Tuesday, November 30, 2010

The End of Life Sub-Blog 1(2)

We still have no idea what is going on with Mrs. Maize but we have picked a path. I met with the vet and we agreed her lump is not smaller, and that doing blood work would not yield any additional answers. Yes, it could tell us whether she had an infection or not -- but that answer could be unrelated to the lump.

Complicating the picture (and creating context) are these things:

1. Maize keeps having front end limping -- it is mostly just a little hitch but three times in the past week has been significant enough to require an anti-inflammatory. Related to the lump -- or not? An infection -- or not? Age -- or not?

2. If the lump is a symptom of something treatable (based on a benefits/burdens analysis), we will treat -- there is no shame in wanting to extend life.

3. Maize had what seems to have been a seizure three weeks ago; this makes me reluctant to use a general anesthesia with her, which was recommended for the biopsy.

4. Maize seems to be feeling fine and is happy -- in no way is she acting sick or ready to make her earthly exit.

And so I talked to the vet about all this, and we agreed that a reasonable plan was to use a sedative and local anesthesia to do a biopsy of the lump. This eliminates the risks of general anesthesia but will give us knowledge of the composition of her lump, which will suggest a direction (or not). Dear Husband was consulted, and he also agreed with this plan -- so we are set for Thursday.

Two things about the biopsy -- we will send it to two different labs in order to immediately have a second opinion. Also, we will put "breed unknown" on the paperwork in order to increase the odds of an objective opinion. There is concern that when "Bernese Mountain Dog" is attached, there is a leaning towards histio; we want to avoid even the chance of a breed bias.

And so that is the plan -- Thursday at 8:45 we will go to the vet and I will stay there as I will not leave dogs at the vet. They will do the biopsy, Maize will have a few stitches and a sore shoulder, and then we will wait and see what the results suggests for the next step.

I think this is a nice "middle" approach, honoring both the possibility that Maize might need life extending care and that Maize does not deserve to assume unnecessary risk.

That said, given all this -- Maize probably has a benign mass and will live to be 15, dropping dead only after George the deer attacks her for chasing his mom, Heidi Marie.

Monday, November 29, 2010

Galen's Blog Contributions

While I was at work today, Galen took a couple of very nice pictures that are Blog Worthy -- let's start with this one of George...

I explained to Galen how I knew it was George and he said I need to get out more and it was not normal to know so much about the deer -- he probably has a point...

And here we have an unposed three generation picture! Syd is in the middle with her mom on one side and grandma on the other -- how cute is that?!

I hope your week is off to an excellent start!

Saturday, November 27, 2010

More Saturday Happenings in Montana

Asia and Mac decided to do some pruning

Zoey practiced looking beautiful (successfully I think :)

Asia and Zoey -- Asia has given up and now loves Zoey almost as much as Zoey loves her...

Maize was on duty -- the Chief of the Fun Police kept things in order...

Maize again -- in a quiet moment


Halo, my little calico dog :)


The End of Life Sub-Blog 1(1)

How is that for a title? No worries -- nothing is changed here and all dogs are upright and happy, but if you get the Alpenhorn you will know from the article I wrote for the December edition that I believe in end-of-life planning for dogs.

In the minutes after Abra was euthanized -- with me sobbing over her still and warm body - the vet said, "you made the right decision." I know those were intended to be comforting words from a vet I very much like and respect -- but they weren't.

Euthanizing Abra was NOT the right choice -- it was the ONLY choice -- and that made it the absolutely wrong choice. Further, I said from the time she was diagnosed that I did not want to euthanize her -- I know allowing natural death can be gentle and that symptoms can be managed, and that is what I wanted for Abra and for me. But in veterinary care, end of life care is typically euthanasia and when all you have is a hammer -- well, you know...

The choices at the end of a dog's life should not be uncontrolled suffering/symptoms or euthanasia -- that is wrong, and shame on all vets and owners who think that way. I am not morally opposed to euthanasia -- but I am very opposed to a lack of choice. And guess what?! The end of life is not something that happens to other people's dogs -- it will happen to yours and mine -- and doing it well means thinking about it before we are in the midst of a crisis.

Maize's situation this week has reminded me of this reality, and brought back all those feelings of helplessness that I had when Abra's symptoms were not effectively managed and I made the only humane choice I could during that awful day of crisis. I won't go through that again.

I admire and respect veterinarians -- and I often don't, if I am to be honest, which I try to be. The truth is that they are very important consultants in the lives of our dogs -- but they are not the decision-makers -- WE ARE. No professional of any kind can or should make decisions for us because we are the only experts in what is right for ourselves and our families -- two and four legged members.

