The lines on his saddle are his ribs, the white specks paint
|This handsome young guy was found as a stray in poor condition. When his Good Samaritan learned that we didn't have immediate accommodations for him she held on and took him to a vet. He is currently being treated for Valley Fever..just two pills a day...and looking much better.
We are awaiting the lab printout from his vet visit; he was negative for all but Valley Fever.
Drifter is getting along well with another GSD, is well mannered inside and has been left loose in the house with a doggie door. About the only thing he has done is get into the garbage which was left out.
He is scheduled to be evaluated on May 18th...please check back for more info and photos. He still needs to be neutered and is desperately in need of a foster home.
UPDATE 5/18: Drifter is emaciated, in fact, he's so thin that if you look at him head on, one cannot see his body at all. He's in very poor coat and we think needs further medical evaluation. Unfortunately he's far away (just north of Casa Grande) so we must get him into foster care in Phoenix in order to do what he needs; for starters...a chest film, blood test and fecal which we would like to do right away.
All that aside, it's apparent that he will be a beautiful black and red studly looking fellow once his health is restored, probably a German/American cross, or all West German.
Drifter was very interested in a group of dogs about 75 yards away so it was difficult to get his attention. He is very approachable, no aggression, alert and responsive to light corrections. He knows sit, will walk very well on lead with an experienced handler, will pull a pushover. We don't think going for walks was in his previous repertoire.
He appears to be between two and three years of age. We couldn't get a real good look at his teeth..he was OK, just pulled his head away. The usual socializing and training is all that it will take to make him a Canine Good Citizen.
It will take a lot of resources and a little time however, to get this boy up to snuff physically. We're waiting for a print out of his initial labs along with his titer in order to make sure the low dosage of meds he'd been prescribed is correct. He weighs only 55 pounds.
This lovely creature needs our help and we need yours. It's that time of the year when we will be seeing lots of neglected and sick German Shepherds in need. The gratitude we feel and that these dogs show us is immeasurable.
Drifter is friendly and fine indoors and while we will only place him with a female or solo, he's getting along well with another male GSD where he is right now. He will chase but not hurt a cat that can take care of itself.
Job one: a safe haven Job two: whatever help with his care our friends are able to provide. Drifter will be be microchipped, neutered and vaccinated prior to adoption.
UPDATE 5/24: Drifter will be transported to his Phoenix foster home tomorrow. He will see our vet next week. Please stay tuned for updates.
UPDATE 5/25: Drifter arrives and plants a grateful slurp on new foster Mom Elaine. We can't wait to get him healthy.
UPDATE 5/28: Drifter had his exam, blood test, fecal check and chest film today. His previously untreated Valley Fever has heavily impacted his lungs and caused his heart to work harder. He's been wandering around with it for quite some time.
He will likely be on long term medication. He has gained five pounds but it's hard to see as he is still looks a bit like a furry skeleton. His temperature was normal and his fecal negative for parasites. He's been eating and playing well. We'll have the results of his blood test by Friday. He had been under medicated for his condition so we had increased his dosage to twice a day upon his arrival with which our vet concurred; hopefully it will be more effective now.
Drifter's foster Mom says that he's close to perfect. He's been a model citizen in the house and on walks. He crates willingly and happily and always has an abundance of kisses to share. He was even cooperative on the X-ray table and his vet tech fell in love with him.
We will not be doing any neuter surgery on this boy until a considerable weight gain and after his next chest film; we're simply looking for improvement with his lungs.
Drifter doesn't know he's sick, he's a cheerful outgoing and friendly guy who just tires easily and has a raspy throat. We're hoping that having been a victim of neglect for so long that it has not done irrepairable damage. He certainly deserves better.
UPDATE 5/30: As suspected, Drifter's enzyme levels were low..borderline EPI -- Exocrine Pancreatic Insufficiency. He will be started on Prozyme, a supplement which will help him to absorb his food and we will be watching closely for weight gain to see if he needs more than Prozyme. Come on Drifter....fatten up dude!
UPDATE 6/3: Drifter is currently on the "back burner" so to speak. We're holding off showing him until we know if and how well he is responding to his treatment protocol. We are accepting inquiries; however, we cannot provide a prognosis for him until he's been on his current medications for another two weeks or so and he's had a follow-up chest X-ray. Right now he's showing signs of improved food absorption but it's too early to know the long term benefits. His progress will be chronicled here.
