Tuesday, October 8, 2013

THE ROLLERCOASTER REPRIEVE



We had a follow up veterinary appointment this morning for D'fer and we have had some very, very good news.  What one vet and a radiologist thought was osteosarcoma may in fact be very severe osteoarthritis.  We sought out a second opinion this week, and had a second set of radiographs (the medical term for X-Rays is Radiograph) done today, ten days after the originals were taken.  What this allowed us to do is compare what his hips looked like ten days ago and what they look like now.  By finding out what the difference is we can find out one of two things; either the rate of cancerous growth is really fast and dangerous OR that perhaps the diagnosis of osteosarcoma was wrong and the diagnosis might be something else.  There are no significant changes between one and the other which means that most likely...we are NOT dealing with osteosarcoma.  We also did chest radiographs and there are no scary shadows on the film showing us that there has not been any cancerous spread to the lungs.  Phew!  Never the less, the radiologist did think that there is cancer in the bone, so we cannot dismiss that entirely.  If this is cancer, it is growing slowly enough that D'fer won't likely drop dead at any moment, and if this is not cancer, then we may have some treatment options that we hadn't had before.  And this brings me to the roller coaster metaphore for today.



D'fer with his celebration stick.  That would be the toy you buy when you get a different diagnosis than osteosarcoma.  Still not a great diagnosis, but better than death at any moment.

The injury that led to the osteosarcoma diagnosis was that Deef had been lame for a couple of weeks, off and on.  He had a sore shoulder and then he was gimping along on his left hip and then his right front leg looked a bit off.  Then one night, just about dinner time, I took D'fer out to pee and he asked me to throw his frisbee.  Normal D'fer stuff.  I took it and gave it back to him because he had been too sore to really play frisbee.  Then he trotted around the yard and did his thing, and brought me the frisbee again.  I took it and dropped it in front of him.  He launched himself into the air (much more forcefully than he needed to mind you!) and on his way up screamed in a way I had never heard him scream before.   He landed in a heap on his left hip.  When he got himself up he wouldn't put any weight on his left hind leg.  Off to the emergency room we went and they took a radiograph.  His left hip looked like scrambled eggs.  Not good.  I asked some questions and the emergency vet thought that he had severe osteoarthritis; a degeneration of the bone in the hip and sent us home with pain meds to keep him comfortable.  That vet visit is when we got onto the rollercoaster.


The injury happened on a Saturday evening so on Monday morning I went into my regular vet who looked at the radiograph and gave me the sad news that this might be osteosarcoma; a form of fast growing bone cancer.  He sent the radiographs out to a radiologist who confirmed his diagnosis.  My world fell apart, and I wrote last week's blog about how I was going to approach treating this.  D'fer's pain has been well managed and when his pain is under control, he really is a happy dog.  He is still quite lame, but he is a happy dog.  Even so, I felt like I was falling, falling, falling.
 

With the encouragement of friends, I sought out a second opinion; the second vet disagreed with the first vet and the radiologist.  Regardless of agreeing or disagreeing, a second set of radiographs would tell us if the image on the film was growing or staying the same.  That leg of the journey has been like the rollercoaster coasting along nicely and politely.  Things don't feel quite so disrupted or discouraging.  I feel quite a bit like I got my life back when I saw the rads today; especially the chest rads that don't show any cancer in D'fer's lungs.

Radiograph number one take ten days ago.  Compare the left and right hip joints; you will notice that one is nice and even and the other looks like scrambled eggs.  Or more technically "the left hip (right on the radiograph) presents with a  moth eaten appearance.  If you know about radiographs, this is a scary looking hip.

Now compare!  Don't worry that the bones aren't in the same exact direction as they were on the first radiograph; you can see that the problem joint is basically the same.  Now if you are like me, you expand this picture and then you look at it with a magnifying lens for fun!  The important part is that the joint didn't change between the first image and the second, even though D'fer was positioned slightly differently the second time.
 

