L-o-v-e

I love this dog so much.

It’s crazy to me to think that many people would have euthanized him either before surgery or after, when he could neither walk nor go to the bathroom on his own. Basically when he was at his lowest, and I was at my most frightened, wondering: how can I possibly manage his condition all by myself? Yet, I never considered not trying. That thought only would have crossed my mind if he were suffering, which he was not, despite his new limitations. There were countless challenges with taking care of him in those early days and weeks - sometimes when I think about it now it seems like a dream - and I'm not sure how I did it.

But it’s amazing to me how far he has come in just over three months. I know he will walk again someday. I will never give up on him! And even if he never walks again, so be it. He is not in pain and remains the same happy, playful, goofy, sweet Ali he always was. Sure, there are things he can’t do anymore, but that’s true of people who are disabled too. And while dogs are not able to conceptualize or think about their disability the way people can, this actually seems to serve them quite well in terms of adjustment; dogs don’t dwell on their disability in the least. It’s the human caretakers who are most inconvenienced, of course: financially, physically, emotionally, socially…there are many lifestyle sacrifices that come along with taking care of a disabled dog. As far as I’m concerned this is what we all sign up for when we invite a helpless being into our lives with the tacit promise to take care of them (not to degrade Ali and his brethren by calling them helpless, but dogs have been [over]bred to be utterly dependent on humans and, in our anthropocentric society, they are, indeed, “helpless”). At the risk of sounding self-congratulatory, I really wish other people valued their companion animals half as much. Yes, I have worked in animal shelters and have seen firsthand just how easily people discard their pets. Even with the magnitude of his injury and the massive cost of treatment, it never crossed my mind not to do everything I could for Ali. So, I have to go into debt. People are in debt for way worse and far more frivolous reasons than saving a life or helping out a friend in need – regardless of species. It just kills me to think of the comment one of Courtney’s friends made when she told him what was going on when Ali was still in the hospital: “a bullet would be cheaper.” All I can say is, I’m glad I don’t know that guy. Okay end of random rumination. I have to go hug my amazing dog now.

It looks like he is just standing there, but…

…this is an important part of Ali’s physical therapy: weight bearing. At least twice a day we come to the park and I have him "stay" for ten minutes in a standing position so that he can put weight on his back legs. This type of exercise is important to counteract the effects of atrophy, which are already quite pronounced (his right hind leg, the weaker, is more atrophied than his left). If and when his motor function returns, it is important that he be strong enough to hold his own weight – otherwise we will have a situation where he can move his legs but is not strong enough to do really anything with them (stand up, walk). I also do “sit-to-stand” exercises with him a few times a day, which are pretty much as they sound. I start with him in a standing position and ask him to “sit” back onto my knee. Lots of praise! Then, with me supporting his hind end, I encourage him to push off and stand up. We repeat this a few times...as many as a wiggly, restless German shepherd can tolerate! This is good for strength and reawakening muscle memory.

So, in terms of Ali’s ongoing physical therapy, it is important to have him bear weight on a regular basis. It can be challenging; ten minutes seems like nothing but it can feel like an eternity to both of us while we are just standing there. I try to distract him with sticks and cookies to make the time go by quickly. It’s hard of course because he is a dog and standing still is not exactly a natural posture at the park! He is such a good boy, though. I can only imagine how much more difficult this exercise that looks like “nothing” would be with some other dogs who are less inclined to want to please their guardians (my late great husky, Kobi, immediately comes to mind!).

