Specialists…

I’m old enough to remember taking the family dog to a vet who ran his practice out of a converted shed in his back yard. Treatment for most any ailment was a shot of antibiotics and a bland diet – his weapon of choice was boiled hamburger and rice. It was the middle 1980s and the very notion, at least in the mountains of western Maryland, that there should be anything remotely like a “specialty” vet didn’t cross any of our minds. Dogs got their rabies shot every 3rd year, ate table scraps mixed with their dry food, and all lasted for somewhere between 8 and 10 years.

Flash forward 30 years…

My bulldog, being typical of his breed, assembled an impressive roster of medical professionals on his “healthcare team.” Cardiologists, allergists, orthopedic surgeons, and anesthesiologists over the course of treating his many various conditions. My labrador, now into old age herself, has already acquired a opthmologist. In the coming weeks it’s likely we’ll add a radiologist, an oncologist, and a general surgeon to her list.

Veterinary medicine as it exists today – with the ability to diagnose and treat the family dog in a remarkably similar way to how how I’d be treated if I walked through the doors at Hopkins with the same symptoms – is a marvel. It’s also a money making juggernaught, but that’s a separate discussion. The practice I’m taking Maggie to this week in hopes of working up a final diagnosis and beginning outline of a treatment plan includes easily a thousand or more years of combined experience in emergency medicine, cardiology, dentistry, dermatology, radiology, neurology, oncology, and ophthalmology, in addition to maintaining six surgeons on staff. Their posted resumes are suitably impressive (yes, I’ve read them all). I’m cautiously optimistic that all this will translate into identifying what the best options look like for the road ahead.

I’m walking into this week with just enough knowledge based on internet deep diving and journal article reading to hopefully ask reasonably informed questions. I’ll be counting on this bunch to know the line between what science can do and what science should do. Don’t get me wrong here, I’m thankful that the state of the art has grown beyond crate rest along with boiled hamburger and rice, but there’s more than a little bit of me that misses simple, country diagnostics and treatment – and its inherent acceptance that the power of medical science to extend life has, and should have, logical limitations.


Diagnosis…

After several rounds of testing, we have a preliminary diagnosis for Maggie of adrenal-based Cushing’s disease. Not being a vet, but being one hell of a good researcher, I won’t attempt to explain exactly what Cushing’s is beyond the fact that it’s a disorder likely being caused by a small tumor located on the adrenal gland that’s making her cortisol levels to go wonky and producing a host of potential symptoms.

In Maggie’s case, the symptoms include excessive thirst / drinking and the accompanying excessive urination, hair loss, and general weakness. At this stage, the disease doesn’t make her feel bad or cause any pain. Based on my observation she’s giving absolutely no indication that she even knows she’s sick. The primary treatment, should it prove to be adrenal-based, seems to be surgical removal, although there are some non-invasive options based on my cursory reading.

I won’t dwell on details at this point, frankly because I don’t have many real details to dwell on yet regarding Maggie’s particular diagnosis. Next week, we’ll be taking a bit of a road trip to a specialty vet who will do an ultrasound to visualize the suspect area and, hopefully, confirm a diagnosis so we can identify the appropriate course of treatment.

I’m already racking up a list of research I need to do between now and then – the success rates of the surgery in question, post surgical life expectancy, impacts on quality of life, and so on. I’ll also have to take a long hard look at my personal ethics with regard to invasive surgery for a dog that by any standard definition has already reached into the “old age” range. Believe me when I tell you it’s times like this when I hate being an analyst by professional and disposition. It’s one of the rare moments when being dumb and happy would appear to be a blessing.

The research and worry is all for a bit later though. Right now it’s Friday evening and I have a happy and contented, if not exactly healthy, dog sitting next to me wanting undivided attention. Tending to that feels like it’ll probably be the most productive and cathartic thing I’ve done all day.

Vetting or: The tale of a sick labrador…

Over the years I’d grown so accustomed to having one sick dog and one well that last month I even noted my budget had gone wonky from the unusual lack of vet bills. You’d think by now I’d know better than to open my electronic mouth and temp drawing the wrath of whatever from high atop the thing. If you thought that, of course, you would be wrong. My mouth has been, is, and seems likely to continue to be my worst enemy.

After a few incidents and observations over the last week or two, what I seem to have now is just one sick dog. Not falling over, edge of the mortal coil sick, but sufficiently sick that we’ve already run two diagnostic panels in as many days and scheduled the next – which promises to be an all day affair for my sweet brown dog later this week.

It’s one of those times when I’m ill served by having a professional and personal bent towards research and analysis – particularly as there’s absolutely nothing I can do about the situation until we strike on a test that does something more than confirm some of the possibilities. Just now we’re tracking it as potentially a kidney issue or a liver issue or the wildcard diagnosis of Cushings disease.

I’m told by those in a position to know such things that all of these are treatable – at least in the sense that it’s often possible to slow down the degenerative processes involved. Time, however, is a remorseless bitch and treatable does not mean “curative.” That at some point everything that’s alive will eventually be not alive is pretty much just one of the rules of nature. Even the best care simply prolongs the inevitable for all of us.

Maggie isn’t in pain. She’s her normal, happy labrador self. That’s something. Personally I’ll feel better when we have an enemy I can fight on her behalf, but for now I’m trying to be calm and contented in giving her endless chin rubs and maximum attention.

What Annoys Jeff this Week?

