LILY - rest in peace, sweet filly

[Gingersmom-Tate]

Sweet Lily, sending jingles your way.

[schwung]

Unfortunately, I do not have good news to report on little Lily.

Lil's bloodwork came back very poor. The call came in while I was driving so here is what I can remember. She has a very low red cell count, her platelets were only 8000 where they should be over 100000. Her white blood cell count was also very low. Her fibronogen was extremely high indicating infection. With the blood cell count being low there are concerns that she might have an auto-immune disorder causing her body to no longer produce blood cells or possibly be attacking its own blood cells. They did a tracheal wash and she had a lot of blood in her trachea and was not clotting well after the procedure due to the low platelets. There is risk that she could bleed out. She's on a broad spectrum antibiotic right now, the results of the tracheal wash will tell them if they are dealing with a bacterial infection (there were abnormalities on the lung xray and ultrasound) and if they need to use a specific antibiotic.

The concern now is cost - and unfortunately it is out of our control how much the county will be willing to spend on diagnosing Lily. There is a test to see if she has an auto-immune disorder but it has to be sent away and wouldn't be back until next week. If so, a steriod may help her, but you wouldn't want to give her a steriod if she just has a bacterial infection. They could do a bone marrow biopsy to determine if she is producing any red blood cells, but that is very invasive and expensive. Getting plasma may help her, but she said something about only having frozen plasma and with her platelet count she will need fresh so they would need to find a donor and it would cost a lot of money. I asked if we could just put her on an antibiotic and see how she does, and that was a possibility. She was also concerned that even with treatment that Lily may not have a good quality of life or future as too much damage may have already occurred.

I did ask if she thought it was something she was born with when she was talking about auto-immune disorders and she said she thought that was unlikely, that likely the starvation weakened her body and led to this.

She has not been able to reach anyone from the county to get any kind of approval on costs. My fear is that she will recommend euthanasia to the county, she did not sound hopeful and kept mentioning the cost of further diagnostics and treatments. Currently Lily is stable and "bright, considering what is going on with her", and they are still waiting the results of the tracheal wash.

I wish I had better news. I am distraught.

[jodycat]

I'm really sorry, Jaime, this is so sad to hear.

Regardless of whether the County would pay for a diagnostic - can we get an estimate? Maybe the SAFE supporters could pitch in and donate money to pay for it, if that's what Dr. Hannah thinks would be the best way to go.

I'm glad she's at Pilchuck and getting good care, at least.

These things, always so hard....

[janice]

put me down for $50 if it can be accepted.

[Sara]

Oh jaime, I am so sorry this has cropped up on top of everything else. My thoughts are with little lilly and of course you and everyone else who has poured their heart and soul into these little guys.

[jodycat]

I sent $100+ fees through PayPal this morning for Lily, but I can add another $50 if it's needed.

[schwung]

Somewhat better news.....Dr. Hannah was able to confer with the vet at Pilchuck, who had finally gotten a hold of King County and they authorized continued treatments (for now).

She is already on both a steriod (in case she has an auto-immune disorder), and an antibiotic (for any bacterial infection). They did not find any abcesses in her lungs but did find some areas of fluid - pneumonia, parasitic pneumonia, and R Equi are all possibilities - the results of the tracheal wash will tell them what type of bacteria they are dealing with and if they need to change to a more specific type of antibiotic.

As of right now they don't have an immediate need for further tests - its just that every hour she stays at Pilchuck the bill climbs. We should know more in a day or two if further tests are needed or how she responds to the current treatment.

[tblover]

Good thoughts going out for lily!!!!

[schwung]

I talked to the vet at Pilchuck today but he didn't really have much of an update for us. Lily is very depressed, eating but not much. They are getting her fever down a bit with medication but it spikes still between doses. They are still waiting for the results of the tracheal wash which should be in tomorrow. For now she is holding her own - no better, no worse.

Bonnie, Jenny and I are planning to visit her tomorrow.

[tangosmommy]

give lil lilly a scritch from me and my boys tango and change...were all pullin for her!!!

[safehorses]

Jaime, were you and Bonnie able to visit Lilly? How is she holding up?

[schwung]

I apologize for the lack of updates. This was a big work weekend and we were all very busy. However, Bonnie, Jenny and I did go and visit Lily both Sunday and today. Lily is in a quarantine stall in complete isolation. We had to follow a very strict quarantine protocol involving stepping into a bleach tub, then putting on plastic boots, gowns, and latex gloves, before we could even enter her stall. On Sunday Lily was pretty depressed. She hadn't finished her breakfast and was lying down when we came. Lily has been partially shaved in order to help with her fever and she looks very different. She did get up after a few minutes but seemed pretty listless, although as we pet her and gave her scratches (which she did enjoy and we did get her lip going a bit) she did perk up a bit, and after an hour or so of our attention she finished her breakfast and ate a little hay, and seemed a bit perkier when we left. The tracheal wash results had come back, but were inconclusive on any specific bacteria. The vet was concerned as he did not feel he was getting the whole picture, that there was infection somewhere that they weren't finding.

Encouraged by the difference our visit had in her attitude, we went back again this morning and spent another half hour with her again. This morning her attitude was much improved, she was up, had finished her breakfast, and was much more bright and interested in us and our surroundings. One of the interns reported that she also tried to kick her during temperature taking, and I took that as a very good sign that our Lily was feeling better.

After our visit with Lily we met with the vet who had been in charge of her over the weekend, in my opinion the best vet at Pilchuck, Dr. Bryant. He sat down with us and gave us a rundown of the situation with Lily. The good news is her fever stayed down over the weekend and has not spiked since Friday, and they are slowly reducing the banamine. Her fibrinogen is down a bit indicating that they are possible starting to knock out the infection. However, there is bad news as well. Lily's platelets and white blood cell count is still very low, indicating that her bone marrow is not responding to the steriod treatments and have not started producing any cells on their own. He outlined a few options for her and went over the pros and cons of each option. His recommendation at this point would be to increase the current steriod she is on and also start her on a new steriod, both targeted at hopefully getting her immune system up and running again. The drug she is on now can be very hard on the internal organs so comes with a price, especially when they up the dosage. The new drug is much safer but takes a couple of days to take effect. The hope is that if they start seeing some results in a couple of days, they can reduce or eliminate the first drug that has the negative side effects.

If Lil does not respond to the steriod therapy in a few days, then that probably means that her bone marrow is permanently damaged. If that is the case, there is nothing that can be done to save her. It is an outcome that we just can't face right now. The vet also feels this has been brewing inside her for some time. He is doubtful at this point that there is any virus involved, that her immune system has been compromised and slowly deteriorating, and it took a small trigger to start an infection in her body and with nothing to fight it, quickly snowballed.

I know that he still had to talk to the county and make sure they authorized continued care through the week to give the new/increased drugs a chance to work. I am crossing fingers they are sticking with her a little longer. I did ask that if the county did not want to continue due to the high costs of treatment, that he give us a chance to decide whether or not it is something we want to try and finance, and he agreed to give me a call in the event that happened.

I have some photos I will post tomorrow of our visit.

[leahlady]

I'm jingling really hard for little Lily. She is such a spunky little girl I hope she has enough to pull through.

Dr. Bryant is surely the best man for the job. He is by far my favorite vet.

[huskiesnhorses]

I will be visiting Lily this morning. I will tell her how much you all love her and give scritches for each of you.
She will always be our girl.

[armoon]

Many prayers for Miss Lily!!!!