<div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman" size=3>Three and a half months after his marsupialization surgery due to a stone lodged in his urethra, Elvis is hanging in. His quality of life does not seem to be significantly impaired. He definitely enjoys food, and needs lots of it. He also enjoys our company and his evening routine with us – especially me. We have a workable routine (bedding on puppy pads, which are changed 4-6 times per day, on top of fleece; his belly is washed 2-3 times per day, furazone ointment applied to the wound area and feet twice a day, antibiotics and metacam daily) and it seems to be working, with some adjustments from time to time.</FONT></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times
New Roman" size=3>The negatives first: there is still a dime to nickel sized area of necrosis around the new opening to the bladder which refuses to heal. Guck accumulates in the opening and urine is held underneath, as well as in the hair around it. The exposed skin is quite pink and bleeds occasionally. The vet suspects this gunk was bacterial. He has a more pronounced odour. It took some two urine collections before the lab agreed to culture it – but once cultured, they refused to do sensitivity testing for the most effective antibiotic<SPAN style="mso-spacerun: yes"> </SPAN>– ‘use your judgment’, they said. (Gee, don’t we all wish for such professional independence??) </FONT></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman" size=3>Elvis was ‘off the charts’, so to speak – a count of 4+ - for both cornybacteria
(normally part of bladder flora, but not at such a high count – should be sensitive to baytril) as well as a count of 4+ for provotella, an anerobic bacteria quite prevalent in the environment. So in addition to the Baytril, Elvis has started on Flagyl today, for 2 weeks.</FONT></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman" size=3>He still cries when he poops, but they are big and manly ones. There seems to be more impaction and junk up the trunk. Whether this is due to age (he’s 5 now), the surgery, or the antibiotics … who knows?</FONT></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman" size=3>He is still eating about twice as much fresh food as before. He lost about
400 grams after surgery, but has regained about 100 gr of that. I became concerned he might be hyperthyroid as well. Two blood tests later, the outcome is the opposite: his thyroid is overworked stressed & underperforming, probably from his metabolism always being in healing mode. A major wound burns up a lot of calories, evidently. So we do not spare him the best, a real buffet, several times a day. Even some organic cereal flakes, which he adores. He is eating plenty of hay, and I provide Critical Care ‘meatballs’ twice a day (mixed with orange juice for extra yum) but he’s not too interested in pellets – it’s a last resort. I also give him wheatgrass from an organic store or juice bar – lots of rich anti-oxidant goodness.</FONT></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman" size=3>The bumblefoot is almost
gone.</FONT></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><o:p><FONT face="Times New Roman" size=3> </FONT></o:p></div> <div class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT face="Times New Roman" size=3>I hope that this learning experience will help others some time in the future, and will lead to a published veterinary article or note.</FONT></div><BR><p> 
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