11 January

Gus’s ME Journal, At The Vet 1/11/18. Bad News, Lots Of Hope

by Jon Katz
Gus’s Me Journal: Bad News, Lots Of Hope

This was an intense and emotional visit to our vet, Dr. Suzanne Fariello. Gus has lost nearly three pounds, a significant loss for a dog that weighted 15 pounds two weeks ago.

This is a serious setback in our efforts to figure out how to treat Gus’s megaesophagus because it suggests his body is not processing nutrition.

If it continues, there is nothing we can do for him, even tube feeding wouldn’t help, and I would not accept that treatment for him.

Dr. Fariello said she was discouraged, but not yet hopeless and neither are we. Still,  we need to reverse it, period malnutrition is one of the fatal symptoms of megeasophagus.  We went straight to plan B, re-arranging his diet and medications.

Gus’s ribs were showing for the first time today, and he looked almost gaunt. My heart sank at this news, it is not good news.

Gus has been eating 1/3 of a can of Purina Pro Plan EN Gastroenteric Veterinary Diet food, we’ve shifted to feeding him four times a day (we have to hold him upright for at least 20 minutes after each meal, and now mixing in Royal Canin’s high-protein, high-calorie recovery diet.

It’s possible the Pro Plan was the cause of the weight loss, even though that is a serious symptom of ME. We’ll know in a couple of days. I’ve already given Gus two of the new feedings (his antacid and anti-nausea medication was also increased.)

I might be imagining things, but I think his belly has filled out a bit already this afternoon. It’s really too soon to know.

Dr. Fariello and I talked frankly about the options before us.

She agreed with me that the specialists don’t really have anything to offer Gus. Although the much-discussed Bailey Chairs are often cited as the best option for treating ME, we have both seen from our separate research that there are about 50 possible treatments for the disease, none of which are believed to be cures.

We see no further reason to consult specialists, we all agreed, they are expensive and their techniques and diagnostic tools are expensive, and they have no magic procedures or pills for ME. We agreed that we don’t need a Bailey Chair right now, and that we are not going to try 50 different remedies or treatments. Our elevated eating benches will arrive shortly.

I will not permit Gus to suffer from malnutrition or a slow starvation and end his days spitting up. Dr. Fariello said she knows how I feel and will respect that, she felt the same way. I will protect you from that, she said, and I wanted to hug her for that. (I did hug her, but it was, she said, quite appropriate.)

Nor am I comfortable with all of us spending our lives and most of our days holding him up or propping him up or making special puree food recipes. We have devoted much of the last two weeks on Gus, and it is not a way we want to live permanently. Maria has lost half of her work week and my own writing schedule has gotten erratic. For me, it’s somewhat  easier I suppose, because writing about Gus is my work. But that doesn’t make it easy.

There are really no end of the things we could try, but we have to have some reason to think they might work. There is no cure of megaesophagus and slow starvation is not acceptable for me, or for Maria, for Gus. We won’t be keeping him alive for us, it has to be for him.

The best one can usually hope for is special diets, elaborate stand-up eating arrangements and some “happy years” of life. The term does not bring me comfort. There is no getting rid of ME.

I told Dr. Fariello that Maria and I were in complete accord about what we think is appropriate for Gus.

We went to see if his weight can go back up and determine if we can limit his food regurgitations.

On that score, this was a good day, there was only one spit-up this morning, and none since, even though he has eaten three meals.

His stool was normal just a few minutes ago, which suggests this new food is being digested. Weight grain is critical, because it will  tell us if nutrition is being absorbed. It’s odd about people who love sick dogs, we become stool scholars.

Maria and I can happily live with an otherwise healthy Gus spitting up his food once in a while, or even once or twice a day. We might get there if we can  get some weight back on him. The last two days have not been sustainable, we would have to give up much of our work to maintain this level of maintenance, vigilance and worry. And there are a lot of animals here, and a farm that needs a lot of attention.

I just picked Gus up and it seems to me already looks better. Is it wishful thinking? Dr.Fariello also did some acupuncture with him, she is not sure if it will help or not, but believes it’s worth a try. He struggled with it, unlike Red.

This is new terrain from me, and I will learn from it. There is nothing solid to cling to, no technological or surgical marvels or magical pills.

I asked Dr. Fariello what it was we were shooting for, what our goals are.

She said she didn’t know, she was quite honest with me. At the moment, we want him to  gain weight and regurgitate less. If we can get there, we can build on it. She is talking to her friends and mentors, some of them specialists, and I am doing my homework online.

This was  a hard and emotional session, it got serious, the stakes seemed high. Maria cried a bit – for her, crying is a way of talking, her emotions are on the surface. I got angry watching Gus squirm and yelp a bit as he got a shot of vitamin B-12 and some acupuncture needles. They he settled down. He is a good, sweet, boy and now is the time to fight for him.

I felt low in the vet’s office, not so much now. He is eating well, keeping his food down, and from his bowel movements, digesting it. If we stay on this track, that will be good news. I feel quite hopeful, and I can’t say it’s based on one solid thing, but there it is.

Maria and I are cautioning each other to be steady. We go up and down, thinking it hopeless, and then when he looks so alert and affectionate and alive, we feel better. That is where we are now. I’d like to stay there for awhile, but we also need to be armored for tomorrow. There is no way to know.

14 Comments

  1. I’m sorry for the bad news. Sometimes the best thing a pet owner can do is let the animal go, but I hope it doesn’t come to that for you and Maria.

