Pippin made it through the night ok at NPEC. They immediately rushed him back to get fluids going and put him under a warmer as his temp had dropped. His red blood cell count was so low his tongue and gums were pretty much the same color as his teeth, and his nails were completely white, too. The doctor said he was literally so critical he was down to hours to live. They called our vet and did some additional x-rays themselves, talked over a plan with Brent, and send him home around 10:30. Pippin got fluids and a blood transfusion over night, and his red blood cell count went from a 7 earlier in the evening to a 33 by this morning. He was at a 9 earlier in the week on Tuesday, and a 15 is where they start transfusions. He was in really great spirits this morning, tail wagging when he saw us and licking everyone, and his tongue and gums were much pinker than they had been all week. Brent took some pictures of him but my camera is with him (he is out delivering food to new baby Cole right now, we figured it would be better to get them their dinner early in case we have to run out during Pippin's surgery.) Both front legs are bandaged up, one of them has the cutest wrap with an Ouch BandAid that Lilli would literally be so jealous of, and they went ahead and put a catheter in the other for quick needle access for all the vets.
The ER vet team went over that set of Xrays in detail with us this morning, and were so nice to stay open until close to 8 when our regular vet opens so we could go straight there (they're just 4 blocks apart). This particular ER is only open overnight, weekends and holidays to fill the gap when your regular office is not open. Our vet was already expecting us and immediately got us back in a room and they had his cytology reports waiting, they had been faxed in at 5:15 that morning. The bioposy of his tumors did not show cancer, however they really didn't show anything. That can be good and bad, good in that he isn't so rampant that it picked up something widespread, but bad in that it didn't give us any answers after waiting two days for them. Apparently that test is only 60% effective though, and we could fall in that other 40%. Dr Ganzberger said our best bet was to head down to BluePearl and get Pippin in surgery since we was finally stable enough to handle it.
So our next stop was down in Brentwood. They had called ahead so once again we were expected. I'd already done some research on them and they really are the top of the game for specialty vet stuff in Nashville. They're 24-7 and run a full ship around the clock with usually several vets on staff at a time. First we met with the critical care vet, Dr P, and talked over his case and just basically his care. Then we met Dr Au. Brent thought they kept saying Dr Oz and that if Dr Oz was working on him it would be a slam dunk! As much as the regular doc is costing there's no WAY we could afford Dr Oz! Dr Au is insanely knowledgeable and went over all the numerous ways to surgically help Pippin, since that really is our only option at this point. All the Xrays and ultrasounds have just been inconclusive and at this point the only way we will know if he can be saved is to actually get in there and see what's in his stomach, and see where he's bleeding from. He was very optimistic about being able to remove the two tumors, the unknown is whether or not that will stop the bleeding, and whether or not there really is cancer in there that has spread. But if we didn't at least try we'd never know. Just expect a can at our front door that says "Funds for Pippin's medical bills" the next time you come over.
And since he is in stable shape for surgery we left him there and they should be operating on him as I type this. They'll call us as soon as he's out and update us, however the sample of the tumors will have to be sent off for testing and results on whether or not they are benign or malignant won't be known until probably next Thursday. Should his surgery go well, he would recover there for anywhere from 1 -3 nights depending on the depth of the surgery and how he handles recovery before we would get to bring him home. But so much of it really depends on how the surgery goes and what all they see in there.
We are just amazed at the outpouring of love and texts and emails and prayers we've had from all our great friends. He is so loved and we are really trying to hope for the best for our Pippin. Brent dropped Lilli off at school this morning right when they opened at 6:30 (normally he drops her off around 7:15 or so), so thankfully we've been able to make all our stops and visits with just us and be able to pay attention to all the great vets we have met with today. I think our vet count today is up to 5 vets and 5 vet techs across 3 different practices this morning. Lilli did wear one of her many Pippin shirts to school today (which I normally wouldn't let her wear to daycare in a million years) to show her support.
So hopefully the next diary entry here will contain some good news!