Wishing you and yours a very Happy Thanksgiving Day with safe travels, and lots of stuffing, gravy and pumpkin pie.

This year we are off to my brother and SIL’s house for Thanksgiving. It is her favorite holiday, and she does a marvelous job of hosting all of us. My only contribution is to bring a sweet potato casserole! I love years like this.

I hope you and yours have a wonderful Thanksgiving day!

Over the River and Through the Wood

by Lydia Maria Child (1844)

Over the river, and through the wood,
to Grandfather’s house we go;
the horse knows the way
to carry the sleigh
through the white and drifted snow.

Over the river, and through the wood,
to Grandfather’s house away!
We would not stop
for doll or top,
for ’tis Thanksgiving Day.

Over the river, and through the wood—
oh, how the wind does blow!
It stings the toes
and bites the nose,
as over the ground we go.

Over the river, and through the wood,
with a clear blue winter sky.
The dogs do bark
and the children hark,
as we go jingling by.

Over the river, and through the wood,
to have a first-rate play.
Hear the bells ring,
“Ting a ling ding!”
Hurray for Thanksgiving Day!

Over the river, and through the wood—
no matter for winds that blow;
or if we get
the sleigh upset
into a bank of snow.

Over the river, and through the wood,
to see little John and Ann;
we will kiss them all,
and play snowball
and stay as long as we can.

Over the river, and through the wood,
trot fast my dapple gray!
Spring over the ground
like a hunting-hound!
For ’tis Thanksgiving Day.

Over the river, and through the wood
and straight through the barnyard gate.
We seem to go
extremely slow—
it is so hard to wait!

Over the river, and through the wood—
old Jowler hears our bells;
he shakes his paw
with a loud bow-wow,
and thus the news he tells.

Over the river, and through the wood—
when Grandmother sees us come,
she will say, “O, dear,
the children are here,
bring pie for everyone.”

Over the river, and through the wood—
now Grandmother’s cap I spy!
Hurrah for the fun!
Is the pudding done?
Hurrah for the pumpkin pie!

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Mr. Max passed away on Saturday, November 3, 2018.

If you have been following his journey with GME the last 4+ years, you will recall he lived well in excess of the norm for GME patients (not leaving the hospital to 3 years is the prognosis).

Ironically, it wasn’t the GME that did him in; it was most likely the steroids that controlled the GME. Max’s gallbladder was not healthy and had not been this whole year. It was 60%+ full of sludge, becoming larger (again), and showing signs of forming a mucocele. If his gallbladder had formed a seal, it could have (would have) burst, leading to a very painful death.

We made the decision to have him have his gallbladder taken out. We dropped him off at Cornell on Tuesday, October 30, 2018. They did bloodwork and another sonogram. The surgeons were very encouraged by how (relatively) healthy he was compared to a “regular” dog with gallbladder disease that opted for this surgery.

On Wednesday, the surgeons attempted to remove his gallbladder laparoscopically. Since Max was immunosuppressed this would have given him small incisions, and (hopefully) an easier time to heal.

While attempting to remove the gallbladder, there was some (caustic) leakage, and they had to revert to the full-cut. We knew this (the full-cut) was a strong possibility as laparoscopic gallbladder removal in dogs is only successful in the best of cases about half the time. The leakage happened because his gallbladder was so friable (thin).

Max made it through surgery fine. He woke up after anesthesia and was doing relatively well in recovery. However, later that evening things took a turn for the worse (with his blood trying to form clots, his low blood pressure, and fast heart rate) and he was moved to the ICU section of the hospital.

The veterinarian doctors at Cornell worked on him for several days. Things were looking up for him on Friday, and I was cautiously optimistic he would make it. The plasma had done its job, the pressers were helping his blood pressure, and it appeared that he would be able to get some nutrition on Saturday.

