Well, yes and no. We met again with Dr. Suzanne Fariello of the Cambridge Valley Veterinary Service to plan the next steps in Gus's treatment for Megaesophagus.
Dr. Fariello and I have agreed to meet once a week for the next few weeks to study the data I'm collecting, to examine Gus and talk about his condition, and to plan for the future.
Dr. Fariello asked me right out if we can live with Gus's condition the way it is – emotionally, in terms of time, financially and in keeping with our own ethics and philosophy. Speaking for Maria as well as myself, I said yes, we talked about it, and we can live with this level of care and disruption.
The good news is that I am discovering some things that make Gus's condition better, and I feel we are making progress.
The bad news is that Dr. Fariello and I both agreed that Gus should not be permitted in the pasture with the other dogs in the morning, he is eating too many things there that disrupt his digestive system and potentially make his Megaesophagus worse.
So I have to alter my idea of him, and the identity I gave him. He might be able to get out in the pasture again if it turns out the Megaesophagus resolves itself or gets much better.
Down the road, we could muzzle him if we wanted him to be out in the pasture with us – sheep pellets and such can be lethal with that disease. We" still make sure he gets an occasional donkey ride. Gus is happy to stay in the house and drag his toys around when we don't take him out. He is nothing if not adaptable.
I understand there are no permanent cures for this disease and it rarely moves in a straight line. There will always be ups and downs, progress and setbacks.
The new plan involves continuing a sucralfate tablet 30 minutes before eating to deal with acid reflux, and also taking 1/2 a metoclopromide pill in the evening to promote digestion in his intention and stomach – this medicine prevents nausea and vomiting.
Dr. Fariello liked and approved of my idea to sprinkle his new food – patted into small "meatball size" chunks with olive oil to help "lubricate" the food as it enters his esophagus (which is a muscle). I was kind of pleased with myself for this.
We also decided to give Gus some food late at night or early in the morning so his stomach isn't empty for many hours, a circumstance that causes some dogs to regurgitate food.
In her office, I demonstrated my method of hand feeling Gus when he is standing up on his hind legs and jumping up for the food.
This accomplishes two things: his head is up when he is eating, and the jumping helps force the food down through the esophagus.
She and I both agreed that Gus does not need a Bailey Chair or other custom-built eating chair. We have ordered a 14″ tall two-bowl bench so we can put some of his food there that forces him to stand up when he eats. I understand Bailey Chairs work well for some people, but not for us at this time.
Maria and I also take turns holding Gus upright in our laps – he seems to like this – for between 10 and 20 minutes after eating.
Keeping him out of the pasture in the morning is a dramatic change, which seems to have paid off so far.
We've kept him out of the pasture for the past several days, and he has not regurgitated food once in that time. Frozen sheep pellets and frozen donkey manure are precisely what is worse for dogs who suffer from this disease.
Gus is a very easy going and adaptable dog, he takes all of this change in great humor and with no struggle or lament.
Dr. Fariello essentially banned all solid treats for good, he can have some soft treats, but nothing that is hard or that needs to be chewed extensively. This is the only part of this disease so far that directly affects Red and Fate, they eat separately and are also easy going.
My own philosophy about treats – I have plenty on hand – is that this something people need to do, not dogs so much. He has a good and active life with plenty of hard toys to chew on and toss around. He will be fine.
For most of their existence on the earth, dogs did not have expensive treats, and I will wean Fate and Red off of them as well gradually. I'm happy to have a treat free household.
Gus will also begin acupuncture treatments in a week. We'll evaluate them to see if they help.
I have received a significant amount of mail and messages and advice about Gus and his illness, but as you know, I am working with Dr. Fariello and Maria to sort this out.
Anything else is a distraction for me and i very rarely take medical advice of any kind from people on social media that I don't know. Every dog is an individual creature, and what works for other dogs is not necessarily relevant for Gus.
I appreciate the impulse many people have to advise me on this, but I don't want you wasting your time. I believe in the approach we are taking, and i find our vet rational, open and very knowledgeable. We work well together. If anyone feels the need to give me advice, feel free but I just wanted you to know how I feel about it.
I will not get angry or upset, I'm growing out of that. Do what you feel you need to do.
So that's what Dr. Fariello calls the A.1 plan, there are other plans as well. One involves seeing a veterinary internist and specialist. i said no, she said that was fine with her.
As many of you know, I have strong ethical reservations about how far to take a dog with a serious or life-threatening illness.
I don't believe in making dogs suffer so humans can feel better about themselves, or in spending thousands of dollars on a dog when so many people are in great need. Dr.Fariello assured me that Gus is not suffering anything more than occasional acid build-ups.
On mornings when Gus has regurgitated food, he seems lethargic and quiet to me, Dr. Fariello believes he might be feeling nauseous, thus the metoclopramide. Otherwise, he is full of play and energy and appetite, things sick dogs don't feel or do.
We won't get to the third until we see how A.1 goes. I am excited by the fact that since our meeting and these changes, Gus has not regurgitated his food once. I am confident we can handle his and live with it. I know that may change, but we'll deal with that if it occurs.
He has lost 1/2 a pound, which could be concerning if it continues, but Dr. Fariello says she is not worried, it is almost certainly the result of switching to a special food with fewer calories than his puppy kibble. She examined him thoroughly, she said he is very healthy, in great weight, strong heartbeat and with good coat and energy and no signs of malnutrition or any other problems.
So that's where we are. I am learning a lot, and on some level enjoying the challenge. I approach it like a chess match, I have to creative and thoughtful. More later.