Desert & Devastation

We just returned from 2 1/2 weeks in the southern California mountains and deserts. What a wonderful break from the snows and rains of this area. In fact, our timing was so good, we missed the torrential rains that caused the flooding and avalanches.

The first portion of our trip was more urban. My husband had to work a few days and we wanted to visit our nephew before he deploys. Both occasions placed us in big California cities. Lucy was quite sick during this period—lots of vomiting and phone calls to the specialty vet back home. We took her off the doxycycline for her nose and that helped, but didn't completely solve the issue. A type of chew that I've given her for years also seemed to upset her stomach, so that was also removed and her energy and well-being improved.

When her health was assured, we got her back to running with us, and though it usually wasn't daily, she did manage every other day. We kept her distance within 7 miles. She loved it! Happy! Spunky! Raring to go! One of the downsides of the desert were burrs from cactus. Not a good mix on dog feet. We had to be very vigilant where we took her and to check her paws carefully during and after. The picture is taken at Mt. Shasta. In January, the trail was covered in dry oak leaves. Lovely!

Surprisingly, or maybe not considering we were in dry deserts, her nose seemed to clear up—even off the doxy. There was still the reverse sneezing and some hacking, but not the constant goobery schnoz.

We returned to cold, damp, foggy weather. Lucy's nose immediately reacted. Constant. And her health went rapidly down hill. From being energetic and running miles, suddenly she wasn't eating or wanting to go on walks. When I got home from work and she didn't even raise her head from her bed, I knew something was horribly wrong. Pneumonia again?

I took her to the vet two days ago and got the results yesterday. I won't hear about pneumonia or not until I get those results today, but yesterday was awful—she has lymphoma. The vet said doing nothing, she might live a couple of weeks to a month; with prednisone, I could double that; with chemo, perhaps a year. The vet gave her some antibiotics while there and that seemed to revive her. For the first time in days, she ate and wanted to go on a walk.

All the "cure" methods are limited; the cancer isn't going away. The chemo would involve weekly vet visits with 1/2 hour drips—and that would be for 6 months or more. Lucy is going on 12 and hates the vet. (Who could blame her? She's spent so much time there in the past 2 years!) We don't want to make her miserable by constant vet visits, even if it might prolong her stay with us. I'm willing to do the prednisone. The vet said it could put the cancer temporarily into remission, but prednisone has its own downside.

When my husband returns tonight, we'll talk about which options we want to pursue. It's awful playing the Final Arbitrator in someone else's life. Although we'd love Lucy to live years and years, we'd want those years to be healthy, happy years. If her time is now, we need to be able to graciously and lovingly allow her to comfortably enter it.

A little sad on a beautiful day

It's sunny and lovely today, but very cold. I'm a bit sad which seems odd when it is beautiful outside. Lucy's breathing is labored today and her hacking and gagging have become quite pronounced. I fear her larynx is becoming worse and creating problems.

I spoke with a neighbor yesterday whose daughter had to put her dog to sleep. The dog was fairly young, but had increasingly complex medical issues. In the end, her body just couldn't keep up with her mind. I applaud the woman for understanding her dog had lost its quality of life. That takes enormous courage. I hope I recognize that for Lucy when the time comes.

We're dog-sitting her cousin, Molly. Molly's 10 month-old energy seems to be enervating for Lucy instead of energizing. Molly demands attention and is as big as Lucy and perhaps heavier. Although she recognizes Lucy-as-Boss, she crashes into her, wriggles past her, is in her face. I want the dogs to work it out themselves, but at this point, unless I intervene, Lucy just goes off to her bed rather than compete with the puppy. I try and give Lucy lots of love and reassurance, but unless the puppy is sequestered, she is so present.

Second Snowfall

It's beautiful and quiet. I have a fire going in the stove and Christmas music playing. Perhaps a tray of cookies in the oven would be appropriate. Lucy, like all dogs, loves the snow. And like a small child with a runny nose, she has her perpetual stringers, now a bit frozen on her face. I have a stack of adult handkerchiefs that I keep by her leash for walks. In house, it's kleenex.

Here are two shots of her enjoying the weather. One is quite blurry, but I still like it. She's looking for a "R-A-T." In the other, she's licking off the offending drips.

Cold!

