Well……. Santa cometh and rather than giving…… Santa taketh away.
I thought this blog post would be about me expressing my gratitude that Bossdin had had no hypoglycemic episodes for almost a month, and, had even been able to do short (very short) runs to find and hold the golf ball when it landed close to him.
Things had been looking so much further UP that what transpired on the evening of 21 December came as a complete shock.
The morning started the same as every other one, bouncing outside for a sniff around and toilet stop. Then it was back inside and straight to the place in the kitchen where I feed him. But today, for the first time ever, Bossdin didn’t want his breakfast. He stood there, looking for food, but when I put it down for him he just turned his head away.
‘Ok’, I thought, ‘you are sick of this for breakfast, let’s try something else’. So I gave him something else and thankfully he did eat it, and also most of his next 3 small meals, but it wasn’t with his usual gusto. This was totally abnormal for him. He’d never been a fussy eater and had never turned his head away from food before.
But, come early afternoon, he was still looking to go out for his daily constitutional to the golf course, so we did. And everything was fine. Unfortunately it was a different story in the evening. He wouldn’t eat any of the 3 different kinds of food I tried to give him for his dinner meal.
I eventually got him to eat some cooked sausages and rice….. but, an hour later he wanted outside and started throwing up. Then there was more throwing up and all his food from the day, bar possibly his breakfast meal at 7.30am had come up. It was also hardly digested at all.
I rang the emergency vet, got some advice and attempted to get him to drink some honey water I made up for him. He wouldn’t. The only good thing was he definitely seemed more comfortable and happy once he’d had the big throw ups.
I was worried of course, with all that food now out of his system he might have a hypoglycemic attack. But, I kept reminding myself that Boss will always go looking for food when he feels a hypo attack coming on, so I left two lots of food out for him, and two lots of water he could drink if he wanted to.
We made it through the night ok and the next day I spoke to my regular vet on the phone and explained what had happened. From my descriptions of the food he had thrown up, and the fact it wasn’t remotely digested, my vet thought it sounded like a blockage or obstruction between his stomach and intestine. He asked me was there any chance Bossdin could have swallowed something he shouldn’t have….. ie like a stone…. ‘Nope’ I said, ‘he’s not a scavenger by nature’.
By the time we got into the vets consult room (22nd December) Bossdin was incredibly subdued, yet prior to that he bounded into the car happily. It’s weird how they can have bursts of normal, happy behaviour at times, despite being so incredibly unwell. It was like while he was at home he was putting on a brave face for me. He was being staunch for me, but once in the clinic room, it was like all the fight left him and he finally showed us all how bad he really felt. Oh my poor darling boy.
Bossdin was SO unwell he let a catheter be put into his leg with just me holding him. Unbelievable! We all knew that fact alone was incredibly significant.
Because of the anorexia and vomiting I was prepared to do the Addison’s test as a last ditch hope it may not be Insulinoma. I hadn’t done the test previously because his symptoms and initial blood work didn’t fit. They analyzed his blood at the clinic and said it didn’t look like an Addison’s crisis, the bloods still weren’t indicating that. So we didn’t do it.
The bloods also didn’t indicate Pancreatitis either. Shit! Anything, anything, would have been better than what I knew deep down to be true. Insulinoma. His glucose level was very low….no surprises there.
We put him on an IV drip of 50% glucose I think it was and he started perking up within 10 minutes. This was done in the consult room, as opposed to him being admitted to the hospital. I said there was no way he would cope with the stress of me not being with him in the hospital area and they agreed. So I sat on the floor with him (and my friend stayed with me too) for 3 hours while we pumped vital fluids into him.
Because of his immediate reaction to the glucose drip my vet said this makes Insulinoma even more likely (remember, we did the fasting blood insulin test and ultrasound in August but they were inconclusive). It was possible that he now had a blockage between his stomach and intestine, caused by the tumour(s) spreading that was stopping his food passing from his stomach into his digestive track. This could account for why he was throwing up food, basically whole and totally undigested.
