Trick Training Helped Lessen the Stress of a Vet Visit for My Reactive Dog

I wasn't expecting to write about a trip to the vet for this week's Positive Pet Training Blog Hop, but Ruby had a rather sudden onset of digestive distress following a strong thunderstorm this week and although I suspected it was stress related, I wasn't taking any chances when blood showed up in her stool. I made an appointment with our wonderful veterinarian the following afternoon and loaded Ruby up in her travel den, which has made drives far less taxing for both of us.

Eyeball Update and Outings with Boca

March 19th marked the one-year anniversary of Boca's conjunctival graft surgery on her right eye, an experience I'm very glad to have behind us. Poor Boca had to wear the Cone of Woe for a total of ten weeks, and it was an extremely stressful time as she stumped a number of professionals with her non-conventional response to treatment and to this day we still have no clear diagnosis. We were also navigating our first major pet insurance claim, a story which thankfully had a happy ending. It was difficult to know what the right thing to do was at the time, with advice from every angle, but we absolutely made the best choice for Boca in order for her to retain her eye and vision.

Five Things I Learned at Ruby's Annual Wellness Check

Ruby did great at her annual wellness check last week. We were able to snag the last appointment of the day and so there were no other dogs coming or going from the office. She took her first ride in her new travel crate and was fairly calm upon arrival instead of all fired up from seeing dogs, cyclists and pedestrians from the car window on the way over. She met the new office cat, Whisper, and greeted her with interest but politely. Whisper even tried to help me hold Ruby's leash while I paid the bill. Here are some results of Little Sister's most recent check-up:

Ruby weighs 18.2 pounds.

It is very important to me to keep my dogs at ideal weights. I was happy to see that Ruby received a body condition score of 5/9, which is perfect...not to brag or anything. People that haven't met Ruby in person are surprised by how small she is - I guess it's true that the camera adds ten pounds! She and Boca often end up looking the same size in pictures, even though Boca is almost twice as big. Ruby is the smallest dog I've ever had but I really love being able to pick her up easily, and she's cute and cuddly without being teeny-tiny.

Ruby does better without me in the room. 

When I lifted Ruby up onto the exam table, she began to struggle and tried to climb up my neck. It was obvious that this wasn't going to work. The vet took her to the back for her parvo shot, heartworm test and physical exam and said she did great. My friend (a mother) said Ruby is like the toddler who throws a fit at daycare until its mother is out of sight. There's that pesky dog/kid comparison again...

The vet described Ruby's temperament as "friendly and outgoing but nervous." 

Ruby is too smart for her own good. When the vet tried to lure her over with treats, Ruby wanted the treats but knew it was a trap. Once her exam was over she was happy and effervescent, even showing off some of her tricks to the vet. I'm glad that even though she is nervous, she recovers quickly, and that even when she is scared she doesn't growl or snap.

Ruby has a tooth that I need to keep an eye on. 

When I pointed out the tooth I wanted the vet to take a look at, she said "I've never seen anything like that..." Leave it to me to have another medical mystery! One of Ruby's big back teeth has a horizontal band running through the middle where the enamel has worn away. It's been this way since I adopted her, noted as something to be addressed in the future on her post-adoption exam. My vet wasn't overly concerned, and since all the rest of her teeth look great it didn't make sense to anesthetize her for x-rays. It's something to watch, and she may need to have it pulled down the road. 

Ruby's microchip scanned correctly.

I was pleasantly surprised when the vet asked if Ruby was micro-chipped and if she could scan her. With all the stories of pets lost around the 4th of July and reunions with owners after being missing for years, this is something that I think should be part of every vet visit, to make sure the chip is functioning properly and the information is up to date. 

After all of the vet visits for Boca's eye this year, it was nice to have one that was straightforward and stress-free, especially with a reactive dog. I was really proud of Ruby's behavior at the vet's office and she definitely deserved the extra treats they gave her. As much as I love my vet, I hope we won't see them again until next summer!

Summertime with the Ginger Sisters

Summertime is in full swing here in Denver, and I spent much of the weekend beautifying my patio in anticipation of spending a lot of time out there with The Ginger Sisters. Boca likes to lounge on the dog bed and Ruby loves chasing her pink tennis ball. This required the obligatory trip to Home Depot. I had already planted some tomatoes and a few flowers in pots - including marigolds with seeds I harvested from last year's marigolds, which I think is really cool - but I needed to improve the tomato situation and wanted more useful plants. I was also hoping to get a lounge chair - my mosaic bistro set is cute but not one bit comfortable to sit at for long. I had plenty of pots but I couldn't resist a darling fox one - it looked too much like The Ginger Sisters. I repotted the three tomato plants and made sure they were out of reach of the dogs since the leaves/stems are toxic. I also had to put two other things I bought (a lobelia and something unidentified that had been pre-treated with pesticide) out front instead of my patio for the same reason. Note to self: look up pet-safe plants before you shop. Then, after all my fretting over the plants, Ruby and Boca decided the potting soil was delicious - thankfully I bought organic. I am thrilled with how it turned out and that I have basil, rosemary, mint, sage and thyme fresh for the picking outside my door, and will hopefully harvest my first patio cucumbers and tomatoes before the year is through! I also planted a cat garden for Nina - catnip and cat grass. It's wonderful to sit in my lounge chair and have a view full of sky. I know that I will be spending a lot of time out there in the coming months.