So now we coast for a bit.  Some things have changed and will stay changed; we still have the radiology report saying that the image on the film looks a lot like cancer.  It still might be.  But it hasn't changed!  The vet cautioned us that we have to remember that it might just be.  Now we have a crate in the kitchen so that if we need to we can easily care for D'fer if he is in pain from his leg.  That will stay.  We are not turning D'fer out with other dogs in the yard because it just wouldn't be a good idea for him to get to running and chasing and rough housing with his friends given the state that his hip is in.  That is a change for sure.  We use the hip helper harness (http://www.hartmanharness.com/) to help him up and down stairs and in and out of the car and over curbs when he is stiff or sore.  Likely we will be using this more and more often as he ages and we are very happy to have it.  Probably the biggest change though is that we know that there will be more diagnostics and possibly more treatments on the horizon.
 
Happy D'fer on pain meds, with his cancer beating Frisbee and his hip helper.  One of the changes we have made is to make a rule that he cannot come upstairs without the help of his hip helper harness.  So nice to see him smiling again.  Good boy! 

 
Right now, D'fer's rads are being sent to the surgeon to see if they can remove the head of the femur and alleviate his pain that way.  IF, and it is a very big if, the surgeon thinks that she can successfully remove the head of the femur, then we will consult an internal medicine specialist and see if his heart is healthy enough to undergo anesthesia.  IF it is safe to anesthetize him, then we will work out a plan involving our veterinarian, the surgeon, the internal medicine specialist or cardiologist, and likely and anesthetist to remove the head of the femur.  This is a big hill on the Reprieve Rollercoaster, because a whole bunch of factors have to fall into place in order to be able to surgically help D'fer.  Knowing it is coming is stressful, and not knowing what the hill will surprise us with is even more stressful, but we are going to go up the hill and down the other side in the company of professionals who are educated and who care deeply about D'fer.

 
There are some important lessons in this experience that are not training related but they certainly do impact training.  The first is that you really need to know a little bit about your dog in order to advocate for him.  I have known for a long time that Deef has been "off" but have not been sure what exactly might be going on with him.  Once we had an injury, I count myself lucky on a number of fronts.  I know a lot about the basic anatomy and organization of the body, and how medicine works, so when the veterinarian wants to do something like taking a radiograph of my dog, then I have a good idea what she is talking about.  Also, I knew the emergency vet really, really well.  Those three things; knowing my dog, knowing a bit about biology and health and medicine and knowing my vet have paid off HUGE dividends this past ten days.  I have been able to talk to the veterinarians, I have been able to identify exactly how D'fer is not "himself", I have been able to ask good questions and I have been able to integrate what is being said so that I can advocate on D'fer's behalf.  When faced with an illness or injury being able to advocate for your dog like this allows you to return to training quickly and effectively.  This is really important.

 
Another thing to think about is that I had really clear boundaries about what I would and would not do to my dog before I needed to pull them out of my pocket and examine them.  I know that although I might amputate a dog's leg if it was injured or if it would buy him years of time, I am not going to amputate his leg to get a tissue sample (one of the options discussed when we had the osteosarcoma diagnosis).  I know that I will not engage in radical, painful, long treatment if it is not going to get us a great deal of benefit.  That means that for my dogs, although I might allow surgery, radiation or chemotherapy to happen to alleviate pain, or to significantly prolong life, I also know that I won't put being alive ahead of having what I consider a minimum level of quality of life.  I made this decision long before I needed it and I have discussed that decision at length with my veterinarian.  In fact I have decided these things about each of the animals I have responsibility for so that I can be certain that in a crisis I am not held over a barrel to make a choice I may not be comfortable with later.  Make your choices ahead of time where possible and then discuss them with your vet.  Doing so will save you a lot of headaches later on when you are faced with the decision and you already have a plan.

