Wheels?

AP here: Today Tonka and I traveled to Oxford, Maryland to K-9 carts east. It does not appear that Tonka is going to be back to blippity blopping on his own anytime soon. When all this first started people immediately started talking about having Tonka in a stroller or a wheelchair. My initial reaction was "NO WAY" the logistics of a 130lb blind dog in a cart seemed impossible and honestly I felt like even thinking that would be giving up hope that he would return to normal. The reality of the day to day dealing with my boy and his multiple disabilities has reminded me that:
1. there is no such thing as normal
2. if there was a normal he never has nor will he ever fit the criteria
3. he needs to be mobile for his emotional and physical well being.
4. It has been 3 months and several specialists and no one seems to be able to find the problem let alone fix it

So after hours of research on the Internet and talking to several people and companies I still have no clue what will work for him. It is hard to research them because when you think you know something is good about one model another manufacturer goes to great lengths to tell why it is not. It appears to be a very competitive and cut throat market. Since I have no experience with carts and being the type A that I am I need to make sure that he absolutely needs a cart and it is the right cart for him. Unfortunately there is no dog cart store where you can go and test drive different models but there is a company within an 2 hour drive that has been making carts for over 40 years so off to Oxford we went.

The company K-9 carts East  is operated by retired orthopedic veterinary surgeon, Dr. Lincoln Parkes. Each cart is individually made based on specific measurements and the website walks you through how to take them or you can make an appointment to visit and they will take them for you. We met with Dr. Parkes and he watched Tonka limp around and we discussed Tonka's varied medical background. His staff took his measurements and showed me how the carts are made, they did not have any quite his size but I did get an idea of how big it is going to be.

If all goes well we can go back in a week and he can try it out and they will tweak it to meet his needs. I am still not 100% sure how I feel about my boy in a cart and I feel like I have failed him with this problem. This has been the first thing that I have not been able to fix for him and it breaks my heart on a daily basis. Perhaps when he gets mobile again things will turn around.

It may be all in his head!

AP here with an update:

I took Tonka to see Dr. Jay McDonnell to see if he might be able to shed some light on what has happened with my boy. He went over the MRI with me and he did not see anything different than what Dr. Harris had seen.

The MRI is a device that uses strong magnets that spin around the patient, and picks up the magnetic signals emanating from the cells as they demagnetize. This gives a picture of the inside of the body without having to use surgery and is more precise than X-rays.

In a dog there are 36 pairs of spinal nerves of the 36 spinal segments which are categorized into the 5 spinal cord segments labeled cervical thoracic, lumbar, sacral and caudal

8 cervical; 13 thoracic; 7 lumbar; 3 sacral; & 5 caudal = 36 total

His lumbar and lumbosacral areas of his spine look great so there is nothing to suggest that his problem is due to a disk problem or stenosis which is a narrowing of a spinal area that would put pressure on the spinal cord or nerves.

He does have some intramedullary (within the spinal cord) hyperintensity within the thoracic part of his spinal cord. A hyperintense signal is a "bright spot" on an MRI. In order to eliminate fluid being the cause such as cerebrospinal fluid they use FLAIR "Fluid attenuated inversion recovery" which is a pulse sequence that essentially removes fluids from the picture. This allows any lesions to be visible. It is not known what has caused his bright spots and in order to get a fuller picture of what has happened we would have to MRI his cervical area and his brain. The plan at this time is to do that in January. The brain and spinal cord are surrounded by cerebrospinal fluid (CSF) and this fluid nourishes the nervous system and protects the brain and spinal cord so it directly reflects what is going on inside the nervous system. Dr. Harris checked for CSF problems at the time of his MRI with a spinal tap and it came back normal. It could be that there is too much CSF and perhaps a narrowing that is inhibiting the normal flow and creating elevated intracranial pressure so he is now on Prilosec. Prilosec which is omeprazole relieves heartburn in people but in dogs it reduces the production of cerebrospinal fluid.

We have seen some improvement with the foot drag which is now a lift and stutter until he gets tired and then it is back to a drag. The incontinence seems to come and go – some good days, some bad so we are just going to create as normal an environment and routine as we can. The advice was to “do the things that he likes and that seem to work and avoid the things that make him worse” and we can certainly do that. We will continue with the acupuncture and anything else that helps him physically. Twice a week I will take him to the park and let him “see” his dog friends and once a week we will go visit his human friends and that should keep him emotionally happy.

I cannot say enough great things about Dr. McDonnell and Dr. Harris. I never felt rushed or pressured into any procedure. They both took the time to go over the MRI results with me and the support staffs were and are always extremely professional and helpful. You can tell when people really care and understand what you and your pet are going through and this group does. I hope you and your pet never need a neurologist but if you do Tonka and I would recommend you check in with Veterinary Neurology of the Chesapeake and Dr. Jay McDonnell, DVM, MS, Diplomate ACVIM (Neurology) and Dr. Jeanene Harris, DVM, MS, Diplomate ACVIM (Neurology)

Throw me a Rope

AP here: I have now been dealing with Tonkas gradual decline for almost 2 months with no answers. The poor boy has been poked, shaved, prodded, physically manipulated, lasered and scanned with no definitive answers. Through it all he has been such a good sport and a gentleman and I have no doubt that he will keep on being such a "very good boy". It all seems so unfair since he is such a good boy. He will be 4 soon and he has never growled nor even snarled a lip towards anyone or anything. It is very frustrating that we have no answers and equally as frustrating that it is only about a 1/4 of an inch lift that the foot/leg needs to do in order to not drag or scuff.

