A Heart of Thanks

It’s been awhile since I’ve posted because Kali’s been doing so amazingly, but seeing as how Thanksgiving is upon us, I thought I should take this opportunity to give the latest update, and express just how grateful we all are for her, her doctors, and our fortune.

Kali had a full check up at ASEC last week, and the results were amazing. I didn’t expect them to be bad, since Kali’s clinical symptoms are non-existent at the moment, and have been for awhile, but still–it was so great to have it confirmed.

They did ECGs and a full kidney panel (called an ISTAT). They opted not to do x-rays because of her current lack of symptoms. For that type of check up, I have to leave her there for a couple of hours while they do their work on her, and then come back so I can have a chat about the findings with the doctors.

So I came back to get her, and once I paid and everything, they ushered me into a room to wait for Dr. Saelinger. She came bearing Llama and a huge smile.

“Well, I’m very pleased today. I don’t want to say her heart is shrinking, but it’s pretty much static from where it was last time. And her kidney levels are much-improved. They are barely elevated–they are on the high end of NORMAL.”

She beamed. I beamed–guardedly, of course.

She said, “I know it was so hard a few months ago. I know you were questioning quality of life, and all that, but you stuck it out. It was hard, but you did it, and it worked. I was telling my interns about this and showing them Kali’s charts as proof that sometimes, a Lasix vacation can really work.”

She was right. It had been terrifying. Remember, how we felt like Kali was surely dying? Remember how I tried to negotiate her meds because I was afraid to start them up again?

Well, it turns out Saelinger and crew were right. And for that, I’m so very happy and grateful. Here’s rundown of where we are now and where we were:

Mitral Valve Disease
11/20/13: STATIC, MODERATE
6/5/13: Moderate to advanced
3/4/13: Progressive, moderate
4/30/12: Mild, well-compensated

Kidney values
11/20/13: BUN 30, creatinine 1.4
08/21/13: BUN 56, creatinine 1.8
08/08/13: BUN 108, creatinine 2.1
08/07/13: BUN >140, creatinine 3.3
08/06/13: BUN 145, creatinine 3.0
07/29/13: BUN: 53, creatinine 2.0
07/19/13: BUN 58, creatinine 2.6

Looking back, I sort of wish we had gotten an explicit warning–something like, “now, it’s common with heart medications that we see kidney distress, so if you see these signs, they are very serious, but we can address them and fix it if you get her in right away.” They always give us sort of generic guidelines in our paperwork at the end of our appointments that include symptoms to watch out for, but I think if I had heard somebody say those things to me ahead of time, I wouldn’t have gotten so panicky. For a layperson, having that (and maybe what kidney failure looks like and that it can be treated/addressed) spelled out could really help–so I’m saying it now to you all:

If your pet is being treated for heart failure, it is NOT unlikely that it could send them into kidney failure. If they DO go into kidney failure, it’s serious, but treatable if caught in time. You might remember that kidney failure looks like this:

• Total loss of appetite, possible stopping of drinking
• Vomiting
• Not going to the bathroom much or at all
• Severe weakness/lethargy
• Overall malaise

So…when you start your regimen, be on the lookout for this and prepare for quick response. And know that it might feel terrifying and like it’s the end, but that it is possible for your pet to bounce back–even though it seems IMPOSSIBLE at the time.

Since the last update, Kali’s enjoyed jazz at the park, a boat trip, running around like a crazy person at Rosie’s Dog Beach, and lots more. The only thing I’ve noticed is that the weather here in L.A. has finally turned, and she’s been shivering. She’s usually the hot one, so it’s unusual to see. That’s okay, though–Beth and Leslie lent us some great sweaters that she loves to put on and wear to fight the chill.

Happier days are here!

She’s looking forward to hosting our annual Thanksgiving dinner here at the house, where she’ll no doubt schmooze and score many tasty morsels. There was a time we didn’t even think she’d be alive on this day, let alone be in shape enough to enjoy it.

Kali, Jason, and Missy enjoying the last jazz in the park for the season back in August.

Kali and Sammy getting in touch with their jazz roots

Kali has made an incredible comeback. Dr. Edstrom, Dr. Saelinger, and all of their support staff is to thank. Kim and I give a tremendous amount of thanks for their hard work, their dedication, and their knowledge.  We also give a heaping bowl of thanks to you all for the well-wishes, prayers, thoughts, and support. We know you want Kali to succeed as much as we do.

