Warning: Medical Stuff. Not gory at all, but if you're squeamish about innards, you may prefer to move along :)
The last two days have been a roller coaster. We took Paisley into the emergency vet on Thursday evening and was told she could have one of three things: an intestinal obstruction, pancreatitis, or Hemorrhagic GastroEnteritis. She had one symptom (bloody diarrhea - I know, sorry folks!!) that was a classic sign of the HGE, but could have been caused by complications from the other two. A pancreatitis test ruled that out. An obstruction would require surgery, HGE would require supportive care and hospitalization for as long as 3 days. As of Thursday night, my plan was to leave Tucson early and take Paisley back to my vet in Phoenix for care. But my vet doesn't do 24 hour care and it also became apparent in the morning that moving her wasn't in her best interest.
On Friday morning, we were told she needed an ultrasound to look at her liver and stomach to hopefully determine presence of an obstruction and to see the health of her organs. I went to visit Paisley with my mom and sister. She was obviously drugged up on pain meds, antibiotics, and fluids. While she looked better, she also appeared to feel awful, if that makes sense. Instead of her usual squealy greeting, we got a couple of high pitched moans. While in the visitation room, she very nearly fell asleep on her feet. We sat with her for maybe a half hour, with her on my lap and receiving lots of kisses. At the time, her ultrasound had not yet been performed, which we were a bit concerned about. We left her, and I felt really awful, but I was glad that I'd been able to see her and see that she was physically looking healthier.
When I talked to the vet after performing the ultrasound, she was very concerned that Paisley's stomach was highly distended and there was a spot on the ultrasound that raised a lot of questions. Her initial thoughts were that there was an obstruction in the small intestine, or that the intestine had folded over on itself. The vet told us she was pretty certain we'd be looking at surgery. I'm so thankful that the emergency clinic sends away their x-rays and ultrasounds to be seen by radiology experts, because the 2 long hours later, the techs came to the conclusion that Paisley didn't have an obstruction, and that the vet had simply captured the connection between the small intestine and colon (apparently rare because of small dog anatomy).
So we were fairly certain that we were dealing with HGE, but neither x-rays nor ultrasounds are 100% unless the obstruction can be clearly seen. The only ways to be certain are to perform surgery or to conduct a barium survey. The vet's thinking was that inflammation had slowed her digestion and left a lot of fluid in her stomach, which stressed the system even more. After much consideration -mainly we were concerned that if we'd eventually end up in surgery anyway, why not just get it over with - we opted for the barium survey. Paisley's stomach was drained of fluid that wasn't moving along, providing a path for the barium. By early evening, we knew that the barium had cleared her digestive tract normally, verifying that there wasn't an obstruction.
As of this morning, Paisley has eaten and kept food down. She hasn't had any of the bloody diarrhea (sorry, folks!) that she was plagued with since yesterday evening. So it looks like our little girl is making her comeback. I'm not sure yet when we'll be able to bring her home. I'm just very thankful this Thanksgiving weekend that we took Paisley in and that we worked with wonderful vets and technicians who helped me and Mr. Kingston (and my mom - thanks, Mom!) make the most informed decisions possible about her treatment. I'm extremely grateful!