dr. a
on thursday morning we dropped sullivan off at 7:00 am for a full day neurological examination. dr. a felt the only way to truly know what was happening was to perform an MRI and spinal tap. upon examination, dr. a noticed decreased withdrawal reflex in sully’s left front limb; but other than that everything checked out neurologically normal.
leery to put sullivan through such intensive testing, we knew that it was a necessary step in determining his diagnosis. when we picked him up that evening, dr. a came into the waiting area and spent a good 25 minutes speaking with us. in a compassionate yet direct manner, she prepared us for likely unfavorable MRI results. she felt given sully’s lameness and presentation that bone cancer was a probable verdict.
one who ‘googles everything’, prior to this conversation with dr. a i researched possible diagnostics given sully’s symptoms and bone cancer was a very viable option. i read on to the prognosis/treatment section and learned quickly that the forecast for dogs with bone cancer is typically very grim. her mention of bone cancer sent us into emotional turmoil that spiralled into a sleepless, tearful night. the thought of losing my sullivan was beyond my comprehension…
side note: i had a plan and this was not it. murphy, my soulmate and first dog is approaching 13. believing he would likely pass first given his age, i sought comfort knowing that i’d have sully to help me through the grief of losing my best friend. sullivan, the white cream in the oreo sandwich of yellow labs is the unwavering glue of the family. he’s not emotional, not needy, simple, easy to love and always there. this can’t be happening to sully. i need him.
on the way home from angell, we stopped at the supermarket and bought sullivan a rotisserie chicken and baked potatoes; his favorite. though he couldn’t eat after midnight, we pumped him up with good food, treats and kisses galore. unaware himself of his potential prognosis or what was to happen in the morning, he loved the special treatment and his calm, cool, collected manner was inspiring to his 2 two-legged friends who were beyond emotional repair and his 2 four-legged brothers definitely having sympathy pains; or maybe just trying to beg for a few scraps of chicken!
on friday morning an angell liason scooped up our beloved sullivan for a day of testing. he endured joint taps of the left shoulder and elbow, tap of the spine, MRI of the spine and brachial plexus and radiographs of his left front limb.
we spent the day nervous wrecks. when dr. a called on friday evening with the results of the MRI she said she had good news and bad news. the good news was that there was no indication of a mass/bone cancer, the bad news…there was nothing that appeared on the MRI to help diagnose sully’s condition. what could it be we wondered? he’s physically a shell of himself, lameness becoming more intense by the week, and lacking his overall happy-go-lucky attitude and smile. what is medically going on?
the caveat: there was slight irregularity in the spinal fluid which could point to an auto-immune disease. it was her recommendation to treat him aggressively for such a condition and hope that the marriage of medications would work in harmony and restore his front leg to good health. dr. a was unable to pinpoint the specific type of AI disease, but tossed out lupus, thyroiditis, generalized demodectic mange and myasthenia gravis as potential players.
unprepared for sullivan to come home mirroring a patch work quilt, we brought our brave boy home once again to enjoy a feast of his culinary favorites as well as a plethora of pills that required the purchase of an 8×10 inch pill organizer.
sullivan was shaved on the top of his head for the MRI and was left with a 4 inch by 7 inch patch on the top of his head. the MRI and radiograph of his front leg required the area to be shaved as well, and a hairless 10 inch by 6 inch patch remained as a secondary battle scar of the testing procedure. additionally, two inch by two inch bands were shaved around each of his lower leg joints during the initial joint tap.
sully’s medication arsenal included: doxycycline, clindamycin, tramadol, gabapentin and prednisone.
the pain medication made sullivan very comfortable and as time went on we saw glimpses of the “sully of old”. his mood improved and he took to his favorite activity: sitting in the back of the car and watching the world go by. the prednisone had favorable and unfavorable effects on his body.
a finicky eater on a good day, the prednisone gave sully a voracious appetite and he would salivate for any type of food or snack. despite his increased eating, sully only gained two pounds and went from his regular 58 pounds to a whopping 60!
the downside to the prednisone was increased water consumption and thus, sully felt the urge to urinate with great frequency. sullivan had not had an indoor accident since the first week of welcoming him to our home in 2005, and he was having accidents left and right. in the night he wouldn’t even budge but wet the bed in a sound sleep. we went through pee pads and did many, many loads of laundry but alas; a small price to pay to hopefully get sullivan on the mend!!
we were to have a follow up recheck appointment with dr. a two weeks after the initial diagnosis and medication prescription. on thursday, august 30th we went to see dr. a and the visit was very hopeful. after doing a routine office exam, dr. a brought sullivan outside and carefully watched his gait. at that time it appeared that sully was bearing more weight on his left front leg and dr. a noted him being of “brighter” mood. encouraged, dr. a developed a plan to taper both the prednisone and pain medications and provided us with a handful of exercises to help increase sullivan’s ability to bear weight. we left angell filled with hope. sullivan was to be checked again in one month.
over the next few weeks, sullivan’s condition plateaued and began to worsen. despite being on significant doses of prednisone, sullivan’s lameness continued to deteriorate and the muscle continued to significantly waste. that said it should be noted that amidst all the wonderful benefits of prednisone, it diminishes muscle mass and thus, we were caught between a rock and a hard place. sully needed the prednisone to hopefully kill any AI disease working its way in the body, but no matter what we did by way of water treadmill or strengthening exercises, the prednisone medically contradicted these efforts. the video shows sullivan’s gait growing weaker and weaker and the true lameness of his front left limb is most apparent. his other three legs were forced to compensate for his atrophied leg. concerned, we called dr. a and on two separate occasions she spent well over an hour speaking to us about options, the presentation of auto immune diseases and much more. we will be forever indebted for her time, listening ear, kindness, compassion and care. after describing sully’s decline, she encouraged us to come in sooner than the one month benchmark.
upon examination at his friday, september 21 recheck, dr. a saw sullivan’s worsened condition. she retook x-rays of his left humerus and abdomen/chest and the results were normal. given sully’s weaker physical presentation on the front leg, bone cancer was a concern; and the x-rays of the chest/abdomen were done to rule out possible spread or occurrence. she writes, “i am not sure what is causing sullivan’s lameness, but possible causes include a neoplastic process or either the bone or the nerves innervating this leg. at this point due to the deterioration I would consider amputation of the limb. other possible tests that could be done before this include bone scan (nuclear scitigraphy), electrodiagnostics, and/or repeating an MRI of the brachial plexus and lower portions of the limbs.”
dr. a’s compassion and care for sullivan and his humans was immeasurable. despite the outcome, we couldn’t have asked for a finer neurologist.
