Saturday, April 25, 2009

Nova's Point of View

Hey, it's Nova here. I know, point of "view", ha ha, very funny, how can Nova have a point of "view" when she can't see? Well, I may not be able to see with my eyes anymore, but I can see with my other senses, like my nose and my ears. I just have to train them to do that type of work. I consider myself really lucky. I have my own personal seeing eye person now (Mom) and even my own seeing eye dog (Emmy). Together we are working as a team to help me learn my new world. Here's Emmy sticking close to me so I feel safe during a nap:

She follows me wherever I want to nap, and stays close by to keep me safe:

Let me tell ya, waking up to darkness is REALLY scary. A few nights ago when I woke up in the darkness I didn't understand what had happened. I thought I was alone, and that I was not safe. Plus, I felt awful. My eyeballs have given me so much trouble these past few years, it's been WAY more hassle than recovering from an amputation and learning to hop on 3 legs. Think of it as the world's worst migraine headache. Your eyeball aching so bad that you can't even think straight.

I mean it, I really felt like total crap:

Then on top of that, I had to spend nearly 2 days in scary places that I didn't want to be, with strangers who poked my eyeballs all the time and fed me disgusting medicines. The medicines worked, here and there, long enough for me to get some relief and to start to understand my new situation. Now that I am back home, with my familiar bed, toys, and smells, I feel safe and cared for. And I am starting to learn my way around my new world so it doesn't feel so dark anymore.

Here my favorite stuffie puppy making me feel safe and loved when I had my bad headache:

Everyone in my pack is trying to help me, but they are also trying to teach me. I am teaching myself a lot too, since I have a much better nose and sense of hearing than my people do. I really appreciate the things Mom is teaching everyone to do. First, everyone is talking to me more, reassuring me that someone is around so I feel safe. But when I am trying to sniff and hear my way to find something, they are more quiet, except for the person who is near the thing I am looking for. This helps me find my way. Also, my sister Emmy has been great. She has pushed my head toward my food or water dish to help me find it, and also walks with me to our different nap spots around the house. So far I have been able to find my way to ALL my favorite spots, even getting up on the couch and on my brother's bed.

Mom has been helping me get outside with my leash. She is still trying to figure out how to size a harness she got for me, but I hope she can do it today. Going outside is still a little hard, but I can tell that Mom is taking me out the same route each time to help me memorize it. Then we go for a walk around the yard just to enjoy the air. Sometimes she'll get me up if she thinks I've been resting too long. I might complain, but I know she is just trying to keep me learning, and encouraging me. Today we even went outside to make this cool garden stone with my pawprint in it. That felt weird to put my foot into the cold, wet concrete, so it took us awhile to get it right. Mom decorated it with pieces of colored glass, and used letter stamps to write "Tripawd Nova":

Mom is hoping I can get my new world figured out before they have to go away for the weekend in mid-May, and again Memorial Day weekend so she Mom can run her first marathon. Speaking of that, a few days before I went blind, Mom called a pet sitter who was recommended by our vet. It turned out that the sitter was a neighbor who only lives 3 houses from us, a retired couple named Cindy and Jerry, they are pawrents to Otis, a golden retriever who walks by my house every day. Mom invited Cindy to come over and Emmy and I won her over in like, 5 seconds, as we are known to do! Mom was so happy that she lived so close and would be able to give us extra special care when our pack is away. Now that I am blind, she is SO happy she found Cindy because going to the kennel or to a strange house would be very hard for me as a blind dog. So when my pack goes away, Emmy and I will be able to stay in our comfortable, familiar home. What a relief.
Yesterday (Friday) I did not feel very well at all. Mom could tell, and I could tell she was sad and worried about me. I was just trying to get through the pain, sleeping, and thinking ahead to when this eyeball won't hurt so bad anymore. I didn't want to eat my dinner, I felt so horrible. Mom had to give me something called Glycerin. Man, that stuff is AWFUL. She had a rough time giving it to me too. The doctor told her she could just get it at the drugstore. She went there and found out that it was in the skincare/first aid section. She was all upset because the bottle said that it could be poisonous if swallowed. She called the vet a few times to make sure she was getting the right stuff. She remembered that it made me barf a few times yesterday, and was so worried about making me barf on top of all the awfulness I was feeling.

Around 8 pm she finally got up the nerve to force feed me 1/3 cup of Glycerin through a syringe. BLEAH. She put towels all around me in case I spit it out. At that point I was feeling so bad I thought I would just swallow it. I ended up feeling better later that night. This morning when I woke up I was feeling good, and ready for a big breakfast. And I was happy that the Glycerin didn't upset my tummy the way it did the other day. But I still don't like it. This stuff is big time NASTY, and I hope you don't ever have to take it:

After breakfast Mom went to take a shower, so I found my way down the hall to my brother's bed. I was definitely ready to wag some tail today, so Mom caught me on video:

After napping there for awhile, I woke up and sensed that Emmy was not in the room. So I got up to look for her. Mom heard me get up and decided to video tape me, so she could show everyone how I am learning to find my way. Here in this video, I found my way from my brother's room to my bed in the living room, without bumping into anything!