On Saturday, Boca had her annual wellness exam. We are still seeing the ophthalmologist regularly and she is completing a three-month course of doxycycline in case her eye issue is bacterial in origin. So far, the left eye is holding steady and her grafted right eye is healed completely and doing great. Aside from her eyes, she is a very healthy girl and she met her prescribed weight loss goal, coming in at 32.9 lbs. We saw a new vet who is helping temporarily while another partner is on maternity leave, and she was very nice. She remarked on how easy and sweet Boca is. After our appointment we stopped at a pet store to get some more goat's milk for the girls. I've been using The Honest Kitchen powder but decided to get them a carton of fresh, raw goat's milk and also a small bag of Wild Calling kibble since we were down to one bag in the pantry. I like to stay stocked up! Everyone wanted to say hello to Boca and know what kind of dog she is. She is such a wonderful potcake ambassador!

After a really lovely rainy spell, our temperatures have been climbing, with Sunday being our hottest day yet hovering around 95 degrees. This is my first summer without A/C (long story) and so far it's not too bad. The dogs are definitely lower energy but seem to handle it well. Boca has taken to crawling under my bed at night - I think this is a holdover from her street dog days when she would find a dark burrow to keep cool. I moved some things around so she has space under there but she really barely fits and it is quite a production, silly girl. The downside to leaving the windows open to cool my room off overnight is that the dogs can hear all the neighborhood sounds: other dogs barking, people talking in the alley, and the odd pre-holiday firecracker. Both Ruby and Boca are noise-phobic, and we are not looking forward to the Fourth of July. A nearby municipality also has a separate fireworks celebration on July 25th, so we will be hunkering down with music, fans and thundershirts several times next month.

Walks with a reactive dog are more challenging this time of year, when everyone else is out enjoying the sunshine, too. We have scooters, skateboards, bikes and strollers to contend with, as well as the occasional off-leash or escaped dog. Last week a Westie on a Flexi-lead got away from its elderly owner and came charging over to us. The loose dog and Ruby had a snarky terrier-off but I was able to keep myself positioned in between them until its owner got hold of its leash again. Boca paid them no mind at all. The owner was very apologetic but can I just say again how much I hate Flexi-leads? I saw so many when I was at the park this weekend and they are useless at best, dangerous at worst. Ruby has been getting better about cars and people, as long as the people aren't moving quickly directly toward her. Sometimes we can even see a dog all the way across the clubhouse lawn and not have a total meltdown. I will call that improvement!

How is your summer going so far? 

Understanding Pet Insurance & Why I Won't Go Without It

 

If you've been following along with Boca's recent Ocular Ordeal, you know that pet insurance saved our butts on treatments and surgery totaling several thousand dollars. While the process wasn't perfect (my claim was initially denied), it did confirm that buying pet insurance for The Ginger Sisters was the right choice for me, and I won't go without it for my dogs. Pet insurance can be overwhelming and confusing, and there are many considerations to explore before purchasing a policy.

Having worked in the insurance industry for fifteen years now, I am comfortable navigating the fine print of coverages, exclusions and claims, something I know can be intimidating. This is by no means a comprehensive analysis, and although Ruby and Boca are both insured, I won't be specifically promoting or linking to those companies here. I use two different companies and my dogs have two very different policies - something that is nice about pet insurance is that it is very customizable. You can find coverages to fit almost any budget.

I have had claims with each of the companies I use; a small suspected obstruction claim for Ruby (which thankfully turned out to be nothing) and a major claim for Boca's conjunctival graft surgery and associated treatments. Both were handled quickly and I had reimbursements in hand or directly paid to my vet within two weeks of submitting the claims. Something that is extremely important to remember is that pet insurance in the U.S. handles claims on a reimbursement basis, which means that they reimburse you after you pay the vet charges for accident or illness. Some companies will pay the vet directly if this is pre-arranged and agreed upon by all parties.

I want to emphasize that every policy is different. Pet insurance is not required by law and so there is little standardization. Every company provides varying coverage options. I've been happy with both companies I use for different reasons - they each have strengths and weaknesses and I like having the real-life comparison. When shopping for pet insurance, here are some of the most important things to look for:

Limits: This is the amount the policy will pay per year or over the lifetime of the pet. There are some companies that have an unlimited lifetime benefit, and others that offer as low as $1,500 per year. Unlimited policies are going to be more expensive, and lower limits will be more budget-friendly.  Some policies have both annual and lifetime caps.

Deductible: This is the flat-fee amount you will pay out of pocket when you have a claim. Some companies offer an annual deductible and others are per-claim. For example, if you have a $500 annual deductible and submit a $1,000 claim, you would be reimbursed $500 (less your co-insurance and any exclusions or adjustments) but any claim after that within the policy year would not be subject to a deductible. If you have a $100 per-claim deductible, that would be subtracted from each claim. Your deductible choice is reflected in the premium - lower deductibles cost more.

If you want something for catastrophic events, such as a long term illness or emergency surgery, but are comfortable paying smaller bills out of pocket, a mid-range limit, high-deductible plan is a good choice. This is what I have for Boca. For Ruby, who needs more bubble wrap due to her flight-risk, high energy and propensity for eating things like gravel and plush toys, I have an unlimited plan with a low-deductible. Ruby's monthly plan costs more than twice what Boca's does, and my own risk management somewhat backfired when Boca was the one who ended up needing expensive treatment. Choosing insurance can feel a bit like gambling. 

Co-pay or Co-insurance: This is a percentage of a claim that you are responsible for. Most companies offer 70%, 80% and 90% reimbursement rates with a few offering 100%. Going back to that $1,000 claim with a $500 deductible, if you also had an 80% reimbursement rate, you would receive back $400 after your deductible and co-pay were applied (and yet another way in which companies differ is the order in which deductible and co-pay are applied to the claim.) Once again, the lower your co-insurance, the higher your premium will be.

