Happenings since October

Charles has had a pretty exciting autumn season. Following his front right leg amputation in September, I was able to finally get him to the vet to try and get to the bottom of his itchiness. But first we needed to solve the issues he was having with bad poops. The veterinarians guessed that with all of the other medications he had been on for the mystery issue that was ailing his right front leg, it is possible that they were inadvertently treating inflammatory bowel disease (IBD). And since he is no longer on those medications, it was reasonable to try a different diet to help with this suspected IBD. Thus, he was put on a new Rx diet, Hills I/D (for sensitive tummies). I was also directed to get him some probiotics (Proviable). With the combination, he hasn’t had any tummy problems and has had consistently great poops! What a relief.

No more tummy problems and Charles is finally starting to feel better!

Now, with the gastrointestinal situation seemingly under control, we could begin to address his itchy issues. You see, here again the doctors suspect that they were inadvertently treating his skin issues with the medications he had been on for his right front leg. The dermatologist told me about an injection that they have called Cytopoint, which contains monoclonal antibodies that bind to a protein in the itch response biosynthetic pathway. This sounded like it was worth a try and let me tell you, it is like MAGIC. We still needed to treat the superficial bacteria and yeasts that were on his paws/skin, but meanwhile he was SO MUCH LESS ITCHY. And after getting a handle on his skin infection, this boy has been cone-free for some time now. This is a HUGE turnaround for us.

With itchies finally under control, Charles can enjoy being outside in the fall without a care !

Additionally, I got Charles a stroller which has enabled us to go on some longer walks. I don’t know who enjoys the walks more between him or I. And with being able to exercise more and not taking prednisone anymore, he has even lost a couple of pounds! This is great news for the long-term health of this lil short-legged tripawd boy.

This boy loves his stroller

In November, Charles celebrated his 7th birthday. This is a HUGE milestone given all of the health issues that he has had in the last three years. From a liver failure diagnosis and “grim” prognosis in February of 2016, followed by leg amputation in September of 2018, to see his seventh birthday was a great blessing. And since Charles is feeling so well, I took him to PetCo for the first time ever to pick out some birthday gifts. I got him seven things for seven years. He was a very happy pup. 🙂

Seven gifts for seven years. Happy seventh birthday to Charles!

Furthermore, Charles has now gained some real fame by being selected as a top 4 finalist in the Barkchshler, an online series by one of the Try Guys. Charles now has over 50K followers on instagram. I am trying to use his account to be an inspiration to his followers as well as to show people how well tripawd dogs can get along!

Charles posing with his Barkchshler goodies at the start of the competition.As if that wasn’t enough, as you can see, Charles’s third eyelid was more prominent and red than I knew it should be at the start of last week (and it had been for several weeks at this point). I made the decision to have him seen by an opthamologist, and what they observed was that he had some cloudiness in his vitreous humor (the fluid that fills they eye), indicating that there were inflammatory cells in his eye. He was prescribed some steroid eyedrops for a few weeks to see if the issue resolves itself. After just over a week, the third eyelid has gone back to normal and we need not worry about him having cherry eye and needing an additional surgery! I will wait for official word on this when we go to the vet again in January to get his liver values checked and also let the doctors re-evaluate his eye.

In the meantime, it is about time to start traveling for the holidays. I want to say thank you so much to the tripawd community. You have been so supportive and I don’t know where I would be without the strength and encouragement that I receive from this little family. I wish you and all of your tripawds the happiest of holidays. Travel safely and we will see you next year!

It seems to never end…

We went for yet another vet visit today. However, this was unrelated to the lost limb. Charles has been weened off of several medications he was previously on for his paw, and now his allergies seemed to be out of control. My poor buddy is so itchy. He has had to remain in his e-collar because when he is not in it, he is gnawing on his paws. Charles has even been waking me up consistently around 4:00 a.m. in the morning because he is so itchy. The first couple of times he did this, he would go outside and stop to gnaw on his feet ever few steps. It was heart-wrenching to watch this behviour.

