Some concerns about Sam

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UpwardDog
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Some concerns about Sam

Postby UpwardDog » Thu Apr 28, 2016 12:13 pm

My buddy is aging and it's got me second guessing myself on how much to be concerned vs how much is just aging.This is my first dog to go through old age with as the responsible adult, so I'm a little insecure or lacking in judgement. I've got him booked for a full physical and bloodwork on Monday. He'll get some more Cartrophen then too I'm sure.

Here are some of the changes that seem to be slowly worsening. I know most are typical parts of slowing down, I just don't want to miss anything that i might want to pay attention to before seeing the vet on Monday:

-gets up more in the night despite the fact that he doesn't ask to go out much in the day

-sleeps a lot

- moving much more slowly, and other signs he's a bit creaky or sore

- zero desire to eat breakfast or a meal offered at noon or afternoon

-much less desire to eat overall. The last few days I've been coaxing him a bit and he's still not keen. he ate the raw egg and a bit of kibble, but not anywhere near a full portion for a dog eating only once a day. Interestingly he's not urping of bile or having volcanic sounding stomach acid gurgling from being too empty that he often got in years past.

-He can be convinced to eat some supper, but still isn't that keen and he'll let it sit there a while while he stands and does nothing. I have taken to feeding him in a crate because otherwise I don't know if he eventually walked away and one of the others ate his food.

-He has zero interest in kibble. He'll come have a bit of real meat like the tripe blend that Will gets as part of his raw diet.

Other than moving around less, not wanting to sit/down unless he's going settle there, I don't really see signs of pain or lameness. He can still jump into the van and onto my bed.

His back teeth have some tartar but nothing dramatic. I'd be thinking about booking a dental at some point if he weren't slowing down so much. I'm not keen on putting him under at this stage and he's not interested in raw bones at all anymore.

Thoughts? Ideas? Things I should be watching out for?

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Re: Some concerns about Sam

Postby emmas_mom » Fri Apr 29, 2016 9:47 am

Sounds pretty typical to what I've experienced with my old dogs, including my current one (Mitzi) who generally will only eat once a day which is often late at night, spends all day sleeping (other than me waking her up to take her outside or give her meds once or twice) and then is up frequently in the night. She's less inclined to go for walks (will do an abrupt about face after a half a block and march me home!).
I think you may find pain meds help with mobility and overall feelings of wellness if Sam can tolerate them. With Mitzi, who can't handle most pain meds, I do try to get her walking twice a day as lack of mobility exacerbates her arthritis.
As with all my old dogs, I find Mitzi is "one step forward, two steps back" - she is clearly declining, but then just as I think it is reaching crisis proportion, she bounces back and does the zoomies, wolfs down a ton of food, barks at me to play with her....
Mostly I just try to respect her right to choose whether or not to eat, to sleep, to have a long walk, to choose the route we go. The only thing that is non-negotiable is her meds (Tylan and benezapril) which she must have every day. Of course, I only have the one dog right now and no kids, so letting my world revolve around her is less complicated than it is for you.
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Re: Some concerns about Sam

Postby UpwardDog » Fri Apr 29, 2016 5:27 pm

Jean, have you tried any meds for sleep for Mitzi? Benadryl?

It's tricky to get food into him with other dogs who DO want to eat around and Sam not wanting to eat in a crate.
Yesterday he wouldn't eat all day and hadn't eaten the day before, but I was able to get some treats into him on our walk--a few pieces of beef heart and hot dog, then he let me hand feed him some kibble. Now I have a poo smear on the sofa and had to trim poo off his very long bum hair .

As for pain meds, I don't think he can tolerate an NSAID, but possibly he could do tramadol or something. I really should walk him two short walks instead of one longer one. I bet that would help him sleep better. It's just that by the time I've got kids to bed and the kitchen cleaned up, the last thing I want to do is walk dogs again.

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Re: Some concerns about Sam

Postby MaisyPancakes » Fri Apr 29, 2016 6:16 pm

Aw, Sams. <3 I think just keeping track of changes, it might help you decipher what's gettin' old vs. somethin' to fix. *I* still have no idea, though, despite my journaling—it basically just helps me feel like I'm doing *something* productive and if a vet asks me anything about a certain day, I can check my notes. When I am unsure/stressed, I just collect data. ;)

Also, as far as I can tell, it seems like once they start showing signs of aging, it picks up the pace quite a bit!! And, they start to have "good days" and "bad days" kind of shit where things aren't always consistent anyway, so you're not supposed to become too alarmed until the decline is persistent. (I panic immediately, regardless.) This is probably common sense, but I am still getting used to things taking much, much longer to improve once something goes wrong.

