Thursday, April 19, 2001 10:20 AM - Tanner's Interests
Dear Lorraine,
Our rose bush has three huge brilliant true red blossoms on it. Each blossom would fit in a 2-cup measuring pitcher! Last night when I took Tanner out for his bedtime ritual, he waked over to the little flower garden under the dining room window where one of the roses had dipped towards the ground because of the wind and the weight of the blossom. It is suspended about 20” from the ground. I was watching Tanner and delighted when I saw him lift his head, then stretch his whole body so he could get close enough to check out that strange object! As he lifted his nose to sniff I wished I were set up with a camera because that would have made an adorable picture! Of course the fact that it was the dark of midnight meant I couldn’t have done it anyway so I will have to keep that picture in my heart. This morning when I told John about it he said, “Tanner stopped to smell the roses!” That is so very true…it is so obvious he is much more comfortable than he has been for a very long time and is enjoying life as a little doggie should be! As John sat at the dining room table this morning Tanner topped it off when he walked over to John and gave him “nose pokes” in the side of John’s thigh. It has been a very long time since Tanner has behaved in such a normal fashion and it thrills our hearts. Later we had to be out a while and when we returned, Tanner greeted me by running for his turkey leg toy to hold in his mouth to greet me. He held it for quite a while as he waited for John to come in through the garage, too.
All of this and he has just started on his third pill! Amazing once the problem is known, isn't it?
Lovingly...Us Three
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Saturday, June 02, 2001 4:29 PM - GENERIC MESSAGE
Dear Ones,
We learned that Tanner has problems (lesions) resulting from the Valley Fever in his 4th cervical and his 9th & 10th thoracic vertebrae. By the time we got him to Dr. Wilkens he had started dragging the toes on both back feet so we are glad we went then instead of waiting any more.
He is on one 50mg capsule daily of Fluconazole CPD. Dr. Wilkens said that goes more directly into the spine. He said to try that for 3-4 days to see if there is any improvement; if not, back we go for surgical intervention. We gave Tanner one at 10:45 this morning with one-half 25mg Rimadyl, a little food and some water just before we left Dallas. Since we have been home, he is stumbling a bit but I cannot see so much toe drag on either foot. Please pray with us that this fixes it!
His blood test showed his body is doing well with the Ketoconazole but of course that is not used now. His x-ray showed no further invasion in his left hind knee, too. We are thankful for those reports
Lovingly, John and Marilyn Sue...and Tanner, too
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Sunday, June 03, 2001 7:52 PM- Sunday...Questions
Hi Lorraine
I wish so much that I could say I see great improvement. I don't. Unless things change dramatically in the next couple of days, we will have to decide what to do. Is it fair to ask Tanner to go through a whole lot more...surgery followed by who knows how long with medical intervention? I am sure there is no set answer to tell us because he is an individual, his case was so long being diagnosed, and it has gone so far. At this time he is still eating pretty well when I hand feed him...so I do. He drinks well and still shows interest in the neighborhood dog noises but turns his back on "the kid" (Beth's Pom)! He has difficulty controlling his back end balance so falls sideways once in a while and his feet and legs go at strange angles. He seems unable to lie down with comfort much of the time but has napped for an hour, maybe two, at a spell throughout the day. He did sleep well last night and we are thankful he could do that
Do you have any suggestions as to pertinent questions we should ask the Dallas vet? If you do, please don't hold back but let us know.
I found an interesting and hopeful site this afternoon called "Bear's Battle with Valley Fever"
It is not about a Yorkie, but a Springer Spaniel I think. Bear was older than Tanner when he contracted the fungus but was diagnosed more quickly. You might find it interesting reading
More when we know more...lovingly, Us
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Tuesday, June 05, 2001 1:39 PM-Cautiously Optimistic
Hi Lorraine
We are cautiously optimistic today with Tanner's seeming slight progress. He is not "knuckling" so much as yesterday, although it does occur from time to time. His back end doesn't always follow his front end like normal and he seems accepting while trying to right himself. It is a sorrowful sight to observe as he drags his hind end until he can semi-control it again.
