Sweetie and the Bird Box Challenge

 

Amber and Sweetie are back with Sweetie’s latest adventure. This one’s for all of you who have spent hours in a vet waiting room and it’s also a wonderful example of the dedication and commitment Old Dog Haven fosters have to their dogs. Enjoy!             

 

 

 

We didn’t have an intention of Sweetie’s story continuing quite so soon, but as December passed she lost some of her verve. She’d always had an issue with regurgitation and vomiting—but these were increasing as her joy diminished.

You may, or may not, have watched the Netflix film called, “Bird Box,” starring Sandra Bullock. Basically, humans try to survive by blindfolding themselves against seeing monsters. Apparently, quite a few folks on social media have confused reality and fiction by blindfolding themselves, and trying to go about their daily lives—they call this a Bird Box Challenge. There are now warnings from Netflix about driving, running around the house, and otherwise being blindfolded when you don’t have to be. Seriously…and yes, I promise this is applicable.

You see, pun intended, that fostering old dogs is a bit of its own Bird Box Challenge. We are blind, to what may, or may not, have been in a dog’s past as we go about the business of helping them have a present and a future. We don’t meet them at their prime, in their youth, in their dewy puppy years. We meet them broken. We meet them when their medical needs outstripped the desire, or the ability, of the humans in their lives. We meet them when intentionally, or unintentionally, they’ve been neglected. Especially, when they’ve been neglected medically. There isn’t a way to take off the blindfold to the dog’s past, so we gather data, observe, intervene, and observe again.

As December passed we posed questions to ourselves as we watched Sweetie’s behavior change. Was this Sweetie’s best possible life? Was this the cancer reappearing in a new system? Was this something else? Were we on the road to letting go?

I’ll be frank—I’ve lived with a nasty nerve disorder in my legs since I was eighteen. Pain is a constant companion even when there’s a smile on my face. So my bias with the humans and the animals in my life is always a knee jerk toward comfort and pain management. I can’t stop my pain, but dammit I will intercede for someone I love. So, my thoughts were definitely centered on the unknown pain potential that might be sucking at Sweetie’s joie de vivre —was this GI, or stomach issue, one that was causing more discomfort than acceptable? We’d already taken away treats, scraps, and random cookies with the special diet. We were cleaning up an increasing number of liquid piles daily. Was the kibble getting stuck in her esophagus? Was it just rotting in her stomach? We’d switched to the special food after not being able to get her tummy happy on an assortment of choices and textures.

 

Sweetie loves going to the vet, let me rephrase, Sweetie loves going anywhere. But she won’t even tolerate her temperature being taken—any restraints, any hint of touching her for a purpose other than adoration and she becomes a bucking bronco. Incredibly strong and Olympic gymnast limber, any tests on Sweetie would require sedation. Even a thorough exam might require sedation. There are risks with sedating old dogs and the last time she was under for X-rays she had a hard time coming out of it. But we were at the place that it felt prudent to check in on her innards with the next level of diagnostics. With Judith’s recommendation and agreement, the decision was made to take Sweetie to the Veterinary Specialist Center (VSC) for an ultrasound and internal med consult. If this was cancer and there was pain, or Sweetie’s organs were being impaired, we needed to know that.

 

Neither Sweetie, nor I, knew exactly what to expect, and while I think Sweetie slept fine the night before, I lay awake wondering if this might be her last night at home with us. I wasn’t doing her any service keeping her going in the dark—we needed to face the monster. Heading off Whidbey Island into “town,” requires several things: a couple of ferries to give (in case there’s a line), books, and sustenance for long wait times. The truck packed, we headed out before the sun rose and made very quick time (no ferry line) to Lynnwood.

The Veterinary Specialty Center of Seattle is nestled between I-5, a few furniture stores, and a couple of business oriented hotels. It’s shaped like a mirrored glass Rubik’s cube. There’s a lobby within the lobby, as there are clearly many rooms and several levels. Watching the traffic to and from the coffee machine, in and out of the glass doors, of those in scrubs, white coats, or suits I felt a bit like I was sitting at the entrance to a Meer cat warren.

Sweetie wanted to say hello to everyone and every dog and cat. Not only is this a specialty center but it’s a 24 hour ER*. A large screen television had the Scott brothers buying and selling property via HGTV. Zig zagged benches were spaced so it was possible to find a nook for an animal to feel safer in, while a plethora of hand sanitizer bottles and tissue boxes were a not-so-subtle reminder that for humans this is flu season.

 

 

Friendly reception staff handed me paperwork to fill out. The question on whether to perform CPR took me aback for a moment. Sweetie hasn’t had a great track record of quick recovery from sedation—with the likely need for sedation did I want them to intervene and resuscitate her? For some that may feel like an obvious “yes” for others an obvious “no”—for me it was a thoughtful no. Doing right by Sweetie doesn’t mean doing everything regardless.

