The Dog House

the dog house

Thursday, 24 November 2011

Raine's Progress and Paige's Medical Update

Just a wee update.

Raine is finally making progress on the self contol front with regards to the other dogs.  A long-standing problem (learned on her first walk thanks to River) is her reaction to the excitement of starting our walks; she will charge, barge and bite (CBB) the other dogs, especially River.  This has started scraps in the past (understandably, I think) and she can be extremely unpleasant with it - not to mention uncontrollable!

Management has been the main thing to date; keeping hold of her at trigger times (house to car, leaving car, first 5 minutes of the walk, not having toys when her and River walk together), while at the same time, working on her responsiveness to me and rewarding the good stuff.

Yesterday, we managed an entire walk without her even attempting to CBB; today, although she did try, she stopped every time I asked her to and was very attentive for the whole walk.  Fantastic!

Paige's update isn't quite so exciting, although it's good in a way.  She had an x-ray on her dislocated toe on Monday; for the week before it had been swollen and sticking out a bit because it is so fat, with no sign of going back to normal so she went in.

Result is no fractures or boney changes or damage; no fluid; just soft tissue changes.  Good news, although the downside is that soft tissue damage takes an age to heal - and while we may defeat the lameness-after-running in time (possibly months), her toe may always be fat and sticking out.  But hey, at least it isn't broken; and at least the chances are very good she'll be able to run as normal in time.

Meantime, I've just got the fun task of trying to build her running up "gently".  Hmm.  Yes.

Wednesday, 16 November 2011

Remy - The Medical Mystery Continues

And so to Remy, my magical mystery dog.

Remy is a puzzle.  At a little over 2 years old, he became the opposite of your typical dobe.  Up till then he was textbook: completely mental, every walk at 100mph, the standard pattern on our countryside walks being Opi running off and him chasing, then her coming back to check in and him chasing, and repeat.  Never a hint of a sensible pace.  At a little over 2 years old, it just stopped.  He started to walk, then plod.  He gained weight; he got horribly cold intolerant (he does have alopecia, true, but it was not bad at this point).


We had his thyroid tested twice, after a lot of insistence; nothing (although the tests were utterly substandard, as I now know, and the vet a moron).  I moved up here not long afterwards and had his heart ECGd; normal.  This was a precaution - if you've read Soli's obituary then you'll understand.  If you haven't, you own a dobe and you've not heard of DCM, I suggest you have a read.

I digress.  In March 2008, he was finally diagnosed as being ever so slightly hypothyroid.  He went on meds.  Over the next few years, his dose was increased twice; then reduced earlier this year.  His symptoms never wavered with the exception of his lethargy - it just got worse.  By last autumn, he was regularly walking 50-100ft behind me at a snail's pace, clearly tired and even panting (Remy doesn't pant.  Ever.).

His heart was scanned properly in July last year - the same day that Soli's DCM was diagnosed and the first hints of Paige's future DCM were revealed.  His heart, though, was picture-perfect.

In November last year, I had him referred to try and pin down the cause of the lethargy, if it wasn't his thyroid.  Mild bronchitis was found, and treated; the panting stopped, as did a very infrequent cough that was so infrequent I thought it was hair in his throat from chews!  But, the lethargy continued.


I decided it was time for another full panel a la Dodds; the vets here tend to just test T4 which is wholly inadequate for a proper diagnosis, and many can't interpret the results properly.  On top of that, Dr Dodds has breed-specific reference ranges and within that, age, sex, weight and neuter status references as well.


I finally managed it last week - oh boy, the fun we have now!


To reiterate: Remy's symptoms have still not improved.  Worsened if anything; he now has hair loss going on on his ears, which are not typically affected by his brand of alopecia, he is more cold intolerant than ever, and the lethargy is still slowly getting worse.


