How I Turned $8,000 of Vet Bills into $1,500 (Or, why pet insurance is awesome and everyone should have it)

You haven't really lived until you've put almost $9,000 on your credit card at the emergency vet, but that's just what I did at the end of January when my four dogs got into some ibuprofen. Ibuprofen ingestion is a serious medical emergency, requiring 48 or more hours of hospitalization to prevent kidney problems, GI ulcers/perforation, and neurological damage - even if the dog eats as little as one tablet of ibuprofen.

Thankfully, due to a quick response and excellent care, my pups are home and naughty as ever. And, thanks to PetPlan, my credit card is doing just fine, too. All four of my dogs have pet insurance, ranging from $20 to $40/month each (Maisy and Lola are more expensive due to their age and breed, respectively).

The expensive, naughty, utterly wonderful beasts in question.

Peace of Mind
The best thing about pet insurance is the peace of mind it provides. Taking a dog to the ER vet is always stressful, but it's so much easier when you know that you can make decisions based on what's best for your pet as opposed to what your wallet will allow. Even once everyone's home and healthy, it's a huge relief to know that I haven't just put myself into ridiculous amounts of debt, even if it would be worth it.


Financial Breakdown
PetPlan offers great plans, allowing you to choose your deductible, reimbursement amount, and yearly maximum. All four of my dogs have the Gold plan, which means they are covered for over $20,000 of care per year. (Some companies do not have a yearly maximum like this, but when I called around several years ago, those plans had more exclusions, or were significantly more expensive.) All four of my dogs have a $200 per-illness deductible, after which PetPlan pays 100% of the cost for the boys and 80% of the cost for the girls.

Here's what it looked like for each dog:

Pyg's total bill was $2,284.11. I pay a $200 deductible, and PetPlan pays $2,084.11.

Maisy's bill was $1,860.74. I pay a $200 deductible plus 20% coinsurance ($372.15), and PetPlan pays $1,288.59

Napi's bill was $1,943.02. I pay a $200 deductible, and PetPlan pays $1,743.02.

Lola's bill was $1,975.32. I pay a $200 deductible plus 20% coinsurance ($395.06), and PetPlan pays $1,380.26.

TOTAL BILL: $8,063.19
MY SHARE: $1,567.21
INSURANCE PAID: $6,495.98

The Process
Here's my favorite part of PetPlan: the reimbursement process. Now, all pet insurance is a reimbursement plan because pets are (technically) property in the US. This means that I had to pay the total cost up front. This is challenging (who has eight grand lying around??), but I guess god invented credit cards for a reason!

PetPlan makes it easy, though. To make a claim, all I have to do is download an app on my phone, take a picture of the bill and any medical records I have, and they do the rest! I made a claim for all four dogs on Sunday around 9pm, and a check was in the mail less than 48 hours later!! (Both the app and the website make it easy to follow the claims process online.) I should have the check by the end of the week.

PS- I am so not being paid to post this. I just LOVE PetPlan a lot. Seriously. Buy insurance for your furry friends. It is worth every penny; the way I figure, this incident just paid for FOUR YEARS worth of premiums. 

Can I give my dog ibuprofen? HELLS NO.

Yesterday I came home from work to find four happy dogs... and a bottle of ibuprofen in the middle of my living room, with the pills clearly chewed on and scattered about. I knew that ibuprofen is dangerous for dogs, so I called the vet. Because I didn't know who had chewed on the ibuprofen, nor how much may have been swallowed, they advised that I rush all four to the emergency clinic. That's where I learned how dangerous ibuprofen is. 

Ibuprofen does all kinds of bad things to dogs, including ulcers, kidney failure, and neurological problems. Worse, it doesn't take much to cause these problems. GI problems, like ulcers, can happen at a dose as small as 25mg per kilogram. For my three little dogs, who each weigh around 15 pounds or 7kg, give or take, that means that as little as 175mg - or less than one tablet of ibuprofen - can cause serious problems. Kidney failure is likely at about 175mg per kilogram, or for my dogs, about six tablets.

By the time we got there, Pyg was throwing up, was lethargic, and was swaying on his feet. Not good. They took him back first and made him throw up. After consultation, we agreed that all four may have eaten some ibuprofen, and so the best course of action was to take the other three back.

That's when I learned that recovery from ibuprofen ingestion is a lengthy procedure. First, everyone has to throw up. Then, they need to eat activated charcoal, which helps neutralize anything that's been absorbed. (Pyg got bonus lipids to help even more since he was so sick and problem ate the most.) Next, they need to have GI protectants (to prevent ulcers or tears in the stomach). Finally, they need at least 48 hours of IV fluids to flush out the system. Regular blood work and UAs are taken to assess if any kidney damage has happened. Hopefully the throwing up and charcoal and fluids prevents that.

We're about 24 hours in right now. Everybody is doing well, even Pyg. He's clearly tired, but he's not dull and lethargic. When I visited, he just wanted to lean on me. I'm waiting for their second set of labs to come back, which will tell us if there's any kidney problems brewing. We don't anticipate this happening with any of them since we got treatment so fast, but I'll update when they're home - hopefully tomorrow, but maybe Monday.

In the meantime- everyone should know that if your dog eats ibuprofen, it is an immediate emergency.

Sigh.

Typical conversation this week:

"So, my dog has a broken rib."

"What?? Which one?"

"Which one do you think?"

"Oh. Right. Of course."

Seriously, if something is going to happen to one of my dogs, it WOULD be Maisy. We don't really know how this happen; best guess is she got in a fight at the dog park. She stole a lab's tennis ball, lifted a lip at a lab, and the lab nailed her. The puncture wound healed quickly, but she became reluctant to jump on the bed, and was more sore in the back than usual.

Long story short, we did x-rays, a diagnostic ultrasound, and now we get to wear this very fancy swat-team-esque back brace for a month and hope the bone chip that's floating around heals up.

Sigh. This dog.

I believe my response to the vet would be an inappropriate post title

I took Maisy in for a just-being-super-cautious bladder ultrasound on Monday. It’s been six months since her huge bladder stones (and subsequent removal). Since that time, all of her UAs have come back great, and she continues to be on the prescription diet to help prevent a recurrence, so I figured it would be a pretty quick and easy appointment.
 
It’s like I don’t even know my own dog.
 
Of course she has bladder stones. Five or six, actually. All small enough to pass, but still. Wasn’t the diet supposed to prevent this? Yes, it should have, but… well, we’ve cheated. Oh, sure, her main meals have been the prescription diet, but she has still gotten the occasional bully stick and we definitely feed her off our plates… The vet didn’t think that would be enough to cause stone formation, but that’s what I’m going with because the alternative is more frustrating.
 
See, there are two main types of stones: struvite and calcium oxalate. Struvites can be dissolved by diet and are therefore the better kind to have. This is what Maisy had last fall. Calcium oxalate, on the other hand, have to be removed surgically. We don’t know which kind Maisy has now, so I’m going with the diet-needs-to-be-stricter theory.
 
