2 January 2018

Gus And His Illness: What I Am Learning

Gus And His Illness

I've had nine days to study Gus, follow my vet's advice,  experiment with his food and eating habits, read about Megaesophagus, a troubling and often deadly illness, and visit the Megaesophagus support groups on Yahoo, Facebook and elsewhere.

Thursday, Gus and I will meet with Dr. Suzanne Fariello of the Cambridge Veterinary Service and go over what I have seen and learned  since he was first diagnosed.

We will make some decisions about where to go from here, and I wanted to share what I have learned with you as well, there might be something useful for you to think about with your own dogs and their health.

Megaesophagus, for those who don't already know, occurs when the esophagus, a muscle that moves from the dog's mouth down to the digestive tract, swells  and becomes deformed and blocks the passage of food.

The symptoms are a continuous regurgitation of food, loss of weight, or aspirational pneumonia. Sometimes the dogs starve, or die of malnutrition. it is serious, life-threatening disease.

Many people use what are called Bailey Chairs to force the dog upright when he or she eats and use gravity to pull the food through the esophagus since it no longer can do this on its own.

No one knows what causes what vets call this "dread disease," and there are no surgical or medical cures. Often, these dogs can live for years, sometimes they will starve without feeding tubes or other drastic interventions. They frequently contract pneumonia, which can be fatal.

Until recently, the disease was invariably resulted in the death of the dog.

For me, the most successful and responsible pathway to health for my dogs is a nurtured partnership between me and my vet. A relationship of trust, honesty, and open communication. I am extremely wary of the growing tendency of people to go online, trade amateur diagnoses, and advance cures and experiments that are not tested or ratified by anyone.

I often find that these sites promote a distrust of science, conventional medicine and vets, who are often portrayed as greedy and corrupt. Dog loves are unhinged enough when their dogs get sick, they don't need to mistrust the very people most likely to help. And yes, animal health dare is ridiculously expensive, as is human health care.

This is not an argument, but my own value system, you are free to have yours. I don't tell other people what to do.

The online sites and support groups that I have seen are effective at offering basic information and emotional support to frightened and sometimes frantic people. There is also epidemic emotionalizing, drama and support of extreme and expensive solutions. It is very difficult for many animal lovers to keep any perspective when their animals get sick.

These support sites are just not for me

I do not trust or rely on people with no extensive training or research when I have a vet with six years of training and considerable experience. My vet is accountable and responsible for her treatment and diagnosis, she follows rigorous medical protocols and knows me and my dog. She also embraces holistic treatments – Chinese herbs acupuncture, laser. I just don't take medical advice from strangers, for me or for my dogs.

Dr. Fariello recommended these support groups to me, and I will tell her I consider that a mistake.  She wants to know these things. They were not helpful to me, other than raising questions about veterinary medicine, and alarming me about not doing things I will never do. I want the vet to guide me, not the message boards of Yahoo.

I don't know a soul on Yahoo, cannot look them in the eye, they don't know me or my dog and are in no way accountable for what they recommend or diagnose.

I have been keeping detailed notes on Gus over the last nine days and I will write-up these notes and give them to Dr. Fariello when we meet, I think they may help us move to the next level of treatment.

In many ways, these nine days have gone well. Gus regurgitated his food on four of those days (once this morning, just as I'm writing this), not at all on the other five. On those three days he regurgitated his food three times, all in the morning, all after eating, and all between the hours of 10 a.m. and noon.

Before we changed his diet and the way he ate, Gus regurgitated four or five times a day, throughout the day,  and he spit up food that smelled especially foul, and seemed to have bile in it, which suggested the food was being blocked and backed up in his esophagus.

It's important to remember that Boston Terrier's, like many small dogs, often have respiratory and digestive troubles because of their small intestinal tract. It's sometimes difficult to separate those troubles from this disease.

Since we switched to wet gastroentric food and feed it to Gus only while he is standing up on his hind legs to receive it – he's a circus dog, we use it – his regurgitations have been different, clearer, without any signs of the brown bile, more like a golden fluid. And not as much.

That's what happened occasionally before the diagnosis. We dance to our food now.

On the three days that Gus has regurgitated, he has been lethargic and visibly uncomfortable. Normally, he's a perpetual motion machine. On the other days, he is energetic and playful.

So most days, he is completely normal.

On those four days he has had diarrhea, his stools were not normal. On the other  days, his stools have been regular and quite normal, which suggests the food is getting into the digestive system and bowels. That is a good sign.

But still, we are clearly not out of the woods.

In those nine days, Gus has never regurgitated in the afternoon or evening. This suggests that Gus may have a digestive issue that occurs when his stomach is empty – he is fed in early evening, and not again until morning, around 9 a.m.

We might also be doing something to spark the regurgitations.

Some dogs, I know, have digestive troubles when they have nothing in their stomach for long periods of time.

If Gus has severe megaesophagus, little or no food would be getting through. And why only regurgitate in the morning, after his breakfast? The real dangers of megaesophagus are malnutrition and pneumonia.

Puppies can sometimes grow out of this disease – Gus is nine months old – adult dogs do not.

My sense is that the switch to Purina  gastroentric canned food has been good for him, I always thought the dry kibble was too rich for him, he often spit up dry kibble.

He eats this new food heartily and seems to process it well. The fact that he can eat while standing up right and almost dancing is good, we don't think we will need a Bailey Chair.

After eating, Maria or I hold Gus in our laps for five to ten minutes while he sits up, enlisting gravity in the move to get the food down and out of the esophagus.

So that's what I know. I hope this new information will help Dr. Fariello focus her diagnosis, and if we can settle his stomach down in the morning, we may move towards a situation we can comfortably live with, at least for now.

I want to do everything within reason to keep Gus healthy and with us, and also stay within rational and ethical and financial boundaries. I'll report back on Thursday.

I have, as might be expected, been receiving a steady stream of medical advice from strangers and friends online. I am working to soften my attitude about advice, not because I want any, but because i see it's embedded in the DNA of social media. Some instinct compels people to offer unwanted advice, and I am working to accept that.

Smart people don't need advice, fools don't take it.

I think most people do not understand that all dogs are different and all people are different and what has worked for their dogs has no real concrete application to my dog or me.

If you feel the need to message me, please do, fire away, i pledge to not criticize you (I might poke fun at you once in a while anonymously, you can take it).

I am not generally a fan of lost causes, I prefer to fight for good causes that are concrete and meaningful. Taking on the dominant ethos of social media – minding other people's business and taking on their troubles –  is already a lost cause.

I reserve the right to speak my mind and fight against hostility and cruelty whenever it pops up. When I upset nasty people, I am doing the work of the angels. That may also be a lost cause, but not one I'll walk away from.

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