Getting Ready for Hope

We got confirmation that Hope and Bellafina can come home tomorrow afternoon. Now, we are rushing around to get a space ready for them. Hope will need to be confined to a small area for a month or more. We do not have "stalls" just shelters opened to 1/4 to 3/4 acre plots. We are working on the back barn, which was slated to be the girls winter barn since it is larger. This past fall we tore off the siding and gutted the barn and put up new siding. In the spring we finished running fencing and stopped since I was pregnant. About a month ago, we put in stone dust to make up the floor of the barn and installed a gate onto the shelter to make a herd health area and an area where we can put hay, grain, etc.

Now, we are sectioning off a small area for Hope. It will be the sick/birthing area in the future. There will be small section inside the shelter and then an opening into a small run so they can get some pasture and sunlight time. It is a small area, but that is what Hope needs right now. Right now, we have posts in and will start running the fencing. We need to cut the hole in the wall and finish off the A at the top of the barn. Alot of work to do, but we have today and tomorrow to work on it. They also suggested using straw to help her footing so we need to buy some. We typically don't use straw in the barns.

I have not seen Hope since before our son was born so I am looking forward to seeing her again. It looks like her care is to keep her confined for a month or more (depending on how the leg heals). Antibiotics injected under the skin every 3 days for 2-4 wks. New Bolton said 2 wks and my vet said 4 wks. New Bolton wants x-rays redone in 4 wks to check on the leg.

Apparently, the surgeon didn't want to do surgery on the leg since she was getting around well and trying to use the leg. He felt it would be better to wait to see if she could fully recover the use of the leg. His theory was that they could always do surgery later, if needed. We will see how she does when she is home. I will need to keep an eye on the leg to make sure the swelling doesn't get worse, but I think we can handle it.

Surgery was scheduled and Cancelled by the Surgeons

Sorry for not blogging about Hope, but my new son is keeping me busy. Anyway, on Thursday (last week) I was told Hope would be the clinical round focus on Friday for the surgical unit. She was not responding as well to the treatment so they were looking at other options to help her leg. On Friday afternoon, I got a call with my "options" for Hope. These were tough options when you consider the financial and time involved with each option. I was assured with each option that she could still be a breedable alpaca. However, due to the antibiotics she has been on and her premature status she may end up being a small alpaca. The leg will be non-functional and would be used as a peg leg for her entire life. I was told she would still be able to cush and get around well no matter what option we did.

Option #1- Long term antibiotics. Hope would come home in a week or so, but would be on antibiotics for up to one year. I was told that the joint is so far gone that eventually it would fuse together and she would use it as a peg leg. She may still need surgery later.

Option #2 - Surgery. They would go in and scrape the joint to get most of the infection out. They would put in a bone graft from her hip and help the joint to fuse quicker. They would also put in antibiotics directly there while they were in there. This would speed up the joint fusion and she would spend less time on the antibiotics. She would need about 2-3 wks of antibiotics and confinement for 2-3 months.

We decided to talk to our vet about the options. We asked her to talk to the vets there and the surgeons. After talking to her, she assured us either option is do-able and we could even look into herbal remedies if we choose option #1. It was up to us. She said the surgeon is very good and she has confidence in him. On Monday, we talked to the surgeon ourselves and then debated some more. After alot of discussion, we figured we came this far we might as well go all the way and do the surgery. Why spend all this money and stop here. Plus, a year's worth of antibiotics seemed excessive to me. I talked to the vet and gave permission to do the surgery.

I got a call on Monday afternoon saying she would be operated on Tuesday morning and they would call Tuesday afternoon with updates. Tuesday mid-morning comes and the phone rings. I figured something went wrong with the surgery. No. They evaluated her that morning and decided it was NOT in her best interest to help the joint fuse at this time. They said she has full range of motion in the joint and is comfortable with it. She is getting around well on 3-legs. So, they recommended waiting 2-3 days and see how she does and they would do some physical therapy on the leg. Okay... now I am confused.

Today, I get a call and am told she is doing well. She tip-toes around on the leg, but gets around well. She is gaining weight, nursing well, everything looks good. They said today they would move her off the IV antibiotics onto a sub-Q injectable and if she looks well tomorrow then she would be able to come home Friday afternoon.

Needless to say, I am happy that she is doing well and doesn't need surgery. However, I am confused about what changed between Mon and Tues. Also, today they said they think they are on top of the infection, which is contrary to what they have said on Friday. When I asked about her care when she came home, I was told 2 wks of antibiotics (every 3 days for the injection) and then to come back or have our vet do x-rays in 4 weeks for them to see how the leg looks.

