Onion's Permanent Trachoestomy (Trach) Info
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Thread: Onion's Permanent Trachoestomy (Trach) Info

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    Almandine's Avatar
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    Default Onion's Permanent Trachoestomy (Trach) Info

    When I was first faced with the reality of the permanent tracheostomy for Onion, I ran a search on PV. This forum is such a mine of information; in several years of membership, this was the first time it had come up empty on a topic I needed.

    I agonised, worried and fretted about whether my decisions were right for Onion, about what life would be like for her, about how I would manage her care. Nobody at my vet surgery had dealt with a dog with a permanent trach at all, nobody at the specialist hospital had dealt with a short faced, foldy necked breed like a pug with one – only greyhounds and horses! Nobody could really tell me if it was “the right thing to do” and I simply couldn’t find any case studies.

    So, while I dearly hope it is never needed, here is all the information I can give to anyone who treads in my footsteps on this topic.


    On Sunday night, Onion was checked into the Animal Health Trust hospital for an airway check under G.A. Her airway had begun to collapse a couple of years previously and it was already established that the collapse was widespread and degenerative.

    Her bark was oddly different and the pitch of her breathing altered, which is why I took her for the check up.

    On Monday morning the surgeon called, with Onion out on the table and told me that her larynx had completely collapsed. He said the removal of the intubation would likely leave her unable to breathe and would I like to let her go while she was anaesthetised. Laryngeal tie backs were out of the question, the only other option was a permanent tracheostomy. The complication rate was high, the risk of infection was high and he was leaning towards letting her go.

    If she were an old pug who’d had a full life, I may have made a different decision. But she was not yet six and still very much full of life and determination. She was not ready to check out. He did the tracheostomy and called again when she was awake and doing ok.

    On Tuesday I was allowed to visit. It was simply a hole, not a tube as I’d expected. It was stitched open and was rather messy but she was moving good air through it and seemed very happy indeed – especially with the sausage chunks I’d brought! She was coughing but that was to be expected – unwarmed, unmoistened air straight into the windpipe is a bit of a shock to the system. I was elated. My girl was happy and breathing. I almost fell over with delight when they said I could take her for a few minutes walk outside! The cold air made her cough so I carried her in her donut bed so she was a little shielded from the breeze.

    We went into the coffee shop, in the warm. There we hit a problem. Suddenly, she couldn’t breathe. She went from fine to gasping in a second. I panicked and thought I’d lose her then and there. I held her throat hole open and talked to her calmly and she got a breath in, she coughed a bit more and then settled. It left me shaking.

    Onion was a little subdued after her initial panic. Suddenly I thought I’d made a hideous mistake. It had only lasted a minute or so, but she had been so frightened. All her hackles had stood up. What had I sentenced her to? But within 15 minutes, she was grinning at me and staring at my bag for another bite of sausage. She sat with me and enjoyed a chewy bone and the surgeon assured me these were teething problems – she would take a little time to get used to her new limitations and find ways of dealing with them.

    I don't think I slept all night.


    Onion having treats in the car with me when I visited. You couldn't have wished for a happier pug!


    On Wednesday, I called to check it was ok to visit and was told she could come home! Elated again! And scared to death of taking charge of the whole care package by myself, what if something went wrong? Ack!

    She had Velcro stuck to each side of her throat hole and a Velcro “collar” round the back of her neck to hold them apart, keeping her neck folds up out of the way. That made my toes curl! She coughed every time she went in the garden and when she got excited, but she was not distressed. She had all of her favourite foods as handfed snacks and I was happy that she was managing.

    It was a wretched night. She couldn’t get comfy to sleep. Every time she dozed off, her airway was compromised and she woke up gasping and coughing. By 5am I was crying and back to “what have I done, this is torture”. She and I finally got to sleep at 7am and I had a feeling in the pit of my stomach such as I could not begin to describe.

    We had 2 hours of broken sleep and then the rollercoaster was on the up again. I took her visiting with me. She skipped up Grandma’s front path like a pixie on midsummer’s eve, a bounce in her step, a sparkle in her eye and ready for some treats! I would never have believed it had I not seen it with my own eyes. She was a different pug to the poor wretch on my bed a few hours before. This was Onion, full of the joys of life, as determined and sparkly as ever. I had made the right choice after all, we just had to get through the “teething problems” and she’d be fine.

