Buford 1/5/99 - 12/8/09 Godspeed--Mommy Loves You

It has taken me about 3 weeks to finally sit down and write an account of the final weeks leading up to that last car ride to the vet and a final farewell to my best friend, Buford. I can only hope and pray that those with more faith than I are correct--it is tough for me to completely believe--that we will one day be reunited at the Rainbow Bridge, Heaven or whatever may be next for all. He took with him a part of my heart that will always be empty.

It started on November 22, 2009....well, maybe it started a few weeks before but there was no consistency to it, just a random episode here and there that I chalked up to a "bad day" that was to be expected. But in hindsight those few "bad days" were warning signs of what was to come. On November 22, 2009 Buford a "bad day," a REALLY bad day. He exhibited bloat symptoms multiple times that day, but 1) he could not go into a full GDV due to his stomach tacking, and 2) each episode resolved with a massive belch within 20 minutes of starting. But still, something was wrong because it happened three separate times that day.

The next day he was fine. Then Tuesday same thing--a longer episode. He calmed down eventually and slept hard. My radar was ringing loudly--something was wrong. He had just been boarded, but he had been boarded a lot this fall for a day or two with no ill effects. He had a touch of constipation but that started to clear so since things were moving, I figured he was alright. He was eating, peeing, pooping, and seemed happy.....except for these random bloat episodes.

Wednesday he was fine. Thursday, same routine; Friday ok; Saturday ok; Sunday--minor episode; Monday: BIG episode---I called the emergency vet where his internist worked. How convenient: the internist was on vacation on this December 14th--it was November 30th. They urged me to bring him and treat him as an emergency case. So I raced. He was in abdominal pain so everyone thought "obstruction." X-Rays revealed nothing. Nothing except food in his stomach, gas in every inch of his intestines and stool ready to exit. We were sent home with every antacid on the market plus Carafate. Instructions--see the internist when he returns.

He responded well to everything until Thursday. 2 episodes a couple hours apart so I raced him over to his regular vet. Everyone was scratching their heads--it made no sense. There was nothing wrong, but clearly there was something VERY wrong. We decided to max him out on the Carafate--his acid reflux was off the charts and in trying to quench the burn he was drinking excessive amounts of water and gulping air, essentially causing self-inflicted bloat. Home we went with a bunch more Carafate tablets.

He again responded well--the Carafate was working.....until December 8th. He was fine at 4:30 PM. I went over to my mother's home for a quick dinner with her and was home at 5:45 PM. While gone he had an episode that I walked in on in the middle--a full blown bloat episode and for the first time went as far as vomiting. He was in pain--from the gas, from the acid and finally from the vomiting. Something must have happened when he vomited as his eyes were completely bloodshot. Not basset hound red, but total red. There were no whites left to his eyes--they were completely blood filled.

....and he finally burped and wagged his tail while looking at me. And my heart broke as I picked up the phone to make the one call we pray we never have to make but know we will one day. I cried to my vet, but I knew in my heart it was his time. He sat with me there on the floor getting ear scratches and head rubs while I talked about options--knowing there was only one.

I hung up the phone, picked up his leash, looked him in the eye and said one last time, "Let's go for a ride baby." And he raced to the car as he always did--as if nothing was wrong. And when I looked at him as we drove I saw two bloody eyes that held so much love I hated myself because I knew this was his last ride, something he loved, but he didn't know.

We got to the hospital and I sat in an exam room with my boy, rubbing his head, scratching his ears and keeping him calm while I talked through everything one last time with the doctor. For him to not get relief from all the meds probably meant that his scarred esophagus and/or stomach lining had started to ulcerate. The only choice would have been to put him on massive doses of predisone to treat the pain.

I looked at him and then at the vet and said, "For how long and for whom, him or me?" The answer was clear without anything being said--it would have been for me, and merely delaying the inevitable and quite possibly causing him more distress. I vowed I would never let him be in pain if I could at all avoid it, and I kept that promise at 8 PM on December 8, 2009.

My Buford baby did not go gentle into that good night. The first attempt: his vein collapsed. The 2nd attempt he almost bit the vet. Finally (and yes, I stayed and I was more of a wreck than can be described in words), the third vein held and my boy drifted quickly and quietly in my arms. In seconds he was gone.....and I wanted to go with him.

