Trials and Triumphs

Exocrine pancreatic insufficiency (EPI) is a genetic condition where the pancreas does not produce the necessary enzymes required to digest food and absorb nutrients causing starvation regardless of the amount of food taken in. For further information and other resources on EPI I highly recommend visiting epi4dogs.com because my knowledge comes entirely through my experiences with Yara. Much of which has been chronicled here on my blog.

EPI is highly treatable, thankfully, but to say the entire thing was a struggle is truly an understatement. Yara has a penchant for stubbornness and from practically the moment she entered my life her choice method to showcase this was refusing to eat. Looking back it’s hard not to focus on all the mistakes that I made. Signs of her EPI were present from the moment she entered my life; her bowel movements were a tan color and always disproportionately large in comparison to how much she ate. Our instructor assured me that this was normal and so I never gave much thought to it. At her first annual checkup she got a clean bill of health, but had dropped an alarming twelve pounds! The weight loss continued steadily over the next three months, which was certainly baffling but not exactly alarming. Other than a noticeable increase in her bowel movements and an occasional bout of diarrhea or vomiting Yara seemed fine.

Portrait of me and Yara on a white background; Yara is standing beside me with my arms wrapped under her bellyThroughout this I was in constant contact with Yara’s school, Fidelco. They were very sympathetic, but hardly alarmed by the weight loss. They offered a bunch of suggestions that included adding everything from vitamin supplements and probiotics to canned dog food and raw beef to her daily meals. At her peak Yara was eating what amounted to more than nine cups of food a day! The addition of the raw beef ignited the first undeniable symptoms of EPI; Yara’s stools morphed into a bright yellow “cow plop” and she started vomiting almost daily. It was exactly the worst thing she could have had in her diet, but I’m strangely grateful that we did because it alerted everyone to how serious things were. Still, it would take nearly two months before she was formally diagnosed. She had a battery of different tests run and they all returned normal results; in fact, the GI test that determined her EPI diagnosis initially showed that she was “marginally” in the range.

By that point I was fully on board with whatever the vet told me. Yara was clearly sick! She never was as ravaged as some EPI dogs I’ve seen, but her ribs were clearly visible at the height of her weight loss. (This photo is the best example I could find.) A fact that the general public made me aware of almost constantly. In fact, there was even a formal complaint made to Fidelco! I tried not to take it as a personal offense when they sent a trainer out within a few days to check on things while for months before they were made aware of the entire situation at every interval and had been completely nonplussed.

The resounding memory of these six months is the amount of stress I was under. I felt pressure from Fidelco to take their advice against my own better judgment or that of my vet’s. This greatly influenced the length of time it took to diagnosis Yara. On the rare occasion that I didn’t side with the school it was made abundantly clear they felt that decision was the root of the problem. I had changed her food, for instance, so that might be the culprit because she was used to the other food. Admittedly, I took a substantial amount of time off because of Yara, but my superiors at work were largely unsympathetic. The level of passive aggression and outright punishment directed towards me probably only furthered my own health issues with chronic migraines. So, when I needed time off because I was sick it was a Big Problem. And I got no respite because everyone from my family and friends to outright strangers made it known how bad things were. People made a point to remark about how thin Yara was and suggest ways to offset this. (“I think you need to feed her more.”) On countless occasions I was accosted in public about my “obvious” abuse; one woman actually dragged me by the arm while literally in the middle of crossing a street to yell at me!

Portrait of me and Yara on a white background; Yara is in harness, lying on the floor beside me, resting her head on my kneeWorst of all was my own personal struggle. I scoured every possible resource for anything that might help. Perhaps she was sensitive to chemicals and so along with her various food alterations she drank only purified water. For months. I changed all of my cleaning and laundry supplies to green products, which I admit I had wanted to do anyway because of my migraines. I went so far as to replace all of her bedding, including a very expensive bed, thinking that she might have an allergy (which she does but that’s a whole other story) and began a long process of eliminating things one by one to determine the cause. But with every change that netted no resolution I kept coming back to one constant: me.

Part of me couldn’t believe that this was possible. I rejected the notion that I was the problem by reminding myself of her nearly flawless work in harness. But every time she refused a morsel of food or had an accident in the house I became just a bit more convinced that she was stressed out by her job. I felt like a rotten human being; I was selfish to want to keep working her and cruel to continue to do so if she wasn’t cut out for this life. Mostly, I felt like a failure. The partnership was faltering and I couldn’t fix it. I was increasingly convinced I was doing something wrong, but proud enough that I wouldn’t dare admit it. Friends tell me they guessed as much, but I never told anyone how bad it really was for me or how close I came to calling Fidelco to take Yara back. To this day I can’t tell you what stopped me. I could say I didn’t want to give up, but I did. I could say that I didn’t want to be parted from her, but that’s hard to believe when every room in the house is covered in dog sick.

