Remember how I was wondering whether a possible misdiagnosis of Valley fever by MarvelVet might be what’s killing my dog? Well…yeah. Just talked to NewVet: the results of the second Valley fever test are back. And no.
No. She does not have and never has had Valley fever.
So basically: we have destroyed this dog’s health and very probably killed her by giving her fluconozale on top of prednisone. Or prednisone on top of fluconozale, however you wish to look at it.
That is not a benign combination. What can it cause? Adrenal gland dysfunction.
And yeah, again. That is exactly what has happened. It destroyed Cassie the Corgi. Her health is permanently ruined, and really, if I had a backbone I’d put her down now.
This has happened under the watch of the Great Skeptic. Remember, I am the one who keeps carping away that one should QUESTION AUTHORITY. Don’t take what your doctor (or a vet) says without looking it up yourself, understanding what ails you, and understanding what the proposed treatments will do for you and to you. Sometimes the treatment is worse than the disease.
That certainly is the case here. We basically killed this dog by putting her on a cough suppressant with prednisone plus an antifungal in the absence of no empirical evidence that a fungal infection was what ailed her. Instead, what ailed her was what was obvious: a bronchial infection that was going around the city at the time and that, probably thanks to the dog’s old age, advanced to pneumonia. She should have been treated with an antibiotic. In fact, when NewVet put her on doxycycline for a UTI, her cough cleared right up.
Well, that’s not funny, given how sick poor old Cassie has been.
Actually, Cassie is presently somewhat better, other than having come completely unhouse-trained. She now poops and pees wherever and whenever she pleases. Fortunately, it’s usually on the pee pads I put in her favorite locales — something that’s getting pretty pricey, since I have to pick up and replace four to six of them a day. But sometimes it’s on the bathroom or bedroom rugs. Yay. At any rate, she doesn’t appear to be feeling as bad as she did.
Which is not to say she appears to be feeling well. I’d guess she’s running at about 80%…maybe 90% on a really good day. Whatever happened to her doesn’t appear to be about to go away.
Meanwhile…hoooboy!
Last night Ruby started barfing spectacularly. She apparently ate something that made her good and sick. It soon became apparent that this was not a life-threatening thing…but by “soon” we mean sometime after midnight.
Ruby and Cassie both are in the habit of “harvesting” mummified oranges that fall off the trees and dry up, often after having been chewed out by the roof rats. They bring these crispy treats into the house, hide them in the bathroom, and crunch them up into crumbs. What a mess to clean up!
Well, they’ve never made either dog sick before, but apparently this time one of them did.
The real concern, though, when a dog starts barfing, is that we have some nut cases around here — apparently among the drug-addled vagrant population — who have been known to throw poison treats over people’s fences, thereby killing their dogs. It’s a strategy used by burglars, but neighbors have reported having small, harmless dogs targeted. So given both dogs’ corgi-esque love of yapping, of course an unexpected, apparently reasonless barfing attack causes some worry.
By 2 or 3 in the morning, though, her stomach calmed down and she seemed OK. Come the light of dawn, she was fine. Fed her hamburger (cooked) and rice this morning and again this evening: she seems to have recovered.
I, however, have yet to recover from the three-hour night. 😀
Today I managed to geta new chapter of Ella’s Story on-line. Not quite by the self-imposed deadline…but only a day late. Since no dollars are concerned, we need not add the dollah-short part.
But this was accomplished, I’m afraid, not by actually finishing the chapter as conceived, but simply by spotting a natural pause and cutting it off there. Between the sick dogs and my natural laziness and a general feeling of overwhelmed-itude, the truth is I’m not applying myself to this project for the enough hours a day to make the required progress. One of the things it illustrates, though, is how amazing those late 19th-century and early 20th-century writers were, in their ability to produce novels on the installment plan. Dickens, for example…and Poe, I believe, among many others, would write segments of novels for periodicals. And of course, they had deadlines, just like a journalist does.