It is also challenging because people just love to walk right up to us in the park, with their dogs no less, even when we are hiding behind a rosebush trying to be inconspicuous. Of course no dog – no matter how well-behaved – can stay still in these circumstances so I have to politely tell them we are doing physical therapy and cannot talk at the moment, and sorry, but no, he cannot meet your dog right now. Ali’s wheelchair is an oddity and I knew he would draw attention but I am patently shocked at how many people flat out stare at us, turn their vehicles around in the street, and just approach us constantly with questions and comments, some innocuous and polite, others just plain annoying and nosy. Some dogs have reacted badly to Ali’s wheelchair and so I am much more cautious about him meeting other dogs in the park. In fact, I pretty much avoid it now. But I can’t take any chances. My neighbor’s dog recently tried to start a fight with Ali after they came up to us in the park and she assured me her dog was friendly. As soon as they sniffed noses her dog went for Ali and I had to pull him away from her – trying to make sure his wheelchair did not tip over in the process! Immediately she apologized and said she realized too late that her dog might react badly to Ali's wheels as she barks at strange objects...including people in wheelchairs (!). Um, I wish you had thought of that beforehand! Anyway, Ali was alright but it has made me even more cautious than I already was, which is why it is a constant challenge dealing with people walking right up to us with their dogs, without even asking if it is okay first. Even when I turn around and walk in the other direction they sometimes follow us! And this is not an off-leash dog park I should add, lest I sound overly harsh. There are signs posted that your dog must be on a leash. It is a de facto dog park however and I really don’t care if people violate the leash law, as long as their dogs are under control, which unfortunately usually they are not! Nothing new – careless dog owners abound in general – but the stakes are higher for sure now that Ali is disabled.

Underwater.

Both Dr. Tieber and Juli were happy with Ali’s progress at his re-check appointment on Friday. Dr. Tieber thinks he definitely has some pain sensation and this is good. She did not seem concerned about the cross extensor reflex. She said this is just a sign of a severe upper motor neuron lesion but does not mean he will not recover motor function. We put him in the underwater treadmill and he did well. When the tank filled up with water and Juli (who was in the tank with Ali) let go of him, he was able to stand with the weight of the water helping him. Although he wasn’t able to walk by himself on the treadmill, his left leg was definitely moving. Juli said he was not strong enough to break through the water on his own, but he was initiating movement and then she would help him complete the arc of a forward step. The right leg is his weaker and though she did not feel it moving she thinks there is “something there.” I am going to bring him back for hydro-therapy appointments once a week moving forward. He will only be in the tank for about 5 minutes each session until he gets stronger. Combined with the exercises we continue to do at home, it is my fervent hope he will continue to improve a little each day. I know he can do it!

Ah, moving...does it ever go smoothly?

I am happy to report that the move went very well! Except for the unfortunate accident I had involving a beer bottle, my wrist, and a lot of blood. No, I wasn’t drunk! I wasn’t even drinking. I swear. I was unloading my van, trying to get Ali’s big orthopedic bed out, when an errant 6-pack started tumbling toward the door (in that weird combination of slow and fast motion). A couple bottles hurtled past me to the ground and smashed in the gutter and in my panicked attempt to keep more from falling somehow I caused another one to crack open and the jagged pieces hit my wrist on the way down. What a mess…glass and beer everywhere (hi, new neighbors)! Once the blood started gushing and I saw where the three main cuts were (one was right in the suicide place, scarily near my vein, and the other was so deep it would more accurately be described as a “gash”), I started to get faint and called my roommate Maggie at work, just so someone would know where I was in case I passed out and bled to death, and she came immediately with our dusty ALDF first aid kit and bandaged me right up. She is awesome!! Why is this relevant to my Ali blog? Well, it was my right wrist and it was really painful (not to mention disgusting) for a couple days and I need both my hands and arms to deal with Ali without hurting us, so it was tricky. But a little over a week later I am completely healed and trying to be much more careful around glass. Although I think I may be accident prone.