After a short wait which took the Property Brothers into the demolition of a kitchen, Bill, one of the vet techs on Dr. G’s team came out to get us. Sweetie was happy to head down the hallway though like many of us plumper ladies she wasn’t thrilled about the scale. Bill’s first question was if I actually knew this dog, or was just a driver. Can you imagine trying to figure out what was wrong with an animal with no information at all? Talk about a Bird Box Challenge. There was obvious relief when I answered she’d been with us since July.

Bill took Sweetie’s initial history, absorbed all of my odd and perhaps helpful (or not) observations from the last few months. Sweetie’s joy has diminished. She regurgitates and/or vomits multiple times per day. She’s begun itching at a particular spot on her belly that appears fine. She smells different. She loves rocks—big ones—and attacks branches. She’s been on a special diet since October 4 and while it was better for a bit now it appears to be getting worse.He performed cursory vitals but taking her temp was foregone because of her aversion to being poked (they could get what they needed when she was sedated).

For those of you who like Jeopardy here’s a daily double in the canine medical term category—“One easily escapes a dog’s mouth while the other requires heaving and effort.” What is the difference between regurgitation and vomit, Alex? Yes, they are different functions, indicating different things and while I’m certain it’s not resume worthy, I’ve gotten adept at identifying each. It’s really not hard to master. Regurgitation sneaks up on the dog—they’re just going along and urp there’s fluid and “stuff” on the floor, or bedding (if you’re Sweetie you prefer things that need to be put through the washing machine). Vomiting on the other hand, is more like human puking—it takes effort on the dog’s part through heaving and contractions, usually brings up bile along with whatever else.

Dr. G was warm, kind, and thoughtful. He and his student observer, Josh, went over a lot of the same background as Bill. Dr. G then explained that with both the regurgitation and vomiting, beginning with an ultrasound would give them a good starting place to see what might be going on. Regurgitation indicates an issue with the esophagus and stomach, whereas vomiting can indicate stomach and lower GI tract issues. No wonder vets ask, “Did she regurgitate or vomit?” Um…stuff came out of her mouth that shouldn’t have?

We all plopped down onto the floor, at Sweetie’s level to help do an initial exam. She tolerated the stethoscope though wouldn’t keep her mouth shut so Dr. G could hear anything useful. She also was quite a good sport about his soft touch on her abdomen and belly. Though she did scrunch up her lips and ur at him (the no teeth thing makes it more Comedy Central than intimidating). She even rolled over onto her belly so he could see the spot I indicated she was itching (not much to see other than her pendulous teats and weird bumps that haven’t changed at all). He didn’t feel any rocks—so yay for not consuming the boulders.

They perform ultrasounds around the emergencies that come in (which I’d want to happen if I was the emergency) so Sweetie and I headed back to the waiting room. I was given the option of leaving her in a kennel in the back with the staff and they’d call me when they were done. But since she hasn’t been in a kennel environment since being at the shelter I didn’t know how she’d react. I’d hang out with Sweetie in the waiting room until they were ready for her. She pleasantly, though purposefully asked anyone remotely in her space to please scratch her butt. They thought they were crossing by us to get coffee.

A second episode of Property Brothers began and the waiting room filled. A pointer with a plate in his leg needed radiographs to see if it was crooked and not healing in the right place. A vomiting cat who was seriously lethargic. A limping senior golden retriever. A springer spaniel needing a blood draw for something they’d been treating.

Ten minutes out from the ultrasound Bill came to take Sweetie back to prep her. Without looking back Sweetie happily headed with Bill. The Scott’s discussed tile choices while an angry orange tabby arrived announcing he was in a crate and hoomans suck. A couple of Lhasa Apsos with very dapper top knots arrived as did a cardigan corgi/pit mix who’s ears pointed opposite directions, with a very swollen front paw. I heard travelers from Sequim, Anacortes, Lynden and Olympia.

As the third episode got going and a faux marble fireplace was installed, a golden doodle came sliding backwards through the door. His human was pulling his harness (carefully mind you) but he was clearly wishing that his super-power Wolverine claws would smash into the floor and give him better leverage. An old grizzled boxer with ear issues came in. And a woman sitting there waiting, with tears streaming down her face, was gathered into a room to say good night to her cat.

At 12:30PM, I was taken back to meet with Dr. G and Josh to go over the results. There was nothing major found. No rocks, no masses, no obstructions. The lymph nodes in her abdomen were enlarged and her bladder wall had thickened which might indicate a history of bladder infections. This wouldn’t surprise me, though we’ve seen no evidence of a current issue. This was all good news—no cancer, we weren’t facing putting her down immediately, but the questions about why all the piles on the carpets weren’t answered. We were ruling things out.

