[9.52 pm, 12/01/2026] PPM 1: The history begins one day back on a Sunday morning where this patient was playing on the road along with his seven brothers, one of which is also a PaJR patient particularly being followed up for his scrotal hematoma and right femur fracture because of another unwitnessed but assumed road accident
[9.57 pm, 12/01/2026] PPM 1: The surviving but lacerated child was removed from the road and placed inside a home where dressing was done
[10.00 pm, 12/01/2026] PPM 1: One of the worrisome signs of sepsis that is currently being tracked in this child is that of loss of appetite and apathy and today's update is that it's been quite variable with some acceptance of water and milk through a syringe
It largely remains immobile as any movement provokes severe pain
[10:10 pm, 12/01/2026] PPM 3: Any painkillers exist?
[11:21 pm, 12/01/2026] PPM 4: Some antibiotics can be given through syringe?
[11:21 pm, 12/01/2026] PPM 4: Is there any hospital nearby?
[8:46 am, 13/01/2026] PPM 1: She's eating chicken pieces well. Looks like that is her pain killer for now.
Perhaps she is not in sepsis. Not sure of the role of antibiotic prophylaxis as overdone in urban ICUs.
There is a lot of stench from the serum that keeps exuding from the wound. That is something we hope will disappear soon
[9:05 am, 13/01/2026] PPM 5: I believe an anti-tetanus shot would have been administered? Its not generally practiced in Indian vet circles.
[9:26 am, 13/01/2026] PPM 1: Thanks for that input. I found an interesting case report here: https://pmc.ncbi.nlm.nih.gov/articles/PMC3113811/
I wonder if this one month old pup is still protected through her maternal antibodies?
We remember her mother too had become ill when she was a pup with jaundice and took a while to get back on her feet perhaps a few years back.
[7.38 pm, 16/01/2026] PPM 1: Today's wound update
[8:30 pm, 16/01/2026] PPM 1: https://youtu.be/1JZ4DnCkG-w?si=EF0iNI4hfwkkU7pR
[9:43 pm, 16/01/2026] PPM 5: Oh poor baby.
[12.23 pm, 18/01/2026] PPM 1: Sunday update:
Basked in the roof top sunlight. Felt cold inside the clinic yesterday. Lots of painful debridement
[8.17 pm, 20/01/2026] PPM 1: Patient update:
Today was slightly more active and playful
[8:28 pm, 20/01/2026] PPM 6: Sir, where is the puppy?
[8:29 pm, 20/01/2026] PPM 6: Looks badly injured.
[8:29 pm, 20/01/2026] PPM 1: In a patient advocate's home in Telangana.
More about it in the description box
[8:30 pm, 20/01/2026] PPM 1: He looks a lot like your puppy.
He was hit by a dumpster truck the Sunday prior to last Sunday
[8:32 pm, 20/01/2026] PPM 6: Yes Sir. Iam really surprised and also happy that even a dog is considered worthy of a PaJR. This is revolutionary. Will subtly pray for its recovery Sir
[9:48 pm, 20/01/2026] 44FPA: He will recover very quickly and play again .I pray from the bottom of my heart and strongly believe it.
[9:53 pm, 20/01/2026] PPM 6: Wonderful to see the prayers. Let the human patients also be given prayer and little bit of humanity from a medical doctor. Right now he is just a body to be treated with synthetic chemical formulations
[8.39 pm, 21/01/2026] PPM 1: Today's update
[6.53 pm, 22/01/2026] PPM 1: Slightly better appetite today
[7.19 pm, 23/01/2026] PPM 1: Has started actively limping around the room and then back to his bed
[8:33 pm, 23/01/2026] ppm 6: Wow
[8:39 pm, 23/01/2026] 44FPA: Darun
[9:48 pm, 25/01/2026] PPM 1: Today's Sunday update is also the child's two week anniversary since she was hit by the dumpster.
She has recovered alertness, playfulness and appetite overall since the first few days when the patient advocates thought that they may lose her to sepsis.
She still has a persistent pus discharge from her fractured right forelimb and I'm reminded of this previous PaJR by one of our previous students here: https://vaishnavimaguluri.blogspot.com/2023/07/general-medicine-case-report-osce.html?m=1
[9:50 pm, 25/01/2026] PPM 6: She is on the path to recovery Sir. She is a brave child. We humans should be ashamed to hit such a baby with a vehicle.
[9.53 pm, 25/01/2026] PPM 1: The patient advocates brought the patient to a bigger area where he could interact with the other dogs rescued in the past, one in 2021 and the other 2022 and was a bit overwhelmed by their curiosity and perhaps a tad bit of hostility following which he became extremely insecure and tried to hide inside the bed of one of the previous dogs!
