The Excorcism

 And so the story goes..

The seemingly never ending saga of an old dog with a fierce determination to persevere and a mom who can't say goodbye..

Savannah has gotten a new set of high performance all terrain shoes. They significantly help her grip on slippery surfaces. My goal is to keep her ambulatory for as long (or forever) as possible. I only put them on after she is unable to keep her feet underneath her. Any crutch I give her will likely make her more reliant and my hope is that she will only need small short periods of assistance as she retains, or hopefully, re-builds her muscle mass.

When two shoes are enough to keep her moving she gets two. When she needs four, she gets four, but I would rather move her to a place where she doesn't need any and not take any steps backwards while we try to keep moving forward.

We take long walks (at least twice a day) over terrain that is varied and includes uphills, grass, pavement, downhills, and navigating through the twists and turns of the yard. She also benefits greatly from the change in scenery, stimuli of being outside and the regimen of daily exercise to help keep her fit and on a schedule of wake and sleep.

Meanwhile, the rest of the family waits with me..and gets up with me,,,and loves the many multiple home cooked meals that get refused by Savannah.

The winter of 2013-2014 has been a long hard cold white winter. It has been tough on all of us. Keeping her warm and walking in spite of endless sheets of ice, tunnels that need to be re-dug every few days, and wind chills which make me pause and re-think every outside exercise walk. I have pushed her thin weak body to the point of exhaustion and still she wakes up each morning to face another day. The silver lining to these stay at home snow days has been more time with her. I am grateful for each moment of each day.

Each aged ill patient of mine has passed while I have been caring for, treating, and trying to maintain the course with Savannah. We have shared our sad days, our attempts to resolve and ease suffering, and still she has outlived, outlasted, and outshined even my most optimistic hopes.

In an effort to help someone else somewhere else with her condition here is what we are doing now;

1. Melatonin, at bedtime. 3-6 mg (dogs over 30 pounds are at the higher end. But I have been offering more lately). She is about 12 pounds.
2. Tramadol, 1/4 to 1/2 of a 50 mg tablet to get her to rest at night if it looks like she is winding up and not settling down.
3. Amitriptyline, a tricyclic antidepressant that is used to treat anxiety and other behavioral disorders. Possible side effects are dry mouth, raid heart rate, and sedation. (I will hope that I don't see the first two). Long term concerns are for the heart.
4. Long walks twice a day. (Mother Nature could you give me a break for a little while?)
5. Feed! Feed! Feed..I am almost embarrassed to confess her current diet. Yesterday, for example, she ate two slices of cheese pizza (my husband loves being sent to pick up pizza for the dog. He helps himself to wings and a pepperoni pie while is he there), 2 Beggin Strips, and a pack of moist and meaty. Now, mind you, this is after she turned her nose up to; chicken, rice, soup, dry and wet cat food, and canned dog food.. Argh, I'm trying.
6. Free access to fresh water. Although yesterday I found her asleep with her back foot completely submerged in it. And one morning I awoke to some weird whistling noise to find her nose almost submerged while she slept.
7. I keep her bundled up and warm. She has lost quite a bit of muscle mass and chills easily. Her room is kept at 70 degrees and I blanket her at night.
8. She is never alone. She is either at work with me (Thank You!! to my wonderful staff!!), at my mom's house, with my pet sitter, or with me..boy, it puts a strain on traveling.
9. I keep her with me as much as possible. Mostly, because I fear her time is short so I am going to squeeze every last second out of her.

My biggest challenge has been keeping her calm and stable. After a few weeks of doing well she starts to become more and more anxious over littler and littler things. More pacing, getting stuck in seemingly impossible places to get stuck in, circling..etc.. It is grueling to watch, witness, and ignore her pleas at all hours of the night. It is exhausting and excruciating. It has caused me on three occasions to debate putting her to sleep. After two or three nights of this I break. I question her quality of life and what I am doing about it. Twice I have given her acepromazine (a potent sedative to relieve her anxiety and allow her to sleep). Both times I have given her a tiny fraction of the dose, and both times she has had a seizure and the wind knocked out of her. She slept for almost a whole day afterward, and had a very tough time recovering after. I was happy to see her sleep and completely guilt ridden to see it hit her so hard. The third time I sedated her was last Thursday evening at 2 am, after she was up all night for two nights in a row, and getting worse. I gave her a tiny amount of morphine subq. It should have taken her about 15 minutes to relax and get sleepy, but, within a minutes she was vomiting violently and passed out. I lay in bed all night thinking that she was not going to be with me in the morning, and feeling a mixed bag of relief that she was peaceful and grief that she was gone.

Twenty-one hours later she woke up, calm, quiet, relaxed and sluggish.

These three drug induced comas were my last resort. Every time I looked at her at these moments I knew I had to do something to give her some respite from her delusional horrors. Each time two days later she emerged herself again. And I was once again grateful to beat the boogie man back to his sideline.

My hope is that she can die an old lady of old dog exhaustion..not a frantic maniacal schizophrene. Its a dual, a long marathon dual between me, the chemist with a bag full of drugs, and that elusive ghost who lives in her head awaiting the exorcism.

For those of you who question my motives, I say, "I am trying every single option to give Savannah a life that she is happy and content in. If I can keep her ambulatory and happy I will try anything and everything. It is my obligation to her and to my patients."

Magpie, on the hunt,,for anything.

Jekyll watches over the kingdom.

Charlie, always playing second fiddle, and too proud to admit it.

The welcoming committee at the clinic.

A big bonus of the job, I get to spend my days with dogs and cats!
And if they will let me, I get to be their biggest fan for as long as they tolerate me.
(Me exhausted after two nights of no sleep with Savannah)

My favorite Jekyll pose.

The pet sitter arrives to take a shift.

And just for smiles....the ever expressive Jekyll, and his long slow wake up and face the world yawn...

May we all be so relaxed and happy to face each day!

If you have a pet question, experience to share, or want to meet other pet enthusiasts you can find us on Pawbly.com. You can find me at the clinic Jarrettsville Vet, or on Twitter @FreePetAdvice, or catching a cat nap in the corner of my house while Savannah takes one of hers...

Related articles to Savannah's condition can be found at;

The Troubles With Growing Old.

Another Turn Of The Tide

Surviving The Delusions

Savannah's Cognitive Dysfunction

Living And Losing The Last Moments Of Your Terminal Dog