Having been up until 4am the last two nights watching my dog suck endless bottles of medical juice into her veins, my head’s not really in the game – but I wanted to post a bit of an update on her condition and the situation as a whole.
First, she’s de-energized but still fighting. She’s having a really hard time keeping any food (and/or pills) down, and is quite nauseated most of the time. We’ve routinely been giving her shots to help with the nausea, and that seems to alleviate it for a while, but hasn’t much helped her appetite (we’re now feeding her baby formula/food as a quick and easy way to get nutrients and protein into her).
Additionally, one of the key drugs is S-Adenosyl methionine (SAMe), which is a horse-choker of a pill that seems barely digested even after waiting 6-8 hours before being regurgitated. Apparently there’s an intravenous version for humans, but none of the vets are able to get their hands on it.
Speaking of vets, we’ve switched from Cao Lang Feng down by the Suzhou Zoo to Wang Wang Gong Guan (汪旺公馆) here in SIP. The closer proximity is a bonus, but the choice was hardly ours. After going to Vet Cao for the last few days, when Maggie went there yesterday the staff explained that if we wanted to stay we’d have to pay the approx. 1500 RMB/day because the dog food distributor had cut off payment there.
Rather confused by this turn of events, the story we got from Vet Cao was that the cheap-ass distributor didn’t want to pay the high costs associated with the “premium” care at Cao Lang Feng Animal Hospital – largely considered the most well-equipped vet in Suzhou.
The distributor (predictably) had a different opinion. He told Maggie that Cao Lang Feng had been using this aflatoxin exposure as a big payday. He accused Vet Cao of ordering unneeded and excessive testing and expensive blood transfusions as a way to beef up the bill – which he knew the “clients” wouldn’t have to pay for. He then also said he’d heard that Vet Cao was overheard saying to a friend, “When else am I going to get a chance to make this money from them?” The distributor seemed pretty bothered by this, as he had a long relationship with the animal hospital. He also added that at least one dog brought in with this problem had died not from the liver damage, but because no one was caring for the dog while it was having an IV.
It’s impossible to say who is right, and so rather than bother ourselves with that unanswerable question, we are keeping focused on maintaining the quality of care that Addie needs. We went to Wang Wang yesterday and checked out the place before committing to the switch, but we had already developed a decent opinion of the place based on recommendations from friends and the fact that this was the animal hospital that tracked down someone to make an 11pm house-call the first night when Addie had the allergic reaction to her meds.
Admittedly, Wang Wang seems like a smaller operation and the staff seem quite a bit younger – but we’re pretty happy with the change. Despite being the “biggest and best”, Cao Lang Feng seemed very cold, dreary and depressing. The staff were curt and none of the vets ever said anything but that we needed to prepare for Addie’s death. Wang Wang, on the other hand, seems warm, bright and the staff (perhaps because of their un-jaded youth) seem to genuinely love and care for animals.
They also gave us hope – and that’s something we really need. We accept that aflatoxin exposure is most often fatal. We know that Addie is going to have to be a damn lucky dog to survive, and even if she does she’s going to have a long road to recovery, which is not likely to ever be “full recovery”. We know this. But it’s not the knowledge of this that’s going to drive us to stay up all night administering IVs, cleaning up her vomit, encouraging her to eat, forcing pills down her throat, and trying through it all to keep a positive attitude in hopes that it will carry over to her.
The other awesome thing about Wang Wang is rather than stress Addie with nerve-straining and vomit-inducing car trips down to the vets office, they’ve sent out a staff member to give her plasma transfusions, deliver the IV meds, and check up on her right in our home.
The toughest bit in all this though is making sure Addie’s got the right meds. I’ve not got the first clue about proper medicine, but I’m also willing to bet that most staff, at any vet’s in Suzhou – or indeed China – has much idea about how to best and specifically treat aflatoxin exposure. The drugs they’re giving her seem to support this, as they all tend to be generic liver failure drugs – helpful, but not necessarily specific enough.
Thanks to the Internet, I came across an article by Eva Furrow, VMD, entitled “Toxicology Brief: The critical care of aflatoxin-induced liver failure in dogs“. It, along with a few other sources, extol the virtues of Milk Thistle, but none of the vets we spoke with here have heard of it.
We took it upon ourselves to track down the stuff. Calling around to pharmacies we weren’t able to find anyone that carried it, but Maggie tracked down the name of a Chinese manufacturer and then went to the pharmacy and asked to see any drugs (natural or pharmaceutical) that help with liver disease – sure enough she found a pack of Milk Thistle pills.
As I mentioned in my post “Why self-medicating is an essential China expat skill“, self-medicating makes me nervous, but trusting that over-worked and under-paid staff at an (animal) hospital have mine or Addie’s best interests in crystal clear focus also makes me nervous.
Milk Thistle is also relatively harmless/safe to administer, so hopefully it helps.
Anyway, lack of sleep has me rambling here. I think I’ll go see what Maggie and the girl from Wang Wang are talking about in the other room.