"Life Moves Pretty Fast ..."

 It's actually kind of hard to keep up at this point. A lot is happening very quickly. Much of it is pretty mundane, but some is significant. There are so many moments that bring tears - and some that are just wonderful.

Let's talk mundane stuff. I finally weaned Nicki off of Proin completely. Instead, she has gone on DES. Now that the Proin has cleared her system completely, she's back to having good solid poops, and hasn't vomited at all. Yes, we're talking dog elimination here again. That's so important, though! You can tell a lot about your pet's health by how they're eating and eliminating. With the threat of diarrhea gone, I was finally able to give her a much needed bath. I'd been cleaning her up when needed; a quick wash in the bathtub. Besides the elimination issues, there was another reason for bathing! More on that later. Back to the meds. I think the DES is giving her some nausea, although not anywhere nearly as bad as the Proin. We're past the induction phase and on to weekly dosing. Her first weekly dose seemed to not sit well. I'll give another standard dose next week to observe her reaction. If it's the same, I'm going to ask her vet if I can spread out the dose in smaller segments, and possibly over more than a day. I think the weekly dosing is for the convenience of owners, rather than the comfort of the dog. I don't mind. I'm already giving her pills three times a day. I'd rather she be as comfortable as possible, not simply easily medicated. 

So why did she need a bath if not for a messy wiggle butt? Because she went to a rocket launch, and it was hella dusty! She's been to rocket launches before. We get together annually with family for a fun day together. The rockets don't bother Nicki! She just hangs out, waiting for pets and attention. There are always plenty of folks eager to comply. This year it was extremely hot and dry. Since the launch is set up in a farmer's field, even though roads are leveled, they're unpaved and very dusty. Besides hot and dry, it was also windy. Hence: dusty dog. Don't worry; we had plenty of shade, water, and cool cars to duck into for relief. One of the pluses for Nicki at these events is the availability of little kids. She usually adores little kids! This time, she just politely accepted pets, but wasn't super excited about it. One little guy, about 18 months, was kind of having a meltdown. We walked over and asked if a fluffy puppy would help the situation. Sure enough, within minutes, both the little guy and his big sister were doting gently on Miss Nicki - not a tear in sight. She fell asleep on the way home. Good job, little girl.

She had worn out all the squeakers in one of her favorite toys, then chewed holes through the fabric. I did a little checking and found the same toy at Walmart for a low price. The husband told me to get two so she wouldn't have a dud toy again - and I did. But I noticed that she wasn't really playing as much with this one. She hasn't really been playing much at all. I can't blame her. I returned one of the toys for a refund today. It doesn't look like it will be worn out enough to need another replacement. Things like this get me down. I was in the habit of getting a special discount card for the dog self-wash at our favorite local pet supply store. When we went for that bath, we used the last punch on the card. I asked to be able to keep the card, and didn't buy a new one. Being practical can really suck.

We're not done having good days and happy times. Not yet. There's much to enjoy still, and we're going to enjoy as much of it as we can. There's no Nicki "Bucket List" like some folks do. We're not young, don't live near a beach, or a spectacular national park, or any of those Insta-worthy things. We're going to eat ice cream, and cuddle, and sit on the back porch watching hummingbirds. Nicky has enjoyed her quiet life with us, and we're going to keep right on with it for as long as we can. 

Reality Check

 Now begins the actual process of dealing with all this. All the meds, and more importantly - what they do to Nicki. She's on 2 heart meds, plus a diuretic for blood pressure. That apparently tipped her body into incontinence. She became completely unaware of leaking urine - and it was not good.

So back to the vet we went, to get meds to fight the incontinence. Within hours after giving her second dose, she began to vomit repeatedly. Then she developed diarrhea. I looked up the side effects of the medication, which were not good. The dosing also seemed too strong for her little body. We stopped that medication immediately. Now I'm fasting her to give her body a chance to purge the medication that caused the reaction. In the meantime, I'm washing a lot of towels, rugs, and dog butt. It's been pretty hectic.

So hectic that it took a while to register: this is not a passing illness. I'm not nursing her back to health. That cannot happen. At best, this could be called palliative care. I'm trying to manage her symptoms to preserve some quality of life for her. I want her to be comfortable and happy.

And that's an end game.

I've been through this. It's hard to stop yourself from becoming hopeful when they perk up and seem to feel better. It's hard to accept that they won't continue to improve. It's hard to be so powerless for someone you love so much.

Ordinary tasks become fraught. The size of the bag of kibble becomes a question mark. How much longer? How long?

For now, I have boiled chicken and rice ready for when her system quiets down, The main priority is to get her heart meds into her. Since she's not getting incontinence meds now, we'll have to go back to taking up her water in the evening, extra walks and trips outside, and fingers crossed for a dry morning. Again. 

The worst of it is that she's such a lady, and all this upsets her. She seems downright insulted to be asked to go out every 1 1/2 - 2 hours. No Lasix for now - not till we speak to the vet again tomorrow to try to get a different incontinence medication.

We're just juggling symptoms, and trying to push against the door to keep the monster from breaking in and stealing her.