We have had good days and then really bad days on good days he sort of lifts the foot with little drag
and on bad he drags and knuckles under. His bad days seem to come after medical consultations with
lots of pushing and prodding. Acupuncture seems to be the only thing that has not caused a bad day yet. I have noticed that lately when he stands at the food bowl his back end starts to sag and his legs bend. When he goes to lay down he starts down and then falls all the way back and then slides his front legs down with his left leg way out to the side in a straight position with very little bend
at the knee.

It is very frustrating that this does not seem to have a cause, or fit any particular known problem. If nothing can be done and this is how he is going to stay that is fine but I would like to know what the problem is. I don’t let him do too much because I don’t want to hurt him in any way but if this is it then I would like to get him back into a normal pattern (a new normal of sorts). I will take him to the park and let him see his friends and we will create a schedule for the urinary problem. I just want to him to keep him safe and happy.

Oops I'm Leaking

Sometimes when I stand up I dribble a little pee on the carpet. AP is not happy that I am not getting better and we still dont know what is wrong with me. We are going to see a new Dr. in Virginia next week and maybe they can figure something out. In the meantime I have to wear a belly band. AP could not find a belly band big enough for me so she made one out of a fleece sheet and an abdominal brace. She bought some Poise Pads and puts one in it and wraps the brace around my waist. I really dont like it but I will deal with it till someone fixes my problem. My friend Carolyn from Carolyns Originals is going to make me a real professionally made belly band. She also made my beach hat that I really like, I am sure I will like her belly band better than this thing...

Home Made Belly Band

MY BOOT

We found a boot that is light enough for Tonka to walk in. It's the ruff wear Skyliner boot.

OK more like stump around in but it protects his nails and his pads so I like it....  On bad days we revert back to the sock and duct tape and it only took 2 days to wear a split in it.

Thank goodness for shoe goo and duct tape.

Acupuncture

I had acupuncture today with Dr. Phillips at GAVH
She stuck some little needles in me (even one in my head). She read through my very large file before our appointment and knew all about all my medical challenges. Maybe this will make my leg work again. She uses these little needles and they don't hurt at all. You can barely see the one in my head.

Pinhead

Physical Therapy

Today Chris Allyn Fritsch, M.Ed, ATC, PT, CCRP and Diana Huey, RVT, CCRA met with me and AP to decide a course of action to get my foot working again. Chris found some swelling in my back and was pressing on things to see if she could get them to go back where they belong. She did some Laser thingy on my back and then they showed AP some things to do with me everyday to try and help me walk better. We have to play a game of tickle the toes which makes me curl my foot up and another game where I have to lay on my side and turn my head up and to the side. I have to have ice on my back 3 times a day and can only go for short little walks.
I'm not sure if I like physical therapy but I hope it helps me walk right again.

Pyr Feet and Duct Tape

My foot is just not working right and it drags so AP is worried that my toe nails and pads are getting torn up so she is making me wear my Woodrow Wear Socks. You can usually get the socks for a discount if you don't mind getting an out of season pattern. Right now I am sporting the Easter Bunny print but hey they were 4 for $10.00. My Ruff Wear boots and my Ther-a-Paw boots are just too heavy for my leg to lift and if I don't wear something my toenails bleed.
The socks don't last because they were not made for dragging so AP has been sewing up the ones I already put holes in. She is now making a duct tape sock/boot which seems to work well.

She starts with the sock on my foot

Then she takes Duct Tape and overlaps strips over the toe area. The trick is to come up high enough in the back to where my foot makes the bend so that I don't wear a hole in the back.

Then she goes around the foot with another strip.

Then repeats the process once more and then she either slips it off and puts it aside for later, or we go for a walk. The duct tape holds up really well unless I get it really muddy and wet, then it starts to un-adhere from the sock.  She keeps a spare with her in her pocket just in case.

Back to the Beginning

Dad and AP took me to CVRC and today I met Dr. Prostredny, AP had him operate on Myatuk years ago and he is really great.  He pushed and pulled on my leg and my knee and then had Mike take some x-rays of my knee. I liked Mike so I was really still for my X-Ray.
CVRC houses several different specialties in one building, it's where my cardiologist, my internist, my neurologist and now my orthopedic Doctors all are. AP says when I walk in I am like Norm on Cheers(whatever that means). Dr. Prostredny talked to AP about my dragging foot and he said that even though I have the hip dysplasia and some arthritis that is not my problem.  He said we are definitely dealing with a neurological problem and left for awhile to talk to Dr. Harris. Then all of us sat down and talked about what is going on with my leg.
All my Dr.s all say the same thing about me - "I don't make anything easy". When they run tests I always come back right on the edge of normal and when they try to diagnosis me I don't give them a lot of clues. I don't mean to be difficult its just the way I am!
Dr. Harris said there is another test we can do but I would have to have anesthesia again so AP said we will have to wait on that. In the meantime we are going to try some therapy and acupuncture to see if that helps me pick up my leg.
I could have had an FCE that is not being shown on the MRI but thankfully if I did it was small. Some dogs that have an FCE are completely paralysed from the shoulders down. The other good news is I can get off all these medications and hopefully soon I can get back to my normal walk to the park. They took another bunch of blood for some tests. I sure am tired of them putting holes in my leg. I would like for the hair to grow back on my leg and my head and for CM to quit calling me Hannibal Lecter head. Idon't know what a Hannibal Lecter head is but AP says its not very nice. All the technicians all told AP I was a good boy and Ms. Gloria from CVCA gave me cookies which was a good day to end my visit.