    Cleaning the wound was a full time job. There is no way a person could do it and work a regular job as well. It needed wiping several times every hour or she’d choke on the mucus. It was cough cough wipe, cough cough wipe, wherever or whatever else was happening. Despite this, the skin was still getting sore and chapped and we had a long vet visit so they could show me how hard to clean the skin and how close to apply the barrier cream and how to apply the fixing spray without getting it in the hole. All of this had to be done at least 3 times a day and took at least 20 minutes each time. Onion didn’t mind it.

    The rest of Thursday was devoted to spoiling Onion. She and I shared a chicken nuggets happy meal at MacDonalds and when she’d finished that, she silent barked for bits of Granfer’s burger, too. It was just a puff of air when she barked. It hadn’t really occurred to me before the op, that her voice would be gone, but she didn’t seem to mind and everyone jumped to attention when she silent woofed, so all was well. It was a marvellous day; very little coughing.

    (continued in next post)
    Last edited by Almandine; 05-07-2008 at 03:44 PM.
    Almandine and the gang - Forty Fortune, Mr Grimson and Hoagie.

    Samson, Treacle, Maisie and the beautiful Onion at the Bridge. In our hearts forever. Joined now, too, by George,Wish, Dannika, Helo and Tank.

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    Almandine's Avatar
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    Back at the Pugnest, we all snuggled on the sofa for evening tv and Onion got into the right position on a blanket against the arm. She slept properly, even dreaming! I was so happy, my girl was getting good sleep and only waking hourly. When she did wake, a quick wipe of the throat to clear it and she’d go right back to sleep again.

    I didn’t dare move her. I pulled a heap of pug beds onto the floor by the sofa. The other pugs and I slept in a pile on the floor while Onion slept on the sofa. Every time she woke, I was there with the tissues, and she was able to settle again. I started to think everything would be ok.

    I had to see a few clients on Friday morning – having moved and cancelled so many appointments for so many days. The first was at home, and Onion rested in a bed by my feet while I worked for the first hour. At noon I took her over to Grandma while I did 4 more hours. She was bright and bubbly and I had no doubt that I’d made the right choice with the trach. Cleaning was down to 15 minutes on the kitchen draining board, I was starting to feel like a seasoned pro!

    I walked the other pugs before going to collection Onion. The family had spoiled her rotten, of course. She had them beautifully trained to her silent woof for more treats!

    I stayed for a cup of tea and a chat and took Onion out to the garden before we left for home. She came back into the warm coughing a little and then settled. Mum was actually saying how well she was breathing, I looked down at Onion and she was hunched up and gasping. She made no sound at all. I could have missed the whole thing, even being in the same room. I rushed to hold her and comfort her. There was no air getting in at all. She just couldn’t breathe. The seconds were hours as her tongue turned blue despite holding the hole open and trying to calm her panic. Every muscle thrashed as she fought, her hackles were all up, I would not wish it on anybody. Nothing helped. I gave up and just held her.

    Then I had a thought. I yelled for Mum to get me a cotton bud, I couldn’t let go of her throat to get it myself. I hooked it right into the hole and pulled out a blood clot the size of my little fingernail. Finally, she took a breath.

    I have no idea how long it went on for. Her tongue and lips were blue but slowly, they paled as I held her throat hole open with both hands and supported her chin so she could rest.

    It was pure chance that I was not alone with her and that there was a cotton bud to hand. It was chance that Dad had just left, minutes before, so couldn’t drive me to the vet with her. If anything had been different, she’d have suffocated to death and I am sure I would have had nightmares for years.

    Onion rested with her face on my hands as I held her throat. She was exhausted and she’d had enough. People tell you that “you know” when it’s time, and there was no doubt she was too tired to fight any more.

    She had a gentle passing, in my arms, with our trusted vet. She was so ready to go, it was an instant release from a body that had let her down. It could have been so different if fortune had placed even one thing in a different order that day. That is worth considering, if you are reading this with a decision ahead of you.

    It’s 2 months today since Onion left us. As hard as it is to lose someone so special, I have the great comfort of believing that all of my decisions were the right ones for Onion. If I could do it over, I’d do the same, but an idea of what was to come would have been helpful.