He rested well last night and ate very well yesterday. He is drinking plenty of water and his bowels and bladder are functioning normally. Thankfully he does not have stomach upsets that can occur so hopefully his body will tolerate the medication well.
I plan to do what I can to alert folks in this area with the hope that other doggies (and their owners) will not have to go through all of this. We have a local columnist who really has a thing for pets and has written about lost pets and the human-interest types of stories. He is well liked and I want to contact him to see what direction I should take to get something in the local paper to inform pet owners.
My understanding is that a simple blood test early on most likely would have prevented much of what has occurred to Tanner. On top of that, if I had been insistent that the Dallas vet read what I presented in bold print (!) the spine might have been treated sooner, too. (After all, you were on track when you asked about Lyme disease early on…May of 2000, remember?) Hindsight is definitely better than foresight, especially if we don't "listen" to what our feelings tell us. Yes, what I wrote would have taken some time for him to read...but...we had been through a lot for a very long time and had the symptoms stated so well as I look back over it all. I do intend to write to Dallas along this line. I do not wish to be obnoxious but I do wish so much that Tanner had had what he needed before he had to go through all of this. And I do hope that others will be encouraged to state what they "feel" is the problem. After all, we do know our pet far better than any doctor seeing him once in a while or for the first time ever. Am I asking too much?
Please thank God for the more hopeful relief we feel today and pray with us that Tanner will continue to improve.
Lovingly with thanks for your thoughtfulness....Us
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Thursday, June 07, 2001 3:59 PM
Forwarding Message to Dr. B from Dr. Shubitz
Dear Dr. B,
Tanner sounds like a tough case. Abelcet might help him. He is a more
complicated case than most people are willing to treat, so we don't have
all that much experience with the outcome of dogs with multiple vertebral
lesions. I am familiar with what they do for humans with this kind of
disease, but that extensive surgery is probably not an option for a dog.
We have treated about 18 dogs with Abelcet. About 60% had a positive
outcome, though most have remained on oral medication. We had one dog with
a vertebral lesion that did very well and is on no medication almost three
years post-treatment. We had one that fractured at the lesion site and
they opted for euthanasia. Our single dog that came in with neurological
deficits was euthanaized at the owner's request after only three
treatments. And the dog with multiple vertebral lesions that we treated
turned out to be aspergillosis which was not responsive to any medication.
A dog in California that was in our study had multiple bone and joint
lesions at diagnosis and was treated aggressively with Abelcet followed by
Sporanox. The dog is being shown 18 months later. I gave them a very
guarded prognosis for the dog to live. So I think there is hope for
Tanner, but we do see bad outcomes sometimes no matter what we do.
With fluconazole, you can leave him on the drug during the treatment with
Abelcet and I suggest you do so because of possible cord involvement.
There is a human article about cryptococcus which shows synergy between the
two drugs in that infection. That does not mean it is true for cocci, but
it is relatively safe to give them both at the same time. You may see a
mild elevation of the liver enzymes but just watch it.
Abelcet is a lipid-complexed form of amphotericin B, the main benefit of
which is reduced renal toxicity compared to the deoxycholate salt
(Fungizone). It appears to penetrate tissues well. It is made by The
Liposome Company in Princeton, NJ, and is available through hospitals and
human drug suppliers. It runs about $250.00/100mg, and the dose we used on
our dogs is 2mg/kg for fifteen treatments. We did two treatment regimes:
daily for 15 days and M-W-F for 5 weeks. We feel the latter protocol
allows longer total exposure of tissues to the drug as it is not cleared
rapidly. The daily treatments were mainly for financial reasons for
hospitalized dogs. During our study, we also increased the dose from 1mg/kg
to 2mg/kg at the suggestion of the company. We did not really see any more
side effects from the increased dose.