My experience as a breeder is that owners too often check their brains at the door when they go to the vet with a dog -- vet says do XYZ to the dog, and owner does it without question, research, discussion, thought, whatever. Critical thinking??!!! Apparently the presence of a veterinarian causes otherwise sensible people to lose this important skill, and the train of medical interventions takes off with someone else as the engineer.

Yes, veterinarians have important -- essential even -- knowledge and skills that we should access and consider as part of our decision-making process, but not as the Word of the Almighty. Consider the recommendation to biopsy Maize's lump -- that came from the pathologist and was relayed to us via our vet.

Okay, that could make perfect sense -- we want to find out what this lump is -- who wouldn't want to know? Well, let's slow this train down and think it through -- because the expert in what is best for Maize and our family is not the pathologist; his or her expertise is important and related to diagnosing, but directing treatment plans? That is not his/her job -- the decision-maker in what is best for Maize is me.

My job as the decision-maker is to consider the input of experts, and to place those recommendations within the context of our situation, our lives, our realities. It is wrong of me to abdicate my responsibility as a decision-maker to anyone else, including a veterinarian.

What do I mean by context? Well, for example, Maize's age (10+ years) and her breed create context. The truth is that she is past the normal life expectancy for a berner, and berners are cancer factories and the cancers usually kill them pretty quickly. We likely would not extend Maize's life through aggressive treatment because at this point, we want her to have quality -- not quantity -- of life, and this reality is part of "context". Her blood work suggests infection -- this is part of "context" and contributes to a decision not to do a more aggressive biopsy. Context consists of all the factors that make a situation unique and individual, and it is what must be considered to design a plan that is also unique and individual.

And so I thought about the recommendation to biopsy -- I considered what benefit would be gained from knowing the exact composition of the lump. We have apparently ruled out Lymphoma -- this is important because Lymphoma is very responsive to chemotherapy so if that, we would want to know in order to make treatment decisions. I am aware that very few other cancers are so treatable, and so a biopsy telling us it is one of the "bad" cancers will give us that knowledge -- but we are unlikely to have any real options in terms of treatment.

I like knowing stuff -- I do. But in this case, my need to know is not worth making Maize go under anesthesia and have a surgery, no matter how minor. I guess what I want to say about that is this: it is not about me. I do not get to make Maize suffer/assume risk just to satisfy my need to know something. If knowing doesn't really change outcome -- and it has risk and/or pain associated with it -- well, we just need to live with a curious mind...

An owner has a responsibility to gain knowledge from a variety of good sources, think carefully and thoughtfully about the options and their burdens/benefits, and then make an informed choice -- that is not the veterinarian's job -- it is ours. We have to live with our choices -- not our veterinarian. And so I called mine and told him/her (there are two -- they are married) MY plan for MY dog -- no biopsy now, follow-up appointment to do a physical exam and discuss options on Tuesday, and give the antibiotics a chance to work on any infection.

I have fired veterinarians who are perfectly good practitioners but who suck at understanding that they are not in charge of my dog's care -- I am. My requirement for my vets is the same as for my own physician -- I want to work respectfully and collaboratively towards common goals with an intelligent, secure professional who has good communication skills and tolerates disagreement. Interestingly, I had a much, much easier time finding a terrific physician for me up here in Montana than I did finding a vet for the dogs -- I wish my own physician was also a vet -- she would be perfect!

But I digress -- the bottom line is this: YOU are in charge of your dog's care -- do not check your brain at the door and become like a five year old following the authority figure's orders. Your dog needs you to think critically, find the best veterinary consultant(s) possible, and stay on as the engineer of that train.

I hope that Maize just has some kind of infection, but it is possible she has something else brewing -- we will know soon enough. And I have already been thinking about potential paths, where I will seek needed information, and so on -- this sub-blog will follow all that with a goal of helping others think through end of life care for their own dogs, even if that care is not needed for many years (fingers and paws crossed that it is MANY years!!!).

Friday, November 26, 2010

MacNews, 4(1)

Our training has been challenged somewhat by weather, but we have adjusted. I have a three car garage that is solely used for training, and so we have shifted gears to obedience since the agility arena is under a foot of snow :)

I am reminded of how many small pieces constitute a simple obedience exercise -- for example, the stand for exam. The dog must stand still, allow the handler to leave, allow the handler to return by walking behind the dog, and the dog must remain still when a complete stranger touches his head, shoulders, and rump -- yikes. And each of those things is further broken in to small steps -- let me give you a couple of examples based on work we are doing.

Today I had Dear Husband help me -- I put Mac on a sit stay (an easier position to hold and more reliable than the stand stay) and stood in front of him. Dear Husband then walked over and touched Mac's head, for which he (Mac, not DH) got a cookie. I returned to heel position (easy since I was right in front of him), gave another cookie and released him.