 
Finally, the most important thing that I did to prepare for the Rollercoaster Reprieve, was to carefully develop and organize a support system for myself.  This network is made up of close friends and family members, of dear and cherished clients, of veterinarians and technicians, of people on the net who have never met me but who have read my blogs and my articles and been to my seminars and who have reached out through this difficult time to help me, John and D'fer.  We are not out of the woods.  We may still lose D'fer imminently; he is after all ten years old with a heart condition.  He may or may not be a candidate for surgery.  He may over do it at some point tomorrow or the next day and fracture the neck of the femur, and we may be right back to where we were last week, when I wrote "IT WILL BE ALRIGHT", but I am confident that it WILL be alright because we have the support we need, we have good diagnostics and we have all the right things happening to help us to survive the Reprieve Rollercoaster and whatever it throws at us.  Thanks everyone; I couldn't have made it through this past week without you!

 



Tuesday, May 7, 2013

FAKE SERVICE DOGS? REALLY?




 I just arrived back from my trip to teach Treibball in Montreal with DogzWorth, and as many of you know this was Deef’s last big trip with me.  I am thinking of a retirement party for him sometime soon.  In many ways it was a great trip with the exception of the enormous access challenge that we faced just before we travelled.  I was travelling by train and as normal for me, I called the day before I was to travel in order to make sure that D’fer was going to be welcome on the train.  I call not because I have to, but because I want the trip to go as smoothly as possible.

The answer I got was somewhat frustrating.  I was told that the company’s policy was to require that all service dogs have certification by a recognized service dog school.  Under the law, this is not required, and probably not permitted, but many companies in many countries all over the world are beginning to make their own policies without regard for what the local laws say regarding disabled people who are accompanied by their service dogs.  And many companies are very concerned about people faking that their dog is a service dog.  Hmmm.

John posted a short blurb on his Facebook page lamenting how frustrated he was with this attitude, stating that we have never met a fake service dog.  I know many people claim that they know of this happening and I know many trainers who have been presented with dogs that clients want trained as a service dog so that they can either live somewhere that a dog is prohibited or that they can travel with their dogs, so I know this is out there, but I think that the whole “fake” service dog issue is a side bar. 

First and foremost it is illegal in most places to fake having a disability.  In the United States there are big fines at the federal level for faking a disability in order to get access to services that might not be available to the general public.  So if you are faking having a disability, then that in and of its self is wrong.  Using an assistive device to perpetuate that is even more wrong, regardless of the type of assistive device that you choose to use.

This is an extremely sophisticated assistive device.  Who trained her, where she came from, and what she does is not as important as the fact that she is never a disturbance in public!


Interestingly the transportation company did not have a policy regarding the use of wheelchairs, canes or walkers, of eye glasses or of hearing aides.  They only had a policy regarding the use of a dog.  Hmmmm again.  So in theory, if you are in need of a prosthetic finger, and you happen to be a bicycle repair guy, you can make your own and no one will care.  In fact, if you do that, you can get yourself an article in the Huffington Post:  http://tinyurl.com/c3qfhvf .  You are more than welcome to travel with your prosthetic finger, even if you are not certified to make one.  That dear readers is discrimination.  If you are permitted to make your own wheelchair, cane, glasses, prosthetics or hearing aides, then why should you not be permitted to train your own service dog?

Something that I think is an important part of disability culture is the right of the individual to determine what the best accommodation is for him or her.  I live with migraines, traumatic brain injury, depression and anxiety.  My dog is able to pick things up, make space for me in a crowd, help me to walk in a straight line and alert me to oncoming migraines and panic events.  My dog makes travel comfortable when I might not be able to go at all otherwise.  My dog frees up the skills of my fellow travelers who might otherwise be asked to pick things up or take care of me when I am not able to take care of myself.  I would far rather have D’fer by my side and not have to explain each day what I need and ask for the help I need in order to be able to go from one point to another.

Not every dog is suited to this work, and not every disabled person is able to train their own dogs, but we need to start considering some of the things that we can do when the situation comes together where a disabled person has a suitable dog and has the skills to train it.  When this comes together, then why shouldn’t we have the right to train our own dogs?

The law already says I am not permitted to create a disturbance in public.  Dogs themselves don’t have the right of access; it is disabled people who have the right of access and who may be accompanied by a working dog.  If I am traveling and my dog was to create a disturbance by barking, or toileting inappropriately, or by jumping on people or by knocking someone down, or by picking things up or carrying things, then it doesn’t matter if the dog is certified; the company has the right to kick me out.  My dog does none of these things.

