Degenerative Myelopathy
Maigret
This is an account of how degenerative myelopathy, DM, progressed in my dog, Maigret, and how I cared for him. I know that when you first learn that your dog has DM, or any serious disease, you're desperate for information and I hope this account can help you understand what your dog is going through and give you some ideas for dealing with a paralyzed big dog. It's an emotional experience to care for a loved pet and you'll find some support for that here too. If your dog has just been diagnosed, don't freak out too much yet; you've probably got a lot of time left together. I don't include much medical science in this account but it might be helpful to know that DM has a synonymous condition in humans - Multiple Sclerosis or MS, an autoimmune disease causing neurological degeneration. The University of Florida's Veterinary Medical Teaching Hospital seems to be the authority on DM right now and there's always a google search.
Update!
It seems there's now a DNA test for DM. See http://www.caninegeneticdiseases.net/DM/ancmntDM.htm.
You'll see that I put an insane amount of time into caring for Maigret and I don't suggest anyone should do likewise. It's an impossibility for most people, especially if your dog is big and you have a full-time, away-from-home job. The time spent before the disease hits, taking walks, playing fetch, making room on the bed, is how you express love for your dog. Fortunately, I have the physical strength required to care for a paralyzed big dog, but even so, I sometimes had to pause to muster strength before bending down to pick up Maigret. You get worn down after a while. Walking aids like carts and slings are available commercially or you might come up with solutions of your own. Online groups provide incredible emotional support and practical ideas. I found the DM group in Yahoo Groups after I needed it but I lurk there sometimes now, unable to let go completely, occasionally offering advice. One web site I found for information and products for dealing with a paralyzed dog was Handicapped Pets.com.
Currently, there's no treatment for DM but you'll run across a lot of information concerning nutritional supplements, which we tried but never seemed to help Maigret. Exercise seems to be about the best you can do for your dog; maybe because dogs just love to get out and happiness makes for better health. We live near a huge open space where my dog Maigret and I had been getting out just about every day for years. I liked hiking off trail, so our routes were always changing and we'd be seeing new things. There are equal parts open grass and woods, lots of steep hills. We'd been to the park almost 2000 times, which seems impossible, but I figured it out and it's true. 365 days a year adds up. You'd think we'd get bored.
Maigret was our second Shepherd. Rimbaud, or just Bo, also a great dog, had DM too, which I've been told is most prevalent in GSDs. My vet goes so far as to call it "German Shepherd Disease". Bad luck that both my dogs got it but good that they were both older, around 10, when they started showing symptoms. Maigret's first sign was when we were out on a hike and he couldn't make a climb up a steep hill. His hind end just seemed to lack the strength and we had to circle back along the contour to flatter ground. I thought that maybe he was just getting a little old and had become fatigued after a couple of hours of bashing cross country. Unmistakable signs appeared about a year later when he began dragging the tops of his hind feet while walking and his run stiffened into a sort of bunny hop. I understand that arthritis or other orthopedic conditions can create similar symptoms and a diagnosis of DM comes after a process of elimination. First thing a vet will do is a simple check of your dog's reflexes, the slowing of which may indicate the possible onset of DM. He or she will turn one of your dog's hind feet so it's top is down on the ground. The dog should immediately pick it up and go back to standing normally, on the pads. Both my dogs would hesitate a second or two before correcting their stance and this hesitation lengthened over the months, till finally they'd just stand there, one foot turned under, knuckles down. Please consult with your vet and do your online research; maybe things have changed since Maigret's troubles, 2001 thru 2005. I've talked to people whose dogs dragged their back feet while walking but were never diagnosed as having DM so I'm not quite sure exactly what other conditions can create these symptoms. Tests such as a myelogram or MRI to help diagnose orthopedic problems like disc ruptures are expensive and in an older dog may not be worthwhile for several reasons besides the cost. These tests are stressful for the dog and even if a disc issue is discovered and DM seems unlikely, surgery may not be a good idea due to the increased risks associated with treating old dogs. These are discussions you should have with your vet. One aspect of DM is that there's supposedly no pain associated with it, which is probably true, since I never saw either of my dogs display any discomfort. With dogs though, it's sometimes hard to tell.