Having amused myself as a magazine journalist for a good 15 years, I can assure you that a journalistic deadline is one helluva lot easier to meet than one that requires you to make stuff up and then turn your imaginings into something believable. Or at least more or less readable. A workaday magazine or newspaper article pretty much writes itself, growing like crabgrass out of your interviews and research online and in print sources. A piece of fiction? Not so much…
To my intense annoyance, I discovered that somehow WordPress had disappeared Chapter 11. I know I put it online, because I remember the images I posted with it, and because those images still lurk in the “Media Library.” So I had to reconstruct that, yet another time-killer.
One advantage Poe and Twain and Dickens and all those had over us wretches in the Digital Age is that all they had to do was write the damn stuff. They didn’t have to publish it, too. They had…oh, does anyone remember them?…publishers who edited and typeset and designed and laid out and illustrated and proofread and printed and distributed their work. Today those who imagine they will find great fame in self-publishing have to do all that themselves. And none of us is qualified to do all those things well.
Not by a long shot. Nor does having to devote half to three-quarters of your time to jobs you don’t want to do and aren’t really trained to do leave enough hours for you to do what you do want to do and what maybe you’re good at: to write. I am so very tired of spending hour after hour after hour in digital ditz! Just to create a table of contents for the 33 chapters I’ve put online in Ella’s Story required me to do 297 mind-numbing, repetitive, tedious computer operations today. That’s not counting the typos, which in having to be redone probably expanded that number by about 10 percent.
I un-friended the FB writer’s group I’ve belonged to for the past two years or so. That was too bad, because each week they give you a chance to publish some magnum opus…which has conveniently allowed me to publicize my emittances with some regularity. Haven’t noticed any increase in sales, though.
What I have noticed, however, is this 7th-grade mean girl they’ve picked up. She’s very, very nasty. Today she took aim at me. My response to that is simple enough: fuckyouverymuch. I don’t hang around where I’m not wanted, so off I went. That, we might add, will be one fewer electronic time-suck. I don’t know whether organizers of those groups try to moderate them, or if they even can — this one is quite large. But evidently someone needs to.
And now for something completely different… Did you know that you can still read books?
No, I mean real books, the things shaped like boxes with this hinge-like strip along one edge to which pieces of paper are attached.
The Brothers Grimm
Couple months ago, I’m at the Costco and I happen to spot this old-fashioned-looking hardback with an embossed cover and gold-leaf print: Grimm’s Complete Fairy Tales.
WTF!?! Last time I saw that book, it was at my great-grandmother’s house in Berkeley, back in another century when normal people could afford to live in Berkeley. It is a beautiful little production, published by some outfit called Canterbury Classics, out of San Diego. Gosh.
So for old time’s sake, I bought the thing. Stuck it on the nightstand and went off and forgot it.
One evening I started browsing through it and was reminded of what a hoot the original Grimm’s tales were. This is great stuff! And perfect bedside reading, when you’re so tired you can barely lift the dogs onto the sack. They’re very short, pretty light (in a strange and sometimes not-so-light way), and none of them require a sustained attention span.
So the other day I’m back at Costco and what do I find but a whole SLEW of these Canterbury Classics! Hot diggety! How can I leave them alone?
Yes, I know: Impulse Buy Hell. But hey: how often do you get to buy embossed hard-cover books with gold-leaf print all over them?
Grab Bulfinch’s Mythology and, by god, the original Thomas Burton’s Arabian Nights.
This stuff is too, too good. It is going to keep me amused for weeks. Maybe even months.
The Brothers Grim: Public Domain, https://commons.wikimedia.org/w/index.php?curid=165364
Frontispiece to Burton’s Arabian Knights. By Adolphe Lalauze (1838-1906) – A plain and literal translation of the Arabian nights entertainments, now entitled The book of the thousand nights and a night Vol. 1, Public Domain, https://commons.wikimedia.org/w/index.php?curid=11033095
Cassie the Corgi is not dead yet, but it’s pretty clear that sooner or later the adrenal gland dysfunction that has afflicted her since I took her to MarvelVet to treat a cough will carry her away.