Sorry for the random blurty post. I kept having to leave and come back and it got all disjointed—and ended up not helpful at all...just commiserating! ;)

Sorry about the lack of appetite and poop butts. :( It is hard, getting old.

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Re: Some concerns about Sam

Postby UpwardDog » Tue May 03, 2016 8:43 am

Sam is down 3 lbs. :frown: He had a physical and blood work. His back was a bit of a mess so he got adjusted. His molars have some tartar so I got him some Leba III to hopefully soften it and scale it off. I'm not keen to anesthetize him right now and it's not a good time to spend $700.

Has anyone tried Leba III? I did a search and didn't come up with much. It's mostly alcohol so I'm highly skeptical.

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Re: Some concerns about Sam

Postby connie » Tue May 03, 2016 11:28 am

Almost everything sounds pretty old-dog-normal with the exception of not wanting to eat. Have you had his teeth checked? I know you said there's some tartar, but I'm wondering about infection and dental disease. Bloodwork done recently -- how's his WBC? Look like he's fighting any infection?

My sister's OES had 13 teeth removed when he was 11. It perked him up no end. :crazy:

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Re: Some concerns about Sam

Postby UpwardDog » Tue May 03, 2016 1:20 pm

His teeth haven't been x-rayed in a handful of years when he had his last dental. Bloodwork should be back tonight I hope so we'll see what it shows.

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Re: Some concerns about Sam

Postby UpwardDog » Tue May 03, 2016 8:17 pm

kidney failure. I'm sure hoping his numbers improve with some hydration

urea/BUN 49.5 (3.2-11)

creatinine 458 (44-133)

sdma (?) 34 (0-24)

Osmolality 338 (278 -306)

hgb 131

hct is also borderline low

wbc was pretty normal I think

lipase is normal

gonna check his urine and BP tomorrow

started him on pepcid and gave him some slippery elm -to see if that helps him feel more like eating and drinking

I made some bone broth and he drank a bowl of that.

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Re: Some concerns about Sam

Postby MaisyPancakes » Tue May 03, 2016 8:37 pm

xoxo, Heather. I know that lots of ODOers have successfully managed kidney stuff for a long time—and Sabine's diet will be super helpful, too! Glad he drank the bone broth—good Sammy! <3 *clutching your hand even though you might not like it very much*

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Re: Some concerns about Sam

Postby connie » Wed May 04, 2016 5:40 am

Yes, it is possible that you can do a lot to modify those numbers with diet and supplementation. Hoping for that! Standard Process makes a Renal Support supplement that I have used with a number of Shelties:
https://www.standardprocess.com/Product ... yntPVQXKB4

Sometimes there is a dramatic improvement on the original numbers and then the dog settles into a 'chronic' state -- quite comfortable, but with special needs re diet and supplements and maybe diapering -- that lasts for quite a long time. Again, seen this in Shelties more than a few times. Hoping you see that with Sam, it's not time for him to go yet!!

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Re: Some concerns about Sam

Postby UpwardDog » Thu May 05, 2016 8:46 am

I'm not sure what to do about his diet since he's not really wanting to eat much. I gave him cerenia last night and he still only at a bit of dehydrated.

He had been eating Acana Ranchlands or Grasslands kibble (with some fresh additions) for a few years because that's what worked for his gut. A couple of weeks ago I accidentally bought Orijen red meat thinking it was Acana ranchlands. OOPS.

Monday, when I took him to the vet, I picked up a box of NRG dehydrated which the dogs always seem to think is very tasty. It's a lot lower protein and phos than Orijen and has oats which have always had a settling effect on his upset belly. http://www.nrgpetproducts.com/vitality/

I got him the bison since chicken and salmon are iffy for him and the dogs seem to like red meat. Sometimes he'll eat a bit, sometimes he won't. It worries me when he won't eat real food like yogurt or raw eggs that he has always liked, but I guess I'm going to have to get used to it. He has eaten a couple of sardines. Knock on wood, he's had OK poo so far.


"Cooked free range meat, ( NRG Original Canine Diet is available in free range buffalo, beef, chicken or wild caught salmon) naked oats, wheat germ, eggs, liver, carrots, grapefruit, winter squash, broccoli, cranberries, limes, papaya, apple, parsley, garlic, goat milk yogurt, flax seed, cider vinegar, egg shell, olive oil.All fruits and vegetables used in all our diets are raw, and edible table grade quality."

