Sunday, October 25, 2015

Dunkin, The Story of the Littlest Life, and All That Matters.



It is a different sort of business that we run here at Jarrettsville Vet. Very rogue in the arena of veterinary hospitals. It is a mix of No Kill Shelter meets Dr. Mag-dolittle. I suppose I knew long ago that trying to be a great veterinarian and being the wealthiest veterinarian were probably mutually exclusive, at least for me. So, I decided early on in my veterinary career that I needed to create a few 'veterinary commandments' to live by. I believed that if I did this in the end I wouldn't stray too far from where my original new grad Pollyanna view point was. This list was to serve as a guiding tool kit for me, the veterinarian trying to grow up in the real world. I thought that if I could write down a few codes to practice by than maybe my naive vision of who I wanted to be wouldn't get beat up by the jaded experienced vet I was told I would inevitably become? That list has served me well. There are days where I have to walk out of the exam room and take a seat to ponder whether or not I can face myself in the mirror the next day if I go back and and comply with the clients wishes. There are times I walk back into that exam room knowing I am going anger and lose that client because I cannot, or will not, provide the service they are asking for. I cannot lose the vet I wanted to become to be the vet others expect me to be.

I have had many people remind me that "I cannot save every pet." Ten years later I still beg to differ.

Such is the prelude to our latest little addition to the JVC family. This is the story of Dunkin, and how little lives matter, even when all of your experience, training, and knowledge tell you to give up.


I have worked in animal welfare and advocacy for decades. It is the backbone to the reason I do everything. It is my roots, my cause, and my  purpose. It is also not my secret.

Jarrettsville Vet resides inside Harford County Maryland. As one of the oldest veterinary clinics in the county we care very deeply about our neighbors and all of the animals within our community. We care about these animals regardless of whether they have parents, resources, or luck. Being homeless, being alone, and being at the mercy of others is only a matter of circumstance and location.

There have been many years of turmoil between myself and the Harford County Humane Society. These have primarily been between differences in opinion in transparency and the actions of what I believe to be fair and just when it comes to caring for the unfortunate strays and surrenders of our county.  I have always felt that in the end those animals were the collateral damage to any and all disagreements. Therefore, JVC has remained committed to helping every pet every time we were asked regardless of how they got to where they were, or, the condition they were sent.

About 4 months ago the HCHS sent out a social media request to find immediate foster care or homes for 33 pets. Within a few hours that plea hit thousands of Facebook page's. It was the great power of social media put to the benefit of those in the most dire of need. One of those who answered the call was our technician. She asked me if she could go to the shelter and take one of those 33 as a JVC foster? This was about the 6th foster we have had in about that many years. I am flattered she still asks, but, she knows I will never say "no."

Taking on a foster from another facility is not an easy task for us. We have a credo at the clinic to not turn away a pet in need and often this manifests as us having to foster a former JVC patient while we find them a new home. (Presently there are 6 cats under our roof looking for homes).

In spite of this, off she went to pick one of those 33 dogs so that we could help keep at least one from being euthanized due to lack of shelter space. She returned that afternoon with two. The first was an older Boxer who was sweet but terribly weathered. Her belly was stretched with sagging skin and dangling nipples, no doubt from countless litters she had been forced to serve. She had a depressed manner that erupted into aggression when any other animal even looked at her. She had been a breeding bitch and learned that if she was going to keep herself alive she had to fend off the hungry competition. Life had not been kind to her, and she was not going to be kind to anyone except the hand that fed her. She, we believed, was our tough case to find a home for. But to make up for that hard case our technician chose a puppy as her second choice. She figured get one easy dog and one hard to place dog, and call it even? One old pet who needed us to find herself and trust again, and one cute little puppy who needed a quick make-over and off he would go with his "happily ever after" and no elbow grease to show for it. That seemingly easy-fix puppy was, Dunkin.

Dunkin was one of those 'so ugly they are cute' dogs. At four months old he was already incredibly charming and desperate to be loved by anyone. He had been found wandering the streets alone, brought to the shelter and so he sat waiting.

Of course we all believed that finding our old ugly Boxer a home would be far more challenging than the cute young Demodex puppy, I mean who wouldn't want a slightly defective, but certainly treatable puppy?


Oh, how true that ignorance is bliss statement is! That little Demodex puppy has proven to be our biggest challenge yet.....

