Encephalitis! Lexie The Wonder Dog

From Bigfork Motorcoach Resort in Bigfork, Montana, Bella Terra Motorcoach Resort of Gulf Shores and points between. 

Our girl, Lexie

This is a hard to write post. I started it in August 2016... finished it in May 2017. It's long too.

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.

Crate rest

The fourteen day steroid treatment was extended (with guidance from the vet in Camp Verde) long after we left the area. Lexie's painful symptoms reappeared within 48 hours anytime we stopped the steroid. Strict crate rest was started mid May (as instructed by the Camp Verde vet) while we were in Park City, Utah. Alternating day steroid treatments, along with rest, continued until the first week of June when we reached our summer destination at Bigfork, Montana.

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.

Early the first day at Bigfork, I called for an appointment at with Barbara Calm, DVM at Calm Animal Clinic. She is a well respected animal acupuncturist but she was out of the office for ten days. Unstable on her feet and moaning in pain, I asked if someone else could see Lexie. We went in immediately and saw Meg Gordon, DVM. That examination resulted in the removal of all steroids for 72 hours, then the introduction of Novox (an NSAID) in its place along with the tramadol, gabapentin and continued crate rest. A definite diagnosis still eluded us though.

The most humiliating part of the exam. Pop assists. "Mom, put that camera away!" 

We followed Dr. Gordon's instruction to the letter, but three days later, as Lexie's moans grew louder and her rear end grew less stable, we returned to the clinic for yet another examination. This time with Karen Hartle, DVM who called for another full compliment of blood work, xrays, urinalysis and ultrasound -- and the addition of a possible hernia and kidney stone diagnosis possibly exacerbated by luxating patella. Still the IVDD, suspected some 90 days earlier, couldn't be absolutely diagnosed upon close examination of the xrays. I scoured each picture alongside the doctor. In the end, Dr. Hartle referred Lexie to Washington State University Veterinary Teaching Hospital in Pullman, Washington -- some 300 miles, 6 hours away. Crate rest continued.

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.

So on Monday, June 15th, three months after Lexie's first painful symptoms, Wayne and I packed a bag, loaded our entourage into the truck and headed to Pullman, Washington. Dr. Angela Nguyen in ER., ICU and Critical Care services listened intently as we described what we observed in Lexie.   Dr. Nguyen proceeded to give Lexie another complete workup.

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. 

On the fifth day after discharge from WSU, Lexie returned to Calm Animal Clinic, for her first acupuncture treatment from Barbara Calm who called us in 45 minutes late with an announcement that she is chronically late to appointments and is a musician. She attributed her tardiness to being such an optimist. Funny thing, I'm an optimist and I'm always on time. Dr. Calm followed the first statement by saying she was running late for a music appointment. I suggested we reschedule as Lexie's condition is the most important going in our life at this time. Dr. Calm realized our serious concern and insisted that we would not be shortchanged on acupuncture treatment visits. We visited briefly to review Lexie's history to this point in time and then Dr. Calm performed her first acupuncture treatment. She reduced Lexie's Metacam dosage by 2/3 and told me to start her on "Harominize the Qi" a Chinese dietary supplement. The acupuncture seemed to help.

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
initial exam. 

Next morning, a consult call to Calm Clinic in Kila let to a second visit to the teaching hospital at WSU in Pullman. Lexie had a 10 a.m. appointment the next morning in the neurology department. As is customary at a University teaching hospital, we were again assigned a 4th year vet student. Julia examined Lexie and reviewed the history, comparing it to the file she had from our first visit. We shared details of Lexie's new symptoms and were in great hopes we would find answers.

Tom Jukier, WSU Neruologist
 Diagnosis: food allergy
Wrong. 

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.

I pre-loaded the three syringes with the anti-seizure medication and we began our third 300 mile trip to Pullman, Washington from Bigfork, Montana.  The ride was brutal. I kept a constant eye to the back floorboard of the truck where Lexie and Ozzie were riding. By now, we knew the route so well. The first 1/3 of the trip through Montana along the rivers edge to St. Regis, Montana where the journey's second third began along Interstate 90 west to Coeur de Alene where we encountered the hardest part of the trip along the mostly 2-lane road south to Pullman, Washington.  To our dismay, Lexie did not have a single seizure during the trip and we reached WSU mid-afternoon of Friday, July 8th.

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
WSU Neruology

Finally Monday morning, July 11th arrived. The MRI was scheduled for 10 o'clock. Dr. Angela Nguyen (who we really liked by now) called to let us know that Lexie was fine and the MRI was on schedule. Lexie did have a seizure a few hours earlier but it was controlled quickly. We held our breath and tried to busy ourselves riding around town, stopping in at one of the department stores and eating late breakfast. By 10:45, the Neurologist, Dr. Sasha Dixon called with the encephalitis diagnosis. A spinal tap had been done. The evidence was clear and undeniable. We were thrilled that it was not a brain tumor.  The neurologist invited us to view the images and the white area of Lexie's brain was clearly visible. Now what?


