Bobbert’s Medical Emergency
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Animal Care Volunteer Lily first noticed Bobbert was acting strange on Monday (12/21), four days before Christmas. As Bobbert has had several residual episodes since his battle a year ago with a meningeal worm, we initially assumed this was another one of those times, and that he just needed a safe place and a watchful eye. On Tuesday (12/22) he was still drinking and eating, but noticeably less so by Wednesday (12/23). First thing Thursday morning (12/24) our alpaca vet provided us with several medications including a gastrointestinal paste and an anti-inflammatory. She too, was operating under the impression that Bobbert just needed a little help to get over this particular episode.
The following day, Christmas (12/25), we placed an emergency call to our vet since, while Bobbert was not worse, he was also not improving. She made a plan to come first thing on Saturday (12/26). Upon her arrival she did not think that Bobbert looked as serious as we had described on the phone, which was a relief. She spent about two hours with us, gave him a full exam and took blood work. All of his vitals were normal, except for a raised pulse, which we attributed to his being poked and prodded. Clinically, it appeared that Bobbert was having one of his neurological episodes, just as he had in the past. To be extra cautious, however, we ran through all scenarios again, including another meningeal worm, Lyme disease, bladder blockage, colic, and every rare thing an alpaca can get. We checked his mouth and throat because he was not eating, but they also presented normally. The vet felt we should continue with the medications and just give them another day or two to make a difference. The most notable issue at the time was dehydration, and we were able to flush him with 180ml of fluid. We planned to continue to provide hydration several times a day.
Lily spent a great deal of time monitoring him on Sunday (12/27) and Bobbert spent a lot of time standing with his alpaca buddy, Cash. Though Bobbert looked like he was trying to take in water and food, it seemed as if his throat would not let him. Again, we placed an emergency call to the vet who felt that since he was making efforts to eat and drink, he was probably turning the corner, and we should continue flushing him for the rest of the day.
On Monday morning (12/28) his lab results came back. His kidney levels were quite high, which we hoped was due to dehydration, and not because he was in kidney failure. At this time, the vet agreed that he needed to go to Tufts University Veterinary Medical Center. Since we no longer had an animal trailer, our executive director, Wendy, taped plastic all over the back of her SUV, and drove him to Tufts. You can see the videos here. By the time she returned, his first doctor from Tufts called with his thoughts and a plan.
The plan consisted of 5 to 6 days at the hospital on IV fluids while they re-ran bloodwork, labs and got him an ultrasound. His electrolytes were low as were sodium, magnesium, and calcium, and they needed to rebalance these slowly and carefully so as not to cause kidney damage. They were also going to make sure that he didn’t have a bladder twist or colic. The plan was to continue to treat him with the same two medications our vet provided, as well as an antibiotic which we had already started him on two days earlier. They were also going to put him on fenbendazole in case it was in fact another worm. We mentioned to that doctor that we were hoping they could place a urinary catheter because of his lack of urination over at least four or five days.
He was on fluids for six or seven hours and they took him for an ultrasound, which revealed the first clinical bad news: there was free floating fluid in his abdominal cavity, which meant that he suffered a tear in his bladder. Normally fluid in the cavity could lead to sepsis, but luckily Bobbert was already on antibiotics and Tufts started loading him up with more. We were informed that they had not given him a urinary catheter since it is nearly impossible in an alpaca because of their urinary tract. In leu of a urinary catheter, Tufts drained the urine from his belly using an abdominal catheter. Unfortunately Bobbert’s lab work indicated he was not a candidate for the surgery necessary to repair the bladder at that time.
At that point, Tufts requested Wendy sign a “do not resuscitate” order (DNR). Because of the bladder tear combined with an elevated heart-threatening potassium level they were very concerned that Bobbert could go into cardiac arrest in the middle of the night. The DNR was because they felt considering how his critical his condition was, it would be unkind to put Bobbert through aggressive lifesaving measures. Wendy made the heartbreaking decision and was told to leave her phone on throughout the night as they would call “if/when” it happened.
At about 7:30 the next morning Tufts called to report Bobbert had survived the night and they were changing his status from critical to stable. Happy news and a huge relief! 12-hours of fluids had balanced his potassium, calcium, and sodium levels enough that he was now a candidate for surgery to repair the bladder. Even so, we were again asked to confirm the DNR as they did not know what they would find on the operating table. Their plan was to repair the tear if they could, and whether they could repair the tear or not, as long as there was enough of the bladder to utilize, they were going to place a Foley catheter. If they could not repair the tear, three to four weeks with the catheter would theoretically allow the bladder to heal itself.
