Blue-Violet Iris Interior

Monday, April 27, 2015

In Sickness and In Health: Pet-Sitting

It's been an interesting journey so far in 2015, one that has been marked by two major themes: pet-sitting and health issues.

February landscape.

The first health issue was mine. On the second day of 2015, I got a migraine that didn't respond to medication. While I constantly have new migraines cropping up, most do respond to my medications or, at the very least, I'm able to sleep them off. This migraine, though, didn't budge. My meds didn't make a dent. It was of the type that I call a "brain-in-flames" migraine, which feels pretty much like how it sounds. I also had a nasty black ball of migraine pain behind my right eye. Add fatigue, cognitive fogginess, and the usual sensory sensitivity, and then next thing I knew, I was spending 20 hours a day in bed, unable to do anything more demanding than read children's books.

Imagine that the light in this video of the sun is pain and you have an idea of what a migraine is like.

That went on for a couple of weeks and then I finally contacted my neurologist. You'd think I might have contacted the headache clinic sooner, but I'm pretty much at the limits of what can be done for my migraines, so I wasn't sure there was any point. But I was getting scared that this unending burning migraine with the ball of pain behind the eye was going to be my new normal, so they checked me out and set me up with three days of DHE injections and though the injections didn't really help dramatically at first, eventually the migraine sort of dribbled off. It was followed by an equal number of weeks of postdromal (post-migraine) symptoms, including serious fatigue and unusual sensitivity in my peripheral vision. While the migraine did ultimately go away, it definitely spooked me. There's nothing more alarming when you have a chronic condition to have some new (and worse) wrinkle appear!

Good ol' Mr. Gorgeous

He spends most of his time sleeping now.
As the worst of the headache was on the wane, I looked after my good friend, Mr. Gorgeous the collie, for a few days. Mr. Gorgeous recently turned 14 million years old, a major accomplishment for any dog and truly astounding for a large one. There's simply no getting around the fact that he is, well, 14 million years old and 14-million-year-old dogs don't live forever. His owners had reported that he was doing well, other than the fact that he is ancient and has degenerative myelopathy. I was shocked, therefore, when I saw him. He was skinny and the coat that gave him his nickname was lacking luster, but what really worried me was that he seemed vacant on the inside. Now, Mr. Gorgeous has never been what you might call a genius and he's only got about half a dozen facial expressions (and, I have long suspected, only half a dozen emotions to go with them), but there's always been someone home inside his eyes. This time it seemed different. And then, worse yet, to use the simplest terms, he pooped his pants in his sleep.

Mr. Gorgeous also has laryngeal paralysis, a condition not uncommon in large, geriatric dogs. As vocal cord function decreases, his bark has been reduced to a whispery "hoo! hoo!"

Degenerative myelopathy causes progressive, irreversible damage to the spinal cord, eventually resulting in total paralysis of the hind end. Mr. Gorgeous' case has progressed much more slowly than I'd initially feared it would and while he walks with a flat-footed waddle and can't swing into his old trot without tripping over his feet, he's remained surprisingly mobile and still tackles the stairs on most days, albeit with a bit of a bunny hop. But the paralysis is still creeping onward and when I saw that he'd had diarrhea without even waking up, I was worried that I was looking at the first signs of loss of sphincter control. There's nothing less dignified than a grand old dog with poo-soaked fur and the idea that this is what it had come to really broke my heart. That vacant look, his loss of pleasure in his food, his lack of interest in having his ears rubbed, and that possible sign of the relentless progression of paralysis made me fear for the worst, and when I said good-bye to him when the gig was done, I said good-bye for real, in case it was the last time I saw him.

The end of Mr. Gorgeous?