We just got back from local vet to get my eyeballs poked to get the pressure checked. Fun, fun, fun. The most exciting thing is that the pressures were normal, ranging from 10-14 in both eyeballs. No wonder I feel so good today! Mom also figured out show to fit me with my Ruffwear harness, and it worked great at the vet, and everything thought I looked very pretty in it. When we got home I went for a long hop around the yard with Mom. Now, I am going to try to explore a little more around the house. But not without a nap first!

Friday, April 24, 2009

A New Role for Me

I was totally exhausted after the long day. I brought Nova home around 5 pm, and she was still blind. It is most likely permanent. The pressure in her right eye keeps spiking, so if it hasn't caused permanent blindness by now, it will probably do so at any time. There is a laser surgery available, but it is just so very expensive, and just a temporary fix, and there is no guarantee it will restore vision without knowing if there is vision even there to be restored. And there is no guarantee it will relieve the pain either. They tried several medications over the course of the day. They would work, then the pressure would spike. So this blindness is likely going to be permanent. I took about 10 minutes to reconsider the surgery, and tried so hard to see which direction my heart would lead me. I decided against it. I am sure I will have bouts of regret, but it just doesn't make sense to spend that kind of money on something that may or may not work, and is only temporary anyway. She could be back to where she was now in as early as a week to 6 months. It's just did not seem like the right thing to do.

So, it appears that I now have a new role. I am Mom to's first Blind Tripawd. A "seeing eye person", if you will. Never thought I would be that, but I am dang proud. Everything right now is what the vets call "guarded". We are treating the pressure with the eyedrops and an oral medication (glycerin, she hates it, and puked it up) for a few days. If she is still blind then, then it is pretty definite that she will be blind permanently. At that point I will likely opt to have the same surgery I had for her in the left eye last week, which "kills" the fluid production in the eye. This will mean total blindness, but will also mean no more glaucoma pain, and no more expensive meds. If she doesn't adapt well and is clearly suffering, well then there will be a much different path to consider. This feels like the "right" route for us. As to how Nova will do as a blind Tripawd, only time will tell.

I have decided that I need to at least give her a few days to see how she does, and take it from there. I had to go with my gut. A Tripawds friend suggested I talk with Nova and try to connect and see if I can sense what Nova wants. I know it sounds wacky, but she is so right. Everything that Nova has done thus far since I've picked her up had communicated to me that she was not ready to give up, so I am going to support that.

Nova was ecstatic to see me when I picked her up, and her senses of smell and hearing seem to have taken over in a whole new way. It was one affectionate snuggle after another. She rode home in the van peacefully resting, then got up from time to time to sniff her way to my shoulder and rest her head on there like she usually does. We had a big long talk in the car about our plan. She thinks she can do it, and wants to try.

When we got home, I ran in to get the leash so I could walk her right out to the yard to pee, and Emmy burst out the door and jumped into the van. They had the most precious reunion ever, I could not stop crying it was so beautiful. Then Emmy led us out to the yard, and Nova's head was held high as she sniffed all her favorite places, slowly, but confidently. Emmy would sidle up to her as if to say, it's ok, I'm here and I will protect you and show you the way. We went in the house and she was different right away. It was like she had decided that it was time to get to know the house by her sniffer and ears. I walked through the living room and kitchen, where she spends most of her time, and watched her slowly sniff and discover the perimeter of the room. She ultimately found her water dish, where she proceeded to gulp up so much water (I shouldn't have let her) that she ended up puking. Before she did that, I offered her food, which she refused, but turned and sniffed her way to her favorite vantage point between the kitchen and the living room. My husband was shocked when she quickly found it, plunked herself down, then a few minutes later abruptly got up, stepped ON to the hardwood (rather than the carpet) and puked up all the water she'd gobbled down. I cleaned it up, and she rested back in her spot for a minute, then sniffed her way BACK to the food bowl, and ate her dinner.

The whole family walked through the house in the meantime, just watching her discover the house in her new way and expressing amazement and encouragement. She spent some time following our voices, all quizzical, like she was intent on learning the "new" map of the house. I went off to my son's baseball practice (since I have missed out on so many of my kids' activities these past few days), and came back and she got up to greet me. And last night (I get weepy just saying this) she sniffed her way and followed my voice into my office to sit in front of my desk while I typed emails. This was clearly not a dog who was ready to give up just yet.

When Nova and I had our heart to heart in the car, I honestly felt her telling me "You need to let me try this, Mom, and see if I can do it." I really feel this, and it is so unexplainable how you can just get these communications from your pets if you really try to connect and believe that you can. We didn't talk timeframe, but the hopelessness and despair of the last few nights was gone. I have to grant her this opportunity, I must. So that's what I will do. This is definitely going to be one of those "one day at a time" situations.

