Thursday, August 11, 2011

The run

Long time no post, but this is a 'no news is good news' delay. Toby is doing extremely well, we just got a full blood work panel done and Toby looks like, well, a normal dog. Some stats are on the shy side of normal but everything is in great range. He's happy, he's healthy and best of all, he's running! I used to run with Toby all the time, it was one of his favorite things. Sometimes I had to put on roller blades just to go fast enough for him. Seriously, 14lb dog can run at a clip of up to 15mph, he's that good. Well when all this went down you start reminiscing on all the good times, for Toby and dad, that was our runs together. We'd go, he'd take off, randomly smell something and make a sudden stop, I'd try to spin on my roller blades, fail, and then get the look from Toby as if to say "why are you laying down, we gotta go?" Then of course there is the at home afterwards when he runs over to Vero with a huge grin, super proud of himself. Next step, make a mess of the water bowl. Followed by trying to sit next to dad and realizing we both make each other hot, transferring to sit on the wood floor, then back to dad and repeat.

Well, Toby is doing so well that he is up for running a bit again. Not as much as he used to, but we're so thankful to have him that we couldn't care less. So off we go, Toby ran, I mean really ran, for three steps then realized he didn't have that level of energy, so trotted it out. He was loving it, until we got to the next street. The street is packed with other dogs, almost every house has at least one, and they love to bark at Toby. As we turn down the street, the chorus joins in and Toby, always one to play for an audience, let loose. We tore down the street with Toby showing off but not only did he want to run, he wanted everyone to see him run. He kept turning his head side to side, as if to look at the barking dogs and make sure they saw him. When we turned the next corner we slowed to a trot. By the time we got home he didn't have the energy to sprint the last little bit but it didn't matter.

Veronica and I are both so thankful. He's a great dog and a very special part of the pack. Speaking of the pack, Meg and Pepper are getting along much better, so much that we can now go on family walks and life around the lily room is much happier (FYI, lily room = LIving + famiLY room, since we both grew up calling it different things). Our schedules have changed a bit so during the week we get in the walk, our food, their food and then spend a little time just relaxing. 3 dogs, 2 people, 1 couch, love it!

We're heading to Rome in another week but when we get back Toby is transitioning to a home cooked diet that UC Davis put together for us. That transition may be interesting since his insulin needs may change but we don't want to leave him on kibble forever. We like kibble for treats and games but otherwise we'd rather use more nutritious, whole foods. We'll keep you posted!

Friday, July 1, 2011

Comeback kid

Things have been going very well for our little fam. Toby had his recheck 2 days ago and his PCV was 37-38%. Phenomenal! We're keeping most of his meds the same for now, but that will likely change next week when we try to decrease even further down. Toby's lovin' it. He enjoys his walks and looks forward to car rides and field trips. We're still trying to get his weight back up, but that might not happen until his diabetes is a little more regulated.

With his IMHA, the doc worries about him eating raw food ever again, so we've had him on a kibble and canned food specifically for diabetics. I don't know about you, but I can't imagine going through my entire life eating the same processed food. So, we're trying out a home cooked diet. Well, we submitted a request to UC Davis and we'll see what they come back with.

PS, we moved into the updated family room last weekend and everyone loves the new space, pictures coming soon!

Friday, June 17, 2011

Puppy cut!

Toby went to the dr earlier this week and we ran some bloodwork on him. Everyone was pleased to see how great he looked. Plus, he had just gotten a haircut by mom and dad so his puppy cut was attracting more attention. Yup, we cut his hair at home and encourage others to do the same. It's so much less stressful than going to the groomer. It takes practice to get the right cut and find your groove, but Toby couldn't care less about what he looks like, even though the first few times the right side of him was a whole lot shorter than the other. As long as treats are involved, and we take breaks in between to let the clipper blades cool down, Toby just sits there. And his hair is growing so fast it's almost even now and you can't tell where his legs and neck were shaved for his many catheters.

Anyway, his bloodwork was good enough that we're going back to his normal insulin and giving it twice a day rather than 3 times a day. This is not only awesome for Toby but for us too as we don't have to wake up at midnight to feed him anymore! Plus, we're decreasing some of his Prednisone too. Because it's still a critical time, we're checking the ketones in his urine every day, and monitoring his energy, appetite, overall demeanor. So far so good, Toby just got back from another Jose Ramon walk and he's all smiles! He goes back to the dr next week, and we'll see how the new insulin dose is affecting his body.

In the meantime we're hoping for beautiful weather to take more walks once our days off come around. Toby hasn't walked as far as he used to, but he's getting there. I think he realizes he has a lot of marking to catch up on!

Sunday, June 12, 2011

Miracle Dog!

They called Toby a miracle dog at the hospital! It's so great to see his energy come back a bit more each day and to have our lil guy back. This week brought back 2 of Toby's signature moves;

1) The Tripod - Toby loves a good belly rub but he doesn't like sitting still when he is excited. Like the ninja that he is, he has a solution, The Tripod. From a standing position, toby will put his head, to the ground, on it's side and then stick his front paws out so he is resting on his neck. From here, we can pet his belly but he can continue to push himself across the floor with his backlegs, thus, getting a belly rub without holding still.

2) The Jose Ramon - we have a variety of walks we take them on, each named by a street or landmark. For example, we have the Jose Ramon, Nikki, Rusty, Round the park and that tail wagginl DOBLE PARK! Jose Ramon is the smallest loop, coming in at just over a mile. As he's improved more and more he's made it farther and farther but always ended up in the stroller with Meg (who rides because of unknown leg pain, we're working on that and she's probably headed in for accupuncture). Not yesterday though. That's right, mark your calendars, Saturday, June 11th of 2011 at 6pm, Toby the invincible not only walked a full mile but walked it with vigor!

Tuesday, June 7, 2011

Too much of a good thing

Yesterday I gave Meg a dental chew to help with her teeth and to keep her occupied. Some days she gets what to do with it, other days she lets it sit in her mouth like a trophy and eventually spits it out and lets it rest beside her. Toby saw Meg sleeping next to it and thought "who would do such a thing? It's meant for eating!". So he barked at me to get my attention, as if to say, "Ridiculous! I know what to do with it!" So I gave it to him instead. Meg didn't seem to miss it.