Update (following day): I suggested that we try halving the dosage of the incontinence meds (Prion). The vet agrees. So last night, when we were awakened at 3:00 am by a slightly damp pupper jumping up onto the bed, after letting her out and cleaning her up, I gave that 1/4 pill. She was dry this morning, but spent the day just not herself. So far no vomiting or diarrhea (fingers crossed, but that didn't start until the 2nd dose last time), but my girl just ain't right. At one point I saw her sitting and staring at a blank wall. When let out, she circles and paces, comes back, goes back out, lather rinse repeat. It's as though she can't quite figure out how to do her business. I did call the vet again to tell her the final verdict on Prion is that it does help Miss Nicki, but the cost to her is too high. Spent the day waiting for a call back. Maybe tomorrow. 2nd dose of the day at 7:00 pm. Keep us in your thoughts.

My Old Dog is Teaching Me New Tricks

 Many times, rescued dogs appreciate familiarity and predictability. Truly *rescued* dogs haven't just been rehomed; they've been saved from bad circumstances. Abusive homes are notoriously unpredictable and volatile. Neglectful situations leave their own, different scars. Both of those are soothed by the predictability of a loving home. Regular meal times with familiar foods. Predictable reactions within the family. No sudden blows, no raised voices, no punishments just for being a dog. 

Last night, Nicki and I went out for our evening walk. It's a small town, and our walking opportunities are limited by the geography of a one-stoplight-town with very few discernible "blocks". I've been letting Nicki choose our course lately in the hope that makes it more enjoyable for her. Last night I wanted to start in a slightly different direction. Basically one of our usual routes, but with a slight variation. That slight variation took us toward an area where we ordinarily finish the walk and head for home. To my surprise, Miss Nicki got to that point and began to follow our usual route - in reverse! She went the way we're used to walking, but - leading the entire way - she walked the route in reverse, then simply headed home. 

Well! She knows the walking routes so well that she can take the initiative to change it up a little! Great! Three cheers for predictability!

Then she did something relatively new. If we come home with a little bag of poo, she now walks directly to the trash can in the yard, pauses in front of it, looks up at me, and waits for me to dispose of the bag. Then she leads the way into the house. HER house. Because she's home, and she loves home.

With all this toileting trouble and the diuretic meds, she's doing something else that is completely new to me. I never had a dog try to drink from the toilet bowl before! Luckily, I believe strongly in sanitation but - sheesh!! That is a new trick I could do without!

Change is Hard

So sleepy. So, so sleepy.

 If you plan to follow this blog (and thank you, if you do), you should be prepared for something; it won't have a happy ending, but it will have an ending. Nicki has a progressive, terminal disease (congestive heart failure). That doesn't magically go away. A lot of what will appear here now will be how we got to this point, and how we're dealing with it now. Hopefully there will be more happy Nicki stories, too. For that to happen, we have to help her manage life with this disease. If we share that process with you, you may have information that you find helpful at some point. That's what this whole blog was started for; to share the journey of a rescued and adopted dog in order to help others.

Nicki has been placed on 3 medications; Enalapril, Vetmedin, and Furosemide. During the first week, they seemed to be helping her, but she was almost always sound asleep. I did some research on side effects, and noticed that two of the meds induce tiredness and/or lethargy. That corresponds to what I've been seeing. I'd been giving her all 3 medications in the morning, then Vetmedin and Furosemide again in the evening. Since Enalapril is one of the meds with tiredness/lethargy as a side effect (Vetmedin is the other), and she only has to get it once daily, I'm shifting that to evening dosing. Hopefully that will allow her to be more present during the daytime. Update: I did do so, but now we have a big problem with incontinence. Nicki had always been a VERY light sleeper. The slightest thing disturbed her. No longer. Now she sleeps VERY soundly through the night, unaware of a need to urinate, and wakes up not knowing that she's soaked. The vet cut her dose of Furosemide by 75%, and I shifted the timing to 2x during the day, but none near night time. Even so, we have accidents. She doesn't go off to pee in the house; she just doesn't realize that urine is coming out. This began *before* I shifted her Enalapril to evening dosing, so I don't think that's the problem. We have a follow up appointment tomorrow. I expect the vet will want to start her on meds for the incontinence. We went through this with our border collie, Daisy, near the end of her life, and the meds helped tremendously.

Since she has heart disease, some of you may be wondering about her diet. Having come to upstate New York from Kentucky, her first 3 years here produced allergies that worsened with each spring. Eventually we switched her kibble to grain free, and supplemented with unflavored, non-chewable biotin caplets coated in peanut butter, a dollop of coconut oil, 500 mg of fish oil (those 3 daily) and - during allergy season - 25 mg of dipehnhydramine, twice daily. For those saying "AHA! Grain free! That causes heart disease!" you need more information. Nicki also gets raw venison, raw fish, raw, frozen chicken wings, vegetables, yogurts, and other variety, including Dinovite powder, at my husband's suggestion. Honestly, I've stopped giving her diphenhydramine since the addition of Dinovite, and her allergies are not bothering her this year. So yes, she gets grain-free kibble, but she doesn't just get kibble. As a matter of fact, we did a post about her food variety here .

So - everything we knew has changed. Nicki is tremendously annoyed by my constant urging to go out to potty (about every 2 - 3 hours). She doesn't get morning cuddles on the bed with me unless I check her first and find dry fur down there. She gets plopped into the bathtub and rinsed off every other day, it seems. She gets more treats - but they all kinda taste funny (because I hide the meds inside them). She can't drink water after 8:00 when Momma and Daddy take the bowls away. And Momma has become paranoid - thinking everything smells like pee.

Mostly I miss the cuddles.