Obviously it wasn’t all for naught and we made it through all of this. Yara’s recovery was very swift and though I did eventually retire her because of her health issues it actually had very little to do with any of this or the fact she has EPI. I’ve since remarked on how profoundly she impacted my life in her short working career even though we had more than our fair share of “downs.” Not that I want to repeat it, but I don’t regret the struggle. For all I know it only made the bond we shared even stronger. Mostly, it made me appreciate all the positives we had. Sometimes it was a way to distract myself from how miserable things were and other times that focus was the driving force behind figuring it all out. Together, we accomplished so much!


This post was written as part of the fifth Assistance Dog Blog Carnival. This edition’s theme is “Achievement” and further information can be found here on the founder’s blog.

Comments

  1. Wow! I can’t believe it took your vet and the school so long to diagnose her! What a long, miserable ordeal. I’m glad you did triumph eventually, even though you did eventually have to retire her.

    • Being that this is a summation of six months or more of events it’s hard to convey all the information. But the fact it took so long to diagnose her wasn’t the fault of anyone, especially not my vet. It was a combination of many things that dragged out the diagnosis, most of which was Yara herself who was virtually asymptomatic aside from the rapid weight-loss. If you really dig through the archives here you can get a better picture of what happened, but suffice it to say it was a complicated situation.

      Part of me is still sad about retiring her. I still feel a bit cheated that our partnership was so short. But I am very happy with Uschi and Yara is still in my life, albeit a bit removed, which reminds me I should call my dad. . . .

  2. Oh My! My heart breaks for you and Yara. I’ve heard similar stories where programs could not or would not see the big picture because they would not Ok vets to do what the vets felt would bring about answers but this one breaks my heart in ways I can’t quite pinpoint.
    Perhaps its because digestive woes have been part of both my boys journeys- Thane’s for sure from Giardia followed by Lyme. I get the struggles for answers, the way the public responds, the struggle for your own stress and health as you try and help a dog that no one seems capable of helping.
    Shaking my head- I have known others with guides who went through similar roads some with EPI diagnosis in the end. I am so glad that you wrote about this- bringing awareness to a disease that isn’t always the first thought a school or vet has when digestion is a factor.
    We learn such huge lessons from our partners with medical hurdles. I thought I had been taught just about everything I could be through my two boys and then I read your journey and realized I have so many more things to learn about
    Hugs

    • First let me stress one thing, Fidelco is far more aware of EPI and they do have an entirely different structure when it comes to guides with medical issues. It wasn’t really relevant to this post to get into all that or what happened during Yara’s recovery, but I don’t blame the school for what happened, though I am glad they took stock of things and have made changes.

      I definitely learned a lot from Yara. Obviously, I learned about EPI and SIBO and severe allergies. Mostly, I learned how deeply I could bond with my guide dog. I had thought my first dog and I were bonded quite well and worked like a well-oiled machine, but it really pales in comparison. A not small part of me still feels cheated that we only got three years together, but that only makes me more grateful we had that long.

      The one interesting thing I learned from all this is that I had very unrealistic expectations for what a guide dog should be or what I would tolerate in a partnership. I used to think handlers that worked dogs with chronic health issues, regardless of the severity, were just crazy. (Though, a severe illness is definitely something else altogether.) I couldn’t imagine having a working dog that wasn’t in peak physical condition and figured I would never accept anything but that. And the entire time I was trying to diagnose and later treat Yara’s health I never even thought about getting another match; her guide work was never an issue and that was the crux of it. I remember a few people I work with, who know very little about assistance dogs, actually asked about getting another guide dog (well, one specifically told me to). After I got over the initial insult that I felt, I was just baffled by the idea. I mean, why would I do that?

  3. I still can’t even imagine the level of pain you went through prior to Yara’s diagnosis. To come to the conclusion that you are the problem, it just has to be incredibly heart-wrenching. I do know the huge relief once the dog’s real problem is found, and treatment to help begins…

    • I find it difficult to talk about, honestly. Not because of the insecurities I was going through at the time — I’m removed enough from that now through the passage of time — but more because I can’t quite articulate where my head was. I don’t generally think of myself as lacking in self-confidence or being filled with self-doubt, which is what I think compounded the issue. I didn’t want to admit that I was even harboring these thoughts, let alone that it was really a possibility. I always figured if a partnership didn’t work out it would be because of the dog, not a lack of ability on my part. So, yeah, it was a pretty dark place to be emotionally and I really don’t know how I kept it from showing to other people. Honestly, the more I think about that year the more bewildered I am by my own actions. Totally worth it and I wouldn’t change a thing, but sometimes even I think I was crazy.

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