FOSTER'S UPDATE 6/6: Steff: Just a quick note to let you know that Drifter weighed 61.3 this morning. That's up almost two pounds from last week when he weighed 59.6 on those scales.
Not a huge amount but it's going in the right direction. To me, he just plain LOOKS better. I might just be getting used to his bony body but I asked a neighbor if he thought Drifter looked like he had gained and the neighbor said yes. I believe he's starting to rebuild lost muscle mass and his stamina is slowly improving. Our walks are now 20-30 minutes and he's recovering faster when we get home.
Also, left him loose in the house for about 7-8 minutes and he didn't get into anything this time. (I emptied the recycle basket before I left.) He appears to have just waited by the back door until I got home. I have left him uncrated the last two nights and he's not done anything wrong. Elaine
FOSTER REPORT 6/13: HPD (High Plains Drifter) is doing fantastic! I just got back from the vet's office and, either last week's weight was incorrect or this week's is incorrect. According to their scales he has gained exactly 12 pounds in one week! This week he weighed 73.3. Twelve pounds seems like an awful lot in one week but he's looking 'gooder and gooder' to me. Even one of the neighbors made the unsolicited comment this morning that he looks like he has gained. She said she can still see his ribs but they don't stand out like before.
The alone time is going very, very well. Left him alone yesterday while I went to Lowe's. Was gone about an hour and still haven't found anything wrong. I think last time when I was out, there was a package of Fig Newtons on the floor. I'm thinking now that he probably wasn't counter surfing - probably chasing the cat and she knocked them off the counter. Elaine
UPDATE 7/8: Drifter is not doing well; he saw the vet yesterday. He had gained but then lost some weight and is back to exactly where he was the day we rescued him; 63.3lbs. His breathing is very labored and he's using a lot of energy/calories in his effort to breathe. We suspect that the Valley Fever has infiltrated the pericardial sac of his heart, his lungs sound terrible.
The decision has to be made with respect to whether or not he would benefit from the extremely dangerous and expensive Amphotericin B IV protocol. This is a treatment that is very hard on the dog and his kidneys in addition to various other side effects. It also requires hospitalization and the vet questions his ability to survive the treatment. Further, the prognosis for this type of progression is typically not good. Meanwhile, he continues on his current course of medications.
We are consulting with experts in the field as to their recommendations, including Dr. Lisa Shubitz, the foremost authority and researcher of canine Valley Fever of the Valley Fever Center for excellence at the University of Arizona.
If only we had gotten our hands on this wonderful boy sooner.....
UPDATE: We conferred, at length with Dr. Shubitz on July 9th. If Drifter does indeed have periocarditis, the treatment will involve a possibly fatal open heart surgery to remove the entire pericardium. If he were to survive the surgery (the prognosis for that is "extremely guarded") his activity level would be have to be considerably lower than normal for the rest of his life. This procedure would also have to be followed by several IV treatments of Amphotericin B requiring hospitalization, also risky and toxic, followed by long term oral Fluconazole or Itraconazole. The cost, without the long term follow-up meds would be a minimum of $10,000.00+. The antifungals afterward would run about $125.00 per month.
The overall prognosis is very poor, especially with German Shepherds. Per Dr. Shubitz we have also learned that pericardial Involvement with disseminated VF lung infections is "highly over represented among German Shepherd Dogs." It has been noted by studies conducted by VFCE at UofA that German Shepherds in particular, with this type of disease progression, have a poor rebound rate even without surgery. In essence, the prognosis, even if these extraordinary measures were undertaken, is extremely poor.
Drifter has an appointment for a thoracic ultrasound on Tuesday. This will confirm the pericardial involvement and give us a better overall picture of the condition of his heart and lungs.
In the meantime, he didn't handle the required meat diet well so we quickly had animal enzymes over-nighted and started him immediately. He is now absorbing his food and getting the nutrition he needs to build up his downward spiraling immune system. They worked so well and so fast that he has resumed chasing the cat! Hopefully this measure will help him fight the good fight. We along with his devoted foster Mom are right there in the ring with him.
UPDATE 7/15: Drifter's ultrasound produced some surprising results. The was no pericardial effusion nor was there any thickening or scarring of the pericardium. His heart looked fine! Even Dr. Robertson was surprised after seeing his original chest film.
