By the time November rolled around Sophie had begun a series of tests to determine the cause of her progressive weakness. This entry will be filled with those medical details, as I remember them. I will try to get through them as fast as possible so you won’t get bored. I also want to share in this chapter of Sophie’s story the missteps we made and the regrets Ken and I have about our decisions in the early days of Sophie’s care. Maybe our regrets will help another pet owner who is going through this same terrible situation.
If you walked into our house in November 2008 it looked a lot like a carpet showroom. Remnants of pale green carpet and sections of chocolate brown carpet once used by our dogs to sit on while we watched TV or lay on while we slept now lined our tiled hallways and kitchen. Sophie’s back legs were giving out under her on a regular basis and the carpet swatches seemed to help stabilize her balance and keep the slipping to a minimum. In some sense Ken and I realized we were entering a new way to live and laying out the carpet liners was one of the first ways we adapted to what waited ahead.
The second adjustment was in the many tests and veterinary appointments Sophie would have in the next few months. The first was at our regular veterinary clinic. The young female veterinarian who saw us was very thorough and listened attentively as we described Sophie’s symptoms. Through a series of exams that included X-rays, blood work and manipulation, the vet was able to rule out a lot of diseases Sophie didn’t have.
Sophie did not have: arthritis, hip dysplasia, an obvious herniated disk, an obvious spinal tumor or spinal stenosis. We looked for tick born diseases and ruled out certain fungal diseases that are prevalent in the Southwest desert.
Because Sophie didn’t have any pain associated with the weakness in her hind legs and because her symptoms were progressing, the veterinarian’s next guess was a disease called Canine Degenerative Myelopathy. DM is a heartbreaking incurable progressive disease of the spinal cord in older dogs that ultimately leads to paralysis and death. It begins with a weakness and loss of coordination in the hind legs. Dogs begin to slip, their legs buckle and later they are unable to stand. It’s as if they don’t know their legs are beneath them.
Paralysis takes about six months from the onset of the disease and may move its way up to the front limbs later on. Sophie was following this course. DM appears to come from a mutated gene that causes the body to remove a protective insulating cover around the spinal cord called myelin. This leads to a breakdown in the ability of the brain to communicate with the spinal cord. The unique feature of DM is the fact that it is not painful.
Because Sophie showed absolutely no signs of pain, the veterinarian suggested we try a new DNA test for Degenerative Myelopathy that was being studied at the University of Florida. Here’s the first misstep that I wonder about. When the test arrived, I was supposed to swab Sophie’s cheek with a sterile Q-tip and wipe it on a card provided with the test kit. The instructions explained that the card would turn a purple color. My first swab on the card didn’t turn purple, nor did the second, so I kept repeating the test. I finally got a very large purple smear to show up on the card, but in my heart I always wondered if I contaminated the test by re-swabbing Sophie’s cheek over and over.
In any case, the results of the test were negative for DM. I’ll never know if the results were accurate or if they were really a false negative or a contaminated test. The results simply said negative and the only sure way to determine a DM diagnosis is by necropsy.
The next step to a diagnosis was a referral to the veterinary neurologists in town for a more thorough exam and a possible MRI. Here was misstep number two and it will haunt me forever.
Sophie and I arrived at the neurology office for one of their first appointments of the day. While waiting to be shown to a room I noticed a brochure that talked about financing the procedures offered at the facility. I knew their tests were expensive, but the brochure made me a bit nervous.
The day of the appointment Sophie was particularly anxious. By the time we were shown to an exam room her whole body was trembling. A young female veterinarian came in and introduced herself and tried to make friends with Sophie. She read the report from our veterinarian and did a brief examination in front of me. She then explained the rest of the exam would be done in the back of the office. She and Sophie walked off together.
I waited for Sophie in the lobby. After the exam, the three of us met privately to discuss the results. The vet believed Sophie’s weakness involved her hind quarters and her front spine. She couldn’t give me a guess as to what was causing the problem, but suggested we run an MRI of her entire spine. I don’t remember the estimate, but an MRI of a big dog’s entire spine came as a shock to me. Even with the test the vet couldn’t guarantee the MRI would give an exact diagnosis, but she said it would rule out more illnesses like a deep tumor or a stenosis. I was told deep tumors are very difficult to remove and could kill my dog or leave her paralyzed, but a stenosis could be helped surgically.
This was a lot of information to absorb in a short period of time.
My mind flooded with memories of Missy when we dragged her to the vet on the day she died. She was having trouble breathing and the veterinarian suspected she had a paralyzed larynx, something she could have lived with if we kept her life calm. He wanted to do a diagnostic test to confirm his diagnosis, but unfortunately something went horribly wrong. Thirty minutes after the harmless test, our baby girl was brain dead and we pulled the plug on her breathing tubes the next morning. Even the veterinarian was very upset over the outcome of his diagnostic test.
Now, a veterinarian who I had never seen before was asking me to anesthetize my very nervous, 10 year-old, weak dog for an expensive test that “might” determine a diagnosis. I freaked, I panicked, I said, “Not today.” Little did I know that decision cut me off from any further help from the neurology clinic. Unless I agreed to the MRI we weren’t going to get any help with physical therapy or aqua therapy or who knows what. We were done.
To this day I wish I had said yes to the MRI. Maybe we would have found a diagnosis and maybe Sophie would have had a surgery that miraculously cured her. Or maybe Sophie would have had an exploratory surgery and died on the table and didn’t have to go through five years of being paralyzed. Who knows what would have been. All I know are my missteps and regrets.