Over the long run, Maigret's degeneration was very slow and constant. Relentless, to use a more negatively connoted word. In the short run, over a month's time, he'd have plateaus and even a few periods of very slight improvement, but then, maybe that was just wishful thinking on my part; nothing obvious. It took about three years for Maigret to go from dragging his feet to not being able to get up on his own. In the middle somewhere was what my vet calls the drunken sailor stage, where the dog has difficulty getting up, stumbles and swerves while walking and occasionally falls down, especially when turning around as the hind legs cross. Through it all, Maigret never showed a lack of enthusiasm for his favorite things, nor, like a 3-legged dog, did he ever seem to even notice his condition. You might hear that a person thinks their dog is embarrassed or emotionally depressed due to their condition. Maybe so, but Maigret sure never lost his spark, at least not until other issues dogged him.
Early challenges with a DM dog start with keeping her/him from slipping and falling on hardwood floors and preventing abrasion sores on the tops of their paws. When Bo started slipping around the house, I tried spraying his pads with an adhesive, but that didn't work out very well as I recall because the adhesive transferred to the floor and made a mess. I ended up spreading runners, long narrow rugs, around the house, and he quickly learned to follow them if he wanted to avoid falling. I found plastic runners at the big box hardware store, which came in handy when he became incontinent. Bo and I had been visiting a dog park since he was about seven, which was all grass and easy on his feet, but we also walked around the neighborhood a lot and along a paved trail near our house. Dragging paws need to be protected from abrasive surfaces, so I made Bo a pair of leather booties for protection. You can buy them these days. He didn't mind wearing them; he always did tolerate having to get dressed up on Halloween and Christmas. When Maigret started dragging his feet, we quit the neighborhood walks and kept to the softer park grass. The fur on the tops of his feet eventually wore away, even on grass, and he had a little bleeding once in a while but I never saw him licking his paws.
Hind end instability progresses with more frequent swaying, tripping and falling down . Eventually, when playing fetch, Maigret's favorite game, I'd have to run with him to lend support. He was weaker on one side and for a while I could walk along that side to steady him with one hand held lightly against his hip, and catch him if he started to fall. After a few months of that, I was having to do all the work and hold his hind end up as he walked; I'd be bent over, using both my hands under his belly. His back legs would still go through the motions, but they could neither propel nor support him. He could still stand up to pee at this point, but I had to stabilize him. Finally I made a sling to help me support him. Slings are available commercially and you can find plans for making them on the Internet. The sling acts like a handle on your dog, allowing you to walk upright and carry his hind end like a bucket of water. The dog's front legs still support the front end. Eventually, Maigret's hind legs just hung still as we went along. Early on, we investigated the dog cart option, but a dog needs a fairly strong front end to be a candidate for cart use. One cart company suggests your dog be able to climb 3 steps using his front legs only, and Maigret couldn't do it, as he also had some arthritis in his front shoulder and a weak wrist. During our dog park days I'd throw a tennis ball that he'd love to get on the first bounce, making big jumps that were probably too much for such a big dog. I always kept Maigret trim but he still weighed 115 lbs. Looking back, I think I'd have tried the cart out anyway, just to make sure.
Even though I had to help him do the fetching, he still loved it. We'd rest after half a dozen 50 foot tosses and as time went by, the rests got longer and the tosses shorter. All this was more work than fun for me, but it was still good to be with my dog and to be doing something for him, and I was getting outside and I'd get to see some great people; the morning regulars with their dogs. (Hi Valerie, Eric, Madeline, Ron, Lilo, Brian, Ellen.) Rain or shine too; I think he liked weather as much as I do, or just didn't care. I always joked to myself that he and I had wood and weather in common. I like to work wood as a hobby and he was obsessed with the stick. Tennis balls were good too but he always preferred a stick and the bigger the better. Nothing as beautiful as a German shepherd proudly carrying his stick.
At home, I'd lay him out in the front yard so he could watch the world go by and I could watch him from my home office. He'd call me with a sharp, high pitched bark when he wanted something, like help getting up. Back when he could still stand if he really put his mind to it, he would manage to get himself into trouble by wandering off a ways and then falling down somewhere, unable to get up a second time. One night while he was out in the yard and I wasn't paying attention to him, I heard one yip and I couldn't figure out where in the dark it came from, though it was at a distance of 50 yards or so. I got out the big flashlight and shined all around to spot his eyes in the dark, a trick I use to spot my cats at night, and there he was, stuck in a neighbor's garden, unable to get up. He was right under the picture window of their dining room, during the meal, and so there I was fetching Maigret, feeling very foolish, hoping they understood what I was doing. Another time, as I pulled into the driveway I could hear him in the back yard repeating his alert bark over and over. In his struggle he'd pooped and it was all over him. I'd been gone a few hours and felt awful that I left him; who knows how long he'd been down. This is when caring for a DM dog starts to get difficult. It's emotionally draining to see your dog go downhill and you have give up a lot of your own life. I'd never him alone for long after that.