So imagine everyone's shock when his result comes in as severely hypERthyroid - huge overdosing of soloxine!  Dose must be reduced immediately, as his T4 level was exactly double the maximum healthy figure.  Double.  And him, clinically hypOthyroid in every way.  Perplexing!  Back in August a vet described him as being clearly poorly medicated, and brachycardic (slow heart rate) - hypO.  When my vet examined him Monday just gone, she said he wasn't brachycardic (but did allow that this was not a surprise, as he was not only at the vets but had been trying to play with every dog in the waiting room...) but he was just normal - not the racing heart one would expect from such a result.



The notes on the report were minimal; stating the numbers, reduce the dose as follows, not much more.  No mention of the A4 page of notes I'd sent with the samples, so I emailed Dr Dodds (she'd been away on business, so the report was done by another vet).  She reiterated: the dose must be reduced.


Possibilities for his persistant symptoms were thus: a) his body was trying to excrete the T4 rapidly to prevent toxicosis, and thus he was not getting the benefit of the hormone and so was presenting as underactive; or b) he has a thyroxine-secreting tumour in his neck or chest.  Both feasible, although I do wonder about (a) when his symptoms have never improved even at a lower dose.


In any case, her suggestion was to lower the dose as per the report, but add a small dose of T3 (the active hormone that the dog's body actually uses (and ours) - T4 being the inactive form).  My vet is currently sourcing that and discussing with Dr Dodds about the case.  He'll be retested in the new year.


Should that not work then the mystery will continue, but other options have been suggested to me; a) a pituitary tumour.  Not common but not unheard of; and such could easily interfere with the thyroid feedback system, skewing the results.  Or b) Plechner's Syndrome.  I am still reading up on this but the general gist is a breakdown in the adrenal system; poor feedback, low (or possibly high) cortisol production which would directly interfere with thyroid hormone use by the body, if it is anything like it is in humans (and everything I've read suggests it is) - adrenal fatigue in humans is a nightmare for mucking up the thyroid, whether directly on the gland itself or indirectly by preventing the body being able to use the hormones.  It can skew results very easily.  Or c), he simply is not doing well on soloxine and could try a different brand - not unheard of.  A lot of people don't do well on thyroxine only, regardless of brand so I am keeping that in mind as option d), although the T3 being added should highlight that as a possibility.



Credit where credit's due though, I mentioned it to my vet who immediately had me write it down and is looking into it as a possibility, along with the other things suggested, although I did neglect to mention the soloxine query.


So for the moment I wait.  He is on the first lowered dose - down by 0.2mg per day for two weeks, then down by another 0.1mg per day from then on, and the T3 added once it's been organised.  He continues oblivious of the fuss he causes, showing off his jammies at the park and peeing on things he shouldn't pee on (this week, a cover for an expensive piece of equipment at the vet, and a gravel bag at a construction area at the park).

Updates to follow as and when the plot twists!

In the meantime, a demonstration that we have at least beaten the weight problem for the most part (well, 'beaten' is not the right word as it is a constant struggle to keep it down, but we have shifted most of the weight he put on after he hurt himself being an idiot in 2006 and took 6 months to heal).


The top photo was him in Summer 2007, at his heaviest of 42kg (he was actually heavier than Soli at her biggest at the same time - and she was a bigger dog than him in structure!).  The bottom was him in October this year, a much leaner 32kg - just 1kg off his goal.  He is now 33kg, a timely reminder of the ongoing fight I have on my hands to keep him lean.  Just a tiny lapse and wumph!  On it goes...

The House of Broken Dogs

Honestly, that's what it feels like at the moment.  The last two and a half weeks have been like a medical drama.  I find myself waiting for the House of the canine world to shed some light on Remy, it's getting that bizarre now - more on that in a moment.

It started on Oct 28th; that long walk in the woods, Soli's last.  Paige dislocated her toe.  No idea how; I just spotted her limping, and something stuck to her foot, or so it looked; on calling her over, her outermost left toe was stuck out at 45 degrees to the rest of her foot!  Luckily just the faintest touch and it slid back in.