    If you have searched this thread from the depths of the PV archives because you need info on the topic, please don’t hesitate to PM me if I can help.





    homer.thepug likes this.
    Almandine and the gang - Forty Fortune, Mr Grimson and Hoagie.

    Samson, Treacle, Maisie and the beautiful Onion at the Bridge. In our hearts forever. Joined now, too, by George,Wish, Dannika, Helo and Tank.

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    Thank you so much for sharing this with us. I felt like I was right there with you the whole way. Now as tears fall down my cheeks, I will give Tilly an extra hug and kiss.
    Last edited by SallyAndTilly; 05-07-2008 at 04:54 PM.







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    Thank you so much for sharing with us, I am sure it was very hard to relive. (as it was hard to read through tears) Thank you for sharing information that may help another in this situation. Big hugs to you.



    “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

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    Gizmo my purr-baby, ^Dega^ , my furry angel watching over me from The Rainbow Bridge

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    Oh Almandine, I wish I could hug you. Thank you so much for allowing us to learn of your experience with Onion's issue. I know it's hearbreaking to tell but it worth it to share yours as well as Onion's experience to help others. We all miss the beautifful Onion. I smile everytime I think of Onion and how my DH laughed when he first heard of a pug name Onion.

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    Millie'sMichael's Avatar
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    I know that all of us agonize over the decisions we have to make for our pugs, but few of us will ever have such difficult decisions with so little time as you, Almandine. I am sure that there is great peace in knowing that you made the right decisions, even though the sadness is now great. Thanks for sharing the details of little Onion's illness. It is sure to help someone facing tough choices.
    Michael
    and Millie, the Pug Goddess of Washington, DC.


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    Almandine,

    I can only imagine how difficult it was to go through this, and I know it's also difficult to share the experience.

    I'm not sure how many of us here have been faced with the decision of trying a permanent tracheotomy...I know we were with CoCo, but to all who do face it in the future, it will be an enormous benefit to have some insight into this issue, and I thank you for sharing this with the community.
    DantePugs

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    I've known that Onion's final hours were terribly hard for you, maybe Paul posted something or told me something privately, but I knew only that you'd been to see your parents when things took such a tragic turn.

    I know it has been hard to relive the experience and put everything in words but hopefully that'll also be somehow therapeutic. I know, beyond a doubt, that other pug owners have been faced with this in the past and others will in the future and I know reading your personal experience will be very important. No matter how much advice we can offer others, nothing means as much as sharing a personal experience.

    Onion was a precious little pug. The calendar you sent me for Christmas stays open, it sits between my computer screen and the keyboard. I look at your pugs and remember all the good times, all the cute pictures of adorable companions who were obviously totally devoted to their mistress.

    Onion touched a lot of hearts in her short life. She lived her years fully and I know if love could have saved her, she'd be in your arms tonight. I've often said you are one of the most resilient people I've ever known - Onion was one of the most resilient pugs!! She fought the good fight, Almandine...and so did you.

    Ann
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    Those we have held in our arms for a little while,
    we hold in our hearts forever.



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    That was so hard to read, Almandine. But it must have been even harder to write-thank you for putting it up here so others may be helped.

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    Oh Almondine, that took me a long time to read through all the tears. How much you loved each other and how happy you made each other. For every thing there is a season and that is true of your time here together. You gave her a gentle passing when the time was right. Thank you for sharing your experience.
    "You cannot afford to subject your animals, or your children, to medical interventions that you do not understand. The belief system upon which the conventional medical model is founded is so faulty, so corrupt and so dangerous that you simply cannot afford to follow blindly." Catherine O’Driscoll http://www.whale.to/vaccine/driscoll1.html

    Hilary & the Pugpillow Gang: Rescues: Denver (10), Tina (7), Murdoch (5) and chihuahua puppy Maximus Spartacus. Always loving my angel-girl Mei-Ling (1994-2009), my cutie-patootie Kim-Soo (1995-2010), my precious Daisy-Bo (1998?-2006), my sweet boyfriend Jake (1997-2010), my little black beauty Betsy (1995-2010), my sweet old grumpy man Gooey (1996-2011), and my sweet gentleman Farnsworth (1998-2012) at the Bridge.

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