Just a little update--Banjo came home last night and she is doing well. She was pretty tired last night, and got a bit sick this morning, but has been very cute and happy all day. She remembered 'sit' (with a little reminding), and we've been working on 'down.' She's had a veracious appetite and has also wanted to chew/eat everything in her sight (pebbles, the wok handle, the rug, her bed, furniture, human flesh, and sometimes one of her 10 different chew toys!). We'll keep you posted on her progress.
~liz
Thursday, August 16, 2007
Tuesday, August 14, 2007
Visit/Coming Home
We went to visit Banjo today and took her for a walk! She was a bit tired and kinda dirty, but much healthier looking and very happy to see us. This was expressed by her trying to eat pebbles and biting us (playfully, in the normal puppy way). She's continuing to improve and unless something goes wrong (which isn't expected), we can go pick her up tomorrow at 6pm. Yay!!!
~liz
~liz
On the Mend
It looks like Banjo is on the mend. Her white blood cells continue to increase. She hasn't had any diarrhea or vomiting for 24 hours. She is eating and drinking. She gets mad when they take her temperature (which is entirely understandable, but not something she was strong enough to do until recently).
She might be home soon.
She might be home soon.
Monday, August 13, 2007
A Reprieve
So just as we were about to arrange putting Banjo to sleep the vet told us that she was looking perkier and eating. We asked for another blood test. The results were good. The level of leukocytes and neutrophils were substantially higher. So we decided to wait on putting her to sleep. It looks like she might have turned a corner. This is the first time her neutrophils have done anything other than get lower. Additionally, her fever is down, which suggests that she is not heading toward septic shock. The vet tells us that her body is damaged enough that she could suddenly take a turn for the worse, but her odds of survival just went up to about 50%.
In the best case, she has four more days in the hospital before she can come home.
The last few days have been craziness. We have been swinging between deciding that she'll probably die and deciding she'll probably live. Weirdly, it is easier to think she is likely to die than to swing back and forth. Now that she is much likelier to live you'd think I'd be full of relief, but, at this point, two things make it hard to feel very much of anything: (i) I am exhausted; and (ii) an emotion is a way of picturing the future and I have insufficient epistemic confidence in any of Banjo's possible futures to picture her future in an emotion-constituting way. Weird.
Also, I have, for the first time, begun to agree with William James that stability of belief is among the chief epistemic virtues. James appears to think it is the sine qua non of a belief-state that it is stable. That is probably going too far, but I can testify that much of what we've been doing over the last days could be understood as trying to reach a stable view of Banjo's future. But circumstances keep requiring a change in belief and so our attempts to form a view have all been failures; and upsetting because of this. When I began to think Banjo might make it, I felt like I was about to freak out. I didn't feel relieved, but rather just very strange. I thought to myself, "obviously I have no idea what the future holds," and this thought came with a kind of vertigo.
Maybe it was the lack of food. We haven't been eating very much or well since Banjo got sick.
-Alex
In the best case, she has four more days in the hospital before she can come home.
The last few days have been craziness. We have been swinging between deciding that she'll probably die and deciding she'll probably live. Weirdly, it is easier to think she is likely to die than to swing back and forth. Now that she is much likelier to live you'd think I'd be full of relief, but, at this point, two things make it hard to feel very much of anything: (i) I am exhausted; and (ii) an emotion is a way of picturing the future and I have insufficient epistemic confidence in any of Banjo's possible futures to picture her future in an emotion-constituting way. Weird.
Also, I have, for the first time, begun to agree with William James that stability of belief is among the chief epistemic virtues. James appears to think it is the sine qua non of a belief-state that it is stable. That is probably going too far, but I can testify that much of what we've been doing over the last days could be understood as trying to reach a stable view of Banjo's future. But circumstances keep requiring a change in belief and so our attempts to form a view have all been failures; and upsetting because of this. When I began to think Banjo might make it, I felt like I was about to freak out. I didn't feel relieved, but rather just very strange. I thought to myself, "obviously I have no idea what the future holds," and this thought came with a kind of vertigo.
Maybe it was the lack of food. We haven't been eating very much or well since Banjo got sick.
-Alex
Sunday, August 12, 2007
Decisions
As reported, Banjo was looking a little better last night, but she is back to anorexia and non-perkiness. Additionally, the numbers of leukocytes and neutrophils in her blood has not increased. The doctor also is worried that she might have "a little septicemia". Today's vet gives Banjo a 10%-20% chance of survival "at best". Given that she has not improved, following the plan from the other day would require putting her to sleep tonight.
