The radiology reports are in:
The radiology reports pretty much what we expected. In plain English, all puppies have fractures; all the fractures are healing. There is some mild deformation of vertebrae in some puppies, but this is not unexpected, nor is it a death sentence. For example, one of the puppies who has this is Mari, and you cannot tell by looking at her that anything is wrong. There are no neurological signs in anyone that would indicate that any deformation would result in a neurological issue. The important thing is that none of the long bones are deformed, and none of the areas of bone growth are affected. "Cortical thickness" describes the thickness of the walls of the long bones, much as one would describe the thickness of the walls of a pipe. The chances are now very high that the puppies will eventually be able to lead normal lives. "Renal secondary hyperparathyroidism" refers to a kidney problem which has already been ruled out. "Ongoing monitoring" refers to x-ray images taken at specific intervals which is something that will have to be done by the new buyers every 8-12 weeks for the next six months or so. We will discuss all this in an upcoming post.
In all of the cases the radiologist has stated that the pelvis cannot be completely visualized. What this means is that the pelvis in every puppy is not yet mineralized enough to show up on an x-ray. Because it is the largest bone in the body, my thought is that it’s also the one that will take the longest to mineralize. I am not particularly alarmed by this, but we do need to see what's going on. Those of you who were in TPO last August may recall an incident where I took Kiki for an MRI to a facility in New Hampshire, was badly very treated and left, and wrote the practice manager regarding my experiences. She responded by firing the three staff members and providing us with a free MRI. I wrote her to explain the current situation and to ask how much they would charge for CT scans of 7 puppies. She write back to say that she is conferring with the facility owners and will respond on Wednesday. If we can bear the cost, this is the next, and hopefully the last, step in the diagnostic plan.
The other part of therapy has been, as you know, hydrotherapy. I've been combining training recall, sit, and stand in the tub which is not only providing basic training but is also encouraging them to use their muscles. I didn't tape it today, but the contrast between yesterday and today's session was absolutely astounding. All the puppies are moving better and their endurance is increasing daily. Ash was literally running in the bath; Mini walked for the first time; Blue was trucking through the water, and so on. Everyone exceeded ten minutes of tub time, which is double that of a few days ago. (They are also super clean to boot!)
I'm also facing a dilemma: Bones, especially those in the legs, need the force and pressure of gravity to stimulate growth and muscles will atrophy if unused. If I let the puppies do nothing as they recover, the chances are that their back legs will not grow as quickly or as well as they should, so in thinking of ways to accomplish this in puppies that are otherwise non-weightbearing I came up with two strategies:
I have two more rehabilitation therapies I am starting next week: The first will involve the use of a wheelchair:
My idea is to remove the leg loops, use an abdominal support only, and to start everyone off in this with their hind end supported so that the rear feet are off the ground, and to gradually decrease that height to a point where they are partially weight-bearing, and then to continue to gradually lower the height according to their abilities to bear weight.
The second idea involves the building of a PVC frame which will straddle the treadmill and from which the puppy will be suspended in this harness:
The same principle of gradually decreasing the height of the back end will apply, and it is my hope that this will help in their recovery. I am totally making all of this up and literally flying by the seat of my pants, but at the same time I simply cannot afford to do nothing. Relying on hope alone is never a good plan and the information on puppy rehab techniques out there is absent, probably because this usually doesn't happen and probably because most people just euthanize everyone and move on. I think the value of life is deserving of more than taking the easy way out.
The third aspect of therapy is one we have already started, which is to provide 350mg of calcium diphosphate to every puppy on a daily basis. We are expecting a shipment of a specifically designed supplement containing D3, calcium, phosphate, and vitamin A which Jason recommended. This goes against my veterinarian's advice, but both Jason and I believe she is mistaken, and for the same reasons.
Over the weekend I will photograph and videotape each individual puppy both in and out of the water so that you can see for yourselves how they are doing and what the issues that have to be addressed in each one are. I should have this posted no later than Sunday.
If I compare today with exactly two weeks ago, the difference is profound, huge, dramatic, and positive. Two weeks ago we had puppies that were non ambulatory, and some of whom were screaming in pain. Mini was hospitalized. No one but Mari was walking, and she was limping badly. The bottom line is that these puppies may never be completely normal, and I doubt anyone will ever pass an OFA exam, but my hope and expectation is that they can have a great quality of life regardless. My greatest hope is that I'm wrong and growth and bone remodelling will continue to the point where they could pass an OFA exam. The body is remarkable in its ability to fix things, especially when it comes to bones, nd especially when it is young and growing. Their healing will take much longer than it would be feasible for them to stay here. In the next few posts I will have times for when to expect your puppy to be able to join you, what to expect, what you will need to do, and so on. We have to expect to wait at least one more month. They will have to continue healing and monitoring with you once they have healed sufficiently to be able to function.
A few posts ago I asked for a miracle, and I realized that I had received one when I read everyone's response about still wanting their puppy regardless. We may even have found a home for Mini, should she recover sufficiently enough to have a normal life. Despite this awful setback, the Miracle Litter is still living up to its name. Thank you, all, for hanging in there and for all your support. You, the puppy buyers, are the miracle this time and I and the puppies the ones blessed by that miracle. If you have any questions I ask you to post them below so that we can all share any additional information and concerns. Thank you, all... so very much.