Our Tripawd Experiences

Yesterday would’ve been Sebastian’s 13th birthday.  I still think of him every day, have his photo as my cell phone wallpaper and find his Husky hairs scattered about the house (true I can’t be sure they’re his versus Nico’s, Brody’s or Luna’s, but I’m sure some of them are still his!)  It’s amazing what an impact a pooch can make on one’s life.  Sebastian spent 11+ years teaching me about friendship, dedication and perseverance.  Despite the myriad of health issues he battled over the years (GI sensitivity, hypothyroidism, soft tissue sarcoma followed by a full leg amputation, and a stint with cancer metastasis into his lungs), he was still cuddly and smiley.  He taught me that no matter what life throws at you, there’s no reason to let it bring you down.  He walked (hopped?) himself out of the vet clinic the evening of his amputation, he was full of love and just as handsome with three legs as he was with four legs.  I still believe the amputation was the best decision and appreciate that it gave us a few more good months with one another.

Despite how much I miss him, my tears have turned to laughter and I continue to speak fondly about my guy as if he was still with us.  We said goodbye to him 6 months and two days ago and in so many ways it seems like it was just yesterday.

I hope wherever he finds himself now, he’s being treated to bunnies he can chase, a bushel of fresh tomatoes and a soft, cushy, warm bed.  I will always love you Sebastian, and will never forget all of the life lessons you taught me without even intentionally doing so.  I’m looking forward to seeing you again someday, my blue-eyed handsome man. <3

Sadly, on the evening of Monday, September 22nd around 8:45 pm Mountain Time we said goodbye to Sebastian with the help of a local emergency clinic.  I arrived home from work after days of watching his breathing abilities continue to decrease and simply knew it was time to say goodbye.  He was wheezing (with a whistle sound on his inhalations) and his cough was persisting.  His gums and tongue were turning pale, which as I understand it, is indicative of a lack of necessary oxygen.  He would still get up when we motivated him to do so and was able to get outside to do his “business,” but it had become clear that he was not getting much enjoyment out of life anymore as he was more or less just laying on the floor in whatever room he happened to plop down in and was continually struggling to breathe.  The decision making process was difficult, but ultimately my husband and I agreed that the time had come.  I called ahead to the emergency clinic to say we were coming as I wanted to avoid being there any longer than necessary.  They were very kind and accommodating and had prepared a room for us by the time we arrived.  Thankfully, I had close to a week since the confirmed diagnosis of mets into the lungs to give Sebastian extra cuddles, love, and delicious snacks (pizza, ham sandwiches, granola bars, sweets, etc.)  I spent a fair amount of time laying with him, petting him and constantly reminding him what a good boy he had always been and that he’d always been an outstanding friend to me.  As the time came, I tried to stay strong for him, knowing he was in tune with my emotions and also knowing that I didn’t want him to be any more scared than necessary.  I laid on the floor with him in the clinic, pet him nonstop and thanked him for all the joy he’d brought me.  He didn’t seem frightened at all and peacefully departed to his next destination without the “scary” stuff that sometimes comes with euthanasia.

Monday night, and all of  yesterday, were very difficult for me emotionally.  I chose to go to work yesterday in order to keep my normal routine in place, believing that it’d help keep me focused on something other than my sadness.  I made it through the day, ran some errands after work and went to bed very early after the terribly emotional evening I had on Monday.  I slept through the night and woke up this morning to help Brody (our other handsome black and white blue-eyed Husky) celebrate his 11th birthday.  I’m working hard on moving forward from grieving over the loss of Sebastian into celebrating the good times we shared together and also repeatedly reminding myself that 12-1/2 years (yesterday would’ve been his 1/2 birthday) is a good life for a 70+ pound purebred Husky who had a variety of health issues throughout the course of his whole life.

I have yet to question whether amputation was the right thing to do.  If faced with the same decision again tomorrow, I would handle it exactly the same way without hesitation (with the exception of potentially doing sooner than we did.)  The amputation brought us a few more months together and I truly believe he adapted quickly and without any issues.  Had the blasted cancer not metastasized into his lungs, he’d still be with us today, but given the mets, humanely saying goodbye was the best “favor” I could give my boy at that point.  I miss his charm already and will always cherish the time we spent together.

