Saturday, April 17, 2010

Merlin walking 4-10

Merlin has more energy and is doing much better, but still only up to about two blocks- partly because he runs for the treats and wears himself out! He's using the K9cart with front extensions. The original owner of the front-extensions replaced the wheels with pink skateboard wheels, which work well, but I'm wondering if we can find something slightly larger, say Razor scooter wheels, to fit. I'm going to have to go on a mission and look for them.

The front wheels for all the various carts have issues. These are nice in the way they attach, permanently, so the dog is put in and out of the cart without removing the wheels or having them get in the way. But the wheels are small and the framework holding them quite heavy, and it would help to have more support for the corgi's front than a single band about 2 inches wide. For a female you can put a wider band in but for a male this would tend to block the ability to pee.

Doggon has better swivel wheels, but a bulkier way of attaching them to the cart, and my dogs aren't used to the Doggon-type cart. (Though Wesley did fine in his.) They also sit wider apart which could be an issue. And Eddies Wheels has non-swiveling front wheels that are a pain to attach to the cart.

What I'd like is partial swivel, so they could turn but only about 45 degrees, allowing wide turns but not ending up sideways (I've never seen a swivel like this.) A lighter framework might also be nice. I like the looks of the K-9 East front extension a little more; it seems like it would be lighter. I need to ask them how hard it is to add and remove from a standard cart. K9 West was an easy do-at-home modification.

What I'm after is wheels that allow a dog to move on rougher terrain than the sidewalk seen here.

Wednesday, April 14, 2010

Test results and change of meds

This is all for Merlin's seizures again, but it does affect his DM. His bile acid test came back bad- this test measures whether or not bile acids, which are produced when you eat, are recycled by the liver after the meal. If the liver is having trouble, the bile acids measured two hours after a meal will still be high. If it is really in trouble, they will be high after fasting. His were high after fasting, so he has to go off phenobarbital.

Now, since he has to go off fast, he'll get a loading dose of KBr. KBr can take 3-4 months to build up to an effective level at the regular dose, so a loading dose builds it up more rapidly. The problem is, that also means lots of side effects, which can include ataxia and nausea, while it is building up. So he may feel a lot worse before he feels better, and the big questions will be does the KBr control his seizures, and after he hasn't felt good for a month is he going to be able to get back to walking again?

Right now he is pretty immobile. I took him for a block yesterday basically holding up his front and pulling him (he didn't want to walk) and I've been carrying him out to potty. (I keep the four-wheel cart outside and just put him down in it.) I'm going to hope he isn't too ataxic and feels up to walking at least a little every day so we don't lose too much, and if he does lose it, hope that being up in Washington in five weeks will inspire him to walk a bit more. I doubt the four-wheel cart will work up there on the dike so I'll either have to help him a lot in the Eddie's cart or take him in to Langley to walk on the sidewalks.

I'm going after work today to pick up the KBr and get him started. After a week we'll drop the dose of phenobarbital and keep our fingers crossed about seizures.

Sunday, April 11, 2010

Under the weather

Merlin hasn't been feeling too good. Monday he wouldn't eat, which meant he wouldn't walk, because he walks for treats (I bribe him to exercise.) So when he wouldn't walk and wouldn't eat dinner, I made an appointment with the vet. I use a practice that has four vets; the owner is our primary vet and one of the younger women in the practice is who I prefer as alternate (partly because I like her and partly because that's who my regular vet usually consults with!) I could get in to see her Tuesday so we did that.

She didn't find anything on gross exam and drew blood to send out. It turned out he had elevated liver enzymes, the most likely cause being the drugs he is on for his seizures, particularly phenobarbital. A more specific test for liver disease is the bile acids test, so I took him in yesterday for that. They draw blood after fasting overnight, then feed him, and two hours later draw blood again. The fasting bile acid level should be low, but if the bile acids that are excreted when he eats are not removed from the blood stream quickly by the liver, the post-eating bile acids will be high.

