A Final Decision for Hamlet

Cold and wind has arrived in Virginia bringing with it temps just above freezing.  Areas to the south of us are having a bit of snow.  We have blue skies and sunshine, at least today. 

I took Hamlet (pictured with Wendy on the right) to the vet this cold morning to have the drains removed.  We have decided to wait to do that on Monday because there's still draining.  The final culture results were returned on Wednesday and my vet called me and discussed the options.  Today we discussed everything again.   While the surgeon removed the area of infection, because he couldn't remove everything (without removing Hamlet's leg) there is concern that the bacteria might still be present in Hamlet's system after this surgery.  We wonder if this is why there was a recurrence of infection after the first surgery, because we didn't use the right antibiotics to get rid of the bacteria--But this is just a guess...The culture that was done before the surgery identified 3 bacteria which are immune to most antibiotics.  One medication that Hamlet is currently taking (zenquin) will get rid of 2 of the bacteria.  The 3rd one however is a strain of e-coli and the only medication that will work to get rid of it is an antibiotic called Amikacin. It is a very strong medication that has a lot of side effects that could occur such as kidney damage, hearing loss, vestibular (balance) disorders. There may also be facial swelling, pain at the injection site, allergic reactions, vomiting, diarrhea, blood disorders, or liver disorders...It goes without saying that Hamlet would have to be monitored very closely by the vet during treatment because old dogs are particularly susceptible to the side effects.  

I've thought a lot about all of this the last few days.  I've thought of what my goals are for Hamlet and what my hopes are for him.  At the top of the list is for Hamlet to be able to enjoy the days he has left and be comfortable and free from pain.  I feel strongly that he's been through enough.  I think Hamlet needs to rest and enjoy the time he has left with us in peace, not be poked and prodded and ill from the side-effects of medications.  So I've decided to continue with the one antibiotic that will get rid of two of the bacteria, and not risk putting him on the Amikacin. 

I don't know what's ahead for Hamlet.  But tonight for the first time this week while I was eating my dinner in front of the tv, Hamlet came to me looking for a small bite of what I was having.  I think and I so hope I've made the right choice.