I left messages with her oncologist earlier in the day and her regular vet, just to get their takes on the situation. The oncologist didn't call me back yet, which disappointed me, but my vet did. He, like the optho and his entire staff, said that they did not feel it was time to give up. I've only had a person or two try to encourage me to not put Nova through such "suffering". But I honestly can say at this point that she is not anywhere near suffering right now. So I am not ready to give up. I will stand behind my girl to the end. Rene from Tripawds pointed out to me that many people think that an amputation is suffering, and cruel to your pet. But we all know better. I think back to that a$$hole back at the oncologist who said that I should have sent Nova to Heaven rather than put her through an amputation. My girl went on to climb mountains and hop confidently with no assistance. So THERE!

Last night went really well. The priority today is to clean the house to make sure there is nothing underfoot for her. Last night she slept on her bed and moved to the couch during the night. I heard her move in the night, and peeked out the door to check on her. Her ear perked up, so she knew I was checking, but she went back to sleep. This morning she found her way to her water bowl with no assistance, then sniffed her way to the door to pee, back in for 10 minute rest in her favorite nap spot, sniffed her was back to her bowl for her breakfast, then back to the door to poop (this is her routine).

I’ve been taking her out on a leash, there are just too many things to bump into outside but she’s doing well. I hope to teach her a pattern to follow to get out to the yard and back. We have an invisible fence, which is useless for her now (they haven't worn their collars since last fall since they learned the boundaries. So she will always need to be supervised. She came back in and sniffed her way to the boys room and jumped up on one of their beds. I am very thankful I have a 1-story home, the perfect style for a blind Tripawd.

Emmy (my other Dane) has been awesome, like Nova's personal guide. She nudged Nova’s head toward her food bowl, and guided her down the hall to the boys’ room. Nova jumped up on the bed like it was no problem and Emmy joined her, with her paw on her, for protection. She has assumed the role of protector. We are Nova's assistance team. She's the seeing eye dog, and I am the seeing eye person.

The only thing I don’t like right now is that I know there is pain from the glaucoma. I’m doing all I can to control it until middle of next week when/if the determine she is permanently blind then she will be able to have the injection in the remaining eye. Then the pain will be gone. I am not expecting any miracles with the eyesight coming back. The pressure is just too up and down in the eye. With the pain gone, we’ll see how it goes. Considering how well she’s adapted in the last 24 hours, I am not ready to quit. And neither is she.

As sad as I feel that my precious girl is blind, I feel this sense of peace that I know we are doing what is right for us, at this time, this moment, in our journey. Today we are going to create a pawprint garden stone together that I have had sitting on my shelf for the last few weeks. I plan to take some videos soon so that I can show everyone how she sniffs her way around to things. I will also add some pictures, I just don't have the time to download them right now, but will soon.

Tough Decisions

I spoke with the Optho around 10 am and he laid out the options. At that point, the pressure was under control (just like it had been yesterday) but there was no sight in the right eye at all. He said we would not know for about 10-14 days whether there is sight remaining in that eye. Trouble was, during that time we would still be battling with the pressures. It would be something that would be next to impossible to monitor, other than running to the vet every day to get the pressures tested. Even then, it was not going to work well since the pressure can go from ok to terrible in an hour. He mentioned that there was a laser surgery that they could do, that would reduce fluid production, but was no guarantee that her eyesight would return. It may likely already be gone, which in that case the surgery would strictly be for TEMPORARY pain relief. He said 6 months is the typical time that the glaucoma can be controlled with the laser surgery. And there was no guarantee that the laser surgery would even work at all.

I got to thinking. Now, if she IS blind, I could always have the same procedure I had done in the left eye last week, the only trouble with that was that he would only do it in a blind eye, and at that point in time he could not say for sure that the eye was permanently blind. What was so very maddening was knowing that I would have to wait for 10-14 days trying to treat it with medication, not really knowing if she was in pain or not, just to see if her vision comes back. It might return from this bout, but she could have another bout at any minute that could cause permanent blindness too. I wish I could do the laser surgery, just to see if it worked, but given that it doesn't solve the problem, it seemed to not make sense to me. Plus, I was still worried that she would not be able to function as a blind Tripawd.

But I didn't want her to be in pain. The surgery in the left eye last week went great, and although she is permanently blind in the left eye, the pressure is gone, and doesn't come back supposedly. So it solved the problem and provides pain relief. What I thought I might opt for is to ride out the next 10 days or so to see if the sight comes back, and also in the meantime see how Nova fares blind on 3 legs. The factor that I don't like is that I won't know for sure if she is in pain or not. That kills me. If her sight does not return in the right eye, and she is faring well as a blind dog, then I can have the less expensive procedure done on the 2nd blind eye.

