When Life Happens

This post has been an extremely difficult one for me to write. Nobody want to think about or concentrate on the fact that all life must end. But on a daily (and if we are lucky, only weekly) basis, that our dog has contracted a fatal infection. We give him medication 2 x’s a day – 6 pills total. But even that has become routine these days. What I can’t handle, are the days when he is in pain. When he whimpers and winces just moving his head ever so slightly to get more comfortable while trying to sleep. When it happens more than one time a day, I start to think, “maybe this is it, maybe the end is near” and I get sad and depressed all over again and realize that life isn’t fair, it isn’t completely without pain and suffering and it grounds me. The feeling that not everything is in our control. All I can do, all I have wanted to do with this post, is to  help others. I can best do that, by starting at the beginning.

My immediate family  consists of Dan and our dog Rocco. Some people might not think a dog constitutes a true member of a family, but for us, he really is. He comes on vacations with us whenever possible, our schedules are influenced by him, we sacrifice for him, we love him unconditionally and he loves us unconditionally.

Dan and Rocco

Dan and Rocco finishing up a neighborhood run.

As many of you already know, Dan and I are active people, and Rocco has always been right there with us. Side by side by side, we are a family. Wether it’s walking the neighboorhood, training for our first half marathon, hiking South Mountain, camping in Northern Arizona or simply running earrands in the winter (where he can stay in the car with the windows down). Rocco likes to be part of what we are doing. When we go somewhere, even to work sometimes, Rocco thinks he should be coming too. He doesn’t know he or the day of the week are any different – he is just part of the pack – and the pack sticks together.

Hydrating Rocco on South Mountain

Hydrating Rocco on South Mountain

Almost one year ago today we came home from work and Rocco wasn’t in his normal spot to greet us. As we turned the corner to see him trying to greet us by walking slowly alongside the wall with a drastic lean to the right, barely wagging his tail, and about to fall over  . We immediately called the vet to see if the lyme disease shot he received the day before could be the culprit. They said it’s not typical to have a reaction, and that we should bring him to the closest ER vet. Dan and I looked at each other and I know he was feeling what I was feeling.

Sick.
Anxious.
Panicked.

It was one of those moments you feel the fragile balance of life unraveling around you. One second your life is going perfect and the next you’ve been smacked in the face by a frying pan. The worst part? You have absolutely no control over it either. You are at the mercy of time and how it all unfolds.

For the next 6 weeks we thought we knew what this was. A severe ear infection that needed to be treated with antibiotics for 6 weeks, no pool time at all during this Summer and no fetch or horseplay. His balance was so thrown off that he couldn’t even get in and out of the car. Imagine a star quarterback suddenly side-lined due to severe head trauma and that is about how Rocco felt I’m sure. He is athletic, agile, and  we’ve been told by every vet he has an athletes heart beat. It was devastating to see him like this. Weighing in at 100 lbs, being a Chocolate Lab and German Shepherd mix, he is not easy to maneuver and assist. Therefore every vet visit, was a family visit. Which also made it easier to cope with the appointments.

After the 6 weeks of antibiotics were up, about 6 days went by. Rocco seemed like he was sore and tired one day especially. We were all ready for bed, Rocco was laying on his bed and then out of nowhere started yelping an ear piercing yelp. Over and over and over again. He was in excruciating pain and we didn’t know how to help him. Every way we tried to position him, he would yelp. He had a f/u appt the next morning with the Vet Neurologist, but we didn’t want to wait. Something was very, very wrong. Noticing he was still a bit off over the previous 7 days, Dan had done some research online and feared Rocco had contracted Meningitis, due to the ear infection not being detected for so long.

It is as this point that I want to say we knew for about 6 months that something wasn’t “right” with Rocco. He didn’t have the same energy, he seemed sore getting up and down and his ears were ALWAYS dirty. He goes in for check-up every 6 months to the vet, and we were cleaning his ears every 1-2 weeks. He even injured his back leg jumping into the back of Dan’s truck once, so we brought him into the vet and they gave him a muscle relaxer and gave us some medication to help with the pain and possible swelling. Rocco is a well cared for, well-loved member of our family. We knew something was wrong, we asked the vets about it each time we had him in, and other than saying he had dirty ears – he was completely healthy. We just figured his hips were giving him grief since he was part German Shepherd. Rocco just turned 5 in April, so he is still young in our book.

Getting back to the night of the 2nd ER visit…

The car ride over was agonizing. I drove while Dan sat in the back seat with Rocco laying right beside him, with his head on Dan’s lap. The 24 hour ER vet is a 20-25 minute drive away and we were lucky enough to hit every light green. Crossing over railroad tracks, made Rocco wimper. When we arrived, Rocco was carried into the vet by Dan. After waiting an hour and seeing multiple dogs come in due to attacks (lot of blood was seen that night), the vet concurred that most likely Rocco has contracted Meningitis. They gave him a shot of morphine and gave us another shot to take home. At this point, we just needed to manage the pain while we waited for him to see the specialist the next day. The drive home was a bit less stressful because the morphine was kicking in for Rocco. (Did you know that dogs metabolize morphine differently than humans? They cannot become addicted to it like humans. Who knew?)

At the Neuro appt. the next day, a slew of tests were in order. The Neuro vet didn’t think it was meningitis – that worried us and also relieved us. We dropped off Rocco this time for him to receive an MRI and lots of blood work to test for various infections. It would take up to a week to hear back on all the blood work, but we were able to see his MRI images that same day. According to the scans, Rocco had an infection in 3 different spots of his spine, this time, the cause was most likely due to an untreated urinary tract infection. (What?!?!) He was to go back on Prednisone and Clavamox until we knew the official diagnosis.