So even though I am training for the stand for exam, no standing was involved, no distance from the dog was involved, and there was only a single pat on the head. I was very confident that Mac could do this, and I was right -- by breaking the exercise down into small components, he was able to successfully complete a step of the more complex behavior known as "stand for exam" :) It is only by completing each little step that one ever gets to the whole behavior chain that constitutes an obedience exercise.

Another example -- the returning to heel position from a stay. This requires a dog to remain still as you walk behind him -- not easy. Today I did two things to practice this. First, I put Mac on a stay and walked about three feet in front of him and then walked to about three feet from his shoulder -- so I was on the side of him across from his shoulder. I clicked and handed him a cookie for remaining still, and repeated several times. I intentionally did not go farther than I expected him to stay -- I like to build success, not failure.

The second thing I did was put him on a sit stay and then stand right in front of him again. I held a cookie in my left hand and let him nibble on it as he remained still while I walked around him -- so he was eating the cookie and I was moving around him -- the cookie distracted him from thinking too hard about me being behind, and he held his stay just fine. Once in heel position he got the cookie, another one for not releasing himself, and then another one after the release word.

We have also been working on heeling, which he clearly had a working knowledge of before he arrived because he is doing very well. Keeping in mind that it was 20 degrees out and I was wearing 14 layers to stay warm, here are some heeling pictures...

Carting in snow is not easy but we have some nice tire tracks now so we stayed in those. Mac continues to get more comfortable in the cart but isn't perfect yet (I say that for the benefit of those of you who are also training novice dogs :) -- sometimes the cart still worries him and we need the snow to melt so we can do the long, straight driveway to get more "miles" under the harness to help him become more comfortable. However, he is doing very well for a novice dog -- it is all about baby steps :)

This is my favorite picture -- he is sticking his tongue out at me!

And that is the latest from MacHeadquarters, where the snow is deep but the training commitment is deeper :)

More Flittery News!

Not to be outdone by her littermates, Peaches Sula had a very successful weekend recently also using her excellent Kaibab nose. Peaches and her mom, Terri, are involved in a new dog sport that I asked Terri to describe for the Blog -- here is what she shares:

K9 Nose Work as a "sport" was developed by three very experienced detection dog trainers to take something they saw their dogs having fun at while they were working to the wider public and to any dog regardless of breed, age or ability. It's all based on a positive training style and is very self rewarding for the dog. Even if the handler calls an incorrect alert in a trial, while they may not pass the test, the dog is allowed to continue until they find the hide and are rewarded. And yes, you get to feed/reward your dog right on the spot at the find. The dog gets to use one of their best innate skills and develop scent searching as a fun thing to do, as the dog is always the lead and the handler secondary. There is a lot of finesse in learning to read your dog, and the dog learns searching skills specific to the sport. The main skill the handler develops is reading their dog, so handlers can be of most any physical ability or age.

The dog is looking for one of three scents depending on the level of competition. Birch, anise or clove essential oil soaked Q-tips (1-3 heads) are placed either in a small 1" or so tin with holes and a magnet to hold it to metal or in some other type of container, like a pen cap. That is then hidden by the judge and the degree of difficulty of the hide based on the level of the competition. In Nose Work 1 the dog has to be able to get their nose very close to source and alert the handler they have found it, only birch is used. In the higher levels there may be multiple hides, multiple scents, and the hides are more difficult to find or reach and in larger areas and an unknown quantity of hides or no hides in which you would call a room "clear". In addition to finding the hide time is a factor as well as handling scores. You can get a title by passing all four elements, Container Search, Interior Search, Exterior Search and Vehicle Search. You can get various top 3 placements by having the fastest time(s) and highest handling score(s) in one or multiple elements and/or as teams.

It is meant to be FUN for the dog, and because of that it is FUN for the handler. And you can do it regardless of whether you want to compete or not. Heck we go to Home Depot once a week and hide things around the store and then take our dogs in to find them. How fun is that on a day when it's freezing cold and pouring rain and you still need to get your dog out for some exercise and mental activity!



(end of Terri's description -- thanks, Terri!)

Terri goes on to share the following about their weekend, "...we put on a "mock" K9 Nose Work Trial in Portland in preparation for putting on a sanctioned NACSW K9 Nose Work Trial in the spring. It was run exactly like a real trial with a certified judge (in fact he was one of the founders) and in all other aspects as well.

Well, my miss Peaches rocked! She beat out a bunch of GSD's, Golden's, Terv's, Belgian's and a few other breeds that are known for their scenting/nose work abilities, including a nationally ranked Earthdog!