It is so cold here in the NW! The weathermen say we are in the longest cold snap we've had in nearly two decades. Day time temps are never above 30. Nights are in the teens. Lucy is in heaven. Snow on the ground and temps that make her ears crisp, her nose ice cold and her heart spunky. Everything is a treat for her when it's cold. And her nose is better. Is it the drugs or the temp?

After my sister-in-law suggested it, I bought a baby nose syringe to try when Lucy's nose is filled. As she put it, babies can't blow their nose either, so I thought I'd give it a try. The first one I bought was an ear syringe for adults (as they were out of the baby equivalent) and she hated that, so it is now in the back of the bathroom cupboard. Today I purchased from another store a baby nose syringe with a detachable tip for easy cleaning. How wonderful!! I don't doubt that Lucy will be equally dismayed by the prospect, but it might help with all the goobers.

New Drugs, New Cocktail Ball

Lucy had access to her cocktail ball last night. It is the first time I've allowed her to play with it since it was taken away. Not only was it taken away, it was thrown away and replaced with a new one. I decided to pitch it as I was concerned there could be bacteria on it that was re-infecting her. I'll never know the answer to that one, although her nose wasn't terribly runny afterwards.

She is also on a new antibiotic: Clavamox. Her nose was getting more and more goopy—both nostrils—and she was obviously suffering from some bacteria. The vet decided we should "pulse" (their word) antibiotics, so we've stopped the Doxycyline for this new one. It was made a huge difference both in the amount of nose goo and, within a day, the color.

Edited to add (many hours later): as of this afternoon's walk, the color is as bad as ever!

Abstinence

Lucy's nose has been active recently. Both nostrils are running now and the goo is yellow-green. Gross. I'm sorry. I never thought I'd be so attuned to this kind of thing and I feel for parents with children who are chronically ill. Your life becomes focused on little things that others would rather ignore. What concerns me is that Lucy is already on antibiotics, so does this mean that she has built up an immunity to doxycycline or that the bacteria is getting an upper hand (stronger, meaner) or something else is going on? The vet and I are becoming best friends.

So what does this have to do with abstinence? Her cocktail ball has been removed. This is her most favorite toy. In fact, it is the only toy she's had that she hasn't lost interest in. At cocktail hour, she starts hounding me to produce the famous orange ball. Unfortunately, it requires a lot of nose action from her: rolling, snorting, poking—and all of those things seem to aggravate an already delicate schnoz. In order to (hopefully) clear up her nose, I've taken her ball away. Last night was the first and she definitely was not happy about it. She waited patiently at first and then not so patiently. She wandered around looking for it, she talked to me about it, gave me the hopeful eye, then the pleading eye, then the evil eye. She will not see it tonight either.

It is difficult to explain abstinence to a dog.

Grateful

We're care-taking Suki for a couple of days while her owners are away. She has declined dramatically since the last time she was here. It takes a lot of manpower to wake her and get her going, and once up, she's only there for a short time before going back to bed. I've "carpeted" the kitchen in non-skid rugs, so when she gets up, she can get to the water bowl without slipping. Her coordination is quite sketchy as she suffers from awful arthritis and her toenails are so long.

She is still eating, but seems to have a difficult time working her tongue and spends more time moving her kibbles around rather than scooping them up. We are using a carpeted ramp her owners brought over for her to get up and down our back stairs (of which there are three). She is good going down the ramp, though she sometimes slips her way down. Coming up, however, is much more difficult. Surprisingly, although she is not a "morning" dog, she seems more coordinated at that time and is able to get up the ramp to come in. In the evening, she needs encouragement and a bit of guidance to maneuver up.

When she first arrived five days ago, I think she was quite confused. When she was awake, her time was spent staring at nothing. This morning, for the first time, she got up with us (5:30AM), went outside, ate breakfast and had her morning biscuit. That was wonderful and very active for her.

Lucy is doing well. Although both nostrils now suffer from rhinitis, she is enthused and involved. Over this past weekend, she ran a total of nearly 12 miles—five on Saturday, the rest on Sunday. She was eager afterward, and appeared neither exhausted nor experienced difficulty breathing. Granted, the weather was cool, but who cares? I am so happy she is such a willing participant.

I am grateful she is still with us, mentally and physically. It makes me even more solicitous towards Lucy and I tell her regularly how much I love her.

