Lewis undergoes complex surgery for broken femur

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Lewis

Lewis spent the weekend of November 10-12 at Dr. Justin Janssen’s in Sheridan, Indiana. Dr. Janssen kept Lewis comfortable and on mild pain killers, while Lewis negotiated his surroundings on three legs. On November 13, we transported Lewis to Dr’s Toni and Gary Cotton of Findley, Ohio. They examined the x-rays and felt that they could do a successful repair of the rear femur, using a human plate.On the evening of November 14, Lewis underwent surgery. The break proved to be far more damaging than the x-rays showed. The bone was split longitudinally. Three veterinarians and assistance from the local hospital were called upon. Lewis weathered the surgery well, and as of morning of November 15, was reported to be able to stand. He is eating and accepting the affection of the veterinary clinic. His prognosis is currently very good. He will be moved later to Dr. Toni Cotton’s farm for a more comfortable stay until we take him back home.

Thank you to everyone for their help and support during this crisis! Starting with our farm sitters, to the veterinarians and all the folks at the ALSA National, our heartfelt thank you for helping us and our llamas get through this ordeal!

Our farm sitters David and Colleen, upon finding the melee of several adult males mixed in with our females and crias, had to individually catch and coral the would-be studs. They lifted Lewis into their minivan for a ride to our vet, an hour away. They waited for our return from Missouri and had a long night that lasted into the wee hours of the morning, making sure all the llamas were safe and accounted for. We don’t know what we would have done without their help at this most critical time!

Thank you to our long-time veterinarian, Dr. Justin Janssen for taking in Lewis during the late evening and caring for him all weekend until our return. We knew he was in the best of hands!

Thank you to all the folks at the ALSA Nationals who unselfishly acted to assist us when we had to rush home, a drive of several hours that could easily preclude our ability to either care for or show our llamas in Columbia. Our friends instantly chipped in to feed and care for our llamas, and made arrangements to groom them before the show and be sure that each llama had a handler to go into the show ring in the event that we could not return in time. Show management and people who found out about our situation all helped, and as we left Missouri to head for home, we knew our animals were in good hands! 4H youth had even been contacted to help out if necessary. We even had an offer to bring our llamas back home to us, in case we could not return that weekend. What a relief to not have to worry about them as we faced the long trip home to unknown damage.

When we returned to the show grounds Saturday morning after hours of driving and a sleepless night, our stalls were clean, and animals ready for the last minute touch ups to enter the show ring. We are truly indebted to the efforts of many people who jumped in to take care of our animals; some friends that we had known and others that we would make the acquaintance of that weekend! Thank you! When people say that llama folks are the greatest, they really mean it!

And lastly, thank you to Dr’s Toni and Gary Cotton for doing the surgery on Lewis. Your willingness to undertake this difficult task in only matched by Lewis’ courage through all he has been through. Our trust in your capabilities has been repaid many times over.

Lewis Comes Home!

Lewis came home this afternoon, though he enjoyed all the attention at the Cotton’s farm, we are happy to have him back! He is not putting much weight on his leg and still needs medication and careful care, but his appetite is good and he seems to be very much like the ole Lewis that we remember!

Fresh grass in the front yard

As the days have gone by, Lewis has been resting more comfortably, able to kush easily and his pain seems to be easing. The long 18 inch incision is healing well. Lewis has gotten to walk to the front yard and nibble some grass, which has been a welcome diversion from his hay! He has gotten excited by the “almost freedom,” and tried to move more quickly on that leg than we would like, so we keep an eye on him to prevent any over-activity.

A White Christmas

Lewis has been stall-bound for the last three weeks with our early snow fall. He still takes twice-daily walks about the garage, but there is no fresh grass to be found! He is reluctant to stand on his healing leg, though he walks easily. The callous forming around the bone appears to result in a difference to Lewis that makes him not want to stand on the leg. We don’t believe he is in any pain at this time as pain killers do not alleviate his reluctance to use the leg. It is still a few weeks before complete healing can be assumed, so we will keep his activity confined until then. He enjoys visitors as a welcome stimulus to his long days of confinement. He also enjoys having his back, neck, belly and all four legs scratched vigorously, and this has become part of our daily ritual!