I stayed alone with him for a while, talking to him, kissing his head and face and trying to pull myself together so that I could drive home. How I got home I'll never know but I did. And I grabbed Della and screamed into her fur. It took Della a full week before she realized her brother wasn't coming home. She hit full doggy depression at that point and would sleep on the couch and wake frequently, snapping her head toward his empty chair and then sighing heavily while she put her head back down and went back to sleep. It's been 3 weeks and she still will not go near his chair.

I miss my boy horribly. I'm learning more and more about Della every day and for that I'm very happy--she is a delightful dog who lived in the shadow of her brother Buford and his ailments for the first 5 years of her life. She is not Buford, and I do not want her to be. But I cannot help wishing he was still here.

I buried Buford on Friday, December 11th on the farm. One of the vet tech's mother owns a farm just over the PA line and her mother offered me anywhere that I wanted to lay my boy to rest. I picked a spot on a terraced area overlooking the lake--it is beautiful there.

Something odd happened a week after he left for the bridge. Because of his struggles with Cushing's Disease, Buford had to go out almost every 2 hours or so--I became accustomed to sleep deprivation many months earlier as this had been going on for close to 2 years. Della was sound asleep next to me in bed--deep sleep in fact, but while she slept, something woke me up. It was a little after 3 AM, a usual "gotta go out" time for Buford. I was awake, very awake. So I picked up my book and started to read. After about 15 minutes or so I heard something that normally would have frightened me--a scratch against wood. I put the book down and listened thinking it was a branch and then I heard it again and it was not a branch--it was a scratch of a nail against the front door. I looked at Della who was still sleeping. And then I saw the cat also sleeping on the foot of the bed. I looked toward the bedroom door and out into the hallway when I heard something else: a woof. And I knew Buford was downstairs in the foyer as he often was, calling up to me not out of need to go out, but rather as a "HI Mom. I'm ok!"

I wasn't frightened, I was calm. My heart wasn't even beating fast. As crazy as it sounds, I'm convinced it was him. I know the sounds of this house better than I know my own inner thoughts and I have never heard anything that sounds like a basset hound woof except when it came from one of the pups. I have not heard it again since that night, although I find myself waking regularly between 3-3:25 AM almost every night.

He was with me from the age of 7 months until his last breath when he was 10 years, 11 months and 3 days old. And I wouldn't trade a single moment I shared with the dog for anything in the world--he was my heart dog and I will always love him.

Rest easy Buford. Until we meet again my boy.

Rough Morning for Buford

I'm not sure what's going on to be honest....yesterday (Friday) I fed him breakfast at his usual 5:30 AM and then I just couldn't stay up so I went back to sleep. I woke up around 7:30 to find him sleeping soundly nearby but I then found 3 areas in the living room where he had apparently vomited (and then "cleaned up after himself). Somehow I slept through the how event but he seemed fine.

He ate a 1/2 can for lunch - we're trying to increase his caloric intake in the hope of putting some weight on him - and he did fine. Dinner: he seemed alright for the most part. A little restless but he climbed up on the couch, snuggled down next to me and went into a normal dog food coma for a couple hours.

Then this morning: at 3 AM he woke up and tried to vomit. After a couple of retches he attempted to eliminate but nothing came out. He only did it once and then went back to sleep. He seemed fine and in his normal "I'm starving" mode for breakfast at 6 AM so I fed him. And it was as if he never had surgery! He gassed up like a balloon but belched and de-gassed fairly quickly. Then the hypersalivation began, and the "hoovering" of anything and everything in order to try to make himself vomit. It took about an hour to get him to to through his process: gas up, slobber, fight me to hoover, belch, de-gas, repeat.

Finally he settled down and fell into a deep sleep around 7:30 AM. I'm exhausted. And of course, it's Saturday------and even if I had to take him back to the specialty/emergency clinic, his internist is at a conference and won't be back until TUESDAY!

I hope he has an easier day....I'm thinking of spreading his meals out thoroughout the day now--same amount but give in smaller portions over the course of the day. Fortunately I am home this time of year and can do this with little inconvenience. This poor dog--he just can't catch a break!

3 Days Post-Op

Buford seems to be doing very well. The crying/moaning he was doing Saturday and Sunday have all but disappeared. He is walking well, even trying to trot a little which I work very hard to try and stop. Too much too soon and we'll be right back into surgery to fix whatever damage he's caused himself. His incision looks good. His appetite is terrific and his "business" is right on track. He has counter-cruised a few times, something I also I trying to discourage out of fear of him ripping stitches, etc.