Monitoring during treatment includes a CBC and serum chemistry at the
start and at least once weekly renal profiles and UA to make sure the drug
is not damaging the kidneys. The drug is delivered IV, preferably using an
infusion pump, in 5% dextrose in water over a period of 1-1.5 hrs. You
will need filter needles to be able to move the drug from the bottle to the
IV bag, and you will need to make several catheter flushes before adding
the Abelcet. For dogs that have poor peripheral veins, we were able to
place a central venous catheter and get 5-6 uses out of it before changing
it. Realistically, you probably can't deliver the treatments for less than
about $150.00, plus whatever lab monitoring costs. I estimate that in
private practice, where you have to buy the drug, it costs between $2500
and $7500 to treat a dog, with the high end for big dogs because the drug
cost goes so high. For Tanner, you will need a bottle of 100mgs and a
bottle of 50 mgs and that should be all - about $500.00 for the drug.
If you would like to talk to me more about the treatments, please feel
free to call, 520-626-8198. I'm on mountain standard time. I will be out
of town until Monday (at a Valley Fever meeting) but you have enough
information in this e-mail to at least make a decision about using the drug
and tracking down the drug and supplies you will need to give it. If you
would like to read an article on its use in veterinary medicine, check out
JAVMA, 1996 Vol 209(12), pp 2073-75.
Sincerely,
Lisa F. Shubitz, DVM
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Friday, June 08, 2001 10:10 AM-My View
Lori;
How grateful we are for your continued interest in
our "pal" Tanner. It is through your knowledge, and
effort, that we found the Vet at the University of
Arizona who has shed more light on the treatment options
and recommended an increase in the level of Fluconazole
he is getting.
While it hurts us to see this precious "little" puppy
struggle with a hind quarter that doesn't work as it
should we are blessed to have Tanner as a part of our
family. Even this very dark cloud has a golden lining.
Our vet, here in San Angelo, who said that he never
would have found valley fever now is committed to the
concept that he will not make that mistake again. So,
who knows, Tanner's pain and struggles may make life
better for many more dogs in years to come.
He still looks at us with love in his eyes even though
we know that he is very uncomfortable. It's as if he
knew that we were doing whatever we could to make him
more comfortable.
I commend you as a breeder, a compassionate animal
lover, and as a friend for your care for Tanner. I just
wanted to tell you how much your commitment means to
each of us. I Thank You!!
john
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Wednesday, June 27, 2001 10:04 AM-Mostly Tanner
Dear Lorraine,
We took Tanner to the vet's yesterday afternoon to have his feet looked at because the dragging has literally worn off hair and raised scabs on the skin and he even has a crack between his toes on one foot. I had been putting olive oil on them figuring that wouldn't hurt even if he licked it but he only did that one time. I think it was too difficult for him to reach easily. He now has bandages that we need to change every other day and we can continue with the olive oil or use Neosporin the vet said. I bought fleecy baby socks to cover his toes that we will use after the bandaging is used up. The vet provided some of the type of tape that sticks to itself but not to his hair...pretty amazing stuff.