DM is a wasting disease, so even though Maigret's appetite was good and he ate a ton, he was losing a lot of back end muscle and his weight was down around 85 to 90. Even so, carrying him back to the car from our favorite field at the park was starting to wear me out, so I finally got a wagon, a nursery wagon with 10" pneumatic tires. I bolted a piece of plywood cut to match the size of his bed to the platform and lengthened the handle a couple of feet to improve the physics of pulling it. It fit in my trunk, sort of, the handle and 2 tires hanging out, and with Maigret tossed in the back seat, we'd head for the park every morning, against all the work and school traffic. I used the wagon to move him the few hundred yards to our spot where we'd play some fetch, Maigret in the sling. Then I'd pull him around on his wagon along the fire roads for a while, enjoying the day. I talked to a guy in the parking lot, a lycra clad mountain biker, who told me he'd recently put his Shepherd down because "He was just trying not to piss on himself." That's where my dog had been for well over a year. It was December, 2004, when I got the wagon. Maigret couldn't get up on his own anymore, and could only walk with almost total outside support of his back end and for only short distances, maybe 5 feet. He seemed happy and still loved to get out.
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| Maigret standing and sitting when his legs were weakening. Sitting, he supported much of his weight with his front legs and once seated, he'd need help to get back up. If he laid down, he could get back to the seated position but no further. Photos taken around August or Sept. 2004. Notice the ever-present stick. | |
Inevitably, a DM dog will depend on it's owner for all mobility. I'm still young enough and strong enough to grab a 100lbs. of dog straight off the ground and I realize most dog owners simply would not have the option to care for a paralyzed dog. Euthanasia would be the only option at this point. I feel for you if you're in this situation, because a DM dog still seems to be happy and ready for action. The heartbreak and guilt will challenge you but if you've given your dog a lot of love and outings during it's life, you've done a great job. You can only do what you can do. Grieving will go on, but after some time, hopefully you'll take comfort in having given your dog a good life.
I'll never forget that Christmas. I caught a nasty flu, nightmares, fever, the works, but I still had to tend to Maigret, hauling him out in the rain to bathroom breaks, because I was the only one strong enough to pick him up. Now I had a taste of what new mom's go through or caregiver's for the elderly. But in a way, I remember it fondly. The time passed like a dream. In the movie "Grand Canyon", Kevin Kline's character, talking to a couple of people at work, describes his state of consciousness at the moment. He feels "buzzed", like he's been up all night but has caught a second wind.
Of course he was incontinent. On his beds I used both disposable absorbent pads and washable ones, the latter when I'd be leaving him longer, like at night, because they work like a diaper and keep his fur dryer. Pooch Pads are what I used, but they're a bit pricey. Disposables are pricey too but you can get seconds at Handicapped Pets.com. To keep Maigret drier, one trick I tried with the disposables was to use small pads in layers. I'd position one centered directly under his pee-pee and another on top of the first pad, but shifted towards his tail, leaving the portion of the first layer directly under his penis uncovered by the second layer. That way, I figured, when he dribbled, the wet would absorb and spread out into the first layer, and the upper layer would keep him mostly dry. Of course, this works only if the dog stays in one place all night, which Maigret pretty much did. To protect the foam of his beds, he had three beds, I bought fitted mattress pads with plastic lining and cut them down to fit the 3ft x 4 1/2 ft beds. The cutting would remove the fitted part of the pad along two sides so I made new fitting trim on those two sides using duck cloth and elastic. These pads were insurance in case the rest of the system failed, which happened rarely. Besides, they were easier to remove and wash than the beds' covers which completely enveloped the foam. There are beds made for incontinent dogs, hammock-like, but I was skeptical. I tried to order one anyway but they'd been discontinued.
Immobility and old age invite other problems. February came and one morning Maigret was clearly in pain. His ears were laid back and he kept his neck stretched out. I inspected his mouth and sure enough, there was a 1/2" growth on his back lower gum, which I thought might be a tooth abscess. I took him in to the vet's that morning, (we now have our own booth), and it turned out to be melanoma, an aggressive form of cancer. They took it out but warned me that it would return, possibly in the lungs or lymph nodes. Funny thing, I hoped the cancer would spread quickly and soon. We were back at the park the next day.