The plan right now is to switch from the stone-prevention diet to the stone-dissolution diet and then do a recheck ultrasound in 6-8 weeks. If the stones go away, we’re all good. If they don’t… well, we’ll figure it out then. The good news is that the stone-dissolution diet can also be used for maintenance. The bad news is that every. single. dissolution diet on the market has eggs in them. Maisy is allergic to eggs. But hey, she’s already on steroids, so hopefully that will prevent any allergy issues.
 
Fingers crossed! On all fronts!

Poodle Eyes

I recently discovered that Maisy's supposed poodle half is as close to confirmed as one can get without a DNA test. I know this because she has Poodle Eyes. Or so her ophthalmologist told me.

In the never-ending saga that is Maisy's health, she has racked up another specialist and two more diagnoses: entropion and corneal dystrophy. Both are inherited diseases, and both are, apparently, common in poodles.

About six weeks ago, I noticed that Maisy was having more discharge than normal from her right eye. She always has some sleep crusties in the mornings, but this had progressed to something weird. The discharge was clear, not the yellow or green one would expect from an infection, so I just kept an eye on it.

When it didn't clear up within a week, I took her into the vet, where they did all kinds of Fun Tests. Maisy was a rock star, and Dr. Jessy commented on how unusual it is to be able to do those tests and not need restraint. She didn't see anything in Maisy's eyes, but she prescribed some antiobiotic ointment and sent us on our way.

The discharge got better by the end of our ten days of drops, so I figured it must have been some weird infection and went on with life. But then the drainage came back... along with an odd white spot on her right eye. It was very small, and my boyfriend had a hard time seeing it, but it was there. It was the weekend, so I completely freaked out and called a vet friend, who told me to watch it for a few days to see if it got better on its own. I did and it didn't, so back to the vet we went.

Not the white spot from the light reflection. Below that- the larger, cloudy spot. 

We did the same testing, and this time, Dr. Jessy saw the white spot. She also noticed some squiggly marks I hadn't seen on the left eye. She had another vet in the practice take a peak at it and while neither knew what they were seeing, they knew it wasn't normal.

True story: the Twin Cities has four animal ophthalmologists. and all four are quite busy. Thankfully, I was able to get an appointment for just over a week away. It wasn't with the U, where I wanted to go because they have all of Maisy's history, but I was very happy with Dr. Trumble from Blue Pearl.

Dr. Trumble was kind, quick, and thorough. Maisy has entropion, which is when the eyelids roll in toward the eye. Maisy has a very mild case, wherein her tear ducts are slightly blocked, which is causing the excess drainage. Dr. Trumble said we could correct it surgically, but that it's a cosmetic thing at this point. I laughed and said no. Ain't nobody got money for cosmetic concerns.

Maisy also has corneal dystrophy. This inherited condition causes mineral deposits to build up on the cornea. Maisy's case is mild, and the hope is that with treatment (EDTA eye drops), we will be able to stop it from worsening. It is unlikely that the white spot will go away, but since it doesn't seem to be affecting her vision, that's okay.

We'll go back in three months to see if the drops are working. Fingers crossed!

Well, I'm Not Entirely Incompetent

The hard thing with a new dog is that you don't know when something's wrong, because you don't know what their normal looks like. When I first got Pyg, he was energetic and playful, but that slowly went away until I thought that maybe the excitement of those first few days was just some weird stress response, and that this new mellow version of Pyg was just who he is.

At the same time, his house training got more and more irregular. I figured this was because it's December in Minnesota, and therefore snowy and cold. And I'm sure that didn't help, but I potty trained Maisy in January weather (always worse than December) for goodness sake. Plus, well, I don't know how well he'd been potty trained before, so... Like I said, it's hard when you don't know a dog's normal.

I have learned a bit about Pyg's normal, though. First, no, the playfulness was not a stress response, and that his personality is to be a funny, goofy, excited little dog. And second, I'm not an entirely incompetent trainer, because Pyg has been peeing outside again!

So what happened? Well, I did that thing that trainers like me always tell clients to do: I took him to see a vet. As it turns out, there was indeed a medical cause for Pyg's subdued nature and training regression. We just don't know what it is, exactly. (Figures. How do I end up with these dogs?) Anyway, his urinalysis did not show any bacteria, crystals, or white blood cells. But it did show some old red blood cells. The vet told me this could be a ninja infection (I'm pretty sure those were her exact words), or congenital bladder stones, or a kidney problem.

We decided we liked the first option best (because ninjas) and started treating with a broad-spectrum antibiotic. And lo and behold: peeing outside! More playfulness and energy, too. Also, I'm not totally incompetent at potty training. Good news all around!

Worried and Scared: A Maisy Update

In the last week or two, I've noticed that Maisy seems... off. She's just slightly stiff. She needs to take a break halfway up the stairs. She's reluctant to jump in the car, and she's slow and sad-looking on walks. Things that would be easily attributable to aging- Maisy is seven, after all- but these are some of the same things I saw emerge over the summer. You know, before her immune-mediated crash? The one that almost killed her?

I called Maisy's neurologist, who told me to increase Maisy's prednisone from 5mg every other day to 5mg every day for 7 to 10 days. Then, we have three options: do 2.5mg daily, 7.5mg every other day, or add in cyclosporine (which tends to be quite expensive). He recommended option one, so that's what we'll do.

But then he added that it is not unusual for dogs to have a recurrence of immune-mediated inflammation after one or two months of reducing the dose. Which we did for Maisy about six weeks ago. He also added that dogs who recur at this point tend to have "less longevity" than dogs who successfully transition to no steroids at all.

It's one thing to suspect that your dog likely won't live as long, but it's quite another to be told so point-blank. I may have cried at work. I'm trying to be positive, though. Not only is Maisy very sensitive to my moods, but being sad and scared and worried won't help me enjoy whatever time I have left with Maisy.

Which I hope is a very long time.

Dear Maisy

Dear Maisy,

You have been an exemplary dog for nearly 7 years, and I have never before needed to write a letter of warning to you. Even through the worst of your reactivity, we have been able to work out a nice balance of special accomodations and appropriate behavior. However, your behavior today was simply inexcusable.

Now, perhaps you've been feeling a bit ignored lately- after all, we have recently hired a new canine companion who has changed some of the social dynamics here at the Thompson Household. However, I would like to remind you that you did participate in the screening and hiring process of Pyg.

Or, maybe you've heard my comments about how you are "the most expensive dog ever" these past few months. I'd like to point out that this was hyperbole on my part, and not to be taken seriously. In particular, it was not a challenge to which you need to rise.

I will state this as simply as possible: Rat poison is not food. Further, when vomiting is induced following such a dietary indiscretion, the resulting puke is also not food.

Please refrain from eating either of these substances in the future, or I may need to take further action.

Sincerely,
Crystal
CEO of the Thompson Household

Note to blog readers: Maisy is fine. She attempted to eat some rat poison at a neighbor's house this morning. Since I wasn't sure if she actually got some or not, I contacted our vet, who advised us to induce vomiting, which I did. There did not appear to be any poison in her puke, and she's been just fine since then, but still. THIS DOG.