Because Toby is diabetic, and now on Prednisone, he drinks a lot of water. What I didn't realize is that every time he eats one of those dental chews, it makes him drink even more water. I was cleaning around the house, doing other things, and it wasn't until John got home that we noticed Toby's belly really distended. He must have had at least 2 big bowls of water, and he drinks like he'll never have access to water again in his life. We called the doc to see how concerned we should be. She advised us to not offer water the rest of the night, and no food at midnight, just a half dose of insulin, and monitor him. Great. We can manage that.

But not so much for Toby. Toby lets out a single bark when he's trying to get our attention, like when a kibble has gone under the couch and he needs help to get it. Well, all night he sat by the empty water bowl and let out single barks. I felt so bad for him because I knew what he wanted, I just couldn't give it to him. Eventually he fell asleep, but those first few hours were painful for all of us!

This morning he was so excited for his breakfast, he ate it all, and it didn't take that long. He had some water too. His belly looks much better than last night but still somewhat puffy, so we're keeping an eye on him. Note to self: don't cave when Toby pouts wanting a dental chew!

On the plus side, his appetite is up, his energy seems up, and he even barked and jumped when we got his food ready this morning. Oh, and it's not raining this whole week, so we get to enjoy some outside time. Maybe we'll even go to the park later. Woohoo!

Sunday, June 5, 2011

First day home, sort of

This is the first Sunday in a few weeks that Toby doesn't have to go to the hospital. In fact, doc said he doesn't need to go back to recheck his PCV for 3-4 days! We even stopped one of his meds for nausea because he hasn't been vomiting. We did add an injection of B12 but that's only once a week. He's eating well, wags his tail, and barks when he's excited to see us. So today, we're lounging all day. We really wish it wasn't raining so we could take a nice walk, but hanging out at home is the next best thing.

Oh, and we got a petsitter so none of the kids have to come to the hospital with me for boarding anymore. The petsitter comes and stays for 4 hours to feed the kids and let them out to potty. I'm sure they all appreciate being able to stay at home where they're more comfortable.

This weekend we'll be doing some more baking, so now's the time to place your order for some goodies!

Friday, June 3, 2011

30!

Thank you all for the crossed fingers, Toby just got back from his PCV and he put up a 30! He's been fighting for that 30 for over a week so it's so great to see. Vero actually had to have another nurse check just to make sure she wasn't willing it to happen.

His energy level is still a bit low, noticed mostly in how easily he can get tired on a walk. His will however is definitely coming back, he's even eating almost all of his food now. Toby's communication style has changed a bit as well, he likes to cuddle more and to be held. I think the heavy level of interaction and dependence with us is making him more people and less dog. Secretly, I kind of want him to pick up a sandal and throw it!

We'd had Toby a year before I saw him do it. I had just gotten home and since he was barking I was ignoring him. I looked down just as he went to the shoes, picked up a sandal and turned his head quickly to throw it. The following look is one I'll never forget. With big, proud eyes and an ear to ear smile he looked at me for praise. It was as if he had just thrown a discus in the olympics and was looking for me to score it, hoping so badly I'd give him a perfect score. This is the point where I, as a parent, came to realize the old saying that parents aren't perfect either, because I laughed. Hysterically. In my defense, it was funny, but still. Toby took my laughter as praise and for a few months we flirted with a sandal/slipper throwing behavior.

So maybe tomorrow we do sandal throwing, today we did 30% red blood cells. So YAY FOR TOBY!

Fingers crossed

We've stopped the daily cyclosporine infusion which means two things. One, Toby doesn't have to go to the hospital everyday and, two, he got his catheter out so he is slated for a b-a-t-h. His demeanor is getting a bit better but his stats aren't..... we don't know what to think anymore but the docs are optimistic. He should be going in for a PCV tomorrow and I'm asking him to put up a 32 so fingers crossed everyone!

Sunday, May 29, 2011

Slow and steady

Well, things are still the same. Toby goes in daily for his cyclosporin infusion and his PCV always come out the same, 28%. We are cutting back on one of his meds, we'll see if that makes any difference. It is nice that at least he is stable, but it's also a very slooooowwwww work in progress to get a PCV above 30%.

We've asked ourselves how long we think Toby wants to keep going in for cyclosporin infusions and having a catheter in his arm. We don't know that answer. He is tired a lot of the time, but he is still super curious. I take him on short walks half way around the block and he always wants to go longer. He walks slowly, but he still wants to go. We try to take him and Meg for long rides in the stroller whenever possible, just so he can get out and see things. After his cataract surgery just over a year ago Toby has a great appreciation for being able to see things, so his stroller rides are even more special.

The only real change is that Toby's brain is somehow missing the connection to the rest of his body telling him when he needs to have a bowel movement. Hence, he sometimes has a BM without even knowing it. He's had a rectal exam by both internists and physically he's fine. It's not a side effect of any of the medications he is on, so they're thinking it's a mental thing, perhaps just due to age. Or perhaps since he has IMHA and is prone to blood clots, maybe he had a minor clot and the part of his brain that tells him "Oh, I have to poop, I should do outside", doesn't work anymore. So sometimes he poops as he's walking, or even sleeping, without even knowing it. It's unfortunate to see, but I don't think Toby cares much. And there are worse things in the world than having to pick up poop.

Tomorrow is Memorial Day, and Monday. John and I are both working so the kids will probably end up staying at the hospital with me all day. They would much rather be at home, but at least this way I can keep a close eye on them.

Thanks to everyone for the get well wishes, and the orders for biscuits and biscotti. We hope to be making more this week!

Friday, May 27, 2011

Quick Update

Sorry for the lapse in updates, there really hasn't been much change for Toby. His PCV is still at 27 and he is still making daily trips to the hospital. The tough thing is that in his case, no news isn't good news. Despite the moments of wagging tail and face licks, most of the time he has very little energy. We're back again at the tough place of asking Toby how long he wants to go on...