AP has ordered a boot to try and protect my dragging foot.The boots we already have are too heavy and my Woodrow Wear socks are too thin and I drag holes in them almost immediately. I don't mind the socks so AP is working on a duct tape solution using them for now till my boot gets here.

MRI - Oh My!

AP here:
I have to say I am not good at waiting and even worse at it when I am waiting on important news. Today was Tonka's MRI and that was an adventure in itself. I had him at the VNoC at 4:30 to get his IV catheter in place and then we waited for about 20 minutes for everyone to get ready. We had to follow the technicians over to the MRI facility which is about 5 minutes down the road fro the CVRC center. Once in the truck Tonka kept licking at the catheter bandage and so I had to keep putting my hand int he back pretending to have treats to distract him. When we got there I had to find a low place to back into the ramp would be at a very gradual slope for him to get down out of the truck. Once I got him out I gave him to the technicians to hold onto while I went to park the truck. They took him in and one of them came back to get me. When we walked thorough the door and I saw that we were in a stairwell with way too many steps he would have had to navigate my face must have dropped because the tech said "it's OK Ryan carried him down". Well Ryan probably weighs a whole whopping 5 lbs more than Tonka so all I can day is he must be in great shape. Then as we got further down I smelled the Tonka poop smell and she said "oh and he left us presents as he was carrying him" and there on the steps were some Tonka poops which she very kindly cleaned up for me.
I hope this is not becoming a habit with him since he pooped all the way up the walkway at Greater Annapolis last week.
The facility does 4 dogs in an evening and Tonka was #3 to go so the humans and the little Maltese that was going last (Vince) sat in the waiting room and did just that- waited. Vince has the same type of symptoms as Tonka but he is 12 years old and he is a very sweet little guy.
They came out once to tell me they were starting the MRI and then again to request permission to do a Cerebrospinal fluid (CSF) tap. Then at about 6:30 they told me they were done and Dr. Harris would go over the results with me.
The great news was that there were no disc problems or any other issues with the spine other than some bright spots on the cord and that is why she did the tap. Dr. Harris is great and she went over all the images with me and explained all the different areas and what we would be seeing if he had a problem.

I had to wait some more because my lightweight of a big dog takes forever to come around after anesthesia and they ended up carrying him out to the truck.

Once we got home dad and I had to lift him out of the truck (still in his bed). I thought his ear was flipped over so I reached down to flip it back and realized they had shaved his head for the tap.

We then dragged the bed with him in it still out for the count around the back of the house and through the back door.

I setup my little bed next to him for the night and he never moved until about 1:30am and then he got up staggered around, ate a little food, drank some water and went right back to sleep.

We still have to wait for the spinal tap results but it is looking like this is an Orthopedic problem.

Two Weeks Out

AP here:
It's been 2 weeks since the original Neurological appointment and I have had the boy on leash walks and a ton of medication. I actually have an excel spreadsheet to track it all which in and of itself is disturbing. I have had to modify the  household schedule (including sleep) to try and keep the boy on some sort of normal routine. He cannot use the stairs so every time he needs to be shifted to another level of the house we have to use the ramp off of the porch outside the kitchen door. Just getting him to the door is a 5 to 10 minute process while he thinks about it. If you try to get him to go somewhere that doesn't suit him its another 5-10 minute process to talk him into it. Needless to say I spend a lot of time waiting.
Our morning goes something like this:
Unlock the kitchen door. Go downstairs and spend 10-15 minutes lying next to him petting him (checking his heart rate) and getting batted at with the giant paw. Give him his 2 pain pills and 2 pepcid in some sweet potato. Throw on sweats, a Jacket, shoes and a hat, run out front and unlock the gate. By now he is up and at the basement door so I put on his collar and leash and out we go to the end of the porch where he stops to sniff for a few minutes before actually setting foot out on the lawn. Then around the house we go and out the gate to the front where he stops at the end of the driveway to sniff again for a few minutes. We have a small court up the street to the left and down the street to the right so once we pick a direction the goal is to walk around the court, go to the bathroom and then home. That sounds like it should not take long but it never quite goes as easy as it sounds. Once we get to the entrance of  a court he puts on the brakes. He wants to walk the big 2 mile loop like we have almost everyday for the past 2 years and he knows he is being short changed. Tonka does not care that he is hurt he just wants his routine and he wants to go meet and greet all his regulars on his walk. I cannot force him to turn down the court without pulling him and possibly hurting him so we have a standoff. I at one end of the leash headed into the court and him on the corner at the other end refusing to move. This is where a little dog would be nice, you could just pick them up and walk on, that is not practical with Mr. 130lb stubborn boy. After 5 minute or so and with me getting down and explaining in his ear that he does not have a choice he will usually give in.Once around the court the same routine plays out again because he does not want to go home.  On my lucky mornings one of his favorite neighbors will happen to come by and will sweet talk him into going around the court or home. Usually it is Marie and he adores her and will willingly go wherever she wants. It is very nice of her to detour from her walk to help us and makes my day start off a little less frustrated. It is also nice to have a second person on those walks where he does not stop to squat but keeps on walking because I have to go back to pick up the poop. If I have a second person they can keep walking him while I double back. He refuses to go back so if I am alone I have to tie him to a mailbox and then go back. He is a good boy so if it is real  early and no one is around I can tell him to wait and he will stand still while I go pick up.
Once home we go through the gate and up the ramp to the kitchen door and inside. Thank goodness for the ramp but it is still hard for him going down as his hind end starts to go sideways and come around on him. He settles down in the living room for a little while and I get his breakfast and his Thyroid pill.
He eats in the kitchen and then we go out the kitchen door where he stands for a few minutes deciding if he wants to go. Then its back down the ramp and out the gate to the front door and the landing which is where he would love to spend most of his day. While he is lounging I give him his anti-inflammatory which is a liquid and a stinky treat to wash it down with. When I am ready to leave for work I have to coax him to get up and come back around the house, though the basement door and to get into his crate.