I’ve suspected for some time that the medications he gave her made her sicker — a lot sicker — than she was. The combination of prednisone and fluconozale, as it develops, is contraindicated: the makers of prednisone specifically say not to give the drug in the presence of a fungal infection, which is what Valley fever is. When combined with prednisone, fluconozale can interfere with adrenal gland function. Fluconozale has a variety of baleful side effects, all of which appeared in the dog. By the time I unilaterally took her off the drug, it apparently was too late to save her from those effects.
Yesterday out of curiosity I looked into the question of whether adrenal tumors and dysfunction could result from an infectious agent. She does sleep on my bed, and as a matter of fact I’ve been feeling fairly shitty of late, myself. Yes, I find, that is possible, but it sure as hell isn’t likely.
However, what should I stumble across atScience Directbut this interesting statement:
It is noteworthy that a major category of antifungal medications, the azoles, can adversely affect adrenal function presumably via liver cytochrome P450-mediated interactions. In particular, the inhibition of CYP3A4 (the most abundant cytochrome P450 in humans) significantly impacts steroid catabolism.133 The most potent antifungal that inhibits the P450 system is ketoconazole (an azole that currently is infrequently used in the USA and Europe), but adrenal insufficiency can occur during the administration of other azoles.134, 135, 136, 137 Additional important inhibitors of the P450 system include antibacterials (such as macrolides and isoniazid) and antiviral agents (such as ritonavir and delavirdine). Hence, clinicians should carefully consider the potential risks associated with the use of an azole or other medications that affect glandular function in patients at risk for, or with suspected or proven, adrenal dysfunction.
SON of a bitch!
This pretty much fits the bill. New Vet remarked that her liver is somewhat enlarged. And yes, Cassie surely IS “at risk for, or with suspected or proven, adrenal dysfunction.” She’s at risk for two reasons:
And then of course we have number 3: evidence of an adrenal mass seen in an abdominal ultrasound.
Okay. It’s probably unreasonable to expect a vet with a busy urban practice to be aware of an obscure study that appeared in 2014. BUT… Putting her on a powerful drug with nasty side-effects in the absence of proof that the dog had the disease for which the drug was intended? Not a good idea. The Valley fever test came back negative, which is not proof that his shoot-from-the-hip guess was wrong. But…if we’d waited four weeks and then tested her again, it probably would have shown positive if she really had VF. Which, in my opinion and in the ever-so-much-better-educated opinion of New Vet, she does not. Even if she did, a more conservative approach wouldn’t have harmed her significantly.
She no doubt did have the adrenal tumor. But like most such growths in aging dogs, it was asymptomatic and probably would have remained so until she died of something else. Now, though, we learn that the fluconozale very likely activated or aggravated a condition that was quiescent.
So in fact what we have here is an iatrogenic ailment that almost certainly will kill the dog within the next few weeks.
I don’t even know how to say how furious this makes me. Poor little Cassie! She was a healthy, active, middle-aged dog one day; a week later she was an elderly, sick dog.
Thanksgiving: Great! Wonderful afternoon with my son’s excellent friends, their beautiful children, their charming grandparents. Wish I could socialize with these folks 365 days a year.
Dog: Still alive. More or less.
Paying work: Some pending but none active, thank God.
Phones: Blissfully silent!
The NoMoRobo system that Cox finally, after years of lobbying, made available to its customers has been in place for two days. And it’s been two days of peace and quiet! One, count it (1) scam call got through, this one with one of the weirdest Caller IDs I’ve seen. On two lines:
V123119420100687
1602875-9937
The second line evidently is a spoofed local number. The top number is emitted by a system called “V-dialler,” commonly used by crooks. Why it wasn’t blocked? Possibly because the series of figures represents a kind of time & date stamp (down to the second), which would mean there would many thousands of V-numbers to get registered in the blocking system. At any rate, that particular series got sent off to NoMoRobo. Unknown whether that’s useful, but typing the figures into NoMoRobo’s web form takes all of about 30 seconds…so, voilà.
