We had a real scary with Sarah on Friday.
I think an explanation as to what we are dealing with is in order to go with the video:
Sarah has Valley Fever, and it has gotten into her bones. At this time, the bone lesions aren’t so bad that they affect her much, but when she has a day when she is sore, Tremadol does the trick.
Problem is, Sarah can’t tolerate the full dose of her Valley Fever medication. It makes her very sick. Therefore, she is on a low dose. The medication is, at most, slowing the progression of the disease.
Concurrently, Sarah has severe bone spurs along her neck, due to some unknown injury in the past. Those vets that suggested surgery gave it a 50/50 chance of helping her with this problem. And those were only the vets that recommended surgery. Remember, we are also dealing with what amounts to untreatable Valley Fever as well…
Since we have had her, a couple times a year, Sarah’s neck problem turns severe. The first time it happened, she was in so much pain she couldn’t move. It came on in a couple of hours. It took nearly a month before she felt well enough to play.
It took a year of vet visits and referrals to come up with a decision. This is what it is based on:
We are not treating the Valley Fever, just slowing it. The amount of slowing is up to debate.
Prednisone is a powerful anti-inflammatory that helps with Sarah’s neck problem. Unfortunately, Prednisone negates the effect of the Valley Fever Medication. Additionally, it has serious side effects if used long-term.
Pain medications have no effect on Sarah when she has a severe neck episode, unless she has the anti-inflammatory benefits of Prednisone on board. If the pain gets too severe, Sarah is in danger of having a stroke. Indeed, one vet hypothesized that Sarah’s ‘funny’ gait is due to a minor stroke in her past.
Sarah’s world revolves around sleeping on the couch (not seriously active unless we are on walks, so she is happy ‘resting’ ). Being sedentary most of the day brings no objections on Sarah’s part (not effecting quality of life).
Sarah eats, drinks, plays and otherwise is pretty happy with her life.
The severe episodes only occur 2 to 3 times a year, and when caught early, take a week to snap out of. It isn’t the pain that takes a while – it’s her energy level. But refer back to her preference for the couch.
Despite being on Valley Fever medication, unlike her siblings, she is not getting better.
This is the ultimate treatment plan for Sarah:
Continue low dose Valley Fever medication.
Start Prednisone immediately when Sarah shows a ‘spell’ coming on. Each time, she is on it for 3 weeks in a descending dose.
Tremadol whenever she shows pain.
If Sarah’s episodes increase in number, discontinue treating the Valley Fever and put her on long-term Prednisone.
After this point, if her episodes increase in frequency, or she STARTS to suffer organ damage from the Prednisone, let her go.
Basically, we keep Sarah comfortable and happy for as long as we can, and we let her go at the point where quality of life is starting to be effected.
You might think we are crazy for what we are doing.
Remember, we took Sarah in when she was about 2, injured, skinny and scared, with an unknown history. We didn’t deliberately seek out a ‘dying’ dog.
We were told Sarah wouldn’t get better and euthanasia was the only ultimate option.
But we were also told, if we were willing to do it, we could manage her condition, and the ‘when’ for euthanasia could be pushed off to some undetermined date, estimated to be within 2 years.
The bad days, blessedly few that they are at this point, are difficult. The end will be absolutely heartbreaking. But everything else… it makes it all worth it.
Sarah has forgotten her past and loves her family and her life. She is so happy! You can see it in her smile. And for all she has given us… I can’t express it in words.
Please, don’t give up on a medical dog, even if you know you will ultimately lose the battle, even if it is a dog you don’t know. Please, give them as much of a good life as they can have. I promise you, you WILL be glad you did.
But if you do, please also remember that there is a difference between ‘alive’ and ‘living and know when to let go.