Rem spent the night at the emergency room here getting a transfusion again. I'll be heading over shortly to visit & hopefully pick him up.
Crystalwood Lodge near Klamath Falls offers a wondrous get-away for dogs and their human companions. My beasts loved being off-leash and running amok among the marshes, fields, and forests. Remington showed signs of internal bleeding again, though; Sunday morning he refused his kibble (but ate a full can of smelly food), and when we went out for a short walk, he stayed fairly close to me on the way out and on the way back just stayed right at my heels, and I slowed down some for him. After that, he didn't much want to stand up at all. His gums weren't quite as pale as the snow that fell Saturday night, but they were awfully close.
Janet, the chef (one of two full-time resident staffers, who were both wonderful), called the on-call weekend vet, who listened to my description, said they'd have no way of doing a blood test on a sunday (which pretty much blew me away--what do they do for emergencies?), and that Rem's symptoms made it sound like he could wait until Monday morning, just keep him completely quiet (he actually said this to me on the phone: "Exercise would be contraindicated." Maybe my careful & detailed description of Rem's illness made him think I spoke the language like a native? Yeesh.), make sure he got plenty of fluids, and if he showed signs of respiratory distress, call him again. The vets are all over in Klamath Falls, which is about a 40 minute drive away--over curvy, sometimes icy, dark (and, to me, unfamiliar) mountain roads. There is no "emergency clinic."
By dinnertime, when Rem was breathing at a rate of about 30 or more a minute while just lying there (Tika and Jake between about 15-20), and kind of almost but not quite moaning or whining or wheezing with every exhale, I realized that I didn't know what qualified as "respiratory distress" . Called vet again. He said "panting and gasping and 60 times a minute." I said that sounded pretty nasty, but he said that I'd have at least 3 or 4 hours after that started before he'd really be in danger. Oh joy.
At that point, Rem just stood there blankly when I took him outside to potty. Looked disoriented. Needed some hand-holding (an odd analogy) to get up and down the slightly steeper front steps.
When we went to bed, me exhausted, he tossed and turned and tossed and finally got off the bed and lay on the floor on the opposite side of the room. I was too worried to have him out of my reach like that, so I moved my blankets and pillows onto the floor next to him. This probably worried him more, him being a worrying kind of man, but I couldn't stand being away from him. He continued to toss and turn and breathe noisily until about midnight, when he suddenly decided it was time to get back on the bed (needing assistance each time), and then he finally dozed off. We slept until about 5:30, when he started being restless and uncomfortable again.
The residents' regular vet (among the owners & staff they normally have 19 dogs on site! Only one this weekend, though--) was off at a conference for the week, and the next vet on their list was in surgery until 11:30. But by the time I had taken the other dogs for an icy-crunchy walk, eaten another wonderful home-cooked breakfast (Rem had no interest in kibble, canned food, or even liver treats by this time, but he snarfed down bits of ham from my breakfast, so I knew he wasn't really on his last legs), and packed the car, it was almost 9:30. Janet and her husband had to drive into town anyway, so I followed them. Arrived at the vet's about 10:45 after a stop to fill the gas tank (what fun--drive from Klamath Falls to San Jose on one tank of gas, with left-overs! There are things I like about the van--).
Rem wanted to walk around and explore, even though he was taking little tiny puppy steps and still had that vague disoriented look every time I would try to go back in the other direction. He *wanted* to go inside the vet's office and sniff around, so we did, and then he hopped onto my lap on the waiting room bench and just wilted onto my lap.
The vet was a nice man and as helpful as he could be under the circumstances. He did the blood test that I requested, which showed Rem's red blood cells at 17%. (Normal is 36-50 or so; transfusion level is less than 20--for his practice, he says he avoids it until it drops below 15%.) The very good things were that Rem was *not* dehydrated this time, AND his pulse was still very strong. Challenge is that, once a dog (or person!) has had a transfusion, the risks of a bad reaction to another one go up dramatically. They don't have any kind of blood bank up there; he sounded a little wistful when talking with me about the treatment Rem's been getting down here. For an emergency transfusion, he said what he'd do would be to go home and get his dog-- Anyway, I asked as many questions as I could think of, and then we agreed the lesser risk would be to beat feet for San Jose and get him a transfusion here if he still needed it.
I called my vet when we were about halfway home & gave her the story, and she pulled Rem's file to leave it for the emergency staff and asked them to call her when we got in.
It was a long drive. Rem tried to prop himself up for the first hour or so to look out the window, leaning back on the partially reclined seat--I also stacked dog beds next to him so he could lean on them--but even that was too much for him and he dozed most of the trip. Took just over 7 hours, including a few stops to potty myself or the dogs. (Tika drove me nuts, as she has occasionally at agility trials, by not pottying for the entire duration of the trip from the lodge--leaving at 9:30--until I finally got her home about 9:30 that evening.)
Blood test showed red blood cells at 15%, so he hadn't stopped bleeding. A transfusion of red blood cells primarily just makes them feel better--they'll have enough oxygen, at least for a while, to brain and body. Then we just wait to see whether it all bleeds away again.
No calls during the night, so that means the transfusion happened with no complications. I'd better take the other beasts out for a W-word and then go over to the clinic. I'll fill in the *wonderful* parts of the weekend, including marsh slogging, bald-eagle sighting, canoeing, eating gourmet meals, later. Here are some photos.
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