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Terms to define on JJ hospital report

LilF

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Last Wednesday JJ (15 1/2 years old) went to the hospital and the Neuro Exam notes indicate the following which I am unable to understand: I understand the "dull mentation" but have tried to look up the following with no success: " Intact Palpebral" " absent menabee and PLR's. " " Postural reactions normal."

I should say that JJ's BUN was very high so it appears the homeopathy may not have been the right remedy. He was determined to have "severe Azotemia." and they did nothing for him there. I had been giving him 3 Azodyl daily and feeding Darwins raw diet (Kidney formula and some of the natural selections and he got sirloin steak with his supplements) Creatinine was 3.1 , BUN >130, Phos 9.4

Also says "suspect kidney failure" Interesting how this report just "suspects this and suspects that"

I was also told his chest had fluid but the FAST scan showed "SCANT pleural effusion" The whole thing is a big contradiction. He was also diagnosed with "left sided heart failure" , again with no fluid in chest and stating "moderate atrial enlargement" whereas 2 months earlier the IDEXX cardiologist called this within normal parameters.

I took him in as his respiration was 45-60 with no panting (I have videos). Yet the doctor said that he was panting. I told her he was nervous and that I slept in the car with him and once or twice he lifted his head to pant a couple minutes and that was it. I also said on the way to the hospital and at home, no panting but OCCASIONAL gaggy cough. So seems like she had a hammer and JJ was a nail. She did not listen to any of my input and made things up, i.e. the panting. When I got there JJ was resting peacefully in the back seat and not distressed. They YANKED him out of the car and carried him in before I knew what was going on. His collar came off. So yes he was then panting. I guess they put him on butorphonal.... Butorphonol???? contraindicated I read for elderly, hypothyroid. Can cause CNS and respiratory depression but they gave him THAT instead of fluids? JJ had no pain---nothing as noted in report. They were sedating a nervous dog.... They took xrays and blood and then they said his heart stopped. I am having a necropsy for the following and above reasons.

Backing up now to when I got there and they dragged him out of the car. (JJ had jumped out of the car after we slept in it the night before and laid in the grass. When time to go he used his ramp to get in the car. So with that in mind (and no panting). The doctor came in and said the following to me after carrying him into the building "as if" he was a dog coding! The doc comes in and she says in rapid fire speed with no periods at the end of the sentences and no emotion.
She said: JJ is critical and he is going to die i need your permission to start and iv and he needs oxygen and do you want a dnr or cpr and do i have your permission to push drugs. I was floored and want to know what you all would do. I said to her JJ has kidney problems and drugs are not a good idea and that I suggest fluids. She said cannot push fluids with kidney or heart problem so she gave him butorphonol I told her I did not want her to work with him if she had the expectation he would die and asked for another doctor. She said "I am the only one here" I asked how much experience she has and she said "I am not going to tell you" (later I found out it is 1 year). I told her I was taking JJ home or to the other hospital and did not want her to work with him (I thought she was going to kill him with her horrible attitude)I was fearful for JJ's safety. I almost got him out and my head took over the intuition---here is the lesson---big mistake---I do believe he died because of her. Everyone I know says JJ was not ready to die that day---maybe soon. I had his euth planned in the back seat of the car and I did not even get to say good bye to him. They made him so nervous and pushed drugs and xrays that his poor little heart stopped. This is the part I cannot live with. She was inexperienced and "suspected" instead of putting together a differential. She poo poo'd my input. Made up that he was panting because hd could not breathe. I told her he had a marked bacteria in urine and the culture and sensitivity was back , it showed enterococcus and he needed ampicillin. So now the vet tech won't talk to me about his last moments and the message here is I should have listened to my strong gut feeling about the doctor that she was going to kill him. The importance of the energy she was sending him. I should have gotten him out even if I had no immediate solution. That is my takeaway to you all--listen to your gut. When the doctor softened up in front of the supervisor I reported her to, she fooled me into thinking she would try and treat JJ... I live with JJ and with him 19hours a day and she didn't listen to one thing I told her. She insisted he could not breathe. I asked her if she read his record and she said "no" I told her he had cardiac tests and has an irregular heartbeat... She heard nothing I said.../ So will see what necropsy shows---doing ALL testing for veterinary drugs including euth drugs (Yes I do suspect her of giving him something) especially since his heart supposedly stopped "right after the blood draw" and he went into agonal breathing. I am sick sick sick. One year experience and she did not call for backup. The cardiologist "glimpsed" the xrays which btw, I requested and don't have yet. I will track it all down and task her with the guessing games played on my dog. Her report is full of spelling errors too---just saying... Would you all have walked out with your dog if the doctor said your dog is going to die? If so why did she rack up a bill. Ha! reminds me of my friend who had a dog being put to sleep and the vet cleaned the dog's teeth first to rack up the bill---no joke------ I realize the importance of energy and expectation and had I taken him out he would still be alive I am convinced.
 

