Read Autumn — Chapter 13
I remember the color of the light in the room the night Autumn first tried to jump on my bed and failed, golden yellow, soft, and warm. It was late and we were getting ready for bed. I was already in bed, reading. Autumn usually came and asked if she could lie at the foot of the bed. In the middle of the night, she did not ask, just jumped up on the bed, curling up at our feet, or coming to the head where even in sleep I would lift the covers for her to clamber to the bottom near my feet. But in the evenings, she pretended to ask before coming up.
That night, Milla was snuggled next to me in the warm down comforter. I was sitting upright, my book propped on my knees. Autumn came over and made an attempt to jump on the bed. She could not make it. She tried again. Foiled again. Finally I arose and put her on the bed. Must be her hips, I thought, and thought nothing more of it.
Over the next several days, she appeared to gradually deteriorate before our eyes. As October closed and November opened, she lost weight and strength. She seemed also to have another bladder infection and drank water excessively.
With interstitial cystitis, Autumn always drank more than the other dogs. I thought this was what was going on, that she was having an exceptionally bad bout of interstitial cystitis, and it was causing her to lose weight, but I thought she should still go to the vet. Again. I made the necessary appointment and three weeks after her first failed attempt to jump on the bed, I took her in to see the doctor.
She had lost seventeen pounds. I could tell the vet was very worried. He wanted to run a number of tests, but thought cancer might be the cause. He could see no other major possibility for the dramatic decline in weight. There was the possibility of diabetes mellitus, he suggested, but I thought this unlikely because she had tested negative for it before. Cushing’s also, but this had also been negative. He offered to run a battery of blood tests to start. If the results from the first set of tests were negative, he would run a second set. Then a third. We would continue testing until we figured out what was happening.
I handed Autumn’s leash to the doctor so he could take her back to the lab. She was not happy and leaned her head towards me, pulling the leash away from the doctor. I pet her head and kissed her and told her everything would be fine. She kept pulling towards me as the doctor led her away. How many times in her life had I watched her disappear behind a door in a veterinarian’s office? How many times did watching the scene cause my heart to constrict and tears of anguish to form behind my eyes? It did not matter how often I had experienced this, my heart always ached as she was led away from me.
I sat in the sterile waiting room of the doctor’s office, staring at the mismatched tiles beneath my shoes. I liked this doctor. He was not Dr. Fletcher, but no one could be him to me. Yet this doctor was kind and honest, and he explained things to me as if I had a brain. The biggest problem with the clinic was that it was in a town about fifteen miles from our home, so trips there were a bit out of the way.
In the waiting area was a giant cage with three kittens in it. Milla was thrilled with these kittens and played with them as we waited. A fat, orange, office cat came through and asked to be petted. It was not very friendly though, and scratched if you rubbed it too long, so Milla left it in favor of the kittens.
Milla ran through the lobby, her blonde curls bouncing, babbling and telling me about the babies. One of the kittens was a light grey color, its fur almost bluish. “See the blue kitty?” she asked me, pointing to it.
“That kitty is blue!” I responded, reaching out to give her a hug. She let me snuggle her for only a moment before running off to the other side of the counter, searching again for the scratching cat.
A half hour later, the door through which the doctor had taken Autumn swung open and the doctor stepped through. His diagnosis was quick: Autumn had diabetes mellitus.
Diabetes mellitus, also known as impaired glucose homeostasis, is a group of metabolic disorders with one common manifestation: hyperglycemia. Chronic hyperglycemia causes damage to the eyes, kidneys, nerves, heart and blood vessels. It is a horrible disease and because of the manner in which it keeps the patient from absorbing food, causes gradual starvation. It results from defects in insulin secretion, or action, or both.
The disease was first identified in the ancient world as a disease associated with “sweet urine” and excessive muscle loss. The elevated levels of blood glucose cause the glucose to build up in the urine. Blood glucose levels are normally controlled by insulin, a hormone produced by the pancreas, which lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Basically, diabetics have too many sugars in their blood and no way to filter them out. It is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime. And Autumn had it. Little did I realize how much this diagnosis would drastically change our lives.
