Rolling Dog Farm Blog

I had a call this evening from Dr. Kristin Gablehouse, one of the equine surgeons working on Brynn, with an update on our little foal.  The doctors did another round of endoscopy today.  They were hoping to find that Brynn’s two ectopic ureters — the tubes that normally take urine from the kidneys to the bladder but are ending up in her vagina instead — were in close proximity to her bladder.  Specifically, they wanted to see if her ureters were laying across the outside of her bladder wall and might actually share some tissue with the bladder wall.

In that case, it would be relatively simple to tie off the ureters at the open end, just before they enter the vagina, and then from inside the bladder punch a hole through the bladder wall and into the ureters.  This would allow the ureters to empty straight into the bladder, like they were designed to do.

Unfortunately, they found the ureters are NOT that close to the bladder, so Plan A went out the window today.  This means more diagnostics tomorrow … and then we’ll find out what Plan B is!

Dr. Gablehouse and her colleague Dr. Ragle are trying to find a way to "fix" Brynn’s plumbing that can be done under sedation if at all possible, rather than general anesthesia.  Because of Brynn’s hole in her heart, called a ventral septal defect, or VSD, she is at risk for anesthesia.  Anesthesia is always risky, but the hole in her heart puts Brynn at greater risk.  If she has to be put under anesthesia, the surgeons will first do an echocardiogram of her heart to find out if the hole has gotten any larger and determine the specific level of risk.

I took the photo above of Brynn several weeks ago when  Alayne was walking her back to her stall in Beauty’s Barn.  It has nothing to do with this update, but I think it’s always nice to see the animal you’re reading about.  The blanket Brynn is wearing was a Christmas gift for her from some very sweet kids here in Montana.

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Alayne and I wanted to thank everyone who posted on our blog such wonderful, heartfelt and supportive comments about Claude, or who emailed those same sentiments to us.  It means a lot to us, and we are very grateful for your support, believe me.  We try to share as much as we can about what goes on here, both the happy stuff and the things that break our hearts.  But it’s particularly difficult when we have to make really tough decisions, like we did on Claude, and do so very publicly by writing about it on the blog.  We’re never quite sure how folks are going to react to the decisions we make, but we feel all we can do is explain what we’re thinking and why, and then let everyone decide for themselves if they agree or not.  Alayne and I were very touched by all of the notes and comments we received about Claude … thank you so much.

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Nichole and I got back to Montana about 10 p.m. tonight; I dropped Nichole at her house and then headed to the ranch.  I took the photo shortly after I let Claude out of the truck to walk around the yard for a while before coming inside.  He immediately found the cot.  (He loves those cots!)

This morning at the veterinary teaching hospital we met again with the neurologist and the attending veterinarian to tell them we had decided not to pursue the surgery and explained why.  I told them that this was the most difficult medical decision we had ever made.  In fact, it was the first time in more than six years of running the sanctuary that we had decided NOT to do surgery on an animal.

Much to my relief, the neurologist told me he thought we had made the right decision in Claude’s case.  He said that the medical team there was concerned about the prognosis for Claude following surgery, and that given all of his issues, they didn’t think surgery was necessarily the best option for him.

I had second-guessed myself many times during a sleepless night and again this morning before we got to the hospital.  Were we making the best choice for Claude?  Could the outcome be better than the neurologist predicted?  What if…?  But when I heard him say we had made the right decision for Claude, all the second-guessing stopped.  I told the neurologist, "You know, I really needed to hear that.  Thank you."

The attending veterinarian told me later in the morning that if Claude had been her dog, she would have made the same decision we made.  Whew.

So then we discussed the near-term treatment plan for Claude for medical management of his neurological and orthopedic diseases.  This will involve steroid therapy, lots of quiet time, a special diet, and mild exercise.

I felt even better when the neurologist told us that medical management of Wobblers Syndrome can be just as effective as the surgical option, so we should not consider this treatment plan a ‘second rate’ alternative.

With the discharge instructions in hand, we loaded Claude into a giant crate and lifted him into the back of the truck … and off we drove to Montana.

Meanwhile, Miss Brynn the blind foal stayed behind at the hospital for more tests.  The staff called me on my cell phone tonight when Nichole and I reached Missoula to tell us that Brynn was doing fine.  At this point I have no idea when we’ll be headed back to pick her up, but we expect to hear tomorrow about the next round of diagnostic results.