To get to the raison d’être of this blog, Ali is doing really well and has settled nicely at our new place in Petaluma. He is using the ramp successfully and the park across the street is very convenient for us. I take him there 3 times a day (2 on work days) to exercise, go potty, and do ten minutes of standing exercises in his cart. He and Rita, Maggie’s dog, are getting along great and I couldn’t ask for a better canine roommate for him right now. She is pretty low key which is good, because he wanted to play immediately when he met her, and when Ali plays he throws his whole body into and even likes to spin around (his infamous “play spins”), so I had to watch him pretty carefully to make sure he did not overexert himself. It has been interesting adjusting to life outside of one room, because of course he sometimes wants to travel from room to room, or greet Maggie and Rita when they come home, and meet new people when they come over. I have to watch him so he does not drag himself, which he definitely was trying to do a lot at first (and still does sometimes) and when he wants to get up I run over and grab him by his Walkabout rear harness (aka his “shepherd handles”), which I leave on him all day until we go to bed, and assist him by lifting his rear legs so he can walk where he wants using his front. The rest of the time he is on one of his beds. Getting to and from work has been a challenge (obviously compared to the convenience of living in my office, ho, ho, ho). Everything takes so much longer, getting him in and out of the car is kind of tricky (and making sure he doesn’t get himself into some weird position while I am driving), but we are getting into the new routine. Last week we were able to join in our first staff dog walk since his surgery over two months ago, which was great. The other dogs were not quite sure what to make of his wheelchair at first, but it didn’t stop Alec from his favorite activity while walking with a group dogs – trying to pull to the head of the pack so he can be the first one in what must appear to onlookers like a dog parade.

I still need to keep his walks short and it’s better for his joints if he walks on grass (hence the park across the street being so convenient), but Juli, his rehab therapist, says eventually he can take long walks in the cart. For now though, she emphasizes that physical therapy is the most important thing I can do with him in the cart, more important than going on walks, and I need to keep doing his exercises throughout the day. She showed me a new exercise where I assist him to sit and then stand several times throughout the day for one minute. She came by last weekend to help with his cart problems and showed me a way to get him to urinate in the cart and it is working so I am very happy about that! Moreover, she believes she see some slight movement at the top of his back legs, where they meet the rest of his body (this is called “proximal motor”). She also believes he has deep pain perception (I pinched his tail once in front of her and she saw him react – the reaction I could not get for the neurologist during our initial re-check exam back in March). Since Juli believes Ali is showing some improvement, she suggested I make an appointment at Animal Care Center with the Dr. Tieber for another re-check. She said because she is not a doctor she can only “assess” Ali’s condition but not “diagnose” and thinks I should get a neurologist’s opinion on what she believes she is observing (i.e. some return of motor function).

After we see the neurologist, Dr. Tieber, we are going to have a rehab appointment with Juli and put Ali in the hydro-therapy tank for the first time. I really hope Dr. Tieber confirms what Juli is seeing. I feel like he is improving too – it seems like I can see his legs moving slightly sometimes in the cart – but I am afraid to get my hopes too far up. Our appointment is on Friday morning. Wish us luck!!!

Moving out of the ALDF office tomorrow!

It has been nine weeks since Ali’s second surgery, which means we have been crashing at ALDF headquarters for two months (if you just tuned in, we are living in my office because my former apartment in San Francisco has stairs and we needed to be on the ground floor for Ali's recovery). Strangely, living in my office has actually become comfortable. It just goes to show how adaptable we are, I guess! Ali has adjusted amazingly well to not having use of his back legs and I have adjusted to living at work in a hybrid office/dorm room the size of a shoebox. The thing is, at this point, living here is a known quantity, whereas my new place has all manner of exigencies and contingencies. There is a whole new routine we will have to create and then there is that ramp…I will have to saddle him up in his cart (a routine in itself to which we are both still adjusting) and use the ramp every single time we need to leave the house. No more sling-walking him outside to go to the bathroom (my back finally stopped hurting, so that actually became easier). I will have to start loading him in and out of the van (with another ramp) to go to work, and in and out of his cart every time we get in and out of the van. Then there is Seniorita (Rita, for short), my new roommate’s dog, whom Alec has not even met yet. This will be interesting!

I am trying not to completely freak out, but moving is always and inherently stressful. Throw in a paraplegic German shepherd with a brand new wheelchair and a new canine roommate and I imagine things can get real interesting real fast. There is also a park right across the street that appears to be a de facto off-leash dog park. It will be nice to have a big grassy area in such close proximity for Ali, but I am not sure how he will be about meeting other dogs in his wheels. He is usually fine at dog parks (as long as he is off leash), but I also need to be concerned with him not moving too much, so I’m not quite sure how this is going to be. My new neighbors also have two dogs who are outside a lot, so…lots of unknown factors, which are making me oddly reluctant to leave my cozy known quantity of an office/dorm room. We have a nice routine here that is working. But it is time to go. I can see how people become shut-ins, though, sort of. I am taking the day off tomorrow to make the move just so I can take my time with Ali and all this newness. Tonight though, I am going to pour myself a glass of wine and stop worrying.