When I called the company, I was told that I would need a certificate from a recognized service dog school.  I have a friend who is trying to fly overseas right now with her service dog and she is going through the same thing.  She has a very highly trained sheltie who assists her in a number of ways, but she does not have a “certificate”.  This discrimination is frustrating and avoidable.

There is a theory that is very interesting when it come to disabled and currently abled people sharing space; it is called Universal Accessibility.  What this means is that without making a special ramp, or changing the configuration of the room; how could we set up the world so that everyone would be welcome.  When you build a building so that it has Universal Accessibility, you think about how a wide variety of people would access your service.  In the case of a train you think about how you might build a train and the platform so that wheelchairs could roll in, and people could walk in and strollers could roll in and we wouldn’t need to preboard if we were disabled because there would be no more difficulty for someone with a wheelchair or a service dog or a baby in a buggy than there would be for someone who is currently abled.

We can also think of this as being something that we do when we make our rules.  Rules should apply equally to all.  No one ever worries about currently abled people rolling into their place of business in a wheelchair that they made themselves.  So if you are NOT disabled, and you decide to take your kitchen chair and the wheels off your bike and meld them together, there is no law that says you cannot travel around just like that.  Why you might want to is beyond me, but it is perfectly legal to do so.  In fact you can do this if you are disabled too, but really, who would want to do this?

When we look at the laws that we live with and the rules that companies make, they are often the result of a problem that has cropped up.  Presumably there have been no problems so far with homemade wheelchairs or prosthetics and thus there are not rules about this.  There have however been problems with service dogs and thus, we have rules, but the rules are rarely universal in nature.  I would implore organizations that make rules relating to service dogs to make fair rules that are in line with the law AND that apply equally to everyone.

If a rule were to state that train passengers are not permitted to make a disturbance either through making excessive noise, littering or leaving their seat area in an unsanitary manner, or interfering with their fellow passenger’s access to the train, we would have a rule that applied equally to service dog users, currently abled people and those with canes, wheelchairs or incontinent babies or service dogs, without specifically listing the service dog as an issue.  We already have a law that requires that service dog users in Ontario carry a letter from their doctor indicating that we have legitimate need for a service dog; why should we need more than that to give us the right to use a dog who is clean, well behaved, not barking and not blocking the aisle?  Fair is fair and I would like to see the rules change internally to reflect that rules ought to be the same for everyone.
 

Traveling through the public realm with a service dog is not nearly as much fun as people think.  The background work that goes into making a service dog candidate into a great service dog is huge.  You have to choose the right dog, and then give him the proper socialization.  You have to train him to cope with all the things that you are going to need to face as an adult doing public access.  You have to teach him to do things that help.  That your dog makes you feel better is not a task; it is an outcome.  If you cannot articulate what your dog does, then he isn’t a service dog.  Assistive devices are not toys, even though they may be a lot of fun some of the time.  If you are thinking about making your pet into a service dog, and you don’t have a disability consider that I cannot choose to not have my disability at any given point.  I am reliant on my dog to make it possible for me to do things, and it is not cool to pretend to have the limitations that a disabled person does. 



Traveling with a service dog is a lot of work.  When we got off the train in Toronto, my first order of duty was to find somewhere that Deef could toilet without inconveniencing any of my fellow travellers.  This weekend, that meant a twenty minute walk, lugging about fifty pounds of gear, out of the building and through construction.  D’fer was really thirsty from our trip so I had to find water.  I purchased a big bottle of water for him and unpacked his bowl and put it down for him to drink.  He drank most of it and then I needed to wait and see if he needed any more.  After waiting ten minutes, I dumped what he didn’t drink, used a dirty shirt from my suitcase to dry off the bowl and repacked everything.  Then we had to walk some more in case he needed to go again.  Have you noticed that I haven’t been to the bathroom yet?  Then we had to hike on back to the train station, and find an accessible bathroom; we don’t fit in a regular stall.  That done, I found a place to wait the hour for my connection.  During that hour four people interrupted my work (I was on my computer) to ask me inane questions about my dog.  Sometimes they ask me really rude questions too.  I am not fond of answering personal questions from complete strangers but it is par for the course when traveling with a service dog.  Why anyone would fake this is beyond me; it is too much work!