Kali and Kim float the day away in September

We know not what is up ahead, but we know what is right in front of us–a healthy, happy Kali who wolfs down her food, prances through the neighborhood, and zooms around at the beach. We know not how much longer we have, but we have gotten so much more than we thought we would. Thank you.

Llama, We Have Liftoff…in the Mist

Well, Kali’s condition continues to go up.  Literally.  When I was getting her and Piko ready for their walk this AM, she performed a very old school maneuver–one I haven’t seen from her in over a month.  When she saw me getting their harnesses, she ran over to me, stopped, and leapt straight up into my arms.  I actually squealed with a mixture of surprise and delight.  This used to be a standard in our getting ready routine, but she hasn’t done it in a very long time, so it was a big deal to see her propel herself completely vertical from a standing position.  I mean, Matrix moves from a dog who couldn’t complete her walks just two weeks ago?  Bravo, I say!  Her stiffness and tremors are seeming to dissipate as well.  I think her overall strength and baseline health is improving, and here are my theories on possibly why:

* Her meds have been tweaked to levels that work better for her kidneys

* Throughout the whole time where she didn’t really want to eat, we kept trying until we found something she would eat (thanks to a lot of help and support from friends).  Even the days when she ate just the tiniest bits of lamb made a difference, I think.  Whatever she would eat on a given day is what she would eat.  As long as it was something, we were happy.  I offered her everything anytime I ate something in case she’d eat a bite.  And maybe those miniscule calories made a difference.

* Her high protein diet (she has preferred lamb and chicken…and the occasional Stella and Chewy’s patty throughout this) is not so great for her kidneys, but ironically, I have a theory that it’s what helped her rebuild her muscle mass and overall strength.

* We kept her walking.  Even on her sickest days, she still wanted to go out, and even if she could only make it like 2 blocks, we let her walk it.  That small amount of activity kept her blood moving, muscles and neurons firing, and her brain working.

* There were days when she wanted to go back out for Round Two of walks, even though I knew she had no power left or intention of walking.  I took her out and carried her the whole way anyhow, believing that the inclusion in routine and stimulation from the outside world was important for her spirit and mind.

* If she showed interest in anything, I pretty much obliged, no matter what it was.  I think that’s another thing that has kept her in the game.  So many seniors (of any species) tend to get left by the wayside and forgotten in the commotion.  I tried to tune in extra hard to see what I could do to bring her joy, which includes our Special Outings.

I dunno..it’s hard to figure out what is truly making a difference, what’s not, and what’s just coincidence.  Correlation is not causation.  But still, I like observing, taking notes, and trying to make sense of it all.  It’s like Llamas in the Mist up in here.

Oh, and by the way…Dr. Edstrom called last night.  Kali’s kidneys levels are stagnant, which is great news.  I’m still guarded about it because it’s only been a week, and it took 18 days from when she started her meds last time for her to enter kidney failure.  I’m not sure when she goes in for her next kidney panel, but I’m sure it won’t be very long from now.

She is doing some fairly regular coughing–about twice a day–which I’m keeping an eye on, and the Great Kibble Standoff of 2013 continues, but other than that, I’d say we have liftoff.

In the waiting room at VCA: “They’re gonna stick me, aren’t they?”

Another sight you don’t see very often…

 

Monday, August 19, 2013: Weekend Recap

Saturday
Plus: we all slept in until 10 am
Minus: Kali woke up in a puddle of pee…in our bed.
Plus: the 2 layers of vinyl mattress covers did their job.
Minus: she’s still not on kibble yet
Plus: we had an awesome special outing, plus an AM and PM walk.  Her energy is great.
Minus: I caught Kim’s cold
Plus: her breathing is holding steady, generally at/around 19/min

Sunday
Minus: Kim’s cold took me hostage, and so I couldn’t do much of anything with her
Plus: Her weakness in front and back legs has improved
Plus: she’s having awesome poops!
Minus: still not on kibble entirely, but had a very good dinner that included some
Plus: she’s looking more like herself

Keeping watch over my cold for me.

