We,mother Kaco and daughter Saya, are working on dogs and cats conservation activities.This is our activities' blog. We hope to share the information with many people, and we also would like to transmit the information. We started the activities in earnest in 2005. Looking for adopters for 9 dogs which some homeless people were unable to look after let us to start the activities.(ル二さん 訳)

2018年3月30日金曜日

すばるのこと About Subaru

昨年末に大きく体調を崩し長期入院となったすばる。
もともと下顎の骨が折れていたのですが、時間はかかっても舌を使って上手に食べていました。僧帽弁閉鎖不全、腎障害、気管虚脱と健康面での不安を抱えていてたくさんの薬を飲んでいるすばる。クリスマス前から食欲が落ちて元気もなく、年末年始のお休みで病院が休みに入ることもあり受診。血液検査の結果が悪く即入院で酸素室に。年末年始を病院で過ごすことになってしまいました。きちんと食べられていなかったので栄養状態も悪くなっていました。
Subaru had some major problems with his deteriorating health and had to be admitted long term into the hospital at the end of last year.
His bottom jaw was initially broken, but even with time, he was able to eat properly and use his tongue. He had mitral insufficiency, kidney damage, and tracheal collapse--so many things to keep me worried--and was taking so many medications. Before Christmas his appetite started waning and he seemed lethargic, so since the vet would be closed for the New Year break, I decided to take him in for an appointment. His blood tests came back terrible, and he was immediately admitted to the oxygen room. Unfortunately he had to spend the New Years holidays in the vet. Since he wasn't eating properly, his nutritional balance was also off.


栄養状態が悪いのに口から食べることができない。強制給餌は誤嚥の心配があります。
なので一時的に首からのチューブフィーディングをすることになりました。
体重が増えて体調も安定したら顎の再建手術をするとのことでした。
Even though he wasn't getting enough nutrition, he couldn't eat with his mouth. At the same time, I was afraid that if we tried to force-feed him, the food might go down the wrong pipe and cause bigger problems, so we decided to termporarily feed him through a tube down his neck.
We could do some jaw reconstruction surgery once he gained some weight and had a more stable condition.

胃も萎縮してしまっているようなので少量をゆっくり、回数を多く。嘔吐による誤嚥性の肺炎が一番心配でした。
His stomach seemed to have shrunk as well, so we fed him small amounts slowly over several times.  More than anything, I was afraid of pnemonia caused by vomiting-induced pulmonary aspiration.

ある日いつものように面会に行くと呼吸がおかしい。看護師さんに伝えるとすぐに先生が診てくださって……肺水腫でした。肺に水が溜まってしまったのです。
One day I went to visit him like usual, and I noticed something odd about his breathing. I told the nurse, who got the vet right away...  It was pulmonary edema--water had filled in his lungs.

酸素室の中で横たわっているすばるの姿を見て、毎日祈るような日々でした。
I felt like praying every single day looking at Subaru lying down in the oxygen room like that.

1週間ほどで酸素室を出て犬舎に戻ることができました。でも輸液は中止。そのためか舌がカラッカラ。相当免疫も下がっているようで耳の血管炎も再発。シッポの先の血流が悪くなって先端が壊死してしまいました。知らない間に体に傷ができそれが拡がって壊死してしまう状態。
After about a week he was able to leave the oxygen room for the kennel, but we had to cancel the blood transfusion. Due to this, his tongue was extremely dry. His immunity seems to have gone down considerably, and the blood vessels in his ears have become inflamed again. The blood flow to his tail is bad, so the cells in the tip have died. Some injuries have occurred without us noticing and spread, causing more necrosis.

 


それでも立ち上がれるまでに回復。「首とシッポのガーゼ交換の時は大暴れなんですよ」と看護師さん。
Despite all this, he's now recovered enough to be able to stand. The nurse told me that he goes berserk when it's time to change his neck and tail gauze. 

体重もほんの少し増えてきてこのまま元気になってくれればと思っていた矢先、今度は発作を起こしたと。
Just as I was thinking that maybe he'll get better becuase he's put on a bit of weight, next started the seizures.

こうなるともう顎の手術は無理です。手術は長時間になると言われています。ただでさえすばるの年齢を考えると麻酔をかけることは怖いのに、発作を起こしたとなるとさらにリスクは高くなります。
With this, now jaw surgery becomes impossible. Surgery would be over several hours, I've been told. Even under normal conditions, considering Subaru's age, I'm hesitant to put him under anaesthesia, and now the risk is even higher with the start of the seizures.

点滴もストップしているしチューブフィーディングと保温だけなら家でもできるのですぐにでも連れて帰りたいのですが、なかなか許可が下りない。ぐったりしている訳ではないのだけれど、寝ているだけで動きがない。正直なところ「あまり時間はないのかも」という不安がありました。だからなおさら連れて帰りたかった。
We've had to stop his IV, and since it's just tube feeding and keeping his temperature stable, I could do these things for him at home. I wanted to take him back immediately, but the doctors won't allow it. He doesn't look too peaceful, but he's sleeping and not moving. In all honesty, I'm afraid he doesn't have much time left; that's why I want to bring him home even more.