His crate is 4x6 and is constructed from 2 exercise pens put together around a PVC pipe frame with 2 Layers of carpet and 2 canine coolers. See Canine Cooler

The Tonka support team comes by midday and lets him out to go potty, gives him his next rounds of pain meds and takes him around front to lay out for a while. They come back again in the afternoon to let him out and stay with him until I get home. He loves to lay out on the driveway and listen to the kids come home from school. He is usually still out there when I get home and we go in and he waits at the landing while I get changed and text his Aunt Carol to bring Nala by for our short little walk. When she gets there we head to one of the courts and go through the same routine as the morning. He is a little more accommodating because of Nala but he knows he is getting shortchanged and will stop on all the corners.

Once we are home it is back up the ramp and through the kitchen to hang out in the living room for awhile. I fix my dinner and then go fix his and he eats in the kitchen again and takes his 2nd thyroid pill. His favorite part of the evening is after dinner when he gets to have a frozen peanut butter kong as a treat.
If he is feeling good he will go and surf the counters and the recycle bin or perhaps stand in the kitchen and bark for treats. Once he gets tired of that he comes back toe the living room to settle in for bed and belly rubs. He starts off sleeping upstairs and then wakes me up between 1 and 3 to take him downstairs, which again is 5 to 10 minutes to decide to go down he ramp. Once inside the back door he has to get settled and then I get to go back to bed for a few hours until 5:00am when the cycle repeats.

During the 2 weeks I have seen improvement, although not "leaps and bounds" but rather small "baby steps". He postures in a semi squat at least for part of a bowel movement now instead of just walking and pooping and he does not drag his toes as much. He still drifts sideways and a hard sneeze will cause him to stumble. We are going to do the MRI to rule out anything degenerative which would leave just Orthopedic and that we can deal with. The surgery for the Lumbar Sacral Stenosis also known as Cauda Equina Syndrome
or anything with the nerves and the spine does not read like something we want to have to go through. Read all about it here

This was not the intent

AP here:
I started this blog to be a lighthearted, feel good kind of place to tune in and learn about how normal a blind dogs life can be. It has now morphed into more of a medical blog about the extreme (not normal) genetic mutant that is my boy Tonka and his varied and continuing medical problems. This was not the intent and I truly wish that he would never have another problem and we could go back to fun and silliness. I do hope that what I write about at least helps someone looking for information or direction. I know with some of his issues I could not find a lot of personal accounts from people going through the same thing and it would have been helpful.

lumbosacral stenosis - say what?

AP Here:
Tonka and I have been to see a Neurologist, Dr. Harris http://www.vetneurochesapeake.com/index.php?page=dr-jeanene-harris at Veterinary Neurology of the Chesapeake www.vetneurochesapeake.com/ . His left hind leg is still not right and he is walking sideways. While he was there he was also seen by Dr.Burgess http://www.cvssvets.com/surgeons.php as an orthopedic consult.  The presumptive results were-

Assessment and Diagnosis

Neuro Localization - Spinal lumbosacral cord (L4-S3): Tonka's neurologic exam is revealing subtle lower motor neuron deficits in his left pelvic limb. Given these findings in association with pain on tail elevation, the most likely location for the problem is at the lumbosacral junction. Possible causes would include lumbosacral stenosis (Type II disk disease, arthritis of the articular facets, and enlargement of associated ligaments and soft tissues). Other possibilities would include neoplasia (primary or metastatic cancer) or infectious/inflammatory diseases; however these are thought less likely.

The best diagnostic test to determine the exact cause for his defecits would be an MRI /- a spinal tap and electrodiagnostics (EMG, MNCV, etc.).

Tonka's mild neurologic deficits are further complicated by concurrent orthopedic disease. An orthopedic exam revealed discomfort on manipulation of both of his hips (left more than right) and radiographs of his pelvis reveal evidence of hip dysplasia and osteoarthitis of the left hip. Tonka also resisted manipulation of his left stifle (knee) and there is concern that there may be a meniscal tear. There is no evidence of cruciate ligament rupture at this time.

Since Tonka had his heart surgery this year and just had the rhinoscopy a month ago we are opting to try medication for a few weeks to see if there is any improvement. If not then we will have the MRI to rule out the Lumbar Sacral problem. I am hesitant to put him back under anesthesia so quickly after the last one and we are just now getting the prednisone out of his system and he is acting more alert and like his old self. We have known about the hip since 2009 and it has never been an issue until now so I am not sure what to think. We will just have to deal with whatever comes our way like we always do. I know he is tired of being poked and prodded and I don't blame him. If you are curious as to what an MRI for your dog costs these days in the Maryland area try $1750.00 and that does not include any additional items like a dye test or spinal tap.