Today, I’m still losing the battle to this cold, but Kali is doing really well.  She went on both rounds of walks this AM (long version both times), and didn’t need to be carried at all!  Her eyes are bright, she’s licking my face more, and she’s very sassy (always a good sign).  For breakfast, I gave her kibble, chicken and some tiny bits of cheese and bacon to entice.  She didn’t eat as much as I would’ve liked, but we’re on the track now of getting her back to pure kibble (no more gravy!).  She’s looking and acting strong enough that we feel like we can be a little tough on her–like, if she misses a meal because she won’t eat the kibble, that’s her bad.  She will eat it when she’s hungry.  It’s really important for her to get back on real food so she gets her proper nutrition.

Piko licking Kali’s eyeballs. This is something they used to do all the time, but haven’t in awhile. I watched them. Sometimes, she gets annoyed by this and runs away, but today, she just laid there, eyes closed, and let him groom her. She really seemed to enjoy it.

She’s due for a follow up kidney panel tomorrow at VCA.  I have to say, I think it’s going to be good.  I would be very surprised if it is bad, given how well she appears.  When her values were so high before, I could tell she was sick.  But right now, she actually seems to be doing really well–possibly the best yet.

This is such a roller coaster, but I’m so glad we’ve been able to ride it.  Kali has been on the upswing now for the past nine days.  We know better than to read anything more into that than what it is…and what it is is GREAT.

Despite the fact that her shaved areas from her IV sites are itching her, she is pretty happy these days.

Special Outing Saturday, August 17, 2013: Cora’s Coffee Shop and SM Beach

For the first time in a long time, we had nowhere to be on a Saturday!  We took advantage of it by sleeping in and taking Kali for a late and yummy breakfast and then a stroll at Santa Monica beach.

We’ve lived in SM a long time and have never been to this local great. It is everything they said it would be!

 

The wait wasn’t too long, but Kali caught a nap anyway.

 

This was minutes before our server told us it was against the Health Code to have her up at the table. “Against whose health code, sir? Certainly not against Kali’s!” I wanted to say. But he loved dogs and was simply relaying the message.

 

“That’s okay; I can eat my bacon anywhere.”

 

Bacon’s not the best food for her condition, but at this point in the game, we’ve decided we are letting her enjoy her borrowed time to the fullest.

 

“I’m full of bacon! Let’s hit the beach!”

 

California Llama

 

“Hark! Is that a Shiba friend I spy?”

 

“Yes! Shiba!”

 

Kali dozes while we watch the rings and slack lines.

 

Time to go home.

 

 

 

 

 

 

 

 

 

Friday, August 16, 2013: No Whammies!

Good morning! I’ll take my chicken and gravy in bed.

Well, things are still moving along here.

Kali re-started all of her heart meds on Wednesday, and so far, she’s still okay.  She has a regular appetite and always eats breakfast and dinner (with some small nibbles in between), but it’s not exactly her kibble.

Currently, the meal she finds acceptable is boiled chicken and white rice, smothered in beef gravy.  I present it on a bed of kibble, which she doesn’t approve of.  She eats around it, but every now and then, one sneaks through.  It’s not exactly a well-balanced situation, so I have been adding Nupro to this disaster–if I mix it up really well and there’s enough gravy, she won’t detect it and will eat it all (the plus side to this meal is that it’s so much easier to hide all of her meds in it versus the lamb, which she is so over).  Also, we did start adding the Nzymes drops to the water.  And occasionally, Llama will opt for a Stella and Chewy’s patty for dessert, which always makes me feel a bit better because those are actually designed to be dog meals.  So overall, we’re trying our best over here in the nutrition department.

Her breathing is good…coughing has popped up a little, but nothing to be alarmed about.

Her urinalysis and culture came back negative as well, so who knows why she was licking so much (of course, she’s not doing it now)?

She’s been walking decently–usually leading us on much longer walks than our pre-heart patient route.  Yesterday, she seemed rarin’ and ready to go, so I let her have at it.  We went far–did the usual long loop, but then she just kept going.  I knew we were in for it–she was going to take us too far out and then run out of gas.  But I just find it impossible to deny her much of anything these days.  She took us down to Pico, around the cemetery, and then back up on 14th, which is where she gave out.  It was a good run. I crouched down and let her hop a ride for the 5 blocks back to the house.