Hindsight

I’m amazed at how well Maisy is doing… and feeling bad because it’s (now) obvious that Maisy was not feeling well for quite awhile. Over the summer she became hesitant to jump in the car. Since she didn’t seem to have trouble getting on the furniture or the bed, I thought maybe she was getting carsick. Nope. She’s now bouncing into the car, even running to it hopefully at other times. Well okay then!
 
I’d also forgotten how much ENERGY this dog has. She’s been a nutcase (in a good way): having evening zoomies again, playing with the cat, even playing with obnoxious adolescent chi-mixes. Although she had never stopped playing ball, she’s redoubled (retripled? requadrupled?) her ball-bringing efforts. It’s getting a bit obnoxious, honestly.
 
Not that I’m complaining! I’m so thrilled to see her feeling so well! She clearly feels better than before she got sick. Yay steroids! I’m so relieved she hasn’t had any negative behavioral side effects with them.
 
Bladder-health-wise, Maisy had a urinalysis on Saturday. I had at done at 3 weeks, which was a bit early (she needs them every 4 to 6 weeks for awhile), but counting is hard. Or something. I’m not sure how I did that.
 
At any rate, it makes the results THAT MUCH MORE exciting as they came back pretty good. Ideally, she should have a urine pH of less than 6.5 and a specific gravity (USG) of less than 1.020. Maisy’s pH was 6.5 on the dot and she had NO crystals! Yay! Her USG was high: 1.050, which means that her urine was more concentrated than we want. We did do the test first thing in the morning, so it had probably been 10-12 hours since she had peed last, but either way, I need to encourage fluid intake. Which is so hard with this dog.
 
We will continue to check her urine every 4 to 6 weeks for six months (when she is due for an ultrasound to confirm there are no stones). The vet- our regular practice vet, not from the hospital- and I discussed other preventative things we could do; she agreed that while effective, the prescription diet is nasty, so in a few months I’ll be consulting with a nutritionist to get a raw/home cooked diet formulated for her. The vet also recommended probiotics and a cranberry supplement (which I already started Maisy on).
 
Any suggestions for increasing fluid intake? I’ve tried broths (usually but not always successful) and adding water to her kibble (I don’t like doing that because I prefer to put her kibble in food toys, but I guess maybe I need to). I want to try drink mixes or even just sugar added to the water. Girlfriend has a sweet tooth like woah. What am I missing? I'd love to hear some other ideas!

A Week of Good News!

Both Maisy and I received great news this week! (Finally. Last month was hard.)

Maisy's Health

Maisy on her 7th birthday earlier this month.

Maisy had a follow-up appointment with the neurologist at the U of MN on Monday. He saw her during her first hospitalization for immune-mediated inflammatory disease of the spinal cord. Although Maisy really, really, really did not want to enter the vet clinic at the U (and really, who can blame her?), she was a good dog for her exam. Perhaps a bit more drama-queen-y than usual, but she didn't try to bite anyone, so I'm calling it a success.

The neurologist was pleased with her quick recovery and said that I could treat her the way I normally do- no activity restrictions! She does tire a bit easier now, but that's largely because she isn't in the same condition as she was before all this. She will continue on daily steroids (down from twice a day) for three weeks, and then will take 5mg of prednisone every other day for 4-5 months.

Maisy has had no appreciable side effects from the steroids. Some dogs get thirstier (and thus need to pee more); this hasn't happened with Maisy. Some dogs will have behavioral effects (heck, I get incredibly grumpy when I'm on high doses of steroids), but Maisy hasn't. If anything, she's friendlier. About the only thing I've noticed is that she wants to lick my face more than usual. I have no idea if that's related or not, and while it's annoying, it's also manageable. The only side effect that might yet show up is muscle wasting. I hope we don't get that!

Of course, Maisy had two issues last month, the other being her bladder stones. She is still on her very restricted diet, and she will need regular UAs and other monitoring. However, this is a highly manageable condition, if expensive. I now have three jobs. It sucks, but what can I do?

Crystal Thompson, CPDT-KA
 That's right! I got my exam results back this week (hey, I took the professional dog training exam the first day Maisy was sick, remember?), and I passed. I am now officially a CPDT-KA. I am thrilled to report that I got a 97% on it! Yay me!

Wait. I missed one on learning theory?

All in all, it's been a great week. Hopefully things continue going this well!

Hopeful for a Full Recovery

Cross your fingers, knock on some wood, put a rabbit foot on your key chain… anything to prevent me from jinxing things here, because I think Maisy might have a full recovery.

As you know, September was a hard month for us. First she landed in the ICU for what turned out to be immune-mediated inflammation of the spinal cord. Then, just as she was starting to recover, she ended up back in the ICU with some pretty bad bladder stones (and a very uncomfortable procedure to remove them). It’s been almost two weeks, though, and over the weekend Maisy started showing signs of being herself again.

She has more energy and stamina again. She’s enjoying her (short, for potty breaks only) walks again instead of plodding behind me like we’re on a death march. She’s even asking for longer walks. Her coordination seems to have returned as well. She’s not tripping over her own feet when going up the stairs anymore.

Her enthusiastic naughtiness is back, too. She’s bringing me tennis balls whenever I’m… well, awake, really! Last night she shoved open the bathroom door and insisted on sitting on my lap while I was in there. She’s joyfully nipping at my heels and running circles around me in the morning.

And, instead of sleeping in the other room or at the far side of the bed, she’s back to sleeping pressed up to me, and last night she slept in my arms for at least half an hour. Oh, I missed that! Perhaps of everything, I missed that the most.

I’m optimistic that she will have a full recovery. Visions of hiking trips and dog shows have returned, and I’ve begun making plans again.

Of course, that isn’t assured. Last night we did the first reduction in her steroid dose. She had been on 7.5mg twice a day, and now it will be 5mg twice a day for a week or so. We’ll see how (if) that changes things. She sees the neurologist next week, and I assume that we’ll discuss steroid use then. Worst case scenario (I think/hope!) is that she’ll be on them for the rest of her life. Since they don’t seem to be affecting her behaviorally, that’s just fine. After all, I take steroids twice a day, too.

The bladder stones actually seem to be the bigger issue at this point. She’s on a prescription diet that I hate, but that I also have confidence in. I’ve had a hard time not giving her little extras; she’s not supposed to have any treats at all. I have always shared everything I eat with her. I wasn’t able to do it cold turkey, but I’ve really cut back, and each day it’s a bit easier. I still plan to consult with a nutritionist at some point.

She will also need pretty regular monitoring, at least for a while. The U of MN Urolith Center actually has a lot of good info on it, with recommendations on how often to test and what parameters to look for. She will need a follow up urinalysis every 4-6 weeks until the specific gravity is less than 1.020, the pH is 6.5 or ungder, and there are no crystals. After that, follow up UAs should happen every 3-9 months. They also recommend either x-rays or ultrasounds every 6-9 months to evaluate for stones. Since none of the billion x-rays Maisy had last month showed any stones, I’ve decided to do ultrasounds.

