6:30, 2:30, 10:30; Life With Keppra Vito

Right now, subject to change without notice, it appears Keppra is key in managing Vito’s seizures.  It’s been hypothesized that the stress caused by the side effects of the KBr counteracted the Keppra that time he had seizures while on both drugs.  We don’t have the side effects, other than the constant hunger, on NaBr.  2 attempts to remove Vito from the Keppra after therapeutic blood levels of Br were reached resulted in seizures in 22 hours or less.  Thus, Keppra is a permanent fixture barring any unforseen complication or a better treatment comes out.

How can such a wee little, rodent like dog control us?
How can such a wee little, rodent-like dog have such power over us?

Here’s the rub with Keppra:  It has a half-life of 4 hours, meaning at the end of 8 hours, it is gone, finished, no longer detectable, leaving the patient open to the possibility of a seizure. Even worse, a missed dose may actually cause a seizure.  It must be given every 8 hours to ensure maximum effectiveness. Not 3 times a day at the most convenient hours, shifting depending on outside activities, but every 8 hours.  This little factoid is why Keppra is rarely the drug of choice for dogs.  Compliance is nearly impossible except for stay at home pet parents.

Vito is a great laundry helper!
Vito is a great laundry helper!

Think about it:  the average day job is at least 8 hours.  Factor in commuting and you’ve already blown the timing of one dose.  Add 8 hours to the already late dose, and you’re looking at the next one occurring in the middle of the night, long after bedtime.  In order to get to work, the morning dose would have to be given hours early.  See the problem?

How does a mere mortal stick with a Keppra dosing schedule?  With great planning and forethought.

I leave for work so early, it’s practically the previous day.  Crabby gets up at 5:30.  He has a 6:30 alarm for Vito’s morning dose.  No chance of forgetting if his pre-work chores get out of hand, the alarm will remind him.

I have a regular alarm set for 2pm.  If I’m working, and the alarm goes off, I drop what I’m doing and go home for Vito’s 2:30pm dose (yup, I have a 2:30pm alarm too).  If my work was not finished before the 2pm alarm goes off, after Vito gets his Keppra, I go back and finish.

After a post-seizure bath.
After a post-seizure bath.

Both Crabby and I have alarms set for 10:30pm.  That’s way past my bedtime, and though Crabby usually stays up at least until 10:30, he has been known to fall asleep on the couch.  The dual alarms insures one or both of us is up to give the 10:30 dose.

In the event one of us can not make our appointed dose, the other gets a call.  Whoever can break away from work the easiest goes home for Vito.

If Crabby or I were to get hit by a truck or  contract some fatal disease, the availability of the other to go to the hospital to visit or claim the body is contingent on how close we are to one of Vito’s dosage times.  For example; if I were hit by a truck at 12:30pm, and Crabby were to receive notification of my impending demise, he is to immediately go home, wait for the 2:30pm dose, and then go to the hospital.  He will time the commute, schedule his miscellaneous emotions and other pertinent tasks and then set an alarm on his phone signaling when he has to leave the hospital to make it home in time for Vito’s 10:30 dose.

A couple weekends ago, Crabby and I painted the town one evening.  But not before I calculated the mileage to our destination, factored in weekend traffic, then gave a 15 minute buffer just in case, and set an alarm telling us when we had to head for home.

To make sure Vito’s schedule is strictly adhered to, we have a white board listing day and dosage time.  After each dose, a check mark goes in the appropriate place.  This keeps Crabby and I from ever having to wonder if the other goofed. Additionally, the snack reminder for Vito’s 2:30 and 10:30 doses are duly noted (Vito insisted on that).

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Photo taken the first time we tried to stop the Keppra.  Vito had a seizure 22 hours later.

Because no medication stops all seizures, and because Crabby has a tendency to freak just as much now as he did when Vito had his first seizure, to the right of the seizure board from a kitchen cabinet hangs the Vito Emergency Bag (VEB, since everything has an acronym now).  In it are a syringe pre-filled with a loading dose of Keppra, 2 syringes of rectal diazepam and Vito’s “chewing” toothbrush (hey, it soothes him to chew it, so who are we to deny him?).  At first twitch, my job is to go to Vito.  Crabby’s job is to bring me the VEB.  Vito gets both the Keppra and 1 syringe of diazepam at the end of the seizure.  He then gets his toothbrush to gnaw on until he’s fully back with us.

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To help us feel this is all worth it, all seizures past April (some occurring between January and April are missing) are noted on the Horde Board in the hallway by the back door.   That way every time we come home, we can count another day off the ticker from the last seizure.   As of right now, Vito hasn’t had a seizure since June 8, the longest he’s gone since we started medicating.

The plan had been, if we ever reached a significant gap between seizures again, to try to wean Vito off his NaBr.  We’ve decided not to go there.  Something is working and we just want it to keep working.  If we do a Br check and find it has dropped below therapeutic levels, we will know the seizures are being controlled by the Keppra alone. Until then, we change nothing.

And so is our lives until the day we die (the dogs are expected to outlive us after all).  There are those, even in the dog ‘community’ who don’t understand the short leash we have to home right now.  I’ve stopped trying to explain.

