The $600 Allergy Test

Popeye has been scratching a lot for the past few months. A LOT. It started around the end of January but didn't escalate to a noticeably severe level until February. It seems that it started around the time the neck craning began (which in turn began around the time he got his cart), but that could just be a coincidence that I started noticing it around then.

For months now, he has been scratching and so far nothing has helped, other than the Prednisone he was on for 2 weeks. He rubs his chin and neck against the carpet. A LOT. It seems like during those moments when his neck craning is at its most extreme is when he plops down and starts rubbing his chin against the carpet. But again, just a coincidence I happen to notice it most during those times? Every morning he wakes up and starts scratching his chin like crazy.

He also chews between the pads of his front paws. A LOT. And scratches his face (or ears maybe?) with his paws. And to a lesser extent, chews on his forearms. He's got patches of hair missing there now.

Benedryl made not the slightest bit of difference. We're going back to acupuncture tomorrow for his 2nd session, but the chinese herbs he was given, along with the fist needle session, hasn't seemed to make any difference either.

Out of desperation, I had the vet draw some blood to submit for an allergen test. I had read that these tests are not necessarily accurate, but I had to try it. I didn't realize how expensive these tests were but even if I had, it probably would not have made a difference (that's what I keep telling myself anyway). I'm still desperate, by the way.



We got the results today. So what did the $600 allergy test determine? It determined that Popeye is not allergic to any of the things they tested him for. Well, maybe.

They ran 2 tests for Popeye--environmental allergens and food allergies. If a dog shows EA units of at least 150, then they are considered allergic to that particular item. Popeye's highest reading was at a mere 30. That was on the environmental test. Of course, only the most common allergens were tested.

There's a note on the results for environmental allergens that reads:

The reportable range of this ELISA is from 0 to 5000 EA units. EA units of 150 or higher may be considered significant provided they correspond with clinical signs; however, the magnitude of signal does not necessarily correlate with the severity of disease.



Based on some online reading (which I did after the fact of course), the gold standard for environmental allergens is a skin test rather than one based on a blood sample.

The vet said that had Popeye tested positive for environmental allergies, there is a desensitizing regimen he could have gone through whereby I think they would give him small shots of that allergen until he built an immunity to it. But no such procedure for food allergies. Which Popeye doesn't have anyway. Well, maybe.

His highest score on the food test was only 18, and that was for whole egg (which I don't remember ever feeding him, by the way). He had 16 and 15 scores for milk, cooked rice, and wheat grain.



You would think that his low scores would imply that he wasn't allergic to any of the foods they tested him for. But no, here's the note:

Not all patients with adverse reactions to food have significant scores on serum IgE tests. The gold standard for determination of food allergies remains the compliant food trial. Diet selection should include patient diet history and should supply a restricted number of one or two novel protein sources to which the patient has not had prior exposure. Diet trials should run a minimum of 10 to 12 weeks.

In other words, the test can yield inaccurate results, and the best way to determine food allergies is put the dog on an "elimination diet" of just 1-2 proteins which he's never had before. I may end up putting Popeye on an elimination diet (which I don't really want to do for any number of reasons I won't go into now), but I wish I had done more research about these blood sample-based allergy tests before doling out $600 for it.

At this point though, I'm not even convinced that the itching has anything to do with specific allergies. I sometimes wonder if it's just the manifestation of some other problem, possibly relating to his neck craning. For example, a nerve issue that manifests itself in tingling paws. If only Popeye could talk.

Triumph's Amputation

Triumph the husky, the first dog ever to have permanently implanted prosthetic legs, has undergone amputation on her remaining implant leg. She is now a double-amputee, just like Popeye. In a brief email to her mom, Moe, I asked where on the leg the amputation was done, since that had been such a major concern of mine before making the decision of Popeye. Moe said that Triumph doesn't have any stumps, that they took the entire leg off. I didn't ask yet since I know Moe must have her hands full right now, but I wonder if that was because the infection from the implant had set in to the remainder of the leg.