  2. I know this is foolish of me, but the day before Gus got sick, I thought, “Oh, God, I hope nothing happens to the dog, they love him so.”
    Now I feel responsible. I know that’s nuts, but that’s how things work in my world. So I’m praying for him, even though I’m agnostic. Because that’s how things work in my world.
    You never know. I spent yesterday morning saying the Desperation Prayer (Oh please, oh please, oh please!), and my water pipes thawed. So maybe it will work for your dog.

  3. Whatever you do, it will be the right thing for you, Maria, and Gus. Your are not obligated to share, but if you choose to do so, your blog readers have an obligation to respect your decisions == whatever they may be. That said, “You Go Gus!”

  4. I’m sorry to hear about your bad news today. Positive thoughts are being sent your way and much hope for the best possible outcome for Gus, you and Maria. Hang in there.

  5. Hello Jon,

    I am very sorry to now of the very serious difficulty Gus is having. I am sure yo are hearing from all sorts of people with ideas and options for you – I hope you do not mind that I add myself to the list.

    There is a restaurant and tavern – the Black Dog Tavern – near where I work who’s namesake has ME. I do not know them, but they speak of a chair they use for his feedings – perhaps this special chair you write of. Their dog is actually named Bentley and they write of him as being otherwise quite normal and apparently doing well. I am sure each case is different, I would be happy to reach out to them to see if there is anything more they may relate that could be of use. The information I hae about them is from their website – http://www.deerridgegc.com/black-dog-tavern/

    in any case, I wish Gus well and Godspeed wherever his journey takes him.

    Sincerely, Jim Currie

  6. I am so sad for Gus, you and Maria and sorry his joyful life is now complicated by illness. I am hoping for the best but I understand this is a serious condition. I had two Boston Terriers and they were great dogs. When my second developed a slow growing cancer we did not choose chemo and let her go when her quality of life began to suffer. I agree with you on dogs and illness. I wish you did not have to deal with this. I have greatly enjoyed reading about your three dogs and reading your books. Thank you for your work.

  7. These are the cards you and Maria have been given. I am confident that the both of you will come to some sort of conclusion with the help of the vet. Nothing is easy and most of all it is not easy when the heart is involved.

  8. Jon & Maria ~
    I’m crying right now reading your latest post. I’m reliving some of my last couple of years with my beloved Boston Terrier mix.

    Bug was a high energy naughty Boston Chi mix that came to me in foster care, having been dropped off at our local animal shelter after a family emergency. She had been purchased by a young man from a local puppy mill that has since been shut down. Our first stop was the Vet – who declared her to be no more than 5 weeks old. After many early challenges, Bug went on to become an agility championship dog and was a joy to travel and compete with. She made friends and fans all over the United States.

    At six years of age, and the top of her agility career, she developed autoimmune inflammatory bowel disease. She had progressive vomiting, diarrhea and weight loss. We had many ups and downs, good days and bad days. Endless trips to the vet for fluids, trials of meds, different foods. The food that finally seemed to stay down was a hydrolyzed protein CAT food (soaked in water) – it was high protein, high calorie and she gained some weight back. This was started after a trip to a nutrition vet at the Univ of MN. We even were able to start agility training again and competed in a few trials.

    This last Spring she took a turn for the worse. The summer was hard on both Bug and our family. In August, she refused to eat for several days. We knew the time had come. Bug was done with painful procedures, needles, tests. I am at peace knowing we did what was best for her. The loss was great, but the gift of our time together was amazing. I was so afraid I would not do enough to keep her alive or try hard enough. I know now that I made the right decision to allow an end to the suffering.

    I am so sorry you are going through this terrible illness with Gus. I am happy that he has you as his advocate and companion. I wish you peace and comfort as you support and love Gus.

    Deb

  9. sending you both hope and prayer,. i’m visualizing gus able to gain weight, keep the food down , and be his active running self.. he is so loved
    and is one special pup, who has filled so many lives with joy
    just to read about him and watch him with all your animals, riding the donkeys and how great he was with the people at the mansion.
    holding all of you in the light….. woof rosie

  10. I to have been going through the same thing with my boy baby ,The only thing I do now is give him some pepto bismol ,a half of eye dropper full seems to do the trick,the first day I gave him 1 in the morning then 1 at night the second day just 1, none the third day ,because he pert right up he is holding down his food and not spitting any thing up and seems to be feeling a whole lot better ,baby is 18 pounds. To me it was worth a try what else was there left .If nothing else it would soothe his stomach,its been a few month’s now and I only give him some when he has what I call flare ups .Ask your vet first. I hope this was some help .Good luck and God bless!!!

  11. re: weight gain. The rescues I work with, almost all, swear by “satin balls” for fast weight gain for emaciated dogs. Not sure if they would work with ME, but it might be a worth a look. Recipe for them is all over the internet with many tweaks and variants too.

    tough decisions to make. It sounds like you have a great adviser in Dr. Fariello. Follow your best instincts.

  12. I am so sorry to read th ebad news. One of the hardest things with being a pet owner is making the decsions about when quality of life outweighs the quantity of life. If the unthinkable comes- and I hope it doesn’t for many years!- take comfort in the fact that Gus had a wonderful joyous adventure in his life at the Farm. And know that all of us who have had to say goodbye ache with you & Maria. Sending lots of good thoughts & hopes that the new diet woks well!
    Margaret, Corgi the Aussie and Ruger the Aussie.

  13. This is heart wrenching to learn that this wonderful boy is in such a bad place. Sending you hope and strength for a better future. At some point we as pet owners (used loosely as who owns who) must make some very hard decisions and after following you here and reading your words, I am sure that Gus is in exactly the right place and that you and Maria will do what is best for him. Blessings to the three of you..

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