One thing that is helping me through this is a book I started reading, Redemption by Nathan Winograd. Winograd is a champion of the No Kill shelter movement and while I read the first few pages with what I would call pragmatic skepticism, the passion of his writing has reminded me of why we're going through this. He notes that a major flaw in shelters is that they blame euthanasia of healthy animals on the public, faulting them for not spaying/neutering, seeking breeders and puppy mills over adoption and failing to provide forever homes. The reality, as he puts it, should be that anytime a health animal is euthanized, it is a failure of the shelter to advocate for that animal and find it a home. It has to be the role of shelters and SPCAs to fight for life.

We're vegans out of respect for life. Toby is in our home out of respect for life. We are fighting hard to save him out of respect for life. Living a life that exercises that belief brings me a great level of peace, even in the midst of this.

Tuesday, May 24, 2011

Celebrating the little things

Toby barked! His big sister, Meg, was out back explaining to a passing dog that this particular stretch of yard belongs to her and her pack. Toby, hearing pieces of this conversation from inside the house, raised his tail and trotted to the yard to add his two cents. Well, one bark so maybe just his one cent. This is a piece of him that we're happy to see. His PCV came back today at 26, which means, medically, we haven't made progress in a bit. The doctors are showing some concern, you see the quality of life that he has right now isn't one he would want long term. His energy level is still low and he spends 4 hours a day in the hospital getting his infusion. So doc is reaching out for some consults. We've tried all the main drugs, the next step is one into obscurity and they tend to be obscure for a reason. Efficacy, side effects, volatility, etc. The other option is to retry drugs that didn't work in a different way, but that has it's own set of issues.

We're staying positive, the moments when we see our Toby in his weak eyes remind us why we're doing this. He really is such a great dog, an amazing friend. Toby is our first dog together and for a moment in time our family was just the three of us. He's simultaneously a Momma's boy and Dad's lil dude, liberal with face licks and happy to accept a belly rub. Everyday we reaffirm our commitment to him, that as long as he wants to keep going we'll be his biggest advocates. The moments when he wags his pom-pom, the little jump he did this morning for food, the small trot he did when he heard us getting a harness out, we hope to see more of these.

Monday, May 23, 2011

Thai-Frida-versary

So we have a couple traditions and two of them converged today.

1) Thai Friday - Thai Friday came about when we lived in Chicago. Thai places are very vegan friendly and in Chicago there are tons that are not only great, but also BYOB with no corkage. Thai Friday was our weekly date night, a chance to focus on each other and our relationship, without dropping a ton of cash on the whole thing. For under $50 we could have a great night out. Now that we work odd jobs our schedules are different. As a result, Monday is our "Friday". Note, please don't confuse this with Thai Monday, there is no such thing, that's just crazy-talk.

2) Anniversary Pizza - We love pizza but finding a killer vegan pizza isn't the easiest thing and when we moved to Santa Rosa, north of San Francisco, we couldn't find an awesome vegan cheese pizza. So on our first wedding anniversary we decided to have some fun and make our own. It was awesome, so awesome that it's awesomeness revurberated into the future at a rate of 1 awesome per year and when that awesome comes around, it threatens to destroy the planet unless it is satisfied with matching awesome, thus balancing awesome..... uh, really we like pizza and making it together each year is a fun celebration.

Well today is our 3rd anniversary and Thai Friday, sooooooo

THAI-FRIDA-VERSARY-PIZZA! And you know what makes it even better
Toby has a bed next to the kitchen, he likes to watch us work and he was with us for the whole prep time. Family high five!

Family focus

Before heading to the hospital today I took Toby and Meg on a walk.  Toby was wagging his tail after I showered and got ready because he knows that after this usually comes a walk. He's still not that strong, but how could I say no to a happy tail wag?  I brought Meg along because she walks much better with Toby.  He gives her a reference point and helps with direction just by being there so she can smell him.  We went down the block and I wanted to turn around so Toby wouldn't over do it, but he wanted to go further.  So we went down the end of that street, and he still didn't want to turn around.  Eventually he did so, reluctantly.  To me that was a good sign, he still wants to go for his walks, albeit slowly, at his new relaxed pace.

I dropped Toby off around 10:45 this morning for his daily cyclosporin infusion.  I brought Meg in the car with me so that on our way back home we could have some quality one-on-one time.   There's a big park a couple blocks away from our house, and Meg and Toby like to run around off leash in one of the empty baseball fields there.  I like it because it's fenced almost all the way around, so they can't get too far, and Meg likes the textures.  Being blind, it helps Meg tremendously to be able to feel where the grass ends and the dirt begins, that way she knows to slow down because the fence isn't too far behind.  Since Toby has gotten sick and his energy level crashed, we haven't gone.  And Meg is still nuts about Pepper intruding in her house, so lately she doesn't like to leave the house to go on walks.  But the park, she knows the park, and she knows that field.  And she was lovin it today!  There was no one around so she had the whole space to herself. She got to sniff whatever she wanted, dig her head in the gopher holes in hopes of finding a treat, and roll around in smelly patches of grass.


When we got home, it was Pepper's turn. Meg doesn't like to stay home alone, so I got the stroller ready for her and off we went, Meg in the stroller and Pepper walking on a leash.  Pepper certainly has her habits either from how she was raised or as evidence by her being a stray for so long.  She likes to poop on concrete.  You can be crossing the street and if she's gotta go, she's gonna go right there in the middle of the road.  It's funny.  And as sweet as she is, she likes to bark at strangers (people that is).  She already feels protective of her pack.  We didn't walk too far or for too long because it was getting pretty warm out, but she got to sniff and bark at things.  We're not the most strict parents.  I know some folks take their dogs on walks to do just that, walk.  No sniffing, stopping, marking of any kind allowed.  Toby is known as Mr. Marker.  He thinks this whole neighborhood is his and I don't mind that he stops all the time to pee on things.  And Meg can't see, so sniffing is like reading the newspaper to her.  I enjoy letting our kids do these things.

I just got back from visiting Toby. His infusion was in progress.  His PCV wasn't done yet, so we'll see what it shows when I go pick him up in a couple hours.  If we can get a couple PCV readings in the 30's, he'll be able to stop his cyclosporin infusions.  Toby will be happy about that.  As much as he knows the nurses at the hospital and gives them kisses, he would much rather be home.  I go visit him and all he wants to do is be held in my arms.  And I just tell him to be patient, and he'll be back home before he knows it.  It's pretty quient in the ward he's in now, so I advised him to take a nap to help time go by faster.