I love that no one who ever sees us inquires about what’s going on or so much as stares at us curiously.  Nope, they just smile and say hello like there’s nothing out of the ordinary happening.  Ma’am.

She is still having significant weakness, stiffness, and trembling in her back end.  I’m not sure if it’s related to her kind of crappy eating, low electrolytes, or perhaps she really has aged a bit from this experience.  Next time we see Dr. Edstrom, I’ll mention it again . Kali’s due back for a follow up kidney panel at VCA next Tuesday or Wednesday.  I’m hoping we have a very uneventful few days and don’t have to go back before that.

Come on, no Whammies…

Wednesday, August 14, 2013: Uneventful is Sometimes a Good Thing

Kali had a pretty strong day yesterday–her best in a long time.  Her dinner consisted mostly of Stella and Chewy’s, and I got her meds in her, except for that darn Pimobendan.  Even these awesome capsules are a challenge because of how finicky she is.  I tried 3 or 4 things (including the lamb), and it was a no go, so I just saved it for today’s AM dose.  It happens sometimes.

Yesterday, I also talked to Dr. Saelinger’s intern, Dr. Vinson (a little bummed I couldn’t talk to her), about Kali’s meds.  I expressed my “slight concern” (aka “sheer terror”) about starting her up again on her Spironolactone and Benazepril.  I even tried bargaining:

“Well, how about if we just do the Benazepril, but leave out the Spironolactone?”  Well the thing is, he said, the combination of all of these drugs together vastly improves longevity, versus just doing the Lasix.  The thing I told Kim when I was relaying this to her later over text is that ASEC’s goal is clearly a long life, whereas Kim’s and my goal is quality of.  What’s the point of Kali living another 10 months if she’s just going to feel sick the whole time?  There is none.  She’s had a great life, and we’re not going to compromise that now.  If she starts feeling badly again, that’s it.  I think we’re going to stand firm and take her off those extras.

We re-started all meds this morning at breakfast.  I said a little prayer as I cut and prepped the pills: Please don’t hurt her.  Please just do your job.

So far, today has been mostly uneventful.  She didn’t eat much breakfast at all.  I totally had to switch to boiled chicken covered in beef gravy for her meds.  Other than that small portion, she didn’t want to eat.  Fine.  I let her be.

Her breathing is normal and there’s no coughing.  She has suddenly, however, developed a limp in one of her front legs (can’t tell which one yet).  I noticed it when she got up this morning, but then she didn’t limp at all on her walk.  But then, she just jumped off the chair a few minutes ago, and limped to the door, so I dunno what that’s about.  Stiffness?  Maybe jumping onto the hardwood is getting to be too much?  If she was eating normally, I’d start her on the supplement we’re giving Delilah for her hips–Nupro–but I’m having enough problems getting Kali to get down her absolutely “must haves.”  There is this one product we learned about on Sunday, when we were at Got Pet Food, shopping for D’s situation.  It’s called Nzymes, and one of the forms it comes in is drops you can add to the drinking water.   So maybe I should pick some of that up.  It’s supposed to be some sort of super supplement, good for whatever ails ya, so I’m sure all the dogs will benefit.

So that’s all from here for now.  She’s all sleeping and whatnot.  We’ll see what today holds.

Yes, our grass is dead. But our Llama is not. It’s all about perspective. Get your sun on, Kali!

 

Tuesday, August 13, 2013: Who Says 13 is Unlucky?

Kali’s having a spectacular day!

I realize it’s only 10:30 am, and therefore, this is possibly a premature characterization of the entire 24 hours, but it’s all about celebrating it as it comes.

Her good day started last night.  Dr. Edstrom called us and gave us the news that her kidney levels have gone done again!  It’s great news, but not surprising, seeing as how Kali isn’t back on all of her heart meds yet.  I’m hoping Dr. Saelinger will see how well Kali’s breathing and coughing is doing and let us be more conservative in the medicine area.

So anyway, after that lovely news, she got her meds last night, went to bed, and didn’t move–no joke–until 7:00 am today.  It was a little later of a bedtime (about 11:30 or so), but still.  I got up a few times during the night to check on her, and she was still in the same spot, the same position.  I didn’t even attempt to move her.  I just checked to make sure she was breathing and let her be.