Godspeed, Sebastian.  Catch ya on the flip-side. <3

Our appointment was quick, but certainly not painless. Sebastian’s x-ray showed that his lungs are now filled with tumors. We looked at the x-ray from June first which looked amazing, and once today’s finished processing we switched over to it and his lungs are literally cluttered with masses. He is still bright eyed, alert, hungry and responsive so for now he’s home, but we were told he probably only has 1 to 3 weeks left with us. Needless to say we are heartbroken, but we will enjoy what time we have left with him and make any necessary decisions when the time is right; we have no intentions of allowing him to suffer.

He’s been an amazing friend to me for over 11 years (he was about 14 months old when I adopted him) and that is something I’ll always cherish. I was hoping for better news, and dreading this news, but I am thankful that today is not the day we need to say goodbye to our beautiful blue-eyed man. Hug your furry friends a little closer tonight and appreciate the time you have with them. It goes much too quickly. <3

So, last time I updated, I mentioned Sebastian had developed a concerning hacking-gurgling-throat-clearing-kind-of-cough.  We saw our primary care vet who said his lungs and heart sound great, which is obviously outstanding news.  She gave him a prescription for Temaril-P in hopes that it would alleviate the crazy coughing symptoms and solve whatever problem was causing it.  We gave him two pills for the first five days and have been down to 1.5 pills for the last couple of days and had planned to step him down to 1 pill for the final five days. Initially, it seemed it may have been a solution as the retching sounds quieted down as did the frequency; however, as of the last couple of days, the cough has become more frequent and with a louder gurgle sound as if he’s trying to cough something up, but so far, it has not become a productive cough.  Our primary care vet is the person who did the initial biopsy and diagnosed his leg mass as soft tissue sarcoma.  She referred us to a surgeon about 25-minutes from home to do the actual amputation given the experience of the surgeon and him offering lower costs versus the hospital where she works.  As you may recall, the surgery took place at the end of June and he’s been bright eyed and getting around pretty well for short distances and around the house without difficulty pretty much ever since.   Given that his x-rays at the time of surgery looked clear and without any signs of metastasis, we all thought it to be unlikely that he suddenly had cancer in his lungs bad enough to be causing this coughing, but we all also know it is in fact a possibility.  The fact that his lungs and heart sounded good led us to believe he isn’t likely suffering from heart or lung disease.  All good, until this morning…

Shortly after the surgery, we noticed what we thought was scar tissue just under the incision site where his leg used to be.  It made sense that there’d be some hard areas under the scar given the amputation and the fact that his leg wasn’t there anymore, nor was his hair.  It didn’t cause us any concern until this morning when I noticed the mass that we thought was simply scar tissue had grown significantly in what seems like overnight.  At this point, I’d say it’s the size of an average doorknob and can be moved around – meaning it doesn’t seem to be attached to his skin or to anything under the skin.  If pushed on, even gently, he sort of gasps for breath, flinches and kind of whines.  My guess at this point is that whatever this mass is may be pushing against his lung on that side of his body leading to the cough and the hacking sounds, but seeing as I am far from a veterinarian professional (despite this being the 3rd battle we’ve fought related to dogs with cancer – 3 dogs, 3 different types of cancer), I decided it’s best to take him in for an x-ray and / or a biopsy to confirm what’s going on now that’s led to this large bulge under his incision site.

Here’s a link to a video so you can see what I’m talking about with the cough: http://youtu.be/hU3SuFJ7SRM

So, friends, I must ask you if any of you have had any similar experiences with your Tripawds?  We do have an appointment at 6:40 pm (Mountain Time) tonight with the surgeon who did the amputation.  I’m nervous as you can imagine and quite anxious to get some answers.  Fingers crossed.

I only have a quick moment, but every day I remember I need to update you folks and then next thing I know, it’s the next day!

