Hoping for the best.

Alec in the van after getting sprung from the emergency hospital...let's go home!



Nap time! When we arrived home, Alec whined fussily for about 15 minutes and then passed right out. Adorably, he is using his cube toy as a pillow.

After two days in the emergency hospital, Alec is finally home! He is doing well post-operatively. The last couple days he was being monitored for heart ayrrhthmias (very common after splenectomies, apparently – if the irregularities had persisted he would have been put on heart medication, but he did not need it). They were also monitoring his red blood cell count and warned me he might need a transfusion after surgery because of how much blood he lost. However, we were lucky and he did not need that either. Finally, they wanted to make sure he was eating well (and not vomiting) and doing okay on his oral pain meds before releasing him. Although he was picky when the staff fed him, he ate heartily for me when I visited him yesterday and he kept it all down so I got the green light to bring him home this morning. I am so happy he is home with me!

When he saw me, Alec began to whine excitedly (he is a very whiny little boy). Because they brought him out the side door directly into the parking lot, and not into the exam room where we had had our visits, I think he knew he was going home. I was nervous about lifting him into the van but that went okay. He has staples in his abdomen and I had to alter the way I normally lift him in and out of the van. I am hoping to not have to transport him while he is healing. The staples have to stay in for two weeks, and he is on pain medication, but nothing else for now. He has activity restrictions due to the staples and his incision, but basically these are the same restrictions he already has because of his back (plus very short walks for now). I was so worried they might hurt his back inadvertently in the hospital. Each time I talked to a new tech or doctor: “And you know about his disability, right?...Okay, just checking!” They were all great and assured me they were being very careful and that there was a big sign on his kennel alerting staff to his back issue.

I look for good news where I can find it, and upon discharge I was happy to learn the final bill was less than the estimate they had given me (because he did not need the blood transfusion or have other complications). The total was $3,887 and I have one credit card that is still within a 6-month introductory period with 0% APR (I actually got it in Feb. to pay for Alec's new rehab treatments in Corvallis – the ones that unfortunately did not work!). This credit card has a $5,000 limit, and with the $1,000 for the rehab treatments from last month, I still had just enough room to put this bill on it, which is good because my other two credit cards are not in introductory periods and have high APR’s (I originally got both of those for Kobi’s chemotherapy treatments a few years ago and now retain them for emergencies, aka vet bills). Not that I will be able to pay this off in 4 months, but I am glad the interest will not kick in right away!

Of course, we are not out of the woods. Today's bill is truly the least of my worries. Alec’s spleen and the grapefruit sized mass that had ruptured, along with a biopsy of his liver, were sent to the lab and I will not learn the results until next week – they said probably Wed. or Thurs. They told me the regular statistics are 60-70% chance it is malignant, but given his age (9) and breed, the chances is higher. Not the greatest odds, but I am hoping for the best: a benign hematoma. If it is malignant, we will have to begin chemotherapy right away, as this is an aggressive type of cancer. So there is a lot more potentially coming down the pike at us, financially and health-wise, the latter of course and without saying always being the most important, but I am scared about hitting the limit on all my cards eventually (it happens fast; I was credit card debt free only a month ago!). But I will cross that bridge when I come to it. Step...by...step. I am trying to keep my thoughts positive.

For now, he is home! He was so cute when I brought him inside. He lay down on his bed and whined softly for about 15 minutes (I think he was just “telling me all about it,” if you know what I mean). I assured him I was very sorry for leaving him at the hospital for two days but that it was for the best, etc. He even let me cuddle him a bit! Usually my attempts to cuddle him elicit escape attempts, but I think he did not mind being babied a little as I listened and sympathized. It was the cutest whine; I am no dog translator, but I think the meaning was transparent: “I am happy to be home but I did not like being in that hospital at all!” Then suddenly he just fell asleep – passed right out on his bed (yes, he is breathing! Of course I checked!), and now his little paws are twitching as he is probably dreaming about his stay in the ICU. Poor little guy is tuckered out. He went from whine, whine, whine to fast asleep in 30 seconds. I hope he continues to sleep and rest. I know he did a lot of sleeping in the hospital, but I think being home in one’s own bed is different.

We have been fortunate so far. His surgery was a success and his surrounding organs looked good. There were no masses on his lungs (they x-rayed those before surgery). He has recovered amazingly well from surgery so far (knocking on wood!). And dogs can live just fine without their spleens, in case you were wondering. Finally, when it happened, I was here with him and brought him in very soon after noticing he was acting strangely (thanks again to Daniela, the wonderful receptionist at my regular vet, who when I called strongly advised me not to wait). This could easily have happened next weekend when I was at a work conference on the east coast. I had planned for a couple friends to take turns watching him, but I doubt they would have been as alarmed as I was by his sudden lethargy; they probably would have thought he was just depressed that I was gone. They obviously don’t know him as well as I do, and likely would not have realized how strange his behavior was or that it was an emergency situation. I almost didn’t (and if you have been reading this blog you know I am borderline obsessive about observing Alec, just because of all he has been through). He could have easily bled to death if much more time had gone by. So if this was going to happen, we have been lucky so far.

I just need our luck to hold out a little longer. I appreciate all the well wishes and support. It really means a lot. If you could do me a little favor and make a wish for a benign hematoma for Alec, I would be so grateful. I know so many people are pulling for him and thinking good thoughts and it helps so much.

And now…I wait. Love is not easy. It holds the potential for the greatest joy but also the deepest pain. The hardest part about truly loving someone, at least for me, is the intense desire to protect them from harm. You try to do everything in your power to keep them safe, but still there are things you cannot control. That's where the hope comes in.