Premiums: This is the bottom line - the amount you will pay for the coverage on a monthly or annual basis. I think many people assume that insurance is too expensive; however, in researching eight of the primary companies I found that premiums can range from as low as $10 a month to as much as $100 a month. I pay $16 a month for Boca's coverage, and if we only ever have the eye claim it will have more than paid for itself in her lifetime. It's one of those things you hope you never need, and if you pay for it year after year without a claim it can be tempting to let it slide. I might be a little superstitious in feeling like that one day I let the coverage lapse is the day something will go wrong. It is well worth it to me to include this monthly cost in my pet budget.

Below is a comparison of the major companies that I put together. The premium range is for a young, medium-sized mixed-breed dog: age, breed and size will affect pricing. I apologize for the tinyness/blurriness and any missing information - this was all gathered from websites. I am happy to email the PDF by request.

Exclusions: This is a big one, and one of the most crucial things to understand before purchasing a policy. While every company has different exclusions, pre-existing conditions are excluded across the board. I find that this is often misunderstood and one of the biggest reasons for dissatisfaction with pet insurance. Many people don't think about insurance until something is wrong, and of course by that time it is too late to get coverage. Even if the pet hasn't exhibited symptoms, but had something related to or indicative of the problem previously noted by a veterinarian, it most likely would not be covered because the pet insurance companies will request all vet records when there is a claim.

Even if your pet does have a pre-existing condition, that isn't always a reason to skip insurance altogether. A pet with hip dysplasia could still have a costly gastro-intestinal illness and a pet with allergies could still tear an ACL and require an expensive surgery. Some companies do not cover genetic conditions, alternative treatments, or behavioral therapy. Routine care and dental care are not generally covered under the standard policy, but many companies offer a separate wellness plan.

Other Considerations: Although it can be tedious to pore over policy wording, it is absolutely essential that you understand what you are buying. In looking over reviews on petinsurancereview.com, I found that negative reviews were very often due to a lack of understanding of their policies or insurance in general. A few things to pay special attention to are whether or not the policy covers exam fees (many don't), dental treatment (most don't), whether the reimbursement rate is the same for specialist and emergency treatment, whether medications are covered (some are automatically, others are an add-on coverage) and what the waiting periods are for accidents and illness (most are between 15 and 30 days, many have longer exclusions for hip dysplasia and other orthopedic conditions). It is also important to note that in most cases, once you have a claim, you cannot lower your deductible and co-insurance or increase your limits.

Something that I hear over and over when weighing the pros and cons of pet insurance is the savings account argument. This suggests that it is better to put the money you would pay toward insurance premiums into a savings account instead. If I had saved the money from both dogs' premiums from the time I adopted Boca, I would have had around $500 at the time of Boca's eye issue, and been short more than $2,500 for her surgery. This plan would not work for me, and unless you are able to set aside several thousand dollars right off the bat, you will not be prepared for a serious illness or major surgery. Since pet insurance usually requires vet bills be paid in advance, it's a good idea to have some savings in addition to pet insurance if at all possible. I do think that a savings account is a fair alternative to pet wellness plans, since those are essentially a savings plan with a discount for routine care (vaccinations, elective surgeries, dental work).

I believe that pet insurance is an essential part of pet guardianship, even if that means you are self-insuring with an adequate savings account or line of credit. Personally, I won't ever go without it. Even the healthiest of pets can have an accident or a sudden illness and vet bills can amass into the thousands of dollars very quickly. Veterinary emergencies and medical decisions are so much less stressful for me knowing that The Ginger Sisters have insurance coverage, although bubble wrap is still a good idea...

What about you - did you make it this far through all that "boring" insurance talk? Have you considered pet insurance?

Boca's Ocular Ordeal...Is Over!

I am thrilled to report that following Part I, Part II, Part III and Part IV of Boca's non-healing corneal ulcer saga, things are finally getting back to normal at the Ginger Sister residence. My three-day weekend was the perfect time to fade out the cone, and while I watched her like a hawk that first day, Boca is far more interested in chewing all the things, sunbathing and napping than rubbing her eye. 

Her eye looks better every day. There is minimal watering, and she is holding it all the way open full time - something she hasn't been able to do in months. If you are curious what it looks like, the photo is here behind a cut. This was taken Friday - the edges of the graft are still sort of raised but it should continue to thin and smooth out. I think it is so incredible that the veterinary ophthalmologist attached the graft with teeny-tiny micro stitches. Can you imagine the steady hand that must take? 

I hope that chronicling my experience will be helpful to others since I could find very little personal documentation about the surgery online when I was researching. We have a re-check appointment on Thursday and after that it will probably be a month before we need to go back.

Boca has been such a trooper through everything - maintaining her goofy, optimistic spirit - but she was so obviously happy to free of the cone! She can fit in her crate (where she loves to sleep of her own accord), curl up in a ball, gnaw on antlers and most importantly, play biteyface with Ruby every morning again:

A video posted by Lara Elizabeth (@2gingerdogs) on Apr 4, 2015 at 6:55am PDT

Boca's Ocular Ordeal: Part IV

Part I

Part II

Part III

Hopefully, this series will be winding down as Boca's eye improves day by day following her conjunctival graft surgery two weeks ago. We had a recheck appointment last Saturday, and a few days before I was feeling very discouraged as she still wasn't holding her eye open very much. The day before the appointment, she seemed to turn a corner and by the time we saw the ophthalmologist she was very happy with her progress and said we were on the right track. Boca does seem to be a slow healer, something to take note of. 