Four days later, by Friday July 13th, we had the final diagnosis. I honestly think I can say it was one of the top 3 worst days of my life. Just thinking about it again, makes me want to cry. The doctor called me, not the assistant at the front desk, the doctor. That is never a good sign. Also, when the doctor is upset, you know you should be worried. She cut right to the chase and told me the test results showed he was positive for an extremely rare fungal infection called Aspergillus. When we were in her office going over the MRI images days earlier, she had already clued us into the fact that we DIDN’T WANT that diagnosis, that it was ‘nasty, nasty stuff’. My stomach sank and my heart started racing. I asked her what does this mean?? She was very hesitant and said, “It’s not good. There are ways to treat it and we need to be aggressive. He needs to get on Fluconazole or Itraconazole or Terbinafine or there is also Polyconazale…” She just went straight into doctor panic mode and my overwhelmed brain was trying to process and follow everything. Bottom line was, if we didn’t treat this and treat it fast and aggressively, Rocco would die. The kicker? We could treat it aggressively and quickly, and he could still die.

When I took this call, I was at work in a meeting. I had stepped out into the hall to take the call; it had lasted so long that the meeting had already ended by the time I got off the phone. By this time, I just needed to cry. I just about ran to my desk, grabbed a key card and ran back out of the office. I made it into the stairwell before I started to ball. I ran out the back door of my office building and called Dan who was working from home, to stay with Rocco. I tried to contain myself and tried to explain to him slowly what was so confusing and overwhelming to me only minutes earlier. Once I got it all out, all I could do was cry so hard I about hyperventilated. I could feel my lips getting tingly and then I was getting light-headed. I just kept saying to him, “I need to come home. I need to get out of here. I can’t be here. I need to come home.” He finally said, “OK. Leave work. It’s ok. You can leave. Drive safe.” I used the key card to get back in, checked my face in the bathroom and then went into the office to pack up and head home. It was about 3 p.m., so it wasn’t too bad. My boss and co-workers knew that we had been waiting for the call and knew all about Rocco’s previous ear infection. Luckily, my boss is incredibly understanding and when I walked past his cube with red eyes and said, “I’ll see you tomorrow. I gotta go.” He got it.

I made it home and tried to explain the phone call better to Dan. I told him to just call her and talk to her directly, and that maybe he could make sense of the next steps. In short, we needed to head to the vet that night and get his prescriptions. While we were waiting, we talked to the nurse at the front desk about polyconazole and intraconazole. We had heard that poly was incredibly expensive – $2,000 for a month supply. Itra was less expensive, but also less effective – it was the older version of the more refined poly. On the drive over to the vet, Dan and I had already decided that to put Rocco on something that expensive was not realistic, that was more than our mortgage payment. But to be sure, we just wanted to ask the nurse. The nurse wasn’t sure and she asked one of the other docs nearby. He confirmed it was $2,000 a month. He then came over and started talking to us about it, all on his own. Explaining that he knew of a study where 5 dogs went on polyconazole for a period of time, then once they were off it, 4 out of the 5 died. I don’t think he knew that our dog had been diagnosed with Aspergillus. But when our faces turned white and we went to sit down, I think he realized what an idiotic move he had just made.

We started Rocco on Itraconazole and Terbinafine based on the vet’s recommendation and after doing a ton of our own research online about Aspergillus and the effective medications. At this point, he was tapering off of Prednisone still, finishing up Clavamox since the doc said he seemed to do good on it last time and occasionally on pain medication as needed. Poor guy was getting a LOT of meds pumped through his system.

It took about 1.5 weeks for us to get him in for his aggressive IV treatments. He needed 6 total and each treatment was about the price of a new Vitamix blender. (If we stopped to do the math on all of this, I’m SURE Dan and I could have taken a 10 day trip to Europe with the money we’ve spent on vet appointments, treatments and medications.) The treatments needed to be spaced out, about every other day or as tolerated. He would also get blood draws and test at every appointment to ensure his liver was not being effected. He was getting Amphotericin B, but a more watered down version than they used to give in the past. Again, this drug was previously considered ‘pretty nasty stuff’. 

It has now been a little over a month since his final diagnosis and life in our house is finally starting to calm down again. Rocco seems to be doing really well. He has a follow-up appointment tomorrow in which I believe they are going to do blood work and test the level of Aspergillus in his body. His initial result was high, 6.66 (yes, on Friday the 13th too).

Rocco can turn his head again, get in and out of the car, rub his face on the carpet, and does upward and downward dog again (albeit stiffly). He still hasn’t gone in the pool and we still don’t play fetch with him. He has gone with us to Flagstaff two times since getting his IV treatments, and he has now been on 5, 1.25 mile runs with Dan and I. He is slowly gaining his fitness back and therefore his quality of life – which is ALL we have wanted for him during all of this. We kept saying, “Rocco doesn’t know his diagnosis. He just knows he’s in pain and can’t do stuff; let’s not dwell on it, let’s help him through it.”

Through ALL of this, Dan and I have stuck together collaborating on what is best for Rocco… and our family. It has been one of the most emotionally difficult times in my life. I love Rocco, but I love Dan way more as one could imagine. Seeing Dan hurt over Rocco being so sick, made ME sick. I had to pull together and be there for both of them – besides the day I received the news over the phone – I’ve tried to be his rock, like he always is for me. Life happens and it’s how you react to the unexpected and unplanned that really matters. It has made us even stronger.

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