The roller coaster emotions of the day included measuring Tanner for a cart. That meant admitting he might not walk on his own again but at the same time gave us hope that he will have freedoms he does not now have. I had sent an e-mail asking whether the cervical lesion would be a problem and the woman responded saying Tanner should be a good candidate for a cart. We then called where I spoke with a woman, Barbara, regarding the measuring. We measured (it takes two!), filled in all the necessary info on the order form, then faxed the order. A woman named Stephanie called immediately and said a couple of the measurements needed to be redone since they didn't fit the norm. She told us to lay Tanner on his side with his back to the wall then measure his hips to bottom of hind foot and from his shoulders to bottom of front foot. Those measurements should be within an inch of one another. That did make the difference so we called her back with the corrections. Stephanie asked if we were helping him try to walk. I told her I generally lift him over the little rise on the way in from the patio to the living room, on the way out when he waits, etc. She recommended we take a throw-away towel, cut 2" strips the long way, wrap one under each hind leg, making a u-shaped loop, hold the four ends and lift his hind end that way. We can even out his spine that way, being careful not to lift him too high. He loves it! The second time I did it, he raised his hind end a little for me to get the towel pieces under him! As soon as he's attached, he's raring to go! He seemed much more comfortable all the rest of the evening, and slept well through the night. (Unless I was so tired I didn't hear him!) His attitude seems cheerier...maybe that's because ours is. We feel like this is the best we can do for him along with the medication he is getting. His hip area is definitely filling in somewhat although he still weighs 10.1 pounds...2.5 less than his top weight. He eats well and drinks plebty of water so is in good shape that way. We are thankful.
I found a delightful site through the K9 Cart Company that has a story all dog lovers would enjoy.
I had already said maybe we would get Tanner a cart then maybe he and I could visit and encourage the elderly and others who require Physical Therapy. Willy's story at this site is a beautiful example of that, pictures included.
Lovingly...Tanner and the Moores
Tuesday, July 03, 2001 5:46 PM-GOOD NEWS
Hi Everybody,
The good news for today is that Tanner now has his wheels...and you should see him go! The only problem comes when he tries to walk too close to a doorway, the fence gate, etc., and he catches the wheels. He will adjust to that I am sure. He has acted like he knew as well as we did what the cart was for. I suspect the towel straps really helped prepare him emotionally as well as physically. He is an amazingly resilient little guy and we are very happy to see him have enjoyment. He and I already took one brief walk but instructions indicate we should not overdo it in the beginning so we'll try to behave ourselves!
Now I must get supper!
With "PAWS " for thankfulness, Happy "4th!"
Tanner, John, and Marilyn Sue
Wednesday, July 04, 2001 11:51 AM- What Else? TANNER
JULY FOURTH, TWO-THOUSAND-ONE!
Good morning all,
Last evening Tanner played with a June bug out on the patio. He cuffed at it with his front paw then bit it, then put it in his mouth. That was when I stopped the fun and removed it from his mouth. After that he pawed at a dried leaf to see if he could get it to wiggle.
Tanner and I had such a wonderful walk this morning. The pavement here is pebbly on some of the streets and that is where we usually walk. We went over one block to a street where the pavement is smooth in comparison and he practically sailed along.
In trying to not overuse the cart per recommended procedure I removed it after he ate his breakfast following our walk.
We saw an acquaintance while we were out and I told him Tanner was celebrating his own independence today.
Twice I noticed Tanner go over to sniff at the cart and sit by it. The second time I decided we might use this as training for him to tell us (or had he planned the training to be the other way around?!) when he was ready to use it so I hitched him up and encouraged him to walk around the house then we went outside. He went running to the bedroom window, the sill of which is about 12" from the floor so provides a good looking-out place for him when we leave the blind level pulled above the height of his head. He ran so fast that he ended sitting on his rump and flailing with his front paws...a good reason to never leave him unattended in the cart! I was making the bed so realized quickly what had occurred. I think he forgot he wasn't up to his usual and raised his front paws to stand to look out as he used to do. It didn't seem to phase him once I had him back to his horizontal positioning.
He appreciated the hugs from Lorraine, Abby and Sarah. He was pretty cuddly last evening and again for a while this morning. Since I need those special times, this has been a good day and it's only now approaching noon!
With "PAWS " for thankfulness,
Happy "4th!"
Tanner, John, and Marilyn Sue
However humble the place I hold
On the lowly trails I've trod,
There's a child who places his faith in me,
There's a dog who thinks I'm God.
Lord, keep me humble, Lord keep me true,
And fearless and undefiled,
Lest I lose caste in the sight of a dog,
And the clear, wide eyes of a child.
~unknown author~
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