This was a distressing day.  What we learned about Claude the blind Great Dane puppy was heartbreaking.  I took this photo just before he was put inside the MRI machine at around 12:30 p.m.  About two hours later, we met with the neurologist to learn the results.  It turns out that Claude has a severe case of Wobblers Syndrome, and his spinal cord is significantly compressed at three different areas in his neck … at the juncture of vertebrae C3 and C4, C4 and C5, and C5 and C6.  On the MRI images we could see the normally round spinal cord was squashed into a flat, almost box-like shape.  It made us flinch looking at it. 

But that wasn’t all.  After reviewing the MRI results with us, the neurologist said, "I wish that were all I had to tell you, but I have some more bad news."  Oh no.

He reached over and put two X-rays on the lightbox.  I could tell before he said anything that we were looking at a very bad pair of hip joints.  One looked like the ball was almost out of the socket.  Those were Claude’s hips.  At 10 months of age, he is already suffering from a severe case of hip displaysia.  I would have guessed that the radiographs belonged to a 15 year-old dog … not a puppy.

I sat there, just floored.  Severe hip displaysia in a 10-month old puppy?

And then we had a long and difficult conversation about the surgery for Wobblers Syndrome, likely outcomes, and what our options were given the orthopedic findings. 

(Claude’s case is the type of Wobblers Syndrome that afflicts young, giant breed dogs, and is different from the Wobblers Syndrome seen in older Dobermans.  It’s a different disease process.)

The neurologist said that Wobblers Syndrome was his "least favorite disease to treat."  To begin with, the surgery — which takes 6 hours and requires three doctors and a support team of three vet techs — typically doesn’t improve the dog’s condition.  Although occasionally you’ll see an animal with a slight improvement in symptoms, generally the best you can hope for is to stabilize the condition and prevent any further deterioration.  This means Claude would remain like he is today … stumbling, falling down, knuckling over on his feet, and sinking to his knees when he pees.  In fact, the vet hospital here generally does five of these operations a year, and they’ve found in follow-up studies that a year later, on average only three cases have what they consider "decent" outcomes. 

We would not want Claude to live like he is today.  Since this started, we’ve seen the spark disappear.  And we know he would suffer pressure sores and constant wounds from dragging his rear feet when they knuckle over.  (Because he can’t feel this happening now, he doesn’t even know he’s doing it.)  Add to this Claude’s already severe hip displaysia, which will only get worse and more painful in coming months, and now we’ve got a quality of life decision to make.

In the best of all worlds, choosing to do the surgery is a major deal … the neurologist said the surgery and 10-day hospital stay for recovery would cost $6,500 to $7,500, and he described it as a "painful procedure" to insert the apparatus that would stabilize his neck — essentially an acrylic cement plate and dozens of screws affixed to his vertebrae.

After two rounds of conversations with the staff at the teaching hospital, a long phone call this evening with our primary care vet in Helena, Dr. Brenda Culver, and several calls with Alayne to review everything we learned today, we concluded that we would not put Claude through this.  Making this decision was agonizing.  We’ll do everything we can medically for an animal, but we have to know the outcome is worth it … and to see Claude continue like this, and to suffer from hip displaysia on top of it, doesn’t seem like the right thing to do for him. 

We’ll bring him back to the ranch tomorrow and then love him up as much as we can before we have to say goodbye.

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Compared to Claude, the news on Brynn was, well, okay.  After a lengthy endoscopy procedure, we learned that Brynn has not one but TWO ectopic ureters, both of which are emptying urine into her vagina.  But she also does have a good-sized bladder, and the reason she seems to have some bladder function is because the urine is flowing back down from her vagina into the bladder.  When it fills up, she actually will pee like a normal horse.  And when we thought we saw urine in her uterus on ultrasound when she was two weeks old, well, we did … she had urine in there today, too.  That’s because the urine is leaking backwards from her vagina and down into her uterus.

The surgeon, Dr. Claude Ragle, needs to run further diagnostics this week, but he was cautiously optimistic that he might be able to re-route the ureters into Brynn’s bladder.  But we won’t know for sure until he completes his tests.  Surgery would not occur until Thursday this week.

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We brought Claude the blind Great Dane puppy and Brynn the blind foal to Washington State University’s College of Veterinary Medicine today.  Our wonderful horse trainer, Nichole Zupan, joined me on the trip to share driving and animal care duties along the way.  I took this photo shortly after we got Brynn settled in her stall.  We were greeted by a very friendly team of veterinarians and fourth-year vet students.  With Claude is Dawn Evert on the left and Lindsey Waffle on the right, both of whom will graduate from WSU’s vet school in May.  Nichole is holding onto Brynn, keeping her from walking over Claude (i.e., the blind trampling the blind).