The to the 29th, that awful, awful day.  First thing in the morning, Paige's toe was starting to swell a bit - to be expected after a dislocation, really.  Then while I was in the bathroom, Tia fell down the stairs.  No harm done, but a hint that her legs are starting to deteriorate.  Stair gate is up now.  An hour later, Soli hopped off the sofa, staggered into the hallway and died in my arms.

The next week saw Paige's toe get quite large and refuse to go down; a visit to the vet got her some pain relief and anti inflammatories.  No joy.

Saffi's colitis had a little flare-up again; diarrhoea and blood, but luckily it settled down quickly enough.

On the 7th, I had blood taken from Paige and Remy to get their thyroids tested by Dr Dodds.  Paige was fine, despite her balding ears; Remy, however, is an enigma.  I shall explain presently.

Paige's toe continues to be a problem.  Last week I enquired about getting her x-rayed and claiming direct from the insurance company (£120 isn't that much but when you've just paid £35 for painkillers, and just shy of £170 for a cremation, it is a lot of money).  Communication between the receiptionist and the practice manager appears to be non-existant; yesterday I had to start the enquiry again with the one receptionist that I know will chase it up.  So waiting to hear.  Poor Paige, in the meantime, has a toe about half as big again as it should be and showing no signs of going down - foolish me thought perhaps a teensy, 10 minute off lead walk on flat grassy ground would be ok.  She was calmer than usual too, but nope, it swelled again.

And Tia's back legs continue to deteriorate.  Slowly, at least, although it has sped up (if that makes any sense) - she had been enjoying one or two 45 minute walks round the park a day, trips to the woods, and that 90 minute walk and only the latter caused her to be scuffing her feet a tiny bit in the evening; in the 2.5 weeks since, she is now scuffing her feet after two 20 minute walks or less.  Old age is a bitch.

And now Remy, who is proving himself to be - after 6 years of symptoms - more so a medical mystery now than he ever has been.  I will give him his own post; there's a fair bit to his medical story.

I begin to wonder at this stage if I am capable of gathering normal, healthy dogs!  I seem to attract them - let's see, my dog-owning history; first dog (the family spaniel cross) died from osteosarcoma.  Not too uncommon in large dogs - dobes are prone to it - but not exactly typical of a spaniel cross!

Then to my own dogs. 

Remy, the puzzle dog, an endocrinological mystery. 
Opi, so far one of the two normal ones, although she does have a heart murmur.
Soli - arrived with spay incontinence.  Went on to develop severe osteoarthritis; hypothyroidism; several dozen lumps and bumps, one of which needed emergency surgery when it 'fell off' from its perch on her side and started to die; DCM; and her constant stress issues.
River - the other normal one, sort of.  Although year before last, she did manage to put a finger-sized hole in her side and I have yet to figure out how she did it, on lead, on a pavement walk away from any buildings or finger-sized-hole making objects.
Saffi - severe and basically untreatable arthritis, save for hydrotherapy and painkillers.  Weight issues and potentially, another hypothyroid dog.
Paige - DCM sufferer of the future, although hopefully it's a way off yet.  And of course her current toe issue.
Raine - Stress, to be brief.  I'll explain shortly.
And Tia, untreated arthritis/anal glands/chin infection/ear infection/partial deafness and weak back legs which are now starting to deteriorate faster.