She is now off all oral medications, with eye drops twice a day, and is doing better little by little. The appearance of the graft changes as time goes on, and I was told that was to be expected. Right now it is in a very red/pink phase but she holds it open more and more. I was surprised that even though the graft covers a good portion of her eye, she still has a swift blink response, which tells me she retained a good deal of vision. The vet said that the graft will smooth out over the next couple of months until it is fully incorporated with the cornea. We have another appointment next week and with supervision, Boca should be able to lose the cone over the weekend - no Easter bonnet for her!

I expected to be alarmed by how Boca's eye looked - especially because her graft is much bigger than most of the photos I found online. Instead, I am just thrilled that she is feeling better, that she got to keep her eye, and that she is the same goofy, loveable girl. One of her nicknames, Bocacabra (a play on "Chupacabra") fits even more perfectly now. I've decided to call it her "supernatural eye" and this has certainly taught me some lessons about inner and outer beauty that I will delve into in a later post. Dogs are the very best teachers of acceptance and adaptability, aren't they?

I continue to be impressed with Boca's insurance company. They issued payment yesterday for her surgical claim and even with my high deductible ended up covering about 75% of the total bills. I've started a pet insurance discussion group on Facebook. Having worked in the insurance industry for fourteen years, six of those in horse insurance, I am comfortable with the jargon and happy to talk about policy wording and comparisons. I hope you'll join, and watch for my pet insurance post coming soon. Meanwhile, Boca, Ruby and I will be getting back to normal at our house with fewer vet visits and no more cone!

Boca's Ocular Ordeal: Part III

Home from surgery on Thursday afternoon.

Who knew that I would still be writing about a seemingly minor eye issue months later? In review, here are Part I and Part II. Boca Face had her conjunctival graft surgery last Thursday. She was her usual wonderful, cheerful self at the vet hospital, but I had an especially hard time seeing her led away. General anesthesia is always a worry, and I just didn't know what to expect with regard to how her eye would look afterward and if it would finally be the end of this long process. Adding to my uncertainty was the fact that for the day or two before the surgery, her eye had been doing much better and her comfort was increased, so here I was making her worse again with the hope that it would then finally swing the other way. She was squinty again on Thursday morning so ultimately I still felt I was making the right decision. 

I was told that Boca's would likely be the last surgical procedure of the day because it was the longest, and not to expect a call until after lunchtime. I was surprised to get a call from Dr. N. at 11 o'clock reporting that Boca was out of surgery and doing well, and that I could pick her up later that afternoon. Boca was groggy and disoriented when I arrived, and I was given her new medications and discharge instructions. I wasn't able to see much of her eye because they put one stitch in the outer corner of her lid to hold it partially closed. She whined most of the way home and seemed happy to be back in familiar surroundings, where she immediately laid down in the dining room. Ruby needed a walk and I intended to let Boca rest, but she pretty much insisted on coming along, so we kept it short. 

She continued to improve over the weekend, wanting to play with new toys we got in our Bark Box and enjoying a beautiful spring weekend. She is a fairly low-energy dog to begin with, so pain medications really knock her out. She spent a lot of time laying on her bed on the patio and snoozing on the sofa. It's hard at this point to tell how her eye is. It is still watering a lot but I was told that is normal. The graft is supposed to integrate with the cornea within about a week, and we have a re-check appointment on Saturday. I don't know when the eyelid stitch will be removed. Complete healing can take up to eight weeks. She holds it open just a little when we are walking or when she is getting a treat, and I have glimpsed part of the graft, a thin layer of semi-opaque tissue. It so far looks better than most of the pictures I've seen online. I hope it will soon feel better, and am maintaining my faith in the skill and confidence of the professionals. 

A note about pet insurance: I'm in the process of developing a full post on pet insurance, but for now I will just say that it has been a lifesaver for me. While the claim was initially denied, their decision to accept the appeal based on my vet's analysis was very fair and since then they have paid every line item from every invoice, responded quickly and compassionately to all my questions and pre-certified Boca's surgery. I was even able to make arrangements for the insurance to pay the vet directly. My first claim payment was direct-deposited into my bank account nine days after submitting the invoice (all the rest of the pre-surgery charges went toward my deductible). I really don't know what I would have done without the insurance and will always consider it an essential part of pet guardianship.You just never know what can happen - I considered Boca my "low-risk" dog and so put her on a high-deductible plan, then ended up having a multi-thousand dollar claim within the first year. I'm so thankful that I was able to make treatment decisions for her without feeling constrained by finances.

Boca's Ocular Ordeal: Part II

Poor squinty girl.

Sadly, Boca's eye issue continues and this will be an ongoing series - Part I can be found here. It's hard to believe that Boca has been squinty and uncomfortable for about 7 weeks now, and I've lost track of how many appointments we've had with the specialist. On Thursday we had another re-check appointment and surgical options were discussed. The first of these is a thermal keratoplasty, in which heat is applied to the cornea and a series of shallow incisions are made to create a surface for better adhesion. Due to Boca's poor (and unusual) response to the diamond burr debridement, the confidence level for this procedure is much lower than it would normally be. The second, more serious and more costly procedure is a conjunctival graft, in which a flap of inner eyelid tissue is bonded over the eye. This introduces a blood supply to the cornea and promotes healing. Vision can be impaired depending on the size and thickness of the flap, but it is the surest way to retain the eye and restore comfort, with a very high success rate. Because it's likely we may arrive at the graft if the keratoplasty failed, the specialist is more strongly recommending it as the primary option. 

