My dog Joey and I began 2015 a happy pair: we were both getting a little whiter, but still having fun learning new things. We’d started a nose work class and had a standing meet-up with friends and neighbors at Starbucks before doing a nearly two-mile pack walk through the neighborhood every morning.
My brain understood that Joey was 13 years old — at least, because who really knows how old a rescued dog really is — but my heart kept focusing on how well other, even older dogs were doing. The dachshund next door lived to be 16. And Joey is a little dog and still active, so he has years to look forward to before I need to worry about old age issues, right?
The changes crept up on us stealthily. In May, Joey seemed to be walking a little slower than he had before. We took a break from nose work classes because I went to a conference in early June. When I returned, his walking speed had really slowed; it tried my patience. It wasn’t the old stop-to-sniff-every-tree-and-bush slowness. It was an old man, side-to-side waddle and difficulty putting one paw in front of the other. He also started licking his paws for hours on end.
A visit to his vet resulted in a diagnosis of back pain; he clearly cringed when she gently ran her hands down his back. She ordered lab work. His eyesight was bad and his hearing was going. The licking, she said, was an allergy.
The blood work came back with no surprises or red flags. His liver enzymes were slightly elevated, so giving him an anti-inflammatory or steroid was out of the question. She gave us a prescription for tramadol, a narcotic-like pain reliever.
A week of tramadol made no difference in Joey’s gait or ease of movement. We went back to the vet.
The vet’s office panics Joey. The terrier who could barely get down our hallway at home was bouncing on and off the couch in the examining room and clawing the linoleum to get out the door. “See?” the vet said. “That’s not a dog in pain!” When I pointed out that the dog she was seeing was not the dog I lived with from day to day, she said she was at a loss for what to do next.
So we went home, still faced with the same issues that had taken us to the vet in the first place.
I reached out to dog-loving friends for a referral to another for a second opinion.
Searching for more answers.
The second vet got the same cringe reaction as the original vet. She recommended laser treatments for his hip joints, acupuncture, B12 shots and a change to a home-cooked diet. The paw-licking is an allergy, she said.
During the course of her examination, she raised the issues of disorientation, confusion and the possibility of canine cognitive dysfunction. That had never occurred to me. The more attention I paid, the more signs I could see. A check of Google, however, showed that while Joey may have had some signs of cognitive dysfunction, he certainly didn’t have all or most of them.
But all of the efforts we made led to modest spike of improvement that always fell back to a dwindling state. At best, Joey’s downhill slide leveled out. Still thinking the issue was back or joint pain, his new vet decided to try a low dose of anti-inflammatory followed by a blood test.
The paw-licking continued. Joey licked raw, red hairless bumps on his paws. His pads hardened. A rusty crust developed between his toes. Because he couldn’t walk easily, his claws grew long. I took him to his original vet to get them clipped. I told the vet tech that his feet were sensitive. They returned him to me telling me how they had taken time and care in clipping his claws.
The vet techs at the second vet office a month later were much more concerned about his paws as they prepared to do the blood draw. He definitely needed a pedicure, but anyone trying to clip his claws couldn’t possibly ignore how necrotic his paws had become. They flagged a vet to take a look.
“This is much deeper than an allergy,” she said. We talked about the unfolding changes I’d noticed: the slow, painful gait; the coat that had gone from flat and sleek to dry to increasingly curly, brittle and cottony (“disordered” the vet described it). The paw-licking had broadened out to include licking his penis with growing skin problems there. It could be a skin problem, the vet suggested, but the coat issues suggested something more systemic. She recommended an abdominal ultrasound to rule out tumors or possible cancers of the liver or pancreas.
The diagnosis: hepatocutaneous syndrome.
The ultrasound, done ironically on Friday the 13th, came back with bad news: Joey has hepatocutaneous syndrome, a liver disease that makes its presence known by protein and fatty acid deficiencies in the skin. He probably has six to eight months left to live. While there’s no cure, there is a treatment — intravenously giving him infusions of amino acids — to help relieve some of the deficiency issues.
As the changes mount in our lives — new diet, new medications to support his liver and puppy pads to deal with increasingly unpredictable bladder control — I haven’t fully acknowledged the terrible loss coming toward me.
Having a name for the problem is a relief, though. The infinite possibilities narrow down to one diagnosis. The endless list of things you could or perhaps should try to see if they help evaporates.
Everything clarifies to how to keep his remaining days peaceful and comfortable.