Years after all of this, I came to believe that the medical problems Autumn experienced arose from problems with her adrenal glands. At the time Autumn was alive, no one really knew what caused interstitial cystitis, but I’ve learned that recent research shows a link to adrenal malfunction. All along the doctors thought she had Cushing’s disease, although she never tested positive for it. And diabetes is one of the symptoms of a long-term Cushing’s dog. Considering Cushing’s is an adrenal malfunction and Autumn’s diseases were all manifestations of adrenal malfunction, I think it’s a safe assumption that this gland did not work properly for her, or else hers was covered in tumors, causing it to keep from doing its job.
The doctor started Autumn on low doses of insulin twice daily. He also wanted us to change her food to a prescription version for diabetics.
“What about her IC?” I queried?
“IC won’t kill her,” he answered. “Diabetes can and will. You will want to do everything you can to lengthen her life span and make her as comfortable as possible during that time. If she eats the wrong food, she could get really sick because she her body cannot filter out the sugars. This can cause all kinds of problems, from blindness to heart failure.”
I got it. Autumn would have to eat what she had to in order to survive the diabetes, IC be damned.
At first, it was somewhat of a struggle to settle into the routine of taking care of a diabetic dog. It took several trips to the vet to get her insulin levels right. We had started her on one type of dog food that she would not eat, probably because it tasted like sawdust, and kind of looked like it too. None of the dogs would eat it. I tried a couple of other brands before I found something she would eat. All of these dog foods were prescription foods and exorbitantly expensive. It was frustrating to buy a bag of dog food that cost nearly one-hundred dollars for a twenty pound bag, only to have every canine in our house turn its nose up at it.
I also had to concern myself with the ingredients of whatever dog food because certain of them would trigger IC episodes. Even though diabetes trumped IC in determining what would land on Autumn’s plate, that didn’t mean I would choose the worst of them and end up causing her unnecessary pain.
It was a struggle to figure out how to manage the diabetes. Because she would not eat most of the foods I would buy, Autumn would either tear down the house getting into trash or escape and go eat someone else’s. This led to several diabetic episodes where Autumn would escape, then wander home, glassy-eyed and practically catatonic.
At the time of her diagnosis, we were living in the country suburb where all the houses looked exactly the same. Shortly after purchasing the house, we installed landscaping and whatnot for the side and back yards. While doing this, we decided to add a sprinkler system to the entire property. Then we fenced a special side yard just for the dogs. Ever since we owned Poppy we had used dog doors to allow the dogs to go out to relieve themselves. These had proved to be a godsend when Autumn starting having bladder troubles. If there was a chance she could make it outside, she certainly tried.
In the new house, we installed dog doors into the garage and out to the doggy yard. This yard ran the entire length of the house, and was fenced on two sides by cedar plank fencing five feet tall. We then installed chain link fencing between the dog yard and our back yard. We placed river rock up the length of one side of the yard, and grass on the other, with paver bricks between the two and along the base of all the fences. The bricks under the fences were fixed into place with cement. Our thinking was that this would prevent Autumn from being able to dig out and under the fence. We thought the cedar planks, placed side by side, would prevent her from squeezing out. Same with the chain link. Basically, this fence was a dog fortress from which we believed she would never escape.
We were wrong. First, Autumn removed the boards from the cedar plank fencing. We nailed it back up and then nailed boards along the base on the outside. She then removed a corner of the chain link fence. This blew our minds. Her teeth in front were all broken in half from ripping off boards and fencing. Once we repaired that hole, she started in on the brick pavers under the fences.
This was the last straw. After Autumn tore a hole in the pavers and cedar fencing, escaping into the neighborhood and getting into someone’s trash, then coming home stoned on blood sugar, I had had enough. I immediately got into my car, drove to the pet store, and bought an underground electric fence, the kind with collars that shocked the dog if it went near it.