aruna

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Hi, @LilF, that sounds like a very intense and painful experience for you. I am sorry this is how JJ passed away and that you felt helpless in the situation and didn't get the treatment that you wished for. My condolences - I'm sure JJ was a great pup and you miss him dearly.
Everyone processes death differently and grieving takes time. Sometimes we blame ourselves - that we could have done something differently. It sounds like JJ's case was very complicated.
In your post you ask what others would have done. I personally have no idea, since it's a difficult situation and you did the best you could. However, I wonder what is your request or need with your post? No one will bring JJ back, however I would love for you to feel more at peace and allow yourself to grieve this big loss.
I'm not sure what kind of feedback you need right now - is there anything specific that would help you?
 

Dr. Jeff

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I'm also super sorry about JJ.
indicate the following which I am unable to understand: I understand the "dull mentation" but have tried to look up the following with no success: " Intact Palpebral" " absent menabee and PLR's. " "
Great questions about translating the exam notes!

Intact palpebral (reflex) is the "blink reflex.

"Dull" mentation is just their commentary on his responses to the environment which ware not BAR ("Bright, Alert and Responsive").

PLR=pupillary light reflex.

"Menabee" is probably actually the "menace" reflex (which means that he didnt blink when a hand was waved at his eyes).
 

LilF

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Hi, @LilF, that sounds like a very intense and painful experience for you. I am sorry this is how JJ passed away and that you felt helpless in the situation and didn't get the treatment that you wished for. My condolences - I'm sure JJ was a great pup and you miss him dearly.
Everyone processes death differently and grieving takes time. Sometimes we blame ourselves - that we could have done something differently. It sounds like JJ's case was very complicated.
In your post you ask what others would have done. I personally have no idea, since it's a difficult situation and you did the best you could. However, I wonder what is your request or need with your post? No one will bring JJ back, however I would love for you to feel more at peace and allow yourself to grieve this big loss.
I'm not sure what kind of feedback you need right now - is there anything specific that would help you?
Hi Aruna

I was asking, knowing the importance of positive energy and expectation. When the vet came in and without any appearance of caring and in quick fire succession said He was critical and he was going to die and do I have permission to start an iv and do you want cpr or dnr and can we push drugs. She also said she did not view the record. When I asked for another doctor she said she was the only one and would not tell me how many years she has been a vet. AT THAT POINT would others have taken him home, especially when my gut instinct knew JJ was in danger from HER. We learn about gut, again as I said positive expectation, intent.... I almost took him home. Would others have wanted someone like this working on their dog. I get a lot of emails from rescues who have dogs in much worse shape than JJ and their docs heal them. ALSO. I cannot say this enough. JJ was NOT panting and she insisted he was . I was telling her that it was nervousness and I am with the dog 19 hours a day and I said he was not panting. The doctor did not listen to my input. So with all we learn here. ...... would others have found another option and taken their dog out of there or let someone with ill intent, dire expectation of death, would not read the history, would not listen to my input, he was in more danger than any physical problem he had. In other words I went against my intuition and let them test him. And why would she give a dog butorphonol that is in her words "critical?" Is what we learn here not to be applied in real life? I was asking what action others would have taken in light of the abject contradiction of what we learn here? It is a difficult question but it is real life and maybe not far fetched from others who may encounter the same or similar situation.
 