His ultrasound was followed by countless digital radiographs of his entire thoracic area as well as his airway; his lungs are not so bad either....he has an upper airway obstruction.
Unfortunately none of the imaging (just about every possible view) yielded anything conclusive other than to confirm that there was no foreign body present.
Drifter did suffer from some respiratory distress from being stressed so everything was stopped and he was sedated to keep him calm and breathing. He was much more relaxed and able to breathe far better afterward.
Drifter will have an endoscopy of his airway on Thursday. This procedure is not without significant risk; it's challenging to get a breathing tube and camera scope down the narrow trachea through which he must also breathe.
The specialist that will do the procedure feels that this will produce definitive results. Until then, we simply don't know what it is and if and how it can be fixed yet. We sure could use some help with his mounting bills, especially if he requires surgery. We're pulling out all of the stops for this sweet boy; he'll have every chance we can give him. Please send positive thoughts and prayers Drifter's way.
7/17: Drifter tolerated both the procedure and general anesthesia very well. Unfortunately the good news ends there.
One of his vocal chords is paralyzed. The scarring and lesions from previously untreated Valley Fever are located where his trachea branches off into the bronchi; too far down for any possibility of surgical intervention. The stenosis (narrowing) of that area is so significant that it is absolutely remarkable to see the size of the opening through which he has thus far managed to breathe..slightly larger than a pin hole. His inability to gain weight is the direct result of the amount of energy and calories he burns just breathing.
Ironically, his blood work indicates that he is indeed responding well to the medications he's been on, however, that does not undo the damage already done. We spent an hour after his endoscopy asking questions, making suggestions and essentially grabbing at straws in an effort to come up with anything that might give him relief. And that's the bitter pill; his vet bills so far have totaled $2,600.00 and we still haven't been able to help him other than to have kept him alive, loved and happy. Yes, despite his struggles, Drifter is a happy dog.
There is one very, very long shot; lung worms. They come only from Coyotes and not too many veterinarians would look for or be able to identify them. They reside, hidden deep within the tissues. And they can be treated. Since his presentation is an unusual one, why not an unusual cause? So we will be sending a fecal sample out of state to look specifically for this improbable possibility.
Meanwhile, we've added a bronchodilator to his Fluconazole and Pancrezyme regimen and we will wait for Mr. High Plains Drifter to either come up with a miracle or tell us when he's had enough. We are very grateful to those of you who have been able to contribute to his care; the need is still great. Thank you so very much.
UPDATE 7/18: HPD seems to be benefiting considerably from the bronchodilator he's now on. We're also assembling the report and images of his endoscopy to be sent to several specialists for additional input. We will continue to exhaust all possibilities.
The results of the cytology and culture taken during his bronchoscopy were negative which also ruled out the obscure possibility of lung worm. In simple terms, the previously untreated Valley Fever infection causes his lymph nodes to swell against his trachea (windpipe) thus constricting his airway, likely in addition to some scar tissue.
All of his radiographs, photos of his endoscopy, reports and labs have been obtained to be sent for further evaluation...we're waiting for one specialist who is out of town and who will also confer with U.C. Davis to see if any type of surgery is an option. His Internest didn't think so but encouraged us to pursue this path.
Meanwhile Drifter is holding his own, staying out of the heat and humidity which is pretty rough on him. Nonetheless, he insists on his short daily walks to which he looks forward.
On the upside, he continues to eat well which is rare for a dog with his progression of Valley Fever. We have already refilled his RX's and his enzymes will soon have to be reordered..any contribution to these expenses would be a tremendous help.
UPDATE: We have consulted with several specialists including a Cardiologist, another Internist and our final consultation with Dr. Shubitz took place on August 15th. We went over all of his diagnostics and reports with her the results of which follows:
There is absolutely no surgical option. It is believed that Drifter has Monocytosis as a result of his Valley Fever infection, as well as laryngeal paralysis. We now have a long range protocol for him which should produce significant improvement within a month and if not, an alternative medication if and when his response or lack thereof so indicates.
We have greatly increased Drifter's daily Fluconazole to a much higher dose. We've changed his food, and added Prednisone to reduce inflammation. He has not gained an ounce so his weight is being watched closely. We are to continue with his Theophylline and Pancrezyme.