Because I have been kvetching about Eddie’s Wheels all day and I am tired of it, just a quick update about Ali’s inability to urinate in the cart. Juli, the fabulous and amazing canine rehabilitation specialist, came by today and rigged a soft saddle on the part of the cart that was pinching his urethra. It seems to be working part of the time. I will know more soon. But it’s nice to know she is willing to help us. I don’t know what we’d do without her! Oh, and she let me know I am not the only person who has had problems with Leslie from Eddie’s Wheels. Apparently, another physical therapist she knows refuses to work with her because of her attitude. But she also told me that Eddie’s Wheels carts are the best on the market and far superior to other brands, in her opinion. So hopefully we can make this work for Ali. But if anyone stumbles on this who is considering a cart for your dog, beware the urethra-pinching saddle if you have a male dog! They won’t tell you about it beforehand but it can be a serious problem. I am afraid Ali may have developed another urinary tract infection from not being able to properly urinate those first couple days in the cart. So this is a serious flaw for which they should take responsibility and be compelled, from a purely ethical standpoint (unbridled capitalism not withstanding), to start disclosing. This not a chair or an ipod they are manufacturing; it is a wheelchair – a ticket to mobility, freedom, and life – for a living being whom somebody loves very, very, very, very, very much.

Photo: Ali in the ALDF kitchen today, before his mid-day stroll.

Hmm, not so "petit" after all...and completely disenchanted with Eddie's Wheels.

Well, it looks like the “little problem” might be bigger than I thought. Leslie from Eddie’s Wheels unfortunately has been less than helpful. First she suggested I try “compressing” his bladder in the cart to get a stream flowing, since part of DM (degenerative myelopathy) is losing sphincter strength. I reminded her that Alec has IVDD, not DM, and explained that he has full bladder control and has not needed to be expressed in over a month. I also let her know that it’s basically impossible to express a dog who has control of his bladder muscles. I told her the only “accident” he had was the day after he got his cart because he was not able to urinate in it (despite the fact that I had no warning of this potentiality). And I said it was my understanding that dogs could urinate and defecate with no problem in these carts and that I would have considered different designs had I known this might be a problem. Finally, I let her know lifting his tail had worked a couple times, and not worked a couple times.

Her reply: “Most dogs can urinate with no problem in our carts, but a small percentage of males do have problems. I am sorry that your dog is one of them. Usually shifting the dog in the saddle solves the problem.”

Well, gee thanks! I only spent $500 on a cart that my poor dog, who has been through so danged much, can’t even urinate in (a serious problem given that a not-empty bladder virtually guarantees a urinary tract infection), which might be fine except for the fact that it says this on their website:

"Your pet can easily relieve itself and perform its normal bodily functions while in the cart."

No mention of the "small percentage" of males who have problems, which of course would be helpful for customers to know before purchasing their cart, a rather expensive item. I can’t believe they would not even mention this “little problem” – a potential risk that the cart will pinch his urethra, thereby making it impossible for him to continue to urinate normally. And then act like it’s MY problem after they sell me the cart! Rrrrr. Yes, I am pissed off. Because Alec has had to deal with so much already and I really thought the people at this company actually cared about their clients’ companion animals. I guess once the sale is made, things change.

Luckily, Juli the rehab specialist is an angel and has been so helpful to us. She encouraged me not to return the cart – which they were only going to refund 2/3 the price of anyway…if I returned it in “new condition.” After paying shipping costs, I probably would have gotten $20 back. Not to mention no more walks for Alec until I ordered another cart and that we wouldn’t be able to move out of the office for several more weeks…ugh! Juli is convinced we can make it work and she even offered to come by tomorrow to see what she can do. We are so grateful for her. She is so much more helpful than the people who actually sold us the product. Thank you, Juli!! Tonight I shifted him around some and he was able to get a stream going, so maybe I will be able to fix this problem on my own. I hope so. No thanks to you, Eddie’s Wheels! I really hope they add a disclaimer to their website so other people will be aware of this potential problem before they put their dog in it.