A paralyzed dog needs to be turned a lot to prevent bed sores, which can be serious, as they provide an open door to the body for infection to waltz in. That's what got Chris Reeves. Maigret hated to lay on his right side, probably due to pain caused by some undiagnosed orthopedic condition, a tendency that had begun at least a year earlier. If I laid him on his right, he'd fuss and struggle and bark until I flipped him back over to the left. I tried to ignore his pleading but he'd struggle and writhe till he was off his bed and onto the floor, so I gave up and decided to let the sores come when they will but not without a fight. I supplemented his regular foam beds with an additional eggshell foam layer and cut a sort of hollow where his hip bone pressed into the foam to further reduce the pressure. I found a foam shop in the area that carries some very nice stuff. Also, I made padded donut rings for him to lay on, which would transfer the pressure from the protruding hip bones to the surrounding area. To make the rings, I got a kneeling pad for gardening and cut a hole in it the size of the area to be protected, about 4 inches in diameter. Then I cut a length of some very soft pipe insulation, the circumference of the hole and edged the hole with it.
A sore did develop and worsen over time, till it became a hole in his skin the size of a quarter. I'd wash it 4 times a day with antiseptic and put antibacterial cream on it and I was bathing him every day and he was on oral antibiotics, so we were managing as best we could. Bed sores, even though they look horrific, aren't very painful because the surrounding nerves are pretty much dead from the constant pressure of lying down. My biggest regret is not dealing with this issue sooner, way back when he was still walking, but falling to that weaker side onto his bony hip. (That's why I tried to always be at his side in the earlier days of the disease, when he was still running a bit but unsteady.) The repeated falls when I wasn't there to catch him, and his tendency to lay on his left side were already wearing the hair down in that area. I hesitated to deal with the sore issue because I figured something else would knock him down before the sore got so bad and I never imagined how nasty looking it could get, though it probably made me more uncomfortable than him. At this point my vets didn't recommend trying to sew it closed because they knew I'd watch it closely, keep it clean, and it didn't make sense to put Maigret through a surgery under the circumstances.
In April, Maigret came down with pneumonia, as did my first dog, Bo. (This is all about Maigret, but Bo's story is very like Maigret's. Bo was such a great dog.) Dogs who eat lying down are prone to this as they're more likely to aspirate a piece of food or water. This particular type of pneumonia is called aspiration pneumonia or AP for short. Bo had it twice. Pneumonia will knock an older dog down a notch never to be regained. Bo never walked again after the first fight with AP and he never fully recovered after the second bout, remaining sickly till we finally euthanized him. After Maigret's recovery he remained so weak he was never able to walk with the sling again and he couldn't go long without antibiotics; a few day off them and his lungs would get rough. During the initial treatment, I took Maigret into the vet's twice a day for 7 days straight, each time he'd get nebulized antibiotics, (inhaled), injected antibiotics and IV fluids. I got a taste for how mechanized medicine is, as it is for people too. After the week was over, my vet told me that each morning the whole staff came in asking if Maigret was still alive; I guess nobody was expecting him to pull through. Maigret's x-rays, taken to diagnose the pneumonia, also revealed another problem called megaesophagus, ME, a loss of musculature around the esophagus, and with it, the normal peristaltic action to move food down to the stomach. Many dogs with ME regurgitate their food and water regularly and have trouble maintaining weight and strength. The biggest ME danger however is that they're very prone to aspiration pneumonia. It's best to feed an ME dog vertically and keep them that way for a good 20 minutes, to let gravity do the work of the now flaccid esophageal muscles. Depending on how bad the symptoms are, caring for an ME dog can be very challenging and fortunately Maigret's symptoms were mild in that he wasn't regurgitating his food. A great ME resource can be found in Yahoo groups; don't miss it if you've got ME problems.
So now Maigret was bedridden but still alert, still loved to eat and he still loved to get out on the wagon, despite his medical issues. Something had silenced his bark, probably something neurological, maybe related to the DM, but he air-barked nonetheless. I'd pull the wagon out in the morning and he'd be air-barking with excitement. At the park, he'd be lying in the grass or on his wagon, I'd toss the stick a ways, and he'd be air-barking. I'd pick him up and run after the stick carrying him but I felt silly doing this too long. People must have thought I was nuts. It kept him interested though and besides I just like to pick up my dog and hug him. Nothing like hugging a big dog. I mostly just pulled him around on his wagon. He'd get lots of attention and he loved it.