[10:52 pm, 25/01/2026] PPM 7: This is an exclusive pajr..unique. Each one is....
[10.57 pm, 25/01/2026] PPM 8: ❤️
[5:16 am, 26/01/2026] PPM 6: If she is in hyderabad, I can meet her please
[12:27 pm, 26/01/2026] PPM 1: He is
[12:35 pm, 26/01/2026] PPM 6: Adress please Sir
[9:35 pm, 26/01/2026] PPM 1: No
[4:51 pm, 28/01/2026] PPM 6: Sir, how is he now?
[4:59 pm, 28/01/2026] PPM 1: Yesterday appeared better. Will ask the advocate to share again today
[5.37 pm, 28/01/2026] PPM 1: Now from the patient's advocate
[5.37 pm, 28/01/2026] PPM 1: Now from the patient's advocate
[9.47 am, 29/01/2026] PPM 1: Today morning
[9:17 am, 29/01/2026] PPM 6: How innocent he looks Sir. Is he eating something?
[10:38 am, 29/01/2026] PPM 1: Yes has a good appetite
[10:38 am, 29/01/2026] PPM 1: Would it be possible to find another home for him. This patient advocate already has two rescued dogs
[10:39 am, 29/01/2026] PPM 6: Yes Sir, I will try from my side.
[11.37 am 29/01/2026] PPM 9: Isn't it good to stay with mother? The biggest advocate[1:05 pm, 29/01/2026] PPM 1: Yes but with dogs who go by smell it can be unpredictable.
When this puppy was reintroduced by the current advocate to the mother and his siblings mother got violent and tried to attack her probably confused by the smell of medicines on his body.
Here's a video of the puppy with his mother immediately after the road traffic accident two weeks back 👇
[1:07 pm, 29/01/2026] PPM 1: Maternal instinct in dogs is most intense during the first 3 to 4 weeks postpartum, when mothers provide constant nursing, grooming, and protection. Intense care lasts about 10 days, after which outing time increases, with a sharp decline in attachment usually occurring around three weeks as puppies start transitioning to solid food.
[1:19 pm, 29/01/2026] PPM 9: Yes, that we see often. When a human baby falls, mother hits it so that next time baby walks well 😌
[1:19 pm, 29/01/2026] PPM 9: Too much of psychology intervention in past half Century has perhaps made the children go haywire in social norms 😜
[1:23 pm, 29/01/2026] PPM 9: Perhaps still there is a long way to understand postnatal blues in other species. However, an expert can tell us more as we delve into nuclear scans in vivo to chemical studies in vitro🙏🏻 31/01/2026 UPDATES
[3.32 pm, 01/02/2026] PPM 1: Today he was again reintroduced to his family but the mother appeared to have forgotten her as inferred from the video 👇
[4:03 pm, 01/02/2026] PPM 9: 🥰🤗
[4:03 pm, 01/02/2026] PPM 9: Healing perhaps
[4:04 pm, 01/02/2026] PPM 9: Worst scenario - 3 leg walking - life moves well (I have seen a mother on 3 legs)🙏🏻
[4:05 pm, 01/02/2026] PPM 9: Please don't think of amputation of foot pads unless the foot is danger to life with infection🙏🏻
[4:07 pm, 01/02/2026] PPM 9: After healing, gentle ROM of each joint - Shoulder girdle, elbow, wrist to have max range
[4:07 pm, 01/02/2026] PPM 1: Yes
Not sure if a surgery similar to our other PaJR patient of osteogenesis imperfecta could have been tried in this case
Link to our other child patient with osteogenesis imperfecta
👇
Osteogenesis imperfecta is blessed with early healing while infected bones go for non union.
Has become extremely playful
Chewed up the laptop cord
[10:44 pm, 02/02/2026] PPM 1: This shows why the laptop cord appeared as an enticing eatable
[10:51 pm, 02/02/2026] PPM 5: Yo Rascal.
[10:54 pm, 02/02/2026] PPM 8: https://youtube.com/shorts/EOX_6fLjSRk?si=xqJCiVLdEU9xBJp7
She is not getting as good care as I used to but I don't worry..
Because with me she was gentle secure safe happy but quickly learnt to show aggression give good fight and attack back when she lost my care.
I do care for her sometimes and she nearly same and just a little aggressive for her interests when I interrupt. I don't mind. I am happy to see independed kid
[11:13 pm, 02/02/2026] PPM 1: Who are her new care givers? When did you leave her with them?