Triumph also has an Eddie's Wheels, which Moe has sent back for adjustments. What the adjustments are I have no idea. But Leslie, the co-owner of Eddie's Wheels, had stressed to me the difficulty that a double-amputee dog without stumps would have manuevering in the cart, which is about the only reason I left stumps on Popeye. So it will be interesting to see how Triumph does in her cart now that both her legs are gone.

I'll be following Triumph's progress closely, one of the reasons being that in the worst case scenario, Popeye may have to have his stumps removed as well. It's still early days and he hasn't been allowed to move as freely as he normally would, so it's still unclear how much wear and tear his stumps will have in the long-term.

Meeting Moe online (was it just a few weeks ago?) and speaking with her over the phone was like a salve to ease my mind. Good luck, Moe. Good luck, Triumph.

You can read the latest about Triumph here: http://triumphthedog.net/

Underneath the $40 Bandage

Popeye came home from surgery with his stumps bandaged. Not because the stumps really needed bandaging, but to prevent Popeye from licking the incision staples. Ever imagine how hard it is to bandage a stump? It's like trying to keep a bandaid around the tip of your finger. In other words, very difficult. So difficult in fact that one of the surgeons I had consulted said it would require bandaging his entire lower body to keep it from falling off.

You can kind of see how the bandaging was done here:


A pretty tidy job actually. They used adhesive bandage and wrapped it around one stump, then flapped over the tip of the stump, over his hips and onto the other side. They told me it probably wouldn't stay on for the entire 2 weeks before I brought Popeye back for a recheck, but that that was ok, since its primary purpose was just to prevent Popeye from licking his incision.

I hoped it would stay on for as long as possible. First of all, that is some expensive bandage and I wanted to squeeze every useful bit out of the sucker.



But also, being a big wussy wuss, I wasn't eager to see the incision wound, although I should be used to it now, having been through both Lauraand Bandit's surgeries. The thought of cuts and blood and staples in the skin gives me the heebie jeebies.

But, as the nurse predicted, the bandage has started to fall off. I'm surprised it lasted this long to be honest. And this is what it looks like underneath.



Actually seeing it isn't as bad as the thought of it. But still, heebie jeebie.

A Happy Pittie

Phoebe always gets excited whenever she sees the woman who raised her for the first 8 months of her life in foster care, before we adopted her. (The brindle pit is her biologically brother, who she hadn't seen for over 3 years, since they were just a few weeks old.) This is the true essence of a pitbull.

Hanging Out in the Backyard

Andrew Sullivan, a popular political blogger that Tyler reads seemingly religiously, recently featured a picture Tyler had taken from our bedroom window.
(http://andrewsullivan.theatlantic.com/the_daily_dish/2009/04/the-view-from-your-window-17.html)

Twittering

Thanks to Brenna for setting up Popeye's Twitter account (http://twitter.com/PopeyeTheDog). This pose is for you.



(Added note: that's actually his favorite stuffed rabbit--all the stuffing has long been pulled out, but he still loves to shake and "kill" it. We are playing tug and I am hiding it from him on his head.)

2 Days After Surgery

Popeye is still supposed to take it a little slow (something about the arteries in his stumps still healing), so he's not allowed to run or chase the other dogs. But here he is getting around.



So one change I have already noticed is that when Popeye hops (his version of "running", which he does when he's excited), he now bounces on his stumps at an angle rather than flat on his butt like he used to. I'll have to keep working on making some kind of cushioning for his stumps.

Triumph's Triumph

About a month ago, I did a google search for double amputee dogs to see what would come up. That was when I came across Triumph's story.

"Triumph's story began in Turkey where she was found beside the road bleeding--her rear legs had been cut off! She was taken to a shelter where the first of many miracles began....they treated her wounds and kept her alive instead of euthanizing her as many would have. Her story was put in the paper there and for the next two months they tried to find her a forever home."

An amazing woman in TN, named Moe, has been Triumph's caregiver and companion for many years now. I think Triumph was the first dog ever to have permanently implanted prosthesis.
"Moe will be the first person to tell you tho that NOTHING in this dogs life has been by accident.....it's as if she has a mission and a destiny that only Triumph and her maker knows. Moe has said many times that she is the blessed one who is at the end of the leash of a dog that is doing the footwork and leaving the results to God. From the first day she arrived in this country Triumph has given back by becoming a Delta Certified Therapy dog who has brought smiles to hundreds of people and children in schools and hospitals."