I have written this for several reasons.  Firstly, if you are a gate keeper who is trying to make sure that those who should not have a service dog don’t, please look first at the behaviour of the dog; if the dog is jacketed and well behaved, on one level, who cares if the person is disabled or not.  If they are not, if they don’t really need the dog they will learn soon enough that it is a big pain in the butt to travel with a dog who isn’t needed, and they will stop doing it.  If in the meantime, you have a well behaved dog on your hands, what harm?  And if the dog is not well behaved, you are within your rights to refuse service to the person solely based on them creating a disturbance.  Secondly, if you are considering faking your need for a service dog, think again.  It isn’t fair to the dog if he has not had the appropriate training to ask him to do the things we ask service dogs to do.  It is also a ton of work for you and it will get you attention you really don’t want.  Thirdly, if you are a service dog user, please make sure that your use of a dog doesn’t inconvenience the people you encounter.  I have seen service dogs who do not mind their manners, whose people don’t clean up after them and who create a disturbance.  YOU are disturbing the peace when your service dog barks, lunges, takes things that don’t belong to you or soils the area he is within, and the proprietor has the right to refuse you service based on YOU creating a disturbance.  Having a certificate from a service dog school doesn’t give you the right to disturb others.  We can all get along if we try, but we all have to try if we are going to get along.

Thursday, May 2, 2013

GUEST POST-Cooper the Puppy!!!



by Seanna Miller

Long before Cooper came home, I had placed the call to Dogs in the Park. Dogs in the Park was known to me – I had played at Sue and John Alexander’s wedding, many, many moons ago. As a matter of fact, Sue Alexander was my supervisor during my high school co-op – even more moons ago! I wanted puppy classes, and I wanted to make sure Cooper had a spot in a class with my good friends. I still remember the first reaction from Sue – “you got a what? A welsh terrier? What interested you in that breed?”


And so I told her. I wanted a breed that was independent, smart, small, feisty, with a sense of humor. I wanted a terrier specifically because I wanted a training challenge. Sue agreed that I would definitely get that. And I did – you can check out the blog post on Cooper here.


Back to puppy class! It had been about 10 years since I had a puppy. Chance, my heart dog, was a brilliant old man. I knew that because he was so easy, because we got each other, that I was in no shape to handle an unpredictable bundle of energy that would be Cooper the Puppy, and then Cooper the Dog.


Sure, long before Cooper came home, I had a crate, toys, food bowls, leashes, collars, harnesses – everything was worked out. I had dogs before, I knew what they were about, but I also knew that I needed help. I knew that puppy development was extremely important and puppy socialization was critical. And, I reasoned, a puppy is like a baby, and if new moms get help and support through all of the social programs out there, why couldn’t I get that same kind of help with my new puppy to ensure he had the best start possible to become the best dog he could potentially be?

 
Our timing was a little off. Cooper was due home a couple of days after the first puppy class, but that would be no problem – The Puppy Guy (aka John Alexander) would take care of us with a private catch up lesson – free of charge! I was also surprised to find out that the classes were an hour and a half long.


Feeling well prepared, Cooper and I went to our first class. He was so small! And the room so big! We went to our first class when he was 8 weeks old – Dogs in the Park takes great care to ensure that the puppy room is bleached to eliminate concerns around parvo, and that the toys are all sanitized. Cooper had a blast, because the puppy room – a nice sized room, was filled with toys, a rocking chair, crates, water bowls – all kinds of things to encourage a puppy to explore.

In our first lesson I learned all kinds of tips to help with toilet training, crating, and nipping. I was able to ask all kinds of questions about some of the odd things that Cooper was doing (I had one of those dogs that did not have any issues with peeing or pooping in his appropriately-sized crate). The Puppy Guy answered them thoroughly, and patiently, and delighted in my little Cooper stories (when Cooper first came home he loved to carry his metal food bowl around). I learned that we now know that choke chains are dangerous for dogs (and why). I trained Chance on a choke chain because that’s what we did 12 years ago – now I know differently, and I do better. Yet another reason why going to puppy class was the right decision for me!