Dr. Jeff

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Wow, thanks so much for your post Lil!
I was asking what action others would have taken in light of the abject contradiction of what we learn here?
Great question!! I think one way is for you and the rest of the HA! community to start changing the vet care system.

It's happening already in lots of small ways, e.g, there were no supplements in vets offices a few years ago but pet parent demand, a growing financial interest, and research has changed that in a little over 10 years.

Mind-body and energy medicine for pets (which you may be referring to) should be coming by 2025. The HA! and Morris Animal Foundations have already gotten the ball rolling:


In addition, a philanthropic HA! member (and of course we welcome others!) has inspired a large research project starting this fall which will investigate the link between cellular energy/mitochondrial function and dis-ease.


Then the link between happiness and mitochondrial function can be investigated and if shown, will hopefully lead to a movement towards the re-growth (and happier) mindset which helps treatment outcomes (and longevity) in people.

The more supportive we can all be, the better IMHO.

FWIW-I'm BEAMing as I write this!😁❤️
 

Dr. Jean

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Oh Lil, I'm so sorry to hear of your terrible experience, and the loss of your buddy JJ.

It's impossible to second guess what the doctor was seeing and thinking. Clearly she had horrible bedside manner and was incompetent in her communication. For instance, she said "panting" when what she probably meant was "increased respiratory rate." I don't know how big a dog JJ was, but for a 10# dog, I would consider anything over 30 breaths per minute to be elevated, regardless of whether there was physical panting. All that said, given the numbers, I'm not sure the outcome would have been much different had you taken him elsewhere.

My experience as a vet helping so many animals cross over has convinced me that once they're "over there" (wherever that might be!) all is forgiven and forgotten. Only the positive accompanies us through that transition. So whatever stress JJ was experiencing has been released, and not even a shadow of it is with him now. So it is also okay for you to release it and, to the extent possible, to forgive what sounds like an inexperienced and somewhat panicky young veterinarian who, I suspect, has lost more than a little sleep second-guessing herself. There are moments that still haunt me 30 years later that I wonder, "if only I had...."

I also believe that there is structure and guidance on our paths. Death cannot occur without the consent of our "higher self." For whatever reason, this was an experience that both you and JJ agreed upon and/or needed on each of your paths.

I agree with Dr. Jeff that a major shift must--and is starting to--overtake the medical establishment. We will be able to heal on an energetic level without all this physical rigamarole. Drugs and surgery will go the way of bloodletting and other techniques that we now consider primitive, even barbaric. Better still, we will be able to maintain optimal health in the first place!

Our HA! community is one place this is happening. But on a universal time scale, we are only beginners. We will have setbacks like you had with JJ. And we can expect MAJOR resistance from all the systems that currently profit from sickness and death. But like persistent drops of water carve away stone, eventually a new paradigm will slide into place, and it will seem so normal by then that no one will even blink!

I know this may be a bit on the woo-woo side, but I hope it helps, at least a little!
 

DanielleDL

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@LilF - I'm SO sorry for your loss. It's obvious that JJ was well loved and lived well because of you. I feel your pain, not only in the loss of JJ, but in the questioning of your choices (I did the same with my little Cricket. Better to heal right now and laugh and love about how amazing JJ is--and I specifically said "is" instead of "was" because I don't believe in death, because the spirit cannot die.).

I hope what @Dr. Jean said above comforts you the way it comforts me, since we think so similarly. And in answer to your question, I probably would've done exactly what you did. Doubt the professional, but feel no alternative but to trust them in a dire situation. And I would ruminate and be angry (and them, at me) exactly as you did/are, and then I would force myself to try and focus on the years of life and love, not the last hours (and would fail, and try, and fail, and try, until it didn't take so much effort. And life with Cricket was a treasure trove of funny and amazing stories, so luckily she made it easy. I'm sure JJ did too.). Again, JJ's spirit is still very much alive (I feel like my old family dog, Quincy, stuck around for quite some time to help comfort us after his body death).