Not this.

This morning when I woke up, I noticed Alec had vomited a little in the night, or maybe that morning. I had given him a CET chew (dental rawhide chewy thingy) the night before, which I have given him many times. There was a chunk of this along with some food in the vomit. I thought maybe he had an upset tummy because he ate the whole thing before bed (sometimes he chews them over the course of a few days, but not always). When we got up he went right to his water bowl and started drinking...and drinking...and drinking. Finally I called him away before he could drain the whole (big) bowl and took him outside where he urinated and defecated like normal, but he did not want to walk - not normal - and just stood there obviously wanting to come back inside. He seemed weak and was acting strange. I brought him inside, thinking again maybe just a little upset tummy. He went straight into his "little house" (his kennel) and showed no interest in breakfast - very unusual. It crossed my mind he might have some of the chewy hung up inside but I (mistakenly, it turns out) thought he could not be blocked if he had peed and pooped. I called his regular vet and they were booked of course, but Daniella at the front desk (who is wonderful) told me if it was a blockage I would not want to wait; she recommended I take him to the emergency clinic. Even though it turned out not to be a blockage, this was very good advice.

As luck would have it, my annual performance review at work was scheduled for that morning. I was going to take Alec in as soon as it was over. When my boss called at 9:30 am, however, she could tell immediately something was wrong (I have neither poker face, nor poker voice, nor poker anything) and she suggested we reschedule and thank god she did. I took him in right after that and he was so weak by the time we got to the emergency clinic. There were dogs in the lobby and he did not even respond (again, highly unusual) and he laid down while I was at the front desk checking in...also unusual for this normally anxious boy. He was weak and lethargic and clearly did not want to walk. What was wrong with him?

After the front desk called for triage, a tech came out to the lobby. He asked me some questions about things Alec might have gotten into. I assured him Alec was rarely out of my sight, and he was not the scavenger type dog anyway - never has been (that was my dear Kobi - totally different story). I asked, but was not allowed to come back with him. I waited. Someone came and told me they were doing an ultrasound to see if he was blocked. An hour or so later the doctor came out to the lobby to call me back. She did not have a poker face either. My heart sank as the panic rose.

She said Alec was bleeding internally - a lot. There was a mass on his spleen, and it had ruptured. There was no blockage; it wasn't the rawhide chewy I gave him. She said I could not have known ahead of time (as I pleaded, "what signs did I miss?? I watch him so closely!"). She told me there are usually no clinical signs for splenic masses until they rupture. She said cancer of the spleen is common in German shepherds but there is a chance it could be a benign hematoma. As remote as this chance may be, it is what I am hoping for.

The only option was surgery to remove the spleen. They recommended x-rays first to be sure there were no tumors on his lungs, in which case surgery might be futile. They brought him to me in the exam room and I said good-bye to him before the x-rays (he was alert but weak...although he walked in on his own, we had to drag him back across the slippery floor on the blanket because he did not want to walk) and waited another hour. The doctor came out to tell me his chest x-rays were clear. Hurdle one. Then he went into surgery. I came back home as there was nothing I could do and waited by the phone. Three hours later the surgeon called to tell me he had come out of surgery okay and was stable. Hurdle two. She had removed his spleen, which had a grapefruit sized mass on it. They sent his whole spleen out to the lab, and I won't know until next Wednesday or Thursday if it is definitely cancer. Again, if you are reading this, BENIGN HEMATOMA is what we are hoping for!!! Alec has beaten the odds before. He has been through so much. I know life isn't fair, but he deserves a break. The estimate for today was $6,300. If it is cancer, chemotherapy will be an option. And of course, one I will take. The prognosis is only 2-6 months without chemo.

Of course I asked, if it IS cancer (please no!!!!), is there a possibility it was all removed when his spleen was taken out? The surgeon told me no; because of the vascular nature of the spleen, with so much blood passing through (unlike some random leg muscle for example) there is the potential that the rest of his cells have been "showered." He would require chemo.

He came out of surgery three hours ago. The surgeon said I could visit in five. I will be heading to the hospital soon. I am writing this to take my mind off things, to keep from drinking too much whiskey. I just poured myself a finger when I learned he made it through surgery okay. I don't know what to do with myself. I am trying so hard to think good thoughts, but my brain is crazy with worry and anxiety. I don't want to let the bad thoughts in. Whiskey helps. But I can't drink too much because I need to drive to the hospital later.

He will be monitored overnight, his heart, his blood levels, etc. If everything looks good tomorrow I can bring him home. Or it may not be until Sunday. As luck would have it, I am traveling to the east coast for work next weekend. I don't think I will be able to stick to the original plan of having friends watch him now. The emergency clinic does medical boarding. I got a quote: $630 for 72 hours. This might be my only option. I was nervous enough leaving him before this...I can't imagine leaving now without him being monitored 24/7.

In keeping with my previous post about bedside manner, the ER doctor who first spoke to us, Maree Doolan, was wonderful. She was so compassionate and really caring and spent time talking with me until I was out of questions. I did not feel rushed. This is a special skill; its easy for busy vets to inadvertently make you feel hurried. This is also what I love about Kristin Sulis, our regular vet at Mt Tabor Veterinary Care (and her wonderful staff). Our neurologist back in California, Lisa Tieber, shared this quality. I have had lots of experiences with vets and if they could all be like this, it would be great. Dr. Doolan even called to check in after the surgeon had already called with an update. Those of you who have been in similar situations know how much that means...not a perfunctory call, but genuine. One can tell the difference, and it made a difference to me.