But her little bout of improvement from last night might recommend departing from the plan and giving her several more days. The vet predicts that this would cost an additional $1600. A friend has offered to put this on her credit card, so we could pay for the additional treatment. (Add this to the $3000 of debt already incurred.) What role should money play in the decision to continue treatment or not?
Suppose that the vet offered to treat her for free. It is not clear to us we would continue treatment under such a condition. If she has a 5% chance of survival (and money were no object), we would definitely not continue treatment. If she had a 15% chance of survival (and money were no object), we would definitely continue treatment. But 10% is in the vague zone -- even ignoring the acquisition of more debt. Euthanasia seems neither required nor forbidden, ignoring financial considerations.
So now we have to ask: how much is the life of a puppy we love worth in dollars? Yikes.
-Alex
But her little bout of improvement from last night might recommend departing from the plan and giving her several more days. The vet predicts that this would cost an additional $1600. A friend has offered to put this on her credit card, so we could pay for the additional treatment. (Add this to the $3000 of debt already incurred.) What role should money play in the decision to continue treatment or not?
Suppose that the vet offered to treat her for free. It is not clear to us we would continue treatment under such a condition. If she has a 5% chance of survival (and money were no object), we would definitely not continue treatment. If she had a 15% chance of survival (and money were no object), we would definitely continue treatment. But 10% is in the vague zone -- even ignoring the acquisition of more debt. Euthanasia seems neither required nor forbidden, ignoring financial considerations.
So now we have to ask: how much is the life of a puppy we love worth in dollars? Yikes.
-Alex
Cautious Optimism
We talked to the vet late last night. Banjo made it through Saturday by getting a little better. Confusingly, though her bloodwork suggests that she ought to be as sick as she was on Friday (nigh unto death), she has begun to show an interest in food. She's been eating and not vomiting. Also the vet tells us she is a bit perkier.
The vet tells us that a rebound in the numbers of white blood cells would normally be the first step in getting better. This is because they are the agent of change -- that which allows the dog to fight the parvovirus and secondary infections. But, evidently, her gastrointestinal system is repairing itself despite her ravaged immune system. Weird.
We'll check later today to see if her immune system is getting better. It needs to get better soon because, despite continuous broad-spectrum antibiotic treatment, she is suffering from opportunistic infections and running a fever.
-Alex
The vet tells us that a rebound in the numbers of white blood cells would normally be the first step in getting better. This is because they are the agent of change -- that which allows the dog to fight the parvovirus and secondary infections. But, evidently, her gastrointestinal system is repairing itself despite her ravaged immune system. Weird.
We'll check later today to see if her immune system is getting better. It needs to get better soon because, despite continuous broad-spectrum antibiotic treatment, she is suffering from opportunistic infections and running a fever.
-Alex
Friday, August 10, 2007
Grim Situation
Banjo had been getting better as of Wednesday afternoon, but her condition has deteriorated since that time. She now has blood in her vomit and diarrhea. Additionally, though the overall number of white blood cells has increased, the number of neutrophils has continued to decline and, the vet informed us, these are the crucial cells. If they continue their downward trend, then Banjo will die.
The vet gives her a more than 10%, but less than 30% chance of surviving. So things are pretty grim. When asked what she would do, she said that if money were a consideration, she would put Banjo to sleep today. If money were no consideration, she would give Banjo until Sunday to improve. Thanks to your generous donations, we felt we could give Banjo one more day to improve in some fundamental respect. But we are not optimistic and neither is the vet.
We decided that there are three crucial criteria of improvement: neutrophil levels, the ability to eat food (and keep it down), and her level of perkiness. If any of these substantially improve by this time tomorrow, then we'll give her another 24 hours. If not, we'll put her to sleep. If all three of them are not substantially improved by this time on Sunday, then we'll put her to sleep. If all three of them have substantially improved by this time on Sunday, then it will probably only be another two days in the hospital.
-Alex
The vet gives her a more than 10%, but less than 30% chance of surviving. So things are pretty grim. When asked what she would do, she said that if money were a consideration, she would put Banjo to sleep today. If money were no consideration, she would give Banjo until Sunday to improve. Thanks to your generous donations, we felt we could give Banjo one more day to improve in some fundamental respect. But we are not optimistic and neither is the vet.
We decided that there are three crucial criteria of improvement: neutrophil levels, the ability to eat food (and keep it down), and her level of perkiness. If any of these substantially improve by this time tomorrow, then we'll give her another 24 hours. If not, we'll put her to sleep. If all three of them are not substantially improved by this time on Sunday, then we'll put her to sleep. If all three of them have substantially improved by this time on Sunday, then it will probably only be another two days in the hospital.
-Alex
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