Wednesday, June 25, 2008

Grooming Counter Conditioning - Day 1

In a follow-up to Lucky's freak out a week ago when at the pet store attached to the groomer's, I decided we needed to engage in some basic counter conditioning.

SO! Yesterday we ran out of food, so I had to go to the store to get more. I decided I would take Lucky with me with lots and lots of treats and a clicker and see where we got. If need be, I would let him go back in the car while I ran in for his food.

We got there and I armed myself with the clicker. I opened the door - click. Picked up his leash and he hopped out - click. I closed the door - click. Then we hung out for a bit, clicking and treating for just being relaxed and calm. I took a step - click. He caught a whiff of the groomer and tucked his tail. We backed up 20 steps until he could relax. I played silly games, clicking and treating. (all the while there's a guy sitting in his car watching us like WTF?) When he had calmed down, I started playing the Come Game, backing up towards the store. With each "Come", we'd pause and play more silly games until he was relaxed.

By the time I got to the door, he was sniffing interestedly at it like "Maybe this won't be so bad." So we went inside. We started walking up the aisle furthest from the groomers, clicking and treating for calm, relaxed behavior. Then down the next aisle. And so forth. We got to the aisle 2nd closest to the groomers and he was loose body and waggy tail. We walked up it. Turned the corner to the aisle next to the groomers. We're walking down it, I'm letting him go his pace. We were about 2 feet from the door when he looked up at it. I tossed a handful of treats on the ground in front of the door. He hoovered them up. We walked past the door.

So I went and got his food, let him pick out a pig ear for later, and we left. The only hitch came at the very end - I put the food in the trunk and turned to walk to the back door of the car and he bucked back on the leash. I think he thought I had tricked him and I was going to take him into the groomer's. So I said "No, silly. Go for a ride!" and he immediately got up and leapt into the car.

So! All in all, a successful first outting. We'll have to repeat the trip again soon. Maybe Friday.

Tuesday, June 24, 2008

Sticker Shock

Yesterday was Lucky's 2nd Percorten injection. This time we actually had to pay the bottle fee (our first week they just charged an injection fee). And it's likely that a bottle will last about 2 months - maybe a bit more if his dosage goes down.


Holy mother of God.

So, that's about $90/month for the Percorten. Our prednisone runs about $23 for 100 pills, so that's about $8/month for those. $100/month for just the meds. I'm not sure how much the bloodwork will cost - he goes in in 2 weeks for his 14-day electrolyte test, then again at 3 weeks and again at 4 weeks. Once he's reasonably stable, he'll only go in every 6 months.

I need to get a credit card for vet expenses that has a rewards program attached. This is going to add up quick. It may as well add up to hotel stays or cash back or something.

Sunday, June 22, 2008

First post-diagnosis swimming trip

He had a BLAST. He got to fetch and swim and roll in a dead possum (ew), and fetch and swim some more.

AND! He got to CHASE.DUCKS! He'd been ignoring them most of the time, being focused on the stick we had for him (basically, a cut-down dowel). But then a few of the ducks started causing a ruckus and he stared at them and you could hear him thinking "Wait a minute. That's PREY!" and took off after them. Scattered them all around, splashing after them and generally having a grand ol' doggy time. As I ran over to herd him back, I passed a couple with a toddler - as I jogged by, the woman asked "He's adorable. What breed of dog is he?"

"Portuguese Water Dog," I called over my shoulder.

She started laughing. I rounded him up and we started back to where we'd been playing. He ran up, "tagged" the dad (meaning he planted a great, wet, sandy paw on the guy's midsection), shook the water off his coat onto the delighted toddler, and went tearing over to The Spouse.

In all, it was a great morning. He loved every second of it. I think we'll be regular visitors throughout the summer. Unfortunately, we didn't have a camera with us. Maybe next time.

He goes in tomorrow for his next DOCP injection. I'm sure there'll be a post after that.

Monday, June 16, 2008

Looks like the groomer will be a no-go for a long time

When he was first diagnosed, our vet said that we'd have to learn his big stress triggers and either avoid them or manage unavoidable situations with his medication. We already knew his biggest trigger was the groomer, so I had figured I'd start grooming him at home to lengthen the amount of time between professional appointments.