Quick note about my previous posts: the laser and VOM therapies I wrote about last time had no effect; Alec did not show any improvements. I was holding off writing that update, for obvious reasons I guess. But I am glad I tried. If only it hadn't been so expensive for nothing to come of it. The doctor was so hopeful at the outset; she was really disappointed he had not improved. Oh well. All of that matters little now. I just need him to get better. Benign hematoma, benign hematoma...and no complications. Please say it with me. Please let him be okay.


I just took this photo a few days ago during a stroll along the river front.

On Bedside Manner

A happy and relaxed Alec in the treatment room at West Hills Animal Hospital in Corvallis, Ore. Note the physio-rolls and rocker board; both are standard equipment used in canine rehab therapy.

I am happy to report that our visit to the West Hills Animal Hospital last week was a success! Alec and I both loved Dr. Moore. I found her to be very knowledgeable and thorough, while Alec was quite comfortable in her presence. She has a wonderful “bedside manner,” which I have learned is not something to be taken for granted. Alec is sensitive and anxious, but can be made calm relatively easily by the right person.

A case in point of a very bad experience I had in this regard was one of the facilities here in Portland to which I took Alec upon moving here over a year ago. The doctor and vet tech were demonstrating to me how to apply the “soft paws” nail caps, which help prevent dogs who drag their paws from ripping their toe nails. Well, Alec (like many dogs) does not like being compelled to lie on his side, and hates being restrained even more. I warned her of this fact. Yet to apply the nail caps, they held him down -- the doctor on one end of Alec, the tech on the other -- basically bear-hugging him with a vice grip to get him to hold still. Of course, this had the opposite effect and made him frantic; he began to thrash and whine and struggled mightily to get up. This made me uncomfortable, but I didn’t want to be “that client” – you know, the annoying person who tells the doctor how to do things. However, I feel I have become a good advocate for Alec without being an obnoxiously squeaky wheel. I voiced concern (“should you be holding him down like that with his back injury?”) and the doctor said, “He is just trying to see what he can get away with.” Well, be that as it may, he also had multiple spinal surgeries eight months before and I was told by his surgeon and rehab therapists to be careful of his back! And here they are restraining him with a full nelson (half nelson? – I don’t know anything about wrestling, but they were pinning him down) while he thrashed and flailed. Finally, I could not take it anymore and said, “That’s enough. I am not comfortable with this, please let him up.” Which they did, but they were clearly internally rolling their eyes at me. The doctor admonished me: “You baby him.”

I did not think this was fair. I know a good amount about dog behavior, and I know "bad" behaviors should not be reinforced. However, this particular dog has sustained a serious injury to his spine. Furthermore, it should be a positive experience for him to come to any rehab facility, which should factor into how he is treated. Maybe he should be “babied” a little so he wants to come back and do therapy...you can’t force a dog to do rehab exercises, and a little positive reinforcement could go a long way. It seemed this was definitely getting off on the wrong paw with Alec – not to mention with me. This was our first visit and she was not earning my trust with her rough handling of Alec. Veterinary "bedside manner" involves handling the human client as much as the canine patient, and I can sympathize with vets who have to deal with difficult clients on a regular basis. I strive to be pleasant and understanding in my interactions with veterinary personnel; I truly appreciate them and I want them to like Alec and me. But I think my concerns about Alec's back injury were reasonable and should have been respected rather than dismissed.

Afterward, I shared my misgivings about the experience with J., our trusted former rehab therapist back in Calif. (whom I was missing very much at that point!), and she was appalled that they would hold Alec down like that given his surgical history. And J. was always a proponent of rehab therapy being a positive experience for the dog. I didn’t realize this was not an attitude shared by everyone in the canine rehabilitation community. I did return to this facility a few times, trying to keep an open mind (I knew I missed our people in Calif. and realized this could be coloring my experience), but that was not the only negative experience I had, and I finally stopped taking Alec there. It’s unfortunate because, as I mentioned, they are conveniently located right here in Portland! Interestingly, I have not heard any negative feedback about this place from others, and I really wish my experience had been better. But I have to trust my intuition when it comes to Alec and what is best for him.

This happened over a year ago, but it serves as a counter example to illustrate part of the reason I liked Dr. Moore so much. Alec had to lie on his side at one point during the evaluation so she could check his reflexes. I found myself involuntarily tensing up, knowing how Alec would react if they wanted to hold him down. I cautioned he did not like lying down/being restrained and briefly relayed my experience at “the other place” and how Alec only became more frantic. Dr. Moore’s response? “I find belly rubs are more effective.” Ding ding ding! Correct answer. We both rubbed his belly and asked Alec to “stay,” and it was 100% more effective than forcibly holding him down. He was such a good boy (sure, he tried to pop up a few times, but it was nothing like his panicked thrashing at “the other place”). By the end of the appointment, nervous whiny Alec was so relaxed he was resting his head on Dr. Moore’s leg. It was remarkable. I should mention Trina, the lead vet tech who is also certified in canine rehab, was wonderful as well. I was so impressed with both of them, not to mention the clinic itself; even the front desk staff was incredibly friendly and helpful. Why is this place not closer to Portland??

Because Alec’s overall experience was very positive, he will be happy to go back again, which is good because we are driving back down to Corvallis every day this week to try the two new treatments Dr. Moore had mentioned on the phone: cold laser therapy and VOM (veterinary orthopedic manipulation). I meant to write an update about that but got stuck on bedside manner. I guess I didn’t realize how important it was – and how variable – until this positive experience! I think it is something we as human patients can relate to as well: sometimes feeling intimidated by a doctor but not knowing if you should speak up. I have learned to do this for Alec, but it is a tricky balance between asking questions and not offending anyone. Although I have found a good vet will welcome questions and appreciate the fact that, as the person who lives with and observes your dog closely all the time, you are a crucial member of the veterinary team. This is part of the reason I am so happy with our current regular vet here in Portland. She is very patient with my questions (and I ask a lot of questions!) and thorough with her answers. She realizes a caregiver who is engaged and paying attention will make the veterinarian’s job easier.