For now, though, I’m just going to enjoy having my dog back. 

Maisy's Home! (Again)

On Wednesday afternoon, we got the results of Maisy's spinal tap and adjusted her medications. One of the things we did was increase her steroid dose. I was warned that one of the side effects would be an increased need to urinate, so when she asked to go out frequently on Thursday morning, I didn't think much of it. But on Thursday afternoon, we noticed that she wasn't actually going every time she squatted. Then she started to squat every thirty seconds, no matter where she was (including in the house, and she is very well housetrained).

I took her to the ER, where an x-ray showed that her bladder was huge, indicating a blockage. They weren't sure what was blocking her since they didn't see any stones, but did a therapeutic cysto (they stuck a needle through her abdomen and into her bladder in order to remove the urine that way). Yesterday they did an abdominal ultrasound and found several small and one large stone (approximately 7mm, which is about the size of a pinky fingernail, I think).

A lithotripsy was performed. This is a non-surgical procedure where they put a small video camera up her vagina and then used a laser to break up the stones. Then they did a combination of stone basketing (not really sure what this is- Dr. Google isn't very helpful!) and urohydropropulsion (a urinary flushing technique) to remove the smaller bits.

Lab analysis showed that the stones were struvite, which is the best kind a dog can have. Struvites are usually the result of an infection, especially staph infections. As you may remember, Maisy was found to have a UTI caused by staph when she was in the ICU a few weeks ago.

Originally, they planned to keep Maisy overnight, but she recovered from the anesthesia quickly and they felt she would be “more comfortable” at home. When I picked her up, I found out what that meant- apparently any time someone came near her, she would snap at them. She was brought out to me in an e-collar with bright red stickers on it that said “CAUTION: MAY BITE.” Poor Maisy. I really don't blame her (I would feel bitey, too!). Oddly, on her discharge paperwork, they said “She is a very sweet girl and we really enjoyed working with her.” Ha.

The plan going forward: She will continue the steroid treatment for the inflammatory disease of her spinal cord, and we're adding in antibiotics for a couple weeks and pain meds as needed. She was also sent home on a prescription diet and orders to follow it strictly. Maybe it was just trigger stacking, but this was the first time I actually cried throughout all of Maisy's health woes this month. And oh, how I sobbed on the phone with friends. I didn't realize how important  it is to me to be able to share junk food with her.

Anyway, Maisy is home and doing well, or at least, as well as she can considering the circumstances. She's very, very tired, but when she's awake she's happy and playful. I am so glad she's here with me. I have no idea what the future looks like, and only a small idea of how it might change, but she's here, and for that I am grateful.

Finally, I just wanted to answer some of the questions I've been getting:

Is this related to the inflammatory disease of her spinal cord?
It's highly unlikely. More than likely, it's just some seriously bad luck. The thing is, Maisy has had recurrent UTIs her entire life (including a previous scare a few years back), so this was bound to happen at some point.

Why didn't they catch this when she was in the ICU before?
I don't know, but I don't think it's because they missed something. They did all the diagnostics they should have. She had two UAs/UCs, and a ton of x-rays. The x-rays she had on Thursday night didn't show the stones, either.

Have you considered a raw diet/supplements?
Maisy was actually on a raw diet before all this started and we used supplements (cranberry, fish oil, and probiotics, mostly, although we'd run out a few months back and I hadn't gotten around to starting them again because money has been tight). When things settle down in a few months (and I have the money again), I'm going to schedule an appointment with the nutritionist at the U to discuss diet again. Although I believe in the prescription diets, I also hate them. I don't think there's any actual meat in the one Maisy's on.

Speaking of money...
Have I mentioned how grateful I am for all of you? To date, I have spent $6,957.77 on Maisy's health care this month alone. There will be more bills to come (neither issue is resolved at this point), but hopefully they will be smaller. I have received $4,444.03 in donations, so I only have to pay $2,513.74 out of pocket. This is still more than what's in my emergency savings, so I'm in the market for a third job. Even so, I cannot even express how thankful I am for everyone who has supported Maisy and I in the past month. I'm not sure what I would have done without your financial assistance.

If you're local, please consider signing up for one of my reactive dog classes to help me pay the bills! I also do private lessons. Email me for more info about either one. I have a class starting next Friday for easily distracted sport dogs and/or mildly reactive dogs that isn't full yet!

I also make and sell quilts and weighted blankets. The weighted blankets are great for people with sensory processing disorder (also autism, insomnia, anxiety, etc.). The shipping for quilts isn't bad, but for the weighted blankets, it gets expensive. Email me for info and pricing. 

Spinal Tap Results

The results of Maisy's spinal tap came back today and... I don't know. It's not bad news, really, but it's not exactly good news, either.

Here's the deal: They tested the cerebral spinal fluid for tick borne diseases and ran a full infectious disease panel (that included things like fungal infections or protozoa). These were negative, meaning that we don't definitively know what caused the inflammation of the spinal cord.

But we do have a guess based on her current condition. Overall, Maisy is doing well. She's bright, perky, eating well, and wants to play. She's been friendly and outgoing with people, though a little reserved around other dogs. I think this is related to low-grade pain that she continues to have- or at least, that I think she has. She moves stiffly and sometimes just looks like she hurts. She has very little stamina; if we go more than four or five blocks, I have to carry her home from our walks. And if she does get this tired, her back end becomes weak and/or uncoordinated. She's tripping a lot more, especially when going up steps.

So, when we look at this picture, the vet believes that Maisy's illness is probably immune mediated. I only kind of understand what this means. I started to google it, but the wiki article talked about increased morbidity and mortality, so I backed the hell out of that window. I do know that the vet said arthritis can be an example of an immune mediated disease. It also means that Maisy's illness is likely going to be a long-term, chronic problem. I spoke with a friend of mine that's a vet, and she said that typically immune mediated diseases can go into remission, but aren't usually cured.

Tonight Maisy will start an increased dose of steroids, roughly tripled what she was on before. We will see how this goes over the next week and then will reassess the treatment plan. The goal is to taper off the drugs, but she may need to be on some dose of steroids for the rest of her life. The good news is that a little known (to me, anyway) side-effect of steroids is that it can actually improve behavior, and so far, Maisy seems to be one of these dogs. (Seriously, I had to drag her away from toddlers the other day.) Of course, they can also cause recurrent UTIs, an issue Maisy already struggles with.

I'm trying not to freak out about the future implications, like whether or not she'll be my hiking buddy again. For the most part, our day-to-day lives should be relatively unchanged (though perhaps with fewer, shorter walks), and I am grateful for that. Right now, I'm trying very hard to just take things one day at a time, and enjoy the present moment with her as much as possible. Since I tend to be a worrier, this is pretty difficult for me, but it's also probably very good for me.

I'll keep you all updated on how Maisy is doing on the steroids...