On today's to do list is making him some liver broth to keep him drinking and hope he'll eat. He's not thrilled with hanging in an ex-pen, but that's teh only way to keep Rosie and Will from snarfing down food he hasn't eaten.

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Re: Some concerns about Sam

Postby JudyL » Thu May 05, 2016 9:43 am

You could try warming some of that broth that he liked and use it to wet the kibble or rehydrate the raw.

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Re: Some concerns about Sam

Postby UpwardDog » Thu May 05, 2016 10:47 am

great minds think alike. I added chicken broth to his food (the NRG dehydrated which I am rehydrating with extra fluid) and he ate some of that.

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Re: Some concerns about Sam

Postby UpwardDog » Fri May 06, 2016 9:26 am

I am anxious about the decisions that lie ahead. How long and how much do I do? There is a price paid for having him confined and on an infusion. He acts like he is being punished when I send him to the ex-pen to hook him back up. I'm also not doing anything with anyone else, because I'm sitting near Sam to watch that he isn't tangling himself in his tubing. I really hate this. This morning has refused breakfast, but is now sleeping and appears pretty comfortable. I hate hate hate not knowing if he's just not feeling like eating, or if the kidney failure is making him feel nauseous or if he's getting the ulcers etc that can go along with this.
I had signed up for an agility class online with Will, but I can't be outside playing with Will because Sam will flip out. This feels like a no win. Last spring and summer were terrible because Ben was dying. I really hoped this summer would be the year we could actually go camping, have fun and do some healing . Instead I'm sitting here having the same emotions I had about Ben, though at least for Sam, I know if he's feeling awful, I can give him a peaceful end.:(

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Re: Some concerns about Sam

Postby connie » Fri May 06, 2016 1:41 pm

Well ... what's the prognosis re the fluids? I mean, he can't live like that ... I'm sorry, that sounds harsh, but you know what I'm saying, I think. If the fluids are to get him back to a condition where he can be comfortable and managed, how long will that take? If that can't be done, then you have some deciding to do. But fluids are usually a crisis management measure, is it different here?

As for the not knowing, I actually think you do know your dog well enough to see or feel when he is in pain. I have always known that with my dogs, in grave medical situations. When Mike told me he had had enough, I went into the vet clinic expecting to have him released to go home, and I found myself saying 'he's had enough, he's done now' just based on the vibes I got from him. If you're not getting that from Sam right now, then he's not ready to check out. And I honestly do not think you will miss the memo when he sends it out saying he IS ready to be done with all this.

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Re: Some concerns about Sam

Postby MaisyPancakes » Fri May 06, 2016 2:52 pm

Oh Heather. :( I'm so sorry. Did the vet tell you for how long you need to do the fluids? I hear you about not knowing in what way they might not be feeling so great. Sucking at coming up with anything helpful to say, but you guys are in my heart.

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Re: Some concerns about Sam

Postby JudyL » Fri May 06, 2016 3:11 pm

Connie's words do not sound harsh to me, they sound logical and caring. I see it as a matter of everyone's quality of life in your household. If the fluid therapy and x-pen are needed occasionally to allow Sam to feel better, to resume eating, and leading a fairly normal old-dog life, then that is a good thing, However, if Sam needs ongoing continuous treatment that will make everyone miserable and still not allow him to be more normal, comfortable and happy, then considering the alternative is not an unkind thing in my opinion.

You know that I went down your path with the two oldest dogs last year and am on the same path with Cinnabon now, who did not have renal issues last fall and now does have kidney dysfunction from the heart meds, and the sad thing, as was with Dixie, is that patients in heart failure cannot have the fluid therapy. :( I can tell you that I devoted a huge amount of time to the dogs' care in each of their final time with the meds and feedings, but my life is more laid back without an active family and children or the demands that you have. I do think Chi and Dixie felt pretty good up until near the end, and they didn't have to live in a cage or be isolated from the rest of the group or be excluded from our normal routine. Had that not been the case, I might have made different decisions for them and for us.

I will support whatever decision you make, because I know it will be an informed one that also comes from your heart and has Sam's best interest in mind.