OR, the other possibility was a stomach ulcer brought on by the constant stress on his body of having permanently low glucose (despite the constant meals). We gave him a Losec pill in the hope that that might settle his tummy. I also took more Losec pills for him to have at home over the next few days….. if he would eat. When we left the clinic my vet thought that Bossdin would eat when we got home. He didn’t. But he did drink some water so that was encouraging.
Another weird symptom I’d noticed over the last couple of weeks was his breath. It was bad. Not foul but different and not his normal breath. I kept checking his teeth and gums but they were fine (I clean them with a soft toothbrush). Once he’d been on the drip for an hour or two, his breath went back to normal. So somehow the glucose directly into his system is tied up with his breath….. I mentioned this to a friend who has unfortunately lost two dogs to Insulinoma and she said, “yes you get this in human diabetic patients when their sugar level drops (ketosis occurs) the breath is often described as smelling of acetone.” I have no idea what acetone smells like but can only assume this is what was happening to Bossdin.
What scares me now, thinking about it, is that I was feeding him high quality protein and complex carbohydrates 4-6 times a day, he had had no visible signs of hypoglycemia so I thought things were at least under control for the time being. But his breath being as it was, and suddenly resolving and going back to normal while he was on the IV drip indicates that despite all the meals and complex carbohydrates he was getting it was clearly not enough. The insulin in his body must have been gobbling up all the glucose as fast as I could get it into him. Well that’s my take on it anyway.
The other telling sign to me was; he should have been putting on weight. With all the extra food he was getting and the now incredibly limited exercise sessions he was having, he should have at least put on some weight I would have thought. But he hadn’t.
The short version as I realise this is becoming a really long post.
Bossdin starts eating little bits of homemade yoghurt in the morning and by the evening will eat small pieces of cheese and even managed two cooked eggs. Halleluiah!!!!!!!!! He was taking honey, licked off my fingers (ok’ed by my vet) and had drunk water during the day. He’d gone out to the toilet and everything was normal. He didn’t throw up. Double halleluiah! He was perking up.
24th December Christmas Eve 2014
At 7am he was looking for his breakfast, but wouldn’t take sausage, honey, yoghurt or any of the things he had previously eaten. I tried cheese again and he ate that. I cooked him some eggs and he seemed keen on the yolks but not the whites. At 7.30am he went a bit ‘funny’ with me and this time when I offered it to him he would eat the honey. He seemed quite bright, definitely on the mend.
I spoke to my vet on the phone who was surprised by this development and said I was to let him eat anything at all, anything was better than nothing, the key was to get calories into him for now. He suggested potato chips, and I asked about sports drinks, for the electrolytes in them. We discussed Bossdin’s situation and I promised that if there were any changes or if he suddenly went down hill or started throwing up again I would know it was time. I knew we were already on borrowed time, and I was determined that he would not suffer a grand mal seizure or go into a coma. These things are possible with Insulinoma.
I shot out to the supermarket to get chips, sports drinks, custard, wheetbix, cottage cheese and anything else I thought I could tempt him with. When I got back he bounded up to me happily. Everything seemed fine. And then I saw the big pile of sick on the floor in my bedroom. The cheese and eggs were not remotely digested. They had come up whole.
I lost the plot. I went into denial for a wee bit. Saying to myself, ‘know one else knows’, ‘you are the only one who knows he’s been sick again’. Eventually I slapped myself round my head and said ‘get a grip girl and do the right thing’. Despite my best efforts I knew the situation was beyond hope. I knew Bossdin could not survive long just living off the honey he licked off my fingers every 20 minutes or so. I also knew it was not remotely fair on him to drag his life out just because I didn’t want to be without him.
I loved him enough to let him go. He went to sleep (sedation) lying beside me with his head resting on my legs at 3.35pm. He crossed the Rainbow Bridge at 3.55 pm Christmas Eve. I buried him in his favourite spot at the bottom of my garden, over looking the lagoon, on Christmas Day.
He was not yet 8 years old. Rest in Peace my Beloved, Beautiful Boy!