I also feel for Suki's owners as I know they will soon have to make an awful decision—the one we hate to make, but are grateful we can offer. With Suki, I've spent several evenings on the floor by her bed letting her know what a fine girl-dog she is and how much we've enjoyed our time with her.

What would we do without our wonderful dog companions? I can't imagine how anyone could treat a dog cruelly or chain them outside and ignore them. They give us so much and ask for so little in return. Our lives are enriched immeasurably by them.

Bad Factory Parts & Old Age

I guess I have to get used to the fact that Lucy's health issues are cyclical. She's once again had several days of reverse sneezing and a runny nose. The last two days she's thrown up her food. That's a new feature, one that I'm unsure is caused by her partially paralyzed larynx or the drugs she must take for rhinitis...or both. She remains eager for a walk, but not so eager to eat. I don't blame her; I wouldn't want to eat either if it meant food wasn't going to stay down.

We were at our in-laws home for Thanksgiving and Lucy piddled inside. This was done purposefully, not like the past where she was dribbling in her sleep. None-the-less, I was a tad embarrassed. Lucy also had a sneezing attack that was severe enough to give her a bloody nose. I think her problem lay with the commotion of Thanksgiving with the puppy, all the extra people, and the fact that she couldn't find that damn cat she could still smell. (The cat is one of their many past pets that has been squished on their street. We won't go there, but the cat met its demise about a month ago.)

This morning she didn't eat her breakfast, but waited until several hours later. We'll see if she keeps it down.

Answers?

The internal medicine vet called today. That pleased me as I was feeling disgruntled that no one from that clinic had called since Lucy's procedure or after I brought her back in on Sunday. Kate's office had already called twice to see how she was doing and they were not involved with the rhinoscopy. (A loyalty booster there!)

The vet (Matt Vaughn) said she has chronic rhinitis. (A friend told me it's the same as hay fever in a person. That sounds so benign compared to the problems she exhibited.) He said there are five types of inflammatory cells. The two he expected to see in Lucy—and did—were lymphocytes and plasmacytes. But with Luce, he also saw neutrophils which usually indicate a bacterial infection which he did not see. He wanted to know how her appetite and energy levels were. I was pleased to report: good! Her nasal discharge is diminishing. My concerns are the reverse sneezing is still with us and she now is constantly clearing her throat via coughing or hacking and she still goes through periods of panting.

I asked him if the intubation could have caused this temporarily or if might have permanently injured her throat/trachea. He said no to the latter and that it is possible the balloon that is used to close off the throat (so she doesn't swallow anything) may have irritated the lining, but felt this not as likely. More probable he said was that she may have aspirated something.

He was very clear—and emphatic—if she isn't better, or she gets worse, by Monday to let him know. It may be the Piroxicam isn't her drug or that we need to put her on an additional antibiotic to clear up what ever is bothering her throat.

She has only barked a couple of times since she's been home and those are feeble, weak barks. They were followed by coughing. He kept referring to her laryngeal paralysis. Initially I thought this was simply the issue of an older dog losing its voice. Au contraire. It's a much bigger deal than I thought. A bad episode in which the dog is heavily panting may see the dog's gums turning blue from lack of oxygen. The dog can collapse and die.

Matt said he didn't recommend surgery on Lucy at this point because she is in a cool climate. He said if she was a warm climate, he'd definitely urge us to have the surgery. Here is a website that has some good information and three short audio files to hear what the stressed panting sounds like. At this point, Lucy only sounds a bit like the last black lab with a cough interspersed. Hopefully this is something we don't have to worry about with her beyond managing her activity level.

His warning, however, is well taken. We'll keep her calm and cool if possible. I didn't think to ask him at the time if she can go mountain biking. I guess we'll just have to closely monitor her.

What a Weekend!

It was a tough weekend for Lucy and me. She felt awful and I felt guilty for putting her through all of this. She slept all day Saturday, though I would consider it fitful. She was definitely conked out, but all of sudden would wake with an hour or more of heavy panting. Whether caused by pain or the inability to breath comfortably through compromised, tender nasal passages, breathing easily was not in the cards.

Saturday evening we had friends over for dinner and she not only got up to greet them, if slowly and quietly, but moved into the living room to sleep. Both big deals as far as I am concerned. The evening though, she woke around 1AM and had a good hour plus of heavy panting. She was obviously quite uncomfortable.