If he "flunks" this test he will need a change of medication. We talked about having him go down on phenobarbital and increase slightly the zonisamide, which has little effect on the liver. In some cases just a decrease in phenobarbital returns the liver to normal; in other cases they need to go off it altogether, which we will hope is not Merlin's case as switching over to KBr takes time and with DM, we don't have time to have him feeling bad or ataxic (a side-effect of KBr.)

He's feeling a little better already, appetite mostly back, and he will walk a little. I've been leaving the K9cart with four wheels out in the back yard and carrying him out to it for relief, but using the counterbalanced Eddie's cart on walks. (I don't want him lying down after or while he pees, hence four wheels for that!) It's so easy to lose strength and hard to get it back, so I'm trying to get him to walk every day. If he isn't hungry he won't walk.

I am constantly reminded that Merlin is old enough that he will only die from DM if something else doesn't get him first. In a way, I'd prefer it be something sudden and unquestionable. DM is such a gradual loss that it is hard to know when it is time to let go. Some dogs seem happy and content right up until their breathing is compromised (and would probably continue just as contentedly on a ventilator if that were an option) and others- and I suspect Merlin will be in this category- grow less happy and more frustrated as they lose function. And the caretaker is part of the equation, also, as it takes a lot out of you to be the caretaker, and requires availability that not everyone has.

One of the members of our DM list had a boxer in early stages of DM when she suddenly died (probably cardiomyopathy). Boxer cardiomyopathy is a terrible thing, and a shock to have one go so quickly, but is that really worse than watching her deteriorate and having to make the decision to end her life?

Saturday, April 10, 2010

That terrible DM

Of course I care about DM because of Merlin. But he isn't the only reason, and he wasn't the first reason, I knew about or cared about DM and puppies being born at risk for DM even though a simple test and judicious breeding can now prevent it.

But I handle cart loans for CorgiAid, and one thing I do is lend carts out, about half to dogs with DM, another quarter to undefined maladies that are probably DM. It isn't the lending of carts, though.

It's that they come back. One came back today, with a brief note. "(Our dog) could no longer use the cart and had to be put to sleep."

Then she went on to say, "That terrible DM took her."

It's true no one knows yet how many At Risk dogs, particularly Pems, will get DM, and it is easy, I guess, from the perspective of a breeder who doesn't think she has had it in her lines, to say the risk is small. But from my perspective it isn't 5% or 20% or 30% or 50%. It's 100%. Of the carts we lend to dogs with DM, 100% will come back within a few months to a few years. That terrible DM takes them all.

And that's the reason I'm argumentative and outspoken and even militant about DNA testing. It's too late for Merlin, and it was too late for Poppy. But thousands of puppies are born each year, and if every breeder had started testing for DM in 2008 and avoided breeding At Risk litters, in 2020 I might have stopped getting notes and emails about the ones that terrible DM took.

Monday, April 5, 2010

Maybe I should just feed him at 4 AM?

Merlin has wanted out at 3-4 am the last two mornings. Yes, he does have to go, and because of DM robbing his mobility- and now his ability to go on his own- he needs me to help him get out and go. I'm sleepy, but I can do that, and still get back to sleep.

But then we come back in and he wants to eat and starts to bark. This morning I was determined to ignore him and tried hard to go back to sleep, but I never really slept, and at 6:30 when there was a brief lull in the racket, jumped up to reward the quiet.

Pills, then he barked for another 45 minutes. Finally he stopped and came into the room I was in, so I jumped up and rewarded his effort with breakfast. Now he is sleeping. Maybe feeding him at 4 would have accomplished the same thing and allowed me to get more sleep! But I figure 4 will become 3, then 2, then every hour on the hour if I give in.

He is STILL perfectly happy sleeping out in the car all day, never barks, wonderful peace for all of us, even if I'm in the car with him. But the weather warms and that is going to come to an end soon, and we have six weeks of warm weather before we can leave for Washington. I'm determined to get him to Washington as I think he will be happier there and maybe have a few more good months.