A handful of friends begged me not to let Nova suffer, and I agreed with them. Stumbling around in pain all the time is suffering. But if she CAN adapt (and I know many who can) then she might not be suffering. What a hard decision. I just didn't know what the road ahead was going to be like in the cancer department. Nova had done so well with her amp, chemo, etc. I feel like I would be throwing it all away if I gave up. But I didn't want her to suffer. There would still the very real possibility that she had lung mets down the line and ends up suffering all the more. My head was spinning from all the decisions and what ifs.

He said I could come pick her up any time I wanted. I arranged for around 1 pm. Just then, my son texted me from school asking me to accompany him to the hospital to visit his Grandma. (His dad died back when he was 7, and Alex has remained very close to his Grandma). The previous night when I was fighting my battle with Nova, he found out that his Grandma was having surgery, and had almost died from complications. He wanted to go see her during school. Anyway, when he first sent me the text, I told him he could drive himself, because I had to pick up Nova. It took me about 10 seconds to regret saying that, I immediately called the vet and said I would be there a few hours later. In this case, Nova could wait, and would likely benefit from the additional monitoring anyway. My son needed me, and I needed to make the time. I was horrendously guilty from missing his track meet the day before.

Going to visit his Grandma turned out to be just the distraction I needed. I was able to focus on someone else, just for a short while, and think things through a little more clearly. By the time we got there she had stabilized, and we had a wonderful visit. It was amazing to see her talking and happy, after being near death just the night before. It got me motivated to approach Nova's situation from a more positive direction. I didn't know what the road ahead of us would be like, all I knew was that we were all going to be loving her big time that night. I thought of some of the things I could do to help her adapt to the blindness. I had purchased her a Ruffwear harness way back in November and thought that might help now. Hey, if Alex's grandma could bounce back from a situation that seemed hopeless the night before, why couldn't Nova?

More to the Story

Unfortunately, the roller coaster began again that very night. Around midnight I heard her whining and bumping into things, woke up to let her out and discovered she was blind again. This time was just as bad as the first. I tried to get her out to pee, as she was very intent on going out, but very distressed, shaking, crying, miserable. I tried to guide her but she charged ahead, panting and confused, and I couldn't turn her around to come back in the house. Every time I tried to lift her she would panic and freak out, at one point she got away from me and went hopping aimlessly toward the woods, tripping over the woodpile and slamming into a tree. I was hysterical at this point, screaming for my husband to come out and help me, but he couldn't hear because he was out cold sleeping. I couldn't go get him because she was wanting to head back for the woods and I didn't want her to hit her head again. It took me awhile, but by lifting her body little by little I get her back in the house. She was thirsty and slammed into the waterbowl looking for a drink. I am crying and panicking.

I get out the medication (Xalatan and Trusopt) and give her a dose in the right eye immediately. I had asked the Optho what I should do if the blindness recurred, and he said give a dose asap and call. This was the best chance to prevent permanent blindness. Plus he said to check and see if her pupil constricts (means there is some vision), and I do that and it is totally dilated to black, I can't even see it, plus the eye is clouding a bit, which is big time bad news, I learn as I frantically Google while I am on hold at MVS. They said get her in NOW. It was almost 1 in the morning by this time. I sat with her for a few minutes, trying to decide if this could wait until the morning. I knew that time was of the essence, and that the only chance she had to save her eyesight would be to get treated immediately.

Once again battled with getting her in the car, in her darkness she was panicky and distressed.
We get there and they can't seem to find my chart, turns out that the most likely place it is is locked in the opthomologist's office, or perhaps he took it home. So they have to get her whole history from me all over again, names of medications, dosages, etc., piecing it together with whatever they can find in the computer. I am furious because I know that with this eye pressure, time is of the essence if you want to save the vision. The exam seemed to take forever, this time the pressure was in the 60s and one reading came in in the 90s. From what I've read, if the pressure is over 50 for more than a few hours or so, it most definitely causes irreversible vision loss.

They started her on an intensive dose of the 3 eyedrops she was on, and admit her for the night. Since nothing was to be known for sure until the Optho came in at 9 am, I decided to drive back home to try to get some sleep (yeah right). They put her in a kennel and she was howling and crying. I wanted to go in there and curl up with her, but she wouldn't calm down, she would just stand and cry. The pain from the pressure must have been excruitating.

When I arrived back home at 4:45 am, I call to check on her, and they say the pressure is still the same, but they were starting her on some oral glycerin thing. I manage to get an hour or so of sleep, wake up at 6:30 and check in with them again. The Dr said that the glycerin brought the pressure down to the upper 20s, not perfect, but much better, a LITTLE of the cloudiness has disappeared. So that was good news. But the bad news was that the pupil would not constrict, meaning there was little if no vision left in the right eye. She said we'd have to wait and see, sometimes you need to wait some time after the pressure comes down to see if there is vision left. She added that Nova had not made any effort to lay down, just standing in her kennel bumping into walls. At least she has stopped crying so the pain must have eased a little.

