sullivan's tripawd life

throughout sullivan’s journey we were referred (by many!) to dr. suzy starr of paws in motion (natick, ma) for water-based therapy treatment. 

we brought murphy to enjoy dr. starr’s heated, indoor pool for recreational swim to keep his hind, arthritic limbs working the best they can. 

on the phone when booking murphy’s appointment, dr. starr asked us to bring sullivan in for an assessment. she gave sully two treatments in the water treadmill in an effort to strengthen his lame front leg; but when no improvement was made she gave us an unorthodox offer. 

dr. starr’s husband, dr. david knapp, is a former orthopedic surgeon at angell. she invited us to her home on a friday evening for her husband to take a quick look at sullivan and make a few recommendations. 

in less than ten minutes, dr. knapp stated that sullivan likely had a nerve sheath tumor in his brachial plexus. apparently nerve-based tumors are very difficult to diagnose and often do not appear on diagnostics; hence the ongoing testing result ambiguity. given the severity of the diminished muscle mass/lameness and the nature of nerve sheath tumors, dr. knapp said that sully would need to have his front left leg amputated. 

he genuinely and warmly assured us that this procedure was in sullivan’s best interests, confirmed that his other three legs were strong and able to bear additional weight, said that sully would come out of the operation happier and stronger than ever before and could live a wonderful, healthy life for many years to come.

both suzy and david projected a speedy recovery for sullivan. unlike dogs who have tragically been hit by cars, or developed a quick onset of bone cancer; sullivan was forced to train and condition his body to walk on three legs since the initial onset of lameness on july 31. though four-legged, sully dragged his lame leg and simply used the toenails on his paw to help with balance from time to time. because of this, sully’s three legs became very strong and it was proven he could get around and navigate with three legs. 

our path did not cross suzy’s by accident. suzy has provided us much needed sound reason, a medical mind and a warm heart. not many people go out of their way to help others, and her countless acts of generosity toward us to benefit our sully are so appreciated.  

as a way of showing our gratitude for the kindness and wonderful care given to sullivan by the angell/mspca staff, a small group of us gathered on sunday, september 9th and participated in angell’s annual “walk for animals”. 

members of “team sullivan” donned red t-shirts with special photographs of sully on display! 

over 3,000 people and upwards of 1,500 animals participated in the walk around the boston common. 

murphy and brown participated in the festivities and proudly “walked for their brother”. unfortunately sullivan’s condition was too debilitating and he was unable to participate in the event. 

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. 

angell is a beautiful facility located in jamaica plan on south huntington avenue. the waiting area is always incredibly clean and patients are asked to wait in dog and cat delineated areas. liaisons call you in for the appointment and take a little time to get a feel for the situation, understand what brings you in, engage with the pet and go over any questions. the adoption wing is to the right of the emergency/medical area. the beauty of angell is its comprehensive, all-inclusive nature. emergency doctors, surgeons, neurologists, radiologists, oncologists, pain specialists and the like are all on staff at all times, working together, to ensure the best is done to save animal lives, diagnose problems and perform proper treatment. 

dr. johns, who is currently dr. brum’s fellow, gave sullivan his initial exam. she spent nearly 45 minutes looking at him from head to toe, examining things that he’s never before had checked: each joint, muscle function, hip movement, eyes, and so much more. she was absolutely phenomenal. after typing all of her findings and sharing them with dr. brum, he came in and did a peripheral assessment of sully to augment dr. johns’s notes. while both doctors mentioned a myriad of possibilities for sully’s condition, namely cancer, immune-mediated illnesses, poly arthritis, orthopedic issues, tick borne disease, etc., dr. brum scooped sullivan up for what we thought was a simple blood and urine test. 