To help monitor Maigret's mood, I kept one of his beds near the kitchen, figuring a lack of interest in food preparation would be a sign that something was very wrong. I wanted to spoil him in his old age with lots of people food, but due to a touchy stomach, he got only small bits. Otherwise we stuck to a mixture of a very good kibble, canned food and brown rice. The rice was for bulk which seemed to keep his stool firm enough for manageability. ME dog owners have experimented with various food consistencies and usually either a slurry or a meatball works. I made meatballs. Four cups of Wysong Senior kibble in a food processor to turn it to a powder. Then add a can of Wysong beef and spin that. Transfer the "dough" to a big bowl, add two cups of cooked brown rice and mix with a spoon. I used a melonballer to make the meatballs. If you have kids, let them do the work; it's like making cookies. I'd sit on Maigret's bed with him and feed the meatballs to him one at a time by hand.
As promised, the melanoma returned, again a growth on his gum, not far from the first site. I'd just taken him up to Lake Tahoe for the weekend where my wife's family rented a house for a reunion. I went a day later than everyone so it was just Maigret & I and I was very much looking forward to the drive. I reclined the front seat of the convertible and built up a level platform with pillows, on top of which I put his bed so he rode high enough to see everything. I'm not sure he had such a good time though; he was clutching the sides of his bed on the mountain roads and I had to keep it slow. The good news was the cancer still hadn't spread to the lymph nodes. The vet removed it and while he was at it he sewed his bedsore closed. We were at the park the next day.
Nothing can replace old fashioned nursing care. Daily baths were routine. It's probably like diapering a baby, (something I've never done), after so many times, I could do it in my sleep. I installed a faucet for hot & cold water in the garage where the washer and dryer were and left a hose out on the front yard, always ready. Poops are easy to deal with if they're solid; just grab it with a plastic bag and if there's a little residue left on the pad, just switch it out. You've got to find the right diet and stick to it. Include lots of loving ups, ear scratches. But care giving isn't easy. One of the regulars at the park, Lilo, is a nurse who cared for her elderly parents when she wasn't at the hospital "Embrace the poop!", she'd joke. And in anticipation of her father's death, she'd say of her life to be, "It's all about me. It's all about me!". Believe me, I wanted a break. I hadn't gone camping for 2 years, and my wife and I hadn't traveled together for 3 years. My in-laws had always taken Maigret when we were out of town but he'd become too much for them to handle. Luckily, I worked at home through much of this and didn't work at all for the last part, so I didn't have to leave the old guy alone during the day for long.
It's June 12, 2005. I'll start writing more, maybe daily. I barely remember Bo anymore, after 11 years. A couple of weeks after Bo was gone I had an incredible and extremely realistic dream. When someone starts telling me about a dream they had, I groan and head for the door, but listen to this dog dream; it's short. In it, my wife and Maigret were there, in a sort of farm yard and Bo was too and I was hugging Bo and crying and saying "Thank you, thank you for letting me see Bo again." over and over. That's it. Not much to it but it's by far the most realistic dream I've ever had. Maybe when I'm an old man and getting nutty I'll swear it really happened. Isn't it true that some cultures consider dreams to be important enough to be part of life, conscious reality? I described that dream to friends and their 6 yr old boy asked me if I had been thanking god. I don't believe in god but I answered yes. He was only six, what else could I say. Besides, what do I know. One other thing about Bo and death. I buried him in the backyard in a hole 7 feet deep. I dug till my wife couldn't see my head any more. You could say I was burning off some grief. Anyway, some months passed, and I'd finally stopped looking over where the grave was and thinking about Bo every time I was near the window. Winter's first rain came one night and had trickled down through the loosened soil and consolidated it, forming a foot deep depression over the grave. It looked like a scene out of the old "Dark Shadows" show; scared the hell out of me for a second. I had to laugh.
You're probably wondering why I tortured this dog for so long. I'd spent hours Googling "dog euthanasia decision" or some variation thereof and I'd had several discussions with my vet about it but I felt Maigret was still having a decent time, what with the food and the multiple daily outings and the attention. Each time something went wrong with him, I secretly hoped it would be a fatal event and a sense of relief would follow the thought. One of my vets made it clear that any time I wanted, he'd give the shot, but I got the impression that my other vet thought as long as Maigret was alert and I could care for him, I wasn't doing him a disservice by keeping him around. No doubt though, I was having trouble letting go.
What you've just read up to this point, for the most part was written while Maigret was still alive. This paragraph is where I informed the reader that Maigret was still alive, despite the past tense I'd used and from here on I would switch to the present tense and a diary-like format. Now, over a year since Maigret's been gone, I've gone back and edited this account, bad spelling and senseless sentences, so that the original transition which took place here no longer worked. The rest of this account is the original diary I wrote.