Sunday saw more of this labored breathing, heavy panting, hacking and her nose begun bleeding. Of all of those, I was least concerned about the blood as they had warned me that might happen. It wasn't excessive, so I figured it was okay. However, the laborious breathing did concern me. I took her back into the clinic and they felt she was okay, but gave me some pain killers (Tramadol) to relax her, help her sleep and maybe heal the irritation in both her nose and throat by relaxing her and therefore not stressing those areas.

What they were most concerned about was her lack of appetite as she needs food in her tummy for the Piroxicam they've sent home with her. They still lean towards chronic rhinitis, though the biopsy results will be in sometime this week. They recommended I warm her food to make it stinky and therefore more appetizing for her as her sniffer isn't sniffing very well at present.

I think her care was good. I think the tech did a good job debriefing us before we brought Lucy home. I'm also sure they told me things that I didn't hear as I was anxious about Lucy's well-being. However, I don't think they gave me enough information. I don't believe they told me that it would be days before Lucy returned to normal. I don't think they mentioned that her breathing would be labored and uncomfortable for her for days because both her nose and larynx/throat had be compromised by the procedures. They didn't say anything about how long it would take her nose to "come back." I mean, if she can't smell her food without warming it, that's pretty bad! And I know they didn't say whether the Piroxicam would eliminate, or affect at all, the symptoms that brought us to this event. This morning she had several bouts of reverse sneezing and anytime she gets up she starts a slow cough sequence that may or may not end with hacking. These are all things I wished they'd covered with me. Do I worry about this or not? The vet I saw yesterday said to give Lucy a week to return to normal, but she didn't think the Piroxicam would alleviate symptoms. It is an anti-inflammatory.

Rhinoscopy Completed

Dropping Lucy off at the vet yesterday morning was awful. When they led her away, she just turned and stared at me with those frightened, accusatory eyes. "What are you doing to me? Are you giving me away?" The CT and rhinoscopy both corroborated no (visible) cancer or aspergillosis. The vet took some biopsies and we won’t hear back on those until the middle/end of next week. His guess is chronic rhinitis. The good part is it can be managed, the bad part, it’s with her forever more.

Last night was pretty awful for her (and me) because she was so restless. Lots of panting and pacing. She did have a bit of nose bleeding, but nothing of concern. I put a mat on the floor in the kitchen (where we've had her at night since she had been piddling) and laid there thinking that having me close by might make her less anxious. Maybe it worked a little, but neither of us slept a wink. I called the vet around midnight and they recommended bringing her in (approximately 45 miles round trip) or give her a Benadryl. I opted for the Benadryl. She did lay down for almost 2 hours (I think I slept then), but she was up again and barfed.

So I called again. I didn’t know if her activity and panting were caused by pain from the procedure, drugs wearing off, or a bad reaction to a drug combination. They said come in or give her another Benadryl. The second one didn’t seem to have any effect on her at all. I got dressed to bring her in around 3AM, but again opted out and brought her bed into our bedroom.

She was more calm there and I think she was quiet for nearly an hour, before getting up and pacing again. I fed her some brown rice and turkey stock and she snarfed it, so I know her appetite is okay. I’ll give her some more time this morning and see if she evens out. I’m absolutely bleary-eyed from lack of sleep and would prefer not to drive in the dark and rain (my least safe driving conditions).

My guess is she’s okay and it is the pain and the anesthesia/meds (for which she’s always had a low tolerance) that are causing her anxiety. Now, nearly 4 hours since I fed her, she's sleeping comfortably and I'm getting ready for another cup of coffee—and hoping I make it until 8PM tonight!

Another roller coaster

Good news from the CT scan, right? Or at least not bad news. But now Lucy's peeing on her bed, on the rugs, on the floor. Not dribbling, peeing a full bladder's worth. When she's sleeping or lying down. Can she not feel it?!? This started last week and hit full stride by the weekend. What I originally thought was her runny nose, I know now was the start of her dribbling.

I took her to her normal vet this morning, but Kate was gone so the back up vet saw us. She took blood and a urine sample and said Lucy's white blood count was elevated, so gave me very expensive antibiotics for a bladder infection and another drug for urinary incontinence.

Friday she goes in for the rhinoscopy and there goes another four digit vet bill. Not that she isn't worth it, but the loss of personal income because of how the economy affects my job, along with the accumulation of unexpected large veterinary expenditures, is becoming overwhelming. The outlay makes me anxious, Lucy's health makes me anxious...

