living with canine addison's disease: kermit's story, part four (the disease and the end)

So what is Addison's Disease, exactly? PetMD describes it:

Mineralocorticoids and glucocorticoids are hormones normally produced by the adrenal glands, which are located near the kidneys. Both of these hormones are critical to the healthy functioning of the body, and an abnormal increase or decrease of either of these hormones can lead to serious health problems if not addressed in time. Hypoadrenocorticism (Addison's Disease) is characterized by a deficient production of glucocorticoids and/or mineralocorticoids. Deficient production of both these hormones can cause a number of symptoms like weakness, dehydration, low blood pressure, depression, heart toxicity, vomiting, blood in feces, and weight loss...

A sudden and severe (acute) episode of hypoadrenocorticism is a medical emergency requiring immediate hospitalization and intensive therapy...

After the initial recovery, your veterinarian will calculate the dose that will balance your dog's hormone deficiency. The dose of these hormones may need to be increased occasionally, especially during periods of stress like travel, hospitalization, and surgery. 

After being diagnosed with Addison's Disease at the age of four, Kermit did quite well on his meds. The vet would adjust them up or down depending on what his blood work said. Giving Kermit meds became part of our routine. The same time every morning, and the same time every evening. 

When we knew he would experience stress, we gave him half a dose more leading up to the event and during the event. The stress could be positive or negative. Having out-of-town guests stay with us for a few days was always a happy, exciting time for Kermit. But the thrill of it all could send him into an Addisonian Crisis, so we'd have to up his meds a bit. Overall, his quality of life was great for a couple of years. We could do this thing.

We thought all was as well as it could be, but then Kermit suddenly collapsed one day. We initially thought it was an Addisonian crisis, but this time, it was different. His body stiffened, his mouth froze open in an ugly attack-like position, and then he started convulsing. It seemed to go on forever, but he came-to after a few seconds, stood up, wandered around a bit, pooped, then drank a ton of water. Then he ran around, perfectly happy. 

We rushed him to the vet, despite his seemingly perfect appearance. Seizures are not normally a symptom of Addison's Disease, so they ran test after test. They found no cause of the seizures, so on top of the Addison's Disease, Kermit had "Non-specific Seizure Disorder," which is a fancy way of saying "we don't know what the hell is wrong with your dog." They speculated that the seizures could be his body's way of reacting to the toll the disease was taking on him, but they couldn't be sure. They said he might never have another seizure. Or he might have many. They couldn't predict what would happen. They kept him on his course of meds and said that if his seizures became unmanageable, we could look at treating them, but that treating them would be invasive, likely consisting of regular injections. 

Over the next couple of years, Kermit's seizures were inconsistent. He would have one every now and again. We'd call the vet, and they would tell us there was really nothing we could do besides comfort him, unless we felt it was time to treat him. We didn't want to subject him to the treatment, and since his seizures were so sporadic and he seemed fine, otherwise, we opted to leave him untreated.

N.A.S.H.A. would often keep Kermit company when he wasn't feeling well.

N.A.S.H.A. would often keep Kermit company when he wasn't feeling well.

As his life progressed, the seizures became more consistent. Unpredictably, he would have cluster seizures, a group of seizures that would occur over the course of a couple of days. We couldn't understand what would set these off, but we noticed a pattern. N.A.S.H.A. would stick to Kermit like glue periodically. And she wouldn't stop licking his eyes, but only sometimes. When we started to really take notice, we recognized that she exhibited this behavior for a day or so only just before a seizure cluster. N.A.S.H.A. could predict Kermit's seizures! 

Still, there was not much we could do, but at least we knew, and there was some comfort in knowing what was coming. And I'm sure Kermit was somewhat comforted by N.A.S.H.A.'s care. He always tolerated her eye-licking, and even seemed to enjoy it. A little love goes a long way.

Kermit's seizures also followed a pattern: He would suddenly drop to the ground, stiffen, seize, then moan and lay there for a minute and wet himself. Then he'd get up and wobble around a bit, falling a few times, then he'd walk around in a daze (the seizures caused temporary blindness for a few minutes), and then he'd poop, drink water, and be fine again. Our role: to keep him from hitting objects that could cause injury, comfort him, and then try to escort him toward the back door so he could relieve himself outside rather than inside. The seizure clusters happened approximately monthly, and he would have five or six seizures over the course of two days.

Kermit would occasionally hit something on the way down and bleed from the mouth...his gums had begun to deteriorate, and the vet advised us not to put him through the anesthesia it would take to treat it. His tooth decay was likely a result of his weakened immune system.

So why did we choose to prolong his suffering? Because other than the two days he was having seizures, his quality of life was wonderful. He was normal Kermit. He ate and played and cuddled. It was really hard to think about euthanizing him when he was seizure-free. 

