Three Years

Time is a strange thing. There are moments when it seems like three years has gone by in a blink of an eye and yet others when I feel it was more like 300. And to complicate matters more it always seems like it’s nonexistent when you need it most, which certainly is a contributing factor to this anniversary post going up more than two weeks late. Not that it’s the first time; I was a day late for our first year.

Portrait of me and Yara on a white background; Yara is standing beside me with my arms wrapped under her bellyThis last year has been a mixture of good and bad for us as a working team. Yara’s had several relapses with her EPI, another bought of SIBO, and developed severe allergies, but also had the most lengthy times of stability in her health, too. And it was this ongoing struggle that ultimately led to the decision to retire her.

It remains one of the single most difficult things I’ve ever done, which is saying a lot because if there’s one thing I’m not known for it’s being decisive. Having no assurance whatsoever of exactly when a new guide dog match will be made, I’ve spent the last six months trying not dwell on the less pleasant aspects of this. Instead, I’ve done my best to celebrate the time we have left. We had a round of professional photos taken at Washington Park. Three times, in fact. Some of which were chosen when Yara was featured at DailyPuppy.com! I even broke down and got a cake to celebrate her birthday in rare form! I’ve also tried to get in some time with all of Yara’s pals one last time, which of course has included photos.

We’ve done a lot of fun things that haven’t had any involvement in my neurotic and roundabout preparations for Yara’s retirement: we went to the Empire State Book Festival, the Tulip Festival, and the Victorian Stroll (which I still intend to finish a post on). All of these were firsts for Yara — and aside from the Tulip Festival, for me as well! We also took a trip to visit Raechel and James, which included attending this year’s Walk for Fidelco and a trip to Mystic Aquarium for my birthday! Speaking of the Fidelco walkathon, we had Jean take some fabulous photos that became our thank you cards for donors.

Headshot of Yara lying in the grassOh, and we also moved! Which actually did fulfill my hope from last year that this year’s anniversary would be at a much less drama-filled abode. Yara now has an entire house to clomp around in.

More recently, we’ve been preparing for the holidays. Yesterday we even went caroling! Of course there is the usual card, which will be sent out tomorrow barring that my fingers can get through the last 30 or so! The house is all decked out and Yara’s matured enough that I’m not constantly finding ornaments strewn about. In fact, so far the only ornament that’s been knocked off the tree has been by me and that was while decorating it. Unlike last year, we actually managed to get to stores to do some shopping without any unfortunate incidents, though, that hasn’t seemed to help me actually get gifts.

Yara and me lying in the grass togetherYara’s been an amazing addition to my life: a phenomenal guide dog and an exceptional companion. Even though the time wasn’t perfect by any means, I wouldn’t trade the experience. Rather, looking back over the last year — and the two before that, I find myself feeling cheated that our time as a team will be so short. There is so much I had planned to do with her by my side, so many things that I am sure she would have enjoyed and even more that I’m intensely curious as to how she would have reacted. I think, for me, the hardest part of letting go is that I didn’t expect it to be so hard. I’ve done the retiring thing before and thought I knew what it entailed and for more reasons than I am able to articulate, this is so very different than before and so much more difficult.

Short as our time has been, I’ll certainly not soon forget how powerful I have found it to be.

EPI

[EDIT: Quick reminder that is related to this post — voting is still going on to support EPI research. Please consider clicking over for the five seconds it takes to add your vote!]

If you’ve been following my semi-constant whinging on about Yara on Facebook and/or Twitter, then you’re well aware times is not good.

Basically the positive news we got from her last round of tests at the vet in July isn’t lasting. Since her major rebound of SIBO last month she’s been on-and-off sick. It’s incredibly inconsistent and until yesterday hadn’t manifested into accidents in the house. Her stool would be somewhat soft one day and then the next it’d be fine.

Anyway, over the last few days she’s had very loose stool and then yesterday morning she had a middle-of-the-night accident in the house that was very close to the “cow plop” type stool that is a trademark of pancreatic issues. And it was quite a somewhat larger amount of fecal matter than is her normal; another hallmark of EPI. So, I called in.1

The vet and I are kind of stumped. All things considered I’m doing pretty much everything I can to keep Yara healthy with regards to her EPI. But the research the both of us have done basically seems to suggest that sometimes dogs just have issues and there’s no rhyme or reason as to what works for one dog and doesn’t for another. But given Yara’s results from July, we’re going with the assumption the current issues are stemming from low B12 levels. She has B12 added to her food,2 but we’ve decided that isn’t enough and so for the foreseeable future Yara’s now back on weekly B12 injections. You can imagine how much I’m looking forward to this.

