Sasha’s Journey: A Medical Odyssey

Sasha is my wonderful 8-year-old German Shepherd whom I’ve owned since she was almost one year old.  Let me tell you about my “Miracle Girl”. I originally bought her litter sister, Inga, and another family chose Sasha. It wasn’t a good fit however so eventually  she joined my crew. What an eventful first day!  I never anticipated a problem between Inga and Sasha as they both attended a local doggy daycare and played together like best friends. What a mistake on my part! Inga, deciding she was alpha, attacked poor Sasha as she walked through the door. So Sasha’s first night in her furever home was marked by an emergency veterinarian trip for the bites she received. There were a few additional incidents but with consistent commands, learning to “eyeball” any signs that Inga was acting dominant and lots of outside exercise the dominance issues stopped. So thankful they worked it out and participating in Schutzhund training and competition gave these high intensity dogs a different direction to focus their energy. Sasha, ever the goofball, is happy to play second fiddle to Inga. Just give her a ball and she’s in doggy paradise. I continued to take them a few times a month to doggy daycare for play and socialization and the owner was amazed how easily Sasha could climb up and over her 6′ high fence. She could also scale our 6′ rear fence but rarely did. She’s always been extremely agile and absolutely LOVES the water (and snow). I’m fortunate in that we live adjacent to a private stretch of river where we go several times a week for water fun during the summer. Since nights begin to get rather cool in the mountains thus affecting the water temperature the next day, our summer swims end in late August.

In the summer of 2013 Sasha stumbled on the bottom inside step and fell. She began to limp but I assumed she hit her foot when she tripped as nothing appeared broken and no cuts or scrapes. However as the next two hours progressed my girl began to limp  to the point of dragging her left rear leg. Thinking it was orthopedic, I contacted Sasha’s local veterinarian  who arranged for her to be seen that day by an ortho vet here in rural Maine. It was about a 1.5 hour drive and about 30 minutes in I suddenly stopped the car and called his office. To this day I don’t know what prompted me to do that but I’m so thankful that I did. Although I’d never met or spoken to him before, he actually got on the phone with me and after giving him a blow-by-blow description of what happened, he told me that in his opinion it wasn’t orthopedic but rather she’d suffered a neurological event called FCE (fibrocartilaginous embolism) which is when a blood clot lodges in the spine causing paralysis. Laypeople refer to it as a “spinal stroke”which is the  dog version of a human stroke. The orthopedist said I was lucky in that there was one neurosurgeon veterinarian in the state so we shifted directions and headed to Maine Veterinary Medical Center in Scarborough to see Alan Potthoff, DVM, DACVIM. Upon arrival  Sasha couldn’t walk as her back-end (particularly her left leg) was paralyzed) so she was carried in by stretcher. An MRI confirmed  FCE and treatment was started immediately. Dr. Potthoff told me that if she didn’t respond within a period of time to the IV therapy she would require surgery to remove the clot. Thankfully my girl responded and surgery was not necessary but she still had a long road to recovery. Since there are no dog physical therapists or rehab facilities where we live in the rural Western Mountain region of Maine, after Sasha’s discharge from the hospital we worked with  Gayle Hickok  LMT, CDT, NMT, the head rehabilitation therapist at Maine Veterinary and now in private practice. Gayle was my lifeline because she knew we couldn’t make a nearly 6 hour round trip for therapy but also knew that ongoing treatment, especially canine hydrotherapy, was integral to Sasha’s recovery. I stayed down there for a week so Sasha could have as many sessions as possible and I could learn the various techniques to the best of my ability. When we returned home I was armed with a plethora of diagrams and written instructions that are still  clipped to a board in my kitchen. Sasha had to stay somewhat segregated from the rest of the dogs because no rough play was allowed. We have a first floor great room so putting up a makeshift partition was relatively easy and we made it about 4′ high. She was confined to the area where the television was, my husband’s recliner and a nice large area rug where she would lay as we massaged her spine and lower body plus did passive range of motion exercises to her left rear leg.  One day I walked in to see her sitting in the recliner;  I was surprised but t excited. Ironically, the recliner has become Sasha’s Chair” ever since. A few weeks later I was in the kitchen and heard “something” in the great room. I walked in to find Sasha had hopped from her recliner to another chair that sat just on the other side of the partition. It was at that moment I inherently knew she was going to make it. She worked hard; my husband set up  course in the front yard of ropes that Sasha had to step over. Once she mastered the height of the ropes (initially inches off the ground) he would raise them a bit and start anew.In the back yard he set up an obstacle course that Sasha had to maneuver. My poor “water baby” had to wear a life jacket for safety in order to do the important water exercises and because she needed an XL, we ordered had to order one. I used the same company that makes their backpacks, Outward Hound. She would go to the river alone with my husband and initially just walk through the shallow edge, building up strength in her quadriceps and hamstrings which was critical for the most severely impacted left rear leg. She quickly progressed to deeper water and before we knew it was swimming. We removed the life jacket and she still swam like a champ! After several months of alternating her daily exercise routine, Sasha regained about 85-90% of her previous function. If you looked closely you could detect the different gait in her left rear leg but she compensated for it. She ran almost as well as prior to the FCE. Life was great! She hiked in the woods with me, played in the snow and jumped in the air to catch snowballs, and her most favorite thing ~ swimming in the river. I found something of interest a year or two ago. Seth Casteel, the award-winning photographer of Underwater Dogs, used Gayle Hickock’s rehab pool to shoot some photos for one of his books. You can see the video on Gayle’s page.

Then came the summer of 2013 when I noticed a few drops of blood on the floor near Sasha one Sunday afternoon when she came in from outside.  Initially I thought she snagged a toenail but upon checking from head to toe I  found an opening near her rectum that was bleeding. We drove her to the Animal Emergency Clinic of Mid-Maine which at 56 miles away was the closest. The attending veterinarian said it was a fistula (an opening) and repaired it surgically. When I took her to her primary veterinarian for a follow-up I was shocked to hear that the fistula was probably not an isolated incident but rather the beginning of something known as PFD (perianal fistula disease). I was dumbfounded and  chose Portland Veterinary Specialists to provide her PFD care and was blessed to have the brilliant Sarah Noble, DVM, DACVIM as her provider. I immediately began researching PFD  only to learn what an insidious disease it is. Many German Shepherds have their tails amputated! In fact, 80% of cases involve a GSD, giving rise to the theory that PFD may be genetically driven. Newer theories have evolved suggesting PFD has an  autoimmune cause as well dietary. as  So began a course of treatment which included immunosuppressive drugs; oral  Cyclosporine, topical tacrolimus, standard oral prednisone as well as a change to a grain free, novel protein diet. The drugs were started at a higher dose and tapered down gradually to a maintenance dose which will be  taken daily for the rest of her life, a lifelong dietary change and a series of laser treatments to her backside. Since the specialty veterinarian practice was a 200 mile RT, we initially took her several times a week. Sasha is such a fighter though and within a year she was in remission where she has remained for 3+ years, a testament to her internist and her own ability to thrive. She resumed swimming in summer and diving for snowballs in winter. We laughed and called her a bunny because when she ran it looked almost like a bunny hop ~ the residual effect of the embolism.

 

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