Updates

so, it has been a while since we updated the world on bowser.

his AIHA has been controlled and he has been stable since september.  his last blood draw showed that his hematocrit levels are the highest they've been since we started this roller coaster ride almost five months ago.  that's a good sign.  we've been steadily decreasing his predisone; he's only taking 10mg a day now.

he has had some ongoing, yet undiagnosed issues with his liver.  his liver counts have been up since september, though through a variety of meds, have been decreasing slightly over time.  this could all be due to the prednisone, and his liver not taking a liking to those meds, or it could just be something we don't know about yet.  I'm more inclined to believe the former as the numbers are coming back down toward normal since we've begun decreasing the meds.  he has been taking denamarin daily and we've added ursodiol into the mix, too, to counteract the effects of the prednisone.

also during this time, his pancreatic enzymes have been a little off.  he's had a couple of ultrasounds to see if there are any issues.  one thought was pancreatitis, though that was not the case.  since nothing was really jumping out as an obvious reason for the fluctuating levels, it was put on the back burner as something to keep watch on, but not directly treat.  during the past month, however, he had some additional symptoms including excessive appetite, frequent defecation (up to 6x a day), eating his own feces, indescribably stinky gas, and weight loss.  upon further testing, it was determined that bowser has EPI, or, exocrine pancreatic insufficiency.  his pancreas no longer secretes the enzymes required to properly digest and absorb food and nutrients into his body.  there have been specific vitamin deficiencies that have cropped up, specifically B12.  his cobalamin levels have been low, too, which could end up impeding his progress with the AIHA since B12 can supplement healthy red blood cells (at least that's what the doc says).  lastly, EPI's effects could potentially create more problems, like diabetes.

so this is our newest battle: EPI.  we are hopeful that this can be managed long-term both effectively and relatively inexpensively.  the specific medication (powdered digestive enzymes) is a huge financial burden of $200-$350/month (depending on where you buy it).  our alternative solution is to feed bowser raw pancreas, which is a much less expensive option, though clearly more difficult to find.  In the meantime, to supplement his vitamin deficiencies, bowser will be getting B12 injections: once weekly for six weeks, then monthly after that.  We have also been provided some meds from the vet that will get us through the next couple weeks until we can fully determine what we need to do and how to get it done.

overall, bowser has made some significant progress.  he's started playing with toys again (though still infrequently); he's remembered how to get up onto the couch; he's cleverly figured out how to use the pile of clean laundry to get up onto the bed to wake mommy up in the morning; he's getting back his old personality.  gone are the days of slow-moving, groggy mr. face, and we're welcoming back his perky attitude.  it's been a long few months, but we're getting through it day-by-day.

more to come as we learn about EPI and how to manage the disease!

Visiting the Face

so yesterday, bowser ultimately responded well to the transfusion.  his RBCs jumped from single digits up to the mid-to-upper-20s.  he was brighter and appeared happier.

today, I decided to go see for myself.  yes, I visited my little man face in the hospital.  and, luckily, my friend ellen was there to join me for moral support.  I mean, not like I was going to be a hysterical mess or anything... ok, well, moving on...

I think that because we were vising "after hours" and it was really just the ER doctors and some techs there, we were able to be put in a room while we visited with bowser.  the last time I'd seen him was monday morning, and he was just... so... not bowser.  anyone who's met him would know there were serious issues.  so when the tech brought him in to visit, and he was actually standing on his own!  and wagging his tail!  and oh, I got bowser kisses!  lots and lots of bowser kisses!  that almost put me over the emotional edge.  he'd been so tired, he couldn't even expend the energy to lick you.  which, again, if you know bowser... you'd know how much of an aberration this was.  but he just wanted to lick you and let you know how happy he was to see you.  and even when I got up to throw something away on the other side of the room, he got up, worried that I would leave again.  which, of course, broke my heart.

it was at that point that I realized we could get through this.  the past couple of days were such a whirlwind.  overhead was the unspoken cloud of "if he makes it. dot dot dot."  but seeing him like this... having some energy again... it reinforced our decision to do whatever we had to do to get bowser better.  I thought of him less as "bowser, our pug who is dying of AIHA" and more as "bowser, our pug who is recovering from AIHA".