We’re trying to avoid putting her back on Metronidazole, the antibiotic she was just on for the SIBO incident. She’s been on it now three different times and while it’s helpful, it’s a bit on the aggressive side. However, given the loose stool her vet is concerned that she might develop another bought of SIBO, so to offset that possibility she’s put Yara on Tylan Powder for two weeks. Because of that I’m giving her Forti-Flora, which is a bit of a stronger pro-biotic than those found the cultured yogurt I generally add to Yara’s food.

Hopefully she’ll improve. She did get sick again last night, which I only discovered as I was headed out the door to work, so we’re home for the day again just to be on the safe side. Yara has an appointment on November 11th for her rabies shot and I’ve now amended that to include a full exam to check up on her. That is if we don’t end up going in before then.

As for me? I’m very torn by all of this. I can’t help but think how I’d have given up long ago if this were just a pet of mine dealing with this. And then I feel horribly callous for thinking that.

I’m just worn out, I guess.

  1. Well, actually the fact that my para-transit bus rolled into my driveway at 5:45 a.m. (35 minutes before it’s scheduled pick up and an hour ahead of it’s “usual” time) had a bit to do with this, too. Since I’d spent the majority of my awake time cleaning up after the dog, I was hardly ready. In fact, I was still in my jammies!
  2. Along with her enzyme supplements, omega-3 fatty acid and probiotics.

Health and “Hunger”

So, after an absolutely hellish Saturday morning and three more days of being woken up at oh-god-thirty to clean up a diarrhea accident and spending roughly $150 at the vet Tuesday, I am happy to say that Yara is doing pretty much fine. Yesterday she had her first formed stool. It’s still very soft, but is a nice, normal color which means she isn’t reacting to the prescription food.

As for me, I caught a stomach bug and spent Wednesday morning having my own issues at oh-god-thirty. Thankfully, I didn’t have to clean up after myself, though.

On a similar topic, epi4dogs.com is hoping to raise some money through Pepsi Refresh for EPI research and a general information/awareness campaign. I’m fully in support of this and hope that you’ll take the few seconds out of your time to click over to that there link and cast your vote. There are some other very worthy causes that you can also vote for, too. I’m sure I sound like a broken record and it’s hard not to after all of our struggles with this horrible condition, but there really needs to be more awareness of EPI. GSDs are the most common breed of dog to be afflicted, but it isn’t a condition solely limited to them. The belief is that EPI is caused through genetics and the aim of the research going on at Clemson University, which is where these funds would go, is to determine the exact genes that create this abnormality.

The other portion of the raised funds will be used towards an ongoing awareness campaign to spread knowledge and information about EPI. While EPI is manageable with proper treatment, there are dogs that die from the extreme effects. Diagnosis can take a long time, especially if the vet you are working with is ignorant of EPI and the symptoms. Without proper treatment, these dogs are literally starving to death. Sadly, some dogs are diagnosed too late and the malnourishment they suffered from EPI has done permanent damage to vital organs. Having a support system during the initial diagnosis and treatment process is absolutely invaluable. I can’t tell you how thankful I am for both of the vets that Yara has seen over the last three years; they’re informed about this illness and better yet they are both invested in Yara. But unfortunately there are still so many vets out there who have never heard of EPI (it’s only been recently it’s been taught in vet school, and I’m not even sure every school covers it) and that leaves a lot of dogs in a very scary place.

Somewhat related to the above in the sense of starving to death at least, I just finished reading Hunger, which is a fascinating young adult novel by the phenomenal Jackie Morse Kessler. (Otherwise known as Jackie Kessler, author of the Hell on Earth series.) It’s the story of Lisabeth, a seventeen-year-old anorexic who is one of the Four Horsemen . . . the Black Rider, Famine. Really, that was all I needed to know to pique my curiosity, which was good because that’s about the extent of the blurb.

Book cover

I feel I should have so much to say about Hunger because it is such a powerful read. Instead I’m left completely blown away and nearly speechless at this terribly short, yet incredibly intense novel. Kessler has managed to take eating disorders and weave a fiercely unrelenting story without being the tiniest bit preachy on the subject. She doesn’t shirk away from the pure physicality or raw emotion and presents Lisa’s suffering in a tangible and gripping way.

