Monday, June 21, 2010

San Andreas is not my fault.


I did a steady 23 miles this morning in an effort to put yesterday behind me. It didn't work but I came back tired and sweaty. That counts for something.

Before I could shower the vet called. Though Al's levels of whatever the indicator is are fairly low, the vet feels confident that Valley Fever is the issue. The dr. did a great job of answering my questions without any overtones of judgment. The basics:
  • The anti-fungal Fluconazole is taken twice a day. The average is 6-9 months of treatment. Some dogs respond sooner and some never do. The vet had a dog who never responded to the drug or its alternatives, got progressively worse and had to be put down. Other dogs respond with an improvement in their symptoms but still have levels high enough that they have to take the drug the rest of their lives. And there is always the chance of recurrence.
  • They do blood tests at 3 months and every three months thereafter to check progress.
  • Fluconazole is hard on the liver, so they also have to check it every three months.
  • Two weeks of Prednisone helps restore his appetite and eases joint pain.
  • The fungus disseminates to various sites, depending on the dog. The worst is the spine because then it enters the central nervous system and leads to seizures. When it gets into the bones it can cause severe joint pain.
He quoted a price for Fluconazole and Prednisone. The former is pretty expensive.
I explained our need to establish budgetary limits and that we needed to talk it over before making a decision so we agreed I'd call him back.

I'm thankful for a wife who is willing and able to talk through difficult issues. Pam and I spent at least an hour discussing things from a variety of angles.
We also found a local pet pharmacy that sells Fluconazole for about 55% of the vet's price.

We've decided to do three months of the treatment. We can see deterioration just in the last week; he has more trouble getting up and down and his appetite is worse. Three months from now we'll look for two things, improved results from his blood tests and significant improvement in his symptoms. If it takes longer than three months we'll go there, but only if we see him getting better at the first interval. If he doesn't show improvement by then we'll feel we did what was reasonable and responsible, and do our best from that point out to make him as comfortable as possible.

Pets are somewhere between golf clubs and children. They're living things, but not people. The OT prohibited cruelty to animals and it seems reasonable to extend that negative to some positive mitzvot to care for a sick pet. Responsible stewardship also factors in, and at a different point for different people. Six-figure income? Dependent on govt. assistance?

Like I said, I'm thankful for the way Pam and I work through difficult issues. On our evening walk we agreed we feel good about the balance we've struck with this approach.

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