Crud…

Today was supposed to be my first day back at the office after Christmas vacation. The crud I’ve been, unknowingly, fighting since Wednesday said otherwise. I really thought I just had a sore throat from kicking up dust when I started clearing out my closet to prep for the eventual renovation. Obviously, it wasn’t just the dust, but that wasn’t painfully obvious until late in the day on Friday.

The good news is that if the rapid test is to be believed, I haven’t been snookered by the Great Plague, but some other upper respiratory bug that’s set up shop in my head. At least I think that’s good news. It’s kind of hard to tell at this point.

I was feeling good enough this afternoon to prop myself almost upright and type this out with my thumbs. That’s quite an improvement from the last couple of days when dragging myself off the couch to let the dog out was a downright Herculean feat of strength. My voice is less gravely and every once in a while, I’ve found I’m able to breath through both nostrils simultaneously. Progress.

With a “not Covid” test result I probably could have hauled my carcass to the office today and been a slightly warmer than usual body in the room. If life in a plague era has taught us nothing else, though, I feel like “keep your germs to yourself” should be an important lesson. I’ve got a mountain of sick leave and won’t feel a moment’s guilt at using it.

Maybe I’ll try to dip my toes back into the exciting world of work tomorrow with telework Tuesday. Or maybe I won’t. I think a lot of it is going to depend on how long I can stare at a computer screen without my eyes crossing or my incredible 15-minute attention span completely losing the thread of whatever I’m supposed to be doing. 

Anyway, today was better than yesterday, so I guess that’s something. 

Another vetting…

Yesterday Maggie and I swung by the vet so they could pull another urine sample. I’m expecting the culture to tell us one of two things: 1) Maggie’s UTI has cleared and the infection wasn’t what has been causing her wildly increased drinking and peeing or 2) Six weeks of progressively more aggressive antibiotics have failed to overcome the infection.

If it’s the former, the consulting internal medicine doc we saw last month has already proposed a preliminary course of action based on treatment to roll back a worsening of Cushing’s symptoms that isn’t indicated by the basic test of cortisol levels. I expect at least another trip to Malvern if that’s the result. If it’s the latter, well, we’ll have to see what’s left in the options box if this particular infection is truly uncontrollable with antibiotics.

I’m in the rather odd position of actively hoping that her Cushing’s has gotten worse. It’s at least the enemy I know – one that we’ve had good success wrestling into an uneasy truce if not submission over the last couple of years. It’s at least a fighting chance for some improvement. The same doesn’t seem to be true if we’re dealing with an unchecked infection.

There’s not much to do now until we see what we’re dealing with. It’s one of those rare times when I wish I was just a little more low strung and zen.

Schlepping across Pennsylvania…

Almost two months ago I noticed that Maggie had started drinking approximately an Olympic sized swimming pool’s volume of water every day. I assumed it was a return of some of the symptoms that led us to her Cushing’s diagnosis. Several rounds of testing more or less proved that wasn’t the case. Her Cushing’s remains controlled, but there was bacterial growth in her urine sample – diagnosis: urinary tract or kidney infection.

After the first week of antibiotics there wasn’t much improvement, so they changed up the prescription to something a little more powerful. Two weeks of that showed some vague signs of at least getting her seemingly endless thirst under control. We’re almost through the second two-week round of antibiotics – for a total of five weeks under treatment.

Overall, she seems far better than she was two months ago. She’s not draining off a gallon of water every time I refill the bowl. She’s not struggling to get her feet under her to stand up and her back legs aren’t apt to fall out from under her every time she tries making a turn on an even remotely slick floor.

When we were in the worst of it, I scheduled an appointment with an internal medicine specialist – basically what I expected was a hail Mary play to find out if there was anything that the rest of us had missed and provide a fresh set of eyes to look over an increasingly thick medical record.

Having a dog that drinks non-stop in and of itself isn’t a huge deal when I’m mostly working from home. All that water has to end up somewhere, but it’s not hard to open the door every hour or two or even to get up in the middle of the night for a trip outside. Starting back to work in the office on a more regular basis created a bit of an issue. As much of a dog lover as I am, living with a critter that can’t help but pee all over the house or whatever room you’ve tried to waterproof isn’t a realistic option… and have you even looked at what getting a dog walked two or three times a day would cost?

I kept the appointment with internal medicine – knowing that if I cancelled and there was any backsliding, it would take a month or longer to get another appointment. I still want a set of fresh eyes to give her the once over and either confirm that we’re getting after the right problem or find out if there’s anything that can reasonably be done to coax a little more quality of life out of the situation. Maybe it’s overkill for a 13-year-old lab, but it’s why I went schlepping across Pennsylvania today.

Nobody expects…

Maggie’s test results were not what either her doctor or I were expecting. We were both more or less convinced that her Cushing’s had advanced a bit and her meds would need to be dialed in a bit to correct for that. What two days worth of testing showed, though, was that her Cushing’s is well controlled and those numbers are almost exactly where they were a year ago.