This reminds me: I am reading a good book right now on this subject called: “Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy Longer Life.” Coincidentally, the author, Dr. Nancy Kay, practices at the Animal Care Center in Sonoma County where Alec had his spinal surgeries, although she never treated Alec and I have never met her. The book, which was published in 2008, is great primer on all things related to being an effective medical advocate for your dog: asking the right questions, finding a vet and clinic you and your dog will love, knowing when to get a second opinion, making your vet appointments less stressful, etc.

Anyway, I will write more soon, but basically Dr. Moore had lots of ideas for new things to try with Alec. She confirmed that his lingering limp is due to a proprioceptive (neurological) deficit, and that the muscles in his right back leg are weakened/moderately atrophied due to his abnormal gait. However, she said he had excellent flexibility and range of motion, which means muscle shortness is not an issue. So she suggested some strengthening exercises I could do at home for the weakness and she thought Alec would be a good candidate for the two modalities mentioned above: cold laser therapy and VOM (veterinary orthopedic manipulation). The catch being that the laser therapy has to be done twice a day (1½ hours apart) for the first three days, then once a day for the next three days, and then every other day, and so on, until it gradually tapers off. The good news is she said we will know by the end of the week if it is working. If we don’t see any improvement by then I will discontinue the therapy. The basic idea behind VOM is it is supposed to open up blocked neural pathways, making it a good modality for dogs with neurological issues. The cold laser stimulates blood flow and aids in nerve regeneration as well, so these two therapies should theoretically complement each other.

So, I took the whole week off work (thank goodness I have saved my vacation days!) and we are making the hour and half trip down to Corvallis every day for the treatments. Speaking of which, we have to hit the road for day 3…more soon!

Two Year Update: Plateau or No?

It has been two years since Alec became paralyzed after a disc shattered in his back, severely damaging his spinal cord. He underwent a multi-level hemilaminectomy (decompressive surgery) on February 9, 2008 and a second hemilaminectomy four days later on Feb. 13. He came out of the second surgery with no use of his hind limbs, no conscious control of his bowels, and no bladder function at all. Things looked bleak indeed, and when Alec presented for his first re-check exam with the neurologist six weeks later, he was given a poor prognosis for return to normal function, based on the fact that his deep pain perception had not returned. I began rehabilitative therapy with him, just in case, and ordered him a mobility cart (doggie wheelchair), which he used for 18 months. If you have been reading this blog, you know that Alec began to walk on his own about a year later (short walks around the block at first), and six months after that, he stopped using his doggie wheelchair altogether.

As I have written in other posts, the most important factors in Alec’s amazing recovery were: 1) regular physical therapy, and 2) time. Less quantifiable, but also instrumental, were my faith in Alec, and my boundless love for him. It has been an incredible two years, difficult and inspiring, confounding and rewarding. Because our wonderful rehab therapist in California, J., impressed upon me the importance of consistent physical therapy (to give him any chance at all to recover some mobility, as well as to preserve what he had left), I followed her advice very closely. It was a formidable challenge, but we persisted, Alec and I together, and it paid off big time; despite the scary hard times in the beginning, I feel like I won the lottery. Alec has been walking outside his cart for eight months now. His left hind leg is perfect as far as I can tell; his right leg lags, however, and cannot make a complete rotation. The result is he has an abnormal gait, or in layperson's terms: he has a pretty serious limp. It does not cause him pain, and he gets around exceptionallyreally well, but he has to wear a protective shoe on walks. Without a shoe, his foot will became scraped because his paw drags slightly – just enough to tear it up except when he is on grass or another soft surface (he does not have to wear the shoe inside). To complicate matters, his abnormal shuffle-step causes whatever shoe I try to wear out quickly; duct tape and shoe goo have become my allies in the battle against the deteriorating shoe. But neither holds up very well to the toe dragging. This small complication aside, Alec arrives at the two-year mile marker having exceeded all expectations.

After a year and a half of steady improvements, Alec now can walk for at least an hour at the park with no problem. He can also easily swim for the same amount of time, and his sessions in the underwater treadmill (UWTM) are now for conditioning and strengthening rather than rehab; each week we incrementally his speed. During that year and a half of Alec's gradual but unwavering progress, every milestone amazed me. With his initial poor prognosis (which eventually was upgraded to “fair” – I was so happy that day!), I took nothing for granted. Since writing this blog, I have had the good fortune to meet other caring people in similar situations with their dogs, some of whom struggle with patience, and I can honestly say I never had that problem. Things were tough, and I was frustrated and scared at times, but never impatient. I think it was a blessing in disguise that the neurologists gave me no hope! It made every little improvement seem the size of a miracle.

After all of these improbable improvements, including what seemed like the pinnacle of Alec’s protracted process of rehabilitation (ditching the cart completely – hallelujah!), at some point during the last six months, I noticed he seemed to have finally reached a plateau. This awareness came slowly. I am with Alec almost 24-7 and even his slight improvements sometimes were noticed by other people before me. It’s like when you live with someone and don’t notice the small physical changes, like a gradual weight gain. Often people will point out to me, “wow, he is getting around so much better than last time I saw him!” – that type of thing. People do still say that, but at some point, I stopped noticing measurable improvements in his mobility (as opposed to his endurance, which we have been working on with faster UWTM sessions and longer walks).