On the other hand, her appetite remains top notch!

Eureka!

It's a little after 3pm and we've just returned from Lucy's CT scan. Another wonderful clinic run by a great team: Veterinary Radiology in Mountlake Terrace. Excellent. Of course one of the finest things they did today was deliver good, if incomplete, news. Dr. Kramer said there is no detectable signs of cancer and he doubts Lucy has any aspergillosis. He doesn't know what she has and recommended we proceed with a rhinoscopy with biopsy of whatever Lucy has going on inside her nose. So it was very good news or at least better than we feared. There might still be something of concern, but at this point, I can sleep easy.

Here's an old picture of Lucy from 2002. I have to post it because she was so healthy then and hopefully, will be again!

Today's the day

This afternoon we take Lucy in for her CT scan. I'm anxious, of course, and Lucy is miffed she's getting neither her breakfast nor her morning biscuit. Unfortunately, the appointment isn't until noon, so she'll be a very hungry puppy by dinner.

Our fingers are crossed that they find nothing and that that indicates rhinitis, nothing worse.

Roller Coaster

Thursday I thought we might have to put Lucy to sleep. She was so ill. Awful reverse sneezing to the point she couldn't maintain her balance; gagging on drinking or eating; hugely lethargic. I was constantly in tears. I wanted to wait, however, for my husband to return from out of town so that he could say goodbye. Coming in late Thursday night didn't give him the opportunity, so we chose to wait until Friday afternoon when he returned from work. But we couldn't do it then; we just didn't have the heart. We knew Kate wouldn't be at the clinic on Saturday, so we decided to wait until Monday.

I sent Kate a long email asking about the efficacy of some alternative treatments: acupuncture, homeopathy, herbs and if she'd be willing to try them or preferred I sought out another vet with whom she could work. Because Lucy's nose drips are green (indicating infection), did she think it was worth putting her back on antibiotics? I called several alternative vets, but those who were highly recommended had a full client list and I had not heard of the others.

Saturday afternoon Lucy rallied. Big time rally. No nose goobers, no reverse sneezing, no gagging, good energy. I was hesitant but willing to think that perhaps she'd been suffering from a huge sinus infection and was now on the road to mend. Sunday afternoon dissuaded me of that thinking as the sneezing and runny nose came back with a vengeance. But no gagging—for that I'm grateful.

I heard back from Kate this morning. Besides being a vet, she is a certified animal acupuncturist, so I knew she'd be willing to consider alternative treatments. She said she'd be more than happy to explore different care modalities though she preferred to first know what we're dealing with. Though my husband would like to start Lucy immediately on antibiotics, I'd rather wait until after the CT scan when we can make more informed decisions.

Lucy's health remains on the positive side. We're concerned how voracious her appetite is, but at least she's eating. We just returned from a three mile walk done at a fast clip. At one point she had a leaf hanging from her nose goo, but she didn't seem bothered, so I chose not to mop her up.

I'm hoping to post a picture of her, if not every post, then close to that. Here she is sleeping last night while we were listening to music. With that perked ear, it looks like she was listening too!

Puddles

The last two mornings I've gotten up and found a huge, wet puddle left on the carpet from where Lucy's nose had drained over night. When she gets up, she's started coughing and hacking. Her energy is good on walks, her appetite is fine, but her symptoms continue to escalate.

I spent some time looking up nasal cancer and ended up sobbing. Both nasal cancer and aspergillosis have symptoms that match Lucy's. Now, after work, not even 5pm, I just had a beer. A beer? Anything but reading more about diseases.

My vet, the marvelous Kate Schottman, sent me many printouts, highlighted and notated, on aspergillosis. I tried looking, but couldn't quite stomach it yet.

As I type, Lucy's laying next to me, snoring and whistling. My girl.

Ups & Downs

I went to see Kate yesterday and feel much better though nothing was resolved or changed. Kate said she'd read up on aspergillosis to see if she could find out anything else for me. Not that I haven't been doing that myself, but I don't understand all the medical jargon and am relieved she'll be able to do some translating.

What I got from the consultation is aspergillosis is not that common although the fungus is everywhere. Kate felt that Lucy's symptom of one nostril being runny swayed her towards a tumor or some blockage other than aspergillosis or chronic rhinitis. She felt those would affect both nostrils. I don't know that that makes me feel better—a tumor versus a fungus?—but the progression of the fungus just sounds so sci-fi.

