Tag Archives: Health

The slightly abridged story of another sick dog…

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Since I seem to be permanently destined to have at least one sick dog on the premises, I suppose it’s only fair that I throw out a little update on what we’ve been up to since late last Friday.

The short version is that over a span of about an hour on Friday night I watched my already sickly chocolate lab go from her normal self to drooling, vomiting, and blasting out unimaginably large quantities of liquefied, high pressure shit. I undertook the “40 minute” drive to the nearest emergency vet with great vigor and complete disregard for pesky details like traffic laws and personal safety. I was more or less convinced that by the time we got there, I’d be dropping her off for a necropsy rather than treatment. I never thought I’d be happy to hear a dog retching and hacking in the back seat. For Friday at least it was the sound of not being dead yet.

After 36 hours of treatment, blood tests, fists full of medication, an ultrasound, and round the clock monitoring, the official diagnosis is “we don’t really know.” The symptoms don’t really present as something directly related to her Cushing’s disease and the ultrasound didn’t show anything radically different than what we saw back in March. Inconclusive.

In the absence of a solid medical diagnosis, I’ve arrived at a speculative cause for all this last week’s problems. What I think happened is that sometime around 6:30 Friday night the dogs found something in the yard – perhaps a mushroom – and noshed on it. For Maggie, already compromised with Cushings and general old age, the result was sudden and violent illness.

The key to my speculation doesn’t actually involve Maggie at all, though. When I got home from the emergency vet around midnight Friday, Jorah’s crate floor was spotted with drops of something. At first I attributed those drops to a reversion to peeing in his crate, but a closer look showed that he too was drooling prodigiously. In Jorah’s case, though, it lasted just a few hours and dissipated. He never showed any signs of feeling badly otherwise, which I know from sitting up through the small hours of Saturday morning waiting to see if I needed to drag another dog in for heroic measures of treatment at weekend rates.

I talked to our regular vet last night and laid out the timeline of events, went over the details from the file, and presented my own observation of the events. Without being led there, his first opinion was that it sounded like they had both eaten something and promptly got sick in proportion to the strength of their respective systems. It’s not exactly a confirmation of my logic, but I was glad to see that his analysis of the available evidence mirrored my own. Unless something is proven otherwise, “ate something” is going to be the official story of what caused this week’s series of unpleasant events at Fortress Jeff.

With leaves coming down and the ground covered it’s going to be horribly difficult if not outright impossible to verify any of this. It’s going to be harder still to comb the area for anything that could further agitate the situation. Part of me knows we’ll be relying on some level of luck in avoiding future problems. It’s not optimal, but we’ve lived here a fairly long time now without something in the yard causing mayhem and chaos. One bad day out of 1200+ isn’t necessarily a cause for panic, but I’d be lying if I said I wasn’t looking at the compound with a new level of unease.

Of testing and cautious optimism…

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I took the morning off today, to take the youngest pup in for another round of testing. The blood tests and urinalysis done over the weekend pointed steadily at major problems with his kidneys, perhaps even towards renal dysplasia – basically a developmental anomaly that would all but guarantee kidney failure in fairly short order after the initial onset of symptoms. That wasn’t what I was expecting to hear, but I spent most of the night last night reading every article and journal entry I could get my hands on without a subscription. If that was, indeed, the worst case scenario, I wanted to know what we were up against. Nothing I read gave me a warm fuzzy.

This morning’s round of testing has given cause for a bit of cautious optimism. Jorah’s urine was concentrated, had appropriate color and smell, and its specific gravity was low, but still in the target range for normal. Those things wouldn’t likely be in the case if his kidneys were in the process of failing. He’s schedule for a trip through south eastern Pennsylvania on Friday to see a specialist and get an abdominal ultrasound. Barring an invasive biopsy, it’s the surest way to verify that his kidneys are correct in size and shape. Cautious optimism.

