Nell at 2 weeks

Nell with Jessica at Cornell

From: Darcy

I have confirmed with Cornell that I will be dropping Nell off on Wed. 10/10 at 7:30 am - her surgery will be with Dr. Harvey. At this point, they are guessing 2-3 days in the hospital.

Sent: Monday, September 24, 2007 5:30 PM

Subject: RE: Nell

Then we have PLENTY of time to say and save up on our prayers for Nell... Darcy she is just too cute.....

Glad that you have a date and hopefully the rest of her life begins after recovery.....You have done an

OUTSTANDING job not only with Nell (althou Above and Beyond with her) but the rest of the N Litter.....

Sent: Tuesday, October 09, 2007 11:13 PM

On the eve of Nell's surgery, I just wanted to send a note to all of her Guardian Angels and some very special people in Nell's life.

This precious little girl is a fighter and her foster dad (Michael Holvey, Jr.) and I would like to thank you all so very much for your generous donations. You are all giving her the only chance she has to live a happy long life. We are scheduled to arrive at Cornell tomorrow morning by 8AM and meet with Dr. Flanders before he takes her to surgery. We will stay until she is out and we have seen her. Right now, the plan is for her to stay for 2-3 days for post op care. We will know more tomorrow. I will let everyone know when she is out as soon as I can.

Nell has an approved family that is very serious about giving her a forever home. Right now, we are all focused on getting her through the surgery and helping her recover. I will send updates often. Thank you all again!!!

Footnote: As some of you know, we had to let our own personal dog, Max, go to the Rainbow Bridge this past February. He was admitted to Cornell with severe complications from Congenital Mega-Esophagus (which has some similar issues as the PRAA Nell has - this is how we were able to recognize Nell's condition as soon as we did). Max left us one month shy of his third birthday. I miss him every day. He was my very very special beautiful boy! I have been told that Max brought Nell to us (which is probably very true, as we were originally not supposed to foster Sophie and her pups). So, I know Max will be with us tomorrow and watching over Nell.

Warmly,

Darcy E. Drons

Darcy just called to give us an update. They are at Cornell and Nell weighed in at 19 lbs. Her surgery is at 11:00 AM. Nell might not have to have the feeding tube after her surgery. I know they were quite impressed with her weight and general physical condition (all thanks to Darcy & Mike). They will be taking pictures thru the surgery and will also be doing a CD for us to put on the website, it will be graphic! They are also doing a DNA on Nell for research at no charge to BrightStar. We will know what breed Nell’s’ Daddy is. This should be interesting. The tech that will be assigned to Nell is quite excited about caring for this little “wonder”. Darcy and Mike were very impressed with Dr Flanders, they had not met him prior to this.

Sheila will update you thru the day whenever she receives any news from Darcy & Mike.

-
Ruth A. Urban, Founder

Another quick update – the CT scan is “broken” at Cornell so they will not be doing Nell’s surgery today. It is supposed to be repaired by the end of the day. Nell’s surgery will be tomorrow unless it is repaired very soon. I believe Darcy and Mike will be staying there a few more hours. Cornell has ordered the food that Nell has been eating so she can continue on her original diet.

-Ruth

Well when Jessica went home at 11pm after her shift @ Cornell and returned in the am. Nell’s bed was filled with stuffed animals………….amazing how they multiply so everyone is trying to make her feel at home. Nell will be scheduled this afternoon for surgery
-Momma She

I am so so thrilled to report that Nell is out of surgery. Great news all around:

- They went in and cut the fibrous band that was supposed to recess in neonatal life and removed it. They said I would not believe that such a small band could cause such an issue for her. Her upper esophagus was "quite large" (hence esophageal dilation/mega-e). However, when they cut the band, her esophagus (where the strictured area was) expanded on its own!! So much so that they decided to NOT insert a feeding tube. They believe there should be no more obstruction to food (she will need to continue her special feedings until Cornell tells us to try to move to solids), but they felt that she is strong enough to heal and continue on with her feedings, as is.

- I was told the surgery is very painful (her chest was cut open) and that they have her on a continuous fentanyl drip and she will be on it at least through the night and will start to ease back tomorrow if all goes well.

- They took pictures of the surgery for us, as well as an endoscope of the esophagus.

- Michael and I are taking tomorrow afternoon off and will be going to see "our" Nellie girl!!!

I will know more about her long term prognosis upon release in a few days.

Thank you all for your prayers and good thoughts!

