Bug FHO Update #5: Rehab

Bug has now completed 5 weeks of underwater treadmill therapy, and we're seeing a HUGE improvement!

We had to wait to start the treadmill until she was weight bearing on her leg, and to get there we did "assisted weight shifts" for a few seconds at a time by supporting her butt and gently lifting the good leg. We also walked around in her pool (see Bugzercisor video).

The biggest change I've been noticing is a huge improvement in her attitude. She's much more relaxed, even in new situations. It's a similar change to when I started her on fluoxetine. I had known she was in pain from her hip, but what a difference less pain makes! She's much less reactive to other dogs and less anxious. I'm so excited to see what this does for her learning ability (dog parkour, agility, and disc dogs, here we come!!)

Below is a short (ok, long-ish but adorable) video of her first vs. fifth sessions on the treadmill. Shout-out to Animal Clinic Northview for the AWESOME rehab program and Susan RVT for all the help with the Bug-let!

Relay Toxicosis: Bug's Brush with Death

Last Friday, Bug tried to kill herself after a run in our backyard woods. 

I woke up at 8:00 am to a comatose dog - no pupil reaction, no gag reflex, nothing. She was absolutely limp but breathing and her heart was beating. She felt cold; Bug has a history of seizures, but even status epilepticus would leave her warm from muscle activity. 

Obviously, I immediately threw her in the car and rushed to the vet. The vet took her history, dumped her with IV fluids, and pulled bloodwork and a tox screen on her urine. I went to work a late, hot mess. Finally, at 2:30 pm we had some answers: the urine screen came positive for barbiturates*. The vet gave me a dismal outlook, as did Googling for canine barbiturate OD. I called my mom to check on the only barbiturate I could think of in the house - an old prescription for a cat: phenobarbital. However, it was safely still in a box, sitting on a tall dresser that was behind an x-pen. Hmm! 

Barbiturates are most commonly used by veterinarians (rather than MDs). And their most common use is in a euthanasia solution. So who tried to put down my dog? Who could have, when I was with her the whole day? Apparently, the barbiturate used in euthanasia solutions (sodium pentobarbital/phenytoin) is insanely stable, persisting in the carcass of a euthanized animal for years. Years. A case study found two pet dogs poisoned from eating a horse carcass euthanized 2 years prior**! In this case, the dogs had found an improperly buried horse 300 meters away in a neighbor's ravine. In another case, an australian shepherd ate something on a beach then appeared sleepy and went comatose two hours later. There had been a beached whale euthanized and removed from the beach a few days before the poisoning, but the dog must have found some of the carcass to eat***. This type of poisoning is known as relay toxicosis. 

The most likely cause of my dog's unresponsiveness was eating something in the woods that had been euthanized. My parents' property is adjacent to a housing development, and the woods we hike in runs behind several of our neighbors houses, so the homes along the woods probably numbers in the vicinity of 50. Because Bug was not out of my sight long enough to exhume anybody's dead old cat, I have to assume that either (1) it wasn't buried in the first place or (2) it was improperly buried and subsequently dug up by wildlife (raccoons, foxes, coyotes all live in the area and wouldn't hesitate to eat carrion.) 

So this is the soapbox: 

If you euthanize an animal, you obviously have compassion. Please, please, bury your pet appropriately! Have compassion on neighbor's dogs, wild animals, and anything else that may try to feed on said pet. If you don't have the ability to bury your pet properly, have them cremated. There are many services to do this for you and some even offer urns or boxes engraved with your pet's name. 

Check your local laws on pet/livestock burial. Bury your pet at least 3 feet (36 inches). AT THE VERY LEAST! Bury deeper in wetter or loose soils. 

*In most cases, veterinarians use an at-home drug test kit found at drug stores. More dogs than should get into marijuana (and present with symptoms similar to Bug's) but owners are afraid of legal repercussions and don't admit to having the substance around their house. (Or don't realize the risk it poses for their dog!) A urine screen is a fast and cheap way to determine what may be causing the problem.

**Kaiser, Amanda M., Warner MacFarland, Roger S. Siemion, and Merl D. Raisbeck. "Secondary Pentobarbital Poisoning in Two Dogs: A Cautionary Tale." Journal of Veterinary Diagnostic Investigation 22.4 (2010): 632-34.