Since the mass consumption of water is something Jorah’s done since the day I brought him home and we’ve established that his kidneys are concentrating fluid and his blood isn’t showing any of the other likely issues, one of the remaining outliers could be that he’s just obsessed with drinking. The fact that it’s possible I gravitated, in a building full of dogs, to one that could have a touch of good old fashioned OCD probably shouldn’t be in any way surprising.

We’re still a ways off from having a truly definitive answer, but moving the one that’s effectively a short term death sentence more towards the unlikely column feels like a pretty good day’s work.

A case against modernizing…

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It’s Wednesday. There would usually be a well prepared post showing up here. The time I had allocated for that today was supposed to be immediately after my 12:30 appointment with the dentist. That would have been fine except for the part where what should have been about an hour or 75 minutes getting a crown replaced turned into a three hour and thirty minute marathon in the chair. All because the magic computer that’s supposed to scan your teeth and order up a perfectly sized crown refused to work. They couldn’t give me a temporary crown until the base for the permanent one was scanned, measured, and sent off to the manufacturer.

Twenty years ago they had a pretty efficient way of taking those measurements. They’d take a mold of the base of the tooth and then send the mold off to be processed. It might have taken a few days longer to process, but you could be in and out of the chair without killing half a damned day. All things considered, I’m not sure digitizing what use to be a straightforward and quick process has really gained us anything in this case.

As it is, I’m disgusted by the whole process. Rather than writing a whole diatribe, though, I think I’ll just stick my nose in a book and nurse this sore as hell lower jaw for a bit.

What Annoys Jeff this Week?

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1. Storming Area 51. The media has been caught up on stories of people who are “planning” to storm Area 51, or the US Air Force facility at Groom Lake, Nevada. I like to think most people have signed on as a lark, maybe because they want to feel like a part of the latest internet sensation. The internet is full of stupid, of course, so I have very little doubt that at least some of them are really “planning” to cross into the facility on or about the appointed date and time. It also seems likely that the type of people most likely to attempt this are the ones least likely to be prepared for what they’ll meet… miles upon miles of some of the most inhospitable terrrain in the United States, almost no services – including hotels, gas stations, and water, and some very irate and serious guards should any of them happen to actually stumble, sunburned and dehydrated, into the restricted area. Planning. I have deep reservations about whether that word means what the internet seems to think it means.

2. Prime day. Every year feels a little more like Prime Day is just an amazon garage sale. It’s certainly a “so what” event from a book perspective. I miss when amazon was a bookseller. Of course I’m still locked out of my Prime account anyway so it doesn’t really matter.

3. Water. The universal advice when getting over a cold is to “drink lots of water.” I’m increasingly convinced that no one who gives that advice has ever actually tried to do it themselves. Water, even the fresh, pure stuff coming up from the well on the homestead starts tasting disgusting after you reach a certain volume of throughput. That’s if you can say it really “tastes” like anything at all. All I’m saying is that if experts want you to flood your system with something, they should make it something that’s reasonably good tasting, I mean where’s the advice to drink lots of hot chocolate or good rye whiskey?

Taking care of business…

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I read an article this morning that indicated “studies report” a massive uptick in the number of people who are seeking mental health treatment because of issues ranging from “the world is spinning out of control” to “climate change is going to kill us all in the next 50 years.” These and similar Big Fears are apparently incapacitating an entire generation of people by filling them with existential dread.

Look, we live in interesting times, I get it. I’ve also studied enough history to know that everyone always thinks the world is ending. When the Soviet Union parked missiles in Cuba, the world was ending. When the German army marched on Paris in 1940, the world was ending. When the heir to the Austro-Hungarian Empire was killed in 1914 and the Europe descended into war, the world was coming to an end.

The point is, we’re hardly the first generation to think the world is spinning off its axis. Although past performance isn’t a guarantee of future results, something tells me that we won’t be the last one to think that either. To our credit, I suspect humanity is far harder to kill off than we we’ve been led to believe.