Photo: A much happier moment right after the cart arrived, before I knew the thing would squish his urethra! Ali is enjoying a flying saucer filled with peanut butter, which successfully distracted him while we put him in the strange new contraption for the first time.

Un petit probleme.

Some things just sound better in French, n'est-ce pas? Anyway, after my exuberant post of last night, I realized we had a potentially serious problem. Alec had not been urinating well in the cart, and I thought he just "needed time" to adjust. Well, that was a bad call, as I noticed he had peed all over his bed, literally right after I posted about how great everything was with the cart. He has not had an "accident" in his bed in over a month, ever since he started going to the bathroom outside... I even took the wee wee pads off his bed last week (is the universe smiting me for letting my guard down?). So it was a giant mess and all over him too. I could tell he felt really bad, he didn't want to go in his bed; his bladder was just full. And of course he was reacting to my distress. I didn't get angry but I did almost start crying - it was just such a mess and I felt so bad! Not to mention confused. Why is he not going? He pooped fine so it's not some psychological "I don't want to go in this weird contraption" type thing. And I noticed he was going over to his usual spot and lifting his tail (which I have come to recognize as the bladder pump), but nothing was coming out. Juli said she never had a problem with a dog not urinating in the cart (of course!) and that maybe it needed adjusting. She suggested I call Leslie at Eddie's Wheels for their advice. So I emailed Leslie photos today of Ali in the cart and she said it did look like a perfect fit, which I was happy to hear. But that means nothing to adjust in order to fix the problem. She said they "occasionally hear of male dogs who cannot urinate while in the cart. We suspect that their urethras are being pinched off by the way they fit in the saddle. The usual solution is for you to gently lift the dog’s rump - using the tail is ok -and see if he can urinate when you elevate his rump a little bit." So I tried that this evening and the first time it didn't work, but the next time it did... althought I don't know if he was able to empty. I will keep trying. If this doesn't work, I don't think anyone has other suggestions... and he just has to be able to urinate in his cart.

The better news is that he is loving his wheels and enjoying his short walks outside. If only we can solve this little problem...

Cart is here...and it fits!

Juli, the rehab specialist, brought Ali’s cart by yesterday and I am SO happy to report that it fits perfectly!! I have been on pins and needles all week worrying about that and I am so relieved!!! (If it didn't fit, we would have had to send it back and wait over three weeks for another cart.) After getting him used to the cart inside, we walked him outside around the building and he loved it – he looked so happy. He was definitely ready to go, go, go but he can only be in it for short, ten minute walks at first until he builds up his strength and endurance. He has been “down” for about two months now, which is a long time. Maggie videotaped everything and we will put footage of his first steps with his new wheels on the website as soon as we figure out how.

The best part, however, is the fact that Juli said she saw his legs moving a little bit while he was walking in the cart (yes, his back legs!). Her exact words: “He’s got motor!” Obviously, this is really exciting!! Next step is she is going to check on him in a couple weeks, after we are settled into our new place, and if everything is going well, we will schedule him for a hydro-therapy session (which was not on the table until his legs started moving), where we get into a water tank and see if he will move his legs, I guess (I’m not entirely sure but I have to be strong for it apparently!). So now we are planning to move at the end of the week, after he has a few days to get used to his wheels. At my new place there will be lots more to get used to – including loading in and out of my van and getting up and down the porch ramp. I am nervous about all that but I hope it will become routine, just like living in my office eventually did! Everything was so hard at the beginning - there were times when I really thought I couldn't do it - but we made it through that and things got easier. Obviously, things improved tremendously when he started going to the bathroom outside. I really can't overempashsize how much that changed things. I feel so fortunate.

Anyway, I must say it was really great to see him walking again – even if it was just around the building. It was a very good day!