***Bischoff, Karyn, Robin Jaeger, and Joseph G. Ebel. "An Unusual Case of Relay Pentobarbital Toxicosis in a Dog." Journal of Medical Toxicology 7.3 (2011): 236-39.

Bug FHO Update #4: pre-weight-bearing rehab

Bug working on rehab exercises and swimming now that her stitches are out. Most of this was filmed week 3 after surgery. Both Bug and the pool tried to die this weekend, luckily only one of them succeeded!

We have an appointment with a rehab veterinarian tomorrow!

Bug's Hip Dysplasia - Update #3: Post FHO

Bug is now 48 hours post-op! 

I've written some thoughts on the past day and a half since I picked her up from the vet.

1. I think Bug is sleeping better than I am! She has a memory-foam doggie bed set up in her "house," while I fitfully slept on a backpacking mat next to her. She's napping a lot, which is good for her recovery. I am just tired without end!

Napping with a snack #winning

2. Last night bruising started appearing. There's a purple mark along her femur. It's to be expected, along with this morning's swelling. I've been icing 20 minutes every few hours to keep down the swelling and pain. She doesn't seem to mind the ice sitting on it.

Bruising at 2 and a half days post-op

3. Her good leg is SORE. She's 90% 3-legged, so that poor hind doing double duty is quite tired, although she's getting better at lying down somewhat slowly, rather than attempting and falling onto the sore hip (she doesn't like me to help, she'll just stand tense and stare at me).

4. Range-of-motion exercises are really difficult - for me! Due to the nature of removing a joint completely and depending on scar tissue to compensate, making sure scar tissue doesn't form limiting the range of motion of the "new" joint is very important. I was instructed to do "75% of normal hip movement 7-10 times, 3 times per day." I'm not entirely sure what 100% range of motion is, so I've been going to the just before the point of pain as gently as I can. I can usually only do about 3 or 4 reps before she decides she's very done. Flexing she's ok with, extending is OUCH. She whines and considers nipping me, so I feel horrible doing this to her!

5. Bug does not like the cone of shame! She's been AMAZING about not licking at her sutures at all, but I've been putting it on while I'm not directly supervising her. Having awesome friends (canine and human!) Bug was able to borrow an inflatable donut "cone" that she likes a lot better - that also functions as a great (wear-able) pillow!

For the near future:

• carefully continue manual ROM
• more ice, crate rest
• soon, short walks on leash (slow!)
• make a consultation appointment with agility/rehab veterinarian Dr. Kathy Topham
• recheck/sutures out (14 days post op)
• one day after sutures are out, start swimming! See: The Bugzercisor! 

Bug's Hip Dysplasia - Update #2: The Bugzercisor

D-day is scheduled!! I'm dog/condo sitting for a friend a week in July, so scheduled the surgery at the very beginning of that week. The details seem to be fitting together perfectly - the condo we're at has a same-level patio for dog potty trips (no stairs!) and little, polite dogs (no behemoths *cough* ROMAN*cough* to knock a sore Bug down).

I had planned on getting a referral when back in Cleveland for PT/rehab because, with an FHO, early and intense rehab is critical to a getting functional false joint. This is because scar tissue is forming the joint - if range of motion exercises aren't done during recovery, it will be limited. Doing a lot of reading on FHOs, the consensus seemed to be that "hydrotherapy treadmill" is what's usually done by veterinarians to rehab dogs (a treadmill filled with water to add resistance and encourage more range of motion), but swimming is almost ideal. So I did some researching and found that a pool deep enough for Bug to swim in was surprisingly cheap at walmart!

Bug's Hip Dysplasia - Update #1: X-rays

I took Bug to the vet today (after much confusion with the receptionist over FHO vs. OFA and ortho vs. repro specialties).** We had good x-rays done under sedation and compared it to ones from last July to see the progression. The BEST news is her right hip looks great still! Her left is showing some pretty serious arthritic changes, but she's a perfect candidate for a Femoral Head Osteotomy (FHO).