Going back to Raine briefly...  Arrived with a suspected food allergy causing severe enteritis; I now know this to be entirely stress-induced.  Any tiny hint of an injury, or her anal glands filling up, an itchy ear, anything - and the stress of thinking that she will need to be handled to sort it out overwhelms her and makes her physically ill.  Last month, she had a bout of it following breaking her dew claw - not a bad break by any means, didn't even require painkillers but because she knew I'd have to look at it, she got entertitis and needed careful feeding and medication for a week.  She lost at least 1kg if not more.  Then since Soli died, I thought she was down from losing her - nope, her glands were full.  And the stress of knowing I'd need to sort them was sending her downhill again.  Not as badly as the claw, for the simple reason that I hadn't realised what was wrong, so I wasn't looking for something; it's the looking that starts it.  As soon as I twigged - the first overt sign being that she wouldn't sit, only lie down and was holding her tail away a bit at the base - she started to almost panic, and I had to keep her on lead when we got home to get it done with.  That 30 second job took almost 15 minutes because she was so worried and I had to take it very, very slowly (the bandaging of the claw took considerably longer, even though I am adept at it, and that was before she got fully ill!).


So, it seems, I am unable to have 'normal' dogs.  The future, while dobe-shaped, has a distinct aura of vet-bill to it as well I think!

Wednesday, 9 November 2011

Tia

Well, I said I would update, and so I shall.  After all, this post is only 8 months overdue...

On Feb 26 this year, Tia joined the gang.  Yep, dog number 8!  O.o

Well, of course, it's number 7 now; but Soli was still very much alive back then.

Tia is not a newbie as such: she was brought home by my brother in mid 2000 from the Dogs Trust, having spent quite some time in kennels up north with no interest and finally being brought south to Kent to try her luck there.  Within a week she was free.

Unfortunately, it wasn't a good match.  Although her first year or so was great - bro was with his ex then, and the ex was very responsible, giving Tia and the other 2 dogs 3 or 4 hours of free running every day, training classes and so on - once they split up it all went downhill.  As soon as bro had sole responsibility, walks dropped to a 10 minute on-lead walk round the block.

Once bro moved out, and back home with me and my Dad, it got worse; walks went to 10 minutes on lead every other day; then every 3 days, then every week... until eventually nothing at all.  I had hoped he would see the damage he was doing in the end - she was going insane from no input at all (she has always been a very high energy dog, working level drive) - but no such luck.  Eventually I reached a point with my own two dogs (I only had Remy and Opi back then) where I could walk them together, so started to work with Tia.  She'd always had serious aggression problems with other dogs - on-lead only, fear aggression from the lack of flight option and terrible social skills.  She would fling herself around trying so hard to attack that she would often go blue from choking herself - even on a harness!

Anyhoo I took to the bigger park in town; ideal for such a thing as the main path runs around the edge of a HUGE playing field (we're talking 5 or 6 football pitches here), with the vast majority of people sticking to that path with their dogs, so I could plonk us in the middle and manipulate the distance to passing dogs easily and with minimal risk of loose dogs running up.  It worked a treat.  Within just 3 weeks, I had her politely saying hello to any and all dogs while on lead (never could let her off, her recall was non-existant no matter what I tried), calm and happy.

Alas, then we all moved away: my parents to Spain, bro and his then-GF to the next village, me all the way up here to Lincolnshire.  I offered to take her with me then - I was studying canine behaviour, he'd seen the difference in her with my input; but no, he loved her too much.  I left with a very clear offer: if anything should ever happen that meant she needed a new home, she would come here.  He poo-pood it and basically ignored me, but I made sure to tell his then-GF and she listened.

2 years on, he visited to swap cars with me (a decision I have regretted since), and told me that she was starting to stiffen up (she would have been 11 by this point); but still, his young son was jumping onto her from the bed and she still wasn't even growling, what a wonderful dog!  (I can hear you all cringing from here...)  The next time I spoke to the GF I reiterated my offer, now with the fear that Tia might bite said son, despite always having adored children.

I never got that call, sadly.  Another 2 years later; the relationship dead, my brother homeless by his own inaction, and Tia needing somewhere to go temporarily so she wouldn't be living in his car.  Good thing too, seeing as she couldn't get into mine when I picked her up - I had to lift her in.  I knew then something was up; she's always been able to leap head-height, no problem.