[11:36 pm, 02/02/2026] PPM 8: Currently - my cook for 25 days.
[11:36 pm, 02/02/2026] PPM 8: Earlier some other people
[5:27 am, 03/02/2026] PPM 9:Wants you to have some relief from this ordeal of PaJR 😅
[5:29 am, 03/02/2026] PPM 9: Let him grow older he will find some way to chew the mobile 🤣
[9.55 pm, 04/02/2026] PPM 1: Today's update[9.38 am, 05/02/2026] PPM 1: This may have been useful for this child?
The osteomyelitic discharge from his right forelimb fracture site appears to have considerably reduced
[7:52 am, 16/02/2026] PPM 9: https://www.linkedin.com/posts/dr-anita-sharma-5b3454202_at-228-am-on-an-icy-road-in-manitoba-activity-7428864894458015745-f3y_?utm_source=social_share_send&utm_medium=android_app&rcm=ACoAAAE2ghQBjK5lO15tU56ZpW2a52Cm_ftnTNU&utm_campaign=whatsapp
[7:57 am, 16/02/2026] PPM 1: To quote:
" Loyalty doesn’t always scream.
Sometimes… it stays silent.
Sometimes… it stays still.
Even when the cold can kill.
Because real love isn’t a feeling.
It’s a choice.
And this dog chose…
not to leave."
[7:58 am, 16/02/2026] PPM 9: Titanic ❤️🙇🏽♂️
[8:22 am, 16/02/2026] PA: 👏👏👏👏👏Darun .. feeling very happy to see.
[8:32 am, 16/02/2026] PPM 1: Revisiting some key events in this PaJR from the last few weeks 👇
[16/01, 20:30] Puppy patient advocate: https://youtu.be/1JZ4DnCkG-w?si=EF0iNI4hfwkkU7pR
[20/01, 20:17] Puppy patient advocate: Patient update:
Today was slightly more active and playful
[20/01, 20:28] Puppy Psychologist: Sir, where is the puppy?
[20/01, 20:29] Puppy Psychologist: Looks badly injured.
[20/01, 20:29] puppy patient advocate: In a patient advocate's home in Telangana.
More about it in the description box
[01/02, 15:32] puppy patient advocate: Today he was again reintroduced to his family but the mother appeared to have forgotten her as inferred from the video 👇
[08/02, 09:04] puppy patient advocate: Today's update on this child's recovery: https://youtu.be/zBn0kpLYKpk?si=sfQxskkLa6ektwjJ
The osteomyelitic discharge from his right forelimb fracture site appears to have considerably reduced.
[10.35 am, 16/02/2026] PPM 1: Update on other similar and currently celebrity patients 👇
"On January 12, 2026, following a short one hour surgery, the doctor, surgeon and care team described the issue as a tear in the cranial cruciate ligament (CCL), described as common in dogs, which required a tibial plateau-leveling osteotomy (TPLO).[10][11][12]
Aloka's care plan will allow him to rejoin the monks on the walk, but limit him to walking no more than ten minutes at a time, up to six times per day during the first week of recovery and gradually increase activity thereafter."
[11.13 am, 22/02/2026] PPM 1: Nature's stitches to this child's degloving injury photographed today, one and a half months later
[12:03 pm, 22/02/2026] PPM 6: Wonderful see the tiny life to have healed. Puppy should get a good family
[12:08 pm, 22/02/2026] PPM 9: Already got. Perhaps born with great 💫
[12:16 pm, 22/02/2026] PPM 1: The patient advocates already have two kids and are hoping to find another family that can adopt this third one @PPM6 preferably before they become too attached
[12:44 pm, 22/02/2026] 44FPA: Darun👏🏼
[1:27 pm, 22/02/2026] PPM 6: Yes Sir
[27/02, 09:50]hu1: MOC (months old child) went away with his brothers and sister gambolling. He was too happy.
[27/02, 09:51]hu1: Initially they were there in front of the house, now not seen.
[27/02, 09:52]hu1: Let us see how he remains through the day. What he prefers
[27/02, 09:53]hu1: Her mother kept on barking initially as usual unwilling to accept her back into the family.
But now I don't hear her.
[27/02, 09:55]hu2: He and his sibs will prefer to live in your home anyday!
[27/02, 10:13]hu1: My happiness was short lived.
[27/02, 10:13]hu1: Too much expectation, I guess.
[27/02, 10:14]hu1: The first signal was the senior resident dog's grumble showing his annoyance.
Then I heard his tiny but powerful squeaks outside the gate
[27/02, 10:15]hu1: He is back in front of the bathroom door on the carpet
[6:44 pm, 27/02/2026] PPM 1: Today's evening update:
[6:46 pm, 27/02/2026] PPM 5: lucky fella!