So we made it back to dermatology today and they offered a new solution: an injection of monoclonal antibodies that bind to one of the proteins in the biosynthetic pathway responsible for the itch response. Let me tell you, this stuff is amazing. We are already able to hang out sans e-collar and it’s only been a few hours.

Additionally, the doctors found some bacteria and yeast on his skin and feet, so we are doing a bath every other day with special shampoo and using other topical treatments on the other days. It is going to be an interesting month until we go back for Charles’ re-check!

In the meantime, you can enjoy this video I made of Charles! He recently gained a mild amount of fame by being featured in a Try Guys (formerly of Buzzfeed) video. This is the result from this series. 🙂

Freeeeeedom!

Charles Avocado VanGogh got his bandage off on Monday! He definitely looks more comfortable without it on, but also maybe a little too ambitious at times. He tried to do the *rolly around on the floor on my back* thing and cried and had to stop because his stitches are probably pulling yet. We may or may not have played a little bit of soccer (just a couple of short throws) because he is demanding to play. It has been raining here though, so I’ve had to be creative in finding a way to let him out to potty while also keeping his incision dry. He’s a trooper throughout it all.

I have ordered a stroller to use when he needs breaks on walks. It arrives today and if it isn’t raining later today I might see if he would like to just be pushed around in it since it is too soon to actually go on walks. 🙂

Sutures come out in 10ish days. Then we can start wearing the Ruffwear harness and going on walks. Getting excited over here!

Charles came home with me on Thursday late afternoon. I had so many questions to ask them. Admittedly, I felt kind of silly asking some of the questions. But you know what they say, “The only stupid question is the question that goes unasked”.

The doctors confirmed for me that the leg was sent to pathology for biopsy and culture. They are hoping that the biopsy will be able to tell them whether or not it was indeed vasculitis, so we have yet to receive any answers as far as that is concerned.

With all of the medications that Charles came home with and the different timings, I spent a few minutes making a schedule so we could make sure that he gets all of the meds that he needs when he needs them.

I noticed when Charles got home that his face was pretty swollen, so I frantically called ISU vet med right away. They told me simply to monitor his breathing and make sure he could still swallow food/water. So me, the anxious doggo mom that I am, watched him meticulously. He was panting a little bit, so I texted my friend who is currently a 3rd year in the vet med program to figure out the difference between panting and wheezing. I decided he was just normal panting due to being warm from the bandage. I loosened his e-collar so it would fit over his swollen head easier and became suspicious that maybe it was too tight. Sure enough, the next morning his face was no longer swollen.

Charles’ swollen face. 🙁 He looked like he had eaten a bumblebee.

I slept with a dim light on all evening with him at the foot of my mattress on the floor (which has always been my bed arrangement with him so he can easily get up and down from my bed). With my head a the foot of my bed, I couldn’t tell you how many times I awoke through the night to make sure he was still there and still breathing. I wasn’t joking about being an anxious doggo mama. In the morning, I got out of bed and knelt beside him. Charles was still zonked. I started to softly speak to him and he awoke startled and crying and ran over to me. We had to spend some time snuggling on the floor so he felt better before I continued to get ready for the morning.

Another issues we have been having since Charles came home is that he doesn’t seem to be in complete control of his anus. He overall is holding most of the poop in (he has had some nice, big poops outside); however, there are little drops of poop that continually come out of his butt and fall on the floor that I have to pick up. Thankfully his poops have hardened up a bit since he first came home and things are not as messy, but it is still frustrating. Obviously I’m not frustrated at him. He goes in for a bandage change on Monday, so if it is still happening by that point I will talk to the doctor about it.

Chillin’ on the floor waiting for his grandma to arrive this morning!

My mom came to visit Charles and I for the weekend. We are so loved by our family. I also received get-well-cards in the mail from my grandparents and my dad. They were really precious and I nearly cried. We are so lucky to have such a loving and supportive family.