In the meantime, Meg and Pepper are sitting on separate couches, tolerating one another (moreso for Meg than Pepper).  And we're waiting for the rest of our pack to come home. It's our 3 year wedding anniversary today, so I'm hoping John can come home early too.  I wouldn't want to go away for our anniversary really.  Our wedding was the happy start to the family and lifetyle we currently have, and I couldn't imagine a better place to celebrate than at home, with our family.

Sunday, May 22, 2011

Lil by lil

There's a lot of negative on this blog. A lot of how hard it is to fight this disease, and how hard it is to fight combination of these two diseases. Toby isn't Toby. he's not the lil guy we love so dearly, but he is in there somewhere. Everyday we see a bit more of him, everyday we celebrate a bit.

He isn't our lil guy, he's not the boy we cuddle with all the time, but he is ours. He is in there somewhere and he is worth fighting for. We set small goals in front of us, small victories to celebrate. We celebrate the small things, the small moments. Toby barked today,it was small,but it was huge. His bark meant so much to us. It meant he was willing to fight for what was his, to fight.

We love these kids, we'lll fight for them. We love when they fight to be with us!

Accessorizing!

Lil Tobes is still working through the right drug setup. His PCV dipped a bit to 26 but that's still good so no cause for alarm. He's still on Pred but his sugar has been okay the last couple days. We need the azathiprine to kick in a bit more though, doc said that until his PCV gets over 30 he gets a daily infusion of cyclosporine, which takes 4 hours.

So on Friday his catheters were both shot, they got pulled. He had already had his infusion that day so he got sent home without a line in him, or, as the nurses put it, without his accessories. He did get a new line yesterday though, so we're back in business. Vero is home with the kids today taking care of the pack.

Pepper also got a new accessory on our last trip to the hospital. Pepper was rescued less than 2 months ago and weighed in at 15lbs, she was very malnourished. She was rescued by a good Samaritan who recognized that she had been abandoned and found her way to our happy home. With everything going on with Toby we were taking Pepper's improvement for granted, her demeanor had been improving and her personality was coming out. She officially got checked out yesterday and weighed in at 18.5lbs! She's still crazy skinny but she has some muscle tone, can stand on her hind legs and even has a bit of a giddy up in her step. She still has some skin issues, well, the seborrhea she'll always have, but she also has some bacteria. She's on antibiotics to clear that up. So her newest accessory is a pink fluffy sweater! It's cute, I have to admit and as one of the docs said, her femininity could use a pick-me-up.

One of the doctors asked is I was comfortable having a dog in a pink fluffy sweater..... My reply - "Not only have I walked a dog in a pink fluffy sweater, I've pushed one in a stroller." Our kids rock and if Pepper looks good in pink, rock on. If one of our kids is too tired to walk but still wants to sniff the world, we'll go for a ride in the stroller. We pretty much have all the great accessories. Which includes seat belts (http://usak9outfitters.com/CCSS.htm), if you don't have one, get one. We have a couple tubs full of different sizes of leashes, toys, collars, seatbelts and harnesses. We even have a raincoat! So for the next week or more Toby also has his catheter, in stylish blue with a purple wrap, rock on lil buddy!

Friday, May 20, 2011

First day home (well, half day)

Toby did well overnight. The way his medications are scheduled, he gets a few meds at 8am and 8pm, but he's on his insulin 3 times a day (8am, 4pm, 12am). So we had to wake up at midnight to feed Toby and give him insulin. John and I also took turns waking up every hour to carry him outside to potty. We have a dog door so he can go whenever he wants, but he's so weak he doesn't make it all the way over there sometimes. He's peeing so frequently because he's been on IV fluids for so long. Hopefully this will be less frequent after 24 hours and we won't have to keep it up for much longer. Even with hourly trips outside, one of the dogs did have an accident in the house last night, and we suspect Toby.

We did have to take him back to the hospital today for an infusion of Cyclosporin since the oral version does not seem to agree with his stomach. We also did another PCV, coming in at 28%! Woohoo! We'll do this whole routine again tomorrow, and maybe Sunday too just to be sure everything is stablizing as it should be. By Monday his meds should kick in so we won't have to take him for infusions anymore.

Poor little Tobes has lost 5lbs since being first admitted to the hospital. At this point we're filling the bowl with food every time and he can eat however much he wants. Ironically we were just saying a few weeks ago that we needed to cut down his food some since he was just over 15lbs and looking like he carried some extra weight. Not that I'm in shape or anything, but diabetics especially have to watch their exercise, diet, and weight, and Toby is no different.

We'll be making a more batches of biscotti and biscuits over the weekend. If you have not asked your friends and family to buy some tasty treats to support a good cause, please do so now! Thank you all for your support!

Orders for locals in Sonoma County

If you are in the Santa Rosa area, we'd be happy to deliver your dog bisuits or biscotti so you don't have to wait for it in the mail. After all, why wait for deliciousness if you don't have to? Just send an email to timefortoby@gmail.com and we'll make arrangements.

Thursday, May 19, 2011

This house is a home

This will be fast. Tell the ones you love that you love them, pull them close and show them what you mean to them. Toby has appointments tomorrow for infusions but tonight he gets to cuddle with family. He isn't "fixed" and we are on high alert but our buddy is home, our lil guy is where he belongs. There is a sense of happiness that the three dogs lounging around our family room brings that words will always struggle to capture, so we won't try. We'll just go cuddle. Snuggle your four legged friends and tell them how special they are. Toby tobes sleeps with his family tonight!

Wednesday, May 18, 2011

G'night lil buddy

Tonight is a "no news is good news" night because Toby held fast at 23% RBC (red blood cell) count. Given the last 24 hours, the crash of vomitting and the change in meds, holding the same is good. More than that, his demeanor this afternoon was great. One of his main doctors told Veronica tonight that she thinks we're the cutest couple. She's a great doctor, not just because of her education and patient care skills but because she always stops us and takes the time to ask us our opinion on demeanor and attitude. After all, nobody there knows his *isms better than we do. And we do let her know. For example, this afternoon I kept picking him up and putting him down because he was getting hot. Doc walked by and asked how I thought he was doing so I showed her how to tell the difference between hot and hot & happy. She told Veronica that she loves that we take the time to watch out dogs emotions, but really, how could you not. You live with them, share space with them. You sleep with them in the same room, which, if you value your sleep like I do mine, is quite a big deal. Our dogs have the right to disturb our sleep if something isn't right, and if they choose to do so we'll pay them the respect to check it out.