Looking Back

A lot of this has been shared on Facebook already, but I need to write about it some more because that's how I deal with stressful stuff. Plus, I wanted to include some of the non-medical happenings and share some pictures.

One week ago yesterday, everything in my world was normal. It was a lazy Sunday spent half-heartedly studying for the CPDT exam when I would have rather been reading a novel, so when my friend Elizabeth invited me over for supper, I gladly accepted. I took Maisy with me even though Eliz has an 18 month old, figuring that Maisy could hang out in a crate if it got too stressful.

It really wasn't. Maisy and Baby O got along wonderfully. In fact, Baby O was more interesting in giving Maisy treats than anything else. Feeding Maisy became a reward for everything else- eating supper, taking a bath, putting on a diaper. First do this, then you can feed Maisy.

We came home, went to bed. Maisy did need to go out in the middle of the night, but considering the sheer amount of junk Baby O had fed Maisy, I wasn't surprised. I did note that she looked a little stiff when we went up the stairs to our apartment, and made a mental note to email her chiropractor to schedule a visit.

Maisy was not in bed with me when I woke up, which is weird. I came out into the living room to find her sitting hunched over, glassy-eyed and panting. She took her medicine, but refused to eat breakfast. I called the vet.

From here, you know the story. In the span of 24 hours, she went from happily playing with a toddler to being admitted to the ICU. That first night, even with IV pain medication, she would cry out in pain every time she was touched. She had a high fever and we didn't know why. Nothing significant came up on spinal or thoracic x-rays, blood work, a urinalysis, or from a neuro consult. She had a spinal tap done, and we finally learned that she has an inflammatory disease of the spinal cord, although we won't know what caused it until the result come back sometime this week.

Those days are a blur in my mind. Visiting hours are pretty limited, but thankfully I have a flexible job and an understanding boss. I saw Maisy twice a day, with regular phone updates in between. The morning after being admitted, she looked better, but just barely. She couldn't settle down until I physically held her in my lap, but it wasn't long until she got up and asked to go back to the ICU. Heart breaking.

That evening, once again I came and brought her to the visiting area. She was restless but also reactive, barking at every noise and movement outside the closed door. I felt awful for her; being sick is bad enough, why did her anxiety have to rear up again? Still, with a lot of coaxing (read: cookies), she was able to lie down with me for a bit. She was even offering me her paw in exchange for food.

On her last day in ICU, I went to visit before she had the spinal tap. Because it was done under general anesthesia, she couldn't have treats. Still, she seemed more settled and curled up with me on the floor. The tech told me that she'd been a bit of an attention-seeker overnight; if the staff were on the other side of the room, she was quiet, but if they were working with an animal in the cages near hers, she'd begin howling. As soon as they came to check on her, she seemed to brighten up and quit vocalizing.

Still, it was clear that it was mom that she wanted. When the vet came in, asking to take her back for a quick test, Maisy refused to leave my side and they had to tug a bit on her leash. When Margaret (Maisy's former vet behaviorist, who works in the same building) came to visit us a bit later, Maisy got up and hid behind me... even though she knows and likes Margaret in other contexts. And when I finally gave her back to the ICU staff, Maisy would not go with them. I had to turn and walk away before she would, and I think that was the hardest thing I've done in awhile.

Maisy was glad to come home. With the antibiotics and steroids, she is making progress each day. I'm actually pretty surprised at how quick her recovery has been. Today- one week from when all this started- she tried to initiate play with a dog friend, has been bringing me her ball, and is just generally acting like herself. She doesn't have her normal stamina and endurance yet, and I expect I'll need to keep her quiet for awhile, but I think she's out of the woods.

Now that I think she's going to have a full (or incredibly close to it) recovery, I'm finally feeling the full impacts of the week's events. I'm finally acknowledging how scared I was. I'm finally feeling the physical effects of so much emotional stress. It was a weekend full of naps and massages and hot baths. And spending time with my dog. I want nothing more that to be with her just one more day; thankfully, it looks like my wish will come true.

I will end today's post in gratitude: I am grateful that Maisy is home and improving. I am grateful that she is acting mostly like herself. I am grateful to the staff at the U who took such good care of my baby dog. I am grateful to all my readers and friends and their friends who made it possible for me to get Maisy the care she needed without having the stress of money over my head. I would have made it work, but I don't know how. It probably would have involved a lot of Ramen and skipped meals. So thank you all for your support and love. I have so much to be grateful for. 

She's Coming Home!

Maisy had a spinal tap this afternoon. The procedure itself went very well (she had a slightly low BP during anesthesia, but meds took care of that). They analyzed the cerebral spinal fluid and found a lot of white blood cells, which is abnormal. There was no obvious bacteria, although the final report from pathology is pending.

This means that Maisy has an inflamed spinal cord/nervous system. We still don’t know why. A full tick panel is being sent out, and they will also look for an immune mediated disease. These results will take about a week to come back, so at this point we’re going to treat with 3-4 weeks of doxy (the antibiotic of choice for tick stuff) and a smallish dose of steroids (to treat the inflammation). She should feel better in 24-48 hours, although she may still have a fever during this time. As long as it doesn’t go over 103.5, I don’t need to worry. 

Oh, and she gets to go home tonight.

I did ask if they thought it would be better for her to be monitored and have the benefit of IV fluids, meds, etc., but they said that she’s so stressed in hospital that they think she’ll recover better at home. This is very true: when I visited her yesterday, she was pretty reactive to noises outside our visiting room. She was back to Old Maisy, Pre-Medication Maisy.

I did have to laugh when the tech this morning told me that she had been a bit attention-seeking overnight. Apparently when they were on the other side of the room, she was quiet in her kennel, but if they were in her area but with another dog, she would howl. As soon as they checked on her, she was fine. Rotten, rotten dog (said with a huge smile and all the love possible).

During this morning’s visit, the doctor had to come in to borrow Maisy for a quick test. Maisy would not get up and leave my side. When I went to leave, again, she would not go with the tech into the ICU area. In both cases they had to… I want to say drag her back, but that sounds much rougher than what happened. She just needed a lot of encouragement to go with them.

Anyway, depending on the results of the pending labs (tick panel, checking for fungi or bacteria in the CSF, her urine culture), we may change the meds/doses a bit, but overall, I am incredibly relieved to have a treatment plan. Maisy isn’t out of the woods entirely, but things are looking much, much better.

Finally, I wanted to thank each and every one of you for your emotional and financial support. I am deeply grateful (and a bit overwhelmed) by your response. I so truly appreciate everyone’s kind words, positive energy, prayers, and hard-earned money. I will post a photo of the final bill later today or tomorrow over on the facebook page (and sometime after that over here, just not sure when) so as to be fully transparent and accountable to everyone.

Thank you so much. Thank you for being part of our lives, and for helping me care for Maisy. I love her with all my heart, and I’m just grateful that I will have another day with her.

Speaking of which… I’m gonna go get my dog. Love you all!

She was fine. And then she wasn't.