A very brief update: Sable is doing great as related to the ivermectin toxicity.  She will make a full recovery and all will be well there.  I met with the Director of our clinic who has processed a request to their corporate office to refund me for the total associated ER cost.  While that helps from a financial perspective, it certainly doesn’t address the scare and concern my husband and I experienced.  I specifically asked the Director of the clinic what his approach would be on a going forward basis to be sure this never happens again.  He indicated they’d be using it as a “teaching moment” and would have a meeting with all of the vets, techs, etc. to discuss what happened and how much worse the situation could have been.  He advised he’d be back in touch with me after their meeting to confirm it took place and to discuss the ideas his staff had to ensure having this happen again was completely out of the question.

Regarding, her itchiness, at this point, they’ve put her on a 10-day cycle of prednisone with the hopes that it will ultimately resolve itself and not require ongoing treatment.  She’s about a week into the prednisone and is not biting, scratching or clawing at herself incessantly any longer; however, she is having several “accidents” overnight… every night.  As she is not the first “baby” we’ve had on pred, I know this isn’t unusual and am hopeful it’ll resolve itself once she’s off the medication.  She is still taking the liver pill and everyone believes that once the ivermectin is completely out of her system (which it should definitely be by now!) the liver will return to normal.  I do realize, and our vet told us, that prednisone will “mess up” the validity of any liver enzyme test we do now so we will re-check her once the pred has run its course.

Long story short, as terrifying as this experience was, she is almost back to her normal wiggly self.

As for Sebastian, our beautiful Tripawd, he is still doing remarkably well.  Every day he’s showing a little more enthusiasm and is getting around a little bit better.  He does have a mass on his remaining front leg near his dewclaw which I’m thinking we need to get biopsied, or at least checked out in some way, but I’m concerned about doing any type of procedure to his “good” front leg given it provides his balance and ability to be mobile.  Has anyone else experienced such a thing?  The mass is still small enough that it could potentially be removed without any issues.  I realize that if it’s cancer again it should definitely go, but my hesitation is “messing with” his only front leg as he’s just gotten used to getting around on 3 legs.  Thoughts from anyone on this situation?  Keep in mind he’s 70+ pounds and will be 12 1/2 in September.  I obviously want to provide him with whatever care he needs, but also don’t want to jeopardize his ability to “keep kicking” given the fact that he’s already down to 3-legs.

So, this post is about Sable, our 2-year old baby who is a 50 pound 3/4 pit bull, 1/4 lab mix.  She is a real wiggle worm.  I was looking for some advice and thought that with everyone’s experiences here, someone may have a recommendation or two.

Here’s the story:

When we first adopted her from an “accidental” backyard litter in Michigan, we noticed her hair was starting to fall out and her skin was irritated.  We took her into our vet (actually our vet came to us as we had a mobile vet who showed up in a big motor home that’d been converted into a mobile vet clinic complete with microscope, x-ray machine, and most of the other stuff you’d find in a regular vet office) and the vet determined Sable had demodex mange based on the skin scraping she inspected under a microscope.  She prescribed “off-the-label” use of  ivermection and provided us with proper dosage information.  For those of you who don’t know, ivermection is a cattle dewormer which is typically injected into the cattle.  With dogs, it’s given orally at a dosage that’s gradually stepped up over time to ensure no neurological issues develop.   It is worth mentioning here that ivermectin often causes issues with herding breeds due to the often present MDR1 (Multi Drug Resistant 1) gene which leads to normal dosages being toxic for the animal in question.

Back to the story… at the time she was diagnosed, she probably weighed 10 pounds or less.  I don’t remember exactly how much she weighed, but it wasn’t much. Regardless, she tolerated the ivermectin without any issue and the symptoms of her demodex mange cleared up and all was well.

Fast forward to a couple of weeks ago.  What appeared to us to be similar symptoms started showing up again.  We called to make an appointment with our vet and learned that our usual practitioner was out of town at a conference for the next several days so I asked to make an appointment with someone else as Sable had become VERY itchy – to the point she was chewing herself raw – hair off, scabs forming, bloody paws, etc.  They set us up to see another provider shortly thereafter.  We had already started her on Benadryl in hopes of alleviating the incessant itching.

