Finn’s Hard Life

This dear old boy arrived just about a month ago from a small rural shelter in Virginia. A shelter volunteer had contacted us to see if we could take an elderly, blind dog they had found as a stray. No one had come forward to claim him. She emailed us a photo of him that broke our hearts: a sad gray face and an emaciated body, ribs sticking out. He was lying on a kennel floor, looking lost and confused. Where am I? Why am I here?

We quickly agreed to take him, and about a week later our pet transportation company picked him up and brought him to us. We knew how skinny he was from the photos we’d seen, and we knew the shelter had been feeding him for the few weeks he was in their care, but we were still shocked to see how thin he was when he arrived. During his health exam before leaving for New Hampshire, the shelter’s vet had rated him only as a 3 on a body condition score of 1 through 9. He weighed just 32 pounds, on a frame the size of a large Labrador Retriever. But even knowing that didn’t prepare us for how gaunt he was.

His eyes were a mess. It was hard to tell what he was blind from, but he clearly had lost his vision a long time ago. His eyeballs were smaller than normal, he always had a lot of discharge from them, and yet he also appeared to have thick cataracts.

He had oral masses in his mouth, his teeth were a disaster, and he frequently made loud, slurping/snuffling sounds while breathing. His ears were grossly infected and smelled rank.  (At times we weren’t sure if it was his mouth or his ears we were smelling.) He has chronic discharge from his right nostril, sometimes tinged with blood.

First Stop — Primary Care Vet

The week after Finn arrived we took him to our primary care vet for a medical exam and full blood work, along with an expanded tick borne disease panel. The bad news came fast. His blood panel revealed he was in kidney failure. He was also anemic. He had a rare tick-borne bacterial illness called mycoplasma hemocanis. (Having learned from working with internal medicine specialists on complex cases, we now ask our primary care vets to order an expanded tick-borne disease panel for things that won’t show up on the standard 4DX panel.)

The vet found that his ears were so badly infected, and had been for so long, that his ear canals had been closed up. She cleaned them out and started him on an antibiotic for that infection, along with doxycycline for his tick-borne bacteria.

What The Veterinary Ophthalmologist Found

The next stop was an eye exam with our veterinary ophthalmologist at BEVS in Burlington. This was the summary of her findings:

Finn presented today for evaluation of blindness in both eyes. Finn’s ophthalmic exam revealed that both eyes have shrunken secondary to another pathology such as chronic uveitis (intraocular inflammation) or chronic glaucoma. Uveitis may have been a primary problem caused by tick-borne bacterial infection or it may have been a lens-induced uveitis (caused by advanced cataract). The cataract(s) may be inherited in origin or could be caused by a primary uveitis. It is often difficult to say for sure if cataract or uveitis came first.

The good news is that Finn appears comfortable with both eyes – there is no redness or squinting and you noted he has not been rubbing at his eyes. The intermittent mucus discharge will always happen because the small eye size allows the eyes to sink back in the orbits which causes increased conjunctival exposure which in turn causes mucus discharge. No treatment is needed at this time.

So Finn had suffered from either uveitis or glaucoma — both of which are painful eye diseases when they are actively occurring — and apparently received no treatment at all. He went blind slowly, and painfully.

A week later I took Finn back to Burlington to see an internal medicine specialist at BEVS for an abdominal ultrasound to see what was going on with his kidneys, as well as for more tests.

What The Internal Medicine Specialist Found

I had three other dogs with me to see various specialists there, and by the time I returned to the exam room where the internist had initially looked at Finn, the doctor was busy writing on the white board all of his findings:

I looked at him and said, “this can’t be good,” and he said, “it’s not, but let’s go through it.”

I won’t get into all the detail, but the highlights were that Finn also has high blood pressure, his kidney values had deteriorated further since just two weeks earlier, he has sludge in his gallbladder … and the list goes on. In a follow-up urine culture test, the internist found Finn has bacteria in his urine, so we are now treating him for that. We’ve since done further tests for leptospirosis (negative) and cortisol levels (the ACTH test, done this past Friday and we are waiting on results to see if he also has Addison’s disease).

The doctor asked us to deworm Finn again (we had already done that when Finn first came) just in case he had a particularly resistant parasite on board. He prescribed a phosphate binder and a potassium supplement to help his kidneys cope with their decreased function. We are consulting with a veterinary nutritionist to develop a  low-protein home-prepared “kidney diet” for Finn.

The internist asked us to begin giving Finn sub-Q fluids at home every other day, which we’ve doing ever since. I sit at my desk with Finn standing between my legs, with the Lactated Ringers bag hanging from a coat rack, as 200 milliliters slowly drip down and under his skin. I hold Finn still with one hand, while with the other hand I hold the needle in place.

And Then The Dentist

While at BEVS our veterinary dentist also examined Finn. Fortunately he thinks the oral masses are benign and not cancerous. He believes the slurping/snuffling noises are from a polyp somewhere in Finn’s throat, but we’d need a CT scan to find out and to determine if surgery is an option. And yes, poor Finn desperately needs an extensive dental. But both of those things require sedation, which is simply not possible in his compromised condition.

Our veterinary dentist and veterinary internal medicine specialist conferred that day, and both agreed that we needed to work on Finn’s underlying chronic medical conditions before pursuing any other procedures.

Now What?

Alayne took Finn back to our primary care vet in Littleton on Friday for the ACTH test, another blood pressure test, and repeated blood work. Unfortunately, his kidney values have deteriorated even further, and his blood pressure remains elevated. I will be contacting the internist at BEVS tomorrow to see what else we can or should do at this stage.

We do know he must have had a truly miserable life before coming to us, given his emaciated, neglected condition. He still seems surprised when we pet him and make all over him, as if he’s never experienced human kindness before. All we can do at this point is give him the best possible medical care, and offer him the love we don’t think he’s ever had. We may not have him long, but he will be loved and cared for until the very end.