Friday, April 24, 2009

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?

1 comment:

Vicki T said...

Oh my gosh, Suzy, I feel terrible reading this and understand your fears pretty well because you are an excellent and very expressive writer. Honey, I know Nova has been through so much, but she can adapt to blindness even on three legs, but she cannot adapt to the pain. I imagine as you wrote this you were terrified about Nova's future and, also, your own ability to deal with a blind 3-legged dog. I'm so sorry I haven't been here for you during all of this. I have very broad shoulders and am always open to tossing ideas around. Please feel free to email me at: vriss@comcast.net and, perhaps, you wouldn't mind if we exchanged phone numbers. Sometimes, talking is so much easier than pounding the old keys. Your pals, Blazer & Vicki Tankersley