A Nasty Surprise

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Leg Incision

Lewis and all of us had a nasty surprise Christmas day when his incision, which had been healed for weeks, came open and oozed a white, ominous pus. Dr’s Toni and Gary Cotton saw him in their office on December 27, and determined that the new callous growing around the break had an infection. Dr. Gary cleaned out the area and inserted a drain. Lewis is now back on antibiotics and has the area flushed twice daily. If we can get the infection cleared up he should continue to heal well. A photo showing the long incision and ends of a piece of surgical tubing inserted to keep the area open for drainage and twice-daily flushing. Not a pretty sight!The good news was that radiographs taken on December 27 showed the bone plate still intact and holding! Other than the infection, the bone is healing and well and we are very hopeful of a good recovery.

Surgery Postponed

We have been kept in suspense all day, however we finally linked up with Dr. Silveira this afternoon. Lewis did not have surgery today, as they took more radiographs and discussed his prognosis with other doctors at OSU. The good news is that there may be more good bone there than the original x-ray showed. However, the chance of saving the leg is still slim. The doctor feels we have a chance and will do surgery tomorrow to clean up the infection. Lewis is still eating well and seems to be feeling well over the course of the weekend. We are hoping and praying that the doctors can indeed work a miracle for Lewis. We are praying for him!

3 Weeks of Antibiotics

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Lewis in Temporary Stall in our Garage

For the past month, Lewis has been on rotating antibiotics to combat a bone infection. Persistent snow coverage and cold weather has curtailed his outside walks. Confined to his stall, visits from other llamas and attention from us does not replace his previous freedom of the pasture. He knows our attention often includes needles (twice daily) and sometimes painful treatment of the incision. He still has the infection, although he is walking well on the days when we have been able to get him outside. The lingering snow has hidden the winter grass in all but a few places, which we have sought out to provide Lewis a welcome treat. We continue to support him and he keeps fighting, although his illness seems to be lasting as long as the cold winter weather. We keep praying to see a turn-around soon.

A Trip to OSU Vet Hospital

This installment is difficult to report, as the news is not good. After fighting the bone infection for a month, we took Lewis to Ohio State in hopes that hospitalization and more aggressive treatment might help him. Their initial radiograph shocked us by showing that the majority of the femur was now badly infected. The plate appears to be the only thing holding the leg together. Lewis seems to feel good and walks quite well, so this extensive damage was unexpected. Lewis will undergo surgery on Monday to determine the true extent of the infection. The doctors feel that Lewis will indeed need a miracle to save the leg. Lewis’ very life is in the balance, and we deeply appreciate all the thoughts and prayers of those of you have written to offer your support for our gentle, brave companion.

Another Hurdle Overcome!

Lewis underwent surgery today, which Dr. Silveira has reported to have gone well. They did not find the bone to be in any worse shape than the radiographs had predicted, much to our relief. The doctor removed a screw, some wire, did extensive debridement of the infected bone, and drained the large abscessed area. The plate is still holding at both ends of the femur and providing support. Lewis this afternoon is in his stall recovering and able to stand, putting some weight on the leg. Extensive follow up will now be done to keep the wound flushed and antibiotics to treat the infection. The next few days are critical to determine if the infection can be overcome. There is a risk that the bone could break in its weakened state. Fortunately, there were no splinters or fractures of the femur, so healing appears to have occurred before the infection set in.Again thank you to everyone who is keeping up on Lewis’ recovery; we truly feel your thoughts and prayers are what are making the difference! We continue to pray for guidance to the doctors and surgeons and Lewis’ own resilience to keep fighting his way back to health!

Lewis has Visitors from Home

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OSU Vet School

We were able to visit Lewis Saturday at the OSU veterinary hospital. Lewis had succumbed to depression and loss of appetite over the last couple of days, and the staff brought Lewis an alpaca buddy from their research program to keep him company. Having another camelid friend in the stall definitely perked Lewis’ spirits. When we visited he was alert and eating well. After his wound was flushed and he received his antibiotics, we were able to take a short walk down the hallway. Lewis was interested in the occupants of the other stalls, and seemed more than happy to continue down the hall; perhaps to where he hoped the van waited to take him home! He reluctantly returned to his stall, where he was fed and we shared lots of hugs and back scratches. He seemed happy and we are thankful that the staff at OSU has made his stay there welcome and comfortable; and especially for his new friend!

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Lewis and Laura

Antibiotic therapy and daily flushing will continue on Lewis and his progress closely monitored. Dr. Silveira is assisted by a team of veterinary students that have been giving Lewis the same special care that they would share with their own beloved pets. We hope he can keep his spirits up through all of this, and we know that their attention and care is a huge part of Lewis’ recovery.

Again we thank everyone keeping up on the internet for their supporting thoughts, emails and prayers!