Another nuisance call came through at ten after 9:00 this evening. It was intercepted. The bastards call at all hours, so the fact that the call is intercepted and forwarded after one ring is a problem: it doesn’t stop them from jangling you up, interrupting whatever you’re doing or even waking you out of a sound sleep. You could probably stop that simply by turning off the ringers on the phone (though I don’t think mine can be completely turned off). But that would mean you’d miss calls from friends and family, unless people could be trained to speak into your voicemail and wait to see if you hear and pick up.
The little dog survived Thanksgiving Day. Most of today she’s been sorta OK, though in the last hour or so she’s had some slippage. She just walked over to the chair where I’m sitting and fell down. And now she…what? She gets up, walks into the corne3r, and appeaers to be lost. She’s sniffing the floor like she’s trying to track something. And there she goes dowbn the hall, fo0llowed by a very puzzled Ruby. I’d better get up and see what’s going on now.
….
Hmmm… Having some kind of episode. She’s very weak. These passages come and go, evidently in response to the emanations or not of the adrenal gland’s hormones. Now she’s shivering. Poor little beast.
Carried her out to the backyard, where she peed and then fell over trying to take a dump.
So, however you look at it, the future is brief for this little dog. We can let her limp along, I guess, as long as she has more good days than bad. That, I expect, will not be for much longer. This is the second day in a row when she’s had an episode that brought on collapse or near-collapse.
…
But it’s late. I tire. Tomorrow is another day. I guess.
Never fails, does it? All real emergencies, terrors, clogged drains, and minor inconveniences invariably happen on a holiday. Or, at best, on a Sunday.
Not so reliably on a Sunday, though: too many resources are open and available on Sunday.
But Thanksgiving? Christmas? The Fourth of July? Ohhhhh yeah! Whatever can go wrong will go wrong…on a major holiday!
Early this morning the dogs and I climb off the bed. Cassie seemed OK but tired, which wasn’t surprising because we spent yesterday evening at my son’s house. She doesn’t sustain even the most routine exercise well anymore: lately, if I try to walk her around the corner and back — about a tenth of a mile — she tires but seems OK. But the next morning she seems exhausted.
When she walked outside to do her thing, and I didn’t notice anything out of the ordinary. But within the hour, she couldn’t stand up to eat her food. She just stood over her dish, shaking all over. She seemed almost paralyzed: couldn’t or wouldn’t walk, and though she was sort of standing, it was more like huddling upright. I had to lift her onto the doggy bed pillow, and then position her so her nose would not be pressed into the stuffing and suffocate her. Even reclining, she continued to shake all over and she seemed unable to move on her own. It was almost like she’d had a stroke.
My son and I are supposed to go to our friends’ house for Thanksgiving dinner. This, we might add, is a bit of a BFD.
So the emergency vet’s receptionist said the wait there right now is several hours. And how much does a trip to the emergency vet cost? “A hundred dollars.” And that is just to walk in the door.
If Cassie is dying, I figure she might as well die here as there.
But now I don’t know what to do about the Thanksgiving thing. I hate to leave her here to die by herself. But…on the other hand, I don’t know that she will die today. She has her ups and downs (though rarely as extreme as this). This isn’t the first time I’ve thought she was on the way out. Apparently these swings are a function of the adrenal gland tumor. Weakness, shaking, collapse, lack of energy, panting, rapid breathing are all symptoms of the thing. So, we might add, is “symptoms seem to come and go.”
There isn’t much I can do for her except let her rest. And frankly, other than putting her down right now, there’s not much a vet can do for her, either.
So I’m sitting there on the bed e-mailing this intelligence to my son: writing her obituary, as it were. And I hear {click click click click} up the hallway. Ruby is standing right there, so it ain’t her. Cassie has managed, somehow, to pull herself to her feet and she’s staggering up the hall toward the kithchen.
She’s walking and she’s stopped shivering all over. And…next thing y’know, she eats a whole plate of dog food..
Well, she staggered outside briefly. Then disappeared. Had to set Ruby to searching for her, which is a trick because one thing a corgi ain’t is a search dog. I’ve worked on the “find” command with that mutt until I’m blue in the proverbial face, and she still only vaguely gets the idea.
