Coffee heat rising

A little…doggy miracle?

Just yesterday, you may recall, I again thought Cassie was pounding at Death’s door. She went in the closet and tried to hide in a corner (again). There wasn’t much I could do about it today: getting into the vet proved to be impossible around a two-hour  choir rehearsal followed by a lengthy special religious hoe-down.

During today’s long-distance sing-a-thon, I got an elaborate earful about Valley Fever from a friend on the choir who has lost three dogs to it. Spent the afternoon in a Holy Blue Funk, singing to God and His Archangels whilst contemplating the demise of my little doggie. Probably tomorrow at 8:30 a.m. sharp, when I’m supposed to show up at the vet’s doorstep.

But…then…on the way home, them thar Angels began to speak. Nay, even to break out into a little song of their own. And the verses went like this:

  1. When you called the vet about her cough, dear Estupida, the first reaction there was that she had a contagious bronchitis that’s been going around. They did not say whether they thought it was bacterial or viral, nor did they put a name to it. They only said they’d been seeing a lot of it, and then said “come get these blue pills.”
  2. The handy-dandy blue pills DID make it better. But when the cough hadn’t completely gone away after 10 days or so, Estupida, you called back expecting to cadge another bottle of blue pills. Instead they invited you and the dawg to make a trip across town to the veterinary.
  3. The vet opined that what ailed the dog was Valley fever, based on an X-ray that proves nothing. That X-ray could also image pneumonia or a bad case of bronchitis; it could also image a heart inflammation caused by heartworm, endocarditis, or congestive heart failure. Any of these would cause a severe cough. The blood panel came back negative for Valley fever but showing elevated values for a couple of measures that can be elevated by any kindof inflammation or infection. Yes, often VF tests do come back negative even in the presence of coccidiomycosis. BUT it is not unreasonable to suspect that such a test could come up negative because of the absence of coccidiodes. A second veterinarian at a different veterinary clinic suggested this and stated that she felt the test results were ambiguous and should be repeated after three or four weeks. So: we have no empirical proof that the dog really has Valley fever.
  4. Nevertheless, assuming the dog probably had VF, MarvelVet put her on a fearsome anti-fungal drug called fluconazole, which is nasty stuff with superbly nasty side effects. Within a few days of beginning this drug, the dog began to grow weaker and exhibit signs of failing health:

Total loss of appetite
Extreme thirst
Incontinence of Biblical proportions
Lethargy
Loss of interest in everything around her
Inability or unwillingness to move around.
Diarrhea
Vomiting
Gastric upset

ALL THESE SYMPTOMS are listed by the UofA Medical School as side effects of that drug in dogs: https://vfce.arizona.edu/valley-fever-dogs/treatment

And wouldn’t you know: she kept on coughing. By now she’d reached a point where every time she tried to drink water, she would choke on it and then start wheezing!

The blue pills are Temaril-P, which contains an antihistamine and some prednisone and whose purpose is to suppress coughing and reduce inflammation. When we took her off the Temaril, the coughing got worse. When we put her on the fluconazole, she got really, really sick.

Sooooo….this leads us to, goddammit,…

  1. What if the problem is NOT Valley fever? What if it isn’t any other fearful disease, either? What if the initial cause of the cough actually was the bug that was going around? She’s the same age I am in doggy years…and the last time I caught a chest cold, it took SIX MONTHS to shake the cough. Maybe the vet’s first guess was right, and it’s simply taking her a long time to get rid of the cough because she’s 12  years old.

Just now my money is on Numero 5.

Tomorrow I’m going to ask him to prescribe more of the Temaril and propose that we keep her on a low dosage for about ten days or two weeks. THEN wean her off and see what happens.

Whaddaya bet the pooch is still alive in ten days or two weeks? And still kickin’…or rather, kickin’ again?

Sick Dog: Deciding what to do…or not to do

Cassie is getting steadily worse. Today she can barely drag herself around, and she refuses to eat anything, even a single piece of the fancy kibble I give her for treats. Twice now, this dog has been so sick that I thought she might die, very soon.

I’ve made another appointment with the “second opinion” vet — turns out the one I saw out there was actually a part-timer, a kind of visiting vet, but now the regular guy (who sees my son’s dog) is back. This afternoon, he will have the joy of seeing a cranky old lady and her sick little dog.

This is what I think…oh, no. Make it this is what I’m sure of: The drug given for supposed Valley fever, fluconazole, is making her very sick. All of the symptoms she’s suffering, except for the bloody urine and the wheezing, are listed as side effects of fluconazole. We do not have any empirical proof that the dog actually does have Valley fever: the first test came back negative for Valley fever. This is not uncommon, and so we moved forward with the first vet’s diagnosis.

