Vets keep reminding me that Rem has a fatal illness and that any continued existence is luck and borrowed time. Folks whose dogs have had cancer tell me that there will be lots of scares and bad days. None of this makes it easy when something goes less than well.
By Christmas midafternoon, Rem's red blood cell count had gotten down to 20 and they were talking about doing a transfusion. Found out that, once a dog has had a transfusion, an additional transfusion has a higher chance of giving a bad reaction--I guess the dog develops antibodies or resistance to the foreign material. So they don't want to do a transfusion unless it's really necessary. (OK, I guess that's true for *any* medical treatment--)
I asked them to do an abdominal xray as well, just in case the bleeding could've been something unrelated to the tumor, but the abdomen looked clear and the part of the chest cavity that was visible had fluid in it, which is what we'd expect from a tumor rupture (that's why they cut the window in his pericardium, actually, to let the fluid drain away from his heart).
I sat with him for about an hour and a half late xmas afternoon, and he seemed tired to me, even when I took him out for a walk, which he should've been excited about. But, at the same time, his red blood count was back up to 23, and it seemed to have stabilized in that 20-23 range by 10 P.M. We hope that means that the bleeding has stopped. And in fact while I was with him from about 10-11, he seemed perkier than he had been earlier in the afternoon.
Still, the night-duty vet felt that a transfusion of red blood cells would still be a good thing, since he did seem droopy. Would give him more energy to deal with life and recovery. I now also know that there are at least 2 types of transfusions they're discussing here--(1) red blood cells (which carry oxygen) and (2) plasma (which includes clotting factors); platelets are a whole 'nother thing.
I'm waiting to hear back from the vet this morning on how the transfusion went and how he's doing today and whether he can come home. The person answering the phone this a.m. said that the doctor was with another patient, would call me back; that Rem was doing well and would be transferred to South Bay (his regular cancer-treatment vet) this morning when the emergency clinic closes down. I was hoping I'd hear back from the emergency vet again before she went home.
He's been over there for going on 36 hours and I really miss having him here and hate to think of him all alone over there (it's a nice big crate with lots of room & dog-friendly staff, but it's nowhere near being at home).