Sylvia Swims

A long time ago AP and CM took me to the canine fitness center and took me swimming. I really didn't like it much and prefer the ocean over a pool. My friend Sylvia who had hip surgery http://blinddogsrule.blogspot.com/2011/02/sylvia-and-her-fho-surgery-trishs-blog.html has had a rough time getting all the mobility back in her leg so she has taken up swimming. AP stopped in to see her at the canine fitness center pool and took a little video of her paddling away. She is much better at than I am and it is really helping her hip.

PICNIC

On Sunday AP and I got to go to a really cool park and meet some new friends and some of our old ones. The new friends were dogs and kids that all have had heart surgery like me. It was a great day and I got to forget about my medical problems for awhile. It was put on by the great people at Inova Fairfax Hospital for Children and the Chesapeake Veterinary Cardiology Associates. 

I met a Collie named Annie

A Newfie named Bouy

Bouy and Annie are also therapy dogs.

I got lots of love from everyone.

The kids were all great and some of my Doctors were there. Dr. Rosenthal was there along with Cari who took really good care of me and AP got to meet Dr. Schmitt who was also in on my surgery

A really cool kid liked my bionic eye.



 It was a really fun time and I loved all the head pats, ear scratches and belly rubs from all the great kids.

Thanks to CVCA for inviting me and to Bouy's mom for the chicken.

p.s. AP borrowed 2 of these pictures from the CVAC Facebook site - we hope that is OK

The hippy hippy shake!

In 2009 I was diagnosed with a problem in my right shoulder and my  left hip. The x-rays of the left hip showed a gap between the ball and socket of  the joint. This means that my hip can slip a bit - the humans call it subluxation. Well my foot slipped off of the step downstairs and I sub-luxed something and now it is really hard for me to lay down. AP and Dr. Woodburn talked about it and they can't give me anything for inflammation because I am just weaning off the prednisone that I was on for the nosebleeds. Dr. Woodburn gave me Tramadol for pain and I have to take it easy. I am supposed to go to the Cardiac, Pediatric picnic this weekend so hopefully I will be feeling better in a day or so.

Ray the Blind Dog

Tonka and I have never met Ray the Blind Dog but we follow his adventures closely. There are alot of similarities in their behavior and they both have Aussies as best friends. Ray's parents put together a video montage of Ray's first two years with them and we loved it so much Tonka is re-posting here:

Fredericksburg Dog Fair

We got up really early to go to the Fredericksburg Dog Fair. AGPR http://www.agprescue.com/ reserved a spot at the adoption park at the fair and my friend Donna http://www.goldenretreat4k9s.com/ organized our part in the event. She has her own boarding kennels and helps AGPR by fostering some of my friends before they find forever homes. Two of my friends Charlie Bear and Snowball were with her today and I got to hang out with them. We setup a tent with a table and chairs and got ready for the dogs and humans from the big downtown dog parade to show up.

Ready for the day!

I met a Mastiff puppy who will one day be bigger than me.



Monster Puppy



Snowball is a great guy. He whispered me the secret of looking really cute so humans will give you more treats.

Snowball

Not sure of this Dog

I met a really big dog but he smelled an awful lot like a human.

  

My friends Tom and Mindel showed up in the afternoon with two puppies Ziggy and Micky. They are very smart and already know how to sit and shake paws.

Mindel and Pups

Tom and Pups

Puppy

My new friend Emily took care of Charlie Bear and after lunch he tried to take a quick nap.

Emily and Charlie Bear



Charlie Bear



Then around lunch time my Uncle Charles, Aunt Brenda and Aunt Texie came by. I had never met them before and it was awful nice of them to come see me. My cousins Betty, Virginia and Chris came as well and bought some of my younger cousins to visit. It was great to "see" them.

Brian and Kaelyn

Connor

AP and Aunt Texie

Chilling with Brian

We had lots of people come by and meet us and talk about adopting a Pyr fromAGPR. It would be great if the humans would open up their homes to  one of my many friends that AGPR is taking care of.

Every dog should have a forever home.

Thyroid Shmymoid - Who's Afraid of a Thyroid

Dr. Woodburn called to tell AP that my Thryorid levels are not what they should be.
He talked to an Internist and my Cardiologist and they have decided that I need to try a low dose of medicine to try and straighten it out.  I will be off the Prednisone soon and am feeling more like my old self. I am sick and tired of being sick and tired....

T-shirts and Coffee Mugs - Oh My!

I love the beach! AP says its like I know that there are no fences or trees to get in my way and I can run around like crazy and not have to worry about hitting something. I also love to dig in the sand - it is so easy to dig a big hole, really quick and then there is the water which is fun to leap in and out of. A special rescue for blind dogs http://www.blinddogrescue.com/  asked to use a picture of me at the beach to show that blind dogs can have normal lives. AP sent them pictures of me playing in the water and if you go to this website you can see what they came up with.
http://www.cafepress.com/blinddogrescuealliance/8103328

Its me- blippity blopping in the surf and I get to be on t-shirts and coffee mugs and AP even ordered "me" on a sweatshirt.  A percentage of the money goes to help blind dogs get medical attention and find homes. How cool is that?

So Tired

AP and CM took me to Annapolis this past weekend and I really wasn't interested in anything which is so not like me.

City Dock Annapolis

I did show interest in the pancakes CM made for breakfast.

I'm just waiting for my pancake...