He went into surgery for several hours last Tuesday afternoon (12/29) and they called us several times from the operating room with their findings. On one call they explained they found that part of his bladder had become necrotic (areas of dead tissue) and that it had fused itself to his abdominal wall. At that point we feared they were going to say there was nothing they could do. Instead, while we were on the phone, the surgeon was able to debride the area (surgically removed the contaminated area), and he was going to stitch the bladder back together and place the Foley catheter. They also flushed his abdomen with fluid to get rid of any residual urine. They also ran test fluid through his urinary tract to make sure that it was not paralyzed and they were able to confirm it was working. They did not see any stones so they ruled out a bladder blockage. They deduced that “about a week ago” Bobbert suffered some sort of traumatic injury that caused the bladder tear. They cannot explain any further as they also opined that he would have had to have had a full bladder at the time and been hit very hard right in that area – almost as hard as a car accident. How this could have happened remains a mystery.
After the surgery was over, the surgeon reported that they were able to repair the bladder. But because the procedure was so extensive, Bobbert had some difficulty with anesthesia and they had to give him a plasma infusion so he didn’t crash. Bobbert went into intensive care and was again considered in critical condition. They informed us that everything that they could accomplish on their end was now done, and it was now up to Bobbert and his strength to see if he would pull through.
The post-operative plan was to keep Bobbert at the hospital for 7 to 10 days, on a Foley catheter and a feeding tube. He also received a “gut transfer” which means they used good bacteria from a cow that they keep on the property and transfuse it into Bobbert to restart his G.I. tract. They will do this several times. Again, they warned us that anything could happen in the middle of the night.
Fortunately, once again we did not receive a midnight call. When we did talk that morning, Tufts reported that Bobbert was doing the best he could considering all that he went through. He was still in intensive care and in critical condition, but they felt he had stabilized, his head was up, and he was alert. He was not yet able to eat on his own but that was not of concern so soon after surgery. The surgeon felt that the morning’s report was a good one, and hopefully Bobbert would be able to recover. There remained a lot of obstacles in his way, including the possibility that his bladder will not heal; that they cannot restart his gastrointestinal tract; and he is prone to another tear in the future. Added to that daunting list is his residual temporary onset paralysis from meningeal worm. The plan includes a catheter for 6-7 weeks (then another trip to Tufts for removal).
On Thursday morning (12/31) they planned to take out his abdominal catheter. He hadn’t wanted to stand up yet but he’s had only been out of surgery 36-hours. They were going to try to get him up. His protein was low but likely because of all the flushing. On a positive note, he was nibbling on food and they said he was bright eyed and “opinionated” for the first time since arriving.
Later in the day Bobbert still would not stand so they did a spinal tap to test his Cerebrospinal Fluid (CSF) as they were concerned that his meningeal worm damage was causing it. Thankfully it came back clean and they hoped he was just being a stubborn alpaca. They did have to give him the rest of the plasma transfer since his proteins were still low. They expected he should start to feel better now that his abdominal tube is removed. That said, they still cautioned us that Bobbert was not out of the woods. We needed to be aware and prepared for the worst.
By last Friday (1/1) Bobbert’s medical bill was estimated to be between $10-$12,000. He’s lucky he is so darn handsome and so loved. But in all seriousness, we are not in a position to go to these lengths for every rescued animal. We make financial decisions on a case-by-case basis and in Bobbert‘s case it’s pretty obvious: he’s Bobbert. He’s been at West Place since he was a baby and long before he became famous on the Dodo, thousands of people knew him and loved him.
On the same day, the doctor actually saw some leaking blood in his urine and had to do another ultrasound to make sure his bladder was okay (it was). They think he has some edema because he is still not ambulatory. And they think he’s not walking because when they relooked at the CSF it was a bit more concerning than they initially thought, so they put him on a medication used for horses on when they get a meningeal worm. They are letting the meds have some time to work. Though their hopefulness has turned back to concern.
On Saturday (1/2) Bobbert’s blood pressure and heart rate finally dropped after being elevated for an entire week, and the doctor felt that perhaps he was finally turning a corner and making forward progress. And instead of speaking in terms of “if“ they started speaking in terms of “when.” When his bladder heals they can get him into a body harness to change up his physical therapy for his legs. When he goes home in a week they are happy to know we can set up a body harness pulley system for his physical therapy. Since they seemed to be cautiously optimistic for the first time, we hoped we could be too.
On Sunday (1/3) they helped him up and of course, he fought back. But with assistance he was able to stand. He was still not walking or getting up on his own and he’s very wobbly. But the hospital was now starting to use words like “pleased” with his progress, and they did not consider him critical anymore. They expected he would make more improvements over the next few days.
On Monday (1/4), Tufts called and Bobbert took a turn for the worse. His proteins remained very low and he needed additional plasma injections, this time with a higher protein. Because all of his bloodwork and his kidney values were good, they could not tell why his protein is low. His edema was also getting worse and he starting to get very puffy around the face and mouth and neck. He was back in critical condition. The doctor was audibly concerned about this new difficult turn of events.
On Tuesday (1/5) we were informed that Bobbert‘s blood transfusion did manage to raise his protein levels, but only to 3 ½, which is still low. They are aiming to get it into the mid fours. He is still looking bloated from his overall edema. He is still critical and likely will be for a while. That said, we are holding on to the few pieces of good news: he has no fever, a great heart rate, is breathing normally, and his droppings are looking better. To look at it optimistically, they are hoping that since his droppings have improved, it means his organs are starting to improve, which should mean that his protein numbers should start to hold. They are checking his triglycerides and they’ve put him on dextrose to make sure that he doesn’t lose too much fat. They are also testing him for salmonella. They are considering him clinically the same today as yesterday and since we were afraid that the news would be much worse, we are going to take this as a win.