The challenges faced and overcome by both Triumph and Moe have been numerous, and make my experiences with Popeye seem like a stroll in the park by comparison.

By the time I had read about Triumph, one of her back legs had been amputated because infection from the implant had set in.



I was excited to read about Triumph, to have discovered another dog out there with 2 missing back legs. I emailed Triumph's mom and introduced Popeye & myself. Soon after I had her on the phone. At this point, I was just on the cusp of deciding once and for all to proceed with Popeye's amputation but still very unsure of whether it was the right decision. I had gotten the opinions of a number of vets but I had not yet met anybody whose dog had actually been through it. I felt that my research wasn't complete without learning the point of view of someone who had practical, hands-on, day-to-day experience with the results of double amputation.

Triumph's circumstances are not identical to Popeye's. Foremost, she is not paralyzed in any way. She had an implant in one leg and so was not a "practicing" double amputee. But Moe was the first person I had managed to communicate with that came closest to fully understanding my dilemma regarding Popeye's legs. She was encouraging and our conversation went a long way to easing my mind about the decision to amputate.

Just a couple of days ago, Moe told me that Triumph's other leg will need to be amputated, because of the infection from the remaining implant. Moe, Triumph, Popeye, and I will be going through the same experience together and no doubt learning from each other as we all do our best to adjust to a new situation.

Triumph's surgery is scheduled for Monday. We wish both her and her mom the best of luck.

To donate towards Triumph's cause or to drop a note of well-wishes, you can visit Triumph's website.

Eating on 2 Legs

Before surgery, Popeye would often lift his butt up in the air when eating with his back legs dangling under him, so this isn't a surprise.

Update on Keiki

In 2006, we fostered a dog named Kiki. She was one of about 50 dogs and lots more cats who were trucked in to San Francisco from New Orleans after Hurricane Katrina hit. As usually happens, I wasn't planning on taking her in to foster. But she was a barker and nobody else was inclined to step forward. So she came home with me that night.

Here's what I wrote about her then:

Meet Kiki.



Kiki is a result of the aftermath of Hurricane Katrina. Like so many others, she was found as a stray in a devastated and forlorn area of New Orleans--starving, confused, alone. And she was still only a young puppy. She spent the next months being moved from overcrowded shelter to overcrowded shelter. Finally, she was put on a truck and driven over the course of 3 days to the Bay Area. This is where the attempt to give her a second lease on life begins.



Kiki is about 10 months old and weighs approximately 30-35 lbs. She looks to be a mix of shiba inu, basenji, and rat terrier, and somewhat resembles a cross between a meerkat, fox, and a raccoon, only goofier. Kiki is spayed, current on shots, microchipped, dewormed, heartworm negative, and comes with a certificate of health. She is crate-trained and gets along wonderfully with other dogs, though she should be fed separately.

After spending 3 straight days in a truck, enclosed in a crate for most of that time, Kiki was a fireball of energy when she arrived at our house. To our admitted relief, however, she settled down quickly after that and has shown herself to be really quite a well-behaved and manageable little girl.





Though far from hyper and bouncing off the walls, Kiki does have the energy of a young, healthy dog. She should have regular exercise, after which she'll be content to zonk out on the couch or in her crate. Kiki plays extremely well with other dogs, from those half her size to those double it.





It's highly doubtful given her origins that Kiki has had much if any training in the past. However, she's proven to be a quick learner. Though not solid yet, she quickly learned "sit." She is crate-trained and is still working on housetraining. She sleeps quietly in her crate beside our bed at night and is crated when we leave the house. She is also very responsive to voice corrections. Kiki is not stubborn at all, and she is very receptive to being told what to do.