PRAA is caused when the main vessel that transports blood away from the heart called the aorta, forms on the right side of the heart instead of the left. This incorrect positioning of the aorta causes the esophagus to be strictured off - only fluids typically pass the strictured area, but solids or semi-solid foods do not. These foods back up and pool in the esophagus in the area before the stricture, causing a dilation or ballooning of that area. A puppy with PRAA will regurgitate food repeatedly until it becomes liquefied sufficiently to pass the stricture. It is most often during the course of weaning that PRAA is discovered. Each time a PRAA puppy regurgitates, it risks inhaling food matter back into the lungs (known as aspiration) causing infection and pneumonia. PRAA accounts for about seven percent of all congenital cardiovascular defects seen in dogs. It is believed to be a hereditary congenital defect, but so far this has not been confirmed since there is so little population of affected dogs to study.

Nell had a good night. They increased her pain medication a bit, as she is alert and wagging her tail when she sees her doctors (and then cries out in pain). They said she is a little drama queen too and that you can tell she is used to being pampered. That would be our Nell girl. Seriously, they want me to be prepared when I see her - "she just had her chest cracked open and the surgery is very painful."

The reason she is in ICU is to monitor her pain medication and to watch for any signs of a Hemothorax - a collection of blood in the space between the chest wall and the lung causing the lungs to deflate. This can happen after chest surgery, but they feel they had a good close and this should not occur.

The good news is they already gave her a small amount of her "milkshake" breakfast and she did not regurge. She is moving up from broth soup consistency (which she had to eat vertically prior to the surgery to be able to digest anything) to milkshake consistency!! They removed her chest wrap for a bit this morning to look at the incision and it is dry and clean.

She will remain in ICU today and we will be able to see her around 5 today. I will bring my camera and give her lots of kisses from everyone.

I will send another update after we have seen her.

Nell is HOME. She was released last night due to her great progress. She is home resting (or foster mom and dad are trying to have her rest - she is full of puppy energy). She has an e-collar on so she doesn't remove her fentanyl patch (which comes off tomorrow). She cannot reach her sutures, but she does have a chest wrap on to keep them from getting caught on anything (it's purple, which coordinates nicely with BrightStar's purple logo).

This morning, I fed her for the first time since her surgery. Per Cornell's discharge instructions,Nell was straight prescription wet food, not watered down, but still elevated and then she is help upright for 10 minutes after each feeding). Her daily caloric intake requirement is 1200 calories (which is about 8 cans of the wet food over the course of the day), that will be re-evaluated on her next visit to Cornell in 7-10 days.

She looks really good. Her eyes are bring and alert. She is even sassy. She is lying here on her dog bed.

Attached are pictures of Nell saying thank you to the wonderful vet student (Class of 2008), Jessica U., who we cannot say enough about. She will be an excellent vet when she graduates in May! Nell and Jess met in August in the Internal Medicine Department on Nell's first visit to Cornell. Jess was doing her rotation in that department. Then we got to see Jess in the hallway when Nell had her surgical consult in September. Then, guess who came through the doors with Dr. Flanders on Wednesday morning? Jess was now on small animal soft tissue surgical rotation. Jess was with Nell everyday from admittance to discharge. She not only took great care of her, she spoiled her rotten for us.

Jess asked if she could use Nell's case as her senior year case study and of course we said yes.

Now, Nell had a great first day back home. She is eating well (albeit very messy with the e-collar) and has not regurged. She is playful and loving and happy to be back home. I am thrilled that Koia, Tanzi, Toby and foster Banjo are all loving with her. In fact, she and Koia slept side by side during the day on a dog bed in the room while I was trying to get office work done. Trying being the key word.

We will remove Nell's fentanyl patch tomorrow night and rewrap her chest. We will monitor her pain level (we had oral pain medication for her). I called Cornell to schedule her next appointment and am awaiting a return call from the scheduler with a date.

Nell is doing so well! Thank you for all your prayers and good thoughts.

I will send another update later this week.

Warmly,

Darcy

Nell's foster mom

She is eating well (at least 8 cans of her special food per day) and even getting some treats (soft cheese, Frosty Paws, yogurt). We go to Cornell next Thurday to have her sutures removed and get a re-check.

Her sister Nadja is back visiting us for the weekend, they were so happy to see one another.

Nell sends kisses.