Dunkin got his name from his donut sized umbilical hernia. After all, hernia's are easy to fix, aren't they? A few tightly placed sutures and all that extra skin gets tucked away. But, what every vet will tell you is that where there is one congenital birth defect there might be others.


Within about 3 days of having him we realized that he had other problems to add to his 'awful skin' and 'umbilical hernia' list. Dunkin also had megaesophagus. Megaesophagus is a condition where the muscular tube of your esophogus is dilated, weak, and distended. Instead of swallowing food and moving it quickly and efficiently into the stomach the pets with megaesophogus hold the food in the esophagus, inside the chest, and this prohibits the food from making its way into the stomach so it can be digested and provide the body the nutrition it needs to grow. This explained why he was such a fragile, thin, bony pup. Within 1 day of diagnosing this he also acquired the typical sequela to ME; aspiration pneumonia. Within two days of the pneumonia we diagnosed him with puppy strangles. Within 2 weeks of finding us Dunkin became a skeleton hovering on deaths door.


In the early days we hoped that Dunkin's condition would improve if we skipped placing food in his mouth so that it wouldn't pool in his dilated distended and poorly functional esophogus. Placing a feeding tube into the stomach requires an endoscope, which JVC doesn't have. So we sent Dunkin to Chesapeake Veterinary Referral Center in Towson. This was the first Go Fund Me campaign we made. Thanks to that feeding tube he put on the weight and muscle mass that he had not been able to do with his chronic incessant regurgitation. That feeding tube allowed him the nutrients and calories his body had robbed him off.

Dunkin gets fed (one of his many feedings a day) through his stomach tube.
Dunkin had gone from looking like a typically puppy with stress induced mange, to near death from pneumonia, to expensive feeding tube placement that all the specialists told us was likely to be futile, to a skeleton near death, to muscle gain and massive feedings done every 3 hours around the clock. Dunkin was as intense a case as there ever was. His first few weeks with us were roller coasters of doubt, denial, trial, error, and bleak prognoses. He was a cause we banded together around and a fateful catastrophic story that seemed to never relent. I was torn between my staff and my clients being hurt if he didn't make it, paying for services that even the experts thought were futile, and a puppy who had no hope if we couldn't at least try something. The problem was we never knew what that next something was?

Who says medicine won't break your heart? How can I ask people to pay for care if I am not even sure the pup will survive? Goodness was I worried that I had gotten everyone involved in a tragedy.

Dunkin says "Thank You Mom!"
He loves to eat!
As his social following grew so to did the facing of his many illnesses, diseases, and preparing the public for his poor prognosis. It is a wonderful and amazing journey to see so many strangers band together for one small life.

Dunkin's story has moved people to donate money when he needed to see a specialist. He has people who beg us for updates. People who stop by the clinic just to meet him (some of them even tell us that they aren't clients but they follow us on Facebook just to see how he is doing), and a team of supportive caretakers that has allowed his frail broken body to overcome obstacles most others would not have been able to.


In the early days we were trying to find him a home. We have since come to realize that his obstacles are too numerous and his condition to fragile and constantly changing to safely place him in anyone else's hands. He can be happy, eating, playful one day and hours later be suffocating from pneumonia and skin swelling. I have had to be honest and realistic with people who want so desperately to be able to will themselves and Dunkin his happy ending. We have had to turn down people begging for him to be theirs because the magnitude of his care is too great and the emotional strain almost immeasurable. There are tears of joy and tears of despair weekly around him.


Dunkin has 24/7 care and monitoring. He is fostered by our technicians and has been shuttled between three specialists. All  in the hopes of finding a root cause and crossing one problem off of his list.

Dunkin has become a part of our family. His story has been told in Facebook posts, visits, and inquiries from his long list of friends.


Do I know what Dunkins future holds? No, I don't. I know that he has a few conditions that we might not be able to ever resolve. I know that his megaesophagus is probably not treatable by anyone at this time. There isn't a surgery, or a procedure, or a way to make it better. He will have to eat standing up for the rest of his life. We will have to manage his sporadic aspiration pneumonia when they occur, and one of them may be so severe that we won't be able to cure him. He is a fragile medical conundrum. He is a little boy who isn't going to be handed anything. He will struggle, and face obstacles every single day. But he has taught us, reminded us, and shown us that it isn't about how many tomorrows you have. That you cannot be bitter and angry that you weren't born perfect, you can only live this day, wag and play and be happy to embrace this moment, because life is a precious, fleeting delicate thing that none of us get a calendar for.