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

Two days later, Lexie left WSU in Pullman for the last time with a half dozen prescriptions. All four legs had been shaved and showed signs of having the iv tubes inserted. A small area at the base of her skull, her tummy and a 4" square swath on her back (near her tail) were shaved too. But she was beautiful. She weighed just over 6 pounds, a loss of more than 2 pounds. Negative fungal,  bacterial and insect born test results allowed us to drop two or three prescriptions soon after but a hefty regime of meds for inflammation, pain and seizures will stay with us forever it seems.

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. 

Lexie's recovery was quick, beautiful and without incident. She regained the pounds she lost and never missed a beat on her short walks. So much prednisone caused her hair to thin but she recovered.

We stayed in frequent touch with the folks at Calm Animal Clinic as they would monitor Lexie's progress and communicate with the Dr. Dixon at WSU for the next 60 days or so.  Finally on August 24th, we returned to Calm Animal Clinic for a final exam, including blood work, to be sure Lexie was well enough for our journey south where Auburn's Vet School would take over her care.

Dr. Barbara Calm holding Lexie while Wayne holds Ozzie. 

It was a long and frightening journey for us but in the end, Lexie and Ozzie both managed to lose their fear of the veterinarian office. This post, begun long ago, is finally finished this last day of May 2017.  Lexie is well and happy. Ozzie too. Wayne and me too.

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! 

Summer at Bigfork, Montana

Bigfork Village Motorcoach Resort, Bigfork, Montana        We arrived on June 4th and spent June, July and August here. I found the resort online the day before we left Brigham City. I called Peggy Hinkle, the property manager who had one lot available for the entire season if we wanted it. The resort is a small  -- 29 sites, all individually owned. There are no amenities or on site manager but the large lots are quiet and filled with tremendous Ponderosa Pines -- just what we wanted. It was a two day drive in the rig from Brigham City. We overnighted at a truck stop in Butte, arrived the second afternoon and signed on for the first month.

From the roadside on the way into Bigfork. 
Snow capped mountain peaks behind the Swan River

The village of Bigfork is on the northeast shore of Flathead Lake, a spectacular beautiful blue lake, proclaimed to be the cleanest in the country. Our campsite (and the whole resort) is a short walking distance downhill to Bigfork village, a tiny but vibrant place for shopping, strolling and eats. (It's a walk uphill back to the resort though!)  The nearest suburban shopping area is 30 miles north around the northeast of the lake in Kalispel.

Entry to Bigfork Village Motorcoach Resort and our site, behind the sign.
Deer feast on the flowers in the bed here around the old wagon. They ate the flowers I had around the deck too.
It's not terribly uncommon to see bear here. 

A nice large concrete patio and wide driveway.
There's a small storage house in back filled with everything needed to be comfortable here. 

A few weeks after we arrived, Chula Vista friends, Penny and Bob, were scheduled be in Polson Motorcoach Resort, 20 miles south of us. We hoped to see them but I knew they had a hectic schedule and guests. To our surprise, they, with guests in tow, stopped by late in the afternoon of July 4th. It was good to see them but it was a short visit and I didn't get a photo to include here.

Our three months at Bigfork were a mix of good memories and bad experiences because of Lexie's health (described in painful detail in other posts). While we saw countless beautiful rivers, mountains, wildlife and skies, we grew weary of being in such a remote part of the country. Here are some of my favorite scenes from around the area.

A storm was brewing somewhere along the northeast shore of Flathead Lake 

A bright yellow blooming field of canola on the route from the resort to Calm Animal Clinic.

Barns in this area are especially photographic. Also along the route to the vet. 

Roadside view north from Polson to Bigfork 

The long ordeal of getting Lexie's medical diagnosis finally ended in mid July. Two weeks later, Tom and DJ arrived for a two week rendezvous. It's been a long time and it was good to see them. We enjoyed many hours visiting on our patio. 

Tom, Wayne and DJ on the first evening... eating pizza. 

Grilled elk steak, sweet potatoes and cole slaw.

Tom and DJ brought loads of food, as they always do and I tried some of the grilled elk.

From their last fishing trip to Alaska, they also brought a gift of delicious salmon and halibut. We had a night of Tom's fried trout and hush puppies too.

Oh, how good it is. This is the only time we eat from the wild.

Another day, we all strolled the streets of Bigfork, attended a street fair and ate fresh, warm apple bread at a local bakery.

Drat!  DJ got the last apple fritter at Brookstone Bakery. 

DJ and me with the dogs in tow. Yep, this was a hot day. 

Good restaurant luck was with us here as we located several superb Bigfork eateries along with a couple of good places in Kalispell.

Patio dining at Flathead Brewhouse Restaurant

Our view of Flathead Lake from the patio of Flathead Brewhouse

Tom, DJ and Wayne
We enjoyed great shrimp and fish tacos at Flathead Brewhouse

Saddlehorn Patio Restaurant. Also along the lakeshore near Woods Bay. 
A favorite outdoor restaurant for burgers. 