On Friday I took Lucky to the pet store that's attached to his groomer. And he just absolutely lost it. Took two steps out of the car, recognized where we were, bucked back on the leash and sat down. I tried taking him in the door furthest away from the grooming shop, he dragged me over to the grass along the side, tail tucked.

I finally coaxed him in the store with the promise of chicken treats (what we were there to buy). He did ok, until I tried walking to the aisle with the treats - close to the grooming shop.

I had to leave him in a down-stay while I did my shopping. He was absolutely terrified that I was taking him to the groomer.

I see a long series of counter-conditioning coming up. Driving out to the store and sitting in the parking lot, popping treats in his mouth, driving home. Gah.

Thursday, June 12, 2008

One week later...

And he is driving me INSANE!

Which one would suppose is a good thing. It means he's feeling better.

But the energy! He's more crazy than he was a month before diagnosis. He's almost as crazy as he was when he was a puppy.

Another thing is his appetite is out of control. He's getting 2 full cups of food a day. Judging by the noise he makes when any other food appears in the kitchen, I think he is hungrier than that. I'm going to have to start adding green beans or some other low calorie food to his meals just to fill him up (and shut him up).

He had daycare yesterday for the 2nd time since his diagnosis. The first week their report read "alert and awake". This week's was "playing non-stop. didn't want to rest". Then he came home and played for another 4 hours. Oy.

What IS Addison's Disease anyway?

This has been the most commonly asked question we've gotten since announcing his diagnosis to family and friends. I've been likening it to diabetes, to give them the scope of what this means for him and for us. It requires daily medication. It requires a lifestyle change. It requires regular blood draws to determine how the medication is working. Etc.

But, a more technical explanation, for the curious, would be this (as taken from the PWDCA and AddisonDogs websites):

Addison's disease is caused when the adrenal glands deteriorate. These small hormone producing glands are located above each kidney and are important for controlling the metabolism of sugar and maintaining the salt and water balances in the body.

The adrenal gland is made up of two layers, the cortex and the medulla. The outer area, or cortex, secretes corticosteroid hormones such as cortisol and aldosterone. The medulla, part of the sympathetic nervous system, secretes epinephrine (adrenaline), which is generally not affected by Addison’s.

There are three forms of Addison’s disease: primary, secondary and atypical. Primary and atypical Addison’s are usually the result of immune mediated damage to the glands. Secondary hypoadrenocorticism is from failure of the pituitary to stimulate the adrenals with adrenocorticotropic hormone (ACTH).

As the adrenal glands cease to produce vital hormones, physical and behavioral symptoms develop, sometimes in an inconsistent manner, so an owner might observe one or any combination of signs: depression, lethargy or weakness, vomiting, diarrhea, weight loss, and/or a lack of interest in food. These symptoms may come and go over months, making diagnosis difficult.

Addison's Disease is often called the Great Pretender because it presents symptoms of dozens of other diseases. Many veterinarians spend time testing for kidney disease, Lyme, cancer, blockages in the digestive tract, upset stomach, etc. etc. About 30% of dogs are only diagnosed when they're in a full-fledged crisis. Most dogs aren't diagnosed until they're incredibly ill. The average age of the dog at diagnosis is between 4-7 years of age (Lucky was 1 week shy of his 3rd birthday).

Some breeds of dogs seem to be more predisposed to developing Addison's: Leonbergers, Standard Poodles, Nova Scotia Duck Tolling Retrievers, Airedales, Bearded Collies, German Shepherd Dog, German Shorthair Pointer, Great Dane, Labrador Retriever, St. Bernard, English Springer Spaniel, West Highland White Terrier, Wheaten Terrier, and Portuguese Water Dog.

This is by no means an exhaustive list. And Addison's Disease can develop in any breed or mix. If your dog exhibits any of the symptoms on the list above, consider Addison's as a possible, perhaps even probable, culprit.

The good news is that, while not curable, Addison's is 100% treatable. With proper medication, Addison Dogs live happy, full, long lives.

Not quite what we expected

Nearly 3 years ago, my husband and I brought home the most adorable little dog on the planet

His name was Lucky, christened such by our breeder's son. He was named that because he was the last pup of the litter and had to be revived, just like the dog in the movie 101 Dalmations. We thought it was so fitting, so we kept the name.