So when 7:00 rolled around today, and I saw her still curled up exactly where she was last night, I was shocked….and felt sure this was a bad sign.  But still, I let her be.  She finally got herself up and came over to me and gave me the Snoopy Vulture look.  You know what I mean–the dog comes up in your face, drops their nose and peers at you over their invisible bifocals.  She bores a hole into your forehead, willing you to get up and walk her.

That used to be Kali’s M.O. before.  She hasn’t done that since before her first hospitalization.  Seeing her do that today was like seeing a ghost–a very happy ghost who needs to pee.  She did cough two times, but she was still bright and pushy, so I got up and let her in the yard while I got dressed.  She peed like…well…she’d been sleeping all night.

She came back in, and did her “I’m going to follow you until you take me out for a walk” maneuver.  That’s another thing she hasn’t done for a long time.  For the past few weeks, I’ve had to do the suggesting.  But there she was, trying to trip me for taking too long in getting ready, just like old times!  Oh, Llama!

She had a great walk, ate another proper breakfast of the kibble-lamb-Stella and Chewy’s mix, and took her meds.  Then, instead of velcroing herself to me, like she has been doing since she came back from the hospital on 7/19, she trotted off to the bedroom to sleep.  This might not seem like an improvement to someone who doesn’t spend 24 hours a day with her, but it is.  This is her usual routine.  She is typically aloof, and likes to be alone.  We call it “adjourning to her study,” because she is known for hanging out in the bedroom solo.

I don’t know what it means, if anything at all…but I’m taking it as a good thing.  I’m interpreting it as she feels like her normal self–enough that she can be independent and do her own thing.  Of course, I could be totally reading this wrong.  But I don’t know–it’s been a long time since this part of her routine has resurfaced.

So there you have it–her breathing is still holding steady at 19/min, and it’s clear.  There’s nothing like a night of solid sleep to set us right, is there?

That comeback might be mounting, after all….

Monday, August 12, 2013: Keep Calm, and Llama On

Well, my original plan for today was to get Kali off the “you can eat whatever you will eat” diet since she’s been doing so well.  Also, I know Dr. Saelinger is probably going to call to check in tomorrow, and will want to start the rest of her meds again, but only if she’s feeling and eating well, so I wanted to get her back to normal.  I figured I wouldn’t offer her lamb for a meal (just for meds) and just wait for her to get hungry enough to get back to her kibble.

However, she had other plans.

I got her medicine in her pre-walk, but she wasn’t interested in eating much, so we went on the walk.  She had good energy and lasted the length of the long version, but somewhere around three-quarters of the way through, it arrived.  What we’ve been waiting for.  What we’ve feared.  Diarrhea.  All of her crazy foods finally caught up to her.  It wasn’t explosive; just the regular kind, so at least that was good.

Once I got through Round Two of walks (I left her home), I gave everyone their breakfast, and she refused hers, so I left it alone.

Most of her day was spent on the couch, licking herself or simply staring at her backend.  She slept on and off, and I ended up taking her for a urinalysis and urine culture, as well as a follow up kidney panel.  We should get those results in a few days.

After our VCA visit, she took me for a walk around the neighborhood.  She was of good energy.  I ended up having to carry her the last half-block back to the car.  I think it was the heat…and probably that she hadn’t eaten.

We got home, and she had dinner (and Pepcid) with the pack.  She had a good one.  I primed her with sizzling lamb, which I mixed in (with the juice) to her kibble.  Then I crumbled some Stella and Chewy’s in there.  It worked.  She didn’t eat all of the kibble, but certainly more than 5 of them.  I’m hoping I can do the same for breakfast tomorrow, and dinner, and so on until I phase out the extras and we’re back to plain kibble again.

Her stomach is totally angry right now–after all, I’ve pretty much disrespected the cardinal rule of dog-food-changing as much as I possibly can.  I can hear it gurgling away while she sleeps, so I hope the Pepcid can rise above it all and keep her from spewing (out of either end, thankyouverymuch).

All in all, though, on the gradient between healthy normal Llama and dying Llama, we’re much, much closer to the former.