Another visit and update

Lewis is still hanging tough, with antibiotics and flushing of the wound. His appetite is still good and although he is quiet, he did “answer” us and seemed happy to recognize us. He also seems to sense the direction of “home” when we walked him briefly. Dr. Silveira gave us encouraging words about the nature of the drainage, and feels maybe they are getting the infection under control. We are hoping that each passing day is bringing some increased bone replacement, although radiographs will have to wait awhile before they show the actual status.We were happy to say hello to Dr. Toni Cotton, who’s visit at OSU coincided with ours. She was going to also stop in and see Lewis while she was there to see how her famous patient was progressing. It has been through the skill and dedication of these veterinarians that Lewis has had a chance to overcome this terrible ordeal.

Lewis Looking forward to a Valentines Day Back Scratch

It has been nearly five years since Lewis’ fateful injury. Lewis continues to do very well. Like his handlers he has grown over his target weight, but he continues to inspire and amaze us with his zest for living and his ability to overcome his disability (blindness).Lewis is always the first to greet new visitors to our farm–often demanding a back scratch before they can proceed to visit the rest of the llamas.

Eventhough Lewis has his own barn and stall, he still insists on spending most of his time on the main barn porch–the area where he was allowed to recuperate after he returned from OSU. While we would like to keep the cleanup away from the main entrance, we just don’t have the heart to lock Lewis out of this familiar turf.

Not much progress but still trying

The latest progress report is that Lewis is running a bit of fever, and is on more antibiotics. The discharge from the wound is clearing, and he is using the leg. However, radiographs from earlier in the week did not show any appreciable bone re-growth. Some dead bone and another broken screw will need to be removed, but due to the possibility that the leg could still break, surgery for this will have to wait.We are now praying that Lewis can keep fighting, and begin to see some bone re-growth. Once enough bone replacement has occurred, further debridement of the dead tissue will be required to completely clear the infection. We hope he can keep holding on during this painfully slow recovery.

Another visit from home

We visited Lewis and went over the latest radiographs with Dr. Silveira. The doctor is encouraged that there is at least some noticeable bone growth and his infection seems to be under control. However a piece of dead bone will need to be surgically removed. As he had discussed with us earlier, this will have to wait several weeks until more growth makes the bone strong enough to operate on with some degree of safety. He also would like to remove the plate at some point, as another screw has broken. Once the bone has recovered fully, the plate will no longer be needed and will become a liability. For now, it is still what is holding the leg together.Lewis continues to eat well, and will walk on the leg when he needs to. He had an opportunity to come home while we await the next evaluation. However, we felt that since the wound still needed daily flushing, and his condition was still guarded, that he was best left at the hospital under close care of trained professionals and staff. We reluctantly left Lewis, knowing he would have enjoyed a respite from the stall confinement, but feared the danger in moving him several hours in our van and caring for him at home were potentially more risky than leaving him in his safe environment. As long as he continues to cope with his situation, we feel he is better off there. We miss him and hope that he can continue to improve to the point where perhaps in a few more weeks, we can bring him home for good!

A Visit and a Walk

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Lewis goes for a walk and munches on the grass

We visited Lewis Friday afternoon, and were able to image walk him out on the lawn outside the facility for some sunshine and grass. The winter has been long in the Midwest this year and the grass is just starting to green up and the air get comfortable. It is hard to believe Lewis has been at OSU for two whole months! He underwent some depression during the past few weeks that was relieved by daily walks outside. He seemed pretty bright and although a little quiet, considering what he has been through, it is obvious that the special care he is receiving is keeping him in the fight back to health.

Dr. Silveira feels the radiographs show enough recovery of bone callous to make him able to tolerate the next surgery and debridement of last infected tissue. If he removes the bone plate, he will install an external fixator to stabilize the leg. Dr. Silveira will be making these judgment calls once he begins surgery and can see the current status of the bone. For the long term, the bone plate should come out, but whether this is the time to do that will be determined during surgery.

Surgery is slated for next Tuesday. Our prayers are with Lewis and with Dr. Silveira to guide him. Lewis will still have a long recovery ahead but perhaps this will be the last surgery, and he can begin a more speedy recovery after this!

Surgery and After

Surgery and AfterLewis has had his first day of recovery after surgery on March 28. He is reported in good spirits and eating, as well as standing. However his exercise will have to be limited due to the fear of putting too much stress on the fracture at this time.

