Reality check (Kathy's version)

The floodgates finally opened this weekend. Sarah started quietly crying after a day of hearing Andee whine every time she left the room (she is still on "cage rest" so she can't leave the kitchen), and that got Charlie started. A few minutes later he was sobbing uncontrollably, repeating over and over, "She has to get better. She just has to." We finally got him to bed, and he seems much better today. I felt helpless trying to comfort him, but I will not lie about this to the children--it is very likely that Andee will not regain the ability to walk. It is very likely that her life will be shorter than a healthy pet. While she is with us, she will be limited in her ability to do almost everything that made her such a thoroughly satisfactory companion before her injury.

We did pretty well today, our first regular workday with Andee at home. Steve had to leave early to go to New Orleans, but I was able to get Andee walked, "expressed," fed, medicated, exercised, and back in her kennel without feeling too rushed before work. At noon, I came home, got her up, walked her, and let her enjoy the day outside on a mat while I ate my lunch outside. Sarah was home at 2:35, and took her for a walk in the cart with just a little help. When I got home at 6, we got her out, fed and watered by 7 pm.

But now she seems tired and lethargic . . . maybe we overdid the exercise? Maybe she's developing an infection? Seems unlikely, since she's still taking an antibiotic prescribed by the LSU Vet Clinic, but she does not look alert. We have another walk at 10pm, so we'll see if she has perked up by then.

Reality begins to rear its ugly head

The reality of caring for a paraplegic dog is hitting home. Her kennel is too big for our kitchen, but we really have no other place to put it. This morning, she had a bowel movement (which is good), but while she was still in her kennel (not good). The feces got all through her tail and upper hind quarter. We could wipe much of it off, but we couldn't get it all. So Kathy gave her a bath to try and wash out what was left. No easy task, particularly carrying her into the bathroom.

We're all getting better at expressing her urine without getting it on ourselves. And Andee is starting to associate the cart with a walk, which makes her a little hard to handle getting her into the cart. But she was tired most of the day, so she stayed settled in her kennel.

What is hardest right now is that this may well be as good as she gets. It is likely that this will be the minimum level of care we need to give her on a day-to-day basis. And unlike a puppy, this level of care won't diminish. This awareness hit the kids hard last night. There was not much we could do or say, except to give them both a big hug.

Reality sucks.

A good start

We brought Andee home yesterday afternoon. The young vet student checked us out on several procedures, including expressing Andee's bladder, hooking her up in her borrowed cart (after an appeal to the supervising vet, we were permitted to borrow one after all), her medications, and the discharge instructions. We will meet with the physical therapy technician on Monday to go through the several different styles of custom carts to decide which style/features will be best.

Andee is restricted to cage rest, and the cage she needs is quite large--a 42" long, 36" high enclosure that dominates the center of the kitchen. The kids have both spent time in the kennel with her. We have a nice kennel pad, and a faux-sheepskin insert on top of that. Although Andee seems comfortable enough in there, she whines each time one of us walks out of the kitchen. But she settled down well last night, and successfully produced copious amounts of urine on several morning outings. Unfortunately, the second of these was in the kitchen after I thought she had completely emptied her bladder outdoors.

I was very proud of the kids today. Charlie helped me groom her, proudly walked Andee in her cart down the street, and explained the situation to several neighbors; Sarah spent some quality time just talking to Andee and getting her interested in a chew toy. But it's clear to me that care of Andee will add about two hours of required activities to Steve's and my day, even though the days themselves will not get any longer. I know we'll get more efficient than we were today, but caring for Andee is going to be a lot like having an infant again.

Frustration is not the most helpful emotion

The new vet student, who serves as the main point of contact between the hospital and the family, did not start off well with me. He uses his cell phone to call patient families and his number is blocked. This means I can't call him back, and can't save his number to my phone with a more descriptive title. Small thing, but it got me irritated before I even spoke to him the first time. His calls are at apparently random times (compared to the clockwork-like am and pm update calls from Crystal). I am not impressed.

I understand that LSU vet school is a teaching hospital, and that these rotations are necessary. But the hand-off has not been well handled, and every conversation with the new "team" has been terse and cold. The entire focus is on getting Andee home--this should be a good thing, but it feels like they just need the bed for another animal now that the surgery is over. I know that my anxiety about caring for Andee is not this student's fault, but it would be nice to have a little acknowledgement that our family is moving into uncharted territory. A misunderstanding over an exercise cart (we were told that we could us the one she has been using temporarily until we can get a custom one for her, and then were told by the new team that we couldn't, and that the cart wasn't necessary, anyway) nearly pushed me over the edge last night.

I am trying to reach the physical therapy technicians, who I hope will offer us some more advice and support. We bought a kennel/crate today, so we may be able to bring Andee home tomorrow. That will give us the weekend to try to get into a routine with her before we jump back into the usual crazy schedule.

The challenge ahead

We got a call from Andee's new vet student. Andee's doing as well as can be expected. But its time for her to be discharged and brought home. That was the message, and with it, the challenge of caring for a disabled pet will begin.

Thursday is Yom Kippur, so we'll use the afternoon to get the house ready. We'll have to get a kennel large enough so that getting her in and out will not lead to back problems of our own. The kitchen is large enough and secure enough that she can hang out there.

But we're not prepared to manually assist her with her bladder, at least not yet. And getting a walking cart may take some time. I'm not sure how Happy, our other dog, will react to Andee. Will she try to help her? Will she ignore her? Will she become depressed? It's so hard to know at this time.

We love Andee and we will do everything we can to make sure she is happy, comfortable and enjoying life. But it is also clear this will be a challenge for all of us.

Last call from Crystal

From Andee's first visit to the LSU Vet School small animal clinic, we have been assigned to the service of Crystal, a veterinary student who has called twice a day with updates of Andee's condition. Dr. Lauer is our DVM at LSU, and she conducted Andee's surgery last week, but it is Crystal who has cared for Andee, and she has been our emotional connection to the clinic. Crystal clearly loves dogs, and seems to care for Andee as if she was her own dog.

Crystal was thrilled on Saturday when we visited and brought Andee some toys for her kennel. Andee likes to carry things around that have her people's scent--she doesn't chew them up, she just likes to have something near her bed area. When I tentatively offered 2 unwashed socks (one worn by Sarah, one by Charlie) in addition to the nice new chew toys, I was relieved when Crystal smiled and said, "I did the same thing when my dog had tendon surgery." We were disappointed to learn that Crystal is rotating assignments at the clinic and that we will be assigned a new vet student today. I'm sure the new student will be very nice, but it's hard to lose Crystal's upbeat manner and friendly way with Sarah and Charlie.

Interesting Article on Potential Therapies

Nanoparticles Used To Deliver Treatment For Brain, Spinal Cord Injuries

ScienceDaily (Oct. 2, 2008) — Purdue University researchers have developed a method of using nanoparticles to deliver treatments to injured brain and spinal cord cells.

http://www.sciencedaily.com/releases/2008/10/081001145120.htm