Not all of his bloating symptoms have disappeared however. The surgeon did say that some dogs who have gastropexy still experience bloating but there is no longer a chance of a GVD since the stomach can no longer twist. Fortunately the symptoms are not very severe: he still licks the air on and off for about 30 minutes after meals--and it always subsides after each burp. Saturday and Sunday he experienced some hyper-salivation as well during the first hour after eating full meals but it also cleared up on its own. There has been no sign of physical bloating, nor has he vomited.

I have noticed that he is still pretty restless after meals--pacing, looking for more to eat, etc. And each time this has happened a very short and slow walk down the block and back again cured him.....well, the walk didn't but the fact that each time he we went he moved his bowels and THEN he settled down. So it appears that the dog who has never really liked walks now loves them and HAS to take them for more reasons than just exercise.

Hopefully he will continue to improve as each day goes by. He seems happy and still quite energetic--a very good thing.

Buford--post surgical update

The surgeon called a little bit ago and said that Buford did very well. Fortunately I have nothing new to report since the last update as nothing additional was found/done to him. He is going to be monitored very closely through the entire night as they need to make sure he does not have an abdominal bleed. He's on morphine (I could use some) and if he's stable enough he will come home tomorrow. I flat out told the surgeon that I'm in no rush to get him home if he's safer there. I'll pay the extra hospitalization charges to keep him there until Sunday just to make sure he's really ok the return home. He said he understood and that we would take it day by day.

Recap:

Gastropexy (stomach tacking)
Removal of spleen due to multiple nodules
Partial liver lobectomy due to the finding of a nodule
Tissue samples being sent for biopsy of stomach lining, intestines and the spleen/liver to UPENN
Clear evidence of esophagus damage from acid reflux (to be treated most likely with Prilosec)

Thank you all for being there for him (and me too).

Buford--surgery tomorrow

Things are not getting better and we may be facing the last option in assisting my boy in having a sense of a normal life. Tomorrow morning I take my baby to the Veterinary Specialty Center in Delaware where he will undergo some pretty invasive surgery. They are going to tack his stomach down (gastropexy), do a surgical exploratory, do an endoscopy and scope his esophagus as well as taking biopsies of his intestines. Here's why:

While the bloat symptom of filling with gas has remained under control he is still clearly experiencing bloating on a regular basis, meaning, after each meal. He paces, he licks the air, he hypersalivates, and he is very uncomfortable for 3-4 hours after breakfast and dinner. The suspicion is that his stomach has been doing a 90 degree twist most, if not all, of his life. And he is now at the point where it has become more and more difficult for his body to unflip his stomach back into a normal position.

**IF** this is indeed the problem (for there is no real way to prove the suspicion unless the internist was to catch an actual twist/flip on an xray) then tacking his stomach may just solve his digestive problems.

If this is not the answer to the problem....we may be out of options and I may have to face making that decision every pet owner prays will never have to be made.

What makes things harder is that he is active, alert, hungry, playful and energetic. He trots the entire way during his 30-40 minute morning and evening walks; he greats me happily at the door when I come home; he plays with Della....and the list goes on. How do you make a decision to end the life of a dog whose very soul has touched your own when he simply does not appear to be clinically ill, but clearly is medically?

I do hope that is not the road we will travel....I suppose I will just have to wait and pray he 1) survives the surgery and 2) the gastropexy works.

Buford: Two Week Update

Buford has had a very good couple of days, almost a full week of "good." Eating well, everything moving through his system properly, etc. I cut out the Carafate after the 2 weeks as instructed he seems to be doing well.

But just a little while ago he threw up for the first time in about 10 days. It was fortunately a pretty normal episode in that he got up off his chair, sat on the floor and threw up the biscuit he had just eaten along with just a some water/mucous. No bloating, nor trying to continue making himself vomit, no insanity like before---but:

This morning he had a problem eating breakfast. The food (canned Hills Prescription Z/D) was from a new case and was not the same rubbery consistency as previous cases. It was a little bit softer/mushier (it that makes sense) and it stuck to the fork more after putting it in his dish. The case was in the garage the last couple of days and it was warm in there but not hot. I put some cans in the fridge and we'll see what it's like at dinner. Perhaps the cold of the fridge will "stiffen" up the food a bit.