Dunkin is one little puppy who needed a miracle and instead got a team of people who will never give up on him. He will be loved every moment of his life, no matter how long that is. He was a gift to all of us that we cherish. He mattered, one little broken puppy who matters more than any dollar, any scientific poor prognosis, and any unarguable bad case with almost no chance of a happy ending could bring. Do I know that his chances of long term survival are poor? Yes. Should that matter in how much we love him? How much we provide for him? and how much he enriches our lives? Well, I suppose that is why I still make decisions based on looking into my patients eyes and not my ability to become hugely profitable.


Dunkin has many people to thank. Without Amanda, Laura, and the doctors and staff at JVC he wouldn't still be with us. We also want to thank all of the people who love him, whether it be in donations, Facebook encouragement, or love. We are grateful to you all!

I wanted to add that since Dunkin was rescued from the HCHS significant changes have been made. Most notably there is a new director who has put a new face of transparency, cooperation, and compassion into the shelter. She knows that we are here to help with the pets of our community and we wish her the very best of luck in her new position!

I also want to add that Dunkin is happy. The one monumental thing we can learn from our pets is to not feel sorry for ourselves. To face each day with a wag and a smile, to never look back, and to always greet each person with love and hope. Dunkin loves life and we love watching him grow and remain the bright spot in every day we get with him. He will always be loved!

Update;
Dunkin passed away on November 7, 2015. He fought valiantly everyday to enjoy life. In the end his list of challenges became too great to manage. He was surrounded by the JVC family who loved him and he will be missed profoundly. 

We will choose to celebrate his life. We will remember how happy he was, how lucky we all were to know him and how much his little life mattered. The immense impact he had on others, and remember that where there is love, there is always hope. 

If you would like to share your stories of your beloved pets please come by the clinic, Jarrettsville Veterinary Center anytime. We would love to hear about your companions and how they enrich your life.

If you would like to ask a pet question please find me at Pawbly.com.

I am also on Twitter and Meerkat @FreePetAdvice.

Thank you all for being kind, and for keeping all of those little lives that matter close to your heart.

12 comments:

  1. Love this little guy and JVC for all that you guys are doing for him. Yes, for as long as he is with us, he deserves all the love in the world!

    ReplyDelete
    Replies
    1. Hello! Thank you for reading and for cheering for him. He just returned from a trip the the UPenn vet school. He has a new treatment plan and is doing very well.. fingers crossed!

      Delete
  2. Your care and compassion shine through. Thanks for being so generous and helping animals. You probably know that is my mission too and the main reason I spend hours each weekend on DineKind Harford tasks. Keep it up. We are making a difference.

    ReplyDelete
    Replies
    1. Hello!
      Thank you for reading and for all that you do everyday to improve the lives of animals! You inspire me everyday and I am here championing the cause with you!

      Delete
  3. Thank you for all you do, Dr. Magnifico, and who you continue to be as a person with a huge heart, first, and a wonderful, dedicated, compassionate veterinarian! The community is blessed to have you, and those of us who have been often touched by your kindnesses and help are grateful to you! What you have been willing to do for Dunkin, and your heart insight, perseverance, and the love you have shown and shared has touched many hearts. Thank you and thanks to your wonderful staff!

    ReplyDelete
    Replies
    1. Hello!
      We couldn't do all that we do without the support and generosity of our clinic and community. We are incredibly blessed to be surrounded by such amazing animal lovers!
      Thank you for reading and for your very kind words!

      Delete
  4. I'd always hoped that my daughter would want to be a vet - instead she chose tending people because, she said, she couldn't take the heartbreak of veterinary medicine.
    Thank God for people like you (& your staff) who CAN take the heartache, & who keep on giving.
    Your parents must be so very proud of you.

    ReplyDelete
    Replies
    1. Hello,
      It takes a village to care for all of us within it. My hats off to your daughter for helping people. Without them I wouldn't have the ability to care for their companions.
      Many thanks for visiting and taking a moment to leave a message..My best to you all!

      Delete
  5. Such an uplifting story! I applaud your dedication to the care of every animal you encounter...this truly embodies all the veterinarians aim to do.

    ReplyDelete
  6. And thanks also from me and one of your Patients, Beau Atkinson another Puppy Strangles pup, thanks for taking care of us and poor little Dunkin,you all tried so hard for him! He was loved and I am sure he knew it. Chris Atkinson

    ReplyDelete