Not that this ostensible plateau bothered me – not at all. Alec had already come farther than anyone had expected, and even when it became apparent after eight months he might be able to walk again on his own, I was told his recovery would very likely not be complete. He may just regain enough ability to walk outside on his own to go to the bathroom and then come back inside, for example. So the fact that he is enjoying hour-long strolls in the park is nothing short of amazing to me! I always knew the improvements would stop. The suspenseful part was when? How well would Alec be doing when he hit that inevitable plateau? The answer, for which I am profoundly grateful, is very well indeed. Limp, schmimp…my boy is walking!

But what if a plateau is...not a plateau? Recently I was emailing with J., our former rehab therapist, giving her an update on Alec and asking her advice about whether she thought I should continue doing the UWTM with him every week now that he was walking on his own and had reached this plateau. Did she think I should concentrate on swimming instead? To my surprise, J. wrote: “I have seen dogs continue to progress 2-3 years out. I would not be surprised if Ali does the same. I don’t think his plateau is permanent.” Huh! I stared at my computer screen in wonderment. This had not occurred to me. I know the scant literature advises the majority of dogs will improve the most during the six months after surgery, but this was not the case with Alec. He continued to show significant improvements way past that marker. Was it possible he had more potential...even after two years? I had to find out.

So after doing some research on rehab vets in Oregon within driving distance, I decided to take Alec to a new specialist, Dr. Julia Moore of the West Hills Animal Hospital in Corvallis (an hour and half drive south of Portland). Alec has been to both rehab veterinarians in Portland, and I thought at this point it would be good to have him evaluated by someone who has never seen him before, someone who will look at him with fresh eyes. I called the clinic last week to ask if it made sense to bring Alec in for an evaluation, given that he is two years out of surgery. Dr. Moore called me to discuss Alec’s situation the next day and I was impressed with her on the phone. I explained that my goal is to learn whether Alec has potential to further improve (and if so, what can I be doing to help him reach his potential?), or if my focus with physical therapy should be maintenance at this point. I have no problem with the latter, but if there is something more I could be doing to help him improve – new rehab exercises or modifications to our routine – I want to make sure I am doing it and not giving up too soon!

We spoke for twenty minutes and she is clearly very experienced in this area. I got the impression she would have a lot to offer by seeing Alec. She also mentioned they are using a relatively new technique called cold laser therapy, for which Alec could be a candidate, and that he could potentially be helped by a modality called veterinary osteopathic manipulation (or VOM). She said she has seen incredible results with these therapies. I am pretty sure laser therapy has been available at other places I have taken Alec, but no one has suggested it before, so it could be that he is not a good candidate; we'll see. I asked whether she had seen improvements in dogs who were two years out of surgery, and she had. She said the first step will be to determine whether Alec’s lingering limp is due to proprioception (position sense/awareness of foot placement), weakness, or muscle shortening, and that there are different things we could try based on which it is. After our conversation, I was very excited for her to see Alec.

They were able to schedule us tomorrow morning, so we will be leaving the house at 7am and braving the rush hour I-5 traffic to head south to Corvallis for our 9:15 appointment. Alec likes to ride in the car, and he will be excited for a new adventure, so no problem there. While I hope she evaluates him and has ideas for new things to try, if her opinion is that Alec has gone as far as he can go in his recovery, I will be happy with that, too. I just want to know whether my focus at this stage should be on maintenance or improvement. I'd hate to NOT be doing something I could be; if this plateau could be temporary, then I want to do everything I can to help him get over it! I don’t want to be greedy, but if Alec’s right hind leg could catch up to his left, and if his gait could further normalize, this would improve things in many ways. He would no longer be in so much danger of injuring his paw, and his body weight would be distributed more evenly. Right now, he still puts excess weight on his front end, which stresses those joints and is not ideal.

So, as incredibly well as Alec is doing at the two-year mark, and as through-the-roof-thankful as I am for every single improvement, if I could be doing something more for him, I want to know about it! This is still a new world to me, and I am continuing to learn. Please wish us luck tomorrow; I will post an update after our appointment. As always, thank you so very much for reading, and for caring.

Happy 9th Birthday, Alec!

I celebrated Alec's 9th birthday yesterday! And yes, there was dog-friendly cake (it was more like a big cupcake). Alec had a great day: swimming at a new indoor facility (more on that soon!), special homemade treats, and his first trip to a nearby park. The best thing (as is the case every single day) was spending time together. That might sound corny, but what dogs enjoy most in the world, once their basic needs are met, is spending time with their human (wish I could tell that to every selfish ignorant jerk who leaves their dog tied up outside all day)...it just so happens that my favorite thing in the world is spending time with Alec. So it works out perfectly. :) You can see the rest of the birthday pictures here.

What wheelchair?

I am ecstatic to report that Alec has not used his doggie wheelchair since June!! He is walking without assistance for up to 1/2 hour walks a few times a day. He has a pronounced limp and needs to wear a shoe to keep him from damaging his paw when we walk outside (his right hind leg will probably never be completely “normal,” but his left leg is pretty much 100%) and because he drags his back toes, the fabric of the shoe wears through really quickly. The shoe is not cheap ($60 for one!), but duct tape can do wonders to keep things from falling apart, so each day I put a new layer of tape over the toes and it seems to be working pretty well. Luckily, a client of his physical therapist donated a couple of these shoes to the rehab center and she in turn donated them to me and Alec, so I am trying to make them last as long as possible. He has not had any toe scrapes or paw issues in some time (knocking furiously on wood!!); that was a recurring problem for awhile and a source of constant worry and stress. But the shoe seems to be working really well to protect his foot and he gets around so well it is just incredible. Recently when I was walking Ali back to the car after one of our river swims (sans shoe – he doesn’t need to wear it on the grass or sand), a gentleman remarked with concern, “I think your dog might have a rock stuck in her paw. She seems to be limping.” I replied, “Actually he was paralyzed not long ago, and is learning to walk again” and I realized, wow – if he can be mistaken for a dog that has nothing wrong with him other than a rock stuck in his paw, he is walking pretty well!!