Unfortunately, overnight Friday things took a turn for the very bad. We received news around noon on Saturday that they were going to try their last option to attempt to raise his blood pressure (human albumin as they do not have canine albumin on hand). Max ended up allergic to the human albumin, something we were warned was a possibility before it was administered.

At that point, there were no other options for him. As we got in the car to drive down to Cornell to say goodbye, the ICU doctor called to tell us his oxygen level was down to 27% (his organs were shutting down), and we made the decision to euthanize him.

There are no words to express our sorrow. It physically hurts to think of Mr. Max right now. I “know” he lived longer than he “should” have with that dreadful disease. I “know” we were lucky to have him as long as we did. I “know” he no longer is in any discomfort or pain. I “know” all this. And yet the pain of our grief is suffocating at times.

Those without pets probably think I am crazy or exaggerating. I am not. We are truly devastated to have lost the little guy.

We can’t help the woulda, coulda, shouldas that led to the surgery decision. Our logical side knows that the gallbladder was a ticking time bomb, and he would have died a horrible death if it had ruptured. He had “a chance” – which is what exactly what his original neurologist told us we were giving him when he was diagnosed all those years ago and we decided to proceed with GME treatment.

But logic has very little to do with what we are feeling right now.

We want him with us. We want him healthy. We want another opportunity to appreciate every day we had with him. We want it all for him. And we are grieving because none of that is possible.

Max was a PITA. He fought with me for 10 years for “pack” dominance. He always wanted to be the alpha. He was a small dog that lived large, and didn’t realize he was little, fluffy, and cute.

He was a true fighter. He lived with a horrible disease for far longer than anyone guessed he could have. His spirit was truly indomitable.

We love him very much. The tears are still flowing and our hearts are still quite heavy – and will remain so for a long time to come. I know there will come a day when we recall all the Max stories with smiles instead of tears. Right now, we just miss him so much it physically hurts.

We will see you on the other side little buddy; we will see you on the other side.

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Previous Max posts (read in order from the bottom up to follow his whole story):

• Max’s GME Update: Distressing News
• Max’s GME Update: Chemo Round 9
• Chemo Round 8 for Max
• FOUR YEARS!!
• Chemo Round 6 For Max
• Chemo Round 5 For Max
• Chemo Round 4 For Max
• Chemo Round 2 For Max
• Max is Back to Chemo for His GME
• Max Had a Relapse
• Mr. Max April 2016 Update
• Max March 2016 Update
• Mr. Max Post Cornell Visit Information
• Max’s Latest GME Update
• Max’s GME Update, One Year Later
• Max’s GME Update, Month 11
• Max’s GME Update
• An Update on Mr Max, March 2015
• Updating Max’s GME
• An Update On Mr. Max
• Last 2014 Trip To Cornell For Max
• Back To Cornell
• Max’s First Cornell Follow-up Visit
• Max Exercises More Than I Do!
• Updating the Mr. Max Situation
• A Mr. Max Update
• Mr. Max, Mr. Max, Mr. Max
• It’s A Mr. Max Post!

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Our dog, Max, suffers from GME – Granulomatous meningoencephalomyelitis. He was diagnosed with this terrible disease in July 2014 and continues treatment to keep the symptoms at bay. GME is incurable, so managing the symptoms for a good quality of life is the best that can be done with the poor dogs with this disease.

For those of you unfamiliar with Granulomatous meningoencephalomyelitis (GME), it is a canine disease where the white blood cells attack the central nervous system. Max is well past historic long-term prognosis for this terrible disease. When he was diagnosed we were told his chances were “not leaving the hospital” – to – “up to three years”.

We were back in Ithaca earlier this week for round 10 of Max’s chemo (2018). We walked in with Max having had a bug, or gallbladder issues, or something the last few weeks.

Hubby and I took a trip to Las Vegas late last month/early this month to go through his Mom’s house. Hubby’s Mom passed away in September, and as the executor of her will, he needed to deal with her possessions and house. We went out to take care of the personal possessions, and for Hubby to engage an estate liquidator and Real Estate agent.

