|Our girl, Lexie|
As far back as March 2016, we anxiously searched to find out what was wrong with Lexie. It began when she lost enthusiasm over the raw carrot treats she gets when I make dinner salads. That evening she seemed unable to maneuver going up or down her foam rubber steps to the sofa seat. We sought veterinary services but no abnormalities could be identified from xrays or ultrasound. Her blood work showed elevated Gobulin which indicated there was some inflammation and it was determined she had an infection and was started on Clavamox. With an abnormally hard abdomen, a sign of a pain, she was also treated with prednisone and a low dose of tramadol with a suspicion that the pain was in her back. Within 24 hours, she responded to the therapies and life returned to normal. (Details of this are covered in a post dated March 24, 2016.)
Less than a month later though, Lexie's pain returned while we were in Camp Verde, Arizona. Rushing her to nearby Montezuma Vet Clinic, Dr. Jennifer Boyd prescribed more tramadol and gabapentin to reduce her pain. A longer prednisone treatment was prescribed following blood tests and another ultrasound. Discussions of her painful history, her age and a common malady of her breed, Inter vertebral Disk Disease (IVDD) was suspected but couldn't be diagnosed with certainty. I researched IVDD, spoke with friends who had experience with pets suffering from it and felt certain it was Lexie's problem. I administered prednisone like clockwork so she could rest and recover.
|Our comfortable site at Big Fork Village Resort and RV Park|
Eager to get a clearer diagnosis of Lexie's condition along with alternative treatments (in which I placed my hope now) I found a veterinarian who performed acupuncture at Calm Animal Care in Kila, Montana, 30 miles or so from our campground.
|Calm Animal Care practices in the little brown building on the left. Just look at this lovely rural setting and Ponderosa pines.|
Owner of this Kila, Montana practice is Barbara Calm. Really, that's her name.
|The most humiliating part of the exam. Pop assists. "Mom, put that camera away!"|
|The second visit to Calm Animal Clinic. Waiting for test results.|
|Ozzie and I sit for a picture with Dr. Angela Nguyen,|
She is an instructor, WSU Vet School ER and ICU Critical Care Vet.
She also is our WSU Vet School champion.
We took a room at the local Holiday Inn for two nights while WSU's Internal medicine, orthopaedic, radiology, rehabilitative services and theriogenology teams performed exhaustive exams of Lexie. In the end, their findings were "urinary tract infection," some "possible mild muscle atrophy" and "decreased resistance to hip extension and bilateral Grade 1 luxating patellas." Lexie was given an acupuncture treatment. No test, except MRI, were spared to pinpoint Lexie's pain. We talked about having the MRI, but decided against it given Lexie's condition and age. Everyone hoped we were onto something now.
|Jessica Bunch is a Certified Canine Rehab Therapist and DVM|
|Mushtaq Memon, BVSc, Ph.D., Theriogentologist at WSU shares some humor with Wayne.|
Wayne needed some humor by this time.
While at WSU, Lexie received one acupuncture treatment and laser therapy with recommendations to continue these sessions with Barbara Calm, DVM in Kila and to begin administering Chinese herbs. We returned to Bigfork with new bottles of omeprezol, tramadol, gabapentin, clavamox and a new NSAID, Metacam, making a demanding "every 8 hour" regime for Wayne and me. It wasn't easy administering all the meds... empty stomach, with food, every 8 hours and so forth. It was a challenge... and I hadn't even looked into the Chinese herb therapy yet.
|Ozzie always waits with us. |
Here, we're joined by Janne Lyngby, DVM, MS Small Animal Internal Medicine Resident who is charged with Lexie's case.
Crate rest continued... now into seven weeks.
Lexie's walk was almost normal for the first few days after but 6 nights later I was awakened by the sound of panting and moaning. She was pacing all over the bed, walking across me -- something she never does, and had begun trying to bring her rear foot up to scratch her upper body every few minutes. Additionally she had begun gnawing at her groin / mammary area.
|Julia, our 4th year student gives Lexie's|
|Tom Jukier, WSU Neruologist|
Diagnosis: food allergy
Upon examination by WSU Vet School resident neurologist Tom Jukier, Lexie was returned to our care with his surprise diagnosis of food allergies and luxating patellas. I gasped when I heard it but we listened intently to his explanation and felt our concerns were falling on deaf ears. Perhaps they all thought we were just crazy hypochondriac dog owners. We accepted the diagnosis, bought a few cans of Hills Science Diet Z/D special food allergy food and said we would discontinue all of the medications we had been giving Lexie, per the instruction. That was June 24th -- well into the third month since Lexie first showed signs of pain. We drove the 300 miles back to Bigfork wondering if we might have been wrong.... could this "food allergy" diagnosis be right? Wayne was beyond skeptical.
Lexie ate only the Hills Science Diet Z/D food for the next few weeks but she ate it with her usual gusto. We ordered a case of the canned bland food and we both watched to see possible changes in Lexie -- good or bad. During this time, I made notes on the margin of my calendar noting that Lexie had begun walking sideways and was terribly unstable. She stopped drinking water and began to urinate and occasionally defecate in the floor. She fell of the sofa when left unattended and seemed to wander aimlessly on the floor, carrying her head low. She no longer barked. We waited and watched, unsure what to do.The only time we saw any trace of the "Old Lexie" was when she became excited at mealtime.