入院から1ヶ月、ようやく退院の許可が出ました。
よーし栄養とって元気になるぞー
A month since he was admitted to the vet, I finally got permission to take him out.
Allllllright! We'll get you the nutrition you need and make you better!

病院で使っていたのはa/d。でもa/dは詰まることが多いし流しやすいようにお湯でゆるくすると量が増えてしまう。なのでロイカナの退院サポートを使うことに。結果、見事に下痢😱 少量で済むものを探してロイカナのクリティカルを試すと下痢することもなく順調。よし、これでいこう!! 1日1本がめやす。
They were using the a/d in the vet, but that can stop up often, so I decided to soften it up with some hot water to make it flow better, which caused the amount to increase. For this reason, I decided to go to Royal Canin for outpatient support. The result: amazing diarrhea. 😱 I decided to look for something that would be okay in small quantities; when I tried Royal Canin's Critical, the diarrhea stopped and he seems to be stable enough. Alright, let's go with this, then! I'm aiming at one a day.

ただね、これお財布に優しくないの😓なので時期を見てパピーミルクに移行。
移行後も順調でした。免疫の底上げもしたかったのでミルクにビタミンB,C,E, DHA,レシチン、ホーソンなどを追加。下痢や嘔吐に注意して少しづつね
But you know, this isn't easy on my wallet.  😓 So thinking about the long-term, I move to puppy milk, which he was okay with. It raises the threshold for immunity as well, so we were able to add some vitamin B, C and E, some DHA, lecithin, and more. Bit by bit, watching out for diarrhea and vomiting.

週に一度の通院で首とシッポの消毒をしてもらって、体重は増えないけど現状維持。血液検査の結果も良好。要求吠えや動き回ることもするようになり順調に回復していました。
I took him to the vet once a week, and during one of our visits, they disinfected his neck and tail. His weight wasn't going up, but his condition wasn't changing either. His blood test results were good as well. He started barking when he needed something and moving around, so he was recovering on a good track.

ところが、3月に入って嘔吐することが出てきました。先生の話では食道内にあるチューブの先端が粘膜を刺激して炎症を起こしているのかもしれないとのことでした。
チューブを抜くわけにはいかないし、薬で様子見です。
However, come March he started throwing up.  According to the doctor, the tip of the tube in his esophogus was potentially stimulating his mucous membrane and causing inflammation. But we can't take out the tube, so we decided to give him medicine and see if it clears up.

そして3月21日の大嘔吐!口からだけでなく鼻や首からも吐物が……
翌朝受診。血液検査の結果、腎臓の数値がバーンと上がってミネラルバランスも崩れている。 高ナトリウム血症。即入院。午後面会に行った時にはわんわん言っていたので良い兆しなのかなと思っていたら「わんわん言えるだけの元気が出たという意味では良い兆しだけど、あれは脳に問題が残ったのかもしれない」と。
And on March 21st, he had a massive bout of vomitting! Vomit matter was coming not just out of his mouth, but also his nose and neck...
I took him for tests the next morning. According to his blood test, the reading on his kidneys had gone sky high, so he was lacking a mineral balance. Hypernatremia. I had him admitted immediately. When I went to check in on him in the afternoon, he was barking, which I saw as a good sign. However, I was told that, while it could indeed be a good sign, there could be some problems remaining in his brain.

入院中、前回の肺水腫のこともあって点滴ができずどうなるのか心配だったのですが、日に日に数値の改善が見られ1週間で退院の許可が出ました。とはいえ、あまり良い状態ではありません。
Becuase of the pulmonary edema last time, I was concerned. What could they do without giving him an IV? However, the reading improved each day, and within one week he was able to come home. That being said, he's still not in a good state.

この先ずっとチューブフィーディングになるすばる。「食べる」という楽しみをなくし 視力も失い 筋力の低下で動くこともままならない。QOLということを考えたらすばるは幸せなのだろうか?
Subaru will be relegated to tube feeding forever. He won't get to experience the joys of eating. His vision is gone, and his muslces are weakening to the point that he can't move as he wishes. What kind of quality of life is that? Can he be happy?

おそらく来年の今頃はもうすばるはいないのかもしれない。生きている「今」を大切に苦しみや痛みのない生活を心がけることしかできない。
さて、すばるの様子を見てこようかな
There's a chance that this time next year, Subaru will not be with us. I can merely do my best to cherish him being alive with no pain or suffering.
So then, let's keep an eye on him.



ぽちっと応援お願いします Every bit of support counts  にほんブログ村 犬ブログへ にほんブログ村 犬ブログ 犬 ボランティアへ