Sunday, December 8th 2013 started very early. At 4:16 a.m. we received a phone call from the Emergency Animal Hospital to tell us that Lex (our four year old Great Pyrenees) had reversed his recovery course and was fading fast. At that moment we had to make the decision of euthanasia or not. On top of the emotional trauma sat a financial trauma. With both Maggie and myself being disabled and surviving on government disability assistance funding Lex’s treatment meant begging to pay the costs. Meanwhile the decision to delay euthanasia unless absolutely necessary proved to be appropriate as he passed peacefully shortly after we talked to the clinic. This was the culmination of an all too short time with Lex and an all too short life for Lex.

Lex came to us on August 4th 2013 displaying signs of neglect. He was underweight, blowing his coat and suffering from an ear dirt buildup. Lex had trouble connecting or receiving affection. Between tailoring his diet and grooming we were able to bring his coat and ear problems under control. His weight still remained a problem though. As Lex began to feel better, his desire to explore overtook his sense of restraint leaving him motivated to easily clear a 4 foot chain link fence.

We have been sharing our lives with Great Pyrenees for the past 13 years moving from one at a time to two as the old saying is correct, the only thing better than a home with one Pyr is a home with two Pyrs. After a year with only our sweet rescue Abby it was time to find a new companion for us and Abby. Surviving on government disability assistance meant finding the right Pyr while meeting financial limitations. Lex was out of the financial range initially though with some modifications we were able to make things work. When Lex’s previous owners brought him up to Midland for us to meet we just knew that Lex needed to be with us and we needed him. There were some points of concern during the meeting as he showed up with a new collar, a fresh bag of a premium dog food (that appeared to have been purchased to make an impression) his bowls and nothing else. His previous owners seemed anxious to place him and were overly concerned about recouping their investment.

Lex had not been Neutered yet and with strong supporting evidence of the many benefits for the animal being Neutered we decided to go ahead with the procedure. Using an OSPCA Spay / Neuter Clinic was well worth the 5 hour total drive time in order to save $400.00. With the procedure approaching we attempted to find out some background medical information on Lex. This led to the discovery that veterinarians have similar restrictions on sharing medical information as human doctors do.

The actual neutering procedure went normally and the healing process seemed to be progressing properly for the first two days. The third day Lex seemed a bit lethargic and when, as instructed, I checked the surgery site the first sign of trouble emerged. Lex’s scrotum had swollen tremendously and was very black though he did not seem to be in pain. We followed the post operative instructions for swelling as there was no mention of the scrotum turning black. Unfortunately it was late in the evening when the problem was noticed and the Clinic was closed. Time for some internet study that provided more information and suggestions for temporary assistive treatment. As soon as our regular veterinarian opened in the morning we called to make an emergency appointment. Here is the situation as provided to us by the emergency clinic.

Discharge Summary: Lex
Lex presented to the O'Sullivan Animal Hospital the evening of December 7th for further evaluation, hospitalization and treatment following castration (Dec 3rd) and presentation to their regular veterinary clinic earlier in the day. Referral bloodwork showed an elevation in Creatinine, low blood glucose and changes to some of his white blood cell counts (lymphopenia and band neutrophils on peripheral blood smear analysis).

Dr. Lemay admitted Lex to hospital and continued with treatments initiated by the referring veterinarian; those included intravenous fluid therapy, IV antibiotics, IV pain management and dextrose supplementation as Lex was hypoglycemic (low blood sugar). On physical exam it was noted that Lex was non-ambulatory, pyrexic, mildly tachycardic, had a moderate degree of scrotal swelling, surgical site dehiscence and infection and swelling of the right hind limb. Lex was assessed to be in septic shock. Lex's treatment plan was to attempt correction of septic shock, stabilization and plans to debride and treat his surgical site infection. Lex's case was then transferred to Dr. Watson for overnight care, treatment and monitoring.
Overnight Lex continued to remain in lateral recumbency, and he was mildly responsive to noxious stimuli (ie. Increase in heart rate corresponding with pain -HR decreased with administration of pain medication). Serial monitoring of his heart rate, blood pressure and oxygen saturation was carried out; Lex remained mildly hypotensive, tachycardic with weak but palpable peripheral pulses, his oxygen saturation was appropriate. Boluses of IV crystalloid fluids were attempted to increase Lex's blood pressure however they were largely unsuccessful. The swelling in Lex's leg was further evaluated and appreciated to be pitting edema - at that time Dr. Watson preformed a complementary cytological examination of Lex's swollen leg; the results of which showed large numbers of bacteria (specifically cocci - consistent with a Strep canis infection). At this point Dr. Watson was concerned that Lex was potentially infected with Streptococcus Canis, a bacteria which can cause septic shock, marked limb swelling and pain - often associated with necrotizing fasciitis (infection and death of associated muscle tissue and fascia). To confirm this diagnosis further testing would have been necessary (ie. Collecting and submitting samples to a laboratory for analysis), however Lex's clinical signs coincided with the typical clinical signs seen with Step, canis infections. This is a very severe form of infection, and very aggressive medical and surgical management is necessary, and unfortunately even with aggressive management the prognosis is poor.
Overnight Lex's vital parameters remained consistent with previous findings; treatments included the continuation of IV fluids, aggressive pain management, IV antibiotic therapy, IV dextrose supplementation and supportive care such as lubricating his eyes and flipping his sides to prevent the development of pressure sores. Sadly at 4:26 am December 8th, Lex's respiratory rate and effort changed, it was assessed that Lex was entering respiratory and subsequently cardiac arrest. He passed peacefully at 4:31 am.

While it is not possible to determine when Lex contracted this infection (pre surgical, at the time of surgery or post-operatively) it was obvious that he was fighting a very severe infection and sepsis (including septic shock and possible necrotizing fasciitis). I suspect that his passing was likely secondary to the sustained septic shock and secondary systemic inflammatory response syndrome and multiple organ dysfunction - unfortunately these are both common sequellae to sepsis.

It was clear that Lex was a dearly loved and cherished family member; and while his passing was sudden and unexpected, he was very fortunate to have known the love, care and devotion that your family had shown him. He was a very lucky dog to have found his way into your family.

Should you have any further questions or concerns please do not hesitate to contact the hospital.

My sincerest condolences,
Signed: Dr. Anne Watson

While Lex was only with us for four short months he is sorely missed by everyone who came to know him. Our experience with Lex has prompted an awareness of potential issues that can arise when acquiring a companion animal without full disclosure. Due diligence when exchanging pets can make all of the difference between long and happy or short, disappointing relationships. To this end I have prepared a ‘Guide to Acquiring a Companion Animal (Pet)’ along with a ‘Purchase (Acquire) Agreement for Companion Animal’ designed to provide protection for both the animal and you.