Kirby even looks younger now

Kirby goes for his checkup on Monday.

Three weeks ago Kirby had his left knee operated on. Two weeks ago he started acting like a young dog.

I never knew him when he was a puppy. Was he clever? Was he adventurous? Was he kind?

Now that his knee has been repaired and he is not experiencing pain, the pup he once was can be seen.

Yes he must have been a very clever little guy.

Yes he must have been adventurous.

Yes we all know he must have been kind.

Just look at him now.

He is walking faster and smoother. He is putting weight on his leg more and more. He is happier and he is more active.

We will repair his right knee this summer and I can just imagine this gentle spirit blossoming even more.

I so wish I had known him since he was a puppy but perhaps knowing him at this side of his life is even more important.

I often tell clients who have adopted dogs whose backgrounds are sketchy — it doesn’t matter nearly as much who gave them the first part of their life — it is who gives them the rest of their life that matters the most.

Dancer and Emily were ready to work

Everyone was shocked to see a cat coming down the hall. Especially a cat being carried in a pouch!

But that’s how Dancer made her entrance to her first appearance as a Pet Partner therapy animal.

Dancer went through all the training required by Pet Partners and aced her evaluation.

Dancer was now very happy to go to work. She loved being held and petted and especially loved being brushed.

She loved teaching people about cats, particularly her breed of cat.

Peeking out from her favorite blanket

She was comfortable being carried and also walked beautifully on her leash. That was something no one had ever seen before – a cat walking on a leash!

Dancer spent about an hour on her first assignment and everyone agreed she should come back again – soon. Some people wanted to keep her and she was so comfy with them, she probably would have stayed with them!

But this gorgeous Russian Blue belongs to Emily and they are an incredible team.

Congratulations to the Love Dogs newest member …  or should we say Love Cats?

Time to go to our new doctor

When you first hear the diagnosis of osteosarcoma your head starts spinning.  All you hear is cancer.

Osteosarcoma is by far the most common bone tumor in dogs, usually striking the leg bones of larger breeds. Osteosarcoma usually presents in middle aged or elderly dogs but can arise in a dog of any age with larger breeds tending to develop tumors at younger ages.

This type of bone cancer usually has a sudden onset. The owner may notice just a few weeks of limping, the swelling around the mass and then discomfort.

All of a sudden a very active dog is on the sidelines.

One of our Love Dogs, Bingo, is one such dog. Just a few short weeks ago she was running in the desert and enjoying her agility classes.

Bingo was adopted when her prior owner had Alzheimers and new homes had to be found for several dogs. No one knows for certain her age but somewhere between seven and ten.

Now she sits with her owner in a new doctor’s office, shaking and scared. The lump on her left front foot is growing more pronounced every day.

The veterinary oncologist spends several hours discussing this type of bone cancer and the options for treatment and potential results.

Amputation of the affected bone is recommended for any tumor involving bone. When the malignant structure has been removed, it is submitted for biopsy and the diagnosis confirmed at that time. Biopsy before amputation is felt to simply add a painful procedure to the patient and, if possible, is reserved for tissue already amputated.

There are benefits to amputation as removal of the affected limb resolves the pain in 100% of cases. There are benefits to aggressive treatment such as chemotherapy and radiation.

There are also drawbacks.

Aggressive treatment means restricted activity, many visits to the vet, considerable pain and considerable cost.

And none offer the one outcome most desired – time.

The average prognosis is months, not years.

So Bingo’s owners started making her bucket list of what once constituted her Quality of Life:

• Running free in the desert
• Playing with her canine siblings
• Jumping with joy when it is mealtime
• Being a therapy dog – a Love Dog

• Is she pain free
• Can she walk comfortably even if she cannot run
• Can she enjoy the company of her human and canine family
• Can she continue to share her love as a Love Dog if only to be admired and petted gently … for a little while longer
• Can she have the best possible rest of her life

This is how you measure a dog’s Quality of Life and the toughest decisions are ones you make out of knowledge and love.

All of Bingo’s fellow Love Dogs wish her the best as she and her family deals with this new challenge.