As you can see, we have been busy with decisions and then trying to figure out why opinions changed there. I guess new vets came on or clinically something got better. I am not sure, but happy to hopefully have them home soon. Tomorrow, I need to get a stall space ready since she will need to be confined for a few weeks to a month.

Hope is on the way to recovery Finally!!!

It looks like Hope will be at New Bolton atleast this week and maybe most of next week, but she is finally responding to treatment. I talked to the vet shortly on Friday, but I was in the hospital in Labor so it was a short conversation. Today, I talked to her in more depth. The cria is doing well. On Friday, they were worried because she was starting to refuse the bottle. Apparently, Hope has decided she doesn't want a bottle she wants to nurse off the dam. They left her in with the dam Sunday night and she nursed on her own and gained weight. They are going to wean her off the IV nutrition and fluids so she can be in with Bellafina full time.

Hope is also getting up and down on her own finally. She is putting her inflamed leg down, but not bearing full weight on it. However, the infection has went from a white cell count in the joint of 250K to 75K so we are finally going in the right direction. Hopefully, it continues to go down quickly. They will redo x-rays in a few days. They are flushing the joint and injecting antibiotics directly into it every few days. They give a break to limit the inflammation from them manipulating the joint.

The lung x-rays on Friday showed that they are recovering and the damage is not as severe as it was. They took her completely off oxygen supplementation last Thursday evening.

Hope will continue to stay at New Bolton until the infection in the joint is gone and she is bearing full weight on her leg. She will be there atleast for this week and probably part of or all of next week. Atleast, she is going to make it and it looks like she will be able to keep her leg.

Leg Infection Not Responding to Treatment

The news this morning was not good. They have been flushing the joint every day and directly injecting antibiotics into the joint. Last night, they pulled fluid from the joint again to see if the white blood cell count in that area was going down. No such luck. It actually went up. The x-rays showed that the area next to it, which is the growth plate, had more inflammation that the last set of x-rays. Thus, it is actually spreading. Not good news. Her prognosis went from good back to guarded again.

They need to more aggressively treat this. They are going to put a tourniquet onto her leg today and inject antibiotics directly into the vein and leave the tourniquet on for 10-15 min and then remove. They are also going to put two different antibiotics into her blood stream via the IV to get it through the entire body and not just the joint. She was getting Naxcel only to treat the lungs/septicemia. They think the septicemia in the blood is gone, but that it settled into this particular joint. We will have to wait for 2-3 days to see if this new treatment is working. If not, the option is probably to put her down. The vet wasn't too optimistic about her life if this new treatment doesn't work.

There is some good news, but it really means nothing if the leg infection doesn't clear up. They have been slowly decreasing her oxygen supplementation. As I mentioned yesterday, her breathing sounded better to me. They took her completely off the oxygen last night and she is breathing fine on her own. Dr. Norton said she is much happier without the nose tube in her. She is also putting her leg down and trying to use it. However, I think that is due to the pain meds she is on.

She didn't gain any weight the last day. They are going to increase her milk again. She thinks that she is using all her reserves to fight the infection.

Today was not the turn for the better I was hoping to get. Will the outlook for Hope ever turn? Is her body strong enough to fight the infection and beat it? I wonder if everything is just too much for her. She is officially 1 week old today and still struggling.

Progess Forward

Once again today I drove up to New Bolton to see my little Hope and her dam. The vet was all smiles when she saw me. I was alittle annoyed with her since she doesn't update me as much as her predecessor did. Anyway, she said overall she saw an improvement in Hope. She tried to put her rear leg down instead of holding it up. She also is gulping down the milk they are bottle feeding her so they are increasing the amount she gets each time.

I spent some time in the stall with them and I have to say even drugged out she seemed better. Her breathing could be heard, but it didn't seem raspy to me like it did just 2 days ago. When she held her head up it was steadier and her ears are starting to be erect instead of floppy. The ends are curling slightly, but atleast they are not flopped back on her head like they have been since birth. She was pretty out of it when I was there since she had just had a dose of pain meds about an hour before. However, I was petting her (I know I shouldn't be, but she is so sick) and she leaned into my hand. She seemed to know I was there and talking to her.

They are helping her stand every 2 hrs when they feed her. The vet was hoping that they could pull more fluid and run today to see if the infection is getting better. She had to talk to the surgon who flushes the joint tonight when he shows up to the procedure.

I am hoping today is a turning point and from here on out we see that she is getting better each day. Hopefully, the infection doesn't spread again. We shall see what tomorrow and the next few days brings. I think tomorrow they are going to do x-rays of the lungs and leg to see what changes, if any, have occurred.