I've wondered before now how I would fare when Mr. Gorgeous' time came. I'm enormously fond of him, sure, and get a big kick out of him, but have never had that soul-to-soul connection like the one I have with my own dog or with Sweetheart the German Shepherd. I've been taking care of Mr. Gorgeous for five years, the longest of any of my dog clients, so I know him intimately, and I knew I'd miss him, but would I grieve for him? The answer is yes. I cried when I got home that evening and cried again in subsequent days as I faced the possibility of the world without Mr. Gorgeous in it. Maybe I didn't have that magical one-being-to-another connection, but this great-big, good-looking dog had clearly claimed a piece of my heart.

A time for reflection.

I was relieved, then, to learn that all this heartbreak was premature. That vacant look, the accident in his sleep? It was all the result of an upset tummy. However, when his owners took him to the vet for a checkup, the vet did find a serious problem: Mr. Gorgeous needed twelve teeth removed. I had wondered if his lack of appetite (and therefore his thinness) was the result of tooth decay, as is very common among elderly dogs, and his owners had switched him to a softer diet, but the mess in Mr. G's mouth went way beyond some sore teeth and into the realm of impeding disaster. He was scheduled right away for oral surgery, and as it happened, his people had to go out of town shortly after the surgery, so I was called in to play nurse.

Mr. Gorgeous, minus a dozen of his teeth, including all of his lower front incisors.

Feeling better.
The first few days, Mr. Gorgeous was woozy and knocked out almost all the time from his pain meds, but he took his pills well enough if they were dabbed with butter and hidden in food that I hand-fed him on a spoon. He seemed uninterested in drinking his water--I think the extraction sites were very sensitive--so I added more water to his already soft and mushy post-op food and fed him several small meals during the day. He did meander after me as I wandered around his property with a camera, but was unsurprisingly subdued. By the time a week had passed since the surgery, Mr. Gorgeous started to perk up a great deal. He was enthusiastic about his meals (especially if I included some baloney pieces--he was quite unimpressed if there weren't a few snippets here and there among the canned food and mushy kibble and would stare at me pointedly through the door until I added some to his meal) and he started licking his bowl clean for the first time in more than year. He not only wanted to get ear noogies, he DEMANDED them, shoving his head into my lap and budging my hands until I rubbed the inside of his ears with a knuckle. He even demonstrated some moments of playfulness. In his old age, Mr. Gorgeous has lost interest in playing, so it made my heart happy to see him showing a bit of friskiness. It was so fulfilling to see his spirit rekindled and to have a hand in the process. Normally, I don't much care to handle pieces of baloney made slippery by canned dog food and dog slobber, especially first thing after I wake up, but for Mr. Gorgeous, it was an honor.

He's not what he was in his prime, but Mr. Gorgeous is still one handsome beast.

A black light revealed a flora infestation.
And then there was the paw fungus. I'd noticed Abbey was licking her paws more a while ago, but she's always done some paw licking when she's settled down and feeling drowsy, so I wasn't overly concerned until I noticed that she had developed saliva stains (which are reddish-brown) on the fur of her back paws. We went to the vet, where she was first prescribed an antibiotic to cure the crusty infections caused by her licking. She was still licking her paws after finishing the antibiotics, so we went back to the vet. This time, with the crustiness cleared away, the source of the itching was apparent: a fungal infection. Dogs carry fungi and yeasts (or "flora") on their feet all the time--it's responsible for the "Frito feet" (paws that smell like corn chips) phenomenon that many of us love--and most of them are harmless. When things get out of control and the fungi proliferate, it's a different story. Abbey picked up a new fungus somewhere and I think that during the time I was away dog-sitting in November and December and she was in her crate for at least part of every day, she probably passed some of the time by licking her paws. Dogs can sometimes get in a sort of trance-like state while licking themselves (I call it "mesmer-licking") and lick and lick and lick, spreading any fungi around, adding in bacteria from their mouths, and encouraging it all to grow with their warm saliva. Fungal infections can be difficult to treat, so the vet emphasized that our best bet was to knock it out as thoroughly and quickly as possible, which would mean that I would have to follow instructions precisely. What did that entail? Prednisone, an anti-fungal medication, daily medicated foot soaks, and preventing Abbey from licking her paws.