when they came back, dr. brum informed us that in addition to a cbc/gen, tick panel (again – apparently tick borne diseases often take a while to manifest), urine analysis and cytology of the right and left carpi/right and left tarsi, sully was examined by dr. nick trout, surgeon and author of “tell me where it hurts”. dr. trout and dr. brum initially thought sully could be suffering from polyarthritis and suggested he get joint taps to examine the fluid. the joint taps showed very mild immune-mediated arthritis. sully also had a series of x-rays (chest, lumbar spine, thorax, c-spine) and an ultrasound of his abdomen to look for masses and abnormalities. everything came back normal. due to the presentation of the affected limb (lameness, muscle atrophy, knuckling) it was recommended that sullivan see one of their board certified neurologists immediately. an appointment was booked with dr. avril arendse  the following morning, thursday, august 16th. 

the above photo shows the incredible atrophy in sullivan’s front limb. given lack us use, the muscle has deteriorated profoundly. while his right front limb is brimming over with muscle, his affected limb is simply a bone jutting out of skin. 

this adorable litte creature is harry. he and his mom, katie, live down the street from us in norfolk. harry has become a good friend of “the boys”, and given his yellow color we joke that he’s part of the “brotherhood” that is the rodeghiero/rapciak canine family. 

harry and sullivan could pass for brothers and are kindred friends. harry and brown attend the same play group at golden ridge farm in walpole and are carpool pals. throughout this journey with sullivan, katie has remained very interested always asking about his condition and progress. a neuromuscular therapist at 360 neuromuscular therapy, katie has been able to give very helpful nuggets of information. 

when harry was small he broke his fibula after an intense play session with a neighbor dog. wanting to go to the best, one of katie’s clients referred her to mspca angell in jamaica plain. hugely impressed with her experience at angell and overall care for harry, katie said “you need to get sully seen at angell”. katie sent a series of emails and opened the door for us at angell. we were given the opportunity to meet with dr. douglas brum and his fellow dr. jacklyn johns on wednesday, august 15th. 


the trip to angell was the first step in our quest to understand sullivan’s condition and provide relief. katie and harry made this possible. 

dr. holmes and i go back a long way. she and i followed similar initial paths in the field of social work/policy before she diverted into veterinary medicine. we often find ourselves talking tips of the trade and exchanging clinical stories during the down time of routine vet visits. 

on july 31, 2012 “the boys” (murphy, sullivan and brown) were having a playdate with their good friend buddy brooks in norfolk, ma. towards the end of the playtime, sullivan began limping quite noticeably on his left, front leg. sure he hadn’t sprained it from running too hard, we checked the paw for an insect bite/sting, burr in the pad or other such external malady. fortuitously, we had a prescheduled vet appointment that afternoon and were most relieved that dr. karen holmes would be able to evaluate sullivan’s condition. 

after review, dr. holmes was unable to make a diagnosis. she drew blood and ran a test for lyme disease as a symptom of tick-borne illness in dogs often presents in lameness. the lyme test came back negative. she prescribed tramadol and gabapentin for sully’s pain and encouraged us to see cathy at sterling impressions for massage. the pain meds kept the discomfort down, but sullivan was not himself and ever-more labored by the day in his walking. we saw cathy once for massage and sadly it was a futile visit. 

dr. homles asked to reevaluate sullivan after a few days and on august 7th we went to windhover for a recheck. at that time she noticed sully’s worsened walking capability and overall lethargy. prior to examining sully fully, she took a larger sample of blood and sent it to a comprehensive lab to be tested for all types of insect/tick borne illness. the results of this blood panel came back days later and there was no insect-related disease in the blood. she then performed a series of manipulations of sullivan’s neck and said, “humm… i bet this dog has something neurological going on…but don’t worry. i’m not talking cancer or anything”.

we made an appointment for monday, august 13th for an x-ray of sully’s neck to assess for neurological weakness. cathy and dr. holmes sedated sullivan and took one simple neck x-ray, which was inconclusive. “slight abnormality of the disc space” was the claim. 