Infected Hock - rear leg joint

As I mentioned in the post yesterday, Hope had started to stop bearing weight on one of her rear legs. They took x-rays yesterday and did a nerve test and things looked normal. They wanted to pull fluid from her joint and test for infection since in horses the septic conditions can go into their joints. Not really normal for alpacas. This morning, I was told that the joint is infected with a white blood cell count of 150K in the fluid joint. *sigh* One step forward and a huge step back. The concern now is to get it treated and hope it doesn't spread to other joints or the bone. They flushed the joint with saline and injected it with antibiotics. They will do this every day. She said Hope is sore and they are giving some pain meds to her. At noon, they are increasing the pain med dose because she seems uncomfortable right now. She said they don't want to increase this med too much because it is also a sedative along with a pain med. If this evening she still seems to be in pain then they will use banamine or another pain med. They don't like to use these in neonates since it has effects on the kidney's - a more serious problem.

In a day or two, they will take x-rays again of both the leg and lungs. Hopefully, we will see improvement in the lungs and leg. They will pull fluid from the joint in a day or two, too, to check the levels and make sure they are on top of it.

Poor little Hope. I hope she has enough fight in her to fight this next infection. Unfortunately, it also means that there is no time frame on when she can come home. Keep this little one in your thoughts and prayers.

The good news is that she is really taking off on the bottle so they will increase her milk consumption. Her weight isn't going up, yet. Hopefully with getting milk it will put some weight onto her.

I went to see Hope today....

Today, after my Dr. appt, I drove over to New Bolton to see Hope and Bellafina. Hope was very tired and could barely keep her eyes open while I was there. She had just come from radiology and had a busy morning. They also were finishing up bottle feeding her when I walked in. Poor little girl. She was shivering when I walked in. I asked them to put a blanket on her. They said it was probably from being on the metal plates in x-ray and it is chilly in that building. Anyway, she actually drank from a bottle today. They said as she gets nutrition from the milk they will back off the IV nutrition. Thankfully, Bellafina is co-operating and they are milking her out so Hope is getting mom's milk. Bellafina hates her abdomen touched, but she is letting them milk her out. When I tried to take the plugs out she screamed and spit and started to cush. Of course, they have been milking her out since Friday so I guess she is getting used to it by now. As they milk her, she just stares at her cria. Poor mom.

Today was the first day that Hope accepted the bottle. She drank the entire contents of the bottle. She isn't stable enough on her feet yet to stand under mom and I will talk about this soon. They said when she is taking 10% of her body weight in milk then the IV nutrition will be stopped. As she increases her milk consumption, they will back off on the IV nutrition so she gets less and less from the IV and more from the bottle. Thankfully, she is getting mom's milk.

Her lungs are sounding the same as yesterday, but better than Saturday. They will retake the lung x-ray in a few days to see how they are doing. Hopefully, it will show less disease. They have backed off the oxygen some and she is doing well with this. I noticed she was raspy sounding when she breathed, but not as bad as she was on Thursday. Her breathing was what prompted me to take her to New Bolton to begin with. They said her lungs sound less watery when they listen to her. She won't be able to come home until her lungs heal so I hope she continues on the right path and they get better each day. Although, I know it will take time.

The new development is that she took a few steps today! However, they noticed she won't weight bear on the one back leg. This is odd since she was weight bearing on them when she was born. They tested her reflexes and nothing showed nerve damage. They took her to get x-rays of the leg and that didn't show any structural abnormalities. The next thing they wanted to do was take a fluid sample from the joint and see if there was an infection in the hock. Apparently, this is common in horses when they are septic, but not so much with alpacas. I should have the results tomorrow- if they could get enough fluid. I understand why the need to do this, but the leg was fine before. I am wondering if she could have just tweaked the hock when she was only using her rear legs to get up and stand. She took several tumbles. However, I don't want to not do the test and then she ends up with a bone infection too. We shall see. I am just happy that she is standing for 10 min at a time and finally took a few steps. She still cannot get up on her own, but they think once she weight bears on that back leg she will have an easier time balancing and getting up.

It seems one thing gets better, but something else comes up. I asked about when she might be able to come home and there is no answer on that. She needs to be able to be off the oxygen and getting up on her own. I am hoping the end of next week. I was hoping the end of this week, but that isn't going to happen.

I am happy to see that her chance of survival is much higher right now. If her lungs would just clear up I think she will be a normal cria and pronking in the field in no time. Praying for the best! I will be visiting her again on Wed and I hope to see more improvement. Until then, I await the morning updates. As long as I don't get a call in the evening or overnight she is doing well.