While gone, Sonny-boy stayed at our home with Mr. Max.

Even though Sonny-boy is 30 years old, holds a number of degrees (including two masters), has been on his own for 10 years AND has a SO who is a NICU nurse (and she stayed over a number of days), Hubby still demanded proof-of-life photos and video daily.

SMH

Max did great with Sonny-boy, but Sonny-boy indicated Mr. Max was off his feed the day before we came home.

Max ate less and less the week after we got home, and he definitely was not feeling well.

We took Mr. Max to his regular vet who prescribed Cerenia, and wow did that help! He stopped throwing up and started to eat pretty regularly.

On the return check-up, he had his wellness exam. His blood test showed a very elevated white blood count, and that was a concern. Was it a bug? Was it the GME? (This was last Thursday.)

We went back to Cornell earlier this week (Monday) – they used that blood test and started his chemo immediately. While there, he also had a sonogram (ultrasound) for his gallbladder, and an additional blood test to check his white blood cells and liver enzymes.

If you have been following along the last few years (particularly this year) you know Max’s gallbladder has sludge in it, and the doctors at Cornell were worried it would form a mucus seal. Those worries are coming to fruition.

Max has “tentacles” (we saw the sonogram, that is as good a word as any) that are now looking to form a plug. No one knows when that will happen. When (probably not “if”) the mucus seal (plug) develops, his gallbladder could (will) burst leading to a very painful death.

We now have a choice… to put Max down, or to have the surgeons at Cornell perform gallbladder removal surgery.

For myself, I always felt the mucus seal (plug) was the end-game. Hubby, however, feels differently.

And so, Max will be having surgery at the end of the month. There are many, many concerns all centered on his being immune-suppressed. Will he survive the surgery? Will he be able to heal? Will he develop an infection he cannot fight off (because he is immune-suppressed)?

Hubby’s thought process is surgery gives him a chance. My thought process is “is this humane”?

I will say that if Max survives the surgery, does heal well, and does not develop sepsis, he will probably feel a whole lot better. His gallbladder has definitely led to gastric distress and discomfort this year. He will still have GME, and that will continue to be treated, but his other issues will be (should be) gone.

The fact that he is the longest survivor with GME at Cornell actually plays in his favor – he has shown he can tolerate GME management longterm. No one knows how long he can continue to do so (we’ve been in undocumented territory for about a year now).

Please wish Mr. Max luck. This is the most dire things have been for him since he first came home after his first chemo treatment over four years ago. He may or may not survive his surgery, but I know this little guy is a fighter. If there is a chance, he will be fighting like crazy to get better.

Here is hoping things go well, and out little PITA will be with us for a longtime to come.

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Previous Max posts (read in order from the bottom up to follow his whole story):

• Max’s GME Update: Chemo Round 9
• Chemo Round 8 for Max
• FOUR YEARS!!
• Chemo Round 6 For Max
• Chemo Round 5 For Max
• Chemo Round 4 For Max
• Chemo Round 2 For Max
• Max is Back to Chemo for His GME
• Max Had a Relapse
• Mr. Max April 2016 Update
• Max March 2016 Update
• Mr. Max Post Cornell Visit Information
• Max’s Latest GME Update
• Max’s GME Update, One Year Later
• Max’s GME Update, Month 11
• Max’s GME Update
• An Update on Mr Max, March 2015
• Updating Max’s GME
• An Update On Mr. Max
• Last 2014 Trip To Cornell For Max
• Back To Cornell
• Max’s First Cornell Follow-up Visit
• Max Exercises More Than I Do!
• Updating the Mr. Max Situation
• A Mr. Max Update
• Mr. Max, Mr. Max, Mr. Max
• It’s A Mr. Max Post!

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• If you enjoyed this post, be sure to sign up for the Ann’s Entitled Life weekly newsletter, and never miss another article!

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