(This a progress report about a ferret, Slink, who had her esophagus accidently
cut during surgery.  Parts one and two are in issues 250 and 251.  This part is
about 75 lines long.)
 
Last I wrote, Slink had her feeding tube removed and was beginning to act a
bit more... well... "ferret-like".  She was eating again, but was not having
an easy time of it - food was entering her nose and trachea.
 
Well, back to the Animal Medical Center we went.  A flouroscopy (sort of like
a real-time X-ray) of her eating revealed that her repaired esophagus had
begun to stricture - scar tissue was forming in the area of the repair, thus
closing it up.  The location and the severity of the stricture meant that
some of what she ate wouldn't get to her stomach but would instead end up
in her lungs.  This was not good for her already severe pneumonia, nor could
it be left untreated.   To make matters worse, the treatment options available
would all entail considerable risk and uncertain outcome.
 
Once again I began questioning if I was doing the right thing by trying to
"fix" Slink.  Certainly, she was suffering - could it be that after all the
suffering she STILL would have to be put to sleep since she was beyond hope?
And, certainly, I was suffering too - both financially and emotionally.
 
I decided that major surgery was out: one option was to open her up again and
to attempt to cut out the strictured area and then to join the two pieces of
the esophagus together again (an esophageal resection).  The stricture could
still recur and it would be going backwards in my opinion.
 
We finally decided to try balloon therapy.  Here, the esophagus is gradually
dilated by inserting a series of rods of increasing diameter down the throat.
Finally, a "balloon" is inserted and inflated at the point of the stricture.
The hope is that the tissue is stretched back out by the balloon and further
that it stays that way. (The balloon itself only stays inside a few minutes).
 
Risks: she would have to have her stomach tube reinserted since she couldn't
eat for some time after the dilation; inflate the bladder too much and the
esophagus ruptures; and no guarantee of success. The uncertainty was compounded
a bit too because best as anyone knew, this procedure had never been done on a
ferret before.  (Hey, if nothing else Slink made the text books.  Or she will,
if there ever is a text book on ferrets.  Dr. Rosenthal, you listening?).
 
Well, the stomach tube turned out to be more of a problem than was expected,
but, nevertheless, the procedure was done.  The surgeon was surprised at how
well it went.  I went back to tube feeding every few hours until she could
once again take food by mouth.  Unfortunately, when she began to eat again,
the food was clearly still getting into the lungs.  We were all a bit shocked.
 
Once again, another flouroscopy revealed a stricture.  The pattern was familiar
to the surgeon (actually, a specialist in these things, not a general surgeon):
he says it's not unusual to have to repeat the procedure in cats and dogs,
though he was totally amazed at how quickly Slink strictured again.  I was
close to giving up when the surgeon suggested repeating the procedure.  I
reluctantly agreed.  Turns out that the stricture this time was quite minor -
in fact, probably just a few fibrous bands of scar tissue which were easily
broken.  Very good news!
 
So, here's how things stand now:
Slink is still being fed via her tube.  In an effort to keep the pneumonia
in check, the doctors are suggesting to avoid mouth feeding for a few more
days.  I have no idea if a stricture is present.  So, I take Slink to work,
(lots of helpful and sympathetic folk there) and wake up at night.  Still
easier than human baby and she fits in the glove compartment (or under the
seat, or in a bag when I take the train).
 
On Tuesday, 26 May, Slink will get another flouroscopy.  Unless the esophagus
is in bad shape, the balloon therapy will be repeated.  If all goes well, she
will be back eating via mouth a few days after that.  It's too early to tell
the final outcome, but I am pretty optimistic.
 
Well, in the interest of brevity I've left out some details, like the two more
2am trips to the Animal Medical Center.  If I didn't know better, I'd think
that Slink gets a laugh out of all this.  Then again, maybe I don't know
better.  Stay tuned for part 4 in a week or so.
 
Bill
 
p.s. I'd like to remind all that Nancy Hartman's Percy was scheduled to have
surgery today at Dr. K.'s.  Percy is very much in my thoughts today - I hope
all is going well.   Bill
 
[Posted in FML issue 0254]