The only thing I can say is this:  Vito is not a sacrifice.  He was, is and always will be, a gift.  In other words, he’s worth it.

It's not fair that Vito has to go through so much.
It’s not fair that Vito has to go through so much.

What Do You Do When Your Dog Becomes Inconvenient

Gertie’s ‘leaking’ has gotten worse.

It’s not a housebreaking issue.  When Gertie needs to go outside, she’ll bark.

It’s more a constant drip.

Can the situation BE anymore inconvenient?????

There is no treatment for an old lady with Gertie’s condition.

And it’s only going to get worse.

We only have one option available.

You really can’t judge us….

I mean, really, what would you do to if you were forced to live with a dog who constantly drips urine?

We really need to find a more fashionable diaper option....
We really need to find a more fashionable diaper option….

No worries about Gertie.  It doesn’t matter how old she was when she became one of us.  Family is family no matter what ‘inconveniences’ they cause.

Run A Muck Ranch News Bulletin: General Health Status Edition

Vito Declared Epileptic

Valley Fever has been ruled out as a cause for Vito’s recent seizures, as has parasites.  It is thought the elevated reading on the blood work may (or may not) be a fluke.  He will return to the vet for a recheck of his blood counts in 2 months.

There is no connection between the ‘start’ of the seizures and Vito’s surgery last month.  It is possible the seizures have occurred in the past, but at times when Crabby and Crazy weren’t near to witness them.

Since Epilepsy is the name given to any condition where seizures occur, but no known physiological cause is found, Vito has earned the right to wear a medical alert collar identifying him as an epileptic.  Problem is, Crabby is too scared to put Vito’s collar back on lest he have a seizure somewhere the collar might get caught on something, choking Vito.

Vito and Emmi chillin'
Vito and Emmi chillin’

Anti-seizure medication should not be stopped once started, but long-term treatment has many negative side effects.  Therefore, only if and when Vito’s seizures increase to a frequency of more than twice a month he will be medicated.  The troublesome part of this treatment plan is that it’s possible seizures are occurring, but they are not seen by Crabby or Crazy.  Still, Vito is not aware they are happening, so, at least for now,  the seizures effect Crabby and Crazy more than Vito.

Emergency obstruction surgery in May, seizures in June.  Poor Big Guy can’t catch a break.

In a related story, Crabby has learned the rewards of worry:  His palpable concern of Vito in Vito’s time of need has resulted in Crabby being tapped as a cuddle buddy for Vito.  Seems Crabby Men and big strong wolves reborn really can express affection….

Sir William Achmed Back on his Fluoxetine

In an earlier post to the Run A Muck Ranch Blog, Crazy bragged about Willy’s 170 degree turnaround in attitude since removal of the relic roots of incorrect dental extractions from the Middle East.  Turns out that near complete turnaround was only temporary as Willy enjoyed a life free of pain for the first time in a long time.

Due to his change in behavior, and under veterinary supervision, Willy was weaned off his Fluoxetine.

Once he became accustomed to the new oral sensation, or lack thereof, and once the Fluoxetine was completely out of his system, that 170 degree change shifted back 60 degrees, at least as it pertains to Crabby.

Willy and Emmi chillin'
Willy and Emmi chillin’

Willy’s battle with Crabby over Crazy’s attention is back with a vengeance.  Since neither of the Run A Muck Ranch day vets will prescribe Fluoxetine in a dosage that will treat Crabby, and can be slipped into his morning coffee, Willy is the one who has to be medicated.  It is better to have a medicated Willy than to have Willy go back to biting Crabby.  Things get awkward at Run A Muck Ranch when that happens.

In a related story, Crazy is seeking a couple’s therapy program for Crabby and Willy.  Since neither of the boys seem to understand it is possible for Crazy to love them both, she has no option but to seek professional help.  Problem is, Willy and Crabby are so freakishly alike, it is unknown if any professional can get through to either one of them.  Still, if anyone knows of a couples retreat they can be sent to, please let Crazy know.

Slugger Pleased Life is Back to Normal

Slugger’s entire life in captivity has been blessed with twice or more a day medications.  Though he did not appreciate the Ivermectin for his mange back in his early days, all meds given in pill form were administered in a slice of tasty cold cut, no less than twice a day.

6 months ago, Slugger’s Valley Fever Titers came back negative.  His vet directed his Fluconazole be reduced to once a day.  Paranoid as Crazy is, she continued with twice a day pills.  3 months ago, with the second negative reading, Crazy did indeed reduce Slugger’s Fluconazole to once a day.

Slugger was crushed.  It took him weeks to understand his evening pill was no more.

PLEASE Momma, gimme a pill!
PLEASE Momma, gimme a pill!

Slugger is pleased to announce that as of his latest titer check last week, the results of which came in today, his Valley Fever titers have elevated with a vengeance.  Additionally, his hemoglobin is way out of whack, believed to be related to the disease.

The result of this development is that Slugger is now back on twice a day Fluconazole, and because the titers came back significantly increased after only 3 months of a reduced dosage, he may be on it for life.

Run A Muck Ranch has never had a kid so happy to be sick!

