Ellie's Last Photo

Rest in Peace our Sweet Baby Girl

Ellie's Special Image from Val

Final Report from Surgeon

Report pre on post surgery by Dr. Keith Allen- 7/12/2010

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On July 2nd Ellie re-presented  to me for surgical stabilization of an Atlanto -Axial luxation. Ellie had done well for several months with a conservative approach by bandaging the cervical region but had had problems with respiratory issues after extended bandaging. Her neurological signs  had stabilized for 2 months and then relapsed. It appeared at this point that the best option for her long term was surgical stabilization.

​The surgical technique chosen was to stabilize C1-C2  with a ventral approach using screws across the C1-C2 joints and PMMA. At surgery the AA joint appeared very unstable and the anterior body of C2 was displaced cranially and dorsally into thespinal canal. The body of C2 was retracted out of the spinal canal and reduced into a more normal anatomical position. I attempted to pass a 1.5mm screw across each C1-C2 joint space but the implants would not hold. At this point I elected to cross pin the joint spaces which was very successful. The pins provided rigid stability and were reinforced with wire and PMMA.

​Following surgery, Ellie was very comfortable and was kept sedated and quiet overnight. We planned on re-bandaging her the next morning. Ellie was walking normally the next day and very comfortable. Unfortunately Ellie started regurgitating and vomiting that night and due to her prior history of respiratory problems in the bandage I felt it was safer to keep her quiet while we got her GI symptoms under control. I was worried about her developing aspiration pneumonia. Ellie’s GI signs resolved but she developed some upper airway nasal congestion from the vomiting and again I was concerned about re-bandaging at that point.  Injectable antibiotics were switched to more  broad spectrum medications in case of pneumonia.

          On Sunday, July 4th, she still had some nasal congestion and had developed aproductive cough suggesting she may have some mild aspiration pneumonia that was responding to medical therapy. She was eating more, was comfortable and walking well throughout the day.

At 11:30pm on Sunday evening, after completing an emergency surgery at the hospital    

I  went to check on Ellie in her cage. She walked up to me wagging her tail and then collapsed in my arms. Her heart rate fell to 30 beats per minute. Ellie was non-responsive initially, I administered intravenous atropine and corticosteroids and her heart responded, but she remained lethargic. Her breathing was shallow and rapid. She returned to a normal heart rate and breathing rate  for about 10 minutes until another episode of collapse occurred.

I elected to radiograph her chest and cervical spine. The surgical repair was intact and

her chest showed no abnormalities. Despite the repair being intact  I re-bandaged her to see if it would make  a difference in her signs, but episodes of collapse continued  throughout the night but she  was becoming less responsive to atropine and her breathing was more erratic.

At 7am on Monday, July 5th, she had a major episode of collapse, withbradycardia and and an acute onset of an abnormal breathing pattern. It became evident that Ellie was losing normal brainstem control of heart rate and breathing. At that point I called  Sheryll  and recommended that she and Lynn come up right away. We sedated and intubated  Ellie to take control of breathing and heart rate. When they arrived we felt considering her continued decline the best decision although heart breaking was to let her go.

I wish I could be certain of what happened and why Ellie progressed as she did. Her signs appeared to be brainstem related and I feel they may have been related to either an acute bleed, infarct or development of acute swelling of brainstem for some reason but I cannot be certain.

Ellie was a wonderful puppy and really loved life, she was a wild child and truly loved her parents who are some of the most devoted and loving owners I have ever met. I know this a really difficult time for everyone and I will always second guess everything that happened. Ultimately, I feel we all gave her the best possible chance and I feel her spirit and spunk will live on in all of those who were lucky enough to have been touched by such a wonderful little girl.

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Keith Allen, MVB, MS, Diplomate, American College of Veterinary Surgeons

Ellie's last day on earth

It is with extreme pain we have to report that we lost our sweet angel baby girl today. She could fight no longer. Rest in peace our precious fur baby. We loved you like our little child and deeply miss everything about you.

Ellie Post Surgery

I will post photos later. Right now just to tired to load them!
Ellie's AAI surgery went fine on Friday July 2. Her bones were too tiny for screws so he used pins, wire, cement. It was "tricky" but surgeon felt good about results.
On Sat July 3, Ellie had a little set back. She began regurgitating- and it made her panic- which made stuff come out of her nose. This issues caused her to not be able to be splinted. And this gi issue is not related to the neck surgery. They did move her esophagus over to perform the surgery which may have caused the panic when the gi attacks happened. Had to sedate her and make her rest. Surgeon said she is not out of the woods yet. Watching over her like a hawk to deal with this issue. Told us she had to stay in the hospital a few more days - that she must have this problem cleared up.
On Sun July 4, Ellie began coughing. Surgeon believes she may have bronchitis or mild pneumonia. Apparently her coughing and gi issues got into her lungs. Cough is productive which is good. Said he would change antibiotic to a more broad spectrum form. Also using nebulizer. She is on IV meds esp to keep her sugars leveled. 
Sun pm- Surgeon said Ellie blew out her iv yet again. Has to give liquids and food by hand, but she is ok with it. She is doing well on the new antibiotic. She is alert and perky. She is pink in color- healthy looking. He doesn't want to try iv anymore for fear of her straining her neck to get it off again. She is still coughing, but producing a lot of junk when coughing. That is exactly what we need her to do to get rid of the stuff in her lungs. 
Surgeon is highly impressed with her walking and mobility skills. The AAI surgery results are very good. We just need her to conquer these problems. It is possible she will not be able to be splinted because of these episodes. 
Everyone is being so wonderful supporting her and her family with thoughts and prayers. 
Next time i log on i hope to be re-energized!