Because Kiki is still a puppy, it is essential that boundaries continue to be reinforced so that she understands what is acceptable behavior and what isn't. Like all puppies, she likes to chew so it will be up to you to help her distinguish what items are appropriate chew toys. She also does have a tendency to bark at men she doesn't know, but continued socialization will help her to overcome this problem. Kiki is already a wonderful puppy with a sweet temperament and a willingness to please--with continued discipline and socialization, she'll grow into an amazing dog.





Kiki is a young dog still in a very important developmental stage of her life. She is still discovering the world around her and learning what she can and cannot do. She bonds very quickly and the bond will be all the stronger if you show her that you are her leader. We hope to find someone that will be a leader to her, that will nurture her and treat her with the kindness she deserves as well as someone who understands the importance of continued socialization, proper training, and good old-fashion exercise.

Kiki is little dog with an amazing spirit. She is going to make the right person or family a loyal and lifelong companion. Kiki is the kind of dog that wants to stay by your side--whatever room you're in is where she wants to be--including the bathroom. When I shower, she even lays right against the bathtub waiting for me. When I'm in bed napping, she snuggles up close (and sometimes upside down). Kiki is playful, huggable, silly and incredibly endearing. Once you have her in your life, you will never know another day without sunshine.






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Today, I received this very unexpected Youtube video response from Keiki's family:

Keiki is doing great. She is happy and as you can see from my video response, some things never change. . . She's one of the loves of my life! :) She's not happy unless she's cuddled up next to me or my wife.



*happy sigh*

The New Car Ride

After months of struggling with the decision to amputate or not, it is a sigh of relief now that it's done. It's still too early to know in just how many ways the removal of Popeye's legs will change his habits and my routine, but the deed is done and that is one less thing my mind has to spin in circles about.

One thing I am thrilled about already is Popeye's ability to ride in the car now. It's something nobody would ever think to think about, unless you actually experience it. For the past couple or so months, as Popeye has reached his full size, car rides have been increasingly difficult for him. My car seats, like most car seats, are dipped and contoured for the comfort (supposedly) of the human body. The contouring has made it difficult for Popeye to rest in the seat because his back legs were so long and unbending. His legs could not conform to the curvature of the seats, so the legs sat like straight rods, only partially supported. This wasn't a problem when he was younger and smaller but became one as he reached full size.

Most dogs' center of gravity is at their rear when they are laying down in the car. Since Popeye's back legs could not fully rest on the seat, he had to continually hold himself up with his front legs, meaning his center of gravity was at the front of his body, propelled forward. If he sat in the back seat, any slightly sudden braking would cause his body to propel forward. Sometimes this would cause him to "stand". But since he didn't have control over his back legs, he couldn't sit back down as his back legs would be stuck in a propped up position. One time recently, I even had a scare as I had to brake quickly and he was actually thrown halfway between the front seats. I started using the seatbelts on him after that but if he shifted his position, his back legs would get caught in them.

So then I started putting him in the front seat again. I placed one of those folding lawnchair cushions in the front seat so that we wouldn't have to deal with the curvature of the seat. I faced the cushion backwards, so that half rested on the seat, while the other half was propped up against the glove compartment. This way, Popeye would have some cushioning if he was thrown foward. But the seat still dipped down. Again, that dipping made it difficult for Popeye to rest his rear fully on the seat so he would have to sit up, with the weight of his body on his forearms, during the entire car ride, which could be and often was over an hour long. But with him in the front seat, I could at least hold his rear down if we had a sudden stop (not ideal as it only left me one hand to drive) and he had that forward cushioning.

But today, for the first time in a long time, I was happy with the way Popeye could sit in the seat. On top of the lawnchair cushion, I also placed a big round dog bed, which would provide some "scrunching" which I hoped would cushion him in. With his back legs gone, he could finally fully rest his rear in the seat. The vet office also provided him with a Ruffwear harness which has a handle so I can help support his body when he tries to walk as he recuperates. Well, that handle was the perfect size to loop the car seatbelt through so on top of being able to rest more comfortably in the seat, Popeye was also securely seatbelted.



It was the first car ride in a long time where I didn't feel anxious or sorry that Popeye had to be so uncomfortable. He was actually able to lay down and nap, just like he did when he was a puppy.