How well he tolerates the large dose of antifungals remains to be seen, however, based on her Valley Fever expertise and experience, he should have been on this very high dose long ago. We're hopeful that the steroids will substantially improve his breathing and food intake. We have also reordered another month of enzymes.
Time will tell.....
UPDATE 8/18: After less than 2 days on Prednisone, Drifter's raspy labored breathing and cough turned to quiet, normal sounds. We then added the large dose of Fluconazole along with his new diet. We know that the Fluconazole will affect his coat; we're hoping that it does not affect his appetite. In just under a week of his new regimen, here's his foster Mom's report:
Next goal: WEIGHT GAIN!
UPDATE 9/3: Drifter appears not to have gained any weight although we will only weigh him once or twice a month now. It's only been less than 3 weeks that he's been on his new protocol so he'll be weighed in mid September. All of his medications (Theophylline, Pancrezyme, Fluconazole and Prednisone) are due to be refilled next week..we are grateful for any help with the cost; even the new food he's on costs $56.00 per 26LB bag and he continues to eat well three times a day. His breathing remains quiet and unlabored..a huge improvement. His steroids will be reduced to once a day at the end of this week so we're hoping this does not have a negative impact on his respiration.
Many thanks to HPD's foster Mom Elaine for maintaining his routine, his walks and keeping us up to date with his progress.
UPDATE 9/17: HPD has gained close to eight pounds. A month ago after throwing the ball three times he was exhausted. Now he doesn't want to quit and his foster Mom runs out of steam before he does. His walks are longer and he's got a spring in his step. His blood work will be run again in November at which point we'll know if his Valley Fever titer has gone down and if he still needs help with enzymes. Waiting is difficult but then again, we inherited a very sick fellow literally on the brink of death so his progress is slow yet very gratifying. He still has quite a way to go but there's no question that this is a new and improved High Plains Drifter! Obedience will begin as soon as the temperature drops.
UPDATE 10/8: HPD has gained around 10-12 pounds and he started obedience class last week! He's still a skinny dog but no longer looking like he came out of a dumpster; his coat is shiny and healthy and he's, for now, off his steroids. We say "for now" as we anticipate his breathing to gradually become a little noisy the longer he's off of the Prednisone. Just in case, we gave his foster Mom a new RX of 100 so he doesn't lose any ground in the event he shows some signs of swelling again.
He is full of himself and over excited around lots of other dogs at the park; all of the nurturing he's been given along with the isolation of a long hot summer has proven the need for honing his social skills; even sick dogs need manners!
We think that by the end of his training session he'll be a real social butterfly with his canine friends. Drifter's Valley Fever titer will be rechecked in about two weeks.
UPDATE 10/24: We ran a new Valley Fever titer and a test to measure HPD's enzyme production earlier this week. His enzymes are now in the normal range; as Dr. Shubitz believed, he is not a true EPI dog and his former low level was due primarily to his overall health status.
We're reducing his enzyme supplements and hope to eventually have him off them entirely. If he can hold his own without them that would eliminate the current cost of $125.00 per month! He is also back on daily Prednisone to reduce the inflammation in his airway and restore his abilty to breathe without difficulty.
High Plains Drifter's recent Valley Fever titer was 1:8..down from 1:32. It's been a long, slow process but we think we're beating this nasty disease!
He'll be staying on his VF meds for another three months after which he will be retested.
UPDATE 11/20: HPD has moved beyond novice to more advanced obedience...he's learned a lot. He's probably going to be on Prednisone for the rest of his life as his breathing suffered as soon as it was withdrawn. He is almost completely off of his enzymes; will be 100% weaned off in one to two weeks. We're waiting to connect with Dr. Shubitz regarding his Fluconazole dosage. His weight has held at around 72 pounds.
Once Drifter's titer is 1:4 or lower, he'll be permanently placed in his forever home. Hopefully, all he'll need at that point is Theophylline, Prednisone (pretty inexpensive) and a VF test every six months. What a great Christmas gift that would be!!