So AP took me to the see Dr. Woodburn today since I have not been myself and I have a cyst on my back that is not healing. He listened to my heart and looked me over and then talked to AP about the fact that I am not myself lately. I have been on this steroid drug that has changed the way I act and think and AP wants me off of it. They also did some blood work to test for something called a thyroid. We will get the results back next week.
I have all these cool events coming up so I have to get better quick!

Diggy Diggy!

AP here:
I spent the morning trimming trees and putting down top soil and the afternoon digging out dirt and adding on to the sand garden I created last year. Tonka perked up enough to come out and give me a hand for a few minutes.

He does love to dig!

Tonka Loves a Good Picnic

I got an invitation to a picnic coming up in October. The great people at Chesapeake Veterinary Cardiology Associates sponsor a picnic with the Inova Fairfax Hospital for Children every year. It's the pediatric heart surgery CELEBRATION. There will be my favoritist things in the whole world there "KIDS". They will have had heart surgery just like me and we get to hang out and have a picnic. AP says there will even be hot dogs - whats better than KIDS and HOT DOGS. I can't wait.

Time to wean off the drugs...

AP spoke to Dr. Gonzales today and we can start cutting back on the medicine I am on. That is a good thing because I have not been myself on this stuff. I just want to sleep and eat. I am really, really hungry and AP won't let me eat a whole lot because the medicine has upset my stomach. If I start getting bad nosebleeds again we might switch to an inhaler. I don't know what that is but I don't think I will like it much. I have really bad doggie manners right now when it comes to food and even tried to break in to AP's little backpack to get some Bill Jacs and I tried to take a pan that had chicken in it off the kitchen counter. I keep getting in trouble but I can't help it I am so HUNGRY......

Tonka Goes to Home Depot

AP here:
Since Tonka is not allowed to do long walks we went to Home Depot for a little visit. The ladies in the garden center gave him a warm welcome with lots of pats and scratches. Then we went in and checked out the different departments. We met some really nice employees that fussed all over him and told him he was a handsome boy...

Picking out carpet



Mom Rent me a Ditch Witch Please!




Lets build a new deck...



Roid Rage (well more like roid naps)

AP here:
Four days of the prednisone and benadryl combo and Tonka is a slug. He has no interest in going for a walk, he does not care that I am in the kitchen making English Muffin pizzas (which usually brings him running for CHEESE), he just does not care about anything.

The results are in!

AP here:
Dr.Gonzalez called this morning to give me the results of Tonkas biopsies from the rhinoscopy.
Diagnostic findings and information:

Nasal biopsies: Mild lymphoplasmacytic rhinitis, left and right
The results were suggestive of mild lymphoplasmacytic rhinitis in both nasal passages. This type of inflammation can be seen with allergies or an autoimmune rhinitis. However, the changes were mild, so it is difficult to say if this could be the cause for the rhinitis. However, rhinitis can results in epistaxis in some cases. No obvious infection or cancerous changes were noted on biopsy.

The recommendation would be to start a course of corticosteroids (prednisone) to treat the inflammation noted to see if this helps with the intermittent epistaxis. If the epistaxis persists and no improvement is noted with the steroid, we discussed that the next step in trying to manage the epistaxis would be to consider ligation of the carotid artery or referral to U. Penn to discuss embolization therapy for epistaxis.

The plan at this time is to continue the antihistamine and to start a course of prednisone.

Assessment:

1) Intermittent epistaxis

2) Mild lymphoplasmacytic rhinitis

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Sylvia Comes to Visit

My friend and fellow rescue Sylvia went swimming today at the canine fitness center. AP and CM took me there once but I didn't like it much see http://tinyurl.com/4ys38mh
Sylvia is still working on getting her hip back in shape after her FHO surgery http://tinyurl.com/3vfu3zf
and swimming is good therapy. Since the fitness center is pretty close to my house her and her human Trish stopped by to say hi. I have been sort of groggy after my anesthesia on Tuesday but I perked up for my guests and strolled the yard with Sylvie. AP said Sylvia is looking really good and the hair has almost grown completely back on her hip and leg.
I really like Sylvia she is so sweet.

Trish will be updating everyone soon with a new blog post and AP wanted to put up some pictures so everyone can see how well she is doing. Isn't she a cutie?

Tonka update

AP here:
Tonka and I returned to the CVRC at 7:30am this morning and the minute he got out of the truck he started sneezing blood everywhere. They hurried him to the back to take care of him and I setup camp for the day in a corner chair. Dr. Gonzales http://www.atlanticvetintmed.com/pages.aspx?content=35 was not free to talk to me until about 11:00. They put Tonka and I into an exam room and he checked him out and made him sneeze a few times. He then explained how the rhinoscopy procedure would go and what they would be looking for. He was very thorough and wanted me to understand that it would not be a fix for the nosebleeds unless they found a cause such as a tumor, polyp or foreign body. He would take some biopsies to send out to a lab to look for other cases such as fungus, allergies or a blood disorder. There is a rare platelet disorder that is found in Otterhounds and Great Pyrenees. http://ahdc.vet.cornell.edu/clinpath/modules/coags/Glanz.htm . Since Tonka had trouble with his femoral artery and bleeding during his heart surgery he wanted to make sure I understood that the scope procedure could become messy. He wanted to do a clotting test before doing the procedure and take some skull x-rays. I started to think that perhaps we should wait and do another week or so of medicines and see it that would stop the nose bleeds but it also seemed like it was the perfect time to do it if we were going to do it. The Cardiology center CVCA is part of the same group and Tonka's heart surgeon Dr. Rosenthal happened to be working at that location so I consulted with him as well.  In the end we had the procedure and this is the update:
No nasal tumors, no polyps, no foreign body,l no obvious cause of nosebleeds
Took biopsies to send out for infection and possibly some rare platelet blood thing that Pyrs can have.
He did real well with the anesthesia - heart was solid- some bleeding still so can't come home till tomorrow.