The new provider did a skin scraping and said she didn’t see any demodex mites on Sable and suggested antibiotics for a few days and ivermectin at that point if it didn’t clear up.  We were able to rule out sarcoptic mange, scabies, and fleas since none of our other dogs are itchy, nor are we.  I asked her if there would be any disadvantage to beginning the ivermectin right away since we all agreed that the symptoms did present as demodex mange, even though none were seen on the scraping.  She said there weren’t any concerns and provided us with a chart that showed how many cc’s to give orally per 10 pounds of body weight.  Since Sable weighs 52 pounds, we were told to give her 5x the amount shown on the chart.  We talked about whether or not we dilute the ivermectin in something else (cherry syrup, vegetable oil, etc.) and we told her we hadn’t in the past, we just squirted it on her food and she gobbled it down.  The vet said that’s very uncommon since the ivermectin is known to have an unpleasant flavor and she commented on what a good girl Sable is to eat it without giving us any trouble.  She suggested continuing the Benadryl at this point.  Our initial appointment was last Monday, July 28th.  We began the antibiotics that night, continued with the Benadryl and started the first step of the ivermectin treatment the next day – Tuesday, July 29th.

We continued on the same course of treatment for the coming days until Sunday, August 3rd.  That morning, we woke-up, fed the dogs and took off to run errands for a couple of hours.  When we returned, we noticed Sable was acting very unusually – super wobbly, HUGE pupils and doing weird stuff like running into walls, pushing her nose up against immobile objects and almost seeming blind.  She wasn’t at all her usual wiggly self.  I called our regular clinic (who has Sunday hours) and they didn’t have any availability so we rushed to the emergency vet.  Upon discussion with them, they determined it was ivermectin toxicity and advised the best course of action would be to empty her stomach using activated charcoal and pump IV fluids for the next 12+ hours.  They admitted her and we went home sad and concerned.  The next morning they called and said we could come pick her up and that they trusted she was stable.  They advised us her liver enzymes were out of whack and that she needed to take a liver supplement

We picked her up, brought her home and she was still almost in a comatose state – very non-responsive to our voices and even to poking at her or gently shaking her about.  I called the emergency vet back and talked about her symptoms.  They advised we could bring her back if we were genuinely concerned.  At this point I started scouring the internet where I learned a few very important things.  Thankfully she was interested when there was food around, when she’d fallen into these deep sleeps, she would eventually wake her up with a medium amount of effort on our part, she was breathing without any noticeable issues and her body temperature seemed normal.  These are all good signs when it comes to ivermectin toxicity.

#1 – Sable had been given several doses of ivermectin that were WAY TOO HIGH for her body size.  Upon further investigation, I was able to determine the dosage chart we were given from the vet assumed we were diluting the ivermection at a ratio of approximately 1:10.  Remember I said we were supposed to step-up the dosage over the course of time  to get to the full dose after more than a week?  Well, on the first day, she received a dosage that was almost double the full recommended dosage.  Meaning, the full dosage she should have received after 10+ days is 0.7 cc’s, but she received 1.25 cc’s on the first day, more the second and third day, and by the fourth and fifth day, she was receiving 3.5 cc’s once per day.  Again, the MAX dose for a 50 pound dog is 0.7 cc’s.  That’s obviously an unacceptably HUGE difference.

#2 – Ivermectin has a half-life of 48-72 hours.

#3 – The symptoms of ivermectin toxicity can take weeks to go away, but they typically resolve themselves as long as the dogs makes it through the rough “overdose” period.

Over the last few days, she has gotten better – at least as far as the ivermectin toxicity symptoms are concerned; she’s still ridiculously itchy – her eyes seem to be returning to normal, her wobbliness is pretty much gone and I haven’t seen her leaning nose first into the wall at all.  Last night, she seemed fine all day but then around 8 pm she fell into a deep sleep and had similar symptoms as far as not responding very much to being called, moved, poked, etc.  As I write this, she’s sleeping again, but opens her eyes about half-way when I call to her.