We had a completely normal weekend. I taught on Saturday, and then hung out with Maisy while I did some last-minute studying for my CPDT exam (which was yesterday, I think it went okay). Sunday we went to my friend Elizabeth’s house, where Maisy followed her toddler around the house. (Apparently pushing treats on a dog is genetic, as we had to reward things like eating and taking a bath with the opportunity to give Maisy a treat. So. Cute.) We came home, ate supper, went to bed.

I woke up alone. This is unusual, but not unprecedented. I figured that she was a little stressed from All The Good on Sunday, what with not biting a kid and all. But when I got up, she just didn’t look right. She was stiff and panting and then she refused breakfast. She never refuses food. Never.

I called our vet. An hour later, we were in their office. Maisy sat hunched over with a miserable expression on her face. She had a slight fever of 102.9 (normal is 101-102.5), but nothing noteworthy. She yelped when the doctor touched her neck. We agreed to do some blood work and x-rays. Neither showed us much of anything, although she did have a faint positive for anaplasmosis, a tick-borne disease. But since the blood work didn’t support that, we figured it was just that she had been exposed to it before- completely plausible here in Minnesota.

She came home with antibiotics, a pain med, and instructions to monitor her temperature. When we left the vet clinic it was 103.3. An hour later it was 104; I called the vet back and they gave me some directions on how to cool her down. Despite this- cool washcloths in armpits and on paw pads, misting her with water, putting her in front of a fan, and having her eat a popsicle (she refused)- her fever actually went up, so I took her to the closest 24 hour clinic, which happens to be the U of MN. She was having a lot of pain in her neck and hips and her fever was 104.5, and we didn’t know why.

They admitted her to ICU, put her on IV fluids, started IV pain meds (fentanyl), and did a CBC and chem panel. Those results were inconclusive, but her fever did go down to 102.6. Spinal x-rays showed mild narrowing of the discs in her mid-back, but we don’t think that’s causing the current issues. A neuro consult ruled out disc herniation. The vet suggested discharging to home and either doing a wait-and-see or further diagnostics tomorrow. I said I needed a few minutes to think about it and then called a friend who is a vet. She told me what questions to ask so I’d know how to go forward.

When I called back, her fever was back at 104.4, despite the IV fluids, so going home was no longer an option. A urinalysis this afternoon showed some bacteria and white blood cells; a urine culture has been ordered. Surgery consulted and agreed that there is no joint swelling.  Tomorrow they will do a spinal tap and a joint tap. Those tests will tell us if she has a bacterial infection of the spinal cord, meningitis, a tick-borne disease, and/or some kind of immune mediated disease like arthritis. 

Her fever is down again this evening at 102.9. Still not normal, but much better. Still- we have no idea what is wrong, and I am so worried.

I also am quickly running out of money. Before I got divorced, I was solidly upper-middle class, and vet bills like this wouldn’t be a problem. But now, single and a social worker, it is. I spent just over $500 at my regular vet yesterday, and the current estimate for hospitalization and diagnostics at the U is around $2700. Plus cost of treatment. And it will obviously be more if she needs to stay another night. I’ve used up my emergency savings on this (and my cat’s ER visit last week), and am getting close to my credit card max.

I need help. I feel really weird doing this, but can you help us? I’ve set up a YouCaring site (the new ChipIn) here. I posted this link on our facebook page earlier, and I am so grateful to everyone who has donated already. And a little overwhelmed; we've gone from "how am I going to afford this?" to "well, I can still pay my rent." Thank you.

If you can’t spare a few dollars, that's fine. Your prayers, good vibes, positive thoughts, and white light (and whatever else you might do) means a lot to me.

Finally, I wanted to address a very common question: we do not think she has that deadly virus that started in Ohio. Her symptoms really don't match up (those dogs have had vomiting and diarrhea- Maisy doesn't.)

Regular and frequent updates are available over on our facebook page.

CPDT Study Session #7: Husbandry

I'm in the home stretch for the exam. I take the exam on Monday, so with less than a week to go and three sections left to review, well... honestly, I'm not worried. Studying has actually helped me feel more confident than less- it's been mostly review!

The husbandry portion of the exam counts for 6% of the final grade and covers general health, grooming, and nutrition. The information from today's post is from Terry Ryan's book and this section in particular was written by RK Anderson and Margaret Duxbury, Maisy's former vet behaviorist and my friend.

The running theme of this section is that as a trainer, you should not try to take on duties outside of your area of expertise. This means that unless you've received the education required to be a vet, groomer, or nutritionist in your area, you should refrain from giving specific advice and instead refer to the appropriate professional. This is especially true when it comes to health information. 

Infectious Diseases and Prevention
A dog exhibiting symptoms of an infectious disease (distemper, parvo, etc.) should not come to class and instead be referred to his veterinarian. The symptoms will vary among disease, but in general, lethargy, vomiting, diarrhea, nasal discharge, and coughing are causes for at least a call to the vet.

Parvo is of special concern as it is highly contagious and can quickly result in dead dogs, especially with puppies. Do not allow sick puppies in class and clean up all areas well if a dog becomes sick afterwards. A solution of 1 part bleach to 30 parts water will kill parvo.

Vaccinations are the best way to prevent infectious diseases. Although I am concerned about over-vaccination, I do believe in vaccinations, especially for puppies. Side effects in healthy dogs are rare and generally minor, and for me, the risks outweigh the benefits. But, personal choices aside, as a professional trainer, you should not put your clients' dogs at risk. Require vaccinations (or titers, but remember that there are fewer studies on the efficacy of using these to determine adequate antibody levels) for all dogs in your classes.

The core vaccines are distemper, hepatitis, parvo, and rabies. All dogs should have these. Depending on other factors- best discussed with a vet, not a trainer- non-core vaccines like lyme, lepto, bordatella, parainfluenza, etc. might make sense.

Because puppies are born with maternal antibodies, and because we don't know exactly when these will wear off in each individual, puppies get a series of shots. The core vaccines (excluding rabies, which should be given after 12-16 weeks) should be given every 3 to 4 weeks starting between 6 to 8 weeks until 12 to 14 weeks. They should be repeated at 1 year and then every 1 to 3 years after that. While socialization is extremely important, puppies should not begin classes until at least 1 week after their first set of vaccines. Thankfully, this means puppies should be able to attend classes starting at 7 to 9 weeks; plenty of time to take advantage of that critical socialization window.

Parasites
Parasites fall into two main categories: internal and external. Prevention, diagnosis, and treatment of these are the responsibility of the veterinarian.

Among the internal parasites we have heartworm (which effects the cardiovascular and respiratory systems) and gastrointestinal worms (which can impede nutrition, causing further problems). The latter type are quite common and can be spread to humans, especially those with compromised immune systems.

External parasites include fleas and ticks and can cause allergies, transmit diseases like lyme, transmit tapeworms, and/or cause anemia due to blood loss.

To Spay or Not to Spay?
Again, this is a conversation best left to the medical professionals, if for no better reason than it is an incredibly complex issue and one that I simply don't have the space/time/education to write about fully. That said, a dog can be spayed or neutered as early as 6-8 weeks, though generally we look at it as happening either before or after puberty.

