Caregiving is a complicated business. It is hard, but also rewarding. It is painful, but also results in humor and positivity. It is a challenge, but I find I am grateful for the extra burden. I haven’t been in a dedicated caregiver role for another living creature close to me in awhile, but since our dog Zoey was diagnosed with a brain tumor in early February, Terry and I are again in this mode. Simply put, it sucks that Zoey is terminally ill, but she is here with us now and for that I am grateful.  In some respects, I didn’t think she would survive the week before she was diagnosed with her tumor. She was in pain and having seizures and we didn’t know what was happening. Now, each week she survives, each day she survives, I am grateful.

Zoey started having seizures this past September, but they happened in a two-week period, when it was still very hot, and then they stopped. At 7 years of age, our regular vet didn’t feel that it was epilepsy since it usually presents when dogs are aged 1-5 and wasn’t really sure what was causing the episodes. She might have mentioned a brain tumor as a possibility, but I blanked on that part of the conversation. Some causes of seizures are never discovered, so with no additional seizures or other signs of a problem, we went on with our regular lives.

When Zoey had her next round of seizures in late January, on a Thursday, we thought it might be related to work being done on the downstairs unit of the two-unit house we live in. There had been evidence that Zoey had had a seizure during the day and then she had one when I got home from work. She didn’t have another one that evening; however, for the first time ever, Bleu and Zoey fought over treats and Bleu nipped Zoey’s nose, breaking skin. I felt like I was living in another dimension that night! I scheduled an appointment with her regular vet, Dr. Theresa, for Monday, but took Bleu into see Dr. Johanna on Friday because he had been having intestinal issues. I brought Zoey along and they put a couple of stitches on her nose.

On Saturday, after our vet’s regular business hours, Zoey started to act very strange. She had no energy, she wouldn’t eat and she had this odd head tilt. Her behavior scared us to the point that we took her to emergency care, where the vet on duty ran tests and gave her fluids and a prescription for Pepsid, feeling that her problems may be intestinal as well as Bleu’s. The intravenous fluids gave Zoey back her ‘step’, her spunk, and so the rest of the weekend was mellow.

On Monday, when I took Zoey to Dr. Theresa, I wasn’t prepared for her to tell me that Zoey was showing signs of a brain tumor or that the only way to diagnose would be with an expensive MRI. I left with her insight, but no action plan at that point. We had Tuesday off of school because of NOLA’s version of a winter storm and I spent time researching canine brain tumors. After doing some digging, I realized that Dr. Theresa was probably right and broke down in tears.

Here are some of the Early Stage Signs according to the Lap of Love: Educational Pet Disease Series:
• Depression
• Head tilt, loss of balance
• Cranial nerve deficits (decreased or loss of vision, difficulty swallowing, voice change)
• Seizures
• Weakness
• Strange behaviors
• Gain or loss of appetite
• Vomiting
• Weight loss

Zoey was starting to exhibit a number of these signs, but was still feeling well thanks to the fluid infusion Saturday night.

Wednesday was Day 2 of our winter storm and neither Terry or I had to go to work. Zoey was showing more signs of strange behaviors, loss of appetite and general weakness, but then she also started to show pain–actually yelping when we touched the general area around her neck–and so we headed to the vet, whose practice was open.

Zoey saw Dr. Johanna this time and we started talking through our options. We decided to do the MRI to have confirmation as to what was really going on and that was scheduled for the following Monday. Zoey was also given a prescription of Tramadol to help ease her pain.

MedVet here in New Orleans does their MRI’s off site at a medical office (of the human kind) and so we left Zoey overnight with their skilled personnel. Dr. Amanda, an amazingly compassionate resident, called me with the MRI results on Monday evening. Zoey definitely has a tumor that is 2 centimeters in diameter and pressing down on the cerebrium. It is a meningioma which is the slowest growing, but it’s already pretty large. There are only a couple of options available:

•have surgery to remove the tumor with a follow-up regimen of radiation and/or chemotherapy

•targeted radiation

•do nothing

•palliative care

After consultation and many discussions, we decided that surgery, radiation and chemotherapy would only give us a few extra months and wouldn’t guarantee quality of life. With surgery, there is no guarantee that there won’t be complications and with chemotherapy and radiation we would have had to board Zoey in Baton Rouge during treatment. Not to mention the expense. Brain tumor treatment in canines is not cheap! However, we couldn’t simply do nothing. That just wasn’t going to happen. So, we have chosen palliative care.

We’ve had to make some modifications to our lives in caring for Zoey. The biggest one is in regards to her meds. She is taking Levetiracetam (Kepra) and Prednisone to help prevent seizures, Tramadol for pain and Omeprazole as an anti-nausea medicine. She gets her pills 4 times a day which means we have had to be very synced into her medicine schedule. Because both Terry and I have not had to contend with multiple medications for any length of time, it took us a month before I realized that we needed a pillbox to keep us on schedule! I was so excited to find the right box—especially after a communication glitch between Terry and I related to her daily Prednisone dosage resulted in Zoey having a seizure. It took another week or so before I picked up a pill cutter. What a concept! I’d never needed one of these before either, but wow, what an invention!

When we adopted our other dog Bleu, we started taking both Bleu and Zoey to daycare once or twice a week for the exercise and socialization (and so Bleu wouldn’t chew up all of our furniture!). Our daycare, Canine Connection, will also give dogs their medications during the day. With Terry and my work schedules, making sure Zoey gets her meds at regular intervals could have been very difficult. Taking them to daycare is one less thing to worry about and becoming an almost daily regular means that Zoey is monitored throughout the day and gets her medicines, while Bleu gets plenty of attention and activity. Unfortunately, Bleu and Zoey, who used to be quite the pair at daycare when they could stay in the same area, are now separated into the ‘active adult’ area (Bleu) and the ‘retiree’ area (Zoey). What is so cute is that a couple of times a day, Bleu will jump up against the fence that separates them to see if he can see Zoey.

One thing that I have found most surprising about this whole experience is how available, helpful and compassionate Zoey’s veterinarians have been. In the initial two weeks of this drama, Zoey saw no less than 5 different vets. Since that point, we have not had any problems refilling prescriptions and Dr. Johanna has been available through text, phone and email when something critical happens like when Zoey came home one evening dehydrated from daycare.

The good thing is that we are getting some extra time with Zoey and we are making the most out of this opportunity. We are taking plenty of walks and enjoying favorite haunts, like heading down to the River at Audubon Park.

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Zoey was even feeling good enough on Sunday to head over to City Park with us to do a Dog Day Afternoon walk to support the New Orleans SPCA!

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A Couple of Helpful Sources:

PetMD

UC Davis Veterinary Medicine

Veterinary Society of Surgical Oncology