Death Does Not Become Her

This post was nearly titled: Morbid Much?

Why? After receiving the news of my beagle-mix Julie's latest trip to the vet, I have been breathing a huge sigh of relief!

I took Julie to the vet's office to have her lethargy, pale gums and tongue, and diarrhea checked out.

My previous post clearly shows how dismal I was feeling -- certain I saw portends of the end. Thankfully, the vet reported that she could find nothing amiss. Nothing except an increasingly taut, barrel-chested body cavity. (Julie has gained a lot of weight over the past four weeks.) Steroids will play havoc on a girlish figure.

A physical exam found no overt joint swelling due to arthritis, and confirmed the unfortunate return of diarrhea. (Poor Julie. Think of that scene from The Truth About Cats and Dogs where Uma Thurman administers first aid to a sick turtle. 'Nuff said!)

A sonogram of Julie's chest cavity showed no masses or lumps, just a whole lot of water weight. Her bloodwork was stable. No change in red blood cell count from last time.

I brought Julie home and hugged her close, thanking her for putting up with my hypochondratic episode. I beg the same indulgence from all of you!

Now, I'm off to bed before parades of pink elephants, twirling badgers in tutus or other freaky hallucinations creep out of the night.

Please do continue to send your caring thoughts and wishes for Julie's medically baffling and complete recovery. Your efforts so far have done wonders!

Julie Update

This is the most recent photo we have taken of Julie. She is scarfing down her dogfood as fast as she can before Little Sprout "steals" it out of her bowl and strews it all over the floor. It is a daily ritual they've developed and play out together.

I had intended to blog today about Little Sprout and all the new things he's learning and discovering (TRUCKS!), like scooping food onto his spoon all by himself and maneuvering the spoon (TRUCKS!) to his mouth without all the food falling off. Some even makes it into his mouth.

Instead I must share some painful and disheartening news. Julie's gums and tongue get a bit more pale each day. She is weakening.

What makes this seemingly sudden relapse more painful is that her last blood test showed her red blood cell count at 33 (35 is the beginning point for "normal" RBC count).

The vet took her off the last of the Immuno-type drugs last Friday and reduced her Predisone down a quarter tablet more. She had shown stability for several weeks and it was the next step in her weaning process. It is such a tragic turn of events.

I want to celebrate Julie and celebrate the place she has held in our lives. Each of us has shared a special relationship with her and she has left an idelible mark of love on our hearts. But all I feel right now is a swelling, desperate grief.

I try to take heart in the following three things. One, that A's Mom assembled an awesome 12x12 scrapbook for Julie that we all will be able to go through to remember her. Two, that we did everything we could do to help her recover. The drugs were stabilizing her but she wasn't really getting better. And finally, that when her time comes she won't be in any pain (just feel fatigued, go to sleep and not wake up).

Even so, our house is going to feel lonely and empty without our little Julie Bumpus.

Watching her slowly weaken casts a bleak and pallid pall over my heart and our house. Nobody but God knows how long we have left with her, so please, send your thoughts and prayers for Julie (for hers to be an easy, restful passing). Or even better, a miraculous and medically baffling recovery.

The Dog Who Lived

UPDATE: I guess God didn't like me making hasty presumptions! Julie's latest blood test results showed a rise in red blood cell count from 12.5 to 21.5. A healthy dog's PVC count in between 35-55, so Julie has made good progress this past week. I cried tears of joy when I heard the news.

It gets better! Julie's reticulocytes (or "retics" - precursors to red blood cells) are up 11.7% over last week. A typical dog generates retics at a rate of 1-2% to replace old, dying cells. So Julie's bone marrow has kicked into overdrive to fill the void.

The doctor says Julie is no longer in guarded condition and can take leash walks, providing it isn't too cold outside. (Anemia makes it difficult to retain body heat so she has to be careful about hypothermia.) She can also climb stairs without putting excessive strain on her heart. What a relief for a worrier-mom like me!