Puppy class became the best fun I would have all week. Cooper loved going to puppy class, because there were other puppies to play with, lots of fun things to do, and of course, he loved his Puppy Guy, from whence all good things came (treats, toys, you name it!). Puppy class would go something like this:

  • ·         In the first class, puppies come in and they would have the opportunity to run around and play, often to the sound of a CD filled with all kinds of strange sounds (this is to help them learn that strange noises are OK!)
  • ·         In the second and following classes, puppies learn that they have to work before they play (following my favorite rule with Cooper – NILIF – Nothing In Life Is Free) by being tethered to the wall and asked for behaviors before getting their first play session.
  • ·         After a short play time, we would pick up the toys, put them away, then work on sits, or downs, or “leave it”. Some days we would have competitions for the longest down stay – Cooper never won those, but we tried hard nonetheless.
  • ·         After this short obedience time, we would let the puppies loose to wreak havoc on the puppy room again. The rule was that the two legged folk would have to constantly be moving around, doing body and collar grabs, immediately feeding and then returning the puppy to play. Puppy class sometimes tired me out more than Cooper!
  • ·         We would toilet the dogs a couple of times during class, outside. The Puppy Guy was always on hand to answer questions, and we learned how to train our pups how to eliminate on cue (so useful!)
  • ·         Finally, my favorite – “Pass the Puppy” where we would sit and talk about various topics related to puppy raising, and handle puppies throughout (examining feet, ears, eyes, paws, etc). Of course, it was also a good time to cuddle those cuties.
  • ·         The class would bounce between these activities so that neither puppies nor people would get bored, or overexcited.

There was always homework to do between classes but handouts describing how to approach the homework were very helpful. The Puppy Guy also answered questions between classes, and I can’t count the number of times we were leaving and there would still be some discussion going on. Dogs in the Park definitely went above and beyond to make sure that the puppies that were entrusted to their class had the support they and their owners needed.

And yes, it did take me FOUR weeks to teach Cooper to lie down on cue. Every one of those four weeks I would come in to class, feeling like I had failed in teaching this essential skill to my puppy (not the lying down part, the lying down ON CUE part), describing in great and – I’m sure – boring detail to The Puppy Guy every single frustration and tactic I had tried. It’s as if Cooper knew what I was up to, and spent much of his time staring off into space, standing rock still, ignoring me completely. The Puppy Guy was sympathetic, and encouraging. I hadn’t failed, he said, I just had to keep trying. Cooper and I would figure it out. His confidence and encouragement kept me going. I still remember the night when Cooper looked at me, sighed, and went into his down. I clicked, I treated, I jackpotted, I partied! I still remember it as my single biggest success during Cooper’s puppy days.


Cooper and his Puppy Guy!  Welsh Terriers love to snuggle....until they see something they want more, which is often almost immediately!



As I write this on the anniversary of Cooper’s arrival into my life, I am reflecting on the amount of time I have spent on my dog – most of it during his puppyhood. Thanks to Dogs in the Park and puppy class, and following on that, their equally impressive Levels classes, I am reaping the dividends of that early work. Cooper is a quintessential welsh terrier, with all of the independence and sense of humor that I was looking for, and he’s a great dog.


I’ve since moved countries and I miss Dogs in the Park terribly. A puppy class at Dogs in the Park is not a simple puppy class. It’s an entry ticket to a wonderfully supportive and accepting community, one that I continue to visit every time I go home. Cooper and I are always welcomed. I have yet to find a dog training school or dog training community that offers everything that Dogs in the Park does.


Puppy class was the single most important decision I made in my dog’s life to date, and it made me my Puppy’s Superhero. What are you doing to be your puppy’s Superhero?


(PS – you can follow Cooper the Dog on facebook, here)


From Sue:
Thanks Seanna for guesting my blog today!  We cannot wait for Dogfest and hope to see you there again this year!