Another view of Flathead Lake from Saddlehorn Restaurant

In Cathedral City last year, neighbor Bob gave me a nice set of ladies graphite shaft golf clubs left behind by a neighbor who no longer played. It was a good full set but I have new ones that I enjoy using. Wayne carried the clubs in the truck until we found someone who wanted them. DJ became the recipient as she plays but didn't have clubs with her this trip.

Going pro. 

We located a 9 hole pasture golf course and DJ tried the new clubs. We had so much fun that DJ and I would go back for a second round.  The local Bigfork course, Eagle Bend, boasted a much higher play rate and their driving range fee was $20 per person.... but that rate is for an entire day with unlimited balls. The course is very near the campground but we only took an afternoon of practice balls there.

DJ, Tom, Wayne and I also spent a day kayaking the Swan River. We rented kayaks at Base Camp Bigfork (highly recommend) and took the 15 mile ride to launch. Unexpectedly, the historically rapidly moving river has dwindled to a trickle and the "float" turned into a half-day work out for us. We had fun, nevertheless.

I took this picture of Tom and DJ ahead of us. Wayne is to my left. 

The Wayner 

DJ. My pictures are awful. DJ has better ones. I'll try to replace someday.

We met just three couples while at Bigfork Motorcoach Resort. Neither developed into real friendships. Several owners seem to take their ownership roles a bit too seriously, I think. I did develop a good friendship though, with the off site property manager, Peggy.

At the end of three months, on September 4th, we left Bigfork Village Motorcoach Resort. We are glad to be pulling out. It's not that we didn't like being here. We enjoyed it as much we could under the circumstances. It's more that the memorable part of our visit will likely be the worrisome experience of Lexie's illness.

Cold, Rainy August Day At Glacier

From Bigfork Motorcoach Resort, Bigfork, Montana        It's been four years since Wayne and I saw Glacier National Park the first time. A mere 40 miles from Bigfork, we couldn't pass up a second day trip there with Tom and DJ.

The weather forecast called for overcast skies, a slight chance of rain and a chilly high of 69 degrees in Kalispell. It would be much cooler still at Glacier.  We all dressed accordingly, except Tom, who wore shorts, of course.  By 9 a.m. we had stopped at the local Subway for sandwiches and were headed north toward Columbia Falls and Glacier National Park. Lexie and Ozzie went too, snuggled in their bed between DJ and me in the back seat of the truck.

The ride north on U.S. Highway 2 took us through some fabulous scenery at Flathead National Forest to the east. 

Tom, DJ, me and the Wayner
This photo was actually taken at the end of our Glacier visit. 

Entering at West Glacier on U.S. 2, our national park visit started at the West Entrance and Park Headquarters where we mapped our route.  Next was Apgar Visitors Center. We stopped for information there before setting out toward Going-to-the-Sun Road north along the eastern shore of Lake McDonald. Fog could be trouble for us today. Rain too. 

Snug, to say the least, each red bus seats 17 -- four across on bench seating and one passenger in front. 

These "Red Buses" are from the 1930's and are part of the earliest history of Glacier National Park. The full fleet numbers 33 and is considered to be the oldest touring fleet of vehicles in the world. The buses have roll-back tops for vertical viewing through the park. We did not opt for the Red Bus tour. We have dogs.

DJ and I walked the grounds around Lake McDonald Lodge and peered into Russel's Fireside Dining Room which was not yet serving customers.

Lake McDonald Lodge

It was downright cold on this damp, overcast day so my excursion around the grounds of was shorter than I would have liked. I rejoined Wayne and Tom in the truck and soon, DJ emerged and we continued our ride.

The 50 mile Going-to-the-Sun Road bisects the heart of Glacier, and hugs the cliffs just below the Continental Divide. It was harrowing at some places.

The air got cold and the fog crept onto us as we eased our way up, up, up into the mountains. Every stop for picture taking was colder than the one before. We finally reached Logans Pass Visitors Center where I thought surely we would freeze. Ozzie and Lexie stayed snuggled their bed under blankets while we four ran through freezing rain to the jam-packed information center and the all important restrooms.

White dots in the center are flowers in bloom.

A final photo op stop for DJ who climbed along the wall for this shot.

We all were a bit disappointed but visibility was just too poor to proceed.




We returned to the truck and inched our way back the way we came through thick fog.

The good news is that we were on the inside lane of the road coming down. A bit less scary.

Back at a reasonable elevation, we came into a group of shops where we devoured the Subway picnic sandwiches we had brought along. Tom located a store selling hot chocolate. Yum. Warming to those chilled bones.

DJ, Tom and Wayne finish a warming cup of cocoa. 

We browsed the shops but made no major purchases. Before leaving the area, we snapped the picture at the top of this post.

Meanwhile... back in the truck. Two furry troublemakers destroy a Glacier National Park brochure and a plastic bag in protest of being left behind.

"Ozzie did it"

So we made our way back to Bigfork, where the weather was splendid. The four of us ate dinner at Bigfork Brewing Company again. Nice to be with friends.