A soft contact lens was placed in Boca's eye at Thursday's appointment, with the hope that it would provide her some relief and even allow some additional healing, but unfortunately even wearing the cone collar, we lost the lens within 24 hours. It was a cool idea - the lens had four black dots around the edge so I could easily see when it was in her eye and I think it did help for a short time. We did not find the contact, but I didn't spend a lot of time looking since putting it back in was not a possibility anyway. 

 Still loves her walks!

At first I was really upset about the idea of the graft surgery, because it will permanently change the appearance of Boca's eye, but I have a fairly short time-to-acceptance phase, and after having my little cry, I think I am prepared to move forward once some other things are in place. She will be my beautiful Boca Face no matter what, and dogs are the very best example of unconditional love. As long as she is comfortable and can hopefully keep her vision for the most part, I will be happy. At this point, the main thing I am waiting for is for the decision on my pet insurance appeal. This will determine if they will pay for the cost of the surgery and the treatment to date (minus deductible, which is high but has already been met and exceeded). I want to also touch base with my regular vet to get a non-specialist perspective. Several people have asked why the eye cannot just be removed - my understanding is that since Boca is not blind in the eye, enucleation is not the best option - its only benefit to my knowledge would be economic. I have also reached out to the shelter director in The Bahamas, to see if she may have some vet connections that might know of some tropical condition that the vets here could be missing. As it is, Boca has been seen by two regular vets and three accredited veterinary ophthalmologists, so we have gone above and beyond second opinions. Still, I think the more information I can gather the better, before making any big decisions. The graft is done under general anesthesia which is always a worry; however, Boca did fine with it when she had a tooth extracted shortly after I adopted her.

As for the Potcake herself, she is doing well under the circumstances. I have been trying to give her breaks from the cone collar which she is very appreciative of. She did grouch at Ruby this weekend because Ruby tried to lick her eye and I'm sure it is painful (as well as unsanitary). She is getting twice-daily eye drops and Rimadyl and maintains her great appetite and cute cheerfulness on walks. She still hoards all the toys and bones on her bed. She had everyone in the waiting area at the vet's office laughing because as I was checking out, she was sprawled out on the floor with her frog legs and her tail wagging. Such a delightful girl. We appreciate your good thoughts as the pieces come together for an eventual resolution to this prolonged problem.

UPDATE 3/10/15 - This morning I received notification that Boca's pet insurance has reversed their denial and has accepted the appeal of our corneal ulcer claim. This is the best possible news and I am incredibly grateful to our ophthalmologist for her influence on the insurance company's decision. 
 

Still hoards all the stuff!

Boca's Ocular Ordeal: Part I

I love you even when you have a cone on your head.

I've been putting off writing this post. I thought if I waited long enough, I could tell the story start to finish and it would have a neat resolution and only one installment. It's been a month, and this will now be part one of Boca's Ocular Ordeal. Since adopting her officially last May after fostering her for three weeks, Boca has had a spot in her right eye. It is a tiny, jelly-bean shaped opacity that did not cause her any apparent problems and was diagnosed by our regular vet as a Florida Spot.

Toward the middle of January, I noticed that Boca was squinting quite a bit and her right eye was frequently tearing. Our regular vet prescribed eye drops and thought it could be allergies or some mild inflammation. We went back for a second visit in less than a week when I did not see improvement. While they did not see much uptake of the stain (which is a neon yellow liquid picked up by any abrasion on the cornea), they changed medications and said we would treat as a superficial corneal ulcer. Normally, these will heal within a few days on their own. 

Unfortunately, Boca's eye was still squinty and watering the following week, so I took her to a canine ophthalmologist at an emergency and specialty clinic where I've spent many hours with Freya, Lasya, Nina and Ruby. This was Boca's first visit. The ophthalmologist thought the spot was possibly scar tissue from past trauma and did not agree with the Florida Spot diagnosis. She did see a corneal ulcer with the fluorescein stain and recommended a procedure called diamond burr debridement, which was described as a tiny dremel that would create a new surface on the cornea to promote healing. It is a common and fairly succesful mode of treatment and although it sounded terrifying to me, only required a numbing drop. When I picked Boca up she was happy and seemed more comfortable, but in the weeks following she has still not improved. Her eye now has a large cloudy area extending over the pupil and despite being on pain medications it is clearly very irritated and continually teary. This is what is known as a 'complicated' or 'indolent' corneal ulcer. In my research I learned that they are frequent enough in Boxers that they are sometimes called 'Boxer ulcers.'

We've had several more visits to the ophthalmologist and have tried several medications including a very expensive, very heavy-duty antibiotic eye drop, all with disappointing results. Last week we tried a steroid drop but the results were not dramatic enough to warrant continuing. I can tell that the vet is as frustrated as I am and we just seem to be on the unlucky side of the statistics for this condition. Tomorrow we will see the third of three specialists at the clinic, and we are hoping for a fresh approach or new idea. There are several different surgical options and I think we may be at the point of discussing them. Because Boca already had an abnormality in that eye, it will not be covered by insurance, even though the vet wasn't able to say definitively whether the spot is the proximate cause of the issue.