Neutering will reduce mounting, marking, and fighting behaviors in 50 to 60% of male dogs, and will reduce roaming in 90% of dogs. It will not calm the dog down. It will reduce the risk of certain infections, prostrate issues, and (obviously) testicular cancer. Spaying will protect a female dog against uterine cancer and pyometra, and if done before the first heat will reduce the risk of mammary cancer. The behavioral benefits of spaying a dog are far less clear.

Medical Conditions that Impact Training
Once again, Terry Ryan's book cautions trainers against making a diagnosis of any particular medical concern. In addition to some of the reasons identified above, it's also due to the fact that there are a lot of different conditions that can result in similar behaviors. Any of these conditions can change behavior or limit a dog's ability to learn, making even the best training less effective.

Among these are hydrocephalus, epilepsy, liver disease, hypoglycemia, hypothyroid, and cushings. Likewise, drugs like steroids, tranquilizers, or benzodiazepines can cause behavior changes. Issues related to aging can cause problems, especially when looking at changing sensory capabilities. Pain is a huge factor in behavior and learning abilities of dogs. Finally, though readers of this blog likely need no reminder, emotional issues like fear and anxiety will also impact training.

Nutrition
Oh, the can of worms that can be opened here. I have a lot of opinions on this subject, and you probably do, too. Suffice it to say that likely the biggest concern here is the dog's weight, especially carrying too much. A fat dog will contribute to medical conditions, pain, and limit a dog's ability to do certain activities.

Grooming
Finally, Terry Ryan's book is silent on this issue. So. Um. Cut your dog's nails? Don't let them get mats in their fur? Teach the dog to accept handling (ah! a training issue!). Beats me and good luck to us all!

Why Punishing Anxiety Doesn't Work

I have asthma. This causes my airway to swell and narrow, making it more difficult for oxygen to reach my lungs. In turn, I become short of breath, my chest feels tight, and I often wheeze or gasp for breath. It’s an awful feeling.

I have a friend with a heart condition. She has poor circulation and sometimes her heart rate increases and her blood pressure drops. The end result is light-headedness and occasional fainting spells.

I have worked with people who have diabetes. You’re probably familiar with this disease in which the body doesn’t regulate insulin well. Sometimes, the body will either have too much or too little blood sugar, and the person can be rendered confused, disoriented, or even unconscious.

My dog has an anxiety disorder. Her brain chemistry is not balanced, and the neural pathways of her brain are abnormal as a result. When something happens to overload those pathways, she may become hypervigilant, pace, or growl and snap at people.

What do all of these things have in common? They are medical conditions that are the result of a physical problem in the body. What’s more, these conditions manifest themselves in behavioral terms. Whether it’s gasping for breath, fainting, or becoming aggressive, the behavior is not a conscious decision made by the sufferer.

I want to be clear on this last point: none of us choose to act the way we do as a result of our respective problems. Believe me, I hate having an asthma attack, and when one is imminent, there is little I can do to prevent it. I definitely do not choose to have trouble breathing- it just happens. Likewise, my dog is not weighing out her options when she encounters a situation too stressful for her to handle. Her brain releases a cascade of hormones and neurotransmitters which causes her to react in a certain way.

This is one of the many reasons I prefer to avoid the use punishment when dealing with dogs with behavioral problems. Just as we wouldn’t hit people in diabetic comas in order to stop them from having low blood sugar episodes, we can’t stop a dog from having a panic attack by using a collar correction. While it’s true that some behavior problems are just that- behaviors- others can be traced back to a medical problem like imbalanced brain chemistry, pain, or some other disease process. It is exceedingly difficult to know the cause of so-called misbehavior in the heat of the moment.

I’m not saying that we should just shrug our shoulders and allow things to continue as they are. If we do, there is a risk of death. Left untreated, I could stop breathing because of my asthma. My friend could go into cardiac arrest. And my dog could be euthanized if she bit someone.

Thankfully, there is a lot we can do to prevent those behaviors. I take inhaled steroids twice a day and avoid chemical scents. My friend takes beta blockers and avoids activities proven to cause problems. Diabetics often take insulin and monitor their blood levels. And my dog takes medication, receives ongoing behavioral training, and I help her avoid stressful situations.

What’s more, each of us have things that we can do when exposure to triggers are unavoidable. Whether that’s following a carefully thought out exercise regime, a well-balanced diet, or a behavior modification protocol, there is a lot we can do to cope with an unpredictable world.

If something happens to push our dogs over the edge, we need to step in and help them. Trying to train through the situation is foolish; it’s like lecturing a diabetic on the importance of a proper diet when their blood sugar drops. It’s too late for that. Glucose for a diabetic or a rescue inhaler when I have an asthma attack is not a viable long-term strategy, nor is it prevention. It’s a response to an emergency situation. When our dogs growl, bark and lunge, or otherwise “misbehave,” that’s an emergency, too. Get them to safety.

We owe it to our dogs to help them deal with stress. Seek out a professional, whether it’s a medical appointment with their vet or a behavioral evaluation with a qualified trainer. Come up with strategies that will prevent problem behaviors from occurring. Equip them with the tools that will help them in the moment. Know how to respond in a behavioral emergency.

And above all- remember that you can’t shock a diabetic’s pancreas into working. So why would you do it to your dog?

Normal, Normal, Normal

On Saturday, Maisy went to the emergency vet because there was blood in her urine. Assuming it was a UTI, but wanting to be sure, the vet and I agreed to do a urinalysis and urine culture. The urine was collected via cystocentesis, which requires using an ultrasound to poke a needle into the bladder in order to obtain a sample.

This would have been fine except that both the emergency vet and the critical care specialist on call thought Maisy's bladder wall had “abnormal thickening,” and there were unexplained white spots in the bladder cavity. The recommendation was to see an internal medicine specialist.

So, we went to that appointment yesterday, where I learned that the culture had come back negative. There were no bacteria, and no white blood cells, and thus, no UTI. She did have an elevated pH, and she had a lot of sediment, including struvite crystals. The specialist recommended we have an ultrasound done to see what had caused the bloody urine, and so we did that today.

The results? Normal, normal, normal. No bladder wall weirdness, no bladder stones, sediment, or crystals, the kidneys looked great, everything was awesome. Our best guess is that the bloody urine was caused by irritation from the crystals- or possibly even some small stones- that were passed when I increased Maisy's fluid intake over the weekend.

I was scared.

Like Maisy, I tend to be a bit reactive, and so I was absolutely freaking out. I tried to hold myself together, and I think I did okay once I quit consulting with Dr. Google (who had me convinced my dog was going to die, indeed, had already died about three days ago). I am grateful for my friends, who offered much support, logic, and rational thought.

Maisy was scared, too.

No, she didn't know that she had already died, but both appointments were very hard on her. The appointment yesterday was the worst. She was fine when we first arrived at the hospital, but was not fond of the physical exam the student gave her (the U is a teaching hospital, so we saw a student first, and then the specialist). In fact, she was so not-fond of it that she buried her head in my armpit and stopped taking treats.