I think Charles is really getting the hang of being a tripawd very quickly. He even has been so motivated as to try and play with his soccer ball or think about jumping up on the couch. He even has his new Ruffwear harness with the handles so I can help him as needed. We are ready to take on the world, three paws at a time!

It started nearly three years ago…

Charles and I had just moved to a new city in a new state, our first big move together. He was 3.75 years old, and I, a 26-year-old human onto a new university to earn my Ph.D. Charles is a very good boy and always has been. He is not known for getting into garbage cans (which can admittedly be a difficult feat for a short dog), or even stealing food of of plates or other surfaces.

Charles getting settled into our new home in Iowa

However, several months after moving, I went home during lunch for a reason I don’t remember, to find Charles acting very strange. It soon became apparent to me that he had gotten into the garbage and eaten the foil wrapper to the burrito I had for dinner the night before.

Being new to the Ames, I had yet to establish a veterinarian for my lil’ buddy. So I called my mother first to see if she thought I would be okay to call the vet from my hometown. I proceeded to call Dr. F and he suggested I give Charles some hydrogen peroxide in an attempt to encourage vomiting of the foil. He wasn’t a fan of the H2O2 (who would be?), but I administered the suggested amount and waited. We went on a little walk so he would hopefully throw-up outside. He did. There was some foil, but not much. This made me worry more.

I had to go back to work and finish the tasks I needed to get done for the day, so I did so with haste only to come back home and find he was deteriorating more. I was able to get him into a local vet that was not too far from my home. This doctor thought that he had simply tweaked his back and prescribed me some anti-inflammatory medication and suggested crate-rest. We went home to do that.

The next day, he seemed to get worse, and I woke up to find him chewing on my cell phone. It was beyond repair. I went home to check on him a couple of times throughout the day and I continued to observe Charles’ neurological state deteriorating. He was walking into corners and “head-pressing” on the wall. I made the decision to take him to the Iowa State University Emergency Vet, but had to have my mom make the phone call for me since I was phone-less. There, the suspected aluminum toxicity, and perhaps something more.

They were convinced that he needed to be evaluated by the neurology service, which I agreed to. They wanted to test him for ingestion of cannabis (which he had no access to as I don’t have any). Eventually, after a couple of days, they landed on the concept of him having a portosystemic shunt, which is a shunt that diverts blood from the vein that moves blood from the large intestine to the liver and instead directly to the vena cava, and thus to the rest of the body.

A couple of months later, we had an ultrasound done to determine the presence of a portosystemic shunt. We had our answer, and it was yes. Now the question was whether or not he had one shunt or multiple, small, acquired shunts.

naked tummy after the ultrasound

You see, one shunt is fixable, but multiple, acquired shunts are not. We scheduled surgery for a few weeks later, prior to which they would do a CT scan to get a better look and see if they could distinguish single or multiple shunts. They thought they saw one shunt, so the proceeded with surgery. However, what they found was completely unexpected. The doctors found multiple, small, acquire shunts and that his liver was completely abnormal. Charle was in liver failure. On top of that, they nearly lost Charles in surgery when his blood pressure dropped. He made it through though. Let’s give that to the fighting corgi sprit he has. We were far from in the clear though. The next few days were touch-and-go, but eventually my little buddy got to come home.

Lil’ buddy just trying to be comfortable and sleep at home after his surgery.

He was on many medications including an antibiotic called Baytril since the biopsies the cultured from his liver grew out some bacteria. Charles was definitely mad at me when we got home, but I slept on the floor with him two nights in a row and he eventually forgave me and got back to his normal goofy self.

Healing up well a few weeks after surgery. Look at that naked tummy!

