8 February

Gus’s ME Journal 2/8/18

by Jon Katz
Something Feels Very Different

Studying and learning about megaesophagus, I realize that I have never felt quite so responsible for the life of a dog that  our family loves than I do for Gus. There was really nothing I could ultimately do for Orson, who was damaged beyond repair, or for Izzy and Rose, who were stricken by cancer, or for Lenore, in so much pain, or for Frieda, who simply grew old beyond probability.

Gus is different, he is not yet a year old, and there is so much mystery and alarm about this disease. Whenever I see Maria holding Gus and singing to him, I think, we have to figure this out.

The first thing I ever read about megaesophagus after I left the vet’s office and heard her diagnosis was this, from PetMD:

“In the past, a diagnosis of megaesophagus was usually a death sentence. Severe cases of the condition make it virtually impossible for a dog to hold down food and water. In health, the esophagus is a muscular tube that pushes what is swallowed into the stomach. A “megaesophagus” is like a deflated balloon. It passively collects food and water until it can take no more, at which point the dog regurgitates all that he has just swallowed.”

I held my breath after this, I was fairly certain Gus would die. He was regurgitating his food continuously, his ribs were sticking out in a frightening way. He just could not keep food down, as in the “severe” cases described.

The more I learned and heard about the disease, the more discouraged and confused I became.

I have worked hard and with determination to figure out if there is anything I can do to alter the course of this disease in Gus, I  know many dogs live with this disease a long time, in various states of illness.

But I could find no consistent or coherent medical treatment that made sense to me, or gave me much hope. This week, I feel differently.  I know the disease is up and down, and fluctuates wildly, I know there is no cure, but we have taken a number of steps that are changing my perspective in a more positive way, showing results,  and helping Gus in ways I thought may not be possible just a few weeks ago.

This has mostly been because of our experimentation and research into diet, into the digestive tract and how it works, and this is what i came to see as a creative challenge. Perhaps an arrogant idea to some: could I figure out a way to feed Gus that would minimize the disease and make it work for him, and for us?

I need to figure things out myself in a world where everyone is lining up sometimes to tell me what to do. This is my problem but I am learning to work around it.

This week, and with the help of our vet and other veterinary researchers, we all came up with a new dietary plan for Gus.

FIrst off, I don’t feed him twice a day, but four, even five times a day.

I use a long baby spoon to keep his portions small so they can be digested more easily, and hold them up so that Gus must stand on his hind legs to eat them. Gus has come to love this game – why not, and I don’t mind it either, it is fun and bonding.

He is actually jumping up and down while he eats, like any good circus clown,  replicating the effects of the Bailey Chair and other custom-build devices designed to help guide the food down through the esophagus. Gus is an easy going and adaptable dog, he goes with the flow, which makes this easier.

It is imperative with megaesophagus that the dog not lose weight, that is the gateway to infection and starvation with this disease. We switched his food immediately to Pro Plan EN gastroentric food. I put in a few drops of olive oil to lubricate the food. We supplemented his diet with Royal Canin high-calorie recovery food that vets use.

He never quite stopped regurgitating his food.

Gus experienced chronic regurgitation, vomiting and sharp weight loss, a month ago it looked very grim for him. But with the help of our vet and the good research published online, we kept experimenting.

The professional advice online was good, the amateur advice I got was not generally helpful. I’m sorry, but I just feel it’s dangerous to manage a disease like this from the ideas and experiences of strangers who are not trained or accountable, and who I don’t know.

If I had taken some of their advice, I would we would be in much deeper trouble than we are now. Gus might be dead.

I don’t say this to be combative, but as an advocate for dogs. They deserve the best advice available when it comes to their health. I also know myself, and I need to focus sharply and avoid distractions if I can do any good and retain all the information I need to retain.

The good wishes of people are always helpful, and mean a lot to me and Maria, and I thank you for them.

I saw that every time Gus ate something outside of the approved diet, he got seriously ill and spent the day discharging food – vomiting, regurgitation and diarrhea. I decided a good muzzle was essential to Gus’s treatment, and it was not simple to find a good muzzle.