Resting

Bad Doggie Mama

Phoebe went in to the vet today for a root canal. For several weeks, I had noticed a little bad breath from her. The raw diet we feed our dogs means that they rarely ever have bad breath.

I remember when I had my german shepherds, who were on kibble for more than half their lives, their breath stank. I thought that was normal, and I guess with most dogs being on kibble, it is normal. But then I switched them to raw and started giving them some whole raw meaty bones. That cleaned off a lot of their plaque and tartar, which in turn made the bad breath go away.

Every once in a while, a little of stinky breath would creep back. That was usually when I hadn't given them whole bones for a while (I started to grind most of their food because they tended to gulp). Then I'd give them a few chicken feet and their breath would be all good again.

So when I noticed the breath on Phoebe a few weeks ago, I thought it must've been because I hadn't given them whole bones for a while. Because I hadn't. We were out and it would still be a few weeks before we got more.

Then about a week and a half ago, while I was rubbing Phoebe's belly, I noticed something on her tooth. A closer look showed that it was cracked.



How long had it been like that?, I wondered. That's what must've been causing her bad breath. So off to the vet we went. Did you know a canine root canal cost $1500?



The good news was that the rest of Phoebe's teeth were pretty clean (another vet thought she was just 1 year old because her teeth were so clean--she's almost 5!) so we were able to skip the teeth cleaning, which would have cost extra.

After the surgery, the vet told us that the tooth had probably been cracked for a while--6 months to a year. 6 months to a year! And we didn't notice! I am ashamed. I guess that's one thing brushing the dogs' teeth would have made apparent to us sooner. But the bones clean their teeth so well, we've just never felt the need (and still don't).

We'll never know what caused the tooth to crack. It could've been one of the raw meaty bones, though we mostly give them soft bones to eat. But if it happened a year ago, there were a couple of occasions then when they got some marrow bones to chew on. Maybe that was it. Or maybe it was the durable nylabone toys that she loves to chew on. It could've been the big dehydrated sweet potato-on-a-rope dog treats. Those things are pretty hard. We'll never know. And so I guess, that means I'll forever live with a small fear that it might happen again.

3 Days & Counting

I have been struggling with the decision of whether or not to have Popeye's hind legs amputated since August 2008. I've changed my mind at least a dozen times since then. Now that I've finally decided to go for it, the days seem to drag ever so slowly and the wait is almost unbearable. The surgery was originally scheduled for Monday, April 27 but I couldn't take the wait so was able to push it up to Wednesday, April 22--3 days from today.

Once I decided to have the amputation done, I took Popeye to 3 different vets before deciding on which one to perform the procedure. All 3 of these vets felt it would improve Popeye's quality of life to have his hind legs removed, but it was very interesting to get their various takes on the more specific details.

The first was an orthopedic specialist who performed Bandit's surgery. By now, I had learned to bring a long rug along so that Popeye would have a carpeted area on which to move. Vet office floors are too slippery for him so he usually remains in his stroller. This doesn't give the vets a very good picture of what he's really like and how he really moves.

This orthopedic surgeon said he was very impressed with Popeye's ability to get around so well. At first he said he would amputate at the hips. But when I told him that not having any kind of stumps would compromise his ability to use his cart (the cart has a straddle for the legs to go through, so without anything to go through, he wouldn't have an anchor to the seat), the surgeon said doing it high up on his thigh would be ok.

When asked how they would bandage the wounds, he said they would have to wrap his entire lower body so the bandage wouldn't slip off--including his penis, meaning he would have to wear a urinary catheter. Thought: no having to change diapers for 2 weeks, just changing the urine bag. Pretty sweet deal, at least in theory.

This surgeon also said he'd want to get video footage before and after, possibly for years after to document the procedure. I kind of liked that, the thought that the surgeon would be there long-term to follow up. Estimate: $4000 range, including overnight stay and 15% rescue discount.

The second vet I consulted with about the surgery is Popeye's regular vet who also performs orthopedic surgery. He too recommended amputating at the hips at first (apparently, this is the norm), until I mentioned the cart. Then it was the same thought on upper thigh as the first surgeon.