The hospital will continue to call us once or twice a day with updates and we will try to keep everyone informed as best we can.
Please send all your positive energy his way that he continues to improve so he can return to all of us. If at all possible, can we ask for your support as well? Veterinary care for farm animals is always very expensive. In this case his medical bills have now exceeded $12,000 and we expect they will climb to $15,000. This is financially devastating and his hospitalization continues.
An Update from the Executive Director:
This is not an update I wanted to write.
Bobbert experienced more complications on Wednesday (1/06) in addition to everything he was already battling. He required another plasma injection with higher protein content to combat elevated levels of medication, which could cause him to become toxic. The doctors still hoped he had a fighting chance and they were seeking permission to have me transport Bobbert’s best buddy, Cash, to Tufts to stay with him for a few days. It was our hope that Cash might help encourage Bobbert to get back on his feet. Tufts was waiting on the results of a salmonella test first, and I awaited their return call.
Unfortunately, a few hours later, Bobbert started open-mouth breathing, which is never a good sign. Though he was still eating, it was purely mechanical and was no longer providing him nutrition. Even with the plasma transfusion they still could not get his protein levels above 3.4 (mid 4s is normal), but even worse is that they could not detect a reason for it. He had no tears or leaks. Protein from his bladder injury would naturally slough off and he likely had some passing through his urethral catheter, but he still should have been able to hold a higher value. It seemed he was not keeping fluid in his blood vessels and it was possible his vessels were leaking into his body tissue, which was causing his recent edema. The doctors started to fear that Bobbert may have begun a total systemic failure. Though I had not been permitted to visit because of Covid protocols, they gave me permission to be there last night.
Before hanging up the phone, they also informed me that, for the first time, they found abnormal crystals in his urine ranging from medium to large in various sizes and arrangements. In that case, they try to dissolve the crystals in different types of aggregates but none would break them down. The lab technician told the surgeons he had never experienced that before. Even though they did not see any bladder stones during his repair surgery, they started to question if it could’ve been an issue all along.
The board chairman and I drove to Tufts last night. Upon arrival, Bobbert’s surgeon met us in the parking lot to warn us that his condition had deteriorated even further in just the period of time it took for us to travel there. He started to exhibit what is referred to as “swan neck,” where he turns his head behind him and lays it on the ground. He had clearly become very neurological and we understood the doctors had done all they could for him, and Bobbert had given it everything he had. The board chair and I sat on the ground and let him sleep in our laps for about an hour and whenever he could, Bobbert would open his one eye and wag his tail to let us know that he knew we were there with him. I don’t write this to upset anybody or cause undue sadness, but only so that everyone who loves Bobbert so very, very much will know the doctors tried their best, he gave it his all, and the decision we had to make was one of the hardest we have ever been faced with here at the sanctuary.
We never thought about having to say goodbye to Bobbert.
He will forever remain the most handsome, the biggest character, and the happiest and most unique creature any of us have ever had the pleasure of meeting. As hard as it was, we had to do what was right to bring him peace. We are so sorry to say that Bobbert passed away on Wednesday, January 6, 2021, but he was surrounded by love and familiar faces.
On behalf of our entire organization, I cannot begin to thank everyone enough for the outpouring of not only your good wishes and prayers for him, but for your incredible financial support. His looming hospital bill will be the largest we have ever incurred. And we could not have given it our all without the help of everyone who contributed. If you are still looking to donate, please know that it will not be in vain and is much appreciated.
I have made it my personal mission to ensure that the incredible and profound impact Bobbert had—on the thousands who have met him in person and the millions who only had the pleasure of knowing him through video—will not be forgotten. He leaves behind an amazing legacy and as soon as we have had the chance to properly mourn this unexpected and heartbreaking loss, we are going to create something special to honor him. The Bobbert Memorial Fund will provide internship scholarships to young people interested in animal welfare. It will provide opportunities to gain hands-on experience and training in a real-world environment for the next generation of humane professionals. Stay tuned for more information about the launch of this program and wonderful Bobbert gifts to treasure.
Thank you all for taking this journey with us and for being by our side. Though we wish Bobbert could have enjoyed another 11 years, his first 11 were packed full of such joy and inquisitiveness, love and playfulness. He made the most of his time and left behind an infinite amount of incredible memories we will keep with us forever.
Rest in the sweetest peace, our dear boy. We love you Bobbert!
West Place Animal Sanctuary
For anyone looking to donate, we still have not received his final medical bill or paid for his burial so any support is appreciated. To help please donate in any of the following ways:
Mail your contribution to:
West Place Animal Sanctuary
3198 Main Road
Tiverton, RI 02878
Please write “For Bobbert” on the envelope.
I thank you all for taking this journey with us and for being by our side.