Go home, Bug, you're drunk! The sedatives
lasted a bit longer than it took to take x-rays ;)

An FHO is where they remove the top of the femur that's supposed to rotate within the pelvis, because none of it is shaped right and it's currently just grinding bone-on-bone (OUCH!). This creates a "false joint" of muscle after healing, removing the source of pain and inflammation from the dog. Some range of motion is lost, but no more pain! Some reasons she made a perfect candidate:

• she's a small or medium sized dog (less than 45 lbs)
• she's an active dog that stays leaner, unlikely to get overweight and overstress her "good" hip
• she doesn't need it done bilaterally - one hip is good as is, so only rehabbing one side is necessary

There's a few other surgeries that treat hip dysplasia, but Bug isn't really a good candidate for them - triple pelvic osteotomy (TPO) is done for puppies that have signs of hip dysplasia but do not yet have arthritic changes to the joint. This surgery re-orients the pelvis, so the angle of the hip socket is better. A total hip replacement (THR) is exactly what it sounds like - bionic puppy hip! However, it's extremely expensive. They recommend THR for larger dogs that would be too big/heavy for an FHO to be as successful.

Now for what you've been waiting for -- the x-rays!

This is from a year ago (Bug was almost 2). There are some arthritic changes and you
can see the left hip (right side of the image) doesn't sit in the socket entirely.

Image from today, two weeks shy of exactly one year later. Bug's right hip
(left on the image) looks good still, but there's a decent progression of arthritis in the
 left hip - the femoral head is no longer smooth and correctly shaped, but
bumpy and rough from grinding in the joint. 

Although it's sad to see how much the arthritis has progressed in a year, I'm glad to have one more expert agree that an FHO is a good plan for Bug. She's still a young dog so I can pretty easily make her life less painful. We've scheduled the "big day" for a month from now while Bug and I are in Columbus watching a friend's dogs. Follow along for pictures/video and updates of Bug's process and recovery!

There's exactly one day left for the Bug shirts fund raiser! https://www.bonfirefunds.com/see-bug-run We sold TWENTY SHIRTS!! A HUGE thank you to everyone for helping my little dog! The fund was successful, so start looking for yours to come in the mail mid-July (right when Bug is going in for surgery!)

**OFA is a registry for pure-bred dogs to prove a veterinarian has x-rayed and examined hips and elbows for genetic orthopaedic problems. I have no clue why they thought I'd want my spayed, mixed breed to get an OFA exam, but.... eh?

Bug also got to do some paddle boarding before the vet appointment today, so today wasn't all bad!

Photography of Adventure

I'd like to have a page dedicated to my photography (more so than just blog posts with nice pictures.) I'm going to tag all posts in this category "portfolio."

On the trail with Karin Coyne, Abigail Curtis and Caleb. Zaleski State Forest, Ohio. 

A winter sunset with Bug in Columbus, Ohio. 

Sulley, Gina, Caleb, and Bug await the start of an adventure. Zaleski Backpacking Trail,  Ohio. 

A cute pause in hiking with Abigail Curtis and Sulley, Bug photobombing. 

Henry McNabb and Bug share lunch on the trail. Chuck Keiper Trail, PA. 

Sulley hesitates to walk through an icy stream, Karin Coyne, Abigail Curtis and dogs Caleb, Gina and Bug look on. Shawnee State Forest, OH.

Abigail and her dog balance across a stream. Shawnee State Forest, OH. 

Sulley and Bug enjoying a gallop on an Ohio hiking trail. 

Bull moose resting in high grasses. Rocky Mountain National Park, CO.

Brad Duncan fishes for Rainbow Trout in a high mountain lake. Zirkel range, CO.

The site of a recent forest fire on a dreary, rainy day. Friendship Park near Douglas, WY.

Gina hunts for critters near Bur Oak Lake, OH.

A sunset in surprisingly beautiful Ohio. Bur Oak Lake.

Sunset over the mountains in the Rocky Mountain Youth Corps camp. Rocky Mountain National Park, CO.

A typical evening with the youth corps trail crew. Rocky Mountain National Park, CO. 

Corinne Abbiss carries in her SUP board off the Pacific in Busan, South Korea.