Keep calm, and Llama on!

Sunday Night, August 11, 2013: 5 Kibbles Closer

Kali had another good day.  She ate a lamb breakfast with her meds before her walk again, and that worked again.  She was energetic and lively.  She also went on Round Two (although I carried her for that one).

We decided not to take her with us to the vet since her licking has gotten a lot better.  Besides, we got enough bad news at the vet (at all of about age 6, Delilah, our pittie, has no hips–total hip dysplasia…but I digress).  So when we got back, I made her a bit more lamb, and a tiny bit of veggie hotdog with bun, which she ate.  She still seemed bright-eyed, awake, and energetic, so we took advantage of it and had a Special Outing.  You can see the details here.

By the time we got home, she was still awake and alert, but it was a long day for her, relatively speaking, so I made an early dinner for everyone (she also got her tummy meds).  This time, I had the idea to pulverize her kibble and try to soak it in the lamb juices/hide it in the pieces of lamb.  It worked pretty well.  I wouldn’t say she ate very much of it–maybe like 5 pieces of kibble all told–but one of the things I’m learning on this journey is that our units of progress are very tiny.  I think that’s what makes it seems so exhausting, so daunting sometimes.  You look at your dog, who isn’t eating anything at all, and you wonder how in the world you will ever get her to eat a full bowl of dog food again–let alone two of them in one day, and you just want to cry at the hopelessness of it all.

But I’ve seen her go from eating nothing all day to eating several foods, several times a day.  Kim is worried all of these different foods are totally going to jack her up (she has a history of colitis, on top of all these foods just not being good for dogs in general).  I understand.  But my thought is if I can keep her eating anything at all, it will keep her energy up.  It will help her body and spirit continue operating, and then we can tip toe our way back to a real diet.

So 5 kibbles may not seem like anything at all.  But to us over here, it’s huge.

She got some good napping in post-dinner, and for a second, I thought we had overdone it with her today, but her breathing rate was holding just fine (23/min).  Kim and I went out to get a bite and pick up some more lamb (she’s gone through a whole pound since Friday).  I made her more, along with the kibble and her meds, and it all went off without a hitch.

She’s now sleeping on the couch with Kim, breathing silently and easily.

ASEC called today to check on Kali (not Dr. Saelinger, because she’s off on the weekends, but her intern).  They’ll call again on Tuesday, and if Kali’s eating normally and still on the upswing, we’ll restart the rest of her heart meds (Benazepril–which is replacing her Enalapril–and Spironolactone).  I’m trying to move her forward so that she’s eating normally by then.  Seems a long way off from where we are now, but even if we’re halfway there, that would be good.  Obviously, a lot of progress can happen in 48 hours.  5 kibbles at a time.

Kim and Kali on our Outing today.

Special Outing August 11, 2013: We Discovered a New and Perfect Park

We took advantage of Kali’s continued forward momentum and had a special outing today.  We took a drive into the Palisades/Santa Monica Canyon area, in search of a park where Llama could just relax, enjoy the breeze, and watch the goings on, undisturbed by other dogs or lots of commotion.

I just pulled up my map on my phone and found a green patch that we hadn’t been to before.  It turned out to be Rustic Canyon Recreation Center, but we have dubbed it “Kali’s Park.”  It’s a little overgrown and tree-covered.  Large enough for her to have room to explore, but not too large that her heart got to pumpin too fast.

Kali had a lovely time, sniffing new smells, relaxing in the tall, cool grass, watching and listening to the kids in the Center’s pool from afar, and even having a little snack.

I like taking her to new places because I think the exposure maybe keeps her brain sharp?  Perhaps the new sights and smells are stimulating for her to investigate and figure out.  And it keeps her life interesting and exciting.

It was really nice to get away from all the hub bub.  We were the only ones in that field on a perfectly sunny breezy SoCal Sunday.   It was quiet and mellow, and the three of us just chilled.

Where will this adventure lead?

“Welcome to Kali’s Park” (insert Jurassic Park music)

The Grasslands Llama investigates

Does a quick check from her lookout point to make sure our spot is secure.

Considering whether she wants to walk around some more or park it.

Okay, time to “relax.”

See where she gets her nickname?

Snacktime after another go around of the field.

<urp!>