Overheated from prednisone and wearing socks to prevent paw-licking, Abbey tries to get some rest by sprawling flat. 

Stylish in baggies over socks.
Abbey had no trouble taking her medications (she gets them in a marshmallow and she looooooves marshmallows) and she was perfectly fine with wearing socks on her back paws, held in place by a cuff of masking tape. She readily accepted having plastic baggies put over her socks when she went outside and she actually seemed to enjoy the inflatable cone that I put on her for a few days after she started licking her lady bits instead of going after her paws. But she hated soaking her feet. All she had to do was stand in a few inches of warm, treated water for fifteen minutes, but it was horribly stressful for her. I'd set a timer and give her a treat every thirty seconds of those fifteen minutes, gently restraining her while singing to soothe her, and although she made no desperate attempts to escape (aside from scrabbling while being lowered into the tub, which she was not about to jump in on her own), she panted anxiously throughout. She hated getting her feet rinsed at the end of the bath, too, though eating peanut butter off a spoon while I throughly washed the solution off her feet made it slightly more bearable. Those two weeks of nightly soakings were miserable and exhausting for both of us!

My poor anxious girl hating every second of her daily foot soaking.

Socks? Check. Cone? Check.
Seatbelt? Check. Let's ride!
And then there was the prednisone. I understand we got fairly lucky as far as Abbey's side effects go, but there were most definitely side effects. I didn't immediately catch on to how voraciously hungry it made her because I was busy making sure that she didn't lose her appetite, a sign of a dangerous complication of the fungal medication. Abbey is fed the same amount of food every day, portioned out with a measuring cup, so with the prednisone cranking up her metabolism, it didn't take long before her spine started showing and her hip bones jutting. We weighed her and were astonished that she'd dropped down to 42 pounds! She'd seemed a little thin after she shed her winter coat, so we'd weighed her just a week or two before starting to treat her for the paw fungus, so we knew that she'd been at 45 pounds. (She usually weighs in around 47.) She'd managed to drop three pounds in just a matter of days, so I ended up doubling her food and spreading it out over three meals a day instead of her usual one. She also drank at least triple her usual amount of water and had to go out every hour or so, it seemed. She became a pooping and peeing machine! We were lucky, though, that she remained in control of those functions, so there were no accidents. However, prednisone also gave her a bit of a personality change. She was bolder, punchier, naughtier. She's never gotten in the trash before, but one day, while I was in the shower, she managed to open the cupboard door, tip over the trash can, and spread its contents all over the kitchen floor, consuming several chicken bones in the process. We had to start putting a stool in front of the cupboard door so she wouldn't go shopping! She was either amped up and pacing and panting or sprawled absolutely flat in an area with good airflow, her tail stretched out, as she tried to keep herself cool. We did a very slow taper off of the prednisone and it was such a relief when I finally got my Abbey back!

She may look like she's smiling, but prednisone made Abbey hot, restless, roughish, and voraciously hungry and thirsty.

The good news is that all that effort paid off. Between the socks and the medication and the foot baths, when the vet rechecked her paws after two weeks, she had a normal and healthy amount of flora on her feet. I still put socks on her when I leave her in her crate because if she gets to licking her paws again her feet could flare back up, but for now, the stressful episode of Abbey and the Paw Fungus is over.