1. Energy. It’s the stuff which lets us stay awake after dinner instead of falling asleep on the couch with a book in our hands. My level has never been high enough to run the risk of becoming a distance runner, but at a bare minimum I could usually stay awake until my already geriatric bed time rolled around. For the last few weeks, though, mine has been missing entirely. It’s a small thing, yes, but it’s altogether frustrating and I need it to stop right the fuck now.

2. It’s never been worse. Three separate times this week I’ve heard either a talking head on television or someone in real life say that “our country has never been more divided” or “It’s never been worse.” One of the main problems with the laughably short human lifespan is that only being around for a few score decades and a lustrum or two means most people who don’t study it have no sense of history. You see way back in 1814 a foreign army burned the nation’s capital to the gound. I’d say that could be considered objectively “worse” than where we stand in 2019. Fifty years after the burning of Washington our country conducted a viscous, bloody, and protracted civil war. Now I’m not an expert, but that seems significantly more divided that we are just now. 

3. Waiting. There’s never been a doubt in my mind that I would eventually get back to being a two dog household. I planned for a reasonable period of adjustment. I also wanted wanted to wait for the winter weather gave way to spring because housebreaking in the winter sounded infinitely more awful then doing it when it’s temperate. There’s also the fact that March and April constitute my  “busy season” at the office. Thanks to one of my distinguished colleagues, though, I’m currently obsessing over any one of four English mastiff mix puppies up for adoption through a rescue outside of Baltimore… and trying to come up with a way to make jettisoning the plan sound at least passingly logical and not at all like something that would be a batshit crazy idea.

On the day after…

Yesterday was darkness, overcast and dreary. Then, as if the universe has some semblance of a sense of humor, just as dusk was coming on, it snowed for a while. Winston hated the snow. Given the arthritis and metric ton of metal in his leg, a natural aversion to the cold isn’t exactly shocking.

This morning, on the day after, was as bright and sunny a winter morning as you could hope to see. I won’t pretend that everything is ok or that I’ve even started adjusting to the new reality. There are still moments when loss is a deep, yawning chasm. Even with the rest of us in it, the house feels unnaturally empty for his absence. In the sunshine today, though, there were also moments of glimpsing what’s beyond all that. At least the big, manly, ugly cry sobbing has given way to a more manageable leaking about the eyes.

There’s not one second of the day I haven’t missed Winston’s slobbering, or the ponderous thump of his steps coming down the hall. Hell, I even started making breakfast for him today before catching myself and very nearly coming unglued.

Today I am immensely thankful for the long Anglo-Saxon tradition of quashing all the bad feelings and getting on with it – stiff upper lip and all that. The rest of my now diminished pack needs the best of me and the gods know that just now I need them more than ever.

Worse than hot takes…

I was thrilled today to see much of the North Korea hot takes that filled my newsfeed over the last few days giving way to the funny animal posts and random memes that I’ve come to rely on social media to deliver.

Unfortunately, my feed was equally crammed with a third category of post that I could have really done without. Instead of making me laugh or teaching me something new, apparently the internet decided that today I needed to learn about every dog available for adoption between New Jersey and central Virginia. Believe me when I say it was 100% information I’d have been happy doing without.

On a typical day I wander through life with a generic sense of wanting all the animals. When the internet uses its communicative powers to give each of those animals form and substance, though, all rational arguments like, vet bills, food, training, and not turning into an animal hoarder flow directly out the window.

So it turns out I’m going to need a break from the internet because not because the news of the day is so upsetting, but because animals are just so damned amazing and I want to bring all of them home.

Ten…

IMG_0305.jpgWalk up to the average bulldog owner and tell them that you’re thinking about adding one to your pack. I’d be willing to bet that 4 out of every five of them will warn you off the breed. They’re sickly – prone to a list of illnesses as long as your leg. They’re rife with potential genetic abnormalities – their airways are too small, their joints are prone to problems, their skin, God help you, will demand seeming around the clock attention. The most common dog foods are apt to trigger a host of potential allergies for them. Bulldogs, despite their popularity, are a troubled breed and not for the faint of heart or thin of wallet.

Having a bulldog means spending a ridiculous amount of time tending to their needs – with medicated baths, lotions, ointments, sprays, and a cabinet full of medication in addition to their basic care and feeding needs. You will develop a closer relationship to your veterinarian and their staff than you ever imagined possible. If the dog itself is an outsized expense, your medical bills for his care are going to spiral quickly into the five figure range and easily keep climbing from there.

My bulldog turns ten today. He’s been my near constant companion for almost every day of those ten years and he’s been a burning hot mess for almost the entire time. I’d hate to calculate the dollar cost of our time together or the number of trips to the vet for everything from noshing an Atavair inhaler weeping skin sores that erupted overnight without warning to months long recuperation from leg surgery.

I know though, that Fortress Jeff wouldn’t be what it is without Winston’s inquisitive eyes, slobbering IMG_0304.jpgjowls, smiling under bite, and undiluted obstinacy. Reaching his tenth birthday today, I’m acutely aware that I’ve got far fewer days left with him than I’ve had with him already. It’s one of life’s great inequities that the time we get with these animals is so incredibly short.

Any conversation I have about bulldogs invariably starts with “I love Winston more than nearly any living creature on the planet, but there will never be another bulldog…” The truth is, I’d be hard pressed to think of what this house would be like without a bulldog in it. The thought itself feels unnatural. There may well be other bulldogs in the future, but Winston will always be my first and the yardstick against which any other would be measured.

Today, of course, isn’t a day to ponder the costs or the future. It’s a day to give him a few extra ear rubs and chin scratches and marvel at the fact I’ve had so long to enjoy the companionship of this incredible dog.