I got her home after the long journey and started the intros to the others - although she remembered Remy and Opi after a while, of course she didn't know the other 5 (and Soli still being there then, would be the hardest one as she always took a few months to get used to new dogs).  And she'd had 4 years of being a solitary dog, going nuts on the lead and being kept away from other dogs apart from the neighbour's springer (of course, selfish, lazy bro didn't bother to keep up my work despite seeing it working), her social skills would be terrible.  So, safety gate in place we began.

She spent the evening sat by the gate, wanting to come in but a bit wary; but clearly in pain.  She was uncomfortable but fidgety from the stress of the day.  This was the typical look of things:



Soon enough everyone was together, and I was able to watch her better.  Over the first few days it became clear she was in considerable pain; I took her out around the block, and despite seeing several dogs quite close by she didn't so much as growl - she was simply in too much pain to even think about reacting.  She was stiff and extremely sore; she couldn't squat at all to toilet and couldn't go beyond the briefest of trots.  She had also been chewing at her tail so much it was bald, and I was told by the ex that it had bled a lot as well; and scratching at her chin.

To the vets with her then, to be given exactly the diagnosis I expected: severe, very advanced osteoarthritis.  I knew from Soli how unbearably painful that condition is.  She was put on rimadyl, which duly had no effect on it at all; we had a fortnight's worth but less than a week later I took her back and had her put on Trocoxil (my drug of choice for Soli and a lifesaver for her, as not even tramadol would touch her pain).  Her anal glands were full and incredibly painful, hence the tail chewing - and had been that way for months, as the ex had told me she'd been chewing for a long, long time.  Her chin was infected - and again, had been that way for dog knows how long.  She also had a nasty ear infection that was causing her to scratch and scream with the pain of the scratching.  And on top of all that, she was overweight - as a younger dog I'd had to get weight off her when she moved in after totally random feeding, and her ideal weight was 28kg: allowing for age, I'd have put her at 29-30kg now but she was 34kg.  Not at all helpful with osteoarthritis.

And just as with Soli, overnight the difference was incredible.  She lost years - the very next morning, having had her first dose only the night before, she was bounding around like a puppy again.  And reacting!  Ooooh yes.  Just as she used to, although with slightly less vigour thankfully - but at this point, she was far from fully treated.

So the work began again.  Thank dog, she seemed to recall some of what I did with her; she was keen on food straight away and calmed down considerably in the first few weeks.  But she was much more stressed outside than she used to be - in part because her eyesight and hearing were very impaired with age.

A few weeks after the trocoxil began, I called on Soli's chiropractor.  I'd noticed that if I walked her on a collar, she would yelp with any pressure from it.  Back to the vet.  Damage from years of pulling like a steam train on a lead and collar; and of course her severe reactions, also done for years on a lead and collar; and being walked on a flexi and collar, being allowed to run full pelt to the end of it and getting snapped back (this is not assumption, incidentally; I saw her being walked that way many times but was never listened to about it).  The trocoxil helped but not enough; she couldn't lie down straight for very long as it hurt.

The chiropractor got to work.  Tia was a mess; vertebrae out of line from all the years of pulling and lunging and so on, and her neck was just horrendous.  Muscles in spasm all over the place, especially in her back.  Even with the trocoxil helping the arthritis, she'd been trying to compensate for pain all over for so long that everything was out of whack and her muscles were just too tight.

After that treatment she improved dramatically again - her aggression lessened a bit, and she was happier.  She still couldn't lay down flat for long, but early days.  She had a second treatment following an incident - she'd tried to barge past the others out of the car, and had managed to pull her back doing it.  That was a horrible moment - she sank to the floor crying out, trying to stand then sit then lie down, totally unable to stop herself hurting and her back was spasming so bad it was clearly visible.  It did settle thankfully, and the treatment a few hours later sorted it out.

Following that, she could lie properly and without pain, and these days her neck doesn't hurt her at all - something we didn't expect!