I hope you don't mind me sharing my favorite poem at times like this (and I am NOT a poetry person):

Do Not Stand at My Grave and Weep
by Author Unknown​
Do not stand at my grave and weep,
I am not there, I do not sleep.
I am in a thousand winds that blow,
I am the softly falling snow.
I am the gentle showers of rain,
I am the fields of ripening grain.
I am in the morning hush,
I am in the graceful rush
Of beautiful birds in circling flight,
I am the starshine of the night.
I am in the flowers that bloom,
I am in a quiet room.
I am in the birds that sing,
I am in each lovely thing.
Do not stand at my grave and cry,
I am not there. I do not die.​

I'll tell Cricket and Quincy (and all the other animals I've known and loved) to show JJ where the good treats are, cuz it's ALL treats ALL the time now (or whatever JJ loved most). I have sad tears for your loss, and happy tears for JJs peace. Big hugs (and/or whatever else you need in the form of supportive, comforting vibes)
 

GinnyW

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Wow, you guys are all great:) Poor Lil - but this is a big learning for all concerned. Me, too - I'm proud to be among you all - what a power we have here....

Blessings on you, Lil....
 

AlysonR

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I just want to add my own 'woowoo' experience healing from the death of a dog. I'd nursed Samantha through 1 1/4 years of anal gland adenocarcinoma, but the time came to say goodbye the day after New Years. She could no longer urinate, and the rest of her short life would have been pure misery. But when the housecall vet came and gave her that first 'relaxing' injection, Samantha gave me such a glare, a "What are you doing? I'm not ready to go, yet!" glare. It haunted me for 3 days, and I wasn't getting any better. I reached out to a friend, and she said I should talk to this animal communicator, so I did. I didn't believe a word the animal communicator said. I was on the phone with her while she was taking her child trick-or-treating, and she was trying to sell me supplements for myself, too. And yet...it worked. She gave me permission to forgive myself and assured me that Samantha had already forgiven me and was very happy. I still cried after that, and I'm crying now as I write this, but the tears are no longer steeped in guilt.

The path to healing doesn't have to be rational, or "correct". It doesn't need to be long, or deep. But you do need to follow it. Look for a way forward.
 

LilF

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@Dr. Jeff @Dr. Jean @AlysonR @GinnyW @DanielleDL @aruna Wow, I do not know how I missed all these posts on JJ.... I am thankful for all your thoughts (REALLY thoughts to ponder) to adjust my brain. Although your experiences with your own dogs ignite your own pain, I can learn and apply nuggets of your coping style to my situation. I DO find happiness that my Gabby (RIP) was right there to lick his face when he came over---maybe even before, I hope. I will talk to an animal communicator but I have found a feather, like right in front of me---hard to miss-- at significant times from both Gabby and JJ (they are in a frame now). I found a feather from Gabby after I was telling her I wanted to be with her. (when I looked up finding feathers, they said to think of what you were thinking before you found the feather.) So finding a feather means there is an angel close and/or your deceased loved one. I have to reread all your posts and let it "sink in". I just keep imagining the torture he went through, that is the part that is hard. I do know he is ok now but how he felt before his little heart stopped crushes me, feeling how frightful and confused he was on top of his being given a sedative on top of his "being out of it" (his usual morning state of mind till noon for many months) I would like to think the vet will regret her approach but she did not have a conscience. I know that if something happened on the watch of my local vet I would be resigned to acceptance because my local vet is compassionate and well intentioned. The vet who put Gabby to sleep made a mistake on her diagnosis but she was compassionate so I don't demonize her. Gabby had a nice passing and the vet gave us all the time in the world. So that "mistake" is easier to forgive and let go. Thank you for the poem, Danielle, and all your painful stories you had to resurrect. I know medicine takes a long time to change. Back in 2009 they were still doing the Rabies Challenge Fund study and now the laws still have not changed. After the discovery of Helicobacter Pylori, the wheels of medicine did not change in their approach to stomach ulcers for years and years. I guess the key is to find the people who are advancing in their modalities and thinking but not so easy. For that reason I don't plan on getting another dog due to not having good holistic care in my area. I am grateful for this site and the learning that benefitted JJ. He taught me to be stubborn in following my gut from now on no matter the resistance and know there is always another way even when the way is not right in front of me. But under no circumstances will anyone ever behind a wall, treat my dog with the intention of "death." I meet with the vet tuesday on the necropsy...it is like reading portugese!! So far they have found no heart enlargement but the emergency vet said moderate atrial enlargement. There are contradictions everywhere. Hah! It says Pale gums and then muddy gums... JJ is shar pei and part Australian Shepherd---gums are black!! I just love my local vet for doing all he is doing,....He gets the cut of my jib.....very compassionate and he said he would like to go into holistic medicine. I hope I was part of that as I always shared what I was doing with my dogs that worked.
 