The plan was to talk to the Optho when he got in around 10 am and see when the pressure was under control. But the big question is, what then? It was looking less and less likely that we would be able to save her vision. But then there was still the pain from the pressure to deal with. The only way to make the pain go away for sure (if it couldnt be treated with meds) is do the injection we did last week in the other eye. That means total loss of vision forever.

I was struggling with “quality of life” issues big time. Generally, a blind dog is no big deal, but everything thus far had shown that Nova was miserable as a blind dog. But then again her misery could have been from the pain. How would I know? I was worried that even if they get the pressure under control (which they did yesterday) that it would shoot way up that night, this weekend, next week, who knows when? And then there would be another round of midnight emergency visits, and worst of all, Nova would be suffering big time.

I really got down and depressed. I was so concerned about her being able to get around on 3 legs, and be blind too. I've always felt that my girl can do anything, but being a front leg amputee she has to almost “launch” into a big hop and go pretty fast to get enough momentum to move forward. When the blindness occured, she would hop more timidly, and tripped over her foot in the process. And when she bumped into things she would get all freaked out, and it was so hard to calm her being such a big dog.

The negative thoughts overwhelmed me. She would need to be monitored and assisted constantly, every time she would have to go outside, eat, etc. Being a couch potato in this case would probably be a good thing, so she had that going for her. But what quality of life would she have living in total darkness, sleeping all the time, and only getting up assisted to eat and go outside? The other issue is that she was a very panicky dog, easily stressed. So that would mean every bump and stumble would get her all worried and upset, or worse yet, HURT because when a Great Dane like her panics it's like Marmaduke, frantic limbs all over the place.

And HOW does one proceed with aggressive cancer treatment (metronomics, although she is off Cytoxan for a week or two), expensive chest x-rays, etc. with a dog in this condition? I was such an awful mess. I just didn't know what to do. I wanted so much to do the right thing for her, but I just didn't know what was right. I had tried so hard to be positive throughout her illness and had spent every cent I could find on her care and treatment. But was this the point where I am doing all of it for me, and not for her? Would it be fair to ask her to endure this?

An Even Bigger Challenge

It's hard to fathom how much Nova's life has changed in the last few days. In the middle of the night early Wednesday morning, I woke up to let Nova out and she was all disoriented, running into things. Hopping very tentatively when the night before she was zooming down the hall. I knew right away it was her glaucoma, and it seemed to have struck her blind. After her surgery in her left eye last week, she had a somewhat slow recovery, very mopey. I thought she might have been in pain.

She had a cataract in her remaining eye, and also uveitis, but had been controlled with medication for almost 2 years. Everything was fine last week in that eye. After the left eye surgery I had noticed her rubbing and scratching at her left eye, and also the right eye. I found that strange since her right eye had always been great. I called the Opthomologist and was told that uveitis can go from controlled to out of control in a short period of time. I had to bring her back in. I was a mess. I couldn't even get her to walk without slamming into things, so I had no clue how I would get her into the car. I didn't know how things could go from good to bad in one night.

I never thought in a million years that the glaucoma might get worse before the cancer. It is so frustrating to have spent months treating her, having her do so well after surgery, chemo, etc., no lung mets, and now it appeared she might be blind! I was overwhelmed. How could I possible cope with a 125-lb blind Tripawd? How would SHE cope? Was the blindness permanent? (With Glaucoma she will be blind eventually, so the question was whether or not her sight could be saved a little while longer.

On the drive there, Nova stands the whole time in the car because she can't see, and she is scared so rides the whole way with her chin on my arm whining like “Mom, I'm scared.” I'm a wreck, talking on the cell phone with my husband discussing different scenarios and such. I hadn't ever thought through what would happen if she went blind as a Tripawd. It really threw me for a loop because she'd had glaucoma for 2 years, and complications here and there, and the left eye (which was the worst eye) didn't get uncontrollable with medication for 2 years. But here she was, scared and shaking and absolutely miserable. She was so miserable, and I kept trying to see how, if this was the reality and she would have to be this way, how could that possibly be a good quality of life for her? Oh geeze, I was SO not ready to think about these things.

I got her to the vet and she stumbles out of the car, walks into a few walls, all while tentatively hopping and whimpering, looking dazed and confused. Lots of sympathetic looks came our way from the waiting room, then a dog starts to notice her from 2 feet away, Nova doesn't even flinch until the dog makes a sound, then she gets her quizzical, tilted head look, like “what was that?” I am a basket case, crying, etc. because it's so dang cute, and she's been scared and cowering all day. We get in to the exam room and start to check her out. First they say that the surgery worked beautifully in the left eye (YAY!), in fact the pressure was so low they couldn't even get a reading.