i was sent home with a sedated dog drooling, unable to walk on his own given the loopy medication and asked to square up on a bill from 3 office visits, an x-ray, medication and massage therapy all of which were completely useless and yielded no medical treatment plan or diagnosis.

while paying the bill, the doctor came out and gave me, as paul harvey would say: the rest of the story: a death sentence, not a treatment plan.  

on may 18th, 2012 sullivan began limping on his hind leg. we initially thought he had tweaked something running or while leaping over rock forms in the yard, but alas, the limping lingered. concerned, and ultimately worried he was in pain, we went to our vet for consult. 

upon examination, the doctors at windhover veterinary clinic were unable to pinpoint/diagnose the problem and sent us for specialized treatment. deramaxx was prescribed to control sullivan’s pain which was quite noticeable in diminished activity level, visible limping, and overall malaise.

we first visited dr. nicole amato at ivg hospital for an x-ray of sullivan’s anterior cruciate ligament (acl). upon physical examination and x-ray review, dr. amato discerned that sully’s acl and accompanying ligaments/joints were all normal, with the exception of age appropriate wear and tear for an 8-9 year old dog. 

windhover’s secondary recommendation was to visit cathy symons at sterling impression animal rehabilitation center of new england. cathy determined that sully had tightness in his iliopsoas muscle and developed a healing plan of massage and ultrasound treatment. weekly and sometimes twice-weekly visits to cathy proved insignificant and there was no change in sullivan’s hind limping with intense treatment. 

supplemental to sullivan’s seeming orthopedic problems was a 1-inch sore on the back of his leg that would not heal. sully would bite and lick the sore with intense perseveration. windhover doctors each took a stab at wrapping the area with various bandages, but sully always found a way chew off the casting. we returned to sterling impression for laser treatment on this sore; but alas, no positive change. given the unimproved, unresolved nature of this condition, sully wore a lampshade elizabethan collar for weeks to prevent licking/biting and was put on various antibiotics (cephalexin/keflex and clindamycin) to hopefully prevent infection and heal the sore. unfortunately, the sore never properly healed. 

over time, sullivan’s hind leg limping subsided naturally. to this day we are unsure of the root of the trouble – be it muscle strain/sprain, neurological abnormalities or whatnot. the lack of medical clarity and status-quo “no positive change” treatment results remain most frustrating. the wound on sully’s hind leg is still present despite herclean efforts to facilitate healing. 

sullivan is a blessing. a perfect dog, he has never been one day of trouble, never wanted for anything and always seems to be smiling! perhaps sounding lame, we often say that sullivan feels grateful for having been rescued and given a safe, loving home.

sullivan has two primary joys in life: running and sitting in the backset of the car watching all the happenings of the neighborhood. 

though we got bamboozled into having him DNA’d one christmas receiving results of standard poodle, corgi and dachshund (no real resemblance with any of the breed trifecta), his incredible speed and intelligence leads us to believe he may be part greyhound or border collie.

for years sully enjoyed playing a game. the second we would get out of the car after a ride, he would stand, still as possible, near the garage door. the second the door started to go up, he would leap the stone wall and run around the whole house trying to race the garage door. so fast, and often affectionately known as “wheels”, it was common that he’d take the win, though the garage door managed a few victories over the course of time too. so physically fit, sully could run for hours on end without tiring. he loves chasing squirrels (even caught a few!), bounding around without care, sprinting the three mile reservoir and running down the driveway to greet any visitor.

the back trunk doors on our cars are always open and more times than not, sully can be found either snoozing the afternoon away or attentively sitting up patrolling the ebb and flow of suburban life on our cul-de-sac. The car, both stationary and moving, is his happy space. A most alert co-pilot, sully barks at cement trucks and motorcycles and never misses out on checking out a fellow canine as they prance down the road with their owner! 

 sullivan is a wonderful middle brother to his two canine best friends murphy (12.5 years) and brown (soon to be 3). murphy and sullivan were fast friends; now inseparable. the relationship between sully and brown was a little more tenuous to develop but now they are best pals. 