The worst part of this has been seeing my poor, sweet Boca in pain and not being able to solve this and help her. Overall, I think she is handling things better than I am. She is wonderful about her three-times-daily eye drops and has a wonderful, joyous attitude. She loves getting breaks from the Cone of Woe when we go on walks and have cuddle time on the sofa. She has even figured out how to chew on Benebones and antlers with the cone on. The staff at the specialty clinic all adore her (one declared Boca her "favorite dog ever") and I've been extolling the virtues of Potcakes on the heels of her charm. The waiting game is a tough one when it comes to our beloved pets, and a medical mystery is not the prize you want to win from the veterinary grab bag. I'll continue to update as I know more, and if any of you have dealt with this eye condition I'd love to compare notes. In the meantime, I'll try to take inspiration from my easygoing island girl and keep my chin up through our latest challenge.

Further Reading:

Corneal Ulcers from Eye Care for Animals

Boca's Big Day with her Lavien Leather Leash

In my fifteen years of dog ownership I've never had a leather leash, so I was happy to try out the Lavien six foot leash. We'd been using it for walks for several weeks, but Boca had a big day on Saturday and I thought we would make our rounds in style. The leash has a sturdy gold-tone clasp (I'd actually prefer silver as pictured in the link, but the gold is nice), strong stitching, and a hefty weight to it. One thing I really like about the leather is that it's comfortable to grip at any point, so even though six feet can feel a bit long in some settings, it's easy to shorten when needed.

 

We had such amazing weather this weekend - a lot of the snow has melted and Boca was happy to feel the grass on her paws again! We had a nice walk around the complex with Ruby before heading out for our errands: Boca had a vet appointment to have her eye checked - her right eye, the same one with a Florida spot, had been watery and squinty for a few days. I also planned to take her to try on some more durable dog boots - despite these sunny January days, we've still got months of snow, ice and salt ahead. 

Boca was so good at the vet's office - the staff love her and one of the techs also has a foster failure Potcake! We waited our turn and the vet thinks that Boca may have some allergies causing her eyes to be irritated. She examined Boca's eye, prescribed some ointment that I already had left over from Ruby's eye injury and Benadryl, and sent us on our way with no charge! She called it a "sanity visit" - I love my vet! In the picture above you can see the nice, padded handle on the Lavien leash. 

I thought Boca deserved a reward for being so well behaved, and since we were nearby a huge dog park, I decided we would go. Dog parks make me nervous in general and Ruby gets too overwhelmed so we go very rarely, but Boca has a much more laid back personality, and I also thought it was a good opportunity to see just how reliable that recall of hers is. 

We walked a little ways before I unclipped her leash, and I immediately called her back a few times to make sure she would come - did she ever! Each time, Boca turned and ran to me with a huge smile, and you can bet I had treats on hand to reward her (I know this a little bit of dog park no-no, but this place is enormous and we had plenty of space). I have our obedience class and our relationship of love and trust to thank for installing an awesome recall. Boca doesn't have the proclivity for tricks that Ruby does, but she knows the most important cue of all. I really enjoyed having some one-on-one time with my wonderful Potcake.

Disclaimer: I was provided a Lavien leather leash in exchange for my honest review. All opinions expressed are my own and I only publish reviews for products I feel comfortable using in the day to day life of my pets.  

It's All Fun and Games Until Somebody Ends Up In a Cone

Waiting to see the vet

What began as a simple afternoon walk resulted in a three hour visit to the emergency vet with Ruby on Saturday. As with many of our mishaps, I blame the rabbits! You see, Ruby darted headfirst into a juniper bush after one and came out yipping and squinting. I could see a tiny speck of blood in the corner of her left eye and knew immediately that I should take her to the emergency clinic. Eye injuries are not something to wait or take chances with.

I've spent far more time at the local emergency clinic than I'd like. My Norwegian elkhound, Freya, spent three days in neurology ICU there last summer, and Ruby had x-rays last winter for a suspected obstruction after eating a piece of a plush toy. It was busier than I had ever seen it on Saturday, and our long wait was quite a challenge as I tried to keep Ruby from seeing other dogs. Even once we were in a room we waited for at least another hour. A tech told me that three critical cases came in at the same time. I knew that we were not a major emergency and was not annoyed by the delay (although I was wishing I'd brought a book!). I was just thankful we weren't there under worse circumstances.

Finally the vet took Ruby back to stain her eye, and showed me where the dye had picked up near the middle of her lens. He prescribed some antibiotic eye drops and we had another long wait back in the entrance area for the prescription and discharge instructions. Ruby had done really well, all things considered, so I was disappointed when one of the employees wheeled a vacuum cleaner straight toward us and sent Ruby into a reactive frenzy. It was especially disruptive because there were several people being obviously faced with difficult news and tearful decisions, so I took Ruby around a partition to try and calm her down.  

In order to keep Ruby from rubbing or scratching her eye, I put Pawz rubber dog boots on her feet that first night. These are a great thing to have around - I used one for Boca when she had her paw pad injury. The next morning I picked up a Comfy Cone from Kriser's - much better than the plastic ones the vet carries, and another smart item to keep on hand. Ruby spent Sunday being quite depressed and followed me around like a little velcro dog, but has since adjusted well to her new accessory. The prescribed eye drops were another story...

Even with my dad's help, it was nearly impossible to get the drops in Ruby's eye. She developed an instant fear of the bottle, and struggled mightily. I thought I was making progress with using the peanut butter bottle and a lot of patience, but after getting one lucky drop in, she became suspicious of that method, too. I knew there was no way I was going to get them in her eye three times a day for ten days, and called my regular vet for an alternative. They prescribed an ointment, which is going much better, although I notice that the redness increases after the ointment is applied so I'll be placing another call this morning to see if that is a concern. Ruby isn't squinting and doesn't seem overly bothered. She will have to have her eye re-stained on Saturday and I hope that it will heal up just fine. I plan to take up the vet bills with the rabbit colony...