A pretty Pyrenees.
After a little bit of downtime, it was on to the next dog! Cutie's owner had to have a hip replaced, so I was called in to walk her and entertain her in the afternoons. While we're now down to a twice-a-week walks-only schedule, for much of the last couple of months, I've seen Cutie nearly every day. It's been something of an adventure, in part because Cutie is smart and sassy with a mischievous twinkle in her eyes and quite a lot of energy for a big four-year-old. She's less go-go-go than she used to be and will settle while at home, but when she's on the go, she is on the GO. At 90 pounds and with four feet for traction, you'd better be ready to go, too! One day, while we were at a park, she started doing zoomies , a popular name for when a dog tucks its rump and runs around in a wild and crazy manner. And they weren't just any zoomies, they were mud zoomies. We'd been walking across a damp field and hit a patch where the mud was several very squishy inches deep under the grass and she went nuts. So not only was I being yanked this way and that, I was being yanked this way and that through the mud. She was quite a mess when I finally got her moved on, so I decided our walk would take us to a nearby creek where the two of us could rinse off a bit. Well, Cutie found the creek even more exciting than the mud and had a wild session of creek zoomies. In the creek! Out of the creek! In the creek! Out of the creek! And all with me being jerked along behind. It's fortunate I was wearing my hiking boots, as I would have likely fallen and been pulled about face first if I'd had any less traction. Oh, Cutie! It's always an adventure.

There's mischief in those eyes.

A wide angle lens has distorted Cutie's size as she stands on the console, but she really is huge! 

Trying to rub off her head halter.
I should add that I'm never walking this big, powerful, playful dog just on a regular collar. Cutie walks best on a head halter, but she hates it, so as long as she's behaving well, I'll walk her on a front-clip harness. It reduces the pulling enough that she's manageable unless she sees something really exciting (or wants to have mud zoomies). Even though I sometimes make her wear the hated head halter, Cutie is always very happy to see me. She has the most ridiculous little bared-teeth grin when I first come in and she's given me the guard dog's ultimate compliment: she doesn't bark when my car pulls into the driveway, just stands at the window and wags her tail! I also love how she'll stand on the center console (looming enormously) when we first get in the car to go somewhere and gives my ears little licks of affection and delight. My own dog does a similar thing and I find it most endearing.

A happy, tired Cutie after a walk.

Of course, it's easy enough for a dog to like you when fun stuff happens every time you come over, so I'm actually very excited about a new client of mine, where the investment is going to be very different, but very rewarding.

The tiny poodle.
I'll call her Pipsqueak. She's a teeny tiny, five pound, five-year-old poodle who is smaller than Cutie's head. My natural preference is for medium to large dogs, but I have to admit, Pipsqueak is adorable. And therein lies the problem. Her owners like to say that she suffers from Too Cute Syndrome. People see her and they go into a frenzy of cooing and touching and getting in her personal space. They want to treat her like a baby, a little living doll. The thing is, while Pipsqueak may be tiny, she's every bit as much of a dog as Cutie is. She's intelligent, well-trained, playful, sweet, mellow, and affectionate. The big difference is that Cutie can knock you over if you infringe on her personal space. Pipsqueak has no such defense: she is physically outsized and overwhelmed by every human being she encounters. She's also a naturally private and rather submissive dog, so is it really a surprise that most people send her hiding under the couch? As someone who has dealt with anxiety myself, I can sympathize. My job, then, as her dog-sitter, is to respect her boundaries and earn her trust in addition to making sure her needs are met. Fortunately, Abbey's leeriness of strangers has given me an education on how to approach an anxious dog: namely, don't approach. After a decade of telling visitors that "when she's ready, she'll come to you," I get to put that into practice with Pipsqueak.

Imagine being swept up and squeezed by a squealing giant standing more than 50 feet tall and weighing more than a ton and a half: that's what it's like to be Pipsqueak. No wonder people unnerve her!