He is still not allowed to run or get rambunctious on land (it is a balance with which I continually struggle – letting him be a dog and not being overprotective, yet remaining cautious and mindful to prevent further injury), but he loves to chase the ball in the water and this summer has been a blessing. I have taken him swimming in the rivers around Portland at least once, and often multiple times, a week. This is the #1 reason I am sad to see this summer slip away. I took him swimming once per week last winter but it was so cold he could only swim for about 20 minutes, whereas this summer he has been able to swim for unlimited amounts of time. There is an indoor warm water swimming facility in Vancouver, Wash., about 30 miles from Portland, called Unsinkable Dogs that I am going to look into for when the weather turns cold. The tanks look pretty small in the photos on their website, so I’m not sure if he will have room to chase the ball, but I will give it a try. I hate to see his happy days in the water come to an end. Maybe we need to move somewhere with an all-year-around warm climate – just so he can swim everyday! In all seriousness, I probably would move us somewhere warmer if I could - preferably near a pristine river or lake with a flat sandy bank - but alas, my job is here. And I suppose there are colder places than Portland, though it didn't feel that way last winter!

A word about serendipity… back in June, Alec developed pressure sores from the cart that became infected. It happened really quickly, like overnight. At this point he was still using his wheelchair for longer walks and I was also taking him for short round-the-blocks about once per day. But due to this skin infection the vet told me I should keep him out of the cart for a couple weeks to allow his skin to heal. When I heard this, I was crestfallen. Would he get enough exercise without being able to use the cart? He was barely walking around the block at that point. Well, those weeks were a turning point, and the infection was a blessing in disguise, because by the end of those weeks, I realized he didn’t really need the cart anymore! He was able to walk longer and longer and seemed to be getting sufficient exercise from walking on his own, and he has only used it once since then. While it was always my goal for him to make the transition to exclusively walking on his own, and this is what we were working toward, being forced to keep him out of the cart for a period of time certainly expedited the revelation that it was possible and he was ready.

I have mentioned the steady barrage of comments (some nice, some rude, most harmless but annoying) I have gotten since being out in public with a big dog in a wheelchair, but I must say there is one comment I never get tired of hearing, and that’s when people see us walking in the neighborhood now and stop to ask (usually after studying us inquisitively for a moment), “Is that the dog that used to have the wheels?” And I happily reply, "Yes, it is! He is walking now." How I beam when I say that. The words feel so good in my mouth and I can hardly contain my joy. Yes, he’s the dog who used to have the wheels… the dog who doesn’t need them anymore.

*** Some people have left comments here about their own dogs having similar issues with paralysis, or grappling with canine physical therapy, and I would be happy to talk you about anything related to my experience with Alec. Please feel free to email me at nrpallotta at gmail dot com. I realize that Alec and I are extremely fortunate, but I also know that time and regular physical therapy can do amazing things, so don’t give up!

Conditional.

One of my pet peeves, so to speak, is the concept of “unconditional love” as attributed to dogs by humans. It is a popular way of romanticizing dogs and while I am loath to be the Grinch who stole unconditional love, there are reasons why I think this “compliment” is over- and misused in the context of human-dog relations.

I first began thinking about the concept of unconditional love after my beloved husky, Kobi, passed away a few years ago. Did Kobi love me unconditionally? Hell, no! But I loved him unconditionally, and this unique feeling, awakened by my relationship with him (which had many challenges), became a cause for serious reflection. At the time I did not question whether other people were correct to wax poetic about how unconditionally their dogs loved them. I just thought I had that certain odd dog: independent of spirit and in no way loyal, a wild-at-heart canine who felt the confines of living within human society more so than the more slavish breeds (or mixes thereof). That was my dear Kobi, whom I always imagined thought of me as being the “food-lady” and “walk-lady,” and not much more. Moreover, I remember with chagrin times when I would cry bitter tears over yet another mess created or willful act of destruction and wonder why Kobi did in fact not love me, perhaps even disliked me! I ruefully laugh about this now, as being the expression of human narcissism it is, but I’m certain the tacit expectations that accompany the cultural ideal of unconditional love were rattling around in my head. Whatever it was, my dog did not have it for me, which led to feelings of inadequacy, which, well… you see where putting unrealistic expectations on dogs can lead! The desire for unconditional love is a human desire, and many mistakes begin when humans look to dogs to fulfill their psychological and emotional needs.

But I digress. The point being that after Kobi passed, I marveled at how fiercely I loved him for all those years in the absence of practically any positive reinforcement on his behalf, and I thought that was a pretty neat capacity we humans have, and wondered why this might not be the more lofty potential result of genuinely sharing our lives with a dog – this awakening in us, as opposed to elevating and celebrating their so-called capacity to love us “no matter what.”