Kermit started to show signs that his mind wasn't all there. After so many seizures, his brain was damaged. We affectionately called him "mashed potato brains." Perfectly potty-trained Kermit would now stare us straight in the eye and lift his leg on the corner of the couch as if it was a fire hydrant. He had just lost his mind. We purchased him some reusable belly band "diapers," and after hearing our story, the lady who made them sent Kermit a custom band with Kermit the Frog on it. Kermit wore a belly band all the time to prevent our house from becoming a urinal. He came to enjoy the attention a diaper change brought, and when we'd release him from them for a naked romp outside, he'd prance around, free. Kinda like taking a bra off at the end of the day, I suspect.

Everyone always says "you'll know when it's time."

We knew it was time when Kermit's mashed potato brains led him to injure himself. He began to chew on his left front leg. At first, it was a little nibble, as if he had an itch that wouldn't go away. When he drew blood, we bandaged him. We took him to the vet, and there was nothing wrong with his leg. He would chew the bandage off, so we put him in a t-shirt. It seemed to help, but he could still get at the leg. He chewed and chewed, and chewed. And he wouldn't snap out of his daze. Our Kermit was gone.

It was time. We all cried, and we all hugged Kermit. My husband honored the agreement we made when we married. I told him "there will be lots of animals in our lives, and I won't be able to 'do the deed' when it comes time. If you marry me, you have to agree to take care of it." Brennen scooped Kermit up and put him in the car. The littles and I watched out the window as they drove away.

For weeks after, I didn't know what to do with myself in the mornings. There was no medicine to administer and no diapers to change. There was just nothing.

Kermit was a special dog with a rare disease that had a huge impact on our lives. Was it all worth it? Without a doubt. I hope he'd think so, too.  

Further reading:

living with canine addison's disease: kermit's story, part one (the adoption)

living with canine addison's disease: kermit's story, part two (our lives before the disease)

living with canine addison's disease: kermit's story, part three (the diagnosis)




living with canine addison's disease: kermit's story, part three (the diagnosis)

We're an active family, and we like to include our pets in the fun when we can. One of our favorite activities to do is a family is to hike in the local mountains. There are trails within walking distance from our house, and even more just minutes away by car. Our local hiking trails are totally dog-friendly. People are awesome about keeping their pets on leashes, and there is an unspoken poop pick-up policy that I love. You know how your dog will poop within five minutes of the start of a walk or hike, and then you have to carry the shit around for the duration? In our local mountains, dog owners pick up the poop, tie off the bag, then leave it on the side of the trail. Then we just pick it up after the hike on the way out. I always try to pick up a couple of extra, just to be nice. I also like the fact that there are trails for all skills of people and pooches. When we hike without the dogs, we head for the more challenging trails, but with our little pups, we head for the flatlands. Something for everyone!

The day we knew something was wrong with Kermit was a hiking day. We took him and N.A.S.H.A. on a flat hike, about two miles round-trip. It was something they had done many times before. Kermit loved the hike, as always, and did great. It was when we returned home that the trouble started. About ten minutes after we got home, he collapsed. 

He came-to fairly quickly, and we felt terribly guilty. Had we pushed him too hard?

We took him to the vet, and when his blood work came back, the vet had a diagnosis: Addison's Disease. I had never heard of it. The vet explained that it is pretty rare in dogs, and it is something humans can have, as well, though it's not contagious. In fact, JFK had Addison's Disease

So what is  Addison's Disease, and what did that mean for Kermit?

Addison's Disease means that your adrenal glands are not functioning properly. It is hard to diagnose because symptoms can point to other things. In Kermit's case, to put it in layman's terms (which I desperately needed), his body was not producing the hormones necessary to deal with physical or emotional stress. So when we took him on that hike, his body wasn't able to deal with the exertion. Symptoms can be sudden or gradual and can stop and start, another factor that makes diagnosis difficult. 

Common symptoms include: lethargy, depression, vomiting & diarrhea, decreased appetite, shaking, and muscle weakness. 

Kermit's collapse was an acute episode known as an "Adisonian crisis." This occurs when the blood pressure drops dangerously low. There is no cure for Addison's Disease, but it can be managed with medication so that additional crises can be prevented and the dog can live a relatively normal life. 

Kermit often had a far-away look.

Kermit often had a far-away look.

Kermit was prescribed a daily dose of fludrocortisone, a medication that had to be taken daily for the rest of his life and adjusted based on regular blood test results. Kermit was helped by the medication, and his Addison's seemed under control. We made sure he ate a healthy diet, gave him natural supplements, and made sure he got regular, moderate, exercise. 

And plenty of love. 

We were heartbroken. We knew he would eventually succumb to the disease, but it was our job to keep him as healthy and happy as possible. It was our responsibility to make sure his quality of life was maintained. Over the next few years, this became increasingly difficult. 