Things were great for a couple of months until he started to develop some sores/ulcerations on his right front paw. The severity of the ulcerations increased with time, and the doctors at his liver checkup consulted with the dermatologists. Everyone was baffled. They decided to do a biopsy on his paw. Unfortunately, through various tests for suspected pathogens, there was no underlying cause determined.

At home after the biopsy. Charles was feeling weird from the anesthesia.

Top of Charles’ paw post-biopsy

They placed him on several different medications: Atopica, Pentoxyfiline, and Prednisone, in an attempt to manage the sores on his paws. Throughout the next one-and-a-half years, and with varying doses of prednisone, it seemed like we were managing it somewhat reasonably as he would have a few months here and there that he could be cone-free. However, the doctors and I know that it is not great for a dog, especially one in liver failure, to be on prednisone long-term. So we decreased the prednisone.

The pads of Charles’ paw never seemed quite right after the last time we decreased the prednisone. They tissue was scaley, thick, dry, cracked, and just weird. The poor guy was stuck in a cone since October of 2017 (though he didn’t let that slow him down!). It made me feel so bad though because we never could get a good handle on what was going on or how to treat his paw.

Still happy as a clam. But my heart was so sad having him stuck in that cone.

We finally officially saw the dermatology service a little over a month ago to talk about his paw, because it had gotten particularly bad in July. They prescribed him some antibiotics after seeing some bacteria on a smear from his paw and decreased his prednisone dose further. After a couple weeks we went back for a re-check and then they saw yeasts on his paw, so we were doing anti-bacterial anti-fungal soap soaks for his paw. After the next recheck, they decided to change the antibiotic he was on as well as to splint his leg in hopes that by taking pressure off of his paw, his pads would have the opportunity to properly heal up. However, just four days after the splint was put on Charles was no longer putting any weight on that leg and it was starting to get a little smelly.

He looked cute but wasn’t feeling well. Time for a trip to the emergency vet.

The next day, the odor was much stronger and he was visibly lethargic. It was a Sunday, so I called the emergency vet to see if I should take the splint off myself or bring him into the hospital. The doctors said to bring him in so that they could better assess what was going on.

When the unwrapped Charles’ splint, what they saw was very upsetting. The wounds were much worse and whatever infection he had seemed to be spreading. The likely course of action would be amputation, but they waited to decide until Monday when the could gather the brains of the dermatology, internal medicine, anesthesiology, and soft tissue surgery departments. In the meantime, Charles needed to stay in ICU for treatment.

Sure enough, I got the call on Monday that they recommended going forward with amputation. I went to spend some time with him on Monday evening, because I knew surgery was a scary thing (especially for a dog with liver issues). The doctors told me that his clotting times were lower than they would want, so they did a plasma transfusion early in the morning before his surgery. I was an anxious wreck all of Tuesday until I received the call that he made it through surgery wonderfully. I was hoping to get to see him on Tuesday evening, but they told me to wait as he was still very sleepy from the anesthesia. So then I was hoping for a Wednesday morning visit; however, the student working on his case told me that Charles was very anxious and over-stimulated, side effects from the pain drugs he was on, and a visit was not advisable. So again, I waited.

When I finally got the call that I could visit him Wednesday evening, I was elated. They told me on the phone that Charles was bouncing around, had gone potty on his own, and was quite spry. I couldn’t wait to see him. He bounced into the room were I was waiting to see him and came right up to me and gave me kisses! He wasn’t mad at me at all. It was obvious that he was feeling so much better!

A visit to Charles on Monday night. He was happy to get some snuggles.

The doctor told me that the sent his leg off to pathology in hopes to get to the bottom of what caused all of this to see if we need to do anything to prevent such an ordeal again. She also told me that Charles is clearly milking everything he can out of the situation including being stubborn and refusing to walk for the option of being carried instead, and making it difficult for them to change his bandages. Sounds like Charles is already back to his old antics.

Now, I am so happy and excited that he is coming home this afternoon. It will be quite the adjustment and any and all advice you have for us is welcome. Thank you for listening to our story!