To read more about Bingo click here

Kirby ws thrilled to be back to work

Kirby had the stitches out of his knee and is doing remarkably well. He walks steadily and puts his weight on that leg to stand and pees like a big boy! He hasn’t done that for months. I remarked to the doctor at our last visit that he is “leaning really well on his bad knee” and he reminded me that this left leg is now his good leg!”

Kirby went to visit with his friends this week – still a little bit slower than usual but he enjoyed the car ride. And he perked up when we got inside. He was very happy to see everyone again and lay on his blanket quietly and enjoyed gentle petting.

We stayed about an hour and he was soooo tired – he fell asleep on the ride home.

Sweet boy will work again today and tomorrow and each day get stronger and stronger.

Kirby has a bald chicken leg!

Well, the cast is off and now the knee has to heal!

Kirby is shaved thoroughly and still has a row of black stitches on the inside of his knee and thigh but he is smiling through it all.

He needs to start putting weight on the leg so we are walking slowly but it is difficult for him. He needs to wear the collar so he doesn’t fuss with the stitches and he hates that.

He ate his dinner with gusto and even that little activity exhausted him, so he rested right afterwards. Then we took a slow stroll so he could do his business. I see how squatting is painful – he took quite a while to find a spot and balance gently. But he did it – such a brave boy!

Then he came in and was so tired. I put him up on the bed and let Benny be with him. Benny wanted to cuddle and I think this made Kirby feel safe and happy.

Every day I expect him to get stronger and use his leg more. Next week the stitches come out and we start physical therapy.

Once this knee heals, we will consider repairing the other one.

He is anxious to go back to work as this past week has been very boring for him. Every time I took Benny out with his vest on, Kirby gave me that look “Why are you leaving me home?”

So the healing continues and our home is much more content now.

He took a few steps

Kirby’s surgery was a success. He came through the anesthesia and spent two days at the Las Vegas Veterinary Specialty Center resting and adapting to his new condition.

It is not uncommon to have combinations of patella luxation and a torn cranial cruciate ligament, but Kirby also had a torn meniscus. Instead of sutures, the doctor put in a pin to stabilize the X-Cap and because of his arthritis they deepened the groove where the patella sits (an MPL procedure).

His left hind leg is in a soft padded cast which offers comfort, reduces some of the normal postoperative swelling, and provides some support. Because it is not possible to observe the surgical incision for problems until a week from now when the cast is removed, I have to check the toes on a daily basis for swelling, excessive heat or pain.

He was very happy to see Santa again

The cast and bandage should be kept clean and dry at all times so we are putting a plastic bag around it when he has to eliminate. Any water or urine on the cast would require returning to the vet to re-bandage his leg.

He was able to walk around the exam room but it was slippery so he started to fall and that was the end of his walking!

He did urinate outside and was able to stretch his legs out behind him, which he hadn’t been able to do — so already he feels better, and has a bit more flexibility.

His ride home in the car was interesting. I brought a little soft bed for him to lie on but he just could not get comfortable. I took some blankets to fold around him to cushion his body and that helped a lot. I drove slowly because bumps made him whine. The little whimper is so sweet but also heartbreaking.

When we get about two blocks from home he always gets excited and knows he is home. This time as we approached the spot he usually realizes is “home,” he stayed in the down position but his eyes widened. He knew. But he did not have the strength to wag his tail or wiggle his little body.

As we pulled into the driveway he looked up at me as if to “It’s so good to be home.”

He has to wear the E-collar at all times until the cast is off but I removed it so he could eat and drink water. He was very hungry. Back it went and we went outside to try and manage the rocks. I wish I had grass for him but he has to figure out how to maneuver on the rocks. And he did. He even pooped – what a boy!

And he will wear a doggie diaper in case he pees in the kennel so the cast stays dry.

I am especially proud of Benny. He is super good today and not running after Kirby at all. He knows – he just knows – and is being such a good brother.

Kirby gets the cast removed in a week and then the sutures out in two weeks. Six weeks is the critical check up … until then Kirby will not work but will rest and get strong and show us how an old dog can still have pep in his step!