[7:19 pm, 28/02/2026] PPM 2: @PaJR Health how has this little pup been doing over the last few weeks?
[7:19 pm, 28/02/2026] PPM 2: (Checking qwen LLM)
[7:20 pm, 28/02/2026] PaJR Health: Here is a summary of the pup's condition over the last few weeks:
*PUP'S CLINICAL OVERVIEW*
📋 *Case Record:* Months old child post road trauma 1 day Telangana PaJR - 🔗 https://pajrcasereporter.blogspot.com/2026/01/1mth-old-child-post-road-trauma-1-day.html
*CLINICAL PROGRESS (LAST FEW WEEKS)*
🔹 *Late January (Jan 25 - Jan 31):*
* The pup presented with severe skin pathology, including extensive erythema, inflammation, purulent exudate, crusting, and alopecia on its limbs.
* Specific injuries noted were a deep, linear laceration on the left shoulder/foreleg (possibly sutured), an irregular, open abrasion on the left distal foreleg/dorsal paw with moderate edema, and an ulcerated right front paw with possible cellulitis.
* A circular wound on the right forelimb also showed signs of active infection (cellulitis, purulent exudate).
* Nutrition logs indicate the pup was receiving dry kibble, soft/mashed food, and a meal of rice with vegetables, Idli, and curry.
🔹 *Early February (Feb 1 - Feb 2):*
* On February 1st, the pup was reintroduced to its family, but the mother appeared to have forgotten it.
* Observations indicated periods where the pup appeared relaxed and alert, with a healthy body condition and clean fur, suggesting some improvement or observations of different body areas.
* However, other logs from this period still described crusted lesions, dried blood staining on the left distal forelimb, and a healing surgical site with sutures on the dorsal cervical/thoracic region. The pup was noted to be alert and responsive.
🔹 *Mid-February (Feb 8 - Feb 16):*
* 📈 A significant positive update on February 8th indicated that the osteomyelitic discharge from the right forelimb fracture site had considerably reduced.
* Observations on February 16th noted the pup as slender, with disheveled and matted pelage, and patchy yellow-brown discoloration, which could suggest issues with hygiene or ongoing recovery. However, no overt open wounds or purulent exudate were visible from the perspective of these specific observations, and the pup appeared without distress in some instances.
* Nutrition logs from this period included a solid food item and a white powdered substance.
Overall, the pup has been undergoing a recovery process from significant road trauma, with initial severe injuries gradually showing signs of healing and reduced infection. There has been a notable reduction in osteomyelitic discharge, indicating progress in recovery.
[7:22 pm, 28/02/2026] PPM 2: @PPM1 Sir this was Gemini again. Will try qwen below
[7:22 pm, 28/02/2026] PaJR Health: *PUP'S CLINICAL UPDATE (FEB 28, 2026)*
📋 *Case Record:* Months old child post road trauma 1 day Telangana PaJR - 🔗 [Case Link](https://pajrcasereporter.blogspot.com/2026/01/1mth-old-child-post-road-trauma-1-day.html)
*KEY FINDINGS (LATEST 4 WEEKS):*
🔹 *Wound Progression:*
- Multiple injuries documented in late January (deep lacerations, abrasions, infections) showed gradual healing by early February, with reduced erythema and no active purulent discharge.
- A surgical site on the neck/shoulder (closed with sutures) exhibited mild erythema but no dehiscence or infection by Feb 2.
🔹 *Infection Control:*
- Osteomyelitic discharge from the right forelimb fracture site *"considerably reduced"* by Feb 8, indicating positive response to treatment.
🔹 *Behavior & Environment:*
- Pup observed as alert and responsive in most logs, though body condition fluctuated (slender with matted fur noted on Feb 16).
- Environment described as "unkempt" in multiple logs, raising concerns about hygiene and risk of reinfection.
🔹 *Nutrition:*
- Diet included dry kibble, soft food, and home-cooked meals (rice, Idli, curry). Caloric intake appeared adequate but inconsistent.
*CONCLUSION:*
The pup has shown *moderate improvement* since the initial trauma, with reduced infection markers and partial wound healing. However, ongoing risks include environmental hygiene, nutritional consistency, and potential complications from prior injuries. No new updates documented after Feb 16.
Let me know if you'd like to explore specific aspects of the case further. 🐾
[7:24 pm, 28/02/2026] PPM 2: @PPM1 Sir qwen being a bit too cautious?