She also assured me if it was the fungus, Lucy's face wouldn't cave in. A silly fear, I know, but I was afraid if it eats away at the bone, that if she bumped her nose, there might be consequences we couldn't visually handle. She said it's more like periodontal disease, slow and invisible. I don't think that's any more pleasant, but I couldn't stand to see Lucy's face altered.

She also supported our decision to do nothing if it's cancer and to not do the ream and flush if aspergillosis. She can come to the house to put Lucy to sleep or prioritize us in a vet visit. That was helpful also.

So I came home yesterday feeling a bit better and thinking perhaps we'll put her through the CT and rhinoscopy just to see what is causing this. I remain conflicted on this because we've chosen not to treat either cancer or aspergillosis, but if it was a small irritant in her nose they could remove, then wouldn't it be worth it?

A depressing prognosis

We took her in Saturday to an internal medicine vet. He was wonderful: very informative and took the time to answer all the questions we posed. He said her lungs sounded fine, so no problem with recurring pneumonia. That was great news. Unfortunately, the meeting went emotionally downhill from there.

She could have cancer, aspergillosis, or chronic rhinitis but of course we won't know which of those without further tests. He recommended first getting a CT scan to see her head and throat structurally. It may show tumors or damage caused by aspergillosis. If the scan looks clean (or doesn't), they'd do a rhinoscopy to see inside the nasal cavities (they may see spores from aspergillosis). If it is cancer, he said radiation is better (and more expensive) than chemo. We've already decided we won't put her through that.

Aspergillosis—what an awful disease! From what I've read, it sounds more prevalent in younger dogs, which I find curious. Why would younger dogs (they specifically did not say puppies) be more affected? At any rate, it's a fungus that eats away at the nasal cavities and can move into the brain. If they see this on the rhinoscopy, they'd scrap out her nasal cavities trying to get as many of the spores as possible and the flush with an antifungal wash. He said he recommends three procedures, although they once did six on a dog and still found it unsuccessful. Plus Lucy could go through all of this and have it come back. His assistant said it is quite a painful procedure and the dog goes home with a pain patch...only to return to the hospital to have it done over again. The treatments run around $2500 a piece.

The tiny bit of information I've seen on rhinitis directs me back to aspergillosis. We're finding this overwhelming.

Lucy is 11 and if we're lucky she'll be with us another 2-3 years. I don't regret putting her through the back surgery despite the long recovery. But I don't think I can put her through the trauma of treatments for what she may be suffering from now. I don't feel it's fair to her, but I will talk to Lucy's regular vet and a neighbor (who is a vet tech) for their input. Perhaps a naturopathic vet may be an alternative. I just don't know.

Medical Maneuvering

I spoke with my vet today and she was kind enough to advise me without seeing Lucy. Lucy's nose issues remain status quo. She's still reverse sneezing (not as much as when she had pneumonia) and she is now "gakking"...making a noise that sounds like she's trying to cough up a fur ball. This happens when she's excited (about to go on a walk or car ride) or drinking water too quickly and makes me nervous about a possible tumor or polyp in her most prized possession—her schnoz.

I could let it ride, but then if it is a growth or something we can solve now, I'd hate to put it off. Kate (the vet) felt using Revolution 3 times in a month may indicate whether Lucy is suffering from nasal mites. However since Lucy is already taking it once a month, Kate thought this wasn't worth it. She recommended we go in for a consultation regarding a rhinoscopy. She recommended a vet (Sherry Wilson at Acces), but when I called regarding prices they were nearly double the cost at Seattle Veterinary Specialists. I think we'll go the less expensive route. Interestingly enough, when I spoke with someone at SVS, they said the cost could vary from $1100 dollars including consultation, surgery, possible over night stay and lab work. It would be less if all those things aren't necessary. Acces said it was $125 for the consultation, $1200-$1400 for the rhinoscopy—labs and overnights were on top of that. That's a fair chunk of change to throw around when there's a less expensive alternative!

Lucy reminds me of Clem, the dog we had growing up. Although veterinary medicine was pretty simplistic back then, Clem spent a lot of time there. He was always suffering from something. I guess dogs are no different than people. Some are just put together using better parts.