Ronnie Illness

So/λοιπόν, about two weeks ago my best friend and constant companion, Ronnie, a fourteen year old Husky/Springer mix, suddenly vomited profusely. The vomit was a strange dark maroon, and did not directly resemble anything he had eaten. I waited to see how things might develop. I wish I hadn't. A couple of hours later he vomited again. A darker maroon and more liquid. His demeanour was subdued. Something was very wrong.

I called the local island vet and arranged an emergency visit. I took my rapidly deteriorating dog to the clinic. Theo, our vet, examined him and diagnosed the most likely cause as ingestion of an anticoagulant rodenticide, rat poison. Theo showed me the lesions around his gums and penis that seemed to confirm the diagnosis. This was serious, life threatening. Ronnie was placed on a course of vitamin K injections twice a day. Rat poison is terrible stuff. Being an anticoagulant, it destroys the blood's ability to clot. The result is slowly bleeding to death, bleeding from inside and outside. Ronnie's stools, urine and mucus were all becoming more and more saturated with blood.

We watched his progress closely over the next five days, but the signs became worse.

Saturday night my son and I sat with Ronnie through the night as he clearly deteriorated. We were losing him. Sunday morning he was too weak to walk. We managed to get Theo to meet us at the clinic, where he immediately performed a blood test. His face was grim when he gave us the news that the platelet level was near zero. Theo advised an immediate visit to an animal hospital in Athens for an emergency blood transfusion. A ferry was to leave the island for Athens in twenty minutes. With nothing but the clothes we stood up in, we high-tailed it down to the port, managed to scream "emergency" in the ticket office, and ten minutes later we drove onto the ferry as the ferry doors were pulled up.

I usually love ferry journeys. This one was an exception, the worst three hour journey of my life. My dog was dying in my arms. We sat on the open deck. I then saw that the straps on the dog carry cradle I had used to get him from the car to the deck had rubbed against his back and my baby was bleeding from the abrasion. I wanted to scream at all the people around us to fucking steer clear with their big feet as they were walking all around us. A few of the passengers could see our obvious distress, and they inquired and offered their kind best wishes. Fortunately the road on Sunday from the port of Piraeus to Athens was clear and we were there in 35 minutes.

We checked him in and they took him from us. Many of you will know the agonising pain I felt. A feeling of unreachable sadness and grief. We had done all we could reasonably do, but we were staring into a future that we could not see, an open wound of precipitous loss, of an outcome most feared.

My son had managed to reserve accommodation in an apartment near the Doukissis Plakentias metro stop that turned out to be a five minute walk from the veterinary hospital. This was a huge relief, as it meant we did not have to contend with driving in Athens traffic at a time when I was stressed out of my brain and most liable to make mistakes driving in an unfamiliar place.

The next ten days drained us emotionally. We would visit daily, see the veterinarian, and try to digest all the scientific information given to us by the doctors and staff whose first language was Greek, not English. The emotional drain was analogous to my dog's blood loss. You could feel yourself having to pull on reserves just to keep walking.

When we visited, Ronnie was visibly weak and tired. He would wag his tail on seeing us and then quickly collapse to the floor and sleep. We sat by him every day for an hour at a time, talking to him and stroking him and wishing with all our hearts for a better outcome.

About halfway through this period some lab tests indicated that Ronnie had not been a victim of rat poison, but instead that this was some sort of autoimmune issue. The body was attacking its own blood cells and destroying them. Once correctly diagnosed and treated, Ronnie slowly, very slowly, started to show signs of improvement. Ultrasounds, though, showed abnormalities in the liver and spleen. More tests, an FNA (Fine Needle Aspiration) under general anaesthetic, were ordered. By the tenth day Ronnie was discharged to us. Aftercare of steroids and probiotics with follow-up blood monitoring was advised. The FNA fortunately revealed no signs of cancer or malignancy. For the technically minded, the final diagnosis is immune-mediated thrombocytopenia (ITP), with concurrent immune-mediated haemolysis.

We waited for a few more days in our rented apartment to remain close to the hospital. On the tenth day we returned home, with a still fraught, but much less fraught, ferry trip back to our island. And now, we are home. Recovery is slow, and my baby, aged fourteen, has been through the equivalent of being battered with a baseball bat. His body is shaved in multiple places for the various cannulas and scans. The worst thing is just how much weaker he is and how much weight he has lost. We do all we can to help his recovery, the medicine, the care, the feeding. There are side effects to the medication, and these will remain until we can taper down the dosage.

The long term outlook remains unclear. As we taper down the steroids, it is possible the autoimmune condition could flare up again. If that happens, it will mean continued higher dosages, and the side effects from the drug will shorten his life too. If we are lucky, the dose will be able to be tapered down to zero or near zero. Ronnie is nearly 14, or around 80 in human years. There is an inevitability fast approaching me like an exit sign on a motorway.

I got Ronnie from the Woodgreen Animal Shelter in Cambridge thirteen years ago. He had been returned to the shelter THREE times, and that only goes to prove that people are idiots. I read the Woodgreen reports, they indeed revealed it was the people who were total idiots! Ronnie has proved himself to be 24 carat gold. We have been lucky in that my life has allowed me to be with him pretty much 24/7/365. Ronnie has made every single day shared with me a better day. I also promised him at the start that I would do everything to make every day of his life the best it could be. And oh, we have had so much fun, and love, and joy. I am relieved that Ronnie was not poisoned. It would have been harder to accept this as a result of someone's callousness in putting down rat poison in a place where pets could get to it than as a natural cause.

We fight on, and each day we see a little improvement. He is now eating well and looking a bit brighter each day. It's hard not to be able to share our normal food with him, so we cook him special treats that we can hand feed him, as if they had come from our plates. I have to place my belt around his hind quarters to support his weight, which his back legs struggle to cope with when mounting steps. The plan now is just to make every day for Ronnie the very best it can be.

Some notes for dog owners.

• With hindsight I now see there were some signs of Ronnie's ailment. Most particularly, in the couple of days preceding him vomiting blood, his smell changed.
• If you see blood in stools or urine, go to the vet IMMEDIATELY. Do not wait!