sully watches the house to make sure any visitors have been approved. he dresses as a pumpkin every year for halloween and is a most enthusiastic welcoming committee for the young trick-or-treaters. never fond of swimming, sully has a great fondness for kayaking. of course donning a life preserver, he loves sitting in the tandem kayak barking at geese, staring at turtles as they sun themselves and  watching with awe as the herron land from flight.  

 sully is very fond of coming to the abundant table www.abundant-table.org. gentle and loving, sullivan is a guest favorite and allows all the guests to pet, kiss and hug him. of course he often makes out in the deal landing a few table scraps, sullivan’s heart is big and knows that he is able to brighten the days of the downtrodden and soften the souls the hard hearted. 

what else can be said about sullivan? he loves baked potatoes, howls the soprano line (to murph’s baritone) whenever beethoven’s moonlight sonata is played, is the best cuddler at night, gets jollied when his little brother chases him around the holly bush in the yard, uncannily resembles “santa’s little helper” from the simpson’s television series, loves ice cream from bubbling brook and has a boundless love for life that is always evident on his face. what have we recently learned about sully? he is a immeasurably strong with a spirit and courage second to none. 

why harp on sullivan’s speedy wheels? an unfortunate medical condition recently jeopardized sully’s ability to run forever…

Sullivan: Day One After Adoption

before delving into sullivan’s recent medical problem, let’s take a minute to get to know the little guy: 


while scrolling through thousands of adoptable canine cuties on petfinder.com, a thumbnail image of one caught my eye: jake. there was something about jake’s kind eyes and characterizing white racing stripe running down the middle of his face that stole my heart. jake was found by a kind soul roaming a tennessee interstate with his siblings and mom. placed in foster care after spending time in a kill shelter, jake was deemed adoptable and his picture/story went viral. it was a waiting game for him as the good folks at great dog rescue followed up on applications, interviewed families and tried to figure out who would offer jake the best possible life given his needs. after much convincing and being approved by the rescue organization, jake was to become family member #4 in a family of aislynn (me), linda (mother) and jake’s soon to be big canine (but don’t tell him he’s a canine – he has lived 12+ years thinking he is 100% human) brother (murphy). we are now a “party of 5” as young brown joined the family in 2010. we were promised that jake was crate trained, house broken, capable of basic obedience and medically well – sentiments that helped my persuasive case of “please, please, please we have to get him”, but ultimately proved fallacious.   

jake became part of our family on april 30, 2005. he travelled in an 18-wheel truck from viola, tennessee to a ‘park-n-ride’ in plainfield, connecticut. freed from his rickety crate, the imposing truck driver said “jake’s people?” and we stepped forward with much anticipation, meeting our young pup for the first time. despite being yellow, i was convinced jake wasn’t the dog we fell in love with online. he was covered with mange, had tar caked in his ears, bucked frantically on leash and decided to scavenger a leaf pile for the remains of a dead mouse. the driver said, ‘ma’am – this dog never been on no leash before’. my mom and i looked at each other thinking: what have we gotten ourselves into? 

change in diet from kibble sold in a hardware store to hearty organic food, attentive veterinary care, some basic obedience lessons and loads of tlc was the perfect recipe for reviving this unconfident, lost soul and transforming him into a strong, healthy boy. 

the next task in this period of transition was getting rid of the name jake. “jake” seemed like too much of a reminder of his roots, and we wanted to celebrate new beginnings and a fresh start. after coming up with a list of five or so names, we went to the fenced schoolyard and called all of the names, hoping our yellow friend would essentially pick his own name. “chance…come!!”, “brewster…here, boy!!” and it went on until my mother yelled: “sully…come!”. in that very moment, our protagonist, formerly known as jake, became sullivan – sully for short. always aware of his humble roots, sully wears his very first jake tag on his collar each day.