So, little bit tired but still very attentive tonight. PCV holding steady, which we're good with. Check the drug war posting from earlier and based off that direction we are happy to hold steady for a bit while the azathioprine kicks in.

We'll find out tomorrow but we are still holding out hope that Toby can come home. Maybe not, we'd understand, but the frequency of our visits the last few days show how much a positive attitude and environment help to the general well being. But why let us tell you, check out these!


Wait a sec, he isn't smiling when I'm holding him! Eh, whatev, I held lil dude for hours today so no worries. Besides, showing interest in his surroundings is big. Oh, soap box moment, just cause you're dog is well socialized does not mean the other dogs are. We love our kids, they rock, but the youngest adoption we've made was at 5 yrs old so we get plenty of well engrained behavior problems. We love walking our family cause everyone sees a couple attentively walking several dogs, often with a stroller for the seniors, and they say "it's okay, they're friendly!" They may very well be, but Toby, though we love him, is nicknamed "Mr. Marker" because he owns this world and your dog only gets to walk in it if Toby says okay. It was sad because when he first went in, he was in his cell and that was it, he accepted that as the depth of what he could keep track off. Now that he is feeling better he is looking around and surveying his situation, that's good. Earlier today a large retriever came in with a snake bite and toby actually made a move in his direction. Couple more days and Vegas will be putting together odds on the Toby V Godzilla battle, (smart money is on Toby in the 5th, Vegas will pick Godzilla but after studying hours of tape Toby will explout his weaknesses!).

Fingers and paws crossed everyone, hopefully tomorrow night we'll be blogging about how Toby's first night back home is going!

Smiles

Quick update, just got back and Toby wouldn't let me leave. He wanted to be held for almost an hour! Very engaged in his surroundings, chowed down some din-din and, check it out
SMILES! It's tough to see cause he's furry but the corners of his mouth are curled up. He's very expressive and we love a good Toby smile. Oh, and yes his neck is shaved and has a couple stitches. His cenral line just came out, still has a catheter in the leg (hence the line on the left) which is feeding fluid and potassium. His neck has been wrapped for over a week so we also made sure to get some good neck rubs!

I told Toby, his goal for the rest of the day - MAKE RED BLOOD CELLS!

Drug wars

Vero mentioned that Toby vomitted last night. After that he hasn't wanted to eat. This all comes as a result of the move back to oral meds. Toby's second disease, IMHA, is an auto-immune condition and treating it means getting his immune system suppressed. Science has found drugs that can do this but none of them come without consequences. The big three are prednisone, cyclosporine and azathioprine. Prednisone cause the major havoc with his insulin and throws the diabetes off but it is effective. We're on 5mg per day now, if we can get the IMHA moving further into remission the we eventually drop off the pred. Cyclosporine is an immune suppressant, Meg is actually on it for itchy skin. Oral cyclosporine can cause vomitting, which the doctors believe is the cause of Toby's vomitting and loss of appetite so we have to stop it. We can put him back on the IV cyclosporine but it is a long infusion with some risks so while it works within the hospital, it doesn't help with the goal of getting Toby regulated at home. That leaves us with Azathioprine as the alternative to Pred, problem with this one is the loading does can take 7 days and Toby has only been on it for the last 4. We're trying to take this one in stride but we're holding our breath a bit. His PCV came up a point to 23% and we'll get another look later today.

His attitude is fairly positive, he really really really wants to be held. We spent a half hour, just hanging out and watching the goings on in the treatment room. He's always been a cuddler, usually he wants to flop down next to you but given the lack of seating in the hospital he was very content to lay in my arms.

We'll update more later today when we get an updated PCV.

Thanks, John, Vero, Toby, Meg and Pepper

Tuesday, May 17, 2011

Day 9

As John wrote earlier, it was Biscotti day. Other than that, it was day 9.

Toby was looking wonderful this morning. Eating well, drinking water. He is on all oral meds now, and he even moved to insulin injections rather than the continuous IV. His PCV is holding steady at 22%. We visited him a couple times and saw his internist early afternoon who said she hopes to send him home on Thursday as long as he stays on the current path he's on.

When we went to see him this evening he looked a bit more tired. Apparently he had vomited in his kennel, and he looked like he felt bad about it.

We told him it was ok, and that we'll move past it.

We just came back from our night visit and he was sleeping when we got there. He smelled us eventually and woke up to give us a nice big yawn

and tons of kisses

We took him out to potty (which he's doing about every 2 hours because he's still on IV fluids) and cuddled for a long time. He ate a few pieces of kibble which we hope he keeps down. His evening PCV was 23%, a slight improvement but we'll take it!

I go back to work tomorrow at the hospital so can sort of keep an eye on him. We're trying not to get too excited about the possibility of him coming home in a few days but we can't help it. John will take a few days off so he can still be monitored closely.

In the meantime we'll think happy thoughts and eat cake-like, good enough for junk food biscotti.

More tomorrow...

Biscotti

The kids love when we make dog biscuits, Pepper paces back and forth in the kitchen hoping we break one because she knows she'll get it. Biscotti days are far less interesting for them, but far more for us.

Nom nom for us! FYI, today was even more fun because the first batch wasn't quite up to par. It tasted great but it was too moist and it will get stale in a week (just means we have to eat it before then!).

This recipe is an at home adaptation of the Veganomicom version (pg 241). I once read, and truly believe that if you want to make a recipe your own, first master it the way it is written and then play with the variations of it. We, of course, highly recomend that you order some from us to help out our lil Toby. But, if you did want to try this at home, here's a couple things to note.