Then, on on the morning of Thursday, July 7th, everything changed when Lexie froze in place with one paw extended upward, while out for a short walk. We jumped into the truck immediately and headed to Dr. Calm's clinic in Kila. By now, these three doctors had become our strongest advocates, though I felt sure they thought we were crazy. As Wayne raced along the country roads, Lexie had clusters of seizures, one after another. Her eyes were glazed and her little body was stiff during the seizures. As they subsided, her breathing was rapid and she panted wildly. When the seizures finally subsided, her body was lifeless except for her heavy breathing.
Dr. Calm began an iv and did blood work within minutes of our arrival. She and her staff were bewildered and told us so. We recapped the two visits to WSU. Dr. Calm suggested the seizures might never recur and could have been triggered by almost anything. She explained the difference between petitmal and grandmal seizures and she gave us her best theory as to what was happening. We discussed, in amazement, the most recent food allergy diagnosis from the second trip to WSU. We all watched and waited for another seizure but no more occurred. Wayne, Ozzie, Lexie and I stayed all day in Dr. Calm's office but nothing else happened so we went home armed with three syringes and a tiny bottle of anti-seizure medication that I was to administer if Lexie went into seizures that lasted more than three minutes. There were no more seizures all that day and we almost breathed a sign of relief hoping it was a one-time event.
|An afternoon in Dr. Calm's private office.|
But that was too good to be true. That evening Lexie's seizures began again. One just before bedtime and four or five in rapid succession during the night. None lasted the full three minutes so the anti-seizure shots were not administered. The next morning, I called Dr. Calm. I was in tears. We had to give WSU another chance. There was nowhere else to turn and we were losing Lexie. Dr. Calm agreed. Next I called Sally Anderson, in the Neurology Department at Washington State University to tell her we were on our way. Sally made sure Lexie would be seen.
The video below is Lexie in a full blown seizure. Be Warned. It is hard to watch and lasts 4+ minutes.
The Emergency Room physician, Angela Nguyen, whom we had met in our first visit, looked at Lexie immediately and could hardly believe she was looking at the same little girl she'd seen less than a month earlier. Another thorough examination began and we all agreed on an MRI for Lexie at the earliest opportunity. Lexie was started on Levitracetam (Keppra) an anti-seizure medication at 8 hour intervals and the MRI was scheduled for Monday morning. I hoped an MRI would be done immediately, but the doctors assured us Lexie's condition was stable and she was no real urgent danger.They explained that fresh minds and hands and a full staff on Monday would be to our advantage. Lexie was returned to us for the weekend with the understanding that we could return to the hospital ER at any hour if she went into seizures. We checked into a hotel and settled in for the nerve wracking weekend. Lexie would sleep in her stroller on my side of the bed, in case of seizure.
The video below was taken in the hotel room on Friday night after we left WSU. Note how Lexie's rear end lack of control. She still is loving that food though.
Sure enough at 11:30 we were awakened by the horrible screams of Lexie in the stroller. I frantically administered the anti-seizure shot as Wayne held our exhausted little girl. I called WSU and we rushed her back to the waiting medical team. The tech on duty assured me Lexie was okay though she sure seemed near death as I handed her near lifeless body over. In a few minutes a very tired Dr. Angela Nguyen emerged to let us know that Lexie was okay. She reviewed a few details of having Lexie admitted through ER for observation for the rest of the weekend. Wayne, Ozzie and I returned to see her Saturday and Sunday and each time she looked worse, weighed less and had less control of her rear legs. We all were suffering. Sunday was the worst day. We held her little limp body, tried to let her walk and attempted taking her for a ride in the stroller. This was almost more than we could handle.
|Pop with Lexie and Ozzie sit on the porch at WSU Vet School.|
Her foot isn't bloody. It's a red bandage holding the IV in her leg.
|Unable to control her back legs, we tried to assist with a walking sling|
|The good news is that she never lost her appetite. She can't stand but she can eat.|
|Sasha Dixon, DVM|
My joy turned immediately to devastation as the neurologist explained that encephalitis dogs lived, on average, two years, after diagnosis. She saw my horror I know and I think she regretted her bluntness. I concluded that the average two years could be expanded when coupled with our love, attention to medication detail and sheer determination.
|The travel route -- Bigfork to Kila and to Washington State University in Pullman, Washington|
|Unable to stand easily without assistance, Lexie is clearly happy to be with Ozzie.|
Fourth year vet student Serena Swan, explains the meds and gives us a happy sendoff soon after this picture was taken.
|An exhausted Lexie begins her journey to recovery with a mostly shaved body|
but I think she felt good the day this picture was taken. We were leaving Pullman for the final time.
|A "onesie" will protect the pink skin on her back from getting burned by the sun.|
I cut a whole in the seat for her tail.
|Dr. Barbara Calm holding Lexie while Wayne holds Ozzie.|
Of particular peculiarity... I've read that encephalitis is common in Maltese yet none of the dozen or so veterinarians, including two neurologists, mentioned it's possibility. Fascinating and bewildering.
|Sleepy Pop and Happy Lexie -- two months after the diagnosis!|