A good knee is hard to find

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Shiloh doing one of his favorite things . . . swimming.

I’m writing this late in the evening.  Barkley and Shiloh are fast asleep, Barkley on his bed, and Shiloh on mine.  We have had Shiloh for six years now, and every night we tell him to go to his bed, and every night he looks at us and goes back to sleep, and we have to either nudge him off the bed or carry him off.  There are a lot of days in six years, and a Lab is a smart animal, so what does it mean?  The bed is comfortable and is smells like us.  Is that why he resists leaving it?  The dog beds are at the foot of ours, strewn with a fuzzy toy in the shape of a cow and a slightly smelly t-shirt of my husband’s that the dogs think is just wonderful.  Barkley likes to take my sleep shirt off the bed and take it downstairs during the day.  I find it there, in the kitchen, or on the living room couch, or in the hallway.  I suppose they each have their own ways of keeping us close, through our smells.

In December 2009 Shiloh and I both had surgery.  I got better, but he did not.  He had the misfortune of having bad genes and had developed elbow dysplasia as a puppy.  Whether the doctor didn’t do a good job, or Shiloh put too much pressure on it, or just bad luck, the bone never healed correctly.  We learned that years later.  What happened after the surgery was that he developed arthritis in the joint.  So, the surgery that had ostensibly been a success in improving the dysplasia, led to another equally debilitating issue.  We had been helping him mitigate it with physical therapy, swimming, and acupuncture. Earlier this year it started getting a lot worse, and then the vet told us that he was getting arthritis in his right front leg.  Now, a dog can do fine with three good legs, but not two.  Being a dog and not a person, he can’t use a cane, or crutches, and he can’t even get knee replacement because the arthritis is so bad there is nothing that surgery can do.  We know this because we went to an orthopedic specialist vet in Virginia.  These specialists exist in animal hospitals where you can treat any kind of ailment from cancer to neurologic problems as long as you are willing to pay.  And pay you do because you are desperate for that one person to tell you what you want to hear, those longed for words “we can help your dog live a normal life.”

Unfortunately for Shiloh, we are still waiting for those words.  Instead we live on the slim hope that we can get a knee (or, elbow, to be anatomically correct for a dog) replacement for his nearly good right leg, which would give him the third good leg.  There are a few places in the U.S. where you can get this kind of surgery, and all of them are far from our home in Pennsylvania.  A hip replacement in a dog is common; elbow replacement is not.

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On our journey to better mobility we have learned a lot.  For example, you can do radiation therapy for a dog to improve pain in the joint.  This is a lower dose than for cancer treatment.   But if you want to do an elbow replacement you should do the radiation therapy after the surgery, not the other way around.  I learned that acupuncture is an effective method of pain management and that a dog with a limp will often get back or hip problems later in life.  This is because a dog is horizontal not vertical.  I can empathize with this as I have some lower back pain and it is nearly always associated with my own knee issues.  I had knee surgery about 18 months ago.  For humans this is common.  You can go to almost any local hospital and find someone who can look inside your knee and repair what ails you.  There are good doctors and better doctors, but there are plenty that know about knees and they are everywhere.  I had knee surgery because of a rabbit.  Before we got Barkley, we had a Boxer named Kellogg.   I used to walk Kellogg and Shiloh together in the mornings when my husband could not.  One morning two years ago I was walking them and they suddenly took off, pulling the leash out of my hands and dragging me to the ground with a thud.  I landed on my right side, thud.  This trauma caused damage to my knee, compounding previous traumas caused by other small animals chased by Kellogg. This is also why I don’t run anymore after thirty years of jogging. I only have one good knee.

My knee healed quickly.  I was lucky.  It wasn’t a meniscus tear as the MRI test had shown – tests are often wrong, and I didn’t need a knee replacement.  Within weeks I was mobile again, and in months doing everything I had done before the surgery.  I had given up running the year before.  I now bike more and keep active in other ways.  After my knee surgery I used crutches for about a week.  My knee swelled up to the size of a cantaloupe.  Ice was my friend those first days.  Finally I could get a pair of pants over my knee and return to work.  While I didn’t move as quickly, my life went on pretty much as before.  Some things seemed unattainable.  Getting to the cafeteria and carrying lunch back was impossible on crutches.  If I asked someone to come with me and carry my food, I could do it.  I had to leave early to get to meetings because I moved so slowly.  I had to ask a neighbor to drive me to work for a few days because I couldn’t drive until the doctor gave me the all clear.  I had to depend on others to fill in the gaps created by my physical limitations.  I thought a lot about Shiloh in those weeks after my surgery.  I understood like I hadn’t before what he felt like and how frustrating it was for him to see his former active life gone forever.  Except for me it was only temporary, not permanent.

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A dog can’t do yoga or ride a bike or do pilates.  A dog can do physical therapy and swim and take a lot of the same pain medication that a human can.  In fact, our dog gets pain pills at the CVS. What does a dog for for the rest of his life when he’s only six and he is in constant pain and only has two good legs?  What does he do when his younger dog brother who is full of vim and vigor wants to chase him around the back yard or wrestle with him?  Shiloh can’t do down more than a few stairs and he can’t run and he has trouble getting up when he lies down.  I understand what this is like as I sometimes have the same problem getting up off the floor. Barkley goes for a walk in the morning.  Every morning we put on his harness and Shiloh follows us to the front door and tries to get out as we open the door.  Barkley goes for a long walk with us, Shiloh cannot.  We take him to doggy daycare where he happily plays with all the other dogs and pays for it for days afterwards.  I drive him down our long driveway and park the car down the street so he can walk the short distance to the playground and sniff around and lie down in the grass, looking up and down the street and watching kids go by as if he is a whole dog.  How do you make a life for a dog who cannot walk?

Shiloh’s life will be full of physical challenges.  He seems stoic about it all, enduring what must be at times terrible discomfort, yet cheerful and ready for the next adventure.  He goes happily to the vet each time, whether for a shot or something more invasive.  He is an incredibly social dog who thrives on interaction, be it with people or other dogs.  He bounds eagerly up to each new acquaintance, not waiting for an invitation or an introduction.  He lets larger and more rambunctious dogs paw at him or jump on him, submitting readily in the name of friendship.

Shiloh cannot get down our thirteen stairs to the first floor.  Up is easier than down.  I carry him down the stairs each morning.  After they eat they come back up, and we rest for another hour or two.  Then I carry him down again.   How long will my knee and back hold out?  He lies still in my arms as I move down the staircase, me counting each stair until I get to the bottom.  He remains still as I move through the living room; I sometimes make it to the kitchen before I have to put him down.  He loves to go out in the car as it only requires him to sit and stare out the window.  When he gets tired he lies down, until I come to a stop and he pops up to look out the window.

Shiloh has two chances at improvement.  The elbow replacement is his best bet.  We have to find a vet who will agree to do the surgery, who believes that he is a good candidate and that the time and money will result in a positive result.  While Shiloh recovers from this surgery he would need constant attention.  We would have to help him do everything, to walk and stand and lie down and eat.  Shiloh, who has been our comfort and buddy would have to rely on us for his every need, helpless for a time with only two good legs.  Are we both strong enough to get through it?

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