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Re: Some concerns about Sam

Postby connie » Fri May 06, 2016 3:42 pm

Also want to say that I am deeply sorry this is bringing back Ben's last weeks for you, because that is a trauma that I cannot even imagine. But this is not connected to that. Sam is your beloved dog, and you will do what is right for him -- not by any objective measures, or going by any list that you can check off or use to measure things, but by the messages you get from him. You might let him go on longer than you later feel you "should have" -- I have done that, but it was never wrong because it was not wrong at the time. You might end his life-of-no-quality at some point and then wish you had waited another week. We've all done that, too. There is almost never the gift of no regrets, in something like this. But regret is a measure of our love for the departed spirit, it's not a guilt trip. Don't do guilt. It's a waste of time, Sander told me so.

What is not unlike the loss of Ben is the helpless feeling of watching a being you love being taken over by a disease process that is inexorable and does not reverse. That is dreadful. And we can't control it. And if we are being mindful, we even give in to the terrible sadness sometimes, and just let it wash over us; where other times we are brisk and efficient and 'handle' things.

Go with God, go with Sam, go with the force. And know that Ben is waiting to have Sam back with him, and they will not be alone even though they are no longer with you.

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Re: Some concerns about Sam

Postby Sabine » Fri May 06, 2016 4:02 pm

However, if Sam needs ongoing continuous treatment that will make everyone miserable and still not allow him to be more normal, comfortable and happy, then considering the alternative is not an unkind thing in my opinion.
I agree with that 100%. You'll know when to draw the line because quality of life is slipping away.

I still feel guilty for waiting too long with Marylin when she went downhill. Looking back, I didn't see clearly enough with her that we tried too hard for us, not for her, and I now wish I had spared her some of that time. Thinking of that, I didn't make the same mistake with Mieze, Laptop, and Monster.

Hopefully it's just a bump in the road and he'll get better, so that you can spend more days together. Sending lots of good vibes.
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Re: Some concerns about Sam

Postby UpwardDog » Fri May 06, 2016 6:00 pm

My understanding is that if they do this 3-4 day flush with IV fluids, some dogs numbers improve significantly and the dog feels better and then may have months of good time where they are feeling decent and can just do fluids as a short subcutaneous infusion over in the evening.

We re-drew blood today and I should have results tomorrow apparently.

Yesterday I was thinking things were looking up. Today he isn't eating or drinking much. He's turned up his nose at food at breakfast tie and supper time, didn't touch the meat/liver/tripe broth, but was willing to eat a couple of sardines and some plain pasta that I hand fed him. Those are really weird choices for him. It's as if he will eat something new, but then won't eat it the next time, which makes me wonder if he ate and then felt sick which he then associates with that food and so will refuse it the next time. At the clinic, the tech offered him dehydrated liver and he ate 4 pieces. (oh sure, eat for the lady who just stabbed you a bunch of times, but not for your person who is cooking and researching and worrying ) As I sat down to write this though, he walked into the ex-pen to lie on the bed in there and I can see that he has a string of drool hanging. It's not because there is food out to drool over, so I assume it's from nausea? I gave him pepcid and cerenia this morning. :(

Geoff brought home burgers and he just ate half of my patty and a couple of fries.

He is hard to judge because he's old but also he's a quiet guy who even in his youth would lie down and near me if there wasn't something to do. How pained or nauseous he feels is something I'm guessing at. Based on his bloodwork and the benefit of hindsight, it would seem that he's probably been feeling not great for a while. I chalked it up to just being old and arthritic and maybe getting some weirdness/dementia.

This dog has been the most constant,comforting, consistent and loving "person" in my life these last 11 or so years and that is saying a lot. Rosie and Sammy have been my heart and soul through all the nightmares of the last 14 years. I want to do right by him and I'm also kind of just scared to lose him. I guess if it comes to trying subcu fluids, I'll do it once and see how he tolerates it. If he hates it, I won't do more I don't think.

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Re: Some concerns about Sam

Postby Amanda » Fri May 06, 2016 10:07 pm

I don't have more to add than has been said except to say that I'm sorry all this is happening and that your rock solid buddy has started to fade. Whatever your choices in this matter, I know you will make the right ones for him and your family. And none will be wrong. Sending you love and prayers for peace and insight for the best course.

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Re: Some concerns about Sam

Postby UpwardDog » Sat May 07, 2016 5:25 pm

A vet called to give me Sam's blood results at 9am- that was fast!
His BUN and creatinine came down, but are still in well into stage 4. His SDMA--a new test-- went UP from 34 to 50 both way high. The vet I saw really didn't know what to make of that, but suggested we should go by how he seems clinically, not the numbers. I told her I was concerned that he felt pretty crappy and didn't know that I wanted to be stabbing him for subcu fuids and further blood tests etc She suggested that border collies are rather sensitive and I might want to take the IV out and see if he seemed happier, do subcu fluids for a few days to see how he did. sounds reasonable. he hadn't fussed at the site, but wasn't too keen on the dressing which wrapped around his paw and I suspect the site was tender.

