Blue underwent his second CT scan and dorsal cervical exploratory surgery on December 4, 2024.

During the procedure, nearly 5 pounds of “mass” was removed from his neck! (Photo below—please note, the image may be graphic, so proceed cautiously before clicking the link at the end of this post.)

We have not yet visited Blue in the ICU, as the staff believes it could upset him too much when we leave. They estimate he will remain in the ICU for another 24-48 hours.

We check in with the ICU team several times a day, and they report that Blue is doing “okay.” He drinks small amounts of water, eats a little chicken, and occasionally wanders around the ICU. Unsurprisingly, the staff tells us how much they adore him.

The swelling around his neck remains a concern. Doctors are unsure if it is entirely surgery-related or if he is still bleeding internally. They suspect two possible underlying bleeding disorders: Von Willebrand Disease (VWD) or a rare blood cancer. Despite the significant impact of the brick wall three months ago, they believe the blood vessels should have healed by now.

Neither of Blue’s parents had VWD nor were carriers, so it’s unlikely he has or carries the condition. The hospital has sent a specialized blood test to Cornell University to confirm this and check for other blood disorders. Unfortunately, the results take about two weeks to process, so we are still waiting.

PHOTO OF 5LBS OF MASS REMOVED FROM BLUE’S NECK

Surgical Notes:
Procedure: CT scan, dorsal cervical explore

Pre-operatively, a 6 mm red area was noted on the left dorsal, lateral cervical region.
An incision was made over the dorsal cervical region, just to the left side. Multiple abnormal, small (2-3mm) blood vessels were present, associated with the superficial muscle. The fascia and muscle were opened along dorsal cervical midline. A large pocket containing hematoma-like material was present, with fibrous and soft adhesions to the surrounding facia.

The pocket extended:

• Left cranial, to the level of the wings of the atlas
• Left caudal in two layers to the caudal cervical region, near the thoracic inlet
• Right cranial, to the third cervical vertebra
• Right caudal, to the right of the caudal thoracic vertebra

Multiple abnormal (new?) blood vessels were associated with the hematoma and adhesions. Ligation was
performed copiously using the Ligasure and electrocautery. Small vessel (~3-4mm) venous bleeding was present in the left cranial pocket, and was ligated.

After ligation, the space was packed with lap sponges for 5 minutes. Small artiole bleeding was noted centrally (very mild), and was ligated additionally with the ligasure. The space was packed with lap sponges again, and no additional bleeding was noted after removal. Deep inspection into all the pockets revealed no additional bleeding.

After ligation, the space was packed with lap sponges for 5 minutes. Small artiole bleeding was noted centrally (very mild), and was ligated additionally with the ligasure. The space was packed with lap sponges again, and no additional bleeding was noted after removal. Deep inspection into all the pockets revealed no additional bleeding.

Ex vivo the hematoma weighed 1.85 kg.

A Bioguard bandage was placed.

Samples: Histopathology was submitted to MSU. Samples were submitted under Dr. Retallack.