We have a 10 a.m. appointment tomorrow with the veterinary surgeon for Brynn’s evaluation and an 11 a.m. appointment with the neurologist for Claude’s evaluation.  By the end of tomorrow, we will have a lot more information on both animals.  Stay tuned for updates on the blog!

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I took this photo of Alayne with Claude the blind Great Dane puppy yesterday morning before she took him to our vets.  By evening, we had a very troubling diagnosis for this boy.

Ever since Claude arrived last fall, we’ve been concerned about his development. His spine was hunched, he was sort of flat-footed, and he never gained the kind of weight we thought he should.  We had two physical and neurological evaluations done, but there was nothing conclusive other than he had carpal laxity syndrome, which was why he was flat-footed.  As he grew, his back never really straightened out, and he became a bit clumsy.  At times it was hard to decide whether this was the awkwardness of a giant, goofy blind puppy, or whether something else was going on.

Despite the inconclusive evaluations, Alayne and I suspected there WAS something else affecting Claude, but we didn’t know what.  We even turned down an offer to adopt him a couple of months ago because of this concern.  Then, in the past two weeks, he began to get really awkward.  He’d slip and fall inside the house for no apparent reason; as he walked, he’d swing his rear legs out in a wide arc; other times he’d have trouble getting up.  And yet these were fleeting moments, and much of the time he was just fine, running and carousing like the 10-month old goofball he is.  But the frequency of these episodes increased in the past week, and we realized it was time to take him back for another neuro evaluation.

So yesterday our internal medicine specialist in Helena, Dr. Britt Culver, examined Claude again.  This time, the diagnosis was grim:  Claude may have Wobbler’s Syndrome, a neurological disorder that affects young Great Danes and older Dobermans.  In fact, Claude is at the typical age for the onset of symptoms and he has the classic signs.

Essentially his vertebrae are growing in a way that they begin constricting the spinal cord, interfering with the body’s ability to transmit nerve signals.  This is a progressive disease, and sometimes it can be managed medically, other times only with surgery … and even then, the outcome is not always assured.  The reason is that surgeons could "fix" the one or two vertebrae pressing on the cord now, but as he grows, new constrictions could develop elsewhere along the spine.  One veterinarian used a freight train analogy:  say you have a derailment because a couple of freight cars get uncoupled … you get them back on the track, start going again, and then two more cars become uncoupled.

What we need now is more information — how severe the cord compression is, how many areas are involved, what the rest of the vertebrae look like.  This means a trip to Washington State University College of Veterinary Medicine to see a neurologist and probably to get an MRI done.

As it happens … we have Brynn’s appointment scheduled at WSU for next Monday, February 5th, so we’re doubling up and will be taking Claude along as well.  We scheduled Claude’s appointment this morning, and we were fortunate that they could get us in on such short notice.  (I was going to devote tonight’s blog to Brynn’s upcoming appointment, but was obviously overtaken by events.)  So stay tuned for lots of medical news on the blog next week!

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I know this photo will probably make you cringe — sorry — but Alayne brought blind Turtle home this afternoon from the vet clinic after her eye surgery.  Turtle was blind from uveitis … something we’re more likely to see in our blind horses than in our blind dogs and cats … and her eyes had remained comfortable until last week, when we noticed some irritation and changes occurring. 

Our vet in Helena, Dr. Brenda Culver, did an exam and found that the lenses in both of Turtle’s eyes had detached and fallen against the cornea.  That’s what was causing the irritation and, as it turned out, pain.  The eye is such a complex structure and changes in any one part can cause a cascade of other things to happen.  That is especially true of an eye disease like uveitis, which triggers inflammation.  It’s like a house of cards collapsing.

Brenda concluded that the only thing we could do for Turtle to give her relief was remove her eyes, a procedure called enucleation.  Brenda did the surgery yesterday.  This is always so hard, seeing them come home without eyes.  As often as we have had to do it … in dogs, cats and horses … it is always a bit startling to see an animal you’ve known with eyes to suddenly have no eyes.  But ultimately we know that they are pain-free, and since they were blind to begin with, that’s all they know too … that the pain is gone.

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I took this photo today of Alayne coming back around noon from Widget’s House, our main dog building there in the background.  Wherever Alayne goes, she has a little cluster of dogs that follows her down to the gate, waits for her, and then leads her back, as you see here.  Just before I shot this photo they had been milling around her feet, and she was threading her way through the throng (oooh, please notice the alliteration there!).  Then the cluster unwound itself and starting stringing out along the trail.