HOWEVER, the right eye's pressure had shot up so high, higher pressure than she had ever had in her other eye. This is something that was totally under control for 2 years, now the right eye decides to go crazy out of nowhere. It was like the fluid production was surgically stopped in the left eye, so it decided to take over the right eye immediately, in just a matter of a few days. I was appalled. The optho came in and said they wanted her inpatient for a few hours, they were going to try some different drops and monitor her, but it was highly unlikely that she would have vision in the eye when all was said and done. He was very grave about it all. Usually by the time you get them in, the vision is gone, he said. So I go off poking around stores feeling miserable for a few hours. Then they called to tell me that they got the pressures down and that she could come home. I was relieved.

I'm sitting in the waiting room and I hear this fast HOP-HOP-HOP-HOP-HOP coming down the hall and she comes barreling around the corner, right AROUND a chair and straight into my arms. The Doctor comes out, shaking his head like they always seem to do for my girl, and says she defied the odds, they got the pressures down and it appeared she had most, if not ALL vision left in that eye. He was shocked, said that I must have got her there in just in time. He put her on the same expensive eyedrops (Xalatan) that I just got her OFF of in her left eye, and said she will likely remain on them for the rest of her life. ARGH.

He also cautioned me that this could be something that could cause her to go blind in a few days, to a few years. I'm was just glad there was more time. I really was starting to panic about her quality of life. I have had blind dogs before who adapted well, but they went blind over time, they weren't struck blind suddenly. If you would have seen how scared and miserable she was you would have understood what was going through my head. Just that morning, I kept looking at her intently, trying to determine if she was telling me that she was tired and was done, and I swear that's what she was saying, but by the end of the day she was sticking her big ol head on my keyboard, licking my face, wagging her tail, asking for her dinner, like it all was nothing.

I went to bed happy, although a little fearful what I knew would be a roller coaster ahead. I was thankful for this reprieve, but worried about how long it would be before we had problems with the eye again.

Saturday, April 18, 2009

A New Challenge

I forgot to acknowledge Nova's 5-month ampuversary here. But, on the 11th of April she was celebrating 5 months as a Tripawd! So exciting! Happy Spring, everyone! Last week a duck decided to lay some eggs in the bushes right in the front yard. Stupid duck! Not exactly the safest place with two stalking, duck-loving Great Danes! Thus far I have managed to keep the girls from eating the eggs although yesterday I caught Emmy "mid-lick". We haven't seen the Mom around in awhile, so are not sure if she abandoned the eggs once she saw the hulking creatures who enhabit our property:
We have a new challenge that we have been dealing with these past few weeks that is not related to her amputation or her cancer in any way. Many of you already know that, on top of her challenge of being on 3 legs, Nova also has the challenge of being blind in one eye. She was diagnosed with uveitis and glaucoma in her left eye a few years ago, and since that time has been blind in that eye. It was hard because we never really knew for sure that she was TOTALLY blind in that eye, but all exams indicate that. With a dog you never really know for sure.

Glaucoma causes pressure in the eyes, and it must be treated for the rest of her lifetime with expensive eyedrops. In the past, the pressure would increase occasionally, which would require us to tweak her medication. But each time, a change in medication would take care of the problem, and she'd be fine again (still not seeing out of the left eye, but the pain would be better).

About a week before we left on her "road trip", we noticed that the left eye had been bulging more than usual, and it was starting to cloud over more, when it really hadn't before. I knew something had changed. She still seemed very happy, although she would occasionally not come for her breakfast or dinner. I called her opthamologist, and he said to put her back on one of the drops called Xalatan. Argh. Xalatan is REALLY expensive, and comes in such a tiny bottle that it barely lasts. The employees at the pharmacy call it liquid gold. So I sucked it up and got another bottle of Xalatan, knowing that last time it did the trick. I was just hoping she didn't have to stay on the Xalatan forever.

I was nervous about having pressure issues with her eye while we were on vacation, because we would be in a somewhat remote place, and so far away from her specialist. We started her back on the Xalatan and a few days before we left on the trip, took her to her regular vet to get the pressure tested. It had come down from the mid 40s to the mid/low 30s, so everyone took that as a good sign. The optho said to keep her on the Xalatan throughout the trip, then check the pressures when we returned.

I gave her all her drops religiously on the trip, but looking at it, it seemed to be getting worse. She didn't seem like she felt bad, in fact, she was more active on the trip then I had ever seen her. But if you look back at the pictures of the trip, and look at her left eye, you can tell there is something there that is not right.