Getting My Dogs In A Row

There was a lot of this going on at my house over the weekend. Boca had dental work on Friday morning - a cleaning and double-rooted tooth extraction - and both dogs received their 3-year rabies vaccinations. Ruby was very glum while her sister was at the vet clinic, though I tried to cheer her up with getting her assistance on some upcoming product reviews and a little trick training. Once we were all together again, everyone relaxed and soaked up the sun.

Ruby's last two experiences at the vet were quite stressful and we have a lot of work to do. Even the jingle of another dog's tags or their shadow visible under the door sent her into a frenzy, which did not bode well for a very thorough exam. I tried the Calming Cap for the car ride and waiting room, but it is clear from Ruby's behavior that this aid is getting into aversive territory for her: I want a calm dog, not a shut-down dog. I don't think it's something that is going to work for us. 

Boca was pleased to see me when I picked her up that afternoon, but was not herself the rest of the weekend. She was extra-cautious about my dad and seemed listless and depressed. I'm happy to report that as of yesterday she was back to herself, and I hope we are finished with vet visits until next year. I think that general anesthesia is so hard on them, and although the tooth extraction was necessary, I may look into the cleanings without anesthesia in the future, especially for Boca who is so cooperative. Has anyone tried it for their pets?

Due to her stitches and the big gap in her smile, Boca's chewing/playing activity must be limited for the week. This has proven to be quite a challenge since even if I separate them and let Ruby play with toys, Boca is not happy to be kept away from the action!  I did let her have her plush purple dragon for a few minutes last night while I played tug with Ruby and she was so cute about it, bringing the dragon to the gate and waiting for me to put Ruby in a down-stay and throw it again. 

The girls were lucky to have my dad's company all last week, and now we are back to our normal schedule with the dog walker. It's a holiday weekend and I'm considering getting a kiddie pool for the ginger sisters to splash around in on the patio. I've also been gathering up some tropical props for a fun summery shoot with Boca, so stay tuned for those pictures! 

I've updated my Facebook cover page for July and hope you'll like us there, too, if you haven't already:

Additionally, I've created a Facebook group for Potcake fans, and have been astounded by the fast-growing membership!

My Bahamian Dog Has A Florida Spot

The camera did not pick up the entire spot, but you can see the cloudy star-shaped area under her pupil. 

I took the ginger sisters to the vet on Saturday for wellness exams and their DHPP (distemper-parvo) vaccines. Boca also got an oral bordetella vaccine since it is a requirement for the obedience class we have registered for in July. Next week they will get their rabies vaccines, and Boca will have her dental work (cleaning and a bad tooth extracted). I prefer to split the vaccines up if possible, and after this year they will be on a staggered 3-year schedule for DHPP and rabies. 

After I had scheduled the wellness appointment a few weeks ago, I noticed a spot of opacity in Boca's right eye, like a smudge on a window. I Googled a few things and tried not to worry about it until I could point it out to our vet, since it didn't seem to be changing or causing her any discomfort or vision impairment. 

The vet had a look and determined that it is most likely a "Florida spot" or tropical keratopathy, something seen only in dogs from the southeastern U.S. and tropical and sub-tropical climates. Since Boca came from The Bahamas, this diagnosis makes sense. There are no other symptoms and the condition does not respond to treatment, so the vet said at this point the condition is just cosmetic, which was great news. 

There is not much information to be found online about Florida spots, and what I did find was in line with what the vet said: no other complications, no treatment. There is one published research paper from a study done on dogs and cats in Sao Paolo, Brazil supposing that it is caused by a mycobacterial infection. The Wikipedia article suggests that fire ant stings are a possible cause. True to her carefree and optimistic nature, Boca seems untroubled by the smudge on her eye, and continues to view life through her rose-colored doggie goggles.

Update: As of Boca's eye issues in 2015, the veterinary ophthalmologists do not believe Boca has Florida Spots.

Two's Company

I couldn't miss another Ruby Tuesday, and hope to be posting regularly again. I've had a hard few weeks, and I can't help but think that Boca came to us from the islands just in time. She's been with me for just a little over a month and has fit into life so seamlessly that I can't believe I considered adopting her out for even one moment. She is the perfect big sister, the most mellow companion, and doubles the joy that is added to daily routines. Walks are more fun, playtime is a riot, and I spend serene evenings on the loveseat book-ended by warm ginger and white bodies. We've had several weekend trips to my aunt's and friend's house in the Colorado Springs area, and Boca integrates into both groups of dogs with a calm and playful confidence. At home she is happiest napping in the sun, even as our temperatures climb into the upper 80s she chooses to sprawl out on the patio concrete in the direct radiance, a true tropical girl. 

I have been working on a few commands with Boca - she has picked up "sit," "paw" and "down," and it's adorable to have the dogs running through them in tandem. Like the big sister she is, if she wants the toy that Ruby has, she bounds up to her and takes it, and Ruby always defers. They sometimes sleep with their heads nestled together and their paws intertwined, or both crushed together in one bolster bed. Boca is pure sweetness: every morning she belly-crawls over the bed with her mouth open blissfully as if she can hardly believe she woke up in this wonderful place called home again. It reminds me to be grateful for the little things. We should all be filled with such regular delight!

