welcome home, Miles

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I am so truly thrilled to share with you all that Miles is home after a week in the animal hospital and two weeks after the initial onset of his condition. He has received excellent care at both VCA Animal Hospital in Lafayette and at the Purdue Small Animal Hospital in West Lafayette. I need to thank especially Dr. Amanda Rigterink at VCA and Dr. Katrina Stewart and Sara Grayson at Purdue. And I also need to thank all of you who provided support, whether emotional or financial, over these difficult several weeks. Without you all, Miles would not be with me, and my life would be much poorer without him.

For those who don’t know, two weeks or so ago Miles stopped eating and became lethargic. He’s always been a very healthy and energetic dog, so I was very concerned and took him in to the vet. They found that he was suffering from a severe and serious condition, immune-mediated hemolytic anemia. In this illness, a dog’s immune system begins to attack its own red blood cells. It’s origins are sometimes specific, such as through zinc toxicity or ingestion of hormonal birth control, but often mysterious, as it has been with Miles. I was told that Miles’s prognosis was not good and that half of the dogs that come to the vet with the disease never return home.

Miles was given medications to fight his illness, including prednisone, a steroid with anti-inflammatory and immuno-suppressive functions; doxycycline, an antibiotic; sucralfate, a stomach protector; Pepcid, to help his stomach with all of the medication; and aspirin, to help thin his blood and prevent the kinds of clots that his condition can cause. I was told that a health dog has a red blood cell count in the mid-30%s; at one point, Miles’s dropped as low as 12%, and we considered giving him a transfusion. But his therapy seemed to be working. While he remained very lethargic, in part due to the medication, his red blood cells began slowly rebounding, and he ate more readily than before.

On Monday night, however, Miles had a major setback. He suffered a thromboembolic event (a stroke) when a blood clot passed through his brain. One moment he was lying comfortably next to me, and the next his body began to shake in a very frightening way. He began to whine and then to howl in a way I’ve never heard before. His legs were splaying out in every direction, he craned his neck awkwardly, and his whole body seemed to crimp together. In a panic I lugged him down stairs, threw him in the car, and raced him to Purdue’s animal hospital. They brought him in on an emergency basis. For two hours, I sat in an exam room, while off and on, I would hear him start howling in terrible pain again, from somewhere deep inside the facility. Finally at around 1 AM his attacks seemed to pass. They told me that he was presenting as a neurological patient. When I left him, they had placed him in a padded run. His little body was curled up and his eyes pointed in two separate directions. He was unable to blink in unison. I left thinking that I would surely have to have him put down the next morning. It was truly one of the worst nights of my life.

But the vets were skilled and calm. Though I had feared that his pain was so severe they should perhaps end it, they had told me that they would hold on through the night and see how he was doing in the morning. Miles was given a catheter and IV. They ran him through a large number of tests to determine his condition. They told me that all of his work indicated that his IMHA had caused a thromboembolic event that caused his condition on Monday night. That was good news, as the initial fear was that brain cancer may have been the underlying cause of both. They also told me he was slowly improving, capable of blinking both eyes together and slowly developing dexterity in his front paws. Over the course of the week, Miles received more treatment, including physical therapy. I went to visit him every day. He was eventually taken off of his IV and catheter when he showed he could eat and go to the bathroom on his own. The next day he was released from the intensive care section into the regular wards. Finally, he was pronounced adequately able to feed and drink on his own, and I was given instructions for care, prescriptions for medication, and he was released to me.

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None of this would have been possible without the incredible generosity of those who contributed to the GoFundMe campaign. Friends, family members, readers, well-wishers, and complete strangers contributed to the campaign. Some of them are people that I’ve read and interacted with on the internet. Many of them are names I’ve never seen before, just people who wanted to help. Every little piece, every $5 or $10 donation, added up as people pitched in, and I was able to give Miles everything he needed from the vet. That simply would not have been possible were it not for these donations. More, I had ample emotional and social support, from people both near and far, physical and digital, friends and strangers. I am more grateful than I can ever say.

With gratitude comes guilt. I find myself wondering what I would have done had I not had access to this money. When I rushed him to the hospital, I had to sign something saying that I would be able to cover at least $700 upfront, just for the initial emergency check in. How many people are in the position to say yes to that? I can’t imagine how many times people have had to decline care. I wonder what I would have done if I hadn’t been able to raise this money – if I hadn’t had my network, if I hadn’t had my advantages. I also wonder what I would do if I were 74 instead of 34 and couldn’t haul him up and down the stairs myself, what I would have done had I still been planning on moving away from Lafayette on the day after Miles’s stroke, things like that. I guess those are useless questions. More than anything, I just wish that everyone was able to get access to the health care they need, human and animal alike, and I feel so fortunate to have had this generosity for me and for Miles.

I am adding the latest invoices to the GoFundMe campaign and will be compiling a careful tally of everything for you all soon.

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Miles is disabled. Although he’s made significant progress in his motor control and mobility, he can’t walk without significant help. It’s unclear if he will ever regain complete control of his limbs. He wears a harness that helps me to carry him up and down the stairs and to spots where he can try to go to the bathroom. We will be doing exercises to try and rebuild his strength and coordination in his hind legs. I also manually manipulate his limbs in order to maintain joint flexibility and health. He’s quite adept at turning himself around, and he can skootch on the floor OK. When he tries to sit he often will fall over, and he drifts naturally to one side when he walks. Sometimes when I support him with his harness, he seems quite dexterous, and sometimes he really struggles to guide himself. Stairs are a complete no go for him right now, but I can haul him up and down the stairs to our apartment OK. What’s harder is that, when I’m leading him around or he wants to go somewhere in the apartment, it’s difficult to tell when he’s resisting my leading him in a particular direction and when he’s just struggling with his condition.

He will remain on steroid and anticoagulant therapies for a long time, perhaps permanently. The prednisone causes him to breathe heavily and gives him a distended belly. He shakes quite a bit from both his condition and the medication. I really dread a heat wave, as even in the relatively cool weather we’ve had recently, going out causes him a great deal of exertion. He is not in complete control of his bathroom function, although we’re hopeful for good progress there. Because he can potentially harm himself when he moves around, when I go out I have to leave him in a confined area; I build him a little nest out of blankets and pillows next to the bed and shut him in with boxes. The underlying IMHA, while it has been very well controlled and should continue to be, is probably not going to ever go away. He will always be at increased risk of another thromboembolic event. We will have to go for repeated checkups and blood tests for some time to come.

I also have to get past a few things myself. I know I will live in fear of another stroke for some time. The powerlessness and terror of that night will stay with me. I am in Mother Hen mode right now and it’s not sustainable. I felt very guilty leaving him to run to the store this morning, and that’s just not gonna work long term. I woke up constantly last night in a panic over him, and of course he was sleeping soundly next to me. I’ve got to convince myself that he’s not made of glass.

All of this is just a way to say that Miles and I have a lot of work ahead of us. I’m happy to do it. The work ahead is part of the good news, after all. And while I wish I didn’t have to do it alone, I’m confident that I can give Miles the care he needs as he continues to make whatever improvements he can. Even if he never gets much better than he is today, he is just the dog that I want, and one of the great blessings of my life.

I know that it’s an unforgivable cliché, but coming so close to losing Miles has made me feel immensely grateful for him and ofor ur time together. My gratitude at having his care paid for by friends and strangers alike is not something I can adequately express. All I can do is tell you that my thanks is beyond words, and that I hope someday that I will have the opportunity to help others in kind, as I have been helped, beyond any fair or rational expectation.

Miles is my best friend, and I love him with my whole heart. I’m very emotional, these days. Miles is Miles.

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