For years I had resisted these kinds of containment systems. I thought they were cruel, shocking the poor dog in the neck, but this was ridiculous. A shock was less traumatic than being smashed by a car.
We installed our fence and sent the dogs out into the yard. We set the range on the wire to two feet. This meant that four feet out from the fence, the collar would start beeping. As the dogs moved closer to the wire, the beeping became louder and faster, more insistent. Then, at two feet out from the wire, the collar gave them a shock.
It worked. It worked so amazingly well, I wished I had installed it years earlier. After two or three shocks, all the dogs stopped going near the fence the second they heard the beeps. Autumn would go to the faster beeps, but then she would stop. She was no dummy.
I no longer thought the fences were cruel. It kept my dog contained and out of the way of cars and other dangers lurking about in the big, bad world. It also kept her from getting out and into food that would cause her to get sicker.
All of the other dogs gradually figured out where the line of the fence was at and never even waited for the beep. They stayed away. When I bought a new house less than a year later, I installed the fence in the dog run area there, and it worked then too, to the point that neither of the other dogs needed to wear the shock collar when they went outside.
It was never this way with Autumn. If she did not wear that collar, she escaped, no exceptions. But she did respect the collar and would not risk shocking herself to get out of the yard ever again.
One major plus to managing the fence situation was that I was able to stabilize Autumn’s insulin injections. Once her blood sugar stopped fluctuating because her food intake was controlled, it was easier to figure out where it needed to be and to maintain its levels.
One rainy Sunday afternoon several months after her diagnosis, but before we installed the underground fence, Autumn escaped and got into something, causing a diabetic episode. These episodes scared me. Autumn would return from wherever she had run off to, listless, her eyes staring off into space. I called it her sugar coma.
It was bound to happen that Autumn would get into something on a day when the vet was not open. She didn’t schedule her medical issues around the hours our vet was working. The result was that I ended up driving her into Portland to a corporate vet’s office in a national pet store chain. I had resisted these offices because I fundamentally disagreed with many of their policies. They tried to sell nearly everyone “prevention plans,” claiming the services cost less with the plan, but they charged more for those services in the first place, and seemed only to ensure the corporation would line its pockets on a regular basis, especially since as a large buyer, it most likely got discounts on many of the products. I also knew from my few vet friends that the wages paid to vets were low and the hours unstable. Overall, as is typical in many such conglomerates, profit drove its motives above all else, and I didn’t like that.
That said, the nice thing about such offices is that they are open many more hours than most smaller establishments. The vet we had been going to was open on Saturday, but not on Sunday. If we needed care on Sunday, they directed us to the emergency vet clinics in downtown Portland or downtown Salem, as they had when we thought Autumn’s stomach was twisted. It was one thing to pay an exorbitant price for such a visit at 3 in the morning, it was quite another in the middle of the day on a Sunday.
I dragged Autumn in to have her hooked up to an IV and get her blood sugars stabilized. After running all the tests, the clinic didn’t even bother trying to sell me their plan. They knew they would make way more money on me just based on Autumn’s many problems.
Yet I loved the doctor. His name was Dr. Horner and he was the closest thing to Dr. Fletcher I had found yet. Because I had read so much medical literature, and spent many hours discussing these issues with Dr. Fletcher, I was well versed in a lot of what was going on with Autumn metabolically. Dr. Horner seemed to sense this, and discussed her case with me at a precise, technical level. He was also extremely kind, and gentle with my dog. Over the years I have taken many animals to see Dr. Horner, and it doesn’t matter if it’s a rat, or a dog, or a lizard, he is always compassionate in his handling of animals.
While I had a good working relationship with the vet we had been using, his office was fifteen miles southwest of our house, towards Salem in a town called Woodburn. Not much later, I moved to Portland, and the new house was even further from the doctor in Woodburn. Once we moved, it was easy to slip into using Dr. Horner as our primary vet rather than the office that was so far away.
Read Autumn — Chapter 15