What initially piqued my interest in the book was the vague description I’d had of it. I’m sure if I’d really searched I could have found out more, but I was thoroughly intrigued by how the author would intermingle these two ideas. (Turns out, as she explains in notes at the back of the book, this isn’t exactly a foreign concept in literature . . . or at least comics.) It’s a truly fascinating juxtaposition and, aside from the uncompromising nature of Lisa’s (and Tammy’s) struggles with food, was the main force compelling me to read on further.

Basically, I’m left kind of bereft of words. It really is a fantastic book.

Yara

While I don’t feel the need to share every last detail of my life with the whole of the intarwebs, I’m not exactly a private person. So, the fact that this announcement is not news to a mere five people is saying a lot.

On June 17th I started the process to retire Yara and obtain a successor guide dog from Fidelco. It still feels incredibly surreal to me. Many of you who know me off the web and probably a good portion of you who do not but are familiar with service animals and our particular health struggles are most probably not surprised that this has been a decision I’ve mulled over for quite some time. Actually making the final decision and going forward from there was hardly easy. Not that retiring a guide dog is ever easy.

Aside from her health issues, I sincerely have no complaints about her as a guide. I won’t say that she never has a moment of distraction or doesn’t make a mistake now and again, but from that very first day in frigid downtown Schenectady when we took our initial steps together she has always been my partner. I don’t think I can adequately express it in words without sounding like I’m exaggerating or being boastful so you can believe me or not. So far as I’m concerned, she is without a doubt a wonderful match for me and constantly proves that she’s practically precision in harness and it is because of these things that retiring her nearly breaks my heart.

One thing that I have mostly kept to myself was how rough that first year was while we tried to diagnosis her weight-loss and assorted health issues. There were days that I would just break down and cry because here I had this amazing working dog and for whatever reason she was having accidents all over my apartment on a daily basis. I felt like a failure as a guide dog user because I couldn’t figure out what I was doing wrong that was affecting her so adversely. Worst of all, I felt I was being selfish for wanting to keep her as a guide and cruel for doing so when the reality of it could have been that she just wasn’t cut out to be a guide dog. At least not for me. I was so very near calling Fidelco and begging them to take her back at several points that I remain to this day shocked it didn’t happen. Especially when as I explained once before how she is when she’s being particularly stubborn about not eating.

In fact, it was only a few short weeks before she was ultimately diagnosed with EPI that my paranoia over being the cause of her issues was set to rest. I won’t say that the circumstances were especially ideal, but it was such a relief to voice the fear that Yara was possibly too stressed by the job and have a guide dog instructor calmly reply, “She doesn’t look stressed to me,” without missing a beat. And if my own inner-battle as a competent handler wasn’t enough to drive me towards the idea of giving up on our working relationship, there was also the months of going between Fidelco’s suggestions and my vet’s as to Yara’s health.1

Somehow, though, I muddled through it because I just kept coming back to the fact that she’s such an awesome guide dog. And, perhaps naively, I felt that things would get better. She would always have EPI, but once she was recovered and was back to a healthy weight it would no longer rule my life. Except, it totally does. The fact is I have taken off twice as much sick time from work because of Yara than I have for myself. Rather than call in sick, I went to work all five weeks I suffered from a horrendous viral cold last year because of the pressure from my superiors to not use my paid leave. I’ve gone to work with migraines because I have practically exhausted all of my accruals, which only serves to make the headaches worse through strain and stress. I don’t blame Yara in the least for this; she can’t help being sick. But that fact doesn’t make it less frustrating when she stubbornly refuses to eat for days on end and then is sick from not eating and not getting the proper dosage of enzymes in her system.

On top of this she’s also developed some severe allergy issue. My best assumption is that she’s reacting to something at my grandparents’ house, since both of her major attacks have manifested after we’ve spent extended time there. I realized after our most recent trip to the vet that I can no longer risk her health and can’t bring her to my grandparents’ any longer. And the moment that thought passed through my mind, I quite literally had to catch my breath. Many times through the years I have come across two major situations with my guides in terms of taking them places: I didn’t feel comfortable bringing them with me; or, I’ve been told that I can’t bring my dog to such-and-such place. With the first, it’s always been my own initiative to determine this and has more to do with my willingness to subject them to an uncomfortable environment for them (e.g., a loud concert) or me (e.g., a job interview) or a situation where I wouldn’t feel safe working them (e.g., Friday nights during college wherein I’d most assuredly get drunk while clubbing). On the second, I usually find myself responding that I most certainly can and am eagerly waiting for someone to try and argue differently. But never have I been limited by my dog itself in where I could take her. It was with this realization that I came to the conclusion that this partnership isn’t working.

