Emergency transfusions + surgery: Fozzie Bear’s story
Beautiful Fozzie Bear required emergency treatment when he arrived at The Ralph collapsed and in shock.
In the days leading up to the collapse, Fozzie Bear had been showing signs of lethargy and had not been eating as well as he would normally do. He was also passing very dark/black stools, called melaena. The black colour can be a sign of bleeding inside the digestive system. His carers realised something was seriously wrong when Fozzie Bear vomited blood so took him to see his out of hours vet. Fozzie Bear was very weak at this point and was immediately admitted, treated with intravenous fluids and had blood tests performed. These blood tests showed that he was anaemic (low number of red blood cells) and needed a blood transfusion. Fozzie Bear was referred to our Emergency and Critical Care Team at The Ralph.
On arrival at The Ralph Fozzie was incredibly weak; he had lost a lot of fluid and was very uncomfortable. He was given replacement fluids, a blood transfusion and pain relief medication. Blood transfusions are often given conservatively and slowly because blood, although life saving, can cause a severe reaction within the patient. After about 10 minutes poor Fozzie Bear once again passed a large volume of vomit with a significant amount of blood. Fozzie Bear was deteriorating rapidly so the decision was made to run the red blood cell transfusion over a much quicker period of 15 minutes rather than the usual 4-6 hours. This stabilised Fozzie Bear for a short amount of time but he soon deteriorated again.
Over the course of the rest of the night, Fozzie Bear received several, red blood cell and plasma transfusions (the yellow liquid in your blood that carries platelets, red blood cells and white blood cells around the body). He was continuing to lose blood, proteins and large volumes of fluid which all needed replacing to help stabilise his body. The Emergency and Critical Care team were eventually able to stabilise and replace Fozzie Bear’s fluid loss but he was still in a critical condition. The team needed to understand what was causing this fluid loss and where he was bleeding from.
Now that he was stable, Fozzie Bear was anaesthetised and gastroscopy was performed (a thin camera that looks inside the organs of the digestive system). The gastroscopy revealed Fozzie Bear had some nasty looking ulcers in his stomach:
The decision was made to take Fozzie Bear straight to surgery where our Soft Tissue Surgery team could take a closer look within Fozzie Bear’s stomach, and attempt to provide some relief. A large amount of blood and blood clots were found in the stomach, so this was cleaned to allow the ulcers to be seen more clearly. Three ulcers were found on the greater curvature of the stomach and identified as the root cause of poor Fozzie Bear’s problems. Because of the severity of these ulcers and the amount of fluid and blood loss they were causing, the best course of action for Fozzie Bear was to remove the section of his stomach that contained the ulcers.
The surgical team removed a 7x7cm area of the stomach (that’s a similar size to a Post-It note) and placed a type of feeding tube called a gastrostomy tube to allow nutrition and medication to be given whilst his stomach healed. Fozzie Bear’s stomach was sealed up with stitches and he recovered well from his anaesthetic. Whilst the surgical procedure was a success, Fozzie Bear was very weak after his procedure and needed a team of dedicated intensive care nurses in the following days to nurse him back to health.
Day by day Fozzie Bear made slow improvements, gradually becoming well enough to return home to his family five days later. His feeding tube has been removed and he is now able to eat by himself. He still has the occasional sickness and discomfort within his tummy, but it has been a remarkable recovery for a remarkable boy!
Team Ralph 🐾