[7:51 pm, 28/02/2026] PPM 1: Also did it hallucinate the idli?
[7:52 pm, 28/02/2026] PPM 2: At some point in the several pictures, it may have shown up!
[7:54 pm, 28/02/2026] PPM 1: 👆this it may have confused. It's rice alone and he used to take lots of chicken and fish with hard bones that he used to chew well from day 1
[7:57 pm, 28/02/2026] PPM 2: Misinterpretation but not hallucination then.
[8.03 pm, 03/03/2026] PPM 9: https://www.linkedin.com/posts/thebetterindia_happyholi-holi2026-animalcare-activity-7434606020058050560-hL_y?utm_source=social_share_send&utm_medium=android_app&rcm=ACoAAAE2ghQBjK5lO15tU56ZpW2a52Cm_ftnTNU&utm_campaign=whatsapp
[8.42 am, 08/03/2026] PPM 1: Today's Sunday update on the months old child
[8.43 am, 08/03/2026] PPM 1: His osteomyelitic wound still appears to be a dormant volcano
[9:24 am, 08/03/2026] PPM 9: Humans suffer a lot perhaps due to exposure to antibiotics. I hope this baby won't if natural food and immunity takes care
[9:25 am, 08/03/2026] PPM 9: I had reported a patient long back that didn't reach publication however
[9:26 am, 08/03/2026] PPM 9: Many cases on "mangled limb" present the decision tree for humans, but pup may be different🤗
[12.01 pm, 08/03/2026] PPM 1: Let's report it now through PaJR.[7.17 am, 13/03/2026] PPM 8: Sultan
[3:33 pm, 14/03/2026] PPM 8: I love this slow medicine.
[4:16 pm, 14/03/2026] 44FPA: If a patient develops a relationship with a Doctor based on the trust, faith and respectful communication talking about hobbies, tea, tourist spot, the weather, nature or other topics then it becomes much more effective. Strongly believe that in such a situation the patient can recover more faster, sometimes even without medicine. I have realised this with own experience.
[4:19 pm, 14/03/2026] PPM 6: This does not fit with medical model of treatment please. There is no medical evidence of this relationship stuff.
[4:19 pm, 14/03/2026] PPM 6: A sick body needs to be treated with medicine.
[4:26 pm, 14/03/2026] 44FPA: Of course medicine is definitely necessary, but in many cases the required dose of medicine can even be reduced. It may be wrong sir...
[4:29 pm, 14/03/2026] PPM 6: Sorry Madam, there might be some truth in what you said but there is nothing in the medical curriculum nor in medical evidence of the relationship aspect between a doctor and patient. And healing
[4:30 pm, 14/03/2026] PPM 8: We can create evidence.
[4:33 pm, 14/03/2026] PPM 8: Modern day Indian dr. Pt. Relationship - too formal and minimal
Doctor-patient topic relationship in books. Formal
Dr pt relationship being advocated for family Physicians - less formal.
Community dr / hcw years back and now - a little informal
What I like - a little more informal to open scope for further detailed insight on psycho-socio-neuro-immuno-financial (way of life) aspects of patient life.
[4:34 pm, 14/03/2026] PPM 8: Important to learn superempathy (or atleast boundaries) to handle it well.
[4:35 pm, 14/03/2026] PPM 8: Relationships invite politics dynamics that creates scope for more damage than good. To pt. Or to dr. Its present now also.
A patient party requesting help with 🙏 can become violent enemy the next moment.
[4:36 pm, 14/03/2026] PPM 6: This is the reason why the patient is just treated with medicine. It is convenient for both.
[4:37 pm, 14/03/2026] PPM 8: Relationship word is vague without clarity of boundry so I am unable to perfectly share my view but I acknowledge that there must be a self decided boundry pattern.
[4:42 pm, 14/03/2026] PPM 8: May be I should just change context and things will fit well.
Context where this exist - not clinic or hospital but old age home, orphanage, small remote rural community. (may be luxury centers of healthcare tourism)
With PaJR model hospital and clinic can extend where dr. Pt. Relationship can enter home.
Eg. Kitchen visit by MBBS in Cuba for treatment of unhealthy eating patterns by education and throwing bad items in trash.
[4:44 pm, 14/03/2026] PPM 8: Eg. Food plates we see from pt. And our food plate/eating habit that we can sometimes show to patient if we want to add the "lead by example".
[4:45 pm, 14/03/2026] PPM 8: Human behavior is complex, so no strategy is magic bullet and have varying effect on case to case basis.
[6.37 am, 15/03/2026] PPM 1: Today's dental update on the child
Bowel update
No comments:
Post a Comment