UPDATE 1/2: We have again conferred with Dr. Shubitz; she had also consulted with Dr. Matz, an expert in the area of Drifter's airway constriction and it all boils down to what we already knew: depends on whether or not the narrowing of his airway is due to scar tissue or swelling of his lymph nodes against his trachea (or both). If it's scar tissie, it will just have to be managed as it is now. If it's only swelling, there's a good possibility that it can resolve with continuing treatment and he can eliminate the Prednisone.
We have weaned HPD off of Theophylline so the only two medications he is currently taking are Prednisone & Fluconazole. Dr. Shubitz feels he should remain on long term (close to a year) anti fungals regardless of his next titer.
In mid January, Drifter will have new blood work and another chest film so that we can better ascertain his progress thus far....fingers, toes & eyes crossed ;-0) He's now an obedience trained guy with a more optimistic future!
Oh, and he's recently weighed in at just under 80 pounds..we're shooting for 85.
UPDATE 2/3: Drifter had an exam, chest film and full Desert Profile blood panel on Jan 30th: His Valley Fever titer was 1:4!!!! Really great news. His labs were ALL NORMAL, and NEGATIVE for Erlichiosis. We're sending his recent X-ray to Dr. Shubitz at U of A for a comparison with his original, baseline film and other radiographs done last May. We should have her input within two weeks if she's not traveling right now.
He has again been weaned down to 10mg Prednisone once a day and has done well. We're moving to 10mg every other day starting tomorrow and will watch his respiration closely for the next couple of weeks. With his next refill we are changing from compounded Fluconazole to generic brand and have asked Dr. Shubitz if that can be reduced to 200mg from 250mg. We'll see what she says.
He will have another titer check in May which will mark our one year anniversary of fighting the good fight. Drifter has proven to be very worthy of the effort and cost.
We wish to extend our eternal gratitude to those of you who were able to help with Drifter's expenses. His medications, diet and diagnostics continue; he must always be tested regularly and watched for any signs that he is out of remission; eventually every six months. His future will always be uncertain, but for now, we are closing in on the FINISH LINE!
Drifter has been weaned down to only 10mg of Prednisone every other day and is holding his own. This was a big goal for us as daily, higher dose steroids can bring about their own problems. He had a skin scraping yesterday..no bugs, no Demodex, just some seasonal dry skin. And.....he wighed 78.5 pounds!
FINAL UPDATE 2/27: We conferred with Dr. Shubitz for over an hour. She reviewed his recent labs (all normal) and compared his most recent chest film with his original. She also addressed all of our questions regarding his maintenance program.
While she referred to his last chest X-ray as a "nightmare" she also indicated that it showed significant improvement over his last. Dr. Shubitz said she was "amazed" that he is, not only alive, but doing as well as he is. She confirmed what we knew; his airway obstruction is scar tissue which will never go away, however, now that we've brought the inflammation under control along with his Valley Fever, it's all about continued management and monitoring.
A considerable part of our success can be attributed to the dedication and cooperation of Drifter's foster Mom, Elaine, who will be officially adopting him this weekend. Along with a bit of luck, we wish them a long and healthy life together!
Sincere thanks to all who cared.
UPDATE 5/22/2010: Our last update was about a year ago. We've had a few inquiries so decided to bring Drifter's progress up to date: he's doing great!
His titer has been checked every three months and held at 1:4. We'd like to see 1:2 and we know that a "negative" won't ever be seen due to the antibodies present in his system. Drifter was taken off Fluconazole entirely last month; his titer will be rechecked in another two months..needless to say, we're anxious to see the results.
His weight has held at between 78-79 pounds. And best of all; he's been off prednisone for many months and has had no difficulty breathing! He was also very gradually weaned off the expensive EVO diet and is now eating regular dry food.
We're holding our breath until his next blood draw...it would be so nice to know he no longer needs antifungals in which case he will be off ALL meds and considered to be in remission. Perhaps he can serve to provide hope for some of the other victims of advanced Valley Fever.
Either way, Drifter is his Mom's and our miracle boy.
Who is this handsome hunk? Is this the guy they said would die? The one, we were told early on, that we were investing too much in the way of resources to try to save? Well, tell that to his Mom three years later. The playful duo paid us a visit today and what a joy to see this happy boy.
Drifter finally broke the 80lb mark and weighs in at about 82..a perfect "holding" weight for him. He was taken off his meds a little too quickly..should have been more gradual.. so he's still on Fluconazole but nothing else and he will continue to be tested regularly.