However, that’s as far as I took this train of thought, as it applied to one particular dog, my Kobi. Only later did I start to think critically about this concept broadly as it is so often applied to the idealized human-dog relationship. If I were so inclined, I could tell myself Alec loves me unconditionally. As opposed to Kobi, he very reliably responds to his name and comes when I call him, and seems to enjoy spending time with me, and never tries to run away from me when off leash. He displays a genuine preference to be at my side rather than elsewhere. Unlike aloof Kobi, Alec gets visibly excited when I come home, whether we have been apart for five minutes or five hours, and seems overjoyed to see me. Yet, does this mean he loves me unconditionally?

Leaving aside questions of whether and what kind of emotions nonhuman animals experience (the plethora of rich studies coming out of the field of cognitive ethology on a regular basis would leave a skeptic hard-pressed to argue that animals do not have complex emotional lives; how similar these emotions are to ours is an interesting question, but also a potential minefield for misplaced anthropomorphism [note that I am also critical of the term “anthropomorphism,” but that is a topic for another day]), let’s take a critical look at the idea of unconditional love as humans apply it to dogs in American culture.

There are a few problems with this concept; perhaps most importantly, it rather conveniently ignores power dynamics. Dogs in American culture are utterly dependent upon their owners (despite the increasing popularity of the term “guardian” among animal protection advocates, we are in reality their “owners” and this is an important distinction under the law) for everything, from the bare necessities like food, water and shelter, to higher order social and psychological needs like companionship, exercise, and mental stimulation. In this way, they are similar to children, who don’t have much of a choice about loving their parents for the simple fact that until a certain age, their parents constitute their whole world. It is well-known that children continue to love parents who abuse and neglect them just as children love parents who provide a loving and secure environment. Unconditional love takes on a twisted and tragic meaning in this and similar contexts, but at root are the powerlessness of the one who supposedly loves unconditionally and the privileged position of the one who is the recipient of this fabled “love without strings.” In a relationship where one party has all the power, it is facile and self-serving to suppose that the powerless one loves the “master” unconditionally. This facet of the dominant ideology serves to legitimize and mask power relations inherent in the dog-human relationship. For, despite the fact that more people define their pets as “family members” in surveys, the sad fact is that this is very much a provisional status, which can be (and all too often is) terminated at will by the member of the relationship who is not legally defined as property, and therefore has the absolute authority to do the defining (and subsequent re-defining).

We live in a country in which countless healthy dogs are relinquished to shelters each year (approximately half of whom are killed) for reasons that range from trivial and entirely fixable behavioral problems, to not wanting to put in the time and effort to find a home that will accept pets, to simply not having enough time to spend with the one-time “family member.” If this is unconditional love, I’d hate to imagine what the conditions would be! I cannot say if all of the people who give up their dogs each year for lifestyle reasons in happier times claimed their pet loved them unconditionally, but it’s a fair bet in a society in which this is a prominent, if contradictory, cultural belief.

What got me started thinking about this most recently was an ad I saw on the Portland Craigslist. I never go on the “pets” section of CL, but I was looking for something specific and while there I was surprised and depressed to see all the “free to good home” ads (surprised because for some reason I thought CL disallowed this type of listing, but apparently they only prohibit sales of animals). Out of curiosity, I clicked on a listing that advertised a free pair of Weimaraners. The ad showed a picture of two dogs, a mother and son, and contained a story about how the owner had fallen on rough times during the recent “economic storm” and could no longer keep these cherished family members. After a few paragraphs detailing the charms of the breed and of these two dogs in particular, the person giving her dogs away had the gall to list as a requirement that the new owner love them “unconditionally.” Holy shit – are you kidding me?

The above scenario, and the countless others like it, exemplifies the other reason why this concept, beautiful and poetic though it may be, is problematic: “unconditional” is an adjective describing a verb: love. Yes, love is in the end a verb, an action, or it is meaningless. This applies to human–human relationships too. But many dog owners treat it as something squishy, just a feeling that can come and go and be transferred to the next owner. No matter how well-intended, this exalted term has been bled of meaning, dubious in its application from the first. The fact that someone would have the lack of self-awareness to demand that the new owner of the dogs she herself is giving away love them unconditionally is revealing. In a society where dogs are legally defined as property, a status reflecting the dominant social values already in place, unconditional love is a fiction, something which can be given and taken away at the whim of the more powerful, in other words, the antithesis of unconditional.

So to quote that old jazz standard, down with (unconditional) love! Let’s be more truthful. At its barest, dog’s love for humans is need-based and human’s love for dogs is capricious and non-binding. While my love for Alec does not fall into this latter camp, nor does it describe the feelings of many of my friends for their dogs, our commitment to our canine charges does not reflect the dominant order. I most assuredly do love Alec unconditionally and I daresay it is the most powerful, beautiful force that exists – a primary force giving rise to other secondary emotions and actions. But I resent this concept being co-opted to the point where a person giving her dogs away on Craigslist can invoke it with straight face and lack of embarrassment at her own hypocrisy. If I sound angry, it’s because I am. It saddens me deeply to know that erstwhile canine “family members” are being put to death in “shelters” every day. Calling attention to the cultural myths that help enable this shameful situation may be akin to shouting into a hurricane, but how long will we as a society, as individuals, allow this to continue?

In the end, whether dogs love us unconditionally is to me the less interesting question than are we capable of loving them this way? And perhaps we need to ask ourselves: why do we need them to love us unconditionally? What hole in our psyches does this fill? What is this deep rooted desire to be loved for simply existing? Dogs are not tools that exist to pump up our egos; I would propose we instead endeavor to earn their love by doing our best to fulfill their species-specific needs. I believe this challenge – and it is an ongoing challenge – is the essence of unconditional love.

PS Alec continues to do amazingly well and the Portland move has been good to us. More updates soon!