I mention this because as he was eating either the food got stuck going down or adhered itself to the inside of his palette. He kept working at it trying to swallow it, acting much when he used to get some peanut butter. Finally he stopped, drank some water and I fed the rest of breakfast to him using a spoon, trying to give him pieces he could just swallow without worrying about chewing, etc.

Following the little vomit episode he started coughing like he had been doing 2 weeks ago and did a short period of the gasping/gagging. I'm going to give him a dose of Carafate in a little while--he's sleeping at the moment, having finally calmed down. He wasn't frantic this time--but he did look extremely worn out. More worn out than he should after a quick vomiting moment like that.

I don't believe my baby will ever be "right" again, I do hope that we can continue to control these symptoms however--he has been so happy, playful and acting like he generally felt better this last week. It is very difficult to see him in distress--sigh.

The Morning After

He had a GREAT night!! From 10 PM - 3 AM he slept like a log--I'm not even sure if he changed position. Granted he was exhausted but I think it was also because he had gotten some relief from his problems.

This morning began at 5 AM because I need to leave for NYUCI w/mom by 8 AM. The schedule of digestive "assistants" that he is taking requires somethings to be taken 30 minutes before eating, some during meals and still another 30 minutes after he took his last medication. If you think you're confused you should see the notes I needed to write for myself.

Breakfast seemed to go well--again, not sign of bloating. Some "normal" post-meal belly gurgles, a regular belch and then some "posterior eliminations" (someone light a Febreze candle please).

It's about an hour now since breakfast was eaten--half of his old food and half of the new Hills Prescription Z/D (looks like there's nothing flavorful about it at all--poor guy)--and he's zonked out on his favorite chair in the living room.

Time will tell if we're doing the right thing but if all continues as the last 9 hours have gone then I'm going to allow myself to believe we're on the right track.

Return Visit to ER Clinic--Potential Relief

I know---it's getting old, but this evening I took the advice of Mary Tipping and took Buford back to the emergency clinic because things were "just not right" and I was a wreck. I called first, explained the situation--filling with gas/air to the point of bloat each time he ate ANYTHING--and they said to immediately bring him back for re-evaluation. I'm thinking "running out of money but what can I do? I don't want him to die because I was stupid."

We met with yet another doctor (4th one so far) who re-examined him, and reviewed his entire file from soup to nuts. It was perhaps the most exhaustive session I have yet to have with a vet. When all was said and done it was agreed that we're all just grasping at straws and guessing what could be wrong. Granted, he has early heart disease and I never would have known that if it were not for all the tests done these last couple days--but that did not explain all the gas he was getting. This doctor agreed.

So, we're treating him for three things: a possible gastrointestinal motility problem, a possible inflammatory condition of his gastrointestinal tract, and a possible reaction to his food and/or gastroesophageal reflux. Also knowing that something else could be in play, he will be seeing an internal medicine specialist as soon as I set up the appointment tomorrow morning.

We came home with Reglan, Carafate, Zantac and Hills Prescription Z/D food to go along with his Trilostane for Cushings and Enalapril for his heart. The way everything has to be given with regard to how often, how much, how soon before meals, how soon after meals, how soon after all oral medication....my head is still spinning! I had to write everything down twice to get it organized correctly and I'm still scared that I'll screw it up. Tomorrow I will pick up one of those pill boxes that spreads things out for a week, etc. YIKES!

**BUT** here's the GOOD news: we survived dinner tonight with ZERO bloat!!! Heck, the boy is so jazzed up with anti-this and anti-that it's a wonder his body even knows it ate food! But he's sleeping soundly on the couch right now and that's the best sound I've heard from him all day.

I hope we get through the night with ease as well as tomorrow morning's meal. I'll be a wreck all day because I have to take my mother to NY for her oncologist appointment, but he will be at his regular vet's for boarding and I'll make sure they know EVERYTHING that's been going on--I'll pay extra for someone to check on him every 30 minutes if I have to!

Things Not Good

Saturday night's dinner turned bad. While eating dinner, and mean WHILE eating, he bloated right before my eyes. It was so bad that he stopped eating. I raced over, yanked the bowl away and realized that he was trying to burp but couldn't. So I started rubbing and lightly patting his sides (like you would a baby) to help him. At first nothing and he was SO bloated that he couldn't breathe and started shaking. I truly thought he was going to either pass out or explode and I'm not exaggerating about the exploding part. FINALLY he belched so loud the it must have been heard down the street!

For the next hour he belched and passed gas on and off but eventually calmed down.