The longer the dog is on this drug, the sicker she gets. Today she will eat nothing at all, and she can barely move around, except to piss out an occasional lake on the family room floor. She is incontinent and unable to get to the back door before it all comes pouring out. Of the phenomena she’s suffering, almost every one of them appears in the University of Arizona Medical School’s list of fluconazole side effects in dogs:

  • loss of appetite
  • nausea
  • vomiting
  • diarrhea
  • excessive drinking and urination, or leaking urine while asleep
  • lethargy

If she doesn’t start to eat, she’s going to starve to death. I cannot afford to hospitalize a dog and keep it on life support so as to administer a toxic drug on the off-chance that three to six months of such treatment will beat back a fatal disease.

I can see four reasonable scenarios to explain what’s going on:

Possibility 1: She in fact had the contagious bronchitis that was going around, but because she’s elderly, it took longer for her to get over it and so it was mistaken for a chronic, endemic disease. In this scenario she does not now and never has had Valley fever; what ails her is either a respiratory infection or the side effects of the drug.

Possibility 2: She does have Valley fever acquired fairly recently and, as is not uncommon, it hasn’t shown up as a positive titer yet. In that case the drug is causing most of the symptoms, with the exception of the cough.

Possibility 3: She’s had Valley fever for awhile (just about any human or dog or horse that lives for any length of time in the low deserts of Sonora, Arizona, and California harbors Valley fever, usually asymptomatically) and it has advanced to the point where it is causing symptoms. In that case, the drug is still causing most of the symptoms, but it’s not likely to do much good.

Possibility 4: Now for something completely different! She has neither bronchitis nor Valley fever, but some as-yet-undiagnosed ailment that is much more serious. Her symptoms may be indicative of that…or may be the side effects of a drug she doesn’t need.

Just talked to First Opinion Vet, who finally had time to call me (it’s the lunch hour here). His money is on Possibility 4. He thinks there’s something more going on than Valley fever. He says the only way we can find out is to mire ourselves in every more complicated and expensive tests, and where the end-point would be is anyone’s guess. He feels that is not a good thing to do to the dog…and I will say, neither do I. Even if I could afford to be sucked into a vortex of medical testing for a dog that is at the end of its natural lifespan, my sense is that it would be cruel to put her through that — especially since it’s likely to be pointless.

As for me, I’m putting money on Possibility 1: she had bronchitis, was inappropriately treated for it, and got over the cough in the normal course of events. And what we’re looking at now is the result of a drug that did nothing for the ailment but has worked wonderfully to make her spectacularly sick.

I had already decided, before His Vetship called, to take her off the drug, stand back, and watch what happens. If she dies, she dies. Like all of us, she’s gonna die anyway. When he called and heard my whinge — and more to the point, heard that the dog not only is not improved but is lots worse — he agreed that we should quit giving her ALL the drugs, including even the small amount of Temaril-P. If it’s true that the worst of the ailment arises from the drugs’ side effects, she may feel a little better even if the underlying problem is something we haven’t figured out yet.

Which, IMHO, is a veterinarianly way of saying “ooops!”

Let’s see what happens next.

Doggy Ups and Downs

Each day, Cassie has her ups and her downs. And it seems that each down gets deeper. She’s in a bad way every morning, but then seems to revive a bit around noon.

Today I noticed she wasn’t in her normal nest. Or anywhere else. Thinking I’d accidentally left her outside, I went running around calling her: no response. Finally I found her in the clothes closet, squirreled away in a corner.

This is not a good sign. In all the ten years this dog has lived here, she has never gone into that closet. Maybe once or twice to sniff at a shoe, but really: she doesn’t go in there.

The other not-good sign: she flat refused to eat this morning. I managed to coax a few bites down her by mixing some of the food with water to make a kind of soup. But she wouldn’t even take all of that. Either she’s having a difficult time swallowing or just doesn’t feel like being bothered. My money’s on the latter: my guess is she simply doesn’t want to eat any more.

If you’re going to let Nature take its course, you’ve gotta listen to Nature and understand what She’s telling you. Today She definitely was trying to say something…

The vet’s office called to say he wanted me to come pick up some Temaril tablets to try to deal with the refusal to eat issue. Why, I don’t know. Temaril is a cough suppressant. She’s stopped coughing, and he knows it.

I am now flat broke, budgetwise: $5 left to live on for the rest of the month. I transferred a hundred bucks over from emergency savings to get through the next week…hope I won’t have to spend much of it, but am basically out of food except for what’s in the freezer and what’s growing in the backyard.

At any rate, the UPs: Along about noon, the dog seems to revive. This is becoming a pattern. But every day, the morning “down” seems worse than the previous day’s. Really, today I thought she might not be alive by the time I got back from the vet’s — it’s an hour of driving, round trip. So I pull the car into the garage, climb out, and hear Cassie barking on the other side of the door!

She hasn’t barked in days.

Fling wide the gates…and lo! There’s Cassie standing there bright-eyed and wagging, looking normal as apple pie.

