PupDate: The Long Slog to Recovery

As some of you know, last November our big dog Drake went lame in one leg. He is barely a year old, and we’d always blamed his doofy clumsiness on his rapid growth. He’s a Mastiff/Great Dane mix who was 60 pounds when we first brought him home at just five months old. Here’s a video of him and our husky, Snax, playing when we first brought him home:

Puppies playing

A video posted by Kameron Hurley (@kameronhurley) on

He doubled in size rapidly, reaching nearly 160 lbs by the time he was at about a year. At some point, though, he started being afraid to go up our stairs. No amount of treats or urging would get him to go up and down more than four steps at a time. We figured he’d developed an irrational fear of stairs. He always had some trouble getting going in the morning, but over time he got worse. We’d thought maybe his left leg would fall asleep while he laid on it at night, and that’s why he’d have trouble getting moving in the morning. After a few steps he would usually work it out.

But then, one morning he pulled himself off the couch to go outside and his entire back end just thumped onto the floor, and he whined at me. I had had growing concerns by this point, and was researching stuff like pinched nerves. I tried to help him up, but he just fell down again. When I helped him up the third time, he was in so much pain that he growled at me. This was pretty shocking, because Drake is the nicest, sweetest dog in the whole world. I’d never once heard him growl. I looped my scarf under his back end and helped him outside to do his business, but he was clearly in intense pain.

When we brought him into the vet, they gave us drugs for the pain, which helped, and had to sedate him to do an xray, because he wouldn’t let the vet touch his leg (“When I tried to touch his leg he growled at me like a dragon!” she said. Yes, he is a large dragon, our Drake). When she sedated him and examined his legs, she found that he had torn not one, but both ACL’s in his back legs. The left was likely completed shredded at this point, causing the two big bones in his leg to slide against each other, putting him in terrible pain. The right was not as bad, but would be soon.

The good news was that we had pet insurance, as Drake has always had a funny walk, and my spouse figured he was going to have some kind of leg or hip problem in the future. So even though the surgeries would be incredibly expensive, we should get 80% of it reimbursed.

What we forgot, of course, is that pet insurance is just as agonizing to deal with as people health insurance.

Drake’s first surgery went well. He had to be confined so that he couldn’t jump or get onto furniture or try and go upstairs for eight weeks. The first four weeks, his rehab schedule proceeded apace. We did everything right according to the rehab book, giving him meds right on schedule – anti-inflammatories, pain meds. We had to put heat on his leg before we took him out every day, and ice on it when he came back in. We had to do passive range of motion exercises, massages, hip sways, and walks of 5 minutes, then 10 and finally 15 minutes. Drake was up and using his left leg better than ever before. He was able to stand and walk on his own. My spouse was able to pick up the majority of this work, and let me tell you – it’s work. Drake had plenty of stamina after the first two weeks. But when we got to week 4 of this schedule, after everything going right, something went wrong.

Knee #1. 12 weeks of rehab. Oof.

A photo posted by Kameron Hurley (@kameronhurley) on

 

His left leg suddenly swelled up. The fluid in his leg sought the path of least resistance, and burst out his old suture scars, pumping fluid all over his bedding. We spent New Year’s Eve and again on New Year’s Day in the vet ER with him, trying to get answers for what was wrong. They took a culture and sent us home with antibiotics the first day, and finally wrapped up his leg the second day, which did put us on the path to recovery, finally. When the results of the culture came back, it turned out Drake had an antibiotic-resistant staph infection. They switched us to a different antibiotic, and he seemed to improve. The trouble was that at this point now we were waiting for the pet insurance to reimburse us so we could do his other surgery, and after two months, they still hadn’t. In the meantime, Drake’s other leg, with the ACL that wasn’t yet completely torn, finally gave out and tore completely, giving him one healing leg and one really bad leg to try and get around on. It became harder to get him up in them morning. He required a lot more help. We got a harness for him that has handles that give us the ability to pull up his rear end, and let me tell you, we have needed it. It got to the point where in order to get him up the stairs outside, we were hauling this dog up all four steps through sheer brute force. We were able to get him in for about two weeks of water treadmill and physical therapy, though, which helped a lot. He was finally able to stand on his own again, even if he still wasn’t up to going on long walks. It was something.

4 hour wait and basically just a bandage. Sigh.

A photo posted by Kameron Hurley (@kameronhurley) on

Finally, I got a book check, and we determined to just spend the book check on Drake’s second surgery instead of waiting for the pet insurance. The second surgery went well, and we got a whole week where everything seemed to progress normally. He was getting up on his own. He was slogging away, slowly but surely, whenever we’d bring him out.

But in week two, he took another turn for the worst. Once again, his leg swelled up. The right one we’d just had operated on, this time. We took him in and got some antibiotics and a culture done. Sure enough, it was the staph infection again. After getting through ten days of this new antibiotic with little change, they switched us to one where you had to wear gloves to give it to him, because it was toxic to humans. We figured this would be a win, and we’d knock it out.

No such luck.