Pipsqueak and I hit it off right away when I consulted with her owners, so much so that she did me the honor of letting me pet her belly before I left. Apparently, I'm only the fourth person she's ever bestowed that privilege upon! She was much more timid when I came by the first time to spend a day with her, just the two of us, but she stayed in the room and on the couch (versus under the couch in a different room), which was a great start, so I just let her be. She pretended to ignore me and I pretended to ignore her. Eventually, she fell asleep. At one point, I looked up and saw that she had edged closer to me. I knew that this was a big display of trust on her part, and honored that trust by continuing to work quietly in her vicinity. She never felt quite comfortable enough to get off the couch during that afternoon, but we did progress to the point where she was wagging her tail when I offered her a treat (and eating the treat, too) and she did solicit some petting, including another offer to let me rub her tummy. I'm going to continue to do some short visits with her before doing overnight work, but I have confidence that as long as I take it slow, respect Pipsqueak's autonomy (and minute anatomy!), and move the relationship forward at her pace, we'll come to be good friends. As much fun as it is to be around a dog that loves everybody, meeting the needs of a dog that is scared to trust anybody is, to me, an honor. It's something that I can do that not everyone else has the patience or know-how to accomplish. Just as I felt is was a privilege to hand-feed Mr. Gorgeous slimy pieces of baloney if that's what he needed in order to recover from his surgery, I feel it is a privilege to work with Miss Pipsqueak and I hope to do right by her.

Pipsqueak rewards me for my quiet patience by licking my hand while letting me rub her belly.

During all this time, there was more migraine chaos. Some of it was caused by turbulent spring weather. I was driving out to Cutie's one afternoon, storm clouds looming and nausea rising, when I thought, "If I don't pull over RIGHT NOW and take some nausea medicine, I'm going to be pulling over in a mile to throw up." After stopping and taking the meds, I thought, "You know, if I'm going to be in danger of puking and likely get a nasty, weather-induced migraine to go with it, I'd prefer to be puking at home." So I hastily cancelled my walking duties, drove home with gritted teeth, paused to dry heave when I got in the door, and then went to bed for three days while the thunderstorms continued. Thankfully, Cutie's owners are very understanding and didn't expect me back until I was fully recovered.

Thunderstorms bring rainbows and migraines.

Some weeks later, I developed swelling in my neck around my throat. I was sure that it was related to a nasty too-much-blood-in-the-head migraine and stiff, sore neck I'd been having, but it was definitely weird. The swelling was sufficient enough to be visible and to put uncomfortable pressure on my throat when I swallowed. I was checked out by a nurse practitioner at my primary care doctor's office, where it was determined that my lymph nodes were fine, which seemed like the only other possible culprit. In the end, an injection of DHE, an erogtamine vasoconstrictor used to treat migraines, cured both the migraine AND the swelling, so I felt vindicated in my belief. I've had it thrice since. I'm thinking that exercise is an important contributor, because after doing research about histamine (an antihistamine helped bring the swelling down the second time it occurred), I realized that I've long had what is known as an exercise-induced histamine response. It's what causes my exercise-induced asthma, makes my nose run profusely when I exercise, and causes occasional episodes of itching. In simple terms, I'm allergic to exercise. Histamine, though we think of it as being solely associated with allergies, is actually what is known as an inflammatory mediator and is at work when there is swelling associated with injury and infections, too. In an effort to bring more white blood cells to an area where there is a legitimate injury or infection, or, in the case of allergies, when there is not a legitimate injury or infection but the body thinks there is, it causes blood vessels to dilate. Migraines also cause blood vessels to dilate. I think there is some interplay going on here when I exercise while I have a migraine, especially one with a lot of swelling, so my body is swarming with histamine and all those great big blood vessels in my neck get the message that they need to expand. I could be wrong, but my hunches when it comes to migraines have a pretty good track record. I'll be discussing all this in detail with my neurologist when I see her in a few weeks.


And finally, a very old, very sick cat that I looked after for a few month passed away. It was his time, but he was loved dearly by his family and will be missed.

So, between collies with oral surgery, paws with fungus, owners with hip replacements, poodles with anxiety, and some migraine weirdness, it's been a very busy spring. Undoubtably, there are more of all of these things to come!

1 comment:

  1. I'm a tad bit jealous of your being allergic to exercise! The migraine suffering is too much, TOO MUCH! I feel your pain! It's awesome that you get to fill your time with such delightfully different animals!