I’m not going to blow sunshine up your ass and tell you every little thing is going to be alright, though. There’s more then enough shitshow to go around. The trick is, you’ve got to turn the news off occasionally. They’re telling the worst stories of the day because that’s what puts eyes on screens. I won’t claim to be immune to the news of the day… but I spend most of my effort looking at the small bits of it I might be able to influence in some way. Put another way, I take care of my business, keep my nose clean, and make sure me and mine are as able to ride out the inevitable storms as well as we can with the resources available.

You’ll find no end to problems in this old world of ours if you insist on looking for them. My advice is to try just focusing in on the ones where you can make a difference instead of the ones that almost seem designed to inflame and distract. Who knows, you might just save yourself a few sleepless night and tens of thousands of dollars in bills from the local head shrinker, so it’s a bit of a two-fer.

Partial diagnostic credit…

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After a morning road trip through some of Pennsylvania’s finest horse country and 30 minutes of abdominal scanning, it turns out that my regular vet had the diagnosis right, but gets only partial credit on the underlying cause. Still, I count that as exemplary work for a condition that presents as a shitload of things that don’t feel like they should really be logically related.

It turns out that Cushing’s is the correct diagnosis, but rather than a tumor of the adrenal glands, the glands themselves were “significantly” enlarge. In fact they’re currently 5 times bigger than they’re supposed to be and hammering out cortisol like its their full time job. Since we’ve ruled out an adrenal tumor, that basically leaves a growth on the pituitary glad as the last culprit standing.

In many ways, the adrenal tumor would have been easier to treat – open the abdomen, remove the tumor (and the accompanying gland), and the symptoms go away. It’s an invasive operation with good success if the dog survives surgery and the first week of recovery. The problem is that 30% of dogs that have this treatment don’t get past that first week. I’m a betting man, but when you’re looking at odds of one in three chambers having a live round, I’d have an awfully hard time pulling the trigger.

I’m waiting now for my regular vet to get the report and work up the treatment plan. My best estimate is that it will be to treat with daily medication to reduce the amount of cortisol being made rather than something surgical. My reading shows that surgery for pituitary-involved Cushing’s is possible, though exceedingly rare for dogs. What this really means for Maggie is she’s likely going to have to take some fairly high powered pills twice a day for the rest of her life. There’s going to be more home monitoring and increased testing at the vet to confirm that everything is working normally. Basically it’s nothing that life with a bulldog didn’t prepare me to deal with already.

There’s a catch, of course. Without dragging her back to the specialists and ordering up an MRI of her brain, there’s no absolute way to know if this tumor is benign or malignant. Research says the large majority of pituitary tumors in dogs are benign. With an average canine MRI running into several thousands of dollars, I’m inclined to let the odds dictate our response on this one. If it turns out to be something more aggressive, the options I’m willing to pursue decrease fairly dramatically anyway.

The prognosis for all of us is the same in the long run, so there’s very little advantage to be found in trying to plan against it. With all that said, I’m cautiously optimistic that we can strike on a way ahead that maintains or improves the brown dog’s quality of life in the short and may even mid-term.

Vetting or: The tale of a sick labrador…

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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?

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1. Second Monday. Look, I’m 100% thankful for the unscheduled Federal holiday on Wednesday. The unintended consequence of this Executive Branch largess, though, was that this week had what is effectively a “second Monday.” Going back the the work after a bureaucracy-free and relaxing weekend is a regular, recurring minor trauma that fills Sunday evenings with angst and dread. Once the week gets going though, the follow-on weekdays are each slightly less traumatic than the day before. Plopping an unexpected day off down in the middle of the week created an unnatural imbalance in the normal flow – and in doing so made Second Monday feel even worse than regular Monday. It’s hard to believe that such a thing is possible, but there it is.