I took her in to the vet on the Monday after Easter and it was bad news. The pressure had shot up into the mid 50s. I called the optho and had to wait all day for a callback. While I was waiting, I researched info on what the options were from here. The eyedrops were getting to the point that they were very expensive, and it is time consuming to give them. Each must be given in a specific order, at least 5 minutes apart. And the Xalatan was really breaking the bank! During my research, I read about the extreme pain that comes from glaucoma. For pressures in the 50s, many sites said that that pain was similar to an extreme migraine headache in a human. UGH! I've had migraines, and I can't imagine doing ANYTHING while in that sort of pain. This girl is amazing. I certainly would have no interest in a sunny day like this if I had a migraine. I would be holed up in my bedroom with the shades drawn.

The optho insisted that there was no way he could tell me what to do without seeing her in person (which of course means an expensive specialist visit at MVS, the fancy-pants specialist facility an hour away in Southfield). My regular Dr. wasn't in, so I had to see someone else, Dr. Lorimer, who I ended up liking better than Nova's regular optho. I had read alot about ennucleation (taking out the eyeball and inserting a prosthesis, then sewing the eye up), and the expense scared me. I am all about positive thinking with Nova's cancer diagnosis, but it didn't seem to make sense to spend a ton on an ennucleation when I have no idea how many months (or years??) she has left.

Dr. Lorimer examined her and agreed that we had reached the point where the pressure in the left eye could not be controlled by medication. The eye either had to be removed, or there was the option of injecting something into the eye to "kill" it (actually kills the cells that create the fluid that causes the pressure). The second was the option I preferred, but the Resident Vet I talked to seemed to think that it was not an option for Nova. I asked about the cost of ennucleation, and was shocked that it cost MORE than Nova's amputation surgery! There is no way I could justify that financially. Especially when I had no idea what type of road there was ahead for her cancer.
(Emmy has been a wonderful sister to Nova, and has helped her through her ruff times! She has become Nova's protector in a way.)

Thankfully, Dr. Lorimer said that he thought that, given Nova's situation with the cancer, that an intravitreal injection was the best option for her, and thankfully it was a fraction of the cost (just a few $100). It could be done as an outpatient procedure, and she would have to be put under full anesthesia. The procedure was typically reserved for geriatric dogs, or dogs who might not otherwise have long life spans ahead of them. It was hard to accept that Nova might not have a long life ahead of her, but if the procedure works, it will keep her pain down for the rest of her days. The eye will turn strange colors (it is a cloudy white now) and will look strange, and will ultimately shrink to smaller than a regular eyeball. But it seemed a better option than putting her through major surgery to sew up the eye anyway.
The surgery went well, and I have noticed no difference in her mobility, which is a relief. That means she was definitely already blind in that left eye, and had already been compensating with her right eye. Right now the right eye is okay, but she does have an immature cataract in there, so there may be more problems that develop in that eye. The plan is to wean her off the eyedrops in the left eye (they are still needed for the next few weeks because of the inflammation caused by the injection), and then keep her on the eyedrops (not Xalatan thankfully!) in the right eye as a preventive measure. My hope is that she will have vision in that eye for the rest of her life. I don't want her to become a blind Tripawd, but if she does, I am sure she do all she can to adapt.

On top of all of this, there was some blood in her urine which might be an indication that the Cytoxan she was taking to keep the cancer from growing might not agree with her. It is common for Cytoxan to cause bladder damage. ARGH. Just what I need is bladder problems in a 121-lb. Great Dane. Her oncologist recommended that we take her off the Cytoxan for a week and check her urine to see if she is healing. My whole life has become one medical issue and drama after another with this dog. But it is so rewarding when I see how happy she is. When this all gets to the point where she is not happy anymore, it will be hard to handle. But thankfully we are not there yet.
Even given all her afflictions, Nova considers herself one lucky dog. Lucky to have a family who loves her, takes care of her, and showers her with affection every chance they get. She especially loves getting snuggles from Daddy!

Wednesday, April 15, 2009

Nova's Excellent Adventure - Friends and Family

Well, our adventure trip was coming to an end. The night before we left to come home, some friends of Aunt Margarets, Terry and Ruth McKinney, came over to pet me and Emmy. Mom had brought her camera to dinner and showed them pictures of all the amazing things a Tripawd could do. Grandfather Mountain, Linn Cove Viaduct, Mount Mitchell... they were all impressed and wanted to meet me.

The McKinney's are some of Aunt Margaret's mountain friends. They play mountain music for a living and had just gotten back from performing in Florida. They play regularly at the Orchard in the summer. They were very friendly, so I just went up and sat right on Ruth's lap:

And I gave Terry a bunch of sloppy Dane kisses.

Emmy was a little more discriminating, she growled at them a little at first. Sometimes Emmy is nervous about meeting new people:

They won her over after a few minutes!

I tried laying on the floor one last time to see if Lizzy would come up and hang out with me. Aunt Margaret wanted to get pictures of us together. But Lizzy was still too nervous. I hope she realizes someday what I big hunk of love I actually am.