June 16
Fortunately, Maigret's eating troubles from the ME have been fairly minimal. He retches a bit after drinking and after eating, but not always and he's never vomited. However, last Saturday Maigret's throat rattling and retching got bad. It's hard to know if the junk near the windpipe which causes the rattle is coming up from the lungs or sitting in the esophagus. If it's the lungs, that means pneumonia. I'd fed him a large slice of turkey and that may have caused the trouble, but who knows. Surprisingly, by Monday he'd improved but we were due at the vet's anyway to have the drain from the bedsore surgery removed. He was already on two antibiotics so we stopped one and added another, Orbax, in hopes of clearing his lungs, which it did in just a day or so.
The next day, yet something else went wrong; he wouldn't sit up on his front elbow. In the morning he just laid flat on this side, but he seemed to be feeling pretty good as he was alert and he enthusiastically went for food. After messing around with him for a while, propping him up with pillows, etc, it seemed his arm and shoulder were tired and sore. I let him lay flat and for periods I'd sit next to him so my thigh is under his chest and his front legs are to either side, a position he seemed to feel comfortable with. This is how I fed him, gave him water and spent time with him. Lilo, one of the dog walking regulars from the park, she has 3 dogs, gave me a sheepskin a while back for Maigret to lay on, (she swaddled her daughter in it when she was a baby), and I rolled it up and stuck it where my thigh would be to prop him up in my absence. He seemed comfortable.
About euthanasia, I just don't see it until I get a clear sign. I've read several accounts of an owner deciding on the shot and they describe how they give the dog that final treat. I figure if a dog's digging treats, what're you giving the shot for? One minute Maigret will be flat out, looking pitiful, unable to move anything but his head a bit. Then I'll prop him up on his sheepskin and he'll spy a squirrel, perk up his ears and look like a young dog, full of life. The time's getting close, especially if his shoulder doesn't heal so he doesn't need to be propped up to look around.
June 19
It's father's day and my dog is doing great; the Orbax antibiotic must be working. He's alert and has little retching or gurgling after eating or drinking. From what I understand, Orbax, like Baytril, is given to treat more difficult infections.
Since Maigret was laying flat that one morning last week, he's had difficulty supporting his front end while I hold up his hind end to pee. Actually, holding him up has been difficult since his pneumonia after which his front was weakened, and it's impossible to hold up his front and back and squeeze his bladder. (By the way, in case you don't know, you can still take your dog out to go potty: Carry him out, put him down in a standing position and while holding his hind end up, place your hands on his sides behind his ribs and press to squeeze his bladder. Keep your feet out of the way.) So, I took a saw horse, removed the top rail and in it's place put a sling made of an old fire hose. I got the hose from a nearby fire station a few years back for something to wrap around a tree for support without hurting it. Even before his front end was unsteady, holding up his back end while squeezing his bladder was awkward, but the pee stand has made pee breaks easy. Where there's a will there's a way. I think it was Isaac Newton who was asked how he did something or other, like invent the calculus or figure out that planets moved in ellipses. He answered, "by thinking about it incessantly", or something like that. (I've probably got this all-wrong, but some genius said something like that.) Newton got his solar system's dance and I got Maigret's pee stand, but I only had to think about 10 minutes. His front end troubles seem to be resolving and he's up on his elbow regularly again and we really don't need the stand anymore, but we'll continue to use it for prevention.
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| Tools of the trade. The wagon, the pee stand and the hose with hot & cold. |
June 27
Just checking in as Maigret's doing well. He's still on the Orbax, for another week, as it seems to be helping him. He's air-barking at the mailman and while riding on his wagon; my neighbor came over and said that as he approached the house, Maigret was alert and happy to see him and generally looking good. We're having our floors refinished and the floor guys just left. We can't walk inside for 4 hours and the cats are all locked out, wondering what's going on. Tonight we can walk inside wearing just socks, no shoes. In 2 days we can carefully move the furniture back in, so till then we'll be living outside on the back patio, where we've been for the last 2 nights. I love sleeping out; the wind's been blowing the big trees overhead and it's cool. We set our bed up, the TV and computer are online, the couch is available, Maigret's bed is next to ours. It gets down to the low 50's at night so I put a wool quilt over Maigret, one my mom made me to take to college, and I set up a piece of plywood for a wind break near his bed. One of the floor guys said he's never seen a sweeter thing than Maigret on his wagon out for a walk.
