Monday, December 23, 2013

Checking In and Updating Biskit's Final Test Results

It's been awhile and lots have been asking so I thought I would write a blog to check in and also to report the final pathology results for Biskit, which I just received Sunday afternoon, December 22. It's been tough, I won't kid you. To have your best friend, your baby, go from being absolutely normal and herself to with God in heaven in just over three days is crippling. It has shaken me to the core, rattled my thoughts and tested my patience and faith. I do believe that Biskit is in a better place and that comforts me.

I haven't been going out much as I need to get all these damn bills paid. For those who didn't know, the week before Biskit got sick I was in the emergency room myself with an unknown and severe allergic reaction that had hives all over my body, my throat swelling shut. So, it's been a rough couple months since I returned to Florida, really rough. But where there is rough, there is often tough, and I'm doing my best to keep it all together.

I was able to rejoin my old softball team down here and hit well during the seven games I played. I was still rusty but it was fun. We'll be playing again in the 'Polar Bear' league which begins January 9. Looking forward to that as it keeps me busy and I was able to secure our old sponsor, Mulligan's, in Altamonte Springs, FL. It's a great place and the sponsor pays all of our fees.

I'm headed to Pittsburgh for the holidays and looking very forward to it. I have not been home in over a year because of my move and that my parents came to see me in Chicago instead. It will be great to be home.

I wanted to also say thanks again, to all of you. Family, friends, co-workers and just anyone who cared to check in, send me a note, card, etc. I have been touched on so many levels and it has given me peace at a time I really needed it.

Now for the final report on my sweet baby girl, Biskit. Here is the initial necopsy/final pathology report from the doctor:

Based on the gross and histological findings of the organs, the pathologists suspects that Biskit became septic (Bacteria in the blood along with severe inflammatory response) from an infection that ascended from her small intestine into her liver which caused the acute liver injury, this led to the acute liver injury, then as the infection became systemic she developed acute kidney injury due to the septic process and multi-organ failure. Very likely the infection was cleared by all the antibiotics she received and therefore the infectious agent was not recognized, but she died due to the severe inflammatory response and the multi-organ failure. Sepsis and multi-organ failure is one of the leading causes of death in human ICU’s and we struggle with it in the veterinary field. The reason for the ascending infection into her liver is likely multi-factorial, but likely due to an abnormal biliary system (chilangiohepatitis).
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I followed up with these questions:

1.) Is this the Pathology report or the Necropsy report? It says necropsy at top and submitted 11/5/2013. Maybe the reports are both combined into one?

It stated: We sent out a leptospirosis titer, which is a potential cause of her acute kidney injury, but the results are still pending. When we spoke in November you confirmed that it was NOT Leptospirosis.

2.) Just so I'm sure, I understand the DX of sepsis and multi-organ failure, but if I'm reading what you said correctly, whatever caused this was not and will never be identified, right?

3.) Last, is there anything in the findings that said how long this might have been occurring before it got bad? Could I have missed signs, things like that? Or is this something based on the findings that hit quick, hit hard and ultimately took my baby girl's life?
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Here is the doctor's response:

1. It is the necropsy report which identifies the pathology of the disease.  Both terms are referring to the same diagnostic procedure. Yeah the leptospirosis test was sent out at the time the necropsy was submitted 11/05/13, at that time the results were pending, as I said, the results were negative.

2. Correct no infectious agents were identified so the specific bug that caused the septic process would never be identified.

3. This is an acute process (few days), there is no way to specifically determine exactly how long before it got bad.

Unfortunately your baby girl was affected by a very severe disease process that affected the entire system and led to failure of multiple organs in a very short time. There is nothing you could have done to prevent this from happening.
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A few final thoughts from me and I will end this blog post. The report did shed some light on where this started, the small intestine. That was never known before. Also, the septic report was new. Obviously, I knew multiple organs were failing because I was with her every step of the way.

But what hurts most is I will never know when it happened or where it happened. What was this awful bug that killed my baby? Where can I find it as I would like to eradicate anything associated with it?

I have been beating myself up since this happened, trying to think of why, where, when, what and how, but that hasn't done much, other than degrade my health and cause extreme sleep deprivation. It is hard for me to fathom that I will never, ever know what took Biskit's life. At times I am very angry, depressed, bitter and feel downright blah but I also know better days are ahead and am doing all I can to stay focused, stay happy and keep enjoying my life.

In the end, those who knew me knew how well cared for Biskit was. She ate special dog food, expensive and grain-free treats and was rarely ever given any table scraps. I wouldn't change anything I did but if I could find out where or what the nasty bug was, I would have gladly eaten it for her to take that pain away. I love you Biskie and I always will.