Lucky is a Portuguese Water Dog. They're an ancient, seafaring breed, a highly intelligent working dog with stamina to work a full day in and out of the water. As an aquaintance described them:
You know how herding dogs are ridiculously smart and energetic because...well...they have to be?

You know how incredibly tiring swimming in the ocean is?

Now imagine a creature that was bred to herd fish.
That should give you an idea of how much time and effort an owner needs to put in to their dog. They're smarter, more determined, more energetic, more clever than any other breed I've met. I love it - it's exactly what we wanted.

We had researched the breed for months, reading books, websites, etc. Like any other breed of dog, they do have their health issues - hip dysplasia, cardio, cancer, allergies, etc. One of the big ones is Addison's Disease, or hypoadrenocorticism. Every line of PWDs is affected in some way. The mode of inheritance is not known. We knew about this going in.

So we brought Lucky home at 9 weeks of age and started life as puppy owners. He was, in almost all respects, a dream dog. He slept thru the night from day one. He was giving reliable cues to go outside at 12 weeks. He picked up the basic commands - sit, down, come, stay - faster than any other dog I've trained. We went took classes in Basic Manners, CGC, Agility - he picked up everything like a sponge.

At home he was sweet, demanding, clever, affectionate, playful. Everything you want in a dog. He'd get the zoomies, woo-woo at the doorbell, play fetch, go for hikes and walks. He loves all other dogs, he loves all other people. He's brave - not storm or sound phobic at all - and brash and amazing. He's the best dog I've ever known.

On May 26, 2008, Lucky looked at his breakfast, picked at it a bit, looked at me, and went to curl up on the couch. This isn't unusual for him when the weather turns warm and it had jumped from 50º to 80º in a day, so I didn't think much of it. However, as the week wore on and he continued to snub food with more regularity, we became concerned. I set up a vet appointment for that Friday. I got home at 3pm and found he hadn't eaten his morning cookie for the first time all week. We went to the vet. Nothing came up on the physical exam. He had been drinking and peeing normally. Temp was normal. Everything FELT fine. So our vet drew blood for some labs and took a stool sample. The results would be in the next morning. She sent us home with some sucralfate (basically something to soothe his stomach) and some bland canned food.

Saturday morning the labs came back. Our vet called and said "I am concerned with his blood work. His BUN is high, and his electrolytes are off. I want to get him in this morning to test for Addison's Disease."

There was much cursing as I hung up the phone. I rushed him over to the vet for the ACTH response test, which would take 2 hours to complete. After the test was over and they'd collected the blood samples they needed, they gave him a steroid injection and some subcutaneous fluids. Basically, they treated him as an Addisonian dog just in case. As the vet said "I don't want him going into a crisis over the weekend and this won't hurt him." The lab would would be back on Monday. He started to improve over the weekend, eating food again and being a bit more active.

Monday morning the vet called back and 3 little words changed everything: "He has Addison's." Even though I had been steeling myself for this diagnosis since Saturday morning, the blow was still crushing. My dog was sick with a chronic disease. He would be on medication for the rest of his life. She asked if we could get him in that day for his first injection. Of course we could.

The medication he's on is a daily prednisone pill, to basically give him the cortisol his adrenal glands don't produce, and also an injection given every 3-4 weeks (depending on the dog), to help replace the aldosterone that is missing. These aren't cheap! The bottle of DOCP is $120 and lasts perhaps 2-3 injections, depending on the dosage. The prednisone costs about $22 for 100 pills. So, every month, we will be spending $50-$70 on medication that keeps our dog alive.

On top of the medication, we have to do our best to keep him out of "stressful" situations. We have to watch his behavior and take any one of the vague signs that could signify an impending problem - depression, lethargy or weakness, vomiting, diarrhea, weight loss, and/or a lack of interest in food - incredibly seriously. It means a lifestyle change for all of us.

Not quite what we expected when we brought that bundle of fluff home.

But, Lucky is still living up to his name. He was lucky to be born. Now he is lucky that we caught the disease before he became really sick or went into a crisis. He's lucky we can afford the medication....with a few budget cuts here and there. We're all lucky to have a great support network in our friends, veterinarian, breeder (who has handled his diagnosis with admirable aplomb), and the extended PWD community.

And, even though this isn't quite what we expected, we're lucky to have him in our lives.