Much to my surprise, he ate a variety of foods for breakfast --some of my muffin, some of the dehydrated I was making for the aussies, figuring someone should eat it and then some cooked pork and rice vermicelli I made for him. That was encouraging :)
I took out Sam's IV and he does seem happier with it out, and of course not being put in the ex-pen to have the infusion.

So, the plan is for me to try to be less of a basket case, do subcu fluids twice a day, (which is 4 stabs with a fairly large bore needle and 400 mls of cold IV fluid into your shoulder area, but at least it's pretty quick), cerenia and pepcid, B vits and my attempt at a home-prepared kidney diet with help from Sabine. By some miracle he is still having fairly normal poop. I am going to just try to pamper the heck out of him.

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Re: Some concerns about Sam

Postby MaisyPancakes » Sat May 07, 2016 9:23 pm

Sounds like a super plan! :) So glad he's eating *and* pooping out some good boopers! I've been told to "treat the dog, not the numbers/images" a few times now, too—kinda hard for me sometimes, but this is where I had to learn to trust my vets. :) Rooting for you guys! We got this!

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Re: Some concerns about Sam

Postby whiteboxerboy » Sun May 08, 2016 6:24 am

I'm just now seeing most of this - Heather I'm so sorry. This sounds like it's berms roller coaster for you.
Everyone has already said what I'd say. Peace and love to you. I hope Sam perks up.

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Re: Some concerns about Sam

Postby SherriA » Sun May 08, 2016 7:22 am

Oh, I'm so glad that Sam has perked up without the IV! I did subcu fluids with Jack for awhile and, while he didn't love it, he tolerated getting poked a lot better than I thought he would.
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Re: Some concerns about Sam

Postby UpwardDog » Sun May 08, 2016 9:31 pm

A crazy, scary, sad roller coaster indeed. I'm glad I have you gals to talk it through with and to ask about diet and fluids and such. He has now eaten quite a few home cooked meals in a row and though he is definitely old and slow, doesn't really appear pained or nauseous right now.

This evening he is asking to go out a ton but I still don't notice him peeing all that much, so I'm not sure what that is about.

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Re: Some concerns about Sam

Postby MaisyPancakes » Sun May 08, 2016 9:40 pm

<3 I wonder if it would be advisable to do something like d-mannose just to do what you can to prevent UTIs. I don't think it's something that can trigger sensitivities but given his tummy (altho it's kicking ass right now!), I thought I'd be extra sure. MP is supposed to do 3 wks on, 1 wk off, because she had gotten 3 UTIs in the last year. Yay for a hungry and old and slow! ;)

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Re: Some concerns about Sam

Postby UpwardDog » Tue May 10, 2016 8:19 am

Last night was crazy old dog night.
I go to do Sam's fluids-warm the solution, find him and get him to come lie on a dog bed in front of the tv with me. I get the needle in and get it running when Rosie lets out a cough which startles Sam (a new thing since his hearing is going, or maybe just new because Rosie didn't used to cough). Sam springs up because that sound panics him and he wants to head for the door. I pull out the needle before he hurts himself and let him outside. he decides he'll stay out for a good 20 minutes and can't hear me at all when I call him to come in. I can't see him because he's black and it's dark. Eventually he comes in and we get it done. Now it's late and I need to unwind.
I laid down on the sofa to watch Outlander. I slide my hand up under the cushions to get comfy and my fingers nails went right into a smear of poop. :kissmyass: I think Rosie, who is unnerved by her own audible farts and is weaker in the back end, might be having the occasional sneaky sleep poo. I let out a groan so will-the super appeaser- licks my mouth and manages to lick my tonsils as I'm extricating my hand and finding the poo. Good times.

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Re: Some concerns about Sam

Postby SherriA » Tue May 10, 2016 9:22 am

Oh Heather, what a sucky night! I had to check to see if it was Nana posting, because that's the kind of thing that would happen to her.

I hope tonight is better....
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Re: Some concerns about Sam

Postby MaisyPancakes » Wed May 11, 2016 12:02 pm

Haha, Sherri!! Yeah, except if it were me, I'd forget which hand and touch my face or something worse would continue to happen!!

Hope your hands and pillows are cleaner and Sam's doing OK today. <3


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