August 22nd 2008 5:11 pm
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Okay.... Whatta' day already!
Now... as for little Miss Sunshine over here.... Baby Emma is 40 hours old now.... and she and I had a busy, yet uneventful night together...
She's taking the formula pretty well.... she's already decided that it's "not worth the effort" to try and suckle, so she just opens her tiny little mouth wide like a baby bird, and waits for me to give her tiny droplets of formula with the med dropper.
I don't want her to "give up" on being able to retain what little suction she's able to muster - so every feeding I start off giving her the bottle.... trying to help her form her tongue and back part of the palate to increase some strength so hopefully, she'll be able to nurse eventually.
When she gets frustrated with that, I switch to the dropper and she happily swallows down at least 1 cc every time. (I know, it's not much, but she's so tiny it seems to satisfy her).
First thing this morning we were off to the vet... arrived before they even opened and was able to get her right in for an examination.
Three hours and two surgical consults later - I'm told that........... SHE HAS A CHANCE!!!!
As slim as it may be.... she has a "fair chance" at growing into a happy healthy little girl!!
Number one obstacle .... she's an orphan ... she's COMPLETELY missed out on the "holy grail" of prevention - - her mama's milk....
While "puppy formula" does carry the benefit of SOME colostrum - we all know that there is NOTHING more sacred to the general health of a newborn, than her mother's milk...... and there's no way at this point, they say - to "go back" and regain those lost antibodies ... and no way to instill new ones.... so Emma is essentially in constant danger, just breathing the air around her!
That alone, keeps me a little ill at my stomach... not to mention overly OCD about her.
"Situation" number two..... it's obvious that Emma has a primary cleft to the lip and nostril.... unfortunately, she also has a secondary cleft to the hard palate. (in the pictures below, I tried to let you see the "split" in the front of the roof of her mouth....)
So.... this means of course, more dangers.... the main concern being, aspiration pneumonia. We have a little bit more of a deterrence against this though, since the cleft is of the hard palate rather than the soft palate at the back of her mouth.... in a good instance, we can bypass the cleft by dropping the formula directly down to the back of her tongue and throat. As long as she cooperates and swallows rather than spitting or bubbling, we can pretty much keep the majority of the liquids away from the frontal opening - and out of her sinus cavity, airway and lungs.
The downside to this, is that as mentioned above, she doesn't use those muscles and never learns to properly "work" her mouth and tongue. (so in addition to trying the nipple at feeding times, I also have a preemie "binky" / pacifier - that I'm using regularly to encourage suckling... it's a little big for her though, so it's tough going... )
The vet says that, while it's still awfully early on to tell, she seems otherwise healthy at this point.
They all let me know right up front that I "maybe shouldn't get too terribly attached to Emma".... ummm, hello..... too late!! But that the fight is certainly worth every effort as long as she shows some positive milestones over the next few days to weeks.
The surgeons want to repair the deformity at 4 - 6 weeks of age.... but they doubt very much that she'll be at a "suitable weight" by then to risk the procedure. So... we just wait... watch... pray… and help her to thrive.
I’ve read through all of the “cleft palate puppy instructions” on the Hennwood website and found much of it helpful….. Emma’s vet though, is very hesitant about using antibiotics as a preventative for pneumonia, so I’m not quite sure yet how I’m going to handle that, seeing as how the use of Cephalexin is so highly recommended by the site owner, experienced in cleft pups.
The vet read a long list of risks related to the prolonged use of Cephalexin – some of which involve a decrease in both red and white blood cells, kidney problems and a compromised immune system - - - which, considering she already has relatively NO immune system to speak of …. I’m not sure how to go with that…
What I didn’t see on the website, is at what age is recommended to begin the preventative antibiotic therapy if I did decide to proceed? Immediately?
As well, the dosage for such a tiny girl of 96 grams…. (I know the method to decipher it is there, but I think lack of sleep has me a little ditzy right now).
According to the vet… she can “pull Emma back” from pneumonia …. But she has no chance of bringing her back from some of the other “adverse reactions” of long term use of the antibiotic….
In the website owner’s opinion, most cleft palate puppies do not survive once pneumonia sets in…. and I for one, having battled pneumonia with my Natalie – am utterly terrified at the idea of watching another little one endure the same thing...
So, this is where we are at the moment…. The vet wants to see her back in two weeks. (evidently she has a bit of faith that Emma will make it to two weeks, which is a welcome ray of hope!)
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