So, my questions to you are whether or not any of you have had any experience with being given instructions to give your dog / cat a potentially fatal amount of a medication?  How did you handle it with the vet who made the error?  Does it seem reasonable to ask them to refund the $80 I paid them for the visit as well as the $550 we had to pay the emergency vet and any associated future costs?

Separately, anyone have any ideas as to what might be causing her itchiness?  At this point, with being able to rule out scabies, fleas, and pretty much any other bug with the amount of ivermectin she’s had and the fact that none of the rest of us are itchy, I’m thinking it might be allergies, but then wonder why the Benadryl wouldn’t be helping?

We have a follow-up appointment with our primary vet tomorrow, at the same clinic where we received the bad instructions.  I did inform them of the issue and what caused and provided specific numbers / dosages.  The poor receptionist sounded as though she wasn’t really sure how to handle it.  I was very kind to her, and will be to the medical director when I see him tomorrow, but ultimately want to be sure this never happens to anyone else, and would like to recover the added expense this has caused.  We are already on a tight budget and with Sebastian’s recent visits, our budget is stretched even tighter than usual.

Advice or thoughts on any of the issues would be appreciated.

<<Geez, what a long post!>>

Sebastian is doing GREAT – still much better than before the ampawtation and potentially better than he had been for the several months or more (the lameness in his leg started around November, 2013.)  In the last week, he’s started running (well, quickly hopping…) around the house and even played with his Husky brothers, Nico and Brody, which is unusual for Sebastian who has never been all that into playing.  He mouthed at their backs and chased them up and down the hallway.  He then came into the living room and leaped himself right up onto the love seat.  I thought it was Brody as I only saw it happen out of the corner of my eye – they look pretty similar, both black and white huskies with blue-eyes – but when I lifted my head to look at him, I saw it was Sebastian and quickly pointed it out to my husband.  It’s easily been MONTHS since Sebastian leaped up onto anything given the painful limp he’d been experiencing before the surgery so we were both very pleasantly surprised.  He laid up there for a while and then when he decided he was done, he gracefully hopped back down onto the floor and meandered himself about the house.  The next day, I stood up from the living room couch and started down the hallway towards the bedrooms and found him laying on the bed / couch that is in our extra bedroom for guests (primarily my Mom, or “Granny” as she’s known in our family.)  The only way he could have gotten up there was to leap himself up once again – from the hardwood floor!  That’s when I quickly took this photo of Mr. Charming:

As you can see, his incision site has healed up quite nicely and his dark hairs are growing back.  I’m not sure how long he stayed up there because my husband and I left the house shortly thereafter and he was down by the time we got back, but based on his happy attitude when we returned, he most obviously didn’t injure himself on the way up or the way down.  He continues to inspire and amaze us day after day.  He’s a wonderful addition to our family and I’m still remarkably glad that we made the decision to move forward with the ampawtation.  I have a close long-time friend who I believe completely hit the nail on the head when he posted a comment on my Facebook page the night we brought Sebastian home.  In his words:

We sometimes forget that our pets are animals. They become members of our family, on the same level as a human being, similar to a son or daughter. 

We forget that animals are instinctively stronger than us. Whether we believe it or not, it’s true. They encounter rough times, real problems. You know what they do? They get back on their feet, without thinking twice. 

Way to be, Sebastian.

Truly couldn’t have said it better myself.