I may have shed a tear of happiness on the way home.  but after what we've been through with him, I think I'm allowed.

bowser and his IV tubes



bowser and a very happy mom



feeling better

for the past few sleeps I have not felt very well and I was really tired and all I wanted to do was sleep and lay down and then my mommy and my daddy left me in a place with all these other people I did not know and it was scary and I did not like it so much but I was so tired that I did not really care. then my mommy and my daddy came back to get me and we went in the car but I was not happy and I usually like to ride in the car but at least this time I got to sit with my mommy on the ride so that was okay. but then my mommy and daddy brought me in to another place like the place we just left and that made me sad but they kept giving me kisses and said oh bowser we love you and you have to get better and you have to stay here so that you can get better and come home with us and I said that sounds really nice but I am too tired so I just put my head on my paws and looked at mommy and daddy.

but then after mommy and daddy left and I got stuck with ouchies the new people I did not know stuck me with more ouchies and then I do not really remember much but when I woke up I felt better and was able to pick my head up and I wanted to talk to my mommy and daddy and tell them that I felt better and could go home with them now but they were not there and it was all the people that I did not know.

I hope my mommy and daddy come and take me home soon. I even miss my brudders.

Transfusion

we got bowser all set up at the hospital this morning, signed our life away to pay for it, and then left knowing he was in good hands.  they were to run their own tests this morning to get counts and would treat from there.  we hadn't been home an hour and a half when we get a call from the hospital informing us that based on the initial counts and testing, bowser's red blood cell count had dropped even more, down to only 9.  he'd been at least around 11-13 before.  so they were prepping him for a blood transfusion.

never in my life did I think I would have to go through waiting to hear back from a doctor regarding a blood transfusion for a human, let alone for my dog.  I am trying to get work done at home (as is das) but it's hard to concentrate.  I am tired; I am worried; I am hungry.

I feel like now is as good a time as any to touch upon the question that many I'm sure would be asking at this point: really?  all this ER stuff?  and now a blood transfusion?  isn't that a little extreme?  it's just a dog.

this is not just a dog.  bowser is, for all intents and purposes, our child.  we care for him as we would care for a young toddler.  he is dependent upon us for food, water, love, and health.  just because he walks on four legs and is covered in fur does not make him any less important to us.  he loves us unconditionally.  he cuddles with us when we are sad and when we are happy.  he doesn't talk back to us.  we are all a family, and bowser deserves to have us do everything that we can to keep him a part of our lives.

Making a move

so... because the vet hospital where bowser is currently being treated is really only open as an emergency room on the weekends and "after hours" during the week... we have to transfer him tomorrow morning (by 7a, dear lord) to another hospital.  das's mother made a few phone calls for us and a good friend of hers recommended us to her vet hospital: pieper-olson veterinary hospital.  we called them tonight, and we'll be able to bring him right in... essentially checking him in as an emergency patient again, even though he's a transfer.  looking at their website, and hearing the recommendations, I am very confident and hopeful that he'll be treated well there.

I would like to try and get some sleep... though not likely.  I miss bowser, and I'm so worried about him.

scared

today I am very scared and I do not think I can curl my tail and be happy because I am very tired and I have all these things attached to me and people poking me with ouchies and I cannot go anywhere and I have not seen my mommy and my daddy in a long time and I do not know why they left me here and it makes me sad and I wish I could see them again. there is a nice lady who brings me outside so that I can go to the bathroom and she tries to make sure that I get my foods and my waters but I do not always want to do those things. I just want to lay down and (sigh).

no news is good news

I am still not in a very stable emotional place right now.  I cried myself to sleep.  I then lay awake thinking of how each sunday I wake up to the little click, click of bowser trotting behind his daddy, following him from room to room as he makes his morning rounds: email, newspaper, sportscenter, sometimes a little coffee.  but this sunday it wasn't like that.  it was quiet.  it was sad.

the vet called at 6:30am.  bowser is stable, though not really showing improvement.  he did not need the transfusion yet.  of course, getting a call at 6:30am does not fill you with warm fuzzies.  when I heard that call and looked at the clock, my heart sank, immediately fearing the worst.  but I guess, our news was better than the alternative.

ultimately, what brought us to this point, was throughout the day yesterday, bowser had been getting, well, gradually worse. no matter how much glucose I gave him, it never really did much to improve his personality, his movements, his desire for food and water, his ability to even stand up unassisted.  I just ended up with sick, tired, frustrated, sticky dog. and a worried, tired, frustrated, sticky mom. at one point during the evening, I sent das a text message while he was at his golf tournament.