The next morning Mom and Alex started to load up the car bright and early. Emmy and I thought that Mom's bed looked a VERY comfortable, so we stayed on there until we realized that everything was gone and they had started the car. We ran out to jump in, we didn't want Mom to forget us! It had been a great vacation and a wonderful place to stay, but we were ready to get home to see the rest of the family.

Once we got to Tennessee, we drove through some really big storms and heard that there had been tornadoes in the area. The rain didn't let up until around lunch, when Alex and Mom stopped for pizza. The didn't share the pizza with us, but Mom let me nap on the boxes, which made excellent chin rests.

When we got near Cincinnati, we stopped to visit Mom's cousin Katie and her sons, and their dog Reggie. Mom's Aunt Sue was their visiting from Cleveland so they had a little reunion and some nice conversation while us dogs had our own "conversation", a group sniff!

This was the first time the sun had come out all day, so we ran around in the yard together and played for awhile.

Sloppy Dane kisses for everyone! I sniffed the boys, Nathan and Alex -

I kissed Aunt Sue:

And I kissed Katie:

Reggie was shocked to meet such large women. He was used to being the big guy, so was a little intimidated by us at first. It was great to meet a new friend!

Saturday, April 11, 2009

Nova's Excellent Adventure - The Orchard at Altapass

After a long nap, Mom took me for a short drive down the Parkway to visit the Orchard at Altapass, which is run by her Aunt Judy and Uncle Bill. This is a historic orchard that is over 100 years old. Several years ago, the Orchard went out of business and was for sale. Mom's Uncle Bill had visited the orchard when he was little, and together with his sister, they decided to buy the Orchard and restore it as a popular destination for locals and tourists along the Parkway.

Mom says that they have done a wonderful job, and it is a great place to visit. The Orchard doesn't officially open until May 1, but there are lots of things going on there all summer long. Things like live mountain music and dancing, fruit for sale along with fudge, ice cream and lots of foods made by locals, a gift shop with cool things made my local mountain craftsmen, hayrides through the orchard (where Uncle Bill tells interesting stories about the history of the Orchard and the area), and much, much more. If you are ever on the Parkway and want to visit, it's at Milepost 328.3. And you can read all about it at

Anyway, it was such a beautiful day that Mom stopped at a few overlooks to take pictures of me. This was at the Table Rock overlook:

You can see Table Rock way out there in the distance, jutting up from the mountains:

This was my first look at the Orchard, from the overlook up on the parkway. It looked pretty cool:

Mom kept snapping away with her camera. Behold the beauty of the mountains!

And behold the beauty of the Great Dane!

We drove down the Orchard road off the Parkway and walked together among the budding apple trees.

I hear some of these trees are over 100 years old!

Sniffin' the wonderful Spring air!

We walked around for quite awhile:

Mom just wouldn't stop with that camera!

She was so glad to see me so healthy and hoppy!

Mom is so crazy about pictures of me, I think she must be putting together a daily "Year of Nova" calendar:

Some cars were slowing down up on the Parkway to look at me:

These are the signs directing drivers to the Orchard. They even have Monarch butterflies there:

It had been a long photo session, so I was ready to go back to the cabin for a nap!

Nova's Excellent Adventure - Mount Mitchell

Thursday was our last day in the mountains, so Mom was hoping for good weather and clear skies so we could go to Mount Mitchell, the highest mountain east of the Mississippi River. It was a 25-mile drive down the Parkway, so she was hoping it would be open. It was! We stopped at a few scenic overlooks on our way to Mount Mitchell. This one was at Three Knobs:

We finally got to Mount Mitchell, and it was a long, winding drive up the mountain. When we got to the parking area near the summit it was FREEZING cold. There was a giant snowball for Emmy and I to lick near an elevation sign, so Mom took more pictures:
Mom had read that the path to the summit was supposed to be "handicap accessible". The observation deck looked to be so far up, she almost decided not to try to go up. There was a lot of snow and ice too. Alex said that we should give it a try, and reminded Mom that reaching the top of the highest mountain in the East would be an awesome accomplishment for a Tripawd. It looked kind of scary up there:
But I knew if anyone could do it, I COULD!
So we started up the snowy, icy trail to the summit.
It was easy for me, although we were so high up, and the path was all uphill, so I was panting a lot.
I MADE IT TO THE SUMMIT OF MT. MITCHELL! Mom must have taken 100 pictures of me and kept hugging and kissing me. And the other people at the top were acting like I just did something REALLY amazing. So I was happy to give Mom a perfect photo by the sign at the summit:
I was so happy that Mom brought me on this trip that I gave her a big sloppy Dane kiss at the top of the mountain:

We even went up on the observation deck to look around. There were mountains as far as the eye could see:
I even met a few people up there, and they were all petting me and asking what happened to my leg:
It was cold, so we started back on the trail down to the car.
I was napping in no time!
Mom stopped at another overlook on our way back to take a picture of Mount Mitchell from afar. I had enough of pictures, so I decided to stay in the car.