Charlie’s Equine Odontoclastic Tooth Resorption & Hypercementosis Cured-ish!

All lesions have healed on Charlie’s gums and he is now eating hard pellets without problems.  The ‘cure’ is attributed to Equisano, a mushroom immune booster recommended by his regular vet as a last-ditch effort to save Charlie’s upper incisors.

Equine Odontoclastic Tooth Resorption & Hypercementosis is actually an immune disease that expresses itself dentally in horses.   According to the specialist vet who recommended extractions, there is no cure.  Charlie’s regular vet agreed, however, she heard from someone who knew someone who used Equisano to manage the condition. Since removal of all top incisors is a pretty drastic treatment, there would be no harm in trying another approach – enter Equisano.

Charlie is the longest committed relationship with a man Crazy has ever had - 19 years!
Charlie is the longest committed relationship with a man Crazy has ever had – 19 years!

If the product is ever discontinued on Charlie, the lesions and tooth soreness will return, so the treatment is permanent.  There is only one source for the product (http://www.equisano.com/).  If you are reading this, please light a candle that Noah’s Nutritionals, the makers of Equisano, never go out of business, lest Run A Muck Ranch be left with a horse that whinneys with a lisp.

Mortimer’s Brain Leak Needs to be Fixed After All

When Mortimer appeared in the driveway of Run A Muck Ranch and demanded to stay, he had a knot on his head.  At the time, the vet determined it was a sebaceous cyst and no further treatment was needed.  Crazy told people it was the unused part of Mortimer’s brain leaking out.

At his recent checkup, however, it was determined that the cyst had had changed, more particularly it had grown and was filling with fluids.  Though it is not hurting Morty in any way, to leave it could cause complications.   First, the shenanigans of Idiot and Stupid (that would be Mortimer and Slugger) have often times resulted in opening the cyst, which can cause infections.  Second, as it grows, the cyst could become cancerous.

Morty with his first little sister ever.  He thinks she's kind of OK - for a girl.
Morty with his first little sister ever. He thinks she’s kind of OK – for a girl.

Rather than take a chance of Morty getting gangrene, requiring a head transplant, or getting cancer, it has been decided to have the cyst removed.

Scheduling of the surgery is forthcoming, contingent on when it can be done so as not to interfere with Morty’s summer camping schedule.

Perhaps if Crabby shows Morty the same heart felt worry and concern he showed Vito, next time the boys are camping in the cold, Morty will cuddle up and keep Crabby warm.

When asked for comment on his impending surgery, Morty replied “Do I get PILLS!  Pills come in yummies! I want PILLS!”

Run A Muck Ranch would like to ask readers to send healthy vibes so the medical issues would subside, but I think at this point we can all agree, not only has that ship sailed, it sank somewhere in the Bermuda Triangle.

The Crazy Dog Lady and The Crabby Man Would Like to Say Something For the Record

Contrary to what some readers might start to think, and they really can’t be blamed for thinking so, there is no Münchausen syndrome by proxy at Run A Muck Ranch.

It is impossible to intentionally cause Valley Fever (Emmi, Slugger, Sarah and Angus), Epilepsy (Vito), unknown neurological problems not related to Valley Fever that don’t result in epilepsy (Sarah),  sporatic attacks of megaesophagus (Sarah)  an unremovable anal sac cyst (Maude),  Equine Odontoclastic Tooth Resorption & Hypercementosis (Charlie), a horse’s inability to eat hay (Hal), a dog’s unwillingness to pass gas or get over constipation without opiates ( DASH!), Cherry Eye on a kid so hyper happy corrective surgeries wouldn’t take, so we have to wait until he gets older and slower to remove his tear ducts, which would then require twice a day eye drops (Hector) or a sebaceous cyst that is undergoing morphological changes that could turn serious (Morty).

Point to be made here, WHAT’S UP WITH A HORSE THAT CAN’T EAT HAY?!?!?!  It is just a matter of time before some strange and new disease pops up at Run A Muck Ranch with one of the ‘healthy’ kids.   Lord knows we have yet to have a kid that didn’t have some problem at end of life, even if end of life was younger than it should be.  But we always fight to the end, while being careful to make sure the point of suffering or lack of quality of life is reached.

Can you tell which one of these kids we have been warned will only live to be 5 to 7 years old?
Can you tell which one of these kids we have been warned will only live to be 5 to 7 years old?

We used to say that there was a star over our home and that all dogs told tale of a magical place that existed under that star.   We used to say that all strays would follow that star and make their presence known to the sucker humans that lived there.

It has taken years to reach this epiphany, but the a ha moment has happened:  Only special needs kids, the kids that have mental or emotional problems, the ones with medical issues, the kids that anyone else would turn away because they are ‘too much trouble’ follow the star to Run A Muck Ranch.

If for no other purpose, I would like this blog to show people that dogs, horses, hamsters, whatever, are still treasures, even if they take a little more work than ‘normal’ ones.   I especially want readers to notice that the vast majority of what you see on this blog is wagging tails, floppy tongues and happy dogs that, unless people were told they were sick or special needs, no one would even know.

Never discount the value of a dog that needs a little more than just a home.