Kirby was happy to see me and remained calm

I was undecided whether I should visit Kirby at the hospital or not after his knee surgery. I did not want to excite him.

But this morning I really needed to see him and how he was doing so I asked if the doctors thought it was a good idea. He is doing really well and still somewhat sedated so I went over early in the morning. He was still groggy.

A nurse brought him out to see me and to see if he got too excited.

He did not.

He looked around a lot to get his bearings and then looked right at me but did not lean or jump to get to me.

That was a good sign.

So we went into an exam room and I picked him up. I wanted to get used to handling him with the cast on and see where he is comfortable being held.

He settled into my arms quickly and stopped whimpering. I only stayed a few minutes and then let him return to his kennel to rest.

I still don’t know if my visit helped Kirby but I know it helped me and if I stay calm around him while he’s healing, he will do better, faster.

He should come home tomorrow and I see his usual kennel will be too small with the cast and E-collar on so I am preparing a larger one for him.

All in all Kirby appeared brighter than I expected and know he will come through this beautifully.

Kirby is spending the night at the Clinic so he is comfortable in the morning

Kirby has always had “bad knees.” Luxated patellas, probably congenital, plagued him over the three years I have him.

Today we had an appointment with the orthopedic surgeon at Las Vegas Veterinary Specialty Center. We spent several hours consulting with Dr. Joshua Rexing. They had to sedate Kirby to take a complete x-ray of his hips and legs.

It was discovered not only does he have the patella problem, but both back legs have cranial cruciate ligament ruptures.

This new development changed the landscape of how we manage his discomfort and inflexibility.

Canine CCL rupture is one of the most common orthopedic conditions seen in a dog.

CCL tears can be acute or chronic, as in Kirby’s case.  Acute is a traumatic injury usually occurring when the dog steps incorrectly on the limb or from jumping. Chronic disease includes age related deterioration of the ligament structure, obesity, conformation abnormalities, and immune mediated disease. With degenerative disease even repetitive normal activities can cause progressive tearing of the ligament.

We discussed treatment options at length. Would Kirby be a candidate for conservative methods such as complete rest and non-steroidal anti-inflammatory medication for six to eight weeks? This route could result in long term decrease in activity and an increasing level of disability.

Conservative measures are not really an option for the little guy as just regular walking puts too much pressure on the knees and since it is both of his knees he needs at least one working leg. Having two back legs in casts for six to eight weeks and then physical therapy would severely limit his activity and ability to lead a normal life.

His age (somewhere past ten) and size also make conservative healing more of an issue. If we tried this and he did not begin to heal, each day we prolong surgery he gets older and weaker and the thought of anesthesia and rehab is more challenging.

Thus we discussed the surgical options. Both knees are affected and on occasion they do bilateral repairs but I did not think this was appropriate for Kirby. He is older and needs one functioning leg and I did not think he could do well with the recovery necessary for both legs at once.

Thus we opted for the Lateral Fabellar Suture Technique (also called the X-Cap) surgery on the left knee, the one which is more deteriorated and the side with the hip that has had previous surgery.

He also will have his patella repaired on this knee while under.

Post-surgery he will require some physical therapy and rest but we anticipate him in his stroller, smiling and greeting people in two weeks.

He will not able to be handled much but can certainly go on simple, quiet visits and show everyone how brave he is.

Then I will re-evaluate if we do the other one right away or wait.

I decided to leave him there today so he can have dinner there and become comfortable with the staff, all new people to him. This way he is fresh when he wakes up and won’t see me … He is super clingy now and not seeing me before surgery will actually be better for him.

I told Benny he had better rest up as he has to do double duty for a while!

Kirby at the vet – not particularly happy!

Kirby is an old dog. No one knows for certain how old he is but when I adopted him about three years ago, he was put somewhere around eight years old.

Thus his joints are “at least ten.”

He has always had luxating patella issues. His knees would pop out and he would shake them back in.

Kneecap slippage affects dogs of various different sizes and breeds. But in particular small dogs and toy breeds are especially prone to luxated patella so if you have a small dog you should get it tested quite early on. Kirby most likely had this problem since birth and it was never corrected thus as he aged it progressed.

