Ripp’s Story, part 2:  The Surgery Consult

I find myself writing this update well before I expected to, as Ripp was able to get an appointment at the NCSU Veterinary Teaching Hospital within a few days of being referred.  We had a great experience with the caring staff there.

Ripp drifts off to sleep in the exam room.

After discussing his history with a third-year veterinary student to make sure they had all relevant information, we had to wait for a few minutes while the student conferred with the faculty veterinarian.  Ripp continued his “not at all worried” attitude and used this time to take a nap.

Next, we met the rest of the team, which included the faculty veterinarian and a veterinary resident, in addition to the student we had already met.  The faculty veterinarian conducted a hands-on exam, with the assistance of the student.  They didn’t need to spend much time on his ears, since it was really very clear that nothing short of surgery could fix the problem.  But the exam was still important.  They were especially interested to know whether Ripp had any facial or jaw pain, as this might indicate that the infection in his ears was affecting either or both of two facial nerves that lie close to the ear canal in dogs.  Luckily, the answer was “no.”  They also asked about any problems with balance.  Although Ripp doesn’t have problems with that now, I filled them in on the rough time he had over Memorial Day weekend.

The team gave him a thorough once-over,
looking for signs of nerve problems in his face.
Luckily, there were no signs of that. 

After the exam, they explained the type of surgery that they were recommending and the potential risks and complications associated with it.  The surgery is called total ear canal ablation, or TECA, for short.  This strikes me as a disarmingly cute acronym for such a serious procedure!  During a TECA, they remove the ear canal and lining of the middle ear, and seal up the opening with stitches.  The tissue that is removed is sent to the lab to identify the kind of bacteria and other beasties that are present so that Ripp can be given the right kind of antibiotics to kill any traces of infection that might remain inside after the surgery.   Ripp needs to have this done to both ears.  A possible complication of surgery is that the facial nerves I mentioned earlier will be damaged.  The surgeon knows where they are and will very carefully move them out of the way, but just moving them may cause a little short-term damage that would make his face droopy for a week or two after surgery.  Of course everyone hopes this doesn’t happen, but I appreciate knowing about the potential in advance so I won’t be surprised if it does happen.

The sandbags gently kept Ripp from
moving while the x-ray was taken. 

The other risk they discussed is the general risk that exists whenever anyone (dog or human) is anesthetized for surgery.  Ripp is 7, which is middle-aged for a German shepherd, and he is heartworm-positive.  This increases the risk a bit, but we think the ear surgery will improve his quality of life so much that it’s important to do it as soon as possible.  The medical team was OK with this, but wanted to do some imaging studies to assess the extent of the heartworm damage, as well as to check out the rest of his organ systems.  Sounds good to us!

The ultrasound showed that
Ripp’s spleen and other
organs look healthy. 

The first thing they did was to take radiographs (x-rays) of his heart and lungs.  When they do this, they barely sedate the dog and keep them still on the table by just placing a person’s hands on them.  To minimize x-ray exposure to the staff, they then substitute sandbags for a person’s hands and dash outside to take the image.  I’m told they usually have about 15 seconds before the dog notices the difference. ;-)  Ripp’s heart and lungs looked great, with no obvious signs of the heartworms.  He still HAS heartworms, of course, and we will get him treated once he recovers from the ear surgery.  But at least we know that the heartworms do not present a big risk during surgery.

The next thing they did was an ultrasound of his internal organs, to make sure he didn’t have any underlying conditions more serious than his ears (cancer, for example).  Luckily, he got a clean bill of health in this regard, so all systems are “go” for the surgery.

Not surprisingly for a specialized surgery like  TECA, this procedure is rather costly.  Our fundraising effort to cover the cost of it launched just a few hours ago as I type this, and the early support has been just phenomenal. http://www.firstgiving.com/fundraiser/germanshepherdrescueadoptions/germanshepherdrescueadoptionssfundraisingpage-1

Later, Ripp had just one thing to say about the experience so far. 
“Um, HELLO?  My ears are not down THERE!
What vet school did you graduate from anyway?
Oh, you needed to do it for the ultrasound, you say?
Yes, I’m SO glad you like the looks of my spleen.
Sheesh!  I’m just glad it’s not winter…” 

In fact, we’re SO encouraged that we’ve gone ahead and scheduled the surgery! This will happen on Wednesday, August 1st.  Look for a brief update that evening after we know he’s safely out of surgery and a more complete report once he’s discharged from the hospital.  Until then, keep this sweetie in your thoughts and prayers, especially on August 1st.  And thank you so much for your support, we’re incredibly grateful.