Jake's Story, Part 2 Over time, Jake started to really have trouble getting up and some mild discomfort and I brought him in but the vet still found nothing wrong with his hips. He gave us some Deramaxx but it didn't seem to help much and it scared me and so he wasn't on it long. Then he seemed to have more pain and lots of trouble getting up. So I called the vet for some Rimadyl and he faxed a script to Walgreens and so Jake started on Rimadyl. This still all seemed like a natural progression to me and I was not real concerned. I felt surely we would find a way to manage it. The Rimadyl helped him immensely and as he went back to his old self, I realized with shame that I had not understood how much pain he had been in. It had been so gradual that I had not realized the extent of it. It was great to see him bounce back. However, after about a month, the Rimadyl did not seem to be helping and he was really having trouble getting up again and so back to the vet we went. Jake was really having trouble walking by this time and when the vet saw him, he seemed surprised. "He is having neurological problems!" he said with concern. The vet took some more x-rays and did the paw test. He picked up a back leg and flipped his toes under and set the leg back down again. A normal dog will immediately right the toes, but Jake did not seem to realize his toes were flipped under. The vet sat me down and explained that Jake would need to see a vet neurologist for further testing to get a diagnosis. I was really shocked but still was confident we would find the problem and fix it. The vet said possibilities were some kind of slipped or protruded disc that can't be seen on an x-ray, assorted disc diseases, and then hesitantly said there was a condition called degenerative myelopathy - or DM - that was common in German Shepherds. I asked what would be the treatment if it was this DM. He quietly said there really is no treatment. He explained there was a protocol that helps some dogs but not all and it is not a cure. But he said it would be unusual that DM would move as quickly as it had on Jake. I took Jake home and looked up DM on the internet. What I read stopped my heart, made my blood run cold, and I burst into tears. As he had said, there was no cure and the dog will continue to loose mobility until complete paralysis. NO I screamed to myself, I will NOT allow my Jake to have this dreadful disease. I made an appointment with the vet neuro and we went to see her. There were a few symptoms that Jake had that did not match DM, but the vet neuro cautioned that DM can present differently in different dogs. We scheduled Jake to have an MRI and spinal tap. After the MRI and while Jake was coming out of the anesthesia, the vet neuro read the films and showed me had a mildly protruded disc and I felt relief. She cautioned me this may or may not be the problem and Jake might still have 'that disease'. She had found DM to be common in large, black dogs. But the only way we were going to find out was surgery. I am sure I was in denial, but I decided that this had to be the cause of Jake's problems and was ecstatic. I had prayed for something to show up on the MRI and it had. I was pretty happy. We scheduled for spinal surgery in December 2004. The day came and I brought Jake to the vet neuro. I was a little nervous, but not too bad and was so hopeful this would fix my beloved Jake. As soon as the vet neuro came out of surgery, her only words were "It was a very mild protrusion and he must have 'that disease'". I was terribly upset but still I realized that was not completely definite and went right into denial. I still had hope maybe the surgeon was wrong and he would fully recover. I bought slings and harnesses to help Jake walk as he recovered and hoped against hope he would walk by himself again. I felt so terrible making him get up to go outside for potty after the surgery as it was very hard on him and I was scared of hurting him inadvertently. I spread some plastic down in the guest bedroom and threw cedar chips on top of that and dragged in some big branches. I was hoping I could fool him into thinking it was close enough to outside that he would simply potty there and not have to go down the ramp. Needless to say, it did not work, but the vet neuro got a chuckle out of it. I continued to research DM and found it was widely mis-overdiagnosed. Since it was diagnosed as a process of exclusion, it could only truly be confirmed through necropsy. And necropsies performed by Dr. R.M. Clemmons, University of Florida and the expert on DM, showed 75% of the dogs diagnosed with DM had not had it. I figured the odds were in our favor. Meanwhile, we had started Jake on a course of physcial therapy including hyrdotherapy. Not only would it help stregnthen him after the surgery, but if he did have DM, exercise was the best way to slow the progression of the disease. He did stregthen as he recovered from the surgery, but never enough to walk again. He seemed to soon plateau to a point where we were not seeing any improvement. I found Dr. Clemmons had developed a DNA test for DM, but it was new and it was developed for German Shepherds (85% of DM cases are GSD) and was not known how well it would work on other breeds. We sent in a sample and it came back negative. I was so happy and allowed myself to hope he did not have DM. At this point, with him not improving, I made an appt to take Jake to the man himself, Dr. Clemmons. Lucky for us, we lived only about 2 hours from the U of FL. On the appointed day, I packed him up and we set out on the drive up to Gainesville. Dr. Clemmons was wonderful and thorough and talked to us for a long time explaining as best he could in layman's terms about DM. He felt - as I did - that it was possible something else was wrong with Jake. His symptoms did not quite fit the profile, but that did not neccessarily mean he did not have DM, as DM can present so differently amongst individual dogs and breeds. I left Jake there for another round of testing and returned home praying something would be found. The next day I received a call that nothing had been found and at this point, we would need to consider that Jake did indeed have DM. I guess deep down I knew that already. It was time to let go of the denial. My baby - my heart and soul, and the sunshine of my life - did indeed have a progressive, uncurable, fatal disease. Before I had taken Jake to Dr. Clemmons, I had read that he was preparing to do a stem cell study on DM dogs, but based on reading the requirements for participation, I wasn't hopeful we would be eligible for the study. To my surprise, Dr. Clemmons did discuss it with us. But it was a few months off, and being an amazingly ethical doctor, Dr. Clemmons said we first had to try a few other things to try to help Jake before we would think about the stem cells. First, we tried the protocol he developed that does help slow the progression in some DM dogs. Sadly, for us it did not seem to help. Jake was deteriorating at a rate faster than most DM dogs. We then tried PEG (polyethelyne glycol) which had been shown to be effective in treating dogs with spinal injuries. It was a shot in the dark since DM is a progressive disease. It did help Jake briefly but the disease came right back and a subsequent injection of PEG did not help. By this time, Jake was showing signs of discomfort in his spine (that is not a symptom of DM and is still a mystery what caused that as nothing ever showed up on any tests to explain it) and I knew time was getting short that I would need to let him go. We went again to see Dr. Clemmons and he discussed the stem cells with us and I signed the agreement. It was literally do or die time and my heart was breaking. Part 1 Conclusion |