As far as bandaging the wounds, his answer was similar to the first surgeon's, but he said they wouldn't wrap the penis so I could still manually express him. Although the idea of not having to express him for a couple of weeks was enticing, I was really more comfortable with keeping things as routine as possible. This wasn't a factor in my decision though. Estimate: $2000 range, including 50% health plan discount (Popeye has a health plan with this clinic), no overnight stay.

Compared to the first estimate, this estimate was almost a sigh of relief. If it had just been between these 2, I probably would have gone with the 2nd vet because the price was half and I didn't think the first vet would add very much to what the 2nd vet could do.

By this time, I was almost considering canceling the appt with the 3rd vet, another orthopedic specialist, because the $2000 estimate sounded like such a sweet deal. But I had taken Popeye to this 3rd vet many months before and was very impressed and wanted to see if this vet would do or say something the other 2 vets hadn't. He had also gotten rave reviews by many people I'd mentioned him to.

So off we went to see vet #3. And I was utterly impressed by his thoughtfulness and consideration of a lot of the minute details that I think most other vets would have taken for granted. First of all, he measured Popeye's legs in the cart. When I had mentioned measuring to the other 2 vets, they said it wasn't necessary. But the thing that makes Popeye's surgery tricky is that it is usually best to leave as little stump as possible (hence, the tendency to remove at the hips) but I needed just enough to put through the straddle of the cart. "Just enough" is the key phrase. This was very important to me.

Vet #3 pulled out his ruler and measured exactly how many cm he would leave. We deliberated on which point on the thigh would be "enough" for the cart. I liked that he took the measurements on each leg twice. When asked about bandaging the wounds, he said he would try to flap the skin over the end and sew it up on the side of the leg so that it wouldn't rub against the floor. That way, all he would need to use would be a large bandaid for just that incision area. That impressed me too.

There were several other minor things that this vet pointed out that maybe in the end might not make that big of or even any difference, but which made me think that he truly thought out this procedure as to how it pertains specifically to Popeye. The surgery itself is not very complicated, it's the little details and the after care that make the process tricky.

Going home, I felt that this was the vet I wanted to use. And of course, he had to be the farthest, over an hour away without traffic. It would take days before I got an estimate from this specialist, and during that time, I of course fretted a little about what it might cost.

I played little games with myself. Would I still use him if it cost $5000? Yes, because sometimes peace of mind is worth a dwindling bank account which can eventually be replenished through hard work and creative thinking. Would I be willing to spend $7000? Probably not, because I didn't think vet #3 would be adding 3x the value as vet #2. There's always the risk that the stumps don't work out and a 2nd surgery would need to be performed to shorten or remove them, and there's no way I could afford a 2nd surgery if the first cost $7000.

I kept thinking it would be perfect (or as realistically so) if his estimate fell between the other 2, somewhere in the $3000. And that's exactly where it did end up. Estimate $3419, including overnight stay and 15% rescue discount. So that's who will be removing Popeye's legs in 3 days.

Doggie Fashion

I have no shame when it comes to pimpin' my dogs out in style.

Junebug (from Lake County shelter -- Tyler's all-time favorite foster dog!)


Phoebe, our resident attention whore (BTW, this "wig" is really a huge gigantic dog rope toy.)


Radar


Prince (from Taiwan)


Meilin (from Taiwan)


Charlie (from Hurricane Katrina)


Mario (from Taiwan)


Kiki (from Hurricane Katrina)




Cupcake (another pit favorite!)


Buffy


Bernice


Nacho (from Mexico) & Ihna (from Taiwan)


Marlee


Abigail (from Taiwan)


Dixie


Junebug again


So many outfits, so little time.

P.S. To reply to Wild Dingo's question, Boomer's a boxer mix. If you stand him next to a purebred boxer, you will see an amazing resemblance in everything other than shape (white streak down forehead, white paws, white chest, stub tail, long jowls). The other parts of him, who knows, guesses have been rhodesian ridgeback, german shepherd, australian shepherd.