Three months after her arrival, I had the conversation I'd been dreading with my brother: the one where I told him that I would not be giving her back to him as he clearly didn't give a damn about her and I knew damn well he'd never bother to look after her properly.  Bad enough when she was younger but simply not an option with her medical needs now.  He tried to blame everyone else and the situation; he couldn't take her to the vet because he hadn't been allowed in the house for the last 3 weeks, so on and so forth.  When I pointed out that she'd been in pain and ill for a very long time - far, far longer than 3 weeks - oh yes, she'd been ill but she was getting better.  Funny, she wasn't getting better when I picked her up, and he'd told me then he was worried because she'd been crying out when she stood up for quite some time.  As usual, just another attempt to make it look like it wasn't his fault.

In the course of that conversation, it transpired that he'd seen her scratching at her for a long time, and heard her crying out with it; he blamed that on her bad neck.  She'd been at her chin for dog knows how long - possibly a couple of years if not longer - he blamed that on food, although he'd 'tried every brand in pets at home'.  The tail he'd 'tried to treat himself' - sorry, but any dog that has chewed its tail so badly that it bled and looked like it might be bald permanently (thankfully not) clearly needs veterinary attention.

All in all, he'd seen so many signs that she was in pain and in desparate need of a vet, but he just couldn't be bothered to take her and deal with it.  Apparently (though I'm not sure how true this is, willing to bet it is though) he was told repeatedly by a number of people that she needed to go, but always said 'she's fine'.

I have often thought, over the years, that this poor dog would wind up like this in her latter years, being ignored by that self-centred arse; I had also often hoped that it wouldn't happen, that his oft-touted 'love' for her would come to the fore when he saw his companion in massive pain and discomfort from the itching but no such luck.  I can only be grateful that he swallowed his idiotic pride long enough to send her here (even though he didn't ask me, I offered to my sister who'd asked if I knew anyone who could take her), even though I know he never would have if he'd known I would refuse to hand her back.  Of course, if he'd looked after her properly, I would have done - I didn't particularly want 8 dogs...

Still, all done and dusted now.  He no longer speaks to me, which is just fine; I still find it amazing that we are related.

Tia is much happier - her dog issues are far improved now, although thanks to those 4 years of nothing she's still not as good as I had her after those 3 weeks all that time ago.  But age and pain has played its part.  She's still a bit stressed at the park but getting better.  And I have just got my copy of Grisha Stewart's new Behaviour Adjustment Therapy book - which looks very promising indeed!

Most of Tia's problems with meeting dogs now are frustration and manners, although there is still a little worry there; but for the most part, she wants to run up and say hello but quickly gets overwhelmed if she does and becomes extremely rude and overbearing; but being on lead, she can't rush up, which pushes her into frustration which then sometimes triggers aggression (less and less though).  She can be lovely if the greeting is good and has made some friends at the park - she had a lovely play with William (a little patterdale X something or other I think) a while back, and it was so nice to see that side of her intact still.

I don't know how long she has left in this world - she'll be 13 in January, give or take, and her back legs are slowly getting weaker, but very slowly.  She still turns into a puppy after her monthly trocoxil dose - so much so that when a friend looked after her for a day in June, her friend actually thought she was a puppy despite the grey face and ears!

Still, she's fine to live out her days here.  She still enjoys her walks - the last walk that Soli did she was with us for, for the full 90 minutes, although that is too much for her now I think.  But she still happily does 45 at the park once or twice a day, and she enjoys having a dog flap again to go mooching in the garden if she wants to, whenever she wants to.  Her chin is an ongoing battle - all that time with no treatment means the infection is pretty set in there and flares up from time to time, but the flare ups are getting less and clearing up quicker.  Likewise with her ear; and the last round of antibiotics for her chin seemed to help with that.  Her hearing improved a bit too.  Her anal glands I can manage myself thankfully, although they've only needed doing once since the vet trip when she first arrived.  The difference in her is striking from that poor, miserable picture above.  She's happy, and she's loved, and that's the most important thing.