they would give the blood. He also told me that he had perked up noticeably, and was moving all 4 extremities on his own. They actually stood him up, and he was able to stand, very wobbly, on his own. Matt felt that neurologically he was probably out of the woods, but that they still wouldn't know for sure until the catheter came out. During the day they repeated the ultrasound, and everything looked pretty good. I was told that it also jived with the neurological improvement that they were seeing (though I'm not sure how they could tell that). He told me that he would be going home, but that Ben (the vet at Danny's admission) would be coming in, and he would call me in the early afternoon. Stupidly, I asked "When do you think he will be able to come home? I can handle pretty intensive care, I can be home 24/7, and as soon as he is ready, I can handle it". He told me that if things continued as they did, maybe he could come home the next day, but that was a very optimistic prediction. I never should have asked, and later on, I never should have pushed the issue.
That afternoon the vet Rick called. Danny was slightly improved from the morning. They had given him the transfusion and he was still off of oxygen, but his pulse ox reading still wasn't normal. He then said something amazing to me: He said "I don't know if I told you, but I grew up with Basenjis - my best friend's dad bred them, and I know how tough they are, but I have never seen a small dog - Basenji or otherwise, as tough as your dog. I really don't know how he survived. He also has the most incredible Basenji temperament I've ever seen. Even now, as we've weaned down his Fentanyl and he is more perky, he is great with all the procedures. He hasn't tried to take out his IV or his catheter. I'm really quite taken aback". He also told me that all of the staff loved him as well, and that he was the celebrity patient. I stupidly asked again about discharge plans, told him what Matt had told me, and he told me that he felt that was extremely optimistic but not out the question. He then told me that we had already gone past the high estimate, so he was going to need to send me an updated one to cover through Friday afternoon. Though that last thing wasn't the most wonderful thing to hear, I was more than happy to pay it; I just knew at this point he would make it. About another 15 minutes the fax of the estimate came: the low end. was about $6000 and the high end was around $7700. The rest of that day was uneventful; I got a status call before bed, but it was basically a "he's continuing to improve and we're feeling better about his recovery" message.
Friday morning Rick called me; he is really the one who was Danny's primary vet, he had been on shift the majority of the time that Danny was there, and as such, really became invested in him and his recovery. He told me that Danny had been doing well through the night, he was stable, eating a little bit (hand-fed), mostly baby food, and drinking water. He told me, however, that Danny was still pretty listless, and he was not sure if Danny would be going home that day. I was a little let down, but decided to concentrate on the good part of the status report, and take what I could get.
At about 3pm, Rick calls me back - actually a little early for the usual afternoon update: "Come on in and pick up Danny, he's ready to go home, just give us about an hour and a half to get everything ready", which meant medications, medical records and X-rays for my regular vet and a bag of IV fluid in case he needed some hydration. Oh, and the bill. Hallelujah, I am jazzed. I scramble to get his sick bay ready for him so it's all set when he gets back. I had a big scrap of floor vinyl that I use for my whelping box and puppy pen when I have litters. I also got a larger wire crate, a bunch of bedding and a 4x4' exercise pen. I put the kennel and pen on the vinyl, with the kennel and one end, and clipped the pen to it. I then took some black thick garbage bags, cut them to the correct width and taped them to the walls of the cubicle that I created. I knew that if I didn't Bobby would (and did) circle the cubicle, growling and get Danny worked up. Even though Bobby did try to stir things up when he came in the room and smelled Danny, he quickly gave up, finding that his stirring the pot was in vain. Then I pretty much filled the whole interior with bedding: Actual dog beds, fleece throws, blankets and a pillow. I then got myself ready and headed off to pick up Danny, a bit fearful of seeing him, since I hadn't seen him since dropping him off after the accident, and I had no idea what to expect. (to be continued)
Doggydad's Life Now: The Viral Monologues by Parry Tallmadge is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Based on a work at doggydad.blogspot.com.
Permissions beyond the scope of this license may be available at http://www.runnymedesilkys.com.
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