One Year Later...

This time last year, Alec was one month out of surgery and had just returned for his first recheck exam with the neurologist. Based on his persistent lack of deep pain sensation, she told me (as any neurologist would have) that he “had a poor prognosis for return to normal function.” In other words, chances were slim that Alec would ever walk again.

At this point, we had moved into a vacant office on the first floor of ALDF headquarters in Sonoma County, Calif. Because Alec had come out of surgery for a herniated disc paralyzed, I could not take him home to our house in San Francisco, which had become inaccessible due to the stairs. We had nowhere to go. That’s how we ended up living in my office. I was sleeping on an air mattress next to Ali’s bed, eating microwave dinners, showering in the sink, and relying on my friends to take garbage bags full of laundry home every couple of days for me (Alec could not control his bladder or bowels and we went through towels, blankets, and sheets at mind boggling speeds). It seemed I did not leave his side for weeks, except to scurry to the bathroom.

I don’t think I registered the stress because there was no room for it. If you have ever been in a similarly stressful situation you will know what I mean. I proceeded hour by hour, minute by minute, doing the best I could with very little information, none of it especially good or encouraging. Alec had been hospitalized for two weeks, and I was terrified to bring him home and have the team of vet techs and doctors who were on hand 24/7 at the emergency facility shrink pathetically to just me, who had no idea what she was doing. Alec could not urinate by himself and I had to manually express his bladder several times a day (if done incorrectly, he would quickly develop an infection). I was shown how to do this at the vet hospital a few times and it was clearly difficult even for the professionals. This daunting task was made more difficult by his size. Although bladder expression is much easier when a dog is standing, Alec could not stand up and I was not strong enough to hold him up (at the vet hospital it took three vet techs to accomplish this task – once he was discharged there was only me) so I had to do it with him lying on his side, which is much harder. We went through box after box of piddle pads and diapers, because in between expressing his bladder, he would constantly dribble/leak and soil his bed. His bowels worked without my help but he had no control over them, so he would begin to poop and then try to get away from it but could only drag himself through it, smooshing it into his fur and his bed. I cleaned him and his bed up many times each day.

These first several weeks were difficult for both of us. But there were bright spots: my good fortune to work at an animal protection organization that allowed Ali and me to move into my office temporarily, a group of generous friends who supplied me with meals, laundry service, moral support, and donations of needed supplies, and an amazing local veterinarian who made “house calls” to my office to check on us every few days to make sure I was emptying Alec’s bladder completely and that he had not developed an infection. Oh, and the brightest spot of all – that Ali did not die, which I certainly thought he was going to during the harrowing days between his first and second surgeries (first surgery: 2/9/08; second surgery: 2/13/08). At this point, he was going downhill and nobody could figure out why. As his condition deteriorated, the neurologist speculated the spinal bruising might be moving up his spine (a fatal condition called "ascending myelomalacia"), which would have eventually paralyzed his vital organs, including his lungs. This was the first time she used the word “terminal” and I will never forget that feeling of falling.

As it turned out, the exact same disc that had been operated on mere days before had shattered again, for no apparent reason. Neither this neurologist nor anyone I have talked to since has heard of this happening before. It is a mystery, an apparently rare occurrence. This is why he had the second surgery. The neurologist told me she could operate again but warned me that it might not make any difference at all. and he could come out no better than before the surgery. It was a gamble. But we were out of options at that point so I said, yes, do it... do anything you can.

So Alec did not die and that was the best gift of all. But he was paralyzed. My playful, goofy, beloved shepherd who only a week before was running in the park playing his favorite game, “stick,” could no longer move his hind legs. However, I was told he could use a mobility cart (doggie wheelchair) to get around, even if he never walked again, and I was eager to do whatever it took to help Alec get his life back. Of course, I still hoped he would regain the ability to walk, but that hope became increasingly dim as the days passed and he still did not recover deep pain sensation, which brings us back to that first re-check in March 2008: my hope dissipated further when he was given that poor prognosis.

There is a lot more I could tell, both about those scary/crazy/stressful early days, and about how Alec began to slowly but steadily improve. I am going to skip over everything that has happened in the last year because much of our rehabilitation journey has been chronicled in this blog. I wanted to write this one-year anniversary post to emphasize how far Alec has come in the last 12 months. Because all you really need to know is that in early Feb. 2008 a disc suddenly shattered in Alec's spine and he became paraplegic. He could not walk, could not control his bladder or bowels, and was expected to be paralyzed for the rest of his life. But he is walking now. Yes, walking…first with a lurch, now with a limp. Last month, he walked around the block without his wheels for the first time and we haven’t looked back. I am gradually increasing his time outside of his cart and he is doing great.

Let me just say it one more time, because it feels so damn good to write this: ALEC IS WALKING. Sometimes it’s hard for me to believe, just like it is hard for me to remember how I groped my way through those first few days and weeks without the panic swallowing me. Alec has defied all expectations. He is amazing. And hey, I am not going to sing my own praises here, but I did not give up on him either, which was also important. I gave him every chance and he took it, from one milestone to the next. Some people have wondered what his attitude was like when he came out of surgery paralyzed. I want to write more about this issue in another post, but I will tell you, Alec means the world to me, and I watched him closely for signs of depression. While there were of course changes and adjustments, Alec always had a good attitude. Honestly, his resilience and irrepressible spirit astonished me. His great attitude continues to this day, and has helped with his physical therapy and everything else we have been through on this road to recovery. Which by the way is not over…but I am happy to report that perhaps the biggest milestone of all has been reached. One year later, my boy is walking again.