Trying One's Best

Lucy's breathing is getting more labored—not as in she can't breathe (lung issues), but that her nose is constricted. It isn't that goobery, so I can only assume that the chronic rhinitis has the inside passages inflamed. She can't take the Piroxicam (anti-inflammatory) anymore as it conflicts with the Prednisone (for cancer). The two together cause awful, horrible ulcers. So what can I do? Should I do?

I've contacted a holistic vet and am waiting for a response. Purportedly she's worked with a lot of cancer patients and has had good success. With Lucy's blood count being so awful, I'm not expecting much change for the cancer, but perhaps she could do something for the rhinitis allowing Luce to breathe more comfortably. None-the-less, I don't want to subject Lucy to the awful anxiety of vet visits.

I hate this "should I do this?" or "am I neglecting if I don't" quandary. I want Lucy to be comfortable. Bottom line. Consciously I realize tossing this back and forth before speaking with the holistic vet doesn't do me any good and just causes me to be anxious while doing nothing for Lucy.

I guess I should just be patient until I have the conversation...

Drug Reconnaissance

Lucy's drugs are running low, so I emailed the vet and got her response. The Sucralfate, Famotidine and Metronidazole can be stopped and saved for later use, if necessary. The antibiotics should be continued for another couple of weeks (depending on what a second xray shows) and the Prednizone is a lifer, for as long as we are blessed with her presence.

Days of Grace

Lucy had been doing well since late Saturday. We didn't have any other bicycling opportunities, but she's been alert and perky on walks. And of course with prednisone, food has kept her focused. She's even been playing with her cocktail ball again and with the benefit of antibiotics, her nose isn't quite as drippy as it's been in the past.

Our contact at SVS, Becca, called the other day to check on Lucy and I gave her the bad news. I must say, we've been extremely fortunate with the vets we've chosen. They've been attentive, in general, and hugely supportive at present.

My husband made a comment last night that gave us pause. It was something we'd both been thinking, but had chosen not to voice—that old "if I don't say it, it doesn't exist" kind of thing. I mentioned how Lucy doesn't like as much rubbing as she used to, so I was only lightly rubbing her now. He said that's because her body hurts and is uncomfortable. We were both quite for a moment, said some 'lovies' to Luce and went on to another conversation. We didn't want to wallow in that sad knowledge.

Today it's snowing again. There isn't a lot of snow, but it is sticking. Lucy only went a half block today before turning around to return home. Her pace was slow.

Golden Day

Saturday was a day of grace. Lucy was not particularly responsive in the morning and although she ate, she wasn't interested in going on a walk. I needed to pick up some Metronidazole for the diarrhea, so brought her along for the ride and perhaps some stimulation(?).

When we returned home, our van was parked in front with the side doors open. My husband was planning on going on a bike ride and had loaded his equipment inside. When Lucy saw the van, her ears perked up and she trotted over to the van and leapt inside! Joy! We decided we'd all go and while he rode, we'd walk.

She wanted no part of walking; she wanted to run! So he grabbed her leash and rode while she loped along side at her steady 7.5 mile clip. Her ears were up, her eyes bright and if dogs can grin, she was wearing a big one! She was so happy and of course, so were we. She went about 2 miles perky as could be.

I expected her to be a bit slowed down this morning, but she's been as chipper as ever. She was bouncy on the walk.

Her drugs du jour are...for her upset tummy:

• Sucralfate (1 gm) 3 X day
• Famotidine (20 mg) 2 X day

For the diarrhea:

• Metronidazole (250 mg) 2 X day

For the pneumonia:

• Baytril (68 mg) 1.5 X day
• Clavamox (375 mg) 2 X day

For the cancer:

• Prednisone (20 mg) 1 tablet 2 X day for 1 week, then 1/2 a tablet 2 X day

Her food is a combo of:

• 1 lb. organic burger
• 1/3 lb. organic liver
• 1 1/3 cup organic brown rice
• 4.5 TB canola oil
• 9 grams fish oil (or 9-1,000 mg capsules drained)

She's gobbling up the food which is stupendous. If she continues on eating (and living), the vet advises me to add 3.3 grams of calcium carbonate and 2.9 grams of dicalcium phosphate. She'll also give me some other recipes so I can vary the diet if Lucy starts getting finicky.