The good news after the surgery was that it went well, with Dr. Silveira debriding considerable dead bone and tissue. He also removed the plate and all the screws, so these will not be able to cause any future problems or infection. An external fixator now supports the leg instead of the bone plate. The fixator can be much more easily removed once it is no longer needed. The bone was packed with antibiotic “beads” and a drain installed for twice daily flushing to prevent further infection. The doctor is optimistic that he has achieved the intended clean up of the bone and surrounding tissue.

The bad news is that the bone callous was not sufficient to supply any support for the leg. Considerable dead tissue was removed, so that the leg is essential broken again. Lewis’ two greatest risks at this time are that the leg could collapse, or that he could become depressed and stop eating. Since everyone is reluctant to take him for his daily walks outdoors, depression is a real danger. However, exercise could stress the leg beyond what it might be able to handle. What a dilemma!

Lewis’ previous stall mate, the beautiful female alpaca on loan from the university research program, is due to have a baby! Lewis now has another buddy, a male alpaca, who is keeping him company.

We appreciate the emails and calls we have received about Lewis. Your prayers are needed more than ever now, as Lewis’ prognosis is guarded until significant bone growth can occur to support the leg safely. The staff at OSU continues to take the best of care of him, and they try to keep his spirits up during this long ordeal. We thank everyone more than you can know!

In Good Spirits and Walking

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Lewis and his Alpaca Buddy

I must apologize for not making more frequent updates; and thank everyone for their emails about Lewis. The latest information is that Lewis’ spirits are good, and he is being walked outside in the lovely spring weather we have finally been getting here in Indiana. He has a new stall mate, an alpaca nick-named “Psycho,” who he tries to steal food from! Obviously his appetite is still good which is always a good sign. The circulation in his lower leg appeared to be affected after the surgery. Hydrotherapy and time have improved this and the leg seems warmer now and he is using it to walk; all good indications.The fixator has been holding now for over two weeks, also a critical factor. However, there is still exudate and infection which is not responding completely to treatment. Lewis will have more radiographs next week to evaluate his progress. The continued infection is worrisome, but his general condition under the circumstances and willingness to keep fighting are encouraging.

The staff at OSU have taken some digital photos of Lewis and the gang, and we hope to put some of them on the site here as soon as we get them, so check back!

Slow Progress Continues

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Lewis’ Leg Showing External Fixator

Lewis did not get the radiographic exam that he was due to have earlier this week. The technicians felt they needed to manipulate the leg to accurately evaluate the condition of the bone, and the doctors felt that it might be too early to perform such manipulation. Since Lewis continues to walk on and use the leg, we are hoping that healing is occurring.The infection may be lessoning, with the drainage beginning to clear up. Lewis’ spirits are such that he still wants to steal food from Psycho; so he has some of his original “gumption” still there! We are so pleased to hear that despite the long confinement and challenging process of healing, that Lewis is “still Lewis.” We owe the staff at OSU more than they can imagine!

A Visit from Home

Lewis had his radiographs, which showed improvement though not complete bone closure yet. When we visited Saturday night we were able to meet one of the students who is taking care of Lewis, and also met another of the students who visited us at the llama show we attended near Columbus. It is obvious what wonderful individuals these are who are helping Lewis cope with his difficulties and day to day trials!Lewis seemed very well to us, much more like himself than on our previous visit. He is adapting quite well to his circumstances, and proving what a fighter he is. We are pleased that he seems comfortable and has an appetite, and is not losing his appetite for live despite his long confinement and daily injections and wound care. The infection is still ongoing and may not clear up until all the external pins are removed. In the meantime we feel Lewis is enjoying a quality of life that is remarkable given the circumstances; our thanks again to the staff at OSU for going the extra mile to make this little llama happy and comfortable!

Fixator is being removed!

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Lewis’ Leg after one Fixator Removed

I spoke with Dr. Silveira today, who confirmed that Lewis was still doing well. He also surprised me when he told me that they are beginning to remove the fixator! One bar had been removed the previous week, and he had just removed the second bar this morning. Only one bar and four pins remain supporting the leg. They felt it was time to introduce some stress to the bone, “micro-motion” that would help the bone callous and induce bone remodeling to complete the healing process. He said Lewis was using the leg but was a little more unstable after the bar removal. This was to be expected, and a limited amount of stress will help healing. Of course I am anxious that the bone does not break, but time has come to move to this new step!They plan to remove the final bar in a week or so. At that time, Lewis will have not support for the leg other than his own bone. If all holds together, Dr. Silveria said we could talk about taking him HOME!

Your thoughts and prayers for Lewis are very appreciated now that he is in the final and critical stage of his healing. If the bone can mend and the infection gets cleared up, Lewis can come home!