There’s a lot of good, but the few negatives that exist are far too much to handle. If she were a pet, I think I’d feel differently, but because she is a working dog her health issues greatly impact my own ability to use her as a guide dog. I certainly can’t work a dog that is displaying signs of being ill, but as I live alone I have no one else to step in to care for her and I definitely can’t leave her alone for a day while she’s sick. Frankly, I don’t want to not work her and use a cane instead or leave her in someone else’s care since as her handler that really is my responsibility. Still, the fact is that when I made the decision to work with a guide dog I signed on for a healthy animal. The expectation is that the dog will be as dependable as a white cane. And while it’s not out of the realm of possibility that a guide dog will become ill anymore than a white cane being unbreakable, the reality here is that I have gone above and beyond a bit of give-and-take in this respect. I don’t regret any of that; not the money spent or the time off work or the endless hours stressing myself sick. But it has gotten to a point where I have given as much as I can and it’s time to admit there is no more left. And so, the best alternative is for both of us to move on.

This is a bittersweet event, though, because there are many things I am truly happy about. One, I will be working Yara until Fidelco finds a match for me and as it stands currently the earliest they will call is December.2 So, while her retirement is pending, it is still quite a ways off. I plan to soak up as much enjoyment from this fleeting time we have as I can. Two, while there is no firm answer as to where she will go once retired beyond the fact that I am not keeping her3 there are two very viable options for a superb post-retirement home. Either of which will allow for us to remain connected! I’ll natter on that later. Most probably when there is solid news to share. And, third, as difficult as it is to let go of a guide dog, it’s hard to not be excited about getting a new dog. Even if that is still a ways off, I’m still a bit giddy about the prospects of my next guide and making a new friend.

I was going to get into the specifics on the retirement/reapplication process, but this post has gotten a might long, so I’ll save that for a subsequent post. Instead, I want to end this with a very heartfelt thank you to the handful of people who have been “in the know” about this entire situation. I was hardly in the best frame of mind before this became official. I had many qualms about this and a list as long as my arm of questions that I wasn’t sure I’d ever get answered. And without those few ears and shoulders I probably would have shattered into pieces. But just as important was that these same glorious people were around after the decision was made to listen intently to my play-by-play of the most finite details and reassure me. Everyone should be so fortunate to have such a great support system as you. <3

  1. I won’t even get into the aftermath of her diagnosis here because just thinking about it sets my teeth on edge.
  2. I am not entirely happy about the very real possibility of training during the winter again.
  3. Much as I would love to, keeping her as a pet wouldn’t alleviate the issues of her health impacting my life. Also, as spacious as my apartment is, it’s not an ideal home for two big dogs.

November 3, 2008

Dr. Gundersen called earlier to give me the results of Yara’s GI test and the good news is that we do have a concrete answer as to her weight loss.

The bad news is that she has exocrine pancreatic insufficiency and small intestinal bacterial overgrowth. Which means she’ll need to be on an enzyme supplement. For the next month, she’ll be on antibiotics to kill the bacterial overgrowth and probiotics to rebuild the proper bacteria in her intestines, as well as weekly B12 shots for the next two months. The vet also suggested a prescription diet of Purina EN as it’s lowfat and low in fiber, but frankly so is the food she’s on and I think it’s better quality. Not to mention since I switched her to the reduced fat EVO, her stools went from kind of tan and mushy to completely normal. We’ll see on that.

Anyway, the enzyme supplement will probably be required for her entire life and is roughly $150 a month. The antibiotics, shots, and probiotics will hopefully only be necessary for the next month or two. But at this point nothing is certain. Will continue to keep everyone updated as I find out more.

EDIT: Spent over $350 at the vet’s yesterday getting all of Yara’s supplies and her B12 shot. We’ll be going back next week for a quick follow-up and to receive another shot; I’m planning to purchase the other six doses then and administer them myself. Two meals down and Yara seems completely unaffected by all this stuff added to her food, she very happily cleaned her bowl both times. She does seem very interested in all the fuss made over its preparation, she sits in the kitchen watching me aptly.