More Results

The blood test came back. Eighty percent of Lucy's blood cells (white and red) are abnormal. The vet said she's at stage 5 cancer. Five? I didn't even know there were that many levels. She said it could be leukemia or some other kind of lymphoma, but that in either case, chemo therapy would not be effective, so we're spared debating that course of action. Kate said she'd never seen blood levels like this...this abnormal, I think is what she meant. I didn't ask.

Lucy has horrible diarrhea. It's contained, meaning she has control over it, but it's basically thick water and rice. Is it the drugs? The cancer? The fact that her diet has changed to burger, liver and rice? All of them could be affecting her. I'm waiting for a call back from the vet to see what she recommends doing about it...if anything.

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.

Snow's Almost Gone!

Hurrah! The snow is almost gone! We've had 3 days of 40 degrees and the grass and pavement are visible. After one last shovel to open the driveway to the street yesterday, I drove for the first time since the 18th .

Molly is with us again. Lucy is getting used to her, but still growls if the puppy approaches while Lucy is getting pats.

Lucy is done with her Clavamox. I'm curious if her nose will stay bacteria-free. Fingers crossed; I can't imagine life on antibiotics is any better for a dog than for humans. The only thing that has come back with a vengeance is her reverse sneezing.

Hungover

Lucy is decidedly wiped out from Christmas. We were with in-laws Christmas day and Lucy was the recipient of many doggie presents which were all food. Being a good mom, I only gave her one, but there were lots of other people around and they were all treating her—she even got turkey! She's barely budged today and hasn't even sniffed her breakfast. It is so obvious she's hungover.

More Snow

The snow keeps coming. I've shoveled twice and am buying stock in Ibuprofen. We're dog-sitting Molly for five days. The dogs are in seventh heaven with this weather. Lucy is definitely showing old dog enthusiasm—spunkier, but not lively, while Molly is doing a drag course around the yard.

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.

Spunky

Lucy felt spunky last night. In fact, she was downright annoying in her persistence. It was great to witness! She wanted her cocktail ball now. I didn't want to give in, but she persisted. Talking, woofing, pawing, groaning—generally making herself heard and catered to. Did I give in? Yes. Eventually. I waited until she was quiet and then armed her toy. Here she is telling me to get a move on!

Play with me!


Pay attention to ME!

A bit of a set back

Lucy is experiencing a bit of a set back. I'm not sure why. She's been on Doxycycline since Friday evening and seemed a bit better by Sunday—not so typical of past antibiotics usage where she's been noticeably better in a couple of days. She improved, but only an iota. The improvement could have been my wishful thinking. Her runny nose seems to have gone away (thanks to the Piroxicam or the antibiotic?), but her hacking and coughing have started back up. The heavy breathing is back too.

I am wondering if it's because I have allowed her to play with her cocktail ball the last three nights which takes a lot of nose action and swallowing from a greater distance. Could this cause the hacking? Or is it because on a recent car ride, I let her hang her head out the window. Perhaps a snootful of air is irritating. I'm going to wait until the end of the week, unless things become far worse, before calling.

I like this picture of her. I'm aware most of her pictures show her lying down, but that's what an old girl dog does best. In this shot, she is eagerly waiting by her bowl for dinner. I've elevated them in hopes it will mitigate the coughing. She is looking at me askance because as far as she's concerned it is way past her dinner time and I should be feeding her NOW. This goes to show her appetite is just fine—as is her energy. She's always eager to go on a walk and still manages a fast clip.

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.