Her tests did reveal a higher than expected number of white blood cells in her urine sample. The cause, ultimately, is unknown… but we’re treating it as a persistent, low grade urinary tract infection since that’s the most likely suspect. Maybe we’re on to something, because she has perked up a bit since we started her on mountains of antibiotics twice a day. Nobody expects the Spanish Inquisition, I suppose.

My poor old girl is still drinking copious amounts of water – maybe slightly less than a week ago – but she’s getting a round a bit better so for now I’m willing to call this at least a temporary win. We’ll see how things look in two weeks when the last of the pills runs out and we’re back to her normal maintenance meds.

This is definitely one of those times where I’m exceedingly happy I never had an interest in having kids… their basic care and feeding, wanting to go to college, or getting married would have eaten into my “Medical Care, Veterinary” annual budget line to an unacceptable degree.

Something of a novelty…

After six days of waiting impatiently, I got a call back from the emergency vet Maggie visited last week. The good news is that the tests they ran confirmed the preliminary diagnosis of a urinary tract infection. After the long and growing list of canine ailments I’ve dealt with over the years, a run of the mill UTI was just about as good an outcome as I could hope to have.

Because in this household we can’t do anything entirely basic, Mag’s urine culture showed that the E. coli bacteria causing the infection wasn’t likely to be fully treated by the particular antibiotic originally given. It did, fortunately, help alleviate the worst of it. Since I’m looking for knock-down, drag-out eradication, though, I’m more than happy to spring for the second 10-day course of targeted antibiotics. It’ll be a small price to pay to get my girl to a place where she’s a) more comfortable, b) not as likely to pee all over the house in the dead of night, and c) can resume her duties as my 70 pound live action foot warmer.

A few weeks ago I laughingly posted on Facebook about a meme showing the average dog owner spends $1000 a year on care and feeding. That sounds awfully low to me, even for a bare minimum of food and medical care. As the science of human medicine marches forward, veterinary medicine marches along a few steps away… with the a corresponding increases in price for the kind of services that owners can now expect and demand.

I’m very thankful that this time around, we didn’t have to chase down anything too dramatic or crash into an aggressive treatment plan. You’ll forgive me, I hope. “Normal” illnesses are still something of novelty here.

Tales of a Sickly Bulldog #487…

English bulldogs are freaks of nature. I mean that in the nicest way possible, but the fact remains that anatomically they’re a creation that would not exist in nature. That’s what makes them endearing to “bulldog people,” but it’s also what makes them prone to all manner of genetic illness.

Currently, my Winston is battling another skin infection. That’s nothing unusual. Bulldogs seem born with skin problems that only get worse as they age. At nearly seven, my boy isn’t a youngster by any stretch of the imagination. I’ve been dealing with skin troubles with him since he was 2. The challenge this time is that the bacteria causing the infection has progressively gotten more resistant to typical antibiotic treatments. In fact we’re basically down to the last one that the vet considers reasonably “safe.” Beyond minocycline there are two others we could have used, but their side effects in dogs are generally worse than what they cure. Other options include a couple of daily IV therapies, but those have the unfortunate side effect of destroying the kidneys while they save the skin. That didn’t sound like a worthwhile trade off.

The long term prognosis for Winston fighting off this particular infection is officially “We’ll see how things look after he’s run the full three week course of antibiotics.” That’s not what I wanted to hear, but if there’s anything I appreciate in a vet it’s giving me an unpleasant truth head on and then working into what options are left from there.

Winston has come through infections before, he’s come back better than I could have hoped from leg surgery, he even fought off a MRSI about 18 months ago. I also know each infection and operation and round of meds take their toll. I’m not ready to start thinking about the decisions I’ll need to make if the options box dwindles down to medicine-induced kidney failure or an infection that will slowly spread across every inch of his skin and make him miserable in the process. We’re not there yet, but the vet’s Very Serious Voice on the phone this afternoon told me that we’re not as far off from there as I’d like to be.

All I can really say as we sit and wait is that I’m determined he’s not going to be left to suffer out of my own misguided desire to keep him around forever. But we’re not there yet and I’ll just have to burn that bridge when we get to it.

Hope (and change)…

All that’s really left to do now is hope that at some point I’ll start feeling better. I’m not saying that I’m lying on death’s door or anything, but I’m feeling crusty enough that I’m pretty much not interested in anything – including writing. That’s saying something for a guy who likes nothing so much as the clickity clack of his own keyboard. The fact is, I’m mostly preoccupied with trying not to launch into a coughing fit at the morning meeting and sitting at my desk pondering what on earth could be going on in my sinus cavity that would turn mucus a disturbing blaze orange color. Seriously. Without getting overly graphic, my right nostril runs in blaze orange and the left in day glow green. Back in the good old days of cigarette smoke, I was no stranger to odd colored things shooting out of my face, but this new color palate is a little disturbing. Sorry about that. I know it was more sharing that you’re really use to here.

I’m sure there are plenty of other things that are comment worthy going on in the world right now and I hope you’ll forgive me for being a little self involved at the moment. All this is really the doctor’s fault if you’re looking for someone to blame. If he’d have just written the prescription I told him to, we’d be happily back to business as usual around here by now.