Egg replacer - the recipe calls for almond/soy milk and flax seed as an egg replacer, stick with that for this one! You need the wet volume of the milk, which we prefer almond. Vero still prefers to dip them in soy milk but let's face it, you're working with almonds so the flavors will definitely work. The one exception is chocolate soy milk, of course there are few things in life chocolate soy milk can't solve. Oh, and the flax, use flax meal. Ground flax and flax meal aren't always created equal and the finer the grind, the better the biscotti. We have been known to throw our flax meal in the vitamix just to get the fine grind. And add a bit more, like 2.5 tbsps instead of just 2. Well, add the 2 and then if you have a liquid, add more, if you have a slightly gooeyness that drips slowly, you're set.

Flour - we try to use rye or whole wheat flour whenever possible, neither of us are particularly gluten sensitive but they're simpy better. For this one though, depends on what you want to. Biscotti are pretty thick to begin with so the whole wheat pastry flour will come out thicker, and the best bet is to cook it less and go for a moister texture. If you really want to make biscotti, go with the all purpose flour.

Hazelnuts - Really, sorry hazelnuts, it's not you, it's me. Go almonds, and go combo of sliced and whole. The combo will hold it together better and requires less of them.

Amaretto - cause once you taste this with almons, you'll know you need it. Not too much though.

Finally, Ghirardelli cocoa. We love the weather in the bay area. We love the gorgeous landscape, the number of things to do, the great people. And we love that Ghirardelli is everywhere! Like when you walk in the store thinking, "self, you've worked real hard and rather than get some generic cocoa to bake with, you deserve the good stuff." Then you look and excited you says "Dude, self, check it out, Ghirardelli is actually cheaper than any off brand!", "Score, self, everything's coming up Milhouse!"

Hoping you're hungry! Toby is eating today, ate a bit too much and a bit came back. Not the worst thing in the world except he made a mess and earned himself a bath. That, in his mind, is the worst thing. We're heading back in an hour or so and will post some more pics of him.

Monday, May 16, 2011

Never just pets

Jenny mentioned one of our greatest points, they are never just pets. We've met plenty of people (and have some family members) who can't understand that we don't want to have kids. We are very grateful that our parents get it, both sides of the family are very supportive and are very proud of their grand-dogs. Life is precious, all forms of it.

Here are two of the quotes that we have used to help others understand our perspective -
 
“Five sparrows sell for two coins of small value, do they not? Yet not one of them goes forgotten before God.” Jesus
 
 “One can measure the greatness and the moral progress of a nation by looking at how it treats its animals” Mahatma Gandhi

Regardless of your own religion of belief, repsect for life should be universal. A couple weeks ago, Toby had been diagnosed with IMHA but had not yet been hospitalized. We were doing our best at home, waking up by alarm every couple hours to let him out, monitoring his demeanor and hoping to avoid the situation we find ourselves in now. One night we heard Toby get up and he was looking for the ramp at the end of the bed but was too disoriented to find it. I awoke to him bouncing between me and mom and hearing the stomach sounds I pulled him to my chest and told him its okay. I knew he had to vomit and he wasn't going to make it outside so I told my kid that this was okay. That's what you do for your own, you support them at their worst.

Several months ago Meg got an ulcer on her eye. It turned out to be a blessing in disguise but at the time it was very hard. We took her in to the hospital and after several hours there we were sent home with 3 sets of drops, giving at least 2 of them every hour. The drops were drawn up sterile for each dose and had to be given 10 minutes apart. For every 60 minutes, at least 15 would be spent giving medications. From the time of that perscription to the time we got into emergency surgery was just under 36 hours. We spent a day and half taking turns every hour to give eye medications before we got into surgery.

Toby is doing pretty well tonight, fairly bright and active. We actually spent most of the night cleaning him up because his soft stool is getting caught in his fur. That's what you do for family. I read Vero's post early today about how we feel about our dogs and just wanted to add some background to it. We don't define our kids by what we paid for them, or what our expectation was. We agreed to adopt life into our family and to care for them, and to fight for them. Getting pooped on or puked on is temporary, it can easily be cleaned. Standing up to fight for Toby when he needs an advocate, that's the kind of thing that means something. There are hard moments that we all face, the moments that terrify us, but it is in those moments that we show our true colors, that we affirm what we believe. We believe that life is precious and worth fighting for. If someday I am to be held accountable for my actions then fighting for Toby will be a moment for me to hold my back straight and affirm that I gave all I had to give.

Night lil buddy, please keep fighting.

Thank you for your support, paws and hugs!
John, Vero, Toby, Meg and Pepper


Day 8

It's about 12:30 PST and I just came from visiting Toby.  By the time I had gotten there he had already eaten 3 times!  Turns out he likes kibble a little more than the boiled chicken.  He ate a few handfuls for his nurse and then ate a few more pieces for me when I got there.  He looked much brighter than yesterday.  He was standing up and looking around, very interested in his surroundings.  He gave me tons and tons of kisses.  Oh and Toby has this way of asking you for more lovin', when he paws at you as if to say "keep petting me", and he did that today!  Oddly it's a behavior we try to discourage so he doesn't beg for attention, but like we've been saying, it's all those bad habits that we miss the most and of course I gave him more lovin' when he asked for it!  It's funny that he wanted to eat kibble because kibble is only a small portion of his diet at home, and really we use it to play games like "find it".  Maybe that's why he wanted kibble, he associates happy times with it.

His internist is happy with his demeanor this morning, and we are changing him to some oral meds (instead of the IV meds he's been getting so far).  He still gets Cyclosporin IV frequently and insulin IV continuously.  Hopefully we'll be able to get him off the IV insulin and just give the injections throughout the day as needed.  He's also been downgraded from a level 3 critical case to a level 2.  This means he's doing a little better and doesn't need the constant monitoring he was getting before.  He will still be very closely monitored, but he won't require as much attention as when he was first admitted.  Level 2 is great because it means he feels a tiny bit better, and level 2 hospitalization also costs far less than level 3. 

If you don't know us very well, John and I don't plan on having human children.  Our children our Toby, Meg, and Pepper.  So to those asking yourselves, why would you put in soooooo much money to save your dog?  Because he's not "just a dog".  Dogs in general are not "just dogs".  Animals, no matter how big or small, are not "just animals" to us.  Toby is our family.  And we will do whatever it takes to save our family.  We've had a rough week emotionally speaking, and we decided that if Toby wants to let go of this sufferable life, we can let him go.  But as long as he wants to fight to stay here, we will fight to keep him here, and do whatever it takes, because that's what parents do for their children.  And after seeing him this morning, looks like he has some fight in him yet! 