Breakfast: same thing but to a lesser degree. I gave him a Gas-X pill before he started to eat and helped him burp while he ate and afterwards. I denied him water for a full 2 hours after breakfast.

The weird part: he swallows tons of air ONLY while eating food, not drinking water.

So, big questions for the vet tomorrow morning (always on a weekend folks, ALWAYS!) because this is scary stuff. I plan to break his dinner and breakfast up into 4 meals instead of two hoping that less at once will be easier on him.

I still think there is something else in play here. Yes we discovered the start of early heart disease and have him medicated for that----but this is too weird/odd to be JUST from heart problems.

Buford is Home!

The boy is snoring peacefully and calmly in his favorite chair next to the fireplace in the family room---you know, the $800 Thomasville chair and ottoman I purchased for myself a year and a half ago and have NEVER sat in.

DIAGNOSIS: moderate mitral and tricuspid valvular insufficiency. He is on 10 mgs of Enalapril to control his high blood pressure and ease the workload on his heart. This seems to have been causing all the coughing and gagging. The vomiting and bloating were just side effects of all the air gulping!

He needs to have his blood pressure, kidney enzymes and electrolytes checked in 7-10 days to make sure that the dosage is correct and not causing other problems. Then he gets to see his new cardiologist in 4-6 months. (I think that **I** better see a cardiologist after all this stress!)

He seems much more at ease and more in control. Earlier he had a small gagging moment but it passed quickly and without any negative results. I think it is going to take some time for him to totally stablize but he seems to be well on his way.

Good to have him home, that's for sure.

Buford--Heart Problems May Be The Cause

He's been at the VSCD in Newport for 24 hours....and since that time has undergone an abdominal ultrasound, abdominal xrays, chest xrays, and tons of blood work.  All of that revealed that for a Cushing's dog, Buford is rock solid healthy.  But it also revealed an enlarged left ventricular chamber as well as a substantial heart murmur.

This prompted me to agree (think more money now) to have him examined by the cardiologist who did an ultrasound on his heart.

Findings: His mitral valve and tricuspid valve are both not closing properly, his heart is overworking because of this and his blood pressure is elevated.  

He is being put on meds to 1) lower his blood pressure and 2) ease the workload on his heart. They believe this will ease the coughing and gagging that they feel is being caused by the extra stress on his heart as well as the enlarged left chamber that is putting pressure against his trachea.

**If his symptoms are not relieved by this treatment they will do a thoracic wash and see if there are lung problems.  This will not be done right now however--we are going to give the heart meds a chance first.

As long as he keeps food down tonight he will be released first thing in the morning.

A Buford Moment of Levity:  Prior to calling me this evening, the night emergency doc, Dr. Vicari, gave him some food.  She said she had to count all of her fingers to make sure she didn't lose any when he tried to snatch it out of her hands!  She was not angry in the least--she was laughing about it and added, "I think he's had enough of us and wants to go home."   Clearly the boy is not a happy camper!

Buford's Latest Battles

The boy is currently at the Veterinary Specialty Center of Delaware in Newport, DE. Initial reason: uncontrollable coughing and gagging causing swallowing of air and bloat episodes. All of this was preceded the day before with a 7 hour vomiting/bloating/de-bloating night and a day spent at his regular vet on anti-vomit meds, fluids, etc. He came home from there and later that night it all started again but worse.

Honestly we're not completely sure what we're dealing with yet. Buford has NEVER been a healthy hound--never, and he's been with me since he was 7 months old. However, he is a sweetheart and deserves as much care as I can possible get for him--so race to vets and I done and will continue to do because THAT is how I am. (can you tell that others have been passing "judgment" on me lately?!)

Ok, back to the situation:

Today he is being seen by an internist, his x-rays will be reviewed by the radiologist who has done his previous ultrasounds over the years, and we will most likely do another ultrasound next week (no appointments available until then). His upper abdomen is tender and slightly swollen--docs are unsure as to whether this is just the trapped air he has gulped into his entire GI tract or if the pancreas is at all involved.

The other "not normal" thing is that he has developed a slight cough over the last few weeks. Nothing regular, usually happens after drinking water--you know, you don't think anything of it because you're thinking "slow down pal, you'll choke." But that cough has returned and precedes all of his gagging episodes. This is another flag that we want to try to find the cause of--it's not normal and could be the indicator of a larger problem.

We just got the Cushings under control and now something else is in play. My poor boy just doesn't get a break.