WTF?

The garage door is open. Ruby is still in the car — I’d taken her with me because I thought there was such a high chance Cassie would pass while I was out fighting traffic, and frankly, I do not want Ruby to decide to eat the remains.

She is a dog, you know…

So Cassie walks outside, Ruby being locked in the vehicle and so unable to make her escape to Yuma. Cassie strolls around, sniffs, pees, acts pretty damn normal. I get the mail, we stroll back inside as though this were just another day in Paradise.

Right away, while she still is acting like she’s going to live, I mix up some more dog food swill, causing her to get about half the remainder of this morning’s dog food down, along with about a third to half a cup of water.

Vet called just a minute ago. I pointed out that Temaril was for a cough and she’s stopped coughing. He said it contains a steroid to reduce inflammation, and can sometimes make an ailing dog feel better. Before I left the Funny Farm, I’d given her one of the remaining half-tablets from the previous bottle. He says it can act pretty fast, and that might explain her apparent revival. He also speculated that she may just feel bad when she wakes from a night of snoozing and it could take several hours for her to begin to feel better.

I reminded him that she’s 12 years old. He said…yeah…but made no further comment on her superannuation. He did remark, though, that Corgis are unusually tenacious dogs, and so one shouldn’t give up on her too soon.

/p>

Cassie: Still Extant…

…as far as I can tell.

Cassie-off-leashWhen I left the house this morning, Cassie the Corgi was very sick, indeed. Worse than before, by far. Coughing and choking and gasping for air and actually wheezing.

In the absence of a doggy thermometer, it’s impossible to confirm or de-confirm whether she has a fever, but her schnozz certainly felt very hot. I mopped her head with cold water — an effective way to address impending heat exhaustion in a dog, BTW. Works better with dogs than with humans because of the difference in the way the brain circulates blood.

She seemed unimproved.

Comes time to leave for choir, the thought crosses my mind: Lady, this dog is not going to be alive when you get back here…

Really, I thought she wouldn’t make it another three hours. She couldn’t walk a few feet across the floor without gasping for air.

But…I was supposed to be down at the church, so off I went, misgivings or no.

So after cruising southerly two or three miles, I go to turn left from Main Drag NS onto Least Annoying Main Drag EW to get onto Main Drag Leafy Parkway, whereinat resides desired House of God. Traffic clears, I make my turn, and

POP! There’s some clown on a bicycle in front of me, on the WRONG SIDE OF THE ROAD, flying through the intersection in the crosswalk.

That is, he’s not traveling on the righthand side of the roadway, as is the law here in our garden state. He’s on the lefthand side, riding on a sidewalk. He’s  in the crosswalk  legally — we both have the light, of course. But he’s not where a motorist would expect to find him, because he’s riding on the shoulder against the traffic.

I jam on my brakes. He jams on his brakes and in his alarm very nearly falls on the pavement. By now cars that were wayyy on down the road are upon us — traffic flows at 45 to 50 mph on that street. He looks confused and scared. I holler GO GO GO!!!! and he jumps back on and dodges out of the way in the nick of time.

Holy cripes. What is the matter with people?

Stumbling across the church parking lot, I think THIS is a towel that I need to throw in. Unnerved by the biker episode and really worried about the dog, I announce that I can’t stay, turn around, and come home.

Not over yet, though:

When I climb back into the car to leave the church parking lot, I notice the statement the vet’s office-lady gave me. I would swear she said the bill was $45. No. They engrossed FOUR HUNDRED AND EIGHTY FIVE BUCKS from my checking account!

Holy mackerel! And that’s just to try to figure out what’s wrong with her! He gave me the pills for free, which was mighty kind of him ’cause it turns out that drug goes for — hang onto your hat — $200 a bottle!!!!!!!

I fly back to the house. From inside the garage I can hear Cassie barking merrily. WTF? She could barely drag herself across the floor 30 minutes earlier.

Fling open the door: they’re both doing the welcome home Odysseus how was the Trojan war? dance. They streak out the side door, as usual, like rockets. Cassie doesn’t get far, but she does manage to work herself up to a dead run. Briefly.

Which is better than what I expected: just plain dead.

Well, we’ll find out tomorrow whether the dog’s lung inflammation is really Valley fever, or if she has some other kind of infection. He said he was sure it wasn’t cancer, so I guess that for $485, we can discard that notion.

There are two similar drugs on the market that are cheaper than fluconazole. In fact, this stuff is for the disseminated state of VF. If it’s just in her lungs so far, then we could probably switch to one of the other drugs, which are a lot cheaper. Dr. Vet and I are going to have to have a little chat about this…

Makes “let nature take its course” look depressingly like good advice, doesn’t it? I guess if I have to put her to sleep because I can’t afford exorbitant amounts of money to get her over this thing…well…