Further reading:

living with canine addison's disease: kermit's story, part one (the adoption)

living with canine addison's disease: kermit's story, part two (our lives before the disease)

living with canine addison's disease: kermit's story, part four (the disease and the end)

living with canine addison's disease: kermit's story, part two (our lives before the disease)

Kermit was an oddball, and, even now, we sit around the campfire with friends, reflecting on his antics. (WARNING: due to the graphic nature of these stories, they may not be suitable for all audiences.)

with us one week

It was the first Saturday night after we adopted Kermit. B had gone to bed, and Brennen was at work late. I was sleeping. A strange noise woke me, and I felt something on my back. It was too late when I realized what was happening. The sound was that of Kermit hacking, standing on my back. On a positive note, he felt bonded to me already. Unfortunately, he vomited all over my back and hair. Totally nasty, right? Now imagine trying to get out of bed, into the bathroom, out of clothes, and into the shower without dripping dog vomit all over the house. Impossible? Why, yes, yes it is. 

meeting the in-laws

Kermit didn't make the best impression on my husband's parents. They are more the "traditional" dog types, and Kermit was as odd in personality as he was in looks. Sweet and sour, basically. We'd planned a nice baby back rib dinner for them the night they arrived from the airport, and, somehow (actual how is a blur), he got a hold of a small bone. 

Kermit tolerating N.A.S.H.A. as a puppy.

Kermit tolerating N.A.S.H.A. as a puppy.

We were initially concerned that he would choke as he made splinters of it, so Brennen tried to take it. Kermit went tasmanian devil on him and tried to make mincemeat of his hand, then ran off under, then behind, the couch. "Like hell!" Shouted my darling, practically turning the table over as he bounded after Kermit. In one motion, he pulled the couch from the wall and grabbed Kermit by the scruff of the neck, yanking him skyward. As he did, a fountain of urine streaked up and across the wall and all the way to the patio door. Kermit got his bone, but stayed outside for quite some time. We finished dinner before scrubbing the wall and putting the house back together. My father-in-law, who is not fond of "situations"–especially during dinner–commented when his son returned to the table "I wouldn't tolerate that during dinner." I just about spit my wine out laughing. I may have been the only one.

cheating on Lizzie

If you read part one, you know that Lizzie was a big black sweet-as-can-be pit bull, and Kermit's first "love." His next steady girlfriend was a big yellow stuffed duck given to my step son, who was five at the time. Thankfully B was never very fond of stuffed animals, and after laughing at Kermit's frequent courting rituals toward the thing, generously said "Kermit, you can just have it." That was best.

learning to use the remote

Brennen and I were chatting in the kitchen over a glass of wine, making dinner together, while B and Kermit sat on the couch watching a show. They were peaceful, and so were we. Until we heard a snarling tizzy, then crying. We ran out to the living room and asked what happened. It took B (unhurt, but shaken) a few minutes to calm down enough to be understood. Through the sniffles, he finally choked out " teach...him use...the remote! Waaaaaaaahhhhh!" We didn't see it either, but I think we all know what happened.

i can't see out the window

Kermit absolutely loved to ride in the car. During most of his life, I drove a Jeep Wrangler. He would basically surf on the center console, panting the whole time, giving me an occasional kiss on the cheek. When he got tired, he'd wander the car. He could even stand on the passenger seat and put his front paws on the giant grab handle above the glove compartment. He'd ride along like that forever and deposit about a million nose smudges on the vertical windshield of the Jeep. Any time I took an actual human passenger, they'd ask "What is all over your windshield? I can't even see out of it!" Thanks, Kerm.

the office dog flop

When we adopted Kermit, I worked at a graphic design firm. It was a family-like environment, and the ultra-cool owners were a dog-loving couple who were happy to allow me to bring Kermit to the office. He would mostly sleep under my desk, but whenever a coworker would open the office door, he would trot over and flop down in front of them, then roll over on his back requesting a belly rub. We coined it "doing the Kermie flop."

um...what the fu¢& is your dog doing? 

My brother-in-law, Greg, was visiting. We'd left Kermit to socialize with him in the living room while we prepared dinner. Greg said "Dude, get in here! What the fu¢& is your dog doing?"

There's Kermit in our papasan chair, leaning back in a semi-standing position, reaching down with his two front paws to his nether-region, pleasuring himself. Only that dog. I swear. We just shook our heads. Greg said "Good for you, Kermit."   

If any of you who knew Kermit have a story to add, feel free to chime in!

Further reading:

living with canine addison's disease: kermit's story, part one (the adoption)

living with canine addison's disease: kermit's story, part three (the diagnosis)

living with canine addison's disease: kermit's story, part four (the disease and the end)