HA! Support

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Here is Lil's description of JJ's life - such a beautiful testimony:

Life started out in an animal hoarding situation for 7 years ending with a humane investigation by the Cleveland Animal Protective League. I adopted him in February 2014 at his supposed age of 7 years old (but he always seemed older). By then he survived heartworm, over vaccination, being returned and a multitude of issues requiring drugs. His teeth broken from the conditions and I promised he would never want for food again. I got my long distance holistic vet on the case. JJ often licked the floor compulsively later to find out his gut needed help. We used a homeopathic remedy for about a year and never again did he have gut issues. Old habits of his situation die hard, he dumped the kitchen garbage all over the floor and even years later ate a plastic bag and vomited it up in one piece without choking. He fell down the basement steps and like rubber, bounces back like a survivor would. He almost lost an ear from a vicious dog bite. He tore his cruciate a few months ago and came back like Rocky Balboa. I thought he would have a short lifespan but with holistic medicine from day one, he stunned me living so long.

JJ was a cuddler, liked to be close. He always found a new place to sleep and he seemed to gravitate to a grounding mat. He melted when his housemate Gabby licked his face like a momma. They got along where they drank water from the same bowl at the same time. JJ was a survivor, quiet, gentle but a will to live and stubbornness unmatched. Before I knew of BEAM I told the vet he seemed clingy and fearful in 2019. The vet brushed it off but I kept nagging. Finally he found a spleen that needed to come out because of my insistence something was wrong. JJ survived another 3 plus years.

Saving the best for last, JJ loved the car, his man cave, his whole life. We went to the park, did errands or he just chilled in his car cave 5 hours a day. On one HMDM call I told Dr. Jeff that JJ didn't like to do much else and seemed depressed. He told me to sit in the back seat of the car with him. I tried it months later and what a home run that was! He loved loved loved it. Smiles and eyes that lit up and sparkled. I sang his special and peppy song I made up about him being a good boy and how good it was to have him here. I pet him and snuggled with him and it became the most treasured memory of the last 6 months of his life. This was quality of life JJ style as I had to restrain foisting "my" idea of life quality on him. I planned the perfect peaceful euthanasia (when it was time) in his man cave, with me, but the events of his death at the hospital got in the way of the best plan. He was my "Rocky", the eye of the tiger.
IMG_3293.JPGIMG_2351.JPGIMG_3626.JPG
I envision you happily frolicking in rainbow fields now, JJ! May your heart find peace, Lil.
 

AlysonR

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a
Beautiful!! But yes, life gets in the way, sometimes. I'd planned the perfect ending for my first dog -- house call vet, he'd be blissfully sleeping when the vet came in and would never wake up. Nope! Didn't happen like that. He got up and circled the vet's van, and the vet asked me why I wanted him euthanized. I had to explain that he was barely eating, and I'd seen his eyes roll up into his head at least twice due to pain. He had spinal myelopathy and was having seizures nightly. After my explanation, he agreed it was time, and my noble pup did finally lie down and go peacefully, but not at the start. For me, a first time dog mom, it was tough.

As I'm sure yours are, all of my pups are 'up there' frolicking, and frolicking in my heart, as well. Heal your heart, and then rescue a few more dogs. Yours is a heart with infinite room.
 

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