2. Cubicle Hell. For all of the wonderful management literature written extolling the virtues of “open concept” workplaces, none of them bother to take into account how the average employee may actually require some time to analyze, read, or complete a work product that requires some level of concentration. I only bring it up because of the increased frequency of people holding entire goddamned meetings with groups of 4-5 others spilling out into walkways or shouted over the top of adjacent walls. Multiply that by as many as 5 of these impromptu “meetings” fired up all at the same time, well, you might as well sit back and start counting ceiling tiles because even pretending to look productive under the circumstances is a lost cause.

3. The human tailbone. I’m not a fancy big city doctor, so I don’t know exactly what a tailbone is supposed to do for a person. I reckon it’s mostly like an appendix – except that when something goes wrong with it it doesn’t burst and kill you so much as it stays right where it is and hurts like a sonofabitch whenever you sit down. In any case, it seems to me that there should be some kind of corrective option beyond, well, just don’t sit so much. That’s fine advice, I suppose, when your day isn’t spent tethered to a desk and reading  volumes of fine print for the minutia that someone is trying to bury in the fine print. And yes, before someone points it out, I know that Churchill worked at a standing desk. He also worked in the bathtub and I am, clearly, no Winston Churchill. 

What Annoys Jeff this Week?

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1. Stomach. My stomach has been trying to kill me off and on for the last few days. It’s not debilitating or preventing me from getting on with my day, but it’s made food something of a dice roll, meaning that I traipse through the day mostly hungry in order to avoid workday unpleasantness as much as possible. Of course continuing to pour coffee down my throat probably is doing nothing to mitigate the issue. Realistically, though, if I’m going to be hungry also having me uncaffeinated feels like it’s just asking for more trouble than we’re trying to avoid.

2. Perceived time. We humans have a bit of an odd relationship with time. We struggle mightily to measure it down to the merest fraction of a second, but it’s really how we perceive the movement of time around us that matters most. I’m grown increasingly interested in the perception of time after sitting at my desk for 37 hours on Tuesday, but finding that the most recent Saturday lasted only 192 minutes.

3. Be nice. Someone from time to time will suggest that I should make an effort to be more understanding – to “be nicer.” I’m sure the suggestion is well intentioned, usually implying that I’d be more approachable, less apt to judge, or in some way become a kinder, more sensitive human being. Seriously? Have you met most people? Piss off with “be nice.” I’ll continue to respond and react to people as their actions and attitudes dictate. If you’d like me to be nicer, I’d recommend convincing people at large to be a little less dumb. It’s a win-win for everyone.

What Annoys Jeff this Week?

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1. Inefficiency. Look, I’m delighted that Big Pharma is reimbursing me 93% of my out of pocket costs for the meds that one of the smart docs from Hopkins tells me will contribute to being able to continue to living better through chemistry. I’d be even more appreciative if their reimbursement scheme allowed for ordering more than a 30-day supply of the stuff at a time. Everything else rolls in as a 3-month supply that’s simple enough to refill once a quarter except this one little pill. It feels like I’m online getting that one refilled or coordinating the refund about every seven days. If you’re going to spend the money either way you could save us both processing time and effort by doing it four times a year instead of 12.

2. Single points of failure. The world is full of people who want to gather all decision making and power unto themselves. I’ve never understood that particular logic for several reasons. First, the ones who seem to be drawn to absolute power are generally the last ones who should be engaged in decision making. Second, there’s nothing more ridiculous than a few dozen people standing around knowing what needs done but being paralyzed for lack of having someone explicitly telling them to do it.

3. Consistency in the space program. I really wish we lived in a country that had consistent and achievable, manned and unmanned space exploration goals. I want NASA to be above politics and be maybe the one instrument of government that is the best reflection of ourselves. I want to see big rockets with the stars and stripes plastered to the side hurtling American astronauts back to the moon and then getting their ass to Mars. To think that’s not the next logical step in exploration is nonsensical and flies in the face of humanity’s eternal struggle to expand into the unknown. Other people will tell you this should be way down on the list of priorities, but those people are wrong and should be quiet.