Ya'll, I can count on one hand the number of times she's refused treats. When Maisy gets stressed, she will take treats frantically, have a “shark mouth,” and dive bomb the treat bag. Not eating? That's practically unheard of, and a sign of serious stress. I felt awful, and after the student left to report her findings to the vet, Maisy cowered under my chair. Again, this is not normal behavior for her.

When the vet came in, Maisy stood up, and pressed up against my legs, but stayed under the chair. It was not easy to coax her out, but we managed to do it. Thankfully, the vet did not need to do much in the way of a physical exam, and instead spent most of her time discussing the possible causes and diagnostic steps to take. Even so, Maisy jumped in my lap, and then scrambled up my shoulders and stood behind my head. This was not height seeking. This was fear. Honestly, it felt good that she wanted me to protect her, but I felt awful that I couldn't do what she wanted and stop the exam from happening.

That feeling got worse today.

Upon the suggestion of my trainer, yesterday I called Maisy's veterinary behaviorist to explain what was going on, and how stressed Maisy was. She consulted with the anesthesiologist (in case Maisy needed sedation in order to do a biopsy), and prescribed trazodone. I'm not sure if it helped. If it did, it wasn't enough.

The first thing they did when we arrived was take Maisy and place an IV catheter for possible sedation. Despite my objections, they did not allow me to go back with Maisy, and it broke my heart to see how reluctant she was to leave without me. Normally she loves people, but she remembered these people. Poor little pumpkin, the looks she gave me were just pathetic.

They returned her to me to wait for the procedure, and she pressed up against me, panting like crazy. Her pupils were bigger than I'd ever seen them, and she licked her lips almost constantly. I felt awful.

Then they took her for the ultrasound. She wouldn't even walk with the tech this time, and they had to carry her. Again, the looks Maisy gave me had me on the edge of tears.

During the ultrasound, they gave her a morphine-derivative to help sedate her some more. The procedure took almost an hour. They said she did well, and she seemed reasonably happy to see me, but still and quiet. Even now, three hours later, she's all drugged out, sitting spaced out, swaying side to side.

She appears quite bothered by her shaved belly. She's walking oddly, sitting stiffly, and keeps sneaking peaks at her stomach to figure out what's wrong. I knew she didn't like wearing things, but I find it interesting that she seems to equally dislike not having enough on.

Maisy also seems displeased with me. When we got home, she refused to come in the house, instead sitting at the far end of the yard. I finally coaxed her in with some treats, but she chose to be in a room as far away as possible from me, one which we never use, one which I've only seen her in once or twice before. I coaxed her out with some potato chips (her favorite treat), but she then went right back in there for an hour or two. She's now sitting in the same room, but with her back to me. She only looks at me when I offer her a treat, and even then, she takes them grudgingly.

I would worry that I'm being excessively anthropomorphic, but Patricia McConnell's dog Willie recently did something similar to her following his own surgery. Thankfully, he seems to have gotten over it, and I trust that, in time, Maisy will, too.

In the meantime, I'm simply grateful that, mad at me or not, Maisy is healthy. I love her more than I ever thought it possible to love a dog.

Emergency Vet Visit

We interrupt your regularly scheduled series of blog posts on dog body language to bring you this important health update.

My parents are in town this weekend, which means that we actually Go Out and Do Things instead of our normal weekend of bumming around. I was pretty excited to learn that the Sculpture Garden is dog-friendly, so we headed over there.

 

Obligatory shot with the iconic Spoonbridge and Cherry.

It was shaping up to be a pretty nice afternoon, strolling among the art, when Maisy squatted and peed red. That's right- several ounces of rust-colored urine came out of my dog's bladder. A few minutes later, she squatted again, and this time, there were four or five drops of blood. Thick, bright red blood.

Our Facebook followers already know that we went to the emergency vet.

I'm lucky enough to live in a large urban area with an abundance of emergency vets, so there are many options for us. We ended up going to the the U of M both because it was closest and because Maisy's been there before for her veterinary behaviorist appointments. I hoped that meant she'd feel comfortable.

I think she was.

I felt kind of silly when they were taking Maisy's history. She was being her new-found outgoing self, and I was telling them that she's followed by the behavior clinic as an aggressive dog. I denied any pain, lethargy, or behavior changes, and she was being super calm. (Okay, so yes, she took a nap at the clinic, but then she came home and played ball with my dad for like three hours. Despite appearances to the contrary, her energy level has been completely normal.)

The vet took me seriously when I said that she was almost literally peeing blood, and decided to get some urine and do a culture. Unfortunately, in order to do a culture, the urine has to be sterile. And to be sterile, it needs to be obtained via cystocentesis, where they poke a needle through the abdomen, into the bladder, and draw out the urine. Not only is this more invasive than I like to be, but it needs to be done under the guidance of an ultrasound (to ensure they're in the right spot), and the machine is in the dreaded back. I asked to go back with Maisy, but there was another dog in the back with a life-threatening emergency, so they didn't want anyone extra getting in the way. Reluctantly, I handed over Maisy's leash and a fistful of treats and sent her off. 

By all accounts, Maisy did well. They ended up muzzling her, which they were extremely apologetic about, but given her history at the U, I completely understood. I'm glad we've been playing around with muzzle training in class, but I wish we'd been more serious about it. I've shaped her to stick her nose in a (greyhound sized) muzzle, and last week I was putting pressure on her nose with it, but since it's hard to find a Maisy-sized muzzle, she'd never actually worn one before. Still, they said she let them put it on with no complaint, and that, aside from a drama-queen yelp when they stuck her with the needle, she laid very still and was a good patient.

Photo by Robin Sallie.

The urine they removed from her bladder was red and thick with sediment, and the results from the urinalysis and culture will be available tomorrow. In the meantime, they sent us home on a broad-spectrum antibiotic, because that much blood is pretty indicative of a UTI. Unfortunately, that's not the worst of it; both the emergency doctor and the critical care specialist saw some abnormal thickening of her bladder wall on the ultrasound (actually more like a lump), as well as some weird spots/dots in the bladder cavity. Since those spots are typically indicative of bladder stones, we ended up taking some x-rays to see if there were any (there weren't), so we're not really sure what's going on. It could be nothing- just an artifact of an older, unsophisticated ultrasound machine, or some inflammation from the raging UTI she apparently has. Or it could be more serious, like some crystals or stones that just didn't show up on the x-ray, or worse, a polyp or tumor. We just don't know.

The vet recommended we see an internal medicine specialist next week to discuss further diagnostics- either an in-depth ultrasound with a specialist and a better machine, or a contrast dye study to illuminate the structures better- and so we have an appointment back there on Wednesday. Add today's (expensive) visit, and an already scheduled follow-up with the veterinary behaviorist at the end of the month, and I'm thinking this is going to be one expensive month. 

Oh well. She's worth it. Even if she does give me a gray hair between now and then as I worry about what that mysterious lump in her bladder might be.