Simple Pleasures

It has been five days since Julie's last blood test and I'm delighted to say that she's still with us. Every day more and more of Julie's personality shines through which makes it easier to focus on daily routines and other happy things. Like Bruce feeding Julie animal crackers.


And giving her lots of love when the animal crackers are all gone. (Maybe they were consoling each other.)

On Thursday she goes in for another blood test to check her packed cell volume. I'm expecting it to be lower than before, but perhaps I will be pleasantly surprised. A few days ago, I was sure that she wouldn't live as long as Thursday. And she may not, but I seem to have new hope. Here she is dozing in a defiant patch of sunlight that belies the winter chill.

By Thursday our little sun worshipper will have run out of meds. It could be that the steroids have been keeping her eating and drinking. That could be a big part of what is keeping her alive. We don't know how much longer she will be with us so we're taking it day by day. Each day is a gift.

As content as she is for the simple pleasure of warm sun on her face, I am grateful for every moment we have left to spend with her. We love you Julie, Julie.

Julie Update & Joop Forever

Julie's latest blood test results showed a rise in red blood cell count from 13 to 14. That's good news, right?

Well yes, but the doctor was quite discouraged. You see, her PCV (packed cell volume) count should have been significantly higher by now. One point isn't enough to hang your hopes on.

There could be a sneaky cancer lurking somewhere unseen that is affecting her bone marrow's ability to generate new red blood cells, or a red blood cell parasite could be the culprit or something that didn't present itself in previous tests.

The doctor recommended we send Julie to a specialist for bone marrow testing and a sonogram. Quite frankly, we can't afford these tests. Even if they found the cause, we've spent all our available funds getting her this far. Julie must either rally on her own using the meds she has or die. It chokes me up.

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UPDATE: I guess it is not God's will for Julie to rebound from this life-threatening crisis.

Julie's full blood panel & CBC (complete blood count) results have come back from the lab: PCV is 12.5 (remember that this number should be between 35-55 for normal dogs). There appears to be no bone marrow stimulus; i.e. no evidence of reticulocytes (or "retics" - precursors to red blood cells) being generated.
This is grave, grave news for Julie.

Her liver and kidneys do not appear to be damaged, which is a blessing. The doctors are not prescribing her any more medications and are not recommending a second transfusion. When her current meds run out her stability should deteriorate.
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I stumbled across this page as I was processing the above information: All Pets Go to Heaven
[Warning: If you tend to tear up easily, grab the Kleenex box now.]

It reminded me of a riveting photoblog from a few years ago about a Dutch dog named Joop whose owner lovingly chronicled his life in a daily dog log. Joop had a huge following. I sat at my desk and sobbed the day he died. I'm sure I was not alone.

Check out Joops's incredible photos on Flikr, then catch up with his owner Henk's latest pet projects. It's good stuff.

Coulda-Bin Calamity (The Tortellini Affair)

Picture this:
Bruce corralled in the dog pen. Healthy dog confined in the powder room. Sick dog thrashing about like a suffocating fish. Me holding onto sick dog's snout with both hands to keep medication in her mouth. Healthy dog slips out of confinement and snarfs remaining med-laced treats out of bowl. Me frantic, calling the emergency number at the animal hospital.

*ring.ring* "Hello?"

"Yes, my healthy dog just swallowed medication intended for my sick dog. Do I need to pump her stomach?"

[Snip a few seconds of conversation where I detail the name and dosage of meds, describe the tasty tortellini in which it was disguised, and the visual imagery above.]

*audible giggles* Ahem, I don't think it will do her any harm. Let me put you on hold while I double check to be sure."

*pregnant pause* (during which time I'm convinced the doctor is laughing hysterically.)

"Hello? Yes, your dog will be fine. That amount of the drug will not harm her. Just be sure to steer clear of contagious areas for the remainder of the day. I wouldn't take her to the dog park, for instance, since her immune system will be a bit suppressed."