Found the patient inside, again unable to walk, shaking again. Picked her up and carried her back to the dog bed. She’s resting and has stopped shaking, at least as long as she’s reclining.
Okay, let’s try to think rationally here.
She doesn’t appear to be in much discomfort, except that she’s too weak to walk. That she ate an entire serving of dog food indicates that she’s not in a lot of pain.
I’m going to have to have her put to sleep in the next few days or, at most, weeks.
Therefore it doesn’t make a lot of sense to rack up a bill of hundreds of dollars to take her to an emergency vet.
Nor does it make sense to spend all of Thanksgiving Day sitting in a veterinary waiting room for something that ultimately can’t be helped.
If she’s going to die today, my being here will not change that.
But she’s probably not going to die today, given that she was able, eventually, to get up and eat, and given the pattern of ups & downs.
Unless things change a lot for the worse, I think I could safely go to our friend’s house. There’s little or nothing I can do for the dog here.
Next week, though, I’m afraid it’s going to be The Time. If she doesn’t pass through the veil today, I’ll have to take her up to one of the vets tomorrow or Monday.
This Event will present a whole series of new decisions:
•Do I get another dog?
If so, what kind of dog?
From where?
• Do I stay here in my house, or move away from the recrudescent Tony Situation?
If I’m right about what Tony is up to (let us hope not!), then I will need to get another German shepherd or similar protective, aggressive dog. There’s a reason I didn’t replace Anna with another GerShep: I’m too old to train and handle a large, high-drive dog safely. This fact inclines us to say “move away.”
• If I move, where do I go?
• Some friends are trying to sell their two-bedroom patio home, by way of moving themselves into an upscale old-folkerie. It’s a nice little house, centrally located, and I would buy it but for two things:
§ One of the reasons they’re moving is that they have a certifiably lunatic neighbor who has made a lot of trouble for them. Out of the frying pan, into the fire!! § It needs about $15,000 worth of renovations.
• Well. And there are some other things:
§ It’s two houses in from Central Avenue, a noisy main drag. § It’s in an HOA. I do not want to deal with an HOA. § The little development borders the canal, which is a superhighway for drug-addicted bums. § It’s within (loud) earshot of Sunnyslope High School, where the band practices and football games blast forth during the fall semester. § They’re asking more than it’s worth, IMHO, especially given that it needs new flooring, a new security gate in front, new landscaping, a gate on the west side through which to roll the garbage can by way of keeping the peace with the crazy next door…and on and on.
•For what I can pay, that leaves either Sun City or Fountain Hills, neither of which are within reasonable driving distance of my life.
If I stay here and Tony starts to do his thing again — frankly, I’d put money on it that he’s up to just that — then I will need to get a dog that’s big enough to be some protection. That represents a) expense and b) hassle. I’ll also need to add to the armory: really, I need a shotgun, because I’ve become too goddamn lazy to drag the pistol to the range and practice.
A new shotgun will cost several hundred bucks…as nothing compared to the cost of moving. I have some friends who are into armaments and so may be able to find someone who knows someone who’d like to sell Dear Old Dad’s heirloom. Unfortunately SDXB has already unloaded (heh) his. But a few hundred dollars is, indeed, as nothing compared to the cost of moving.
I might be able to get an older, fully socialized GerShep from the German Shepherd rescue. But that poses its whole new set of questions:
• How will Ruby take to a new room-mate? •Given enough provocation, will this proposed GerShep exterminate Ruby? • The German shepherd’s lifespan is nine to eleven years, during which one can expect to have to deal with some very expensive ailments. Do I really want to do that again? For a dog that I may have for, say, five years at the outside?
Is that soap opera still extant?Days of Our Lives… A fine time-waster, right up there with Facebook and Twaddle and Google News. 😀
So here’s a question: how do dogs KNOW you’re touching food when they’re around the corner and cannot see you, and when you have not introduced any new food smells into the environment?
There are only two possibilities: either they can hear your fingers moving or they have dog-lepathy. My money is on the second: the beasts can read your mind faster and more accurately than a mosquito can. And as anyone who has ever tried to swat a mosquito senses, few creatures are more telepathic than those bugs.