"I think bowser needs further medical attention. I hate to ruin your evening, but could you come home sooner rather than later?"

knowing das's opinions on emergency vets and their exorbitant fees, I clearly meant business when requesting we visit one at 9pm on a saturday evening. there are two within a close distance, and after a little research, I opted for one that had "better reviews", if you will. there was more information available on the ER practice itself, and the vet backgrounds were extensive enough to make me (us) feel better about taking him there.

we went right down, bowser laying in das's lap while I drove.  once we got there, we were seen pretty quickly; there weren't any other waiting patients.  the vet got a little history since all we were going on at that point was "low sugar levels".  she then did a quick physical exam and proceeded to ask us questions about any lead in the yard, and said she was going to take him out back for a quick blood test.

she came back with bowser, and very patiently and honestly, informed us that bowser's red blood cell count was "life-threatening low".  she then proceeded to say that if we brought him home and did not admit him to the hospital, he would die.

das and I knew what we were going to do, but after the tears and the initial shock, we reviewed our opions anyway.  we needed to know what this would mean in the long run.  what would bowser's life be like after this?  would he always need medicine?  would he just "get over it"?  would he even respond to any treatment?  we were briefly educated on the illness, and there would be three categories into which bowser could fall: fully recovered, recovered but with medicine cocktails for extended periods/rest of his life, or, well, no recovery.  we knew that 66% was certainly worth fighting for (I would have even fought with less of a chance) and we admitted him.

and now here we are.  waiting on news, but fearing what that news might bring.

heartbreak

I have experienced many different emotions in my life.  but I was not prepared for this one.

in a nutshell, the diagnosis is AIHA, or auto-immune hemolytic anemia.  and our baby bowser could die this weekend.

he is currently at an emergency vet, and may need a blood transfusion.

I have no words, only tears.

oh so tired

maybe mommy and daddy were right about me not feeling so good.  I do not really feel like doing anything today.  I am very tired.  I do not want to eat and I do not want to drink and mommy just keeps trying to put sticky stuff in my mouth but I do not want it because I just do not want it!  blecch!

daddy left early this morning and he told me to be a good boy and that he loves me that he hopes I feel better and he is going golfing and will be home later and that I really really need to feel better because he loves me very much.  and then mommy left too and said that she was going to watch a movie but would be back very soon and then I just laid down and waited for them to come home and then mommy came home and said bowsieface you do not look like you feel better and I said no mommy I do not feel better please do not give me anymore sticky stuff and I do not want kibbles or water either please.  so then mommy and I sat on the big bed and watched tv and mommy doesn't think that I heard her but I could hear her when she was talking to me and telling me she was worried about me and I think she was crying but I can't tell because I was so tired and I couldn't keep my head up or give her kisses to tell her that I love her too.

you want me to do what, now?

so, as one might assume, we were concerned that mr. face had fallen over a couple times.  we've had some issues with him in the past, medically, so we don't want to really take any chances.  in speaking with the vet this afternoon, we found out that everything looks fine (great?) but that his glucose levels seemed low.  his suggestion?  give bowser... wait for it... some honey, or karo syrup to bring up his sugar levels.  does that pseudo-prescription come complete with a handservant to adminster said uber-sticky substances into the mouth of said dog?  the same dog who is loving and tender and cuddly until you try and force any unapproved object like a toothbrush or a medicine syringe into his mouth at which point he somehow manages to come down instantaneously with lockjaw and starts wiggling away from you like an oiled pig.  let me tell you... I can't wait.  it should be grand.

feeling punky

yesterday I wasn't feeling so swell.  mommy and daddy said that it isn't right that I fell over on my own and then couldn't get back up right away so they said that I needed to go see the doctor to find out if I was ok but I think I'll be ok because I only feel kind of punky and I still want to eat my foods and drink my waters and play with my brudders and all that stuff.  but I had to go see the doctor anyway and I had to sit and wait and sit and wait and sit and wait and daddy's arms were getting tired and there were all these other aminals there and they were making noise and they were not happy either just like me but mommy and daddy kept saying you are a good boy bowser we love you bowser and kept giving me kisses and I said ew stop I do not want anymore kisses mom blech!  but then we got to go in and see the doctor and he said hi bowser how are you and then he was talking to mommy and daddy and said I was looking ok and I thought that duh I know that I could have told you that but no one listens to the little black pug but then he stuck me with a sharpie but I was a good boy and did not cry and then he said good boy bowser and mommy and daddy said oh you are a good boy bowser and then the doctor told mommy and daddy that he would talk to them later or something like that but I don't know because I stopped hearing them.  then mommy and daddy brought me home and I took naps until they got home.