July 6
Maigret's Orbax ran out 3 days ago, and his lungs started getting a little rough, so he's back on the orbax. Resistance can become an issue if an anti-biotic is used for too long, though I don't know how long a period is considered safe. I suppose it depends on the particular type of bacteria present and we never did a test to determine that. I think there were some things we could have done for Maigret, medically, that we didn't do because of his multiple problems and age. Also some treatments and diagnostics are invasive and carry risk as well as cause stress, which can also be dangerous. There are two prominent hip bones and the sore over the relatively less prominent bone is now a class 4 sore, like the other. Keeping them clean seems to be keeping infection away, however. Last weekend, while putting up crown molding in the house, I listened to a 2 hour radio show on the skin. Chris Reeves' wife was interviewed concerning bed sores and I guess Chris's pressure sore troubles began when the pillow that he sat on while in his wheelchair was misaligned somehow. Care giving can be a real craft.
July 15
Maigret's gone and it feels odd opening this file. Everything's odd and this going take some getting used to. Big danger in caring for an old dog - needing them as much as they need you, not to mention the 2000 hikes together and the 13 years and the dog park visits and drives in the car, my head out one side, his the other, on and on. We had a lot of fun together. I can't seem to do anything today unless it's Maigret related; thinking about him, looking at his pictures, putting away his stuff. If I didn't have my wife to cry with I don't know how I'd deal with this. I went over and hugged my neighbor and cried on him and I think I scared him. He'll probably stay inside for a while. I went to swat a mosquito but I've had enough of death for a while. My wife and I took a walk at the park where Maigret and I spent so much time and I pointed out places where Maigret liked to go, his water holes, where we'd toss the stick along a path and I'm sure I'll be there every day for a while. I've got half a mind to go dig him up for some more kissy-face, as my wife calls it. She just fell apart when we got home with him.
The night of the 13th he never slept while trying to get oxygen, though by morning he seemed a little better. He still had a lot of rattling in his breathing but not with every breath as during the night. I took him in to the vet's and out of the discussion we decided to double his Orbax dose to 3 a day and watch for continued improvement. He spent the whole day, neck outstretched, head sort of swaying with drowsiness, water dripping from the end of his nose. I'd said after the last pneumonia in April that I wouldn't pursue all the treatments again and opt for euthanasia, considering his other problems and his age. His two bedsores were each now silver dollar size and a bit smelly. Another melanoma tumor was just starting to grow in his mouth and of course he was immobile. As a healthy adult dog with good indentations after his ribs he weighed 115 and now he was 80 pounds. He was eating and curious about anything going on in the kitchen still but that was the only positive sign. He hadn't air-barked when I got out the wagon for a couple of weeks or so. I almost stopped the injection but I was operating with my head at that point. I'm fairly comfortable with the decision but I still wonder. (People around me were wondering why I waited so long.) I have a hard time judging the extent of a dog's suffering and I sure don't know what death brings. My vet, wife, and others who know me and Maigret, were more certain that it was time. More than time. I've read about people giving their dog a favorite treat just before the injection and I faulted the owners, figuring if the dog was still eating, why put it to sleep. But that's exactly what I did. That morning, when I turned down the offer for the full treatment list, I guess I'd already made the decision though I'd hoped he'd be feeling better by evening.
We found a cat in our yard some years ago that was in very bad shape and we put it in a big box and drove it down to the emergency vet. They said it was beyond help and needed to be euthanized. As the Dr. yammered on I almost lost it, wanting to scream, "Do it then. The poor thing's suffering! Do it NOW!" I just didn't want my dog to spend another night suffering and his future was bleak. Funny how the discussion concerning human end of life issues often seems to have more anger in it than compassion and understanding.
During one discussion with my vet about euthanasia, he'd mentioned that few of his clients thought they'd put their dog down too early; that avoiding suffering in the face of a poor prognosis was what most people wanted. If Maigret did beat the pneumonia again, not a good chance of that since the first time the vets were betting on him not making it, he still had the melanoma, the bed sores and the ME. I guess we were both worn out.
We buried Bo, our first shepherd in a hole I dug 7 feet deep in the backyard and did the same with Maigret. It's startling to stand next to such a hole. I dug Maigret's hole back when he had the pneumonia the first time; I didn't want to get caught with a dead dog and nowhere to put him and wasn't sure how long it would take me to dig such a hole; I'm 11 years older than I was when I dug Bo's hole. Turns out it only took 3 hours, though I dug like mad to exorcise my grief at the time. I was worried then he wasn't going to make it. Yesterday, filling it back up was the same, though more sweat and tears this time. It was 100 out. I've forgotten a lot about Bo and now that Maigret's gone I wish I'd kept a diary of our hikes and everything else we did. I want to remember everything. I can't get enough of Maigret talk. I hope I dream about him.