The next steps would be x-rays of her chest and stomach, and maybe a blood panel to compare to previous ones. At that point, Dr. G would speak with Judith again, go over results and decide if we simply try a few things or finish out the tests with an endoscopy to gather all the data in one swoop. I was again given the option to leave and they’d call me, but it was okay with me to sit and wait. I had books. There were vending machines.

The sign in the waiting room indicated that emergencies had a three hour wait time. That was explained that animals were triaged and made comfortable in the back. I think it’s safe to say that humans had to wait three hours to speak to the vet, but the animals were treated and stabilized quickly. Luke the old boxer and a copper dachshund were both still waiting when I took my bench by the back wall. At 1:40 the waiting room seemed to have reached capacity and was emptying—my sense was animals were transferred into the back for all of the procedures. The waiting room merely the tip of an iceberg with much of the mayhem obscured behind walls.

An eight-week-old puppy came in with a very blue mouth from chewing and ingesting a package of blue Crayola clay. The humans didn’t have the packaging (always take the package if you can to the ER with your animal) so were asked to call Poison Control to see if there was any information available. The tech whisked the puppy into the back, along with a bit of clay.

Sally, another vet tech on Dr. G’s team and one of Sweetie’s earlier butt-scratchers, came out to let me know that the x-rays showed nothing major. Sweetie was in the line, 3^rdin line, for an endoscopy. The plan was to bring her back out to me between procedures but she was snoring and comfy in the back—so we left her alone. I didn’t have to have her next to me, I just wanted this day to be as easy on her as possible.

Another happy couple purchased a new home, in a better neighborhood for kids, and began their open concept remodeling…Quigly a yellow lab carried on an entire conversation in multiple voices while Walter was walked around to wake him up a bit before he could go home. Walter had his favorite squeaky toy removed from his stomach. I bet Walter won’t see another squeak toy when he gets home. The blue mouthed puppy was released for observation as the clay didn’t appear to do anything in water other than crumble, and no one knew exactly how much he’d eaten. By 4:15 I’d been there long enough to see the next shift of front desk arrive and most of the waiting room empty.

Two tiny puppies with parvo symptoms were rushed in and down the hallway.

A woman who’d brought in a speckled pit mix earlier in the day returned and was taken to meet with the doctor. She was entertaining a toddler. When they returned to the front, she faced that terrible parental moment of juggling grief and her oblivious youngster.

Another episode kicked off while I finished book number one, and dug into book number two…A dainty hound in a black and pink puffy coat trotted in. Apparently, she’d taken half an onion off the counter to gnaw on. They brought the rest of the onion with them. She gets into all kinds of things she shouldn’t so this wasn’t their first time there.

At 6:21PM, the endoscopy was complete and Sweetie was in recovery. Dr. G. was just as kind and warm at the end of his very long day as he was in the beginning. Apparently, Sweetie had regurgitated and vomited several times while in recovery—it included kibble. Her stomach still had a food coating and some kibble in it for the endoscopy. Since her last meal was at 5:00PM the day before that was almost a full 24 hours. Her esophagus showed some granularity which indicates inflammation, but we’d wait on the biopsy results. The sphincter at the top of the stomach (think heart burn and reflux symptoms) was closed—a lot can’t be put on that because under sedation sometimes they close, but if it had been open that would have been indicative.  There were no masses or obstructions in the esophagus, or the stomach. No rocks, no branch bits, no cancer, woo hoo!

GI, esophagus, and stomach issues can be tough to diagnose—we knew that going in. Knowing there is nothing glaring is actually helpful. We have time to try things and the potential to reverse the slump. We are trying a medication that speeds up the motility in her GI tract and also tightens that sphincter. We are keeping her on the special food, though we may try another one and/or adjust the medication moving forward.

 

 

Sweetie happily raced over (still slightly drunk) when Bill brought her out to the empty waiting room—it was just me, the Scott brothers, and reception at that point. She snored with her head on my thigh as we drove home listening to Sia belt out songs about surviving, breathing, and being unstoppable. It’s true—I could have dropped her off and come back to pick her up—going shopping at the mall instead of reading and watching. But that’s not what I signed up for—that’s not what any of us sign up for. We are there for the Challenges and we sit in waiting rooms when needed. Because really…don’t we all deserve someone willing to sit in a waiting room and guide us when we’re blindfolded?

 

 

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*For the purposes of this blog I’ve changed names of the humans and animals we encountered throughout our day—not because I have anything other than glowing feedback, but no one there knew I’d be sharing our experience. Besides, there were many tears and heartbreak that passed by us—as an emergency department and specialist center there have to be a relatively higher number of losses. It feels more respectful to keep names non-identifiable. That’s the only thing changed.