 

Boca arrived with severe infections in both ears, but with the careful attention of the fantastic vet associated with the rescue group (who I am switching over to because she is just that great) and two rounds of medication, they have cleared up miraculously. It is recommended that I proactively clean her ears thoroughly at least once a week in case it is a chronic condition. She also has a tooth that will probably need to be pulled and I have an appointment for vaccinations for both girls later in the month. Boca will have her pre-dental bloodwork at that time and the cleaning/extraction scheduled soon after. I've also noticed a tiny opacity in her right eye - I'm somewhat concerned but will see what the vet has to say and take each thing in stride. Her skin and coat have improved tenfold, which I owe at least in part to a quality diet and supplementation with coconut oil and Organic Pet Superfood. 

Mealtimes are easy: I know from past experience that some picky eaters are cured by the presence of another dog and Ruby is no exception. For the most part they are getting Honest Kitchen Love with added green beef tripe for breakfast, and Fromm kibble with an Addiction canned topper for dinner. Boca is not so far a fan of fruits and vegetables like Ruby is, but loves any sort of biscuit or training treat. Elder kitty has not suffered with this addition: although Ruby can still be obnoxious with her, Boca treats her very politely. This week I've been transitioning to leaving the girls in the kitchen area for the afternoons while I'm at work. I was able to do some shorter trials while on vacation last week, and it went well. Boca will spend the mornings in her crate and the second half of the day in the kitchen with Ruby. All in all I simply adore having two dogs again. The house feels more full, Ruby is happier and more enriched, and Boca is so clearly exactly where she belongs.  

Tug Training and First Vet ER Visit

In one of last week's posts I mentioned an unexpected trip to the vet hospital, and being thankful for pet insurance.  That trip and Ruby's illness that prompted it was scary, but I'm happy to report that she recovered without incident and I've taken some extra precautions since then.  The night before we rushed off to our local emergency clinic at 7:30 p.m., Ruby had swallowed a small piece of a plush toy - the "skin" if you will, she spits out the innards - probably not bigger than a quarter, and not for the first time.  I have fished many a similar piece out of her mouth and thought I was fairly vigilant in supervising her plushie disemboweling, but clearly not vigilant enough.  I didn't think a lot of it that evening - as I said, it was not the first time and things had "come out okay" before; however, when she began throwing up repeatedly the next night, my first frightening thought was "obstruction" and I was not going to mess around.  Although she'd been groaning at home, Ruby perked up substantially at the clinic and charmed all of the staff.  It's a place I became far too familiar with during my elkhound Freya's illness, and it was tough to be back there, this time worrying that my new little girl could possibly require surgery.  After a precursory exam, the vet took Ruby back for x-rays, and it was a huge relief when the radiology report came back with no major findings.  They administered some anti-vomiting medication and some subcutaneous fluids, then sent us home.  I was advised to keep her on a bland diet and watch for any other signs of illness, but they expected she would be just fine, which she was. 

This incident prompted a revision of our toy policy and the discarding or re-homing  of most of her plush toys.  I kept only two that had not been damaged, and those along with tug toys are kept in her now seldom-used crate, re-purposed into "toy jail" and brought out only for closely supervised play sessions.  I've phased out the rope tugs as they tend to unravel and shed so quickly, and switched to the Walk-e-Woo TugGRRR which is made locally here in Colorado and which is holding up superbly so far.  While it does have fur in the middle, the main tugging part is nylon webbing, and Ruby goes absolutely nuts for it, which I'll talk about next.  She has a selection of balls and durable rubber toys (our favorite by far still being the Hide-A-Squirrel Extreme) out at all times when I'm home, and nothing but an occasional stuffed Kong in the kitchen when I'm gone.  I got her a new toy at Kriser's this weekend - a seemingly tough silicone newt - which lost a limb within minutes.  The limb was recovered, the cute newt tossed.  It astounds me that there are so many toys on the market that appear they would only be appropriate for a toothless dog.  What toys and tugs have you found that stand up to jaws and claws? 

As for tugging...it's become not only our go-to energy-burning game played several times a day, but an extremely useful training platform, and a motivation equal if not greater than high-value treats! I used "training within the game" to teach Ruby's "spin" to the right, and we're pretty close to nailing "twirl" to the left.  I ask her to jump up on the sofa and back down with a sort of "schew"-sounding cue, and can't help but think this would translate perfectly to the flyball box if we ever pursued that sport.  My training goal for this month, also in light of the toy-gulping incident, was to work on a reliable "drop it," and I'm delighted to say that is coming along really well with the tug.  I've successfully recovered a few stolen socks and last night, a pilfered blackberry (safe for dogs but I wanted to test out the command on a food item).  I ask for various commands in between tugging rounds, such as "relax," "roll over" and sequences of the aforementioned "spin" and "twirl," and I was thrilled when I was able to take the tug, ask for a "down," drop the tug on my feet in front of Ruby with a "leave it" command, and never lose her eye contact.   I'm noticing her self-control improve immensely, and while she does still get carried away once in a while (which results in "Game Over" and the tug going back to toy jail) this is happening less and less.  I'm anxious to try taking the tug out with us, on walks or to the park, and see if it can be a viable distraction/reward for her trigger managing. It's wonderful to have a play and training tool that she obviously enjoys so much.  

I'd like to take a moment to welcome our new followers - I am ridiculously giddy whenever I see a new faces and comments as I think one of the most exciting aspects of blogging is meeting fellow pet lovers and sharing experiences and ideas.  Since Ruby and I spend part of most weekends curled up on the sofa with a book, I've decided to combine my passion for reading and dogs and start including book reviews here - watch for the first one coming soon!