When I visit later today I'll try to take a few pics of our little guy.  He'll probably be chomping on kibble : )

Sunday, May 15, 2011

Day 7

I visited Toby earlier this morning and he didn't look any worse than yesterday, but no better either.  I had a conversation with his internist who felt as disappointed as I was that he wasn't getting any better as fast as we would like.  Despite the changes to his meds he still did not have much interest in food.  I tried offering him boiled chicken and he turned it away.  I decided to give him time to relax and return in a few hours. 

Since then I've gone back another two times.  Mid-day he wouldn't eat.  But by this evening when I went he had!  Apparently a nurse walked by his kennel with a bowl of kibble tossing around and Toby perked up when he heard it.  So the nurse offered him kibble and he ate a handful of it.  I got there just a few minutes later to hear the news and also offered more chicken, he ate that too!

Still, the internist said she expects Toby to be in the hospital at least 4-5 more days.  And that's assuming he gets better from this point.  If he worsens I imagine it will add on even more days. 

John should be home soon and we'll visit Toby again.  Hopefully he will be eating and brighter than he was earlier.  Keep your fingers crossed (super tightly crossed!)

Saturday, May 14, 2011

Day 6

Not much of a change today. He's still alert enough to sit up and give besos and he did eat a bit more tonight. We re-introduced a few oral meds and based off of the timing of the gastritis onset we suspect one of the drugs may give him problems so we swapped it out.

His PCV is still in the mid teens, which isn't great, but we don't want to do another transfusion if we don't have to. We're in the range now that as long as he stays alert like this, no transfuion, if his demeanor changes then it may be neccesary.

Vero is off tomorrow so she'll be visiting him frequently and updating.

Night all

Friday, May 13, 2011

Baking Night

Hi All,

I know this has been asked so here are some pics of the doggie biscuit baking night. NOM NOM NOM NOM.





Ingredients - peanut butter, rolled oats, whole wheat flour, soy milk, veggie stock and baking powder

Shelf Life - 2-3 weeks - these treats are baked for a longer shelf life and a bit more dental help. They're rolled thin, baked on low heat for a longer time then dehydrated so they have a nice crunchy texture.

The winery has an event tomorrow night and Vero works a 4 x 10 schedule so it looks like biscotti baking night is Sunday, more pics then. But in case your dogs are drooling.....




Day .... wait what day is it

Well, for time in the hospital without getting let out to come home, even for a couple hours, then we're on day 5. 15 days since we took him in for lethargy and the biliruben in the urine. Just about two weeks since the diagnosis. From our standpoint though, it would have been day 6, the number of days since our Toby acted like our Toby. Lil buddy stands less than a foot off the ground and weighs in at a whopping 15 lbs (if he's sporting some winter weight), but he is a beast. He's got the fluffy maltipoo tail that could cut through steel when he's real excited. When we walk him he constantly pulls on the leash, a behavior we constantly try to curb but now miss. Really, many of the things we have been trying to train out of Toby are things we would be happy to see. Pulling on the leash, barking when we come home and, of course, the quick bark, pause and running outside to bark at any dog being walked by our yard!

Things had been getting tough, seeing your kid with barely the strength to situp is not easy. Worse is looking into his eyes and seeing the plea, the look that cries "please make it all better dad." Last night though, we got to see Toby, our little guy, He sat right up and had tons of besos for us. We took the camera in this morning and caught his face licking, smiling happiness.

face licking goodness


yeah, he licks his own face too

and a good solid head shake

It was a small victory but it meant a great deal. There had been some tough conversations about what the right thing to do was, whether we were doing this for us or if Toby would want this. Lots of tears, lots of leaning on family for love, but seeing Toby brought us all back together, back to the fight.

We just got back from the hospital and the nurse on duty suggested we take him out to see if he wants to pee. He did, and the good news about that was that she tested him and he didn't have any ketones in his urine, suggesting he is through the DKA. After he peed he stood at the edge of the sidewalk, looking at our car. He knows it's ours, he knows he wants to go in it, he knows he wants to be at home with us. We miss Toby, we miss the little white fluff trotting through the house and that big pom pom of a tail wagging in excitement. Night Toby, we'll see you in the morning.



The Family

Hi All, Thank you to everyone who is reposting this! I know some of you don't know us personally so allow me to introduce our little family.

John, Veronica, Toby (aka Toby Tobes or Tobes), Meg (aka MegMeg or Lil Baby MegMeg) and Pepper (aka Silly Chili Pepper)


Veronica and I met and fell in love in Chicago where we're both from. We both worked as employee benefits consultants in downtown Chicago, had a great condo in Old Town and spent our free time exploring the city for adventures. Life was good, but we wanted great. Three years ago we had a great opportunity to rent a house up near Hood Mountain in Sonoma County and decided it was time for a change and time to explore different fields in search of passion. I found a job at Deerfield Ranch Winery and Veronica started working as a receptionist at an animal hospital in Santa Rosa. Things moved pretty quick and within 6 months of being here we owned a foreclosed home that we fix up in our spare time and Vero starting working as a nurse at the hospital. We knew we wanted dogs someday and kept saying that once we get more of the house done, then it would be the right time. The right time found us though.

Enter Toby, our now 8 yo maltipoo.

Toby had been drinking more water and peeing in the house. Sidebar - if you really know Toby, he pees in the house to tell you something is wrong. Since his IMHA diagnosis he has peed inside a few times to let us know we need to take him in. All the floors in the house are finished except for one room which has some cardboard boxes on it for us to take out. He always pees on those boxes. He's not trying to hurt anything, it's just a way for him to communicate how he feels. Anyway, so Toby was drinking more and peeing inside. His family brought him in and turns out he was diabetic. Not life threatening diabetic but he would need insulin. His family decided that they couldn't care for him and the doctor persuaded them to surrender Toby to the hospital instead of euthanizing him. Before we met Toby, the decision was made rationally that with my work as a former volunteer paramedic and Veronica as a nurse, we could easily draw up and administer insulin (in fact, anyone can easily draw up and administer insulin). Once we met Toby, rational gave way to emotional and we brought our gorgeous boy home. Toby came from a one dog family and entered a one dog family. He was spoiled with belly rubs and long walks. Life was great and we were getting more done on the house so we started looking for another dog, both because we love dogs and to find Toby a friend. Quick note, for those of you who have experience with diabetic dogs, yes he got cataracts and yes he has had the surgery. Lil man loves his new eyes, that was a great day for our family. More on that at another time.