At breakfast time I usually set a small package of blueberries on the table, first because I like to munch them and second because I use them as high-quality dog treats. This morning after sponging a few of those and a few pieces of kibble (also used as bribes), Ruby retreats to the kitchen, there to perform the wacky little dance she uses to lobby for a higher-value treat: to wit, a strip of chicken jerky. The human is not getting off its duff: the stubborn creature persists in chowing down on its own food while reading the current issue of TheEconomist and ignoring the puppy.
With Ruby out of the line of sight on the far side of a set of kitchen cabinets, the human reaches for a blueberry.
Like a SHOT the dog is at the table, the familiar look of expectant joy beaming from her furry little face.
HOW DID SHE KNOW? I didn’t touch the plastic. I’m wearing nothing that can rustle with movement, and even if I were, how would she know what movement was made? I have not bitten into the berry and so have not released any delicious parfum de myrtille.
Really. Seriously. There is no other explanation than dog-lepathy. The damn dog reads minds.
Cassie the (Ailing) Corgi seems…sorta OK today. Not so very bad off. Not so great. Both hounds are both off snoozing just now. Just as with cats, dog life seems to consist mostly of lobbying for food, eating, and sleeping.
She coughed a little this morning, so I sprang the Robitussin DM on her. That was a trip! 😀
Go ahead…just TRY to dose your dog with red-dyed artificially sweetened goop flavored with essence de faux fraises! You never saw so much red sticky stuff all over the floor since the time you dropped a mixing bowl full of freshly mixed cherry Jell-O on the floor when you were eight years old!
She just walked in to deliver some barking. And happily enough, she can bark without falling into a coughing frenzy now. That surely is some kind of progress. She’s looking more and more emaciated, though, which is progress of a different sort, I expect. In a different direction.
The other day I was wondering when it was that I first noticed Cassie was beginning to take on the old-dog look. And lo! WordPress conjured the answer at the end of yesterday’s whinge, in the list of “related posts” it automatically generates. It was just short of a year ago: late December, 2017.
Cassie came along in June of 2008, at which time the Humane Society claimed she was two years old. Those rescue society estimates are usually pulled out some volunteer’s tail end, so anything’s possible…even the possibility that she was more like three. Until very recently, she’s been exuberantly healthy, so it would be easy to figure she was younger than she might have been. But by last December, she was starting to take on that “old dog” look, graying a bit around the schnozz, beginning to look a little sunken around the eyes. If she was sick, though, it didn’t show in her behavior.
Next year is 2019. So if she lives that long — and if we believe she was two when I got her — then she’ll be about 13 next year. That is longer than any of my canine room-mates have ever held forth, with the possible exception of Greta the GerShep. I guessed Greta was about seven when I inherited her from the neighbors. But those people were exceptionally feckless. My guess assumed they got her when she was a small pup, but neither of her adult humans was competent to train her as smoothly and perfectly as she was trained. Greta, of course, was a genius among dogs. But even geniuses must have some sort of learning curve. She could have been a year or two old when they got her from someone who knew what they were doing, in which case she was well over 12 when she shuffled off this mortal coil.
But otherwise, I’ve never had a dog live longer than 12 years. One died of a spinal tumor. Others just expired when they reached what for a large dog is old age. Anna was a wreck when I finally dragged her into the death chamber. And I’m afraid that will be true of Cassie, unless we’re lucky and she dozes off into the other world during the night.
The weather is beautiful. I should go out and buy a flat or two of flowers. But of course that would entail getting up and moving around.
So here’s a question: 
Cassie came along in June of 2008, at which time the Humane Society claimed she was two years old. Those rescue society estimates are usually pulled out some volunteer’s tail end, so anything’s possible…even the possibility that she was more like three. Until very recently, she’s been exuberantly healthy, so it would be easy to figure she was younger than she might have been. But by last December, she was starting to take on that “old dog” look, graying a bit around the schnozz, beginning to look a little sunken around the eyes. If she was sick, though, it didn’t show in her behavior.