Warmly,

Darcy

Nell has been doing very well since then and is schedule to receive her 3rd puppy booster, her rabies and get microchipped this Friday (Cornell instructed us to wait two weeks from her re-check to allow her immune system to "heal". To give Nell a high plane of nutrition, we were told we could start feeding her soaked dry food. She is doing well with that and right now the soaked dry food is mixed with the A/D wet food. Nell is also starting to eat small pieces of soft treats - cheese, chicken pieces, Frosty Paws. Nell has to be held upright 10 minutes after she eats - our trigger is we know she is in the clear when we hear her burp after each feeding. Holding her upright for 10 minutes is happily becoming harder and harder for me to do because she is gaining and growing, so "daddy" gets to do that as often as possible, which of course he loves because she snuggles her head under his neck.

The surgery (thoracotomy) appears to have been a success! However, Nell will need to be fed upright for her lifetime to lessen any chance of getting aspiration pneumonia. The surgery removed the stricture, but, it could not correct the damage that was already done to her esophagus, so the "pouch like" pocket will always be there (which we knew going in). The belief and hope is that her food will continue to pass by it as she grows. We are all confident that as her esophagus heals and grows stronger she will be able to eat more "normal" food.

We are taking Nell this Sunday to spend time with her potential forever family, which includes a fur sister, Skylar. I cannot lie - this is extremely difficult for me, but I realize that Nell deserves to have a family that can be with her during the day, everyday, and this family can. This particular family has had a special needs dog before and are clients of Cornell's. Even though Nell will only be a special needs dog at feeding time, it will always be best for her to be fed small amounts, frequently throughout the day. This family does not live far and if all works out, they will be adopting an extremely loved/loving, spoiled/spunky and very lucky girl. They will also be a very lucky family to have her. The adoption will have a clause that Nell will come back to us when they go away and cannot take her with them, as Nell will not be a dog that can be boarded. Plus, selfishly, that means we get to stay part of her life.

I cannot wait to watch her grow up. She has already grown by leaps and bounds. I bet she weighs in at 30lbs. on Friday. She is also growing taller. She is almost as tall as our Toby, a 2 year old 36 lbs hound mix (our GSD wanna be). She is full of energy! She is very playful! She wants to put everything in her mouth and she loves to pounce on bugs - it is too funny. She knows the sit command, her recall is excellent, she is now 90% house trained (she had a harder time, because she had so much water intake before because she was eating mostly liquid) and she is crate trained. She is very "demanding" at feeding time, she will sit and bark at us if we are not moving fast enough while preparing her food and I have to look at her and say wait (lol). Oh, and she has a bark like her Mommy Sophie, quite deep for a dainty female. I could go on and on. I love "my" Nelly Belly!!!!

Attached are pictures from just 2 weeks after surgery - you can still see where she was shaved. Sheila who took these great pictures called her the patchwork girl. Her fur is really growing back now and I need to get more pictures.

I am planning on bringing Nell to the M&G in Rochester next Saturday the 17th so people can see how well she is doing!!!

Nell sends all her Guardian Angels and special people in her life a big hug. She would especially like to thank BrightStar's "Afghan Annie" for making her a beautiful purple Afghan to keep her warm on the cold nights and sending her a care package. Hugs and Kisses Annie!!

Please feel free to let me know if you have any questions about Nell's progress and I promise to update again soon.

Warmly,

Darcy

Hi - these were taken today at the Meet and Greet at the new PetSmart on Jefferson Road by BrightStar's Nancy F. (who is also one on Nell's Guardian Angels). Can you believe she is 28lbs??? She is now on a protein diet which in part consists of oats, raw lean beef, vitamins, oil, etc (yes, only Nell could get her vegetarian foster mommy to touch raw meat) and she may end up being a 60-65lbs!!!!.

Click here for Pictures from Petsmart, Henrietta, NY:

I am so proud of her! We love "our" Nell.

Well.....Nell's forever parents are coming to pick her up next Saturday, 12/1. They are coming to our house to spend some more time with us, we have already been to theirs, so we can go through how to make her raw food and her feeding routine, etc..

Nell will only be 20 minutes away from us and will come back to us to stay (along with her new fur sister, Skylar - a 10 year old Rottweiler) when her new parents go on vacations (which I will encourage them to do often!).

I am not sure how I will do without Nell yet, but I know she will be just fine without me. David and Cheryl will love her, spoil her and take extra special care of her. I will always be here for her too.

I may need to be sedated next weekend, Michael is nervous (lol), so I will send an update as soon as I can.

I love this little girl and I thank all of her Guardian Angels and special people in her life for all they have done for her.

Darcy