I was never interested in babies but my sister-in-law is pregnant and there's lots of talk about the baby and I'm really happy about it. Nice to see some life.
If you're going to be dealing with a paralyzed dog for long, hang in there. It'll get tough at times, like when the diarrhea continues for a few days. You just get him back to a nice clean bed and out it comes again. Even when the stool is consistently solid, you wake up at night, nose to the air, checking for the sign that you need to get up and change his bed. If your dog is big, this is physical work. You'll be picking him up at least a half dozen times a day. Keep the hole in the small of your back when you lift or bend over. I could pretty much stay in a good mood through it all because he was my boy and I didn't mind taking care of him. After your dog is gone, you'll only wish you'd done more, had more photos, remembered more.
It's been a couple months now since Maigret died. You know that tired, buzzed feeling I mentioned earlier? Tired but content. Riding on ease. I'm still feeling that, more or less, at times. Kind of like you're in a big city, on the street, but you're wearing headphones listening to music you love. You're observing and content. Separate. Detached. Flight attendants were buying me beers because I stayed mellow on overbooked planes. Middle seat? No problem. Peace.
I want to remember and record as much as I can about our times together so I'm going to continue updating this account with anything I remember about the old days. So you can skip all this as this stuff will interest only me.
This is how owners of megasophagus, ME, dogs spend the 20 minutes or so after a meal, giving gravity time to pull the food down to towards the stomach. This photo is older though, before Maigret had ME. I was just hugging him. I always loved that dog.
My wife & I would take Maigret into town for various festivals, where we'd wander the streets, get good food, listen to music. At one event, a woman approached us when we were sitting in the park eating and I was feeding Maigret bits of salmon. She wanted to tell us how taken she was with Maigret's gentleness when taking food from me. He was always a sweetheart, not wanting to hurt a fly. He hated it when I swatted at a bug, always moving away, either because he thought he might be next, (though we never hit him), or he just hated violence. Elevators freaked him out; he'd splay his legs and grip the floor, if a dog can do that, as soon as the car started up or down. And he'd avoid all metal grates in urban sidewalks, even the solid ones, so we'd constantly be cutting people off while swerving back and forth. He was a sensitive boy.
As a pup, at the dog park, Maigret could sense when I was ready to go home and he wouldn't come to me. I don't know how he knew when it was time to go, but dogs are perceptive. I once sat in the car in an empty parking lot, door open, in a downpour, for 5 minutes, while stubborn Maigret stood 20 feet away getting soaked, just looking at me. Finally one day, after spending an hour chasing and diving for him, I decided to get smart. I made a leash of about 6 feet of bungee cord followed by 20 feet of rope with a clasp on the bungee end. About 10 minutes before I wanted to leave, I'd clip it on his collar and continue to toss the stick or whatever we were doing. The bungee was to absorb any shock if he stepped on the leash. When it was time to go, he thought he was safe at 25 feet away, but I could simply reach down and pick up the rope and reel him in. After only a week of this, he no longer tried to avoid me and we retired the long leash. I suppose another approach would have been to experiment with trying to find out what tipped him off about when it was time to go. I'm still curious. And why didn't he run when I approached him with the long leash? Anyway, it worked.
My wife took him through a yr and a half of training, from which be won a second place trophy. Early on she was a lot more involved in his life than later. I sort of stole him from her with the game of fetch, which she never had the taste for. He got hooked and that's all he wanted to do; that and hike, which I happen to love too.
Maigret was born at a suburban house where the mother lived and where I first saw him, in a fenced in area inside the garage. Each pup had a different color collar on and he was "yellow boy". The breeder, the owner of the father, asked us questions to get a feel of who were and how we thought about pets. We told her we already had a shepherd, that was Bo, and he was 12. She asked where he slept and we said "On our bed.", which was the right answer. She paired dogs with the people, and I think we got Maigret because he was a stubborn one and she knew he'd be a bit of a challenge. We were pretty young and had experience. He wasn't show quality, which we weren't interested in, but he sure was handsome. I never got tired of looking at him. I loved to watch him.
There a few little ponds in the park but he was no water dog, at least not in the beginning. As a pup, at the beach, a wave rolled him good and I think that made him shy of any water, big or small. His early dog paddling was comical; front paws rising way out of the water in front of him and splashing down. He finally figured out that if he settled down and kept his paws under water he'd make progress and most importantly, get the stick floating out there.