Now we wait

Yay for the Eyeball - Boo for the Nose

AP here:
I spoke to Dr. Woodburn this morning and he felt that we should have a rhinoscopy done to try and figure out what is going on with these nosebleeds. I called the internal medicine department at Chesapeake Veterinary Referral Center (CVRC) and scheduled it for 8:00am Wednesday. Tonka's recheck for the pressure problem in his good/bad eye was also today and we got to Dr. Weigts office at 3:30. As soon as he walked down the ramp from the truck he started to sneeze and blood went everywhere. He bled down the ramp, down the sidewalk and into the office. The staff hustled him into a room and Dr. Weigt put some drops of Epinephrine in his nose and stopped the bleeding. Once that was over she numbed his eye and took his pressure and it was down to 10 which is the best news we have had in a while. The debris in the eye is also down so the medication is working. We can drop the pred. acetate down to once a day again but keep the azopt twice a day. Once we got home Tonka's kids came up and visited for a few minutes and then he took a nap. Around 5:45 he got up and went outside and after a minute he started sneezing and the blood started pouring. I tried for about 15 minutes and couldn't get it to stop even with some epinephrine so off to the ER we went http://www.aavec.com/. They checked him out and we all agreed that he should get the scope done Tuesday instead of Wednesday. After a complete blood work up and chest x-rays they let me take him home for the night and we are to return at 7:30am to transfer him from the ER's care to Internal Medicine.

Out Go the Lights!

AP here:

Cathy's sister Julie came to visit and they were supposed to go to the beach for a long weekend. They drove down but the next day they were forced to leave the beach and come home due to mandatory evacuations. Then Hurricane Irene came and took out the power. Not that Tonka cares about the lights but he does care about the Air Conditioning. I care about the monsoon rain since I have to drag him out to go potty even in regular rain. The wind was whipping and the rain was really coming down but we had power when we all went to bed on Saturday. At 2:00am the power went out and by 3:00am the house was stuffy and Tonka was barking to go potty. He went out and laid down under the porch where the sideways rain had already gotten the carpet wet about a quarter of the way in towards the house. I stayed up to keep an eye on him and the water and afeter about an hour he came back in and went back to bed. I sort of slept another hour in the recliner in front of him for a while and then got up. Time to get the generator in place and full up with gas. Thankfully the generator we have (thank you Mom and Dad) can power the refrigerators, the fish tank and some fans just fine. It stayed windy for most of the day and Tonka was enjoying the breezes. Once the wind died down the sun came out and it got hot and humid. Everyone moved to the basement for the night since it is cooler and that is where Tonka usually sleeps anyway. The power was only out from 2:00am Saturday to 12:30am Monday but definitely long enough to make you miss it. When it came back on of course all the lights that we had flipped the switch on came on and woke us up. Julie and I shut all the windows, and put the house back in order.  It was great to turn off the noisy generator and climb back in a real bed in the air conditioning - it was not great to wake up to a blood stained carpet where Tonka had another nose bleed.

Back to the Bus Stop (well almost)

I love it when the kids go back to school because I get to "see" them at the bus stop. Today was the first day back and I took off  on my walk in the hopes of hitting all the stops. When I got up to the field by the pool it was so nice outside that I decided AP and I should run around and play.
Then I got to the 7'11 and Mr. Steve was there with Henry so I stopped to try and beg some of his breakfast pastry but AP said NO. I didnt realize it but that made me just late enough that when we crossed the big street the kids were already getting on the bus. I was not happy that I missed them but then the Moms fussed all over me and told me how handsome I was so that made it better. Tomorrow I will make sure I get to "see" the kids.

Oh Poop!

AP here:
I am very happy to report that there have been no nosebleeds for the past 3 days. I am not so happy to report that the other end of the Tonka has been emptying it's contents profusely. He started with diarrhea yesterday and it continued on into today. he got me up at 1:30 then again at 3:30 to go out and then one last time at 4:00. The 4:00 woke me up and I basically just stayed up because I was not sure which end of him a large clump of hair actually came out of. It was centered in a puddle of rust colored liquid. Rust colored or dark brown vomit is not a good sign and usually indicates blood from an ulcer. Prednisone and NSAIDs can cause this and since he is on a steroid drop for his eye and nose I was concerned. Not being 100% sure of where it came from I bagged it and stayed up with him and monitored him for any signs of distress until the vet opened. His breathing and heart rate where normal and his gums and capillary reflex were fine so I didn't want to drag him out to the emergency vet unless he either showed signs of stress or we had another episode. Now his vet is only open on Sundays for emergencies and I respect that and he was not in any obvious distress. Of course in my mind suspected vomiting of blood with a huge hairball that could be part of a larger obstruction is an emergency. So I was at their doorstep with the sample bag when they opened this morning but they were really busy. Their phone was ringing off the hook and we did not have an appointment so... off we went.
Since my first concern was for Tonka I went up the road to the emergency clinic which I should have just done at 4:00 in the morning. We saw Dr. Coles at Anne Arundel Veterinary Emergency Clinic http://www.aavec.com/ and she was great. I had to give her the whole history and she took the sample and came back to tell me it was not vomit which was a great relief. She told me that the amount of steroid he is on for his nose and eyes would not be enough to cause stomach bleeding. The hairball is most likely from him licking his paws to clean off the blood for the 3 days last week. I showed her his youtube video of him romping at the beach last weekend and she also told me that sand can cause stomach upset and diarrhea. We started Metronidazole today so the hind end of him should be fine within 24 hours and now I need to go take a nap