We are about a month in (the actual amputation was on 06/12/14) and Sebastian has continued to make outstanding progress.  Since being off the Tramadol and Gabapentin, his eyes have brightened and he is much more alert.  He is getting around very well and has even ventured off the carpeted runners and area rugs to the linoleum in the kitchen with what I believe to be a pretty good level of comfort and stability.  He has stopped “nesting” in weird places (under the kitchen booth, on the bedroom closet floor, etc.) and has even gone back to doing his normal “tuck and roll” which he’s done since we first met.  The tuck and roll I’m referencing is something he does when he comes near one of his “people” and rubs his face on our laps while licking us constantly.  He’s the same cuddle monster he’s always been, just with one less leg.  He has had normal bowel movements and seems to have stopped urinating in the house, though every once in a while we do notice a bit of urine just drip out when he’s relaxing.  The vet said this could be a result of him being a senior (he turned 12 on March 23rd), or could be indicative of an infection of some sort so he’s back on the antibiotics and we’re keeping a close watch on how often it’s happening and whether or not there are any specific triggers that cause it.  Honestly, it seems to me that it’s happening only when he’s very relaxed and having his tummy rubbed.  His hair is starting to grow back where he’d been shaved which is cool to see.  As a fluffy Husky, he has a seriously thick coat so I was curious as to when, or if, it’d grow back.  Initially we thought it was bruising but then realized it was actually the return of his black hair. Despite it being dark peach fuzz at this point, it is obviously on it’s way to growing back properly.

I realize this is a short update, and it doesn’t include any photos of his handsome face, but I have limited time right now… I promise to post another update sometime soon.  The moral of the story here is that this was DEFINITELY the right decision to make and I have yet to regret it.  I’m grateful to have him with me every morning when I wake-up and am relieved to see the pain gone from his eyes! <3

Sebastian came home a week and an hour ago. In that time, he’s made some significant progress. He hasn’t whimpered in days, which I’m sure is a good sign, he’s up and down the couple of stairs from the backdoor into our yard without a problem, and he’s getting up and moving around much quicker and with less hesitation. Combined with the good stuff, he has a couple of weird things going on… He has NO appetite for dry kibble anymore for starters. Give that dog a hot dog, some pie, or almost any other “people food,” and he gobbles it right down, so at least he’s eating. (But let’s face it, who would want dry doggie kibble of you could have people food?!)  Also, he seems to be drinking quite a bit more water than before the amputation. Not sure what that’s about, but thinking maybe it’s from all of the pain medication? I’m totally speculating and making that up honestly. Also, he’s peed in the house multiple times in the last 24-ish hours. He didn’t have any accidents the first several days, but overnight last night, he left us several yellow floods, most of which were on the rugs we just bought. Fortunately, they’re machine washable (at least the runners are… The area rugs don’t really fit so we will hose them down in a car wash bay tomorrow or the next day… For now they’re rolled up waiting for their journey to cleanness…), but just the same it’s not the perfect situation. After peeing all over the place overnight, when I woke up this morning and got up out of bed to let him out, he stood up and just started peeing right on the rug where he’d been sleeping. I’m not going to worry too much about it yet, but I’m hoping it stops, well, pretty much now. The other weird thing he’s doing is laying places he never used to go at all – for example, he keeps crawling under the booth in our dining room, which let me tell you, isn’t a large or comfortable looking place to be. To top it off, once he’s down there, he curls himself around the base of the booth, and then he has a heckuva time getting back out from under there. He’s also been laying directly in front of our front door and in his brother Brody’s crate. Until the surgery, I don’t recall him ever laying in any of those places. The crate I can understand to some extent since it’s close to the backdoor, but near the front door (which is clear across the house), and especially under the booth, strike me as particularly strange.

All that said, I still believe we made the right decision; the pain from the oozing, bloody, pudding-like mass is gone, neither he nor our other canine-kids seem to notice his leg is gone at all, and his incredible adaptability and progress still continue to amaze me.

So we are now about 77 Hours past the end of surgery and Sebastian is doing remarkably well. He’s navigating our house and yard pretty much on his own and finally pooped this evening… Yay! Twice earlier he lifted his back leg, in true Sebastian style, to pee on the spot where his doggie brother, Nico, had just peed. His stability isn’t perfect yet by any means, but he didn’t fall over, so I’m sure he’s getting close to having steady footing. We’ve bought about $200 worth of rugs and runners in the last couple of days so he would have a carpeted path to all of the rooms in the house since we have all wood / tile floors. The rugs helped a LOT in letting him get around as before we put them down he’d be hopping right along until his back legs found some slick flooring and then they’d slip right out from under him. He does a great job at following the path of runners we made through the hallways.

I feel comfortable saying that he’s exceeding my expectations entirely and has adapted faster than I ever thought he would.