October 16, 2011

My Last Night with Gonja

It’s a bit past 1:00 A.M.  Gonja is resting peacefully.  I’m not sure if he’s going to make it through the night.  I’m almost certain what’s wrong though, Gonj has a brain tumor. 

Exactly three weeks ago Gonja began what would be a 36 hour episode of petit-mal seizures.  It didn’t start out that severe, but as the episode progressed the seizures became more frequent until they were coming every twenty minutes or so. 

An emergency room visit at hour six of the episode had given me good and bad news.  Except for glucose, his bloodwork came back perfect.  And elevated glucose was normal for a seizing dog.  First seizures for an 8.5 year old who’s otherwise healthy usually means a fatal brain disorder.  My only hope was that it was a late onset of idiopathic epilepsy.  It’s rare, but it does occur. 

I understood the conclusion of the blood test because of Dawn.  Dawn had had her first seizures when she was about a year old.   In a dog that young, it’s usually just the opposite of a fatal brain disorder, it’s idiopathic epilepsy.  Dealing with epilepsy isn’t trivial, but it’s not that hard either.  We also know from people that seizures themselves are basically painless.  I had studied up on this before I took Dawn home with me.  In dealing with Gonja, I found that my memory cell was still quite functional---the details regarding seizures had not disappeared.

Gonja’s seizing continued after returning from the emergency room.  At that point, it was about once every hour or so, they were petit-mal seizures lasting only a few seconds, and he was resting comfortably between them. 

I talked to my vet that morning, hour nine, and he asked about putting Gonj on phenobarbitol.  We decided not yet.  I wanted to try prednisone and see if that would help.

During the day, the seizures continued and became more frequent.  I brought Gonj into my living room where I could observe him and keep him safe. By the time it was dark, petit-mal seizures were coming every 20 minutes and lasting as long as a minute. 

I had seen Dawn seize many times, and hers were grand-mal, so watching a dog seize doesn’t affect me that much.  Dawn would also pace for about thirty minutes after each of her seizures, a relatively common post-ictal behavior.  I got used to seizures, but the pacing always bothered me. 

Gonja paced as well and for him it didn’t stop.  By evening, he was clearly exhausted.  He’d lay down and within seconds start seizing.  And then he’d start pacing around my living room again.  Desperate to give him a chance to rest, I finally got him to stop by putting him in a crate.  In this, he was at least sitting or laying relatively still, and though he continued to have partial seizures every twenty minutes or so, he was at least resting between these.

The next morning, my vet made it clear we had to do something to stop the seizing ASAP.  One of the problems with seizures is they have a tendency to build on themselves.  I’m sure that’s what scared my vet.  I did have phenobarbitol left from Dawn and started Gonja on that. That did the trick. 

The three weeks between then and this evening, Gonja did great.  The most I saw were issues that could easily be ascribed to the phenobarbitol.  And the “old Gonja” was coming back.  Yard time went fine, so watching him carefully, I even took him out for a few runs.  His tugline slacked on the way back, but that may well have been the drug.  His last run was on Sunday.  A wagging tail as I undid harnesses told me what I wanted to see. 

During the day, Monday, he did seem a little more lethargic than I had seen, though I still figured it was probably the phenobarbitol. 

I was feeding the dogs just a bit before ten that evening.   I noticed Gonja wasn’t coming out from under his platform.  I went to see what was up and found him totally unresponsive.  Pulling his body out from under the platform, I saw no sign of life.  I took a minute to cry, and then I finished feeding.   Responsibility is for the living.   After this, I brought the body into the house.  

Hearing his heart and seeing him breathe meant I didn’t have to cry anymore, not yet.  It also meant I had a lot of decisions to make.  Living an hour away from emergency care means I don’t use it cavalierly.  More to the point, it was very likely they wouldn’t be able to do anything for him.  And if Gonja was going to die, I’d rather it be in my living room with me than by himself at an emergency clinic.

I called and talked to the emergency vet.  He said that given everything, it was almost certainly a brain tumor.  He suggested grinding up prednisone, dissolving it in water, and administering it rectally using a syringe.  He did say sometimes dogs rally from these episodes.  He also confirmed that the only thing he could do for Gonja was euthanize him.

After talking to the vet, I administered the prednisone as he suggested.  I then took Gonja’s temperature, 92.5.  That explained why he was so unresponsive in the yard. 

I brought him upstairs and placed him on the convertible futon couch I had configured as a bed.  As he warmed up, he started paddling.  It was never a real seizure, just leg motions, but it was almost continuous.  And sometimes he’d cry weakly, though distinctly.  Keeping him alive with the hope of a prednisone miracle, something that’s not too uncommon, still wasn’t an easy decision.

As the paddling continued, I started emptying my medicine cabinet into Gonja’s rectum in the hope that he could relax long enough for the steroid to have an effect.  I also figured that if I overdosed him with the valium and phenobarbitol in an effort to get him to relax, it would be no worse than driving to Missoula.

He ended up resting for only an hour and a half in the first go.  Then came about three hours of light paddling.  At 05:30, I gave him another dose of phenobarbitol, and that let him sleep. 

It’s now 1:35 in the afternoon.  I’ve talked to my vet.  There’s good news and bad.  Nothing I did with the drugs should cause Gonja any permanent harm.  That he’s still unconscious may be the result of all the drugs I gave him.  The bad news is it would be much more encouraging if he had regained consciousness. 

I’m not sure what I’m going to do, but given everything, I’m leaning toward waiting til tomorrow morning.  If he doesn’t wake up by then, I’ll say good-bye.  And if he starts paddling again, I’ll take the drive to Missoula as well.  If he wakes up and doesn’t paddle, I’ll nurse him and see how he progresses.  The third dose of pred is about six hours off. 

It’s now Tuesday evening.  When Gonja awoke, he immediately started paddling.  I waited about fifteen minutes to see if it would stop.  It didn’t.

The paddling did drop off during the ride to Missoula.  At the vet’s office, he was actually pretty relaxed, only a vestige of the paddling showed.  My vet commented that Gonja came in in better shape than he had expected.  I said me too.  But  after a short bit of thought and examination the vet confirmed what I suspected, that it would only be a short time before the paddling would start again----maybe a couple of days, more likely just a few hours.  And Gonja’s condition would only get worse. There wasn’t going to be a prednisone miracle. 

I’ve lost six dogs since I came to Montana.  Of those, I’ve only been able to really say good bye and “you’re a good dog” to two.   One of them was Gonja.  He was too young, but aside from a few bad days, he had a great life. 

Never a star, he was an honest dog.  During the time I had him, he completed more mileage racing on my A-team than anyone else.   In a kennel of 22 dogs, some dogs give the pack its personality and some dogs are just along for the ride.  The Gonj was definitely one of the former.  I miss him.