Lately he has exhibited some pain and less motion. I actually found out how far the problem had progressed when we visited our vet for another concern. I thought he might be developing bladder stones again and when they tried to do an x-ray they found his back legs could not be straightened without causing great pain … Kirby screamed bloody murder.

Good news – no stones. He is however producing too little urine so we have a plan to increase his liquid intake.

Bad news – his back knees are getting worse and he is in pain and losing flexibility.

Even though luxating patella is not an immediate problem, it is one you need to pursue because it will only progress. Especially in light of Kirby’s unknown age, if it continues to worsen, he becomes less a candidate for surgery every day.

So we are going to a veterinary orthopedic specialist tomorrow to determine the level of his condition. If the knees are still Grade I or II, no surgery is indicated. He is currently on pain medication and perhaps the addition of alternative therapies such as acupuncture or physical therapy may help.

But if he has progressed to Grade III or IV injury surgery is the norm.

Diagnosis is made by looking at how long the dog has been exhibiting symptoms like limping and lifting his leg, physical exam and an X-ray of the thigh and the knee.

• Firstly, let me understand the Grade Levels and what is being recommended
• What if we delay surgery and it worsens? Can pain medications be used over a long period of time?
• Since both legs are affected, is it recommended to do a bilateral procedure or one at a time? Kirby has already walked on three legs when he had hip surgery, and since the leg would be in a cast, I would think one at a time is preferred, but that does extend the time of healing.
• How long is the healing process and can Kirby continue to work if in his stroller and handled minimally?
• If we do one leg and find he has not responded well, can we not do the other?
• What are his risks with anesthesia? He has had several procedures this year and I am always nervous when he is put under.
• Can he be bathed and groomed throughout the healing process?
• Can he go outside to eliminate?
• Will he need to be kenneled for weeks or allowed to move on his casted leg?

And of course there is the cost for such procedures. These surgeries are not inexpensive but a little guy like Kirby is worth every cent.

So tomorrow is a big day for us and will determine how Kirby lives the rest of his life.

Coco the Love Dog was always a happy dog despite living with diabetes

Tuesday, March 27 is the 24^th Annual American Diabetes Association Alert Day. On this day the public is invited to take the diabetes risk test to find out if they are at risk for developing Type 2 diabetes.

This is a good time to also consider your dogs. Canine diabetes is more common than you think and diabetes mellitus occurs in about one out of every 400-500 dogs.

Diabetes mellitus is often called “sugar diabetes” and it comes in two types:

• Type 1 diabetes is caused by the insufficient production by the pancreas of the hormone known as insulin.
• Type 2 diabetes is a result of an inadequate response by the dog to insulin.

Excessive drinking and urination are the most common symptoms, but you also want to watch out for weight loss, signs of poor skin and hair coat, liver disease, vomiting, weakness in the rear legs (diabetic neuropathy), secondary bacterial infections and dehydration. And just as in humans, often it is trouble with their eyes that signals diabetes with infections, ulcers or cataracts.

Coco the Love Dog lived with Type 1 diabetes and had been insulin dependent for many years until her passing at age fifteen. Early on she settled into a fairly stable routine of 9 units of Humulin N twice a day with meals. She aged well and eventually required a dose of 11 unites twice a day but was still an active therapy dog until three weeks before her death.

Coco, as many diabetic dogs do, developed double cataracts and was not considered a good risk for surgery thus she spent many of her later years sightless. She also lost her hearing but this did not deter from a full joyful life. At the age of twelve she learned a while roster of Touch Commands and loved her new “language.”

A proper diet is critical to the health of your diabetic dog. Many premium dog food companies have diets that are beneficial to the control of the diabetes as well as weight loss. These diets are usually high in fiber and carbohydrates. Your veterinarian will give you specific instructions on the type of food, amount to be given and what times of the day you should give it.

One of the first symptoms in Coco was great fatigue

For many years Coco’s meals consisted of the recommended dog food combined with cooked chicken, tofu, and brown rice and she just loved it. Enjoying their food is critical as they must eat in order to get their insulin.