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?