First Aid and CPR for Pets

AP here:
Today I attended a class for First Aid and CPR for Pets in Columbia Maryland. It was the PetTech^® Pet Saver™ 8 Hour Program taught by Merrill Warchal owner of PetStructor www.petstructor.com/
The class was really informative and the other students were all engaged and eager to share additional knowledge and help each other out. I hope I never have to use life saving emergency measures on an animal but it is good to know that I now know what to do if I had to. Merrill kept the infomation easy to understand and the hands on helped reinforce what we were learning. You can find out more about the course here www.petstructor.com/petsaver_curriculum.html and I recommend it to pet owners as well as those working with animals such as rescue and shelter personnel or pet sitters. She has a snout to tail assessment sheet that is well laid out and should be used by all pet owners to help notice and keep track of any changes in their pet. Catching things early is key in keeping your companion happy, healthy and leading a long life.

Dear Mother Nature

Dear Mother Nature,
Every animal is special to the people that love them and my dog is no different. My Tonka dog is also very special to those that know him and I could not ask for a better companion, but Tonka is also physically special as well.
He is classified as a special needs dog. He was born blind, with a hernia and a hole in his heart; he averages about 2 seizures a year. He has had glaucoma and a cataract and now has either seasonal allergies or a nasal polyp or tumor that is causing nose bleeds. He is a genetic misfit and there is no doubt that in your grand plan of "only the strong survive" he was not supposed to make it this far. However, he is not in the wild where "only the strong survive", he is with me and a whole lot of other people that love and support him.
Every time you throw something new at us with the intent of weeding out the weak, we fight you, and we are going to continue to fight you. So Mother Nature it is you against US. The US also happens to include an amazing team of Doctors and all the technological medical advances of the human species. This tends to even the playing field a bit.
In the end you ultimately always win and death is inevitable for all, but that should be many, many years down the road.

I am simply requesting that for now you just give the boy a break.

Sincerely,
Tonka's Peeps

Bloody Nose

AP here:
Tuesday Tonka and I went for our morning walk and he had some blood on his right front leg so after looking all over I found some on the floor next to his red rubber nylabone. I chalked it up to a tooth or gum thing form chewing on the toy. We played a little at the park and he was prancing around.

We looked under some toadstools trying to find the toads.

When we came home we had a normal morning routine, he ate well and everything seemed fine.

In the evening we went for a early walk because we had a vet appointment to discuss his breathing, sneezing and his itchy ears. We ran into his friend Pepe and walked with him for awhile.

Then we were off to the vet. Tonka was seen by his good friend Dr. Woodburn who came back with a diagnosis of allergies and no ear infection. So Benadryl twice a day and Genesis spray for the ear flaps. So much for no more medication - now it was drops for the pre-glaucoma eye and pills and spray for the allergies.Oh well allergies we can deal with right?

Wednesday morning was just like any other until after he ate his breakfast. I heard him go out the doggie door and went down to check on him. The first thing I noticed was something liquid on the bottom of his food bowl and when I swiped my finger at it I came back with a finger covered in bright red blood. I immediately went out and found him in the yard and checked his mouth, his gums, his tongue and found -nothing. I called the vet and they suggested I come in so I grabbed his leash and out the door we went. As he was making the turn to go up the ramp in the truck he sneezed and bright red blood came running out of his nose. He licked right off and you couldn't even tell it had been there. Mystery blood solved and now I knew the blood from yesterday was not from chewing a bone! I got him up the ramp and started up the truck and called the vet on the way to tell them the origin of the blood. I then called the cardiologist to see if this could be heart related and then called the opthomologist to see if it could be caused by the new drops. the specialists all came back with a no-not likely but wanted to be get up to date with whatever the primary care vet had to say. Dr. Woodburn was in surgery so we saw Dr. Gerity whom Tonka also really likes (she took care of him when he had the heart arrhythmia). She looked up his nose, checked all his vitals and had his blood pressure taken. Since Tonka had just been there the night before and had been fine the belief is that he has allergies that have caused rhinitis of his nose and has probably broken a blood vessel and when he sneezes it breaks open and bleeds. So she added to his on going medicine list two additional drops of the same steroid that goes in his eye but these two go up his nose. I also now carry a bottle of Epinephrine to use in case the bleeding will not stop.

Thursday morning came and Tonka got up and went outside to sleep on the back porch. When I went out to check on him I found him with bloody paws and a small puddle of blood in front of him. I cleaned him up and he laid his head back down to go to sleep. He came in later and wanted to go for a walk so we started off down the street and ran into his friend Marie who was coming up the street. He decided he wanted to walk with her so he turned and we headed back up towards the house. Once we got past the house he decided that it was best if we just turned and went home so that is what we did. Hopefully the medicine will start to work and this does not turn out to be anything other than a blood vessel.