Enter Meg, shown here as the thing we call "blanket monster"

Meg, a long haired Jack Russel, was saved by another hospital in Sonoma. At the time, she was 12 years old, very itchy and suffered from untreated glaucoma. Similar story as Toby, the doctor persuaded the owners to release meg and one of the nurses fostered her. We took Toby over to meet Meg and walked them over to a park. His indifference to her was HUGE! Huge as in great in this context, Our Toby is a beast of a dog who would take on Godzilla if he saw him pee on our yard. We brought Meg home for a sleep over and by day 2 they were calmly accepting of each other. We got to know Meg, brought her into the pack and started trying to regulate the pressure in her eyes and her itchy skin. There came a time when we weren't sure we had done the right thing though. She didn't seem to have much motivation to go walking and was often lethargic, blind dogs tend to sleep more but we worried about her. Then the blessing in disguise, Meg got an ulcer on her eye. We ended up talking to a surgeon about enucleation, removing her eye. The conversation was emotional but looking back, entirely unnecessary. Meg had no vision, she may have had the slightest concept of light but only to perceive night and day, not enough to see shadows. So out comes the first eye. Pressure goes weird on the other, out comes the second. Post op Meg was the happiest lil MegMeg we had met to date, huge snout full of grin and happy grunts! Turns out the pressure in her eye had most likely been giving her a headache, a DECADE LONG HEADACHE. Our no eye Meg loves walks, loves belly rubs and loves rubbing on furniture (based on her shedding we suspect she is attempting to build a twin and sneak out to go party in SF, a la Ferris Bueller style, we're watching you MegMeg). Energetic Meg and Toby are great friends, they aren't too mushy about it but they are great together.

And then, Pepper.

Life again fell into a routine and we completed more of the house. We decided that once we got everything but the kitchen done we would get a third dog. I love when we make these rational decision, they're so funny in retrospect. Pepper, a ~8yo Cocker Spaniel came into the hospital with a good Samaritan who recognized her unhealthy appearance. With patchy hair, oily skin covered in wart like growths and weighing in under 14lbs (for her size, she should be 25-30lbs), Pepper needed some love. Funny thing, before Vero had even seen her, one of the doctors joked to a few nurses "Have you seen Veronica's new dog yet." Although said as a joke, we love it, we're proud to have that kind of reputation. Pepper was stabilized at the hospital and the animal control came to get her, before they left with her Vero gave them her phone number and said call before you put her down. Shelter protocols can be debated all day long depending on if you view them as a business, public service or a municipal humane service but at the end of the day, it was going to take months to get Pepper up to weight and even then she would still have Sebhorrea (oily, itchy skin with patchy hair and crustys). So we got the call. Some people asked why adopt Pepper when so many other dogs have such a better chance. Some people asked if we were just going to foster her. The best I can describe out motivation, we want to love the ones that need love the most. We rescued a puppy from our neighbors a while back. They had gotten the dog as a gift but that person couldn't take them so we offered to take find her a home. This pup was gorgeous, great Burmese Mtn Dog with mits the size of his face and a beautiful coat. Looking at him, we just called the HS, they were full, so we went down to animal control to surrender him. Before we left 2 employees and a person in the lobby were asking when he would be available for adoption. That guy will be loved, Pepper needed to be too. We're still getting to know Pepper but in 2 months she has put on 4 lbs and has much more energy and a much improved demeanor. She is still learning that this pack is forever, but she'll get it.

We love our family and things are tough with Toby in the hospital but you do what you have to for family, so we stick together to get through this. Last night was a big night for Toby, he ate a couple ounces of chicken and didn't vomit. He slept through the night and his pic was from this morning(5/13), he sat right up and had tons of besos (kisses in spanish) for us. Take a good look in his eyes, he actually looked like himself, there was joy in his eyes for the first time in a week!

Thanks
John, Vero, Toby, Meg and Pepper


Time for Toby

Looks like blogger is still re-launching everything, this is a repost from our FB note.

Toby is an adorable malti-poo who was diagnosed with diabetes a couple years ago. At the time his family was unable to care for his desease and rather than euthanize, we convinved them to release Toby to our home. Toby quickly stole our hearts and became a beloved family member. Recently, Toby was diagnosed with IMHA, Immune Mediated Hemolytic Anemia, a disease noted by his immune system attacking his red blood cells. The treatment for IMHA significantly worsened his diabetes and in a short time he was hospitalized.
Toby's bills are quickly rising and he has a long road ahead of him to get stabilized. When he joined this family we made him a promise to fight for him, to give him the time he needs to get through this. To help Toby we are selling Time for Toby Biscuits, available for both people and dogs. Please help us fight for Toby, please help us give him more time.

Wednesday, May 11, 2011

Is there a cure

No, not in the sense that we can get rid of these diseases. That's why Toby needs time, so we can get him balanced. Toby's diabetes is regulated by insulin and diet. The IMHA will be drug regulated and closely monitored by testing. The tough thing right now is getting the balance. The drugs for the IMHA are Prednisone, Cyclosporen, Doxycyclin and Leflunemide. The Pred especially wreaks havoc with the diabetes and has created his current DKA, diabetic keto-acidosis, which is basically a flare up of his diabetes.

His situation is basically an episode of House at this point, we are trying to stabilize and regulate him to get our Toby back. We can see it in his eyes, he's actually a bit more there today than yesterday, but he's tired. We're with him day by day, fighting for him, and we know he's fighting to come home with us. That's why we're doing this, because Toby needs time. Time for us to get him regulated, to get the meds right, to get him balanced.

Thank you for your help!