He went through a whole regimen of these, all the while refusing to put weight on his right leg, and still weak in his left leg. Getting him outside three times a day, let alone get him to all his doctor’s appointments, was an ordeal. Because Drake still couldn’t get up on his own, my spouse had to stay home to care for him while I was at ICFA. At this point, they put him on a new antibiotic, trying to find something, anything, that would clear the infection. The new one, tetracycline, was very cheap, but it interfered with his other medications and gave him a horrible stomach upset that left him screaming in discomfort several times a night. He was already feeling pain from the infection in his leg, and pain from muscle wastage. If you’ve ever had to sit in bed and listen to an animal scream and know there is nothing you can do for them, you know how awful this is.

Then, when I was at ICFA, Drake stopped eating.

Our dog has always had a huge appetite. The one thing that remained constant through the whole horror was that he was eating regularly. But I noticed a couple days before I went to ICFA that he would leave his breakfast and not eat it until dinner. Once I left, my spouse said that Drake ceased eating all together. The vet gave us an appetite stimulant, but Drake wouldn’t eat anything. My spouse went through the whole pantry – chicken, peanut butter, butter, sugar, brown rice, honey, mayonnaise – everything he could think of, and Drake wouldn’t eat his pills with it. So my spouse, having worked at an animal shelter, had to pill him – basically force the pills down his throat through the back of his muzzle where there are no teeth, then hold his mouth closed until he swallowed. This was agony for both involved. This went on the entire time I was at ICFA. I was starting to wonder if I’d come home to a dying dog, or if he was already dying.

My last day of ICFA, my spouse managed to get Drake to eat some brown rice and vegetables mixed with kibble. He’s a hero like that, which is one of the reasons I married him.

So when I got home, Drake seemed much more alert and happy than I expected. He had lost a scary amount of weight, and he could not get up on his own – he hadn’t stood up by himself in weeks, at this point – but at least he was eating. Our standards were lower.

We had a new medication, the tetracycline, but in addition to giving Drake horrible stomach pain, his leg was not looking better. In fact, in the days after I got home from ICFA it became abundantly clear that Drake was fading fast again. Yes, he was eating, but his leg was sporting new bumps ready to burst, and he was lying on the leg and trying to guard it from us. He wouldn’t let us touch it. He finally got so bad he wouldn’t even whine anymore. He just laid in the living room on his bed, curled up in misery.

The vet did another culture, and recommended we wait for the results before we decided on a treatment plan. But it was clear to us that the tetracycline wasn’t working. The problem was we only had one option left, and that was to give Drake a particularly dangerous antibiotic via IV which would cost us about $150 per injection, per day, for 7-10 days. I was less concerned about the money (royalties were due any day) and more concerned about Drake dying. But the truth was, as I told my spouse, Drake was dying right now. We were watching him die. I have worked at a vet clinic before, and my spouse worked at a dog rescue, and even if the vet was being optimistic and conservative, we knew better in this case. We feared that if we waited another week to start, Drake would be too weak to endure the treatments. So against the vet’s recommendation, we didn’t wait for the culture, and we started the antibiotic IV treatments.

Drake improved almost immediately, but had to have urine analysis done every three treatments to make sure his body was handling the drip without, you know, giving him kidney failure. So I waited for the first results before I started being optimistic. Luckily, he is a young dog, and he passed the first urinalysis just fine. About five days into the treatments, the vet called with the results of the culture. Sure enough, as we’d suspected, the infection had adapted to the tetracycline, and had indeed been slowly killing Drake. “You made the right decision,” the vet admitted.

On Friday, we hit Day 7 of Drake’s treatments, and his perpetually oozing wound has finally closed. Just to be safe, now that his second urinalysis came back OK, we are doing two more treatments to make absolutely sure we’ve beaten the infection. On Monday, we’ve scheduled his first water treadmill visit since his second surgery.

It was been a long and exhausting trek, and we still have months of rehab left to go. What this whole ordeal has made me consider, though, is the coming health crisis with antibiotic resistant infections. While Drake was oozing everywhere we’d wash his bedding, clean his leg, wear gloves, and scrub our hands religiously. At the vet, they scrub him up and scrub themselves with the same amount of vigor. We are cautiously optimistic that we’ve finally caught the infection this time, but going through the vast number of antibiotics and treatments we had to to get here brought the horror of this particular apocalypse that much closer. People die of infections today, yes. But you don’t think about dying of an infection when there’s a hospital right down the street today. You don’t think you’ll get cut by a thorn, or scrape your knee, and die from it. Yet those days are coming back. In researching these types of infections I found that more and more people are dying from them. Drake’s surgery went from routine to life-threatening slowly and then all at once. It was scary. It was scary that some days he seemed fine, and he’d rally, and then he’d be back at death’s door.

He is snoring this morning. One more treatment today for his infection, tho they may extend until Monday just to be sure it’s beat.

A photo posted by Kameron Hurley (@kameronhurley) on

Clearly we care a lot about our animals. We don’t have kids, so for us, the dogs are part of the family. He still has about 6 to 8 weeks of rehab to go, but here’s to hoping the worst is over. He is a great dog, and we are happy to have him around, however awful the last six months have been for all of us.

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