I spent a lot of time searching for the right muzzle, and we got one, the OutFox brand, and it has helped greatly. Gus gets to go outside and run around with the others, but can no longer eat sheep and rabbit waste, they were nearly killing him. The texture of animal waste and dry foods and treats  made it perfect for getting stuck in the esophagus and blocking digestion.

No treats for Gus of any kind. I sometimes give him a crumb.

When we eliminated that eating problem, I re-examined the diet. I felt the EN food was not filling Gus up, it is a bland, low-calorie food. I wasn’t certain about the olive oil either, Gus would often spit up a yellow liquid that didn’t seem to be food.

A few weeks ago, and with the approval of my highly trained experts, we rebuilt Gus’s diet and digestive functions. He is getting motility medication three times a day to promote faster digestion. He is getting regular acupuncture treatments and Chinese herbal medications to go with the acupuncture and his food.

I am putting two tablespoons a day of plain yoghurt into his food for liquidity and to lubricate the food so it will move through the esophagus. This was my idea, the vets loved it. We switched the main food to Pro Plan turkey and sweet potato, a higher calorie, more filling food that might curb Gus’s voracious grazing inside and out, and keep  his weight up.

Every dog is different, what works for one may not work for the other, so experimenting is essential. It doesn’t matter what happened to somebody else’s dog, it matters what happens to Gus.

We are continuing to add the Royal Canin Recovery food into the mix: one-fourth Royal Canin, three-quarters Pro Plan turkey and potato.

I mix all of this up in the morning in one bowl and add several teaspoons of water. The food is soft but solid, and almost but not quite soup.

I feed him in very small amounts five or six times a day from the bowl. It takes me some time in the morning to prepare the food, but it is simple and fast the rest of the day. It is fortunate I work at home. I no longer take Gus to the Mansion or anywhere else for therapy work, I can’t risk him vomiting in those facilirties.

After each meal, Maria or I hold Gus upright in our laps for 10 or 15 minutes. Maria often sings to him, and sometimes plays healing chants on  her phone. I have to be  honest, I think this is helping, Gus loves being held, loves the music, and somehow, it seems to help him digest  his food quickly.

I can tell by the gulps and burbs.

I forgot to mention I give him a Pepcid tablet three times a day.

Over the past four days, Gus has not regurgitated once, nor has he vomited or spit up any liquid or bile, as was happening frequently. His stools are small, sometimes soft, but generally firm. He is flatulent, as is typical of the breed, but that is much preferable to spitting up.

We have not used up our Nature’s Miracle this week, or even used it at all, the first time in several months. This is different.

I am fully prepared for the disease to rear up at any time, that is what megaesophagus does, we are prepared for that.

But this turn seems different from the others. It is lasting longer and Gus seems solid – hungry, no burping, gulping or other signs of indigestion.

Since the very recent days when megaesophagus meant certain death, researchers seem to be focusing on diet as a control, or eventually a possible cure. Some people force feed their megaesophagus dogs with stomach feeding tubes. Maria and I are not comfortable with that options, we both believe it is not humane for the dogs, or for us. We never mean to keep Gus alive by any means at all costs.

There are boundaries and limits – time, money, work, emotion – so far, it is all in balance. Gus is a special dog, and he has certainly worked his way into our hearts and lives.He is part of our family.

But that doesn’t mean we can’t keep him alive and living a normal, happy life. We’ll just have to see. This week was just fine.

As I said up top, this feels different to me. Fingers crossed. More later.

 

 

2 Comments

  1. Totally understand this. We had an Australian terrier who at EVERYTHING he was like a vacuum cleaner on floors. Never did the floss thing but learned to only use covered wastebaskets or (even now after Taz has passed) keep wastebaskets on countertops especially in my hooking room. We have spent lots of time going through his stool specimens to see what exactly he has eaten and if it has passed or is a vet call needed. Carry on and good luck Gus is an adorable dog!

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