"Thank you, doctor. Goodbye"

This is the crowning event of a morning spent trying to force-feed Julie, my sick dog, her meds.

At 5:00 p.m. we take Julie in for more bloodwork. In my little corner of the world it is snowing, with a layer of rain turning to ice on top of the snow. Businesses are shutting down right and left due to "bad weather" and people are fighting traffic on the "bad roads" to get home.

In reality the weather is not bad at all. It's actually quite picturesque. But because of all the over-stressed, maniacal drivers that can't fathom slowing down for a fraction of a second, it is not the optimal driving situation to take your pet or your family out in. But we desperately need the information this PCV test will provide so we can discuss next steps. So we go.

Please God, let there be an improvement in the red blood cell count.

Julie Update & "Know your s--t".

Julie had her blood work done yesterday and the results were:
no change



Her red blood cell count is still 13 and there is no evidence that her RBCs are regenerating. Since she is eating, drinking and eliminating well [← euphemism alert!], the doctors recommended we take her home, continue her bland diet and cocktail of medicines, and bring her back in three days for another blood test.

Every situation has a lighter side, and I was amused when the doctor sent home a fecal scoring (a.k.a. poop) chart to help us more accurately report Julie's eliminations to the doctor.

Mr. Ridiculous has dubbed the photocopied chart the CRAPCON scale and posted it proudly by the back door. It was too fuzzy to post (you didn't REALLY want to see it anyway) so for any hardcore crapheads I offer up instead this link to "the best poo story ever."

If you clicked on the link above, it took you to a website called (I'm not kidding about this.) poopreport.com. It just goes to show (yet again) that there really are No Boundaries on the Internet. What intrigued and repulsed me about poopreport.com (enough to write about it) was that they named their marketplace "buttplugs." Eww.

One last bit of randomness. Since I used a euphemism I felt it only fair to include a perplexing (but I can't look away) Euphemism Generator Let me know if the euphemisms make sense to you.

Bringing Julie home

We just checked on Julie's condition and there is no significant change. So I will recap what we know so far.

Julie is being treated for Immune Mediated Hemolytic Anemia - her immune system is attacking (prematurely destroying) her red blood cells faster than her bone marrow can produce new cells. Red blood cells carry oxygen from the lungs to all other tissues in the body, so Julie's body is starving for oxygen.

So far tests have revealed no underlying cause for Julie's body to be attacking its own red blood cells. But since there has been no sign of her bone marrow kicking in to generate new red blood cells since her transfusion and drug treatments, the doctors are recommending sending her to a specialist for a sonogram (for a closer look at her organs -- maybe there is cancer lurking somewhere that the x-rays couldn't detect) and a bone marrow test. Both of these tests are expensive and won't necessarily get us the answers we need.

We've made the extremely painful decision to bring Julie home, even though her condition has not been stabilized. We would like to continue giving her fluids and immuno-suppressant medicines through the weekend in the hope that her bone marrow may still kick in and start generating new red blood cells to replace the destroyed ones. But if she doesn't respond to this treatment we will have to make the painful decision to put her to sleep.

Words fail me to adequately express how bereft I am (we all are) about our dear, sweet Julie. She's only 5 1/2 years old. She's only lived half her life. She's not in any pain, but severely fatigued, dazed and confused. She's one of my babies and she's probably not going to survive more than a few weeks. She wants to come home, so we're bringing her home.

This is immensely hard for me. Emotionally. I don't want her to die. I don't want to see her die. There is nothing I can do to help her except make her feel comfortable and loved.

People have said to me that I am obsessively devoted to my pets. To me they are my children. (They were my children before I had children, which is not so uncommon.) They've said that once I have children of my own I will view my pets differently. I can categorically say, without a shadow of a doubt, that I do not feel differently about my pets. I still love them with my whole heart. (Well, maybe not so much the Molly fish in the fishtank. But I digress.)

They ARE my children.