Peach won:
• 1st Overall (cumulative of 4 individual events)
• 1st in the Team event (cumulative of 3 events on an assigned 3 dog team)
• 1st in the Vehicle Search
• 2nd in the Interior Search
• 3rd in the Exterior Search (during a crazy snow and sleet storm!)
• 6th in the Container Search (where the time difference between 1st and 6th was less than 3 seconds)
• She also got her "mock" version of the NW1 Title."

Strong work Peaches and Terri!!!!!!!!! Congratulations :)

P.S. No biopsy for the Mrs. -- she feels fine and so we will just wait, continue the antibiotics, and see what unfolds -- hopefully nothing :)

Thursday, November 25, 2010

Sydney's Thanksgiving Prayer

Dear goD:

I am grateful that Galen is back and that I am small enough to fit on his lap so we can watch football together on Thanksgiving. I am also grateful that we all got to chew on bones today and that my snow theme party hasn't ended yet but mostly I am grateful for Galen.



Wednesday, November 24, 2010

A Ride Up

Maize's bloodwork shows a possible infection (high white cells but no fever) and the cells they looked at from a swollen lymph node do not show Lymphoma (YEA!) -- it shows cells consistent with an infection or potentially another malignancy but they recommend a biopsy.

Since Maize is feeling perfectly fine (on Monday morning she was barely walking and clearly not well), I am going to think about the biopsy and what would be gained by doing it versus waiting and seeing what happens. At her age (10 years, 4 mos) I am not sure we would aggressively treat a cancer anyway -- so knowing sooner rather than later (if it is cancer) might not benefit her/us.

She has been started on antibiotics now -- maybe it is best to see what happens with that... Putting her under anesthesia to do a biopsy to possibly diagnose something we would not aggressively treat anyway -- hmmmm.... and when it could just be an infection....more hmmmm....


Last but not Least!

COOPER Whitby! (he is the one with the big head ;)

And this is unrelated to anyone's pictures BUT I just came across this on a friend's website, and thought it was interesting:


Dear Husband just showed up, surprising us all. He borrowed a Jeep and drove all night, arriving safe and sound to spend Thanksgiving with us -- even though I have never cooked a turkey and won't be starting anytime soon :)

Still waiting on Maize's test results but she is feeling just fine -- will update when we know more...

Tuesday, November 23, 2010

Snowy Zoey

A pretty, clean, flashy dog + ten inches of new snow + fun red ball = LOTSA pictures...

Birthday Pictures!!!!!!

We do not have everyone (hint, hint) but here are some pictures from our Glitterati babies, who are now TWO!

This is Ruben Hudson Rock Star in Arizona...

Murphy Sutton had a real party in Montana!!!

Here is extra cute Tara Geneva with her mom in Utah...

Mika Ireland also had a real birthday party out there in California!

Zaida Jamaica having fun in Colorado...

I just got these of Rainey Toronto from Joan -- thanks, Joan!

Here is Sydney Sydney at her snow theme party, which was taken to a bit of an extreme as we are now snowed in...

Heidi Marie and George were in a big hurry this morning to join the party!

Note the contrast between the first picture and the last :)

So, who are we missing?????

Monday, November 22, 2010

Mrs. Maize

Maize is feeling better this afternoon and was just out enjoying the snow :)

Life is Bittersweet -- and Snowy

For Sydney's second birthday today, we decided to have a snow theme party. I go outside with the camera and Zoey runs to find her ball -- for some reason she thinks the camera means a game of fetch :)

Here is our fancy show dog

Sydney really appreciated the snow theme party :)

She wanted everyone to know that Zoey is not the only one who likes to chase balls -- here she is with a blue snowball...

Mac thoroughly enjoyed the party!

In fact, he thought maybe he should have the red ball and told Zoey to go find a pink one because red is a boy color...

He also played with the birthday girl...

Asia thought it was very fun to just lay in the snow and look majestic...

Halo thought it was the perfect time to work on branch pruning again.

A good time was had by almost all...

I say "almost" because our morning also included an urgent vet visit -- Maize was not herself this morning and I took her in immediately. She likely has some type of cancer -- we will know more tomorrow.

I am reminded that life is just a series of ups and downs. We cannot let worry and fear about the inevitable downs ruin the joys associated with the good times -- both are part of the fabric of our lives. I know it is possible -- and even necessary -- to coexist with happiness and sorrow -- and in fact, that bittersweet sorrow reminds us to embrace the joy that comes our way.

So we celebrate Sydney and her littermates who are two today (pictures later or tomorrow), and we grieve that our beloved Mrs. Maize is likely facing the final part of her journey.

Such is life -- smiles and tears, birthday cake and funeral potatoes...