Big blind Kenai is in the foreground; she had headed down to meet the ensemble and turned around to come back.  Next is Holly, the tan dog with curled tail, who is typically in the lead.  Holly is our director of home-ranch security and sees her main job as protecting Alayne from all dangers, real and imagined (i.e., all imagined).  She is always in front of Alayne, clearing the path.  When she thinks too many dogs are crowding Alayne or not showing her enough respect, she charges in, barking like mad, to restore order.  (Creating chaos in the process, of course.)

Holly is not disabled — she was a semi-feral stray who was dumped out here a few years ago.  We socialized her and I was preparing to adopt her out when Alayne, in a moment of weakness, overruled me and said she was staying.  (That’s a long story for another blog post!)  Holly — or "Agent Holly," as she is also known — settled into her role protecting Alayne.  Why she thinks Alayne needs a personal bodyguard we don’t know.  Maybe since she’s not disabled Holly figured she needed a job to justify staying at the ranch.  Oddly, Holly sees me as a sparring partner, someone to roughhouse with … she’ll often try to start a "fight" by coming at me prancing on her two back feet, pawing at me with one of her front feet.  (Human/canine relationships can be quite complex, eh?)

Next in the line behind Holly is blind Goldie, while three-legged Cody and Birdie are at Alayne’s side. Hidden behind Cody is little Daisy the miniature Dachshund,who had been patiently waiting at the gate for Alayne, along with the others.  Coming in from the left is blind Evelyn,who’s always been a party girl and thinks it sounds like fun over there somewhere.

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Blind Goldie loves soft squeaky toys … but really only the squeaker inside them.  She can smell a soft toy no matter where we try to hide it, but if it turns out not to have a squeaker in it, she’ll the drop the toy in a second and wander off.  No squeaker, no fun.

Her only goal is to rip the squeaker out, chew on it for a few minutes, and then come to us looking for a new toy.  She has no interest in the toy itself.  Occasionally Goldie’s approach is to shred the entire toy, scattering the stuffing everywhere, and then happily crunch the squeaker while she lies amidst the fluffy ruins of the dead toy.  The squeaker is like a trophy of some sort.  (She never eats it, by the way … just chews on it until it’s punctured so it can’t make any sound, then she abandons it.)

But Goldie’s more common approach is what we call ‘heart surgery.’  She chews a very small, precise hole in the toy, carefully extracts the heart — i.e., the squeaker — and then leaves the toy behind intact.  To show you what this looks like, this afternoon Alayne and I put Goldie on a chair next to one of her recent successful "heart operations."  Notice that little hole in the chest of the toy … it’s exactly the size the squeaker was.

The real beauty of this is, we still have a toy left to give the other dogs!

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Alayne and I had just finished feeding the dogs yesterday evening when I looked over in the living room and saw this scene — that’s blind Callie on the left, sharing the cot with her friend blind Kenai. 

You’ll notice the eyes look very different.  Callie is blind from progressive retinal atrophy, so her pupils are completely dilated to let as much light in as possible.  The glow you’re seeing is from the flash bouncing off the retina in the back of the eye.  (Regular blog readers will remember seeing Callie’s "glow" from earlier photos.)  Kenai, on the other hand, is blind from cataracts, which is why you’re seeing the light reflect off the white lens in each eye.

This scene reminded me that Callie has a thing for big dogs … she loves curling up with them, sleeping next to them on cots, or just hanging out next to them.  Now, we have lots of smaller dogs here, like Widget and Goldie and the rest of the Dachshund brigade, but Callie seems to prefer the big dogs like Kenai (who tips the scales at 100 pounds).  We’ll often find Callie also snuggled up next to blind Helen, our 105-lb Rottie.  She also loves grooming them, as I showed in a post from last November.

I know "big" is relative when you’re a Dachshund, but this plump little girl definitely likes her big friends.

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If you missed the Today Show segment this morning — yikes, it finally ran in the last 15 minutes of the 3-hour program! — it is now available online at the Today Show Web site here.  Click on the "Launch" button under the photo of Alayne with blind Penny and that will bring up a new window with the video.

We will be getting a tape of the Today story from NBC that we can digitize and post on our own Web site, but that may take a week or so before we can get it turned around.

We’ve had a phenomenal response to the Today piece — it will take us days to reply to all the emails we’ve received just today … more than 400 to me and over 150 to Alayne!  So if you don’t hear from us immediately, please bear with us … you’ll know why!