January 20th 2014 I was fortunate enough to meet the most amazing creature I've ever met in my life named Gizmo. I can't even put him in the same category with all of the other pets we've had over the years, because he wasn't. He instead became my child and my affections for him felt just as strong, if not stronger.

Gizmo came into our home the tiniest rack of bones. So delicate I was afraid that just picking him up, I'd hurt him. We all thought that he was just a terrible case of neglect. That he'd been starved and deprived of veterinary care and that with some loving care we could repair him. The first month he showed very little progress in the weight department. The hardest challenge was just getting Gizmo to eat. I cried many times over him. Sitting on the floor, hand feeding him daily a variety of different foods, trying not to upset his stomach.

During this period of time Gizmo would also limp on and off again, alternating legs and would yelp sometimes when we'd pick him up. His previous owner who relinquished Gizmo to All Paws Rescue had taken him to Banfield for the limping and was given a bottle of joint supplements. She was just as clueless as us.

Gizmo was initially treated, suspecting Addisons with prednisone and then was kept on it to increase his appetite. The test came back negative and with me explaining the alternating leg lameness, they added Doxycycline to treat for a possible tick disease. During the second month his health seemed to almost return completely. He gained weight, stopped trembling, wasn't painful to the touch and his limping was minimal. He zipped through our house like crazy, hopping up and down off of furniture. Playing with toys. Cooing at my arrival home and anytime I'd come back into a room when Billy was holding him. He loved nothing more than cuddling up next to me and it was the same for me. I'd never had a dog who'd needed me so much, that I needed so much in return. He'd become such an integral part of my day. Seeing him better should have been enough, but I needed answers. A video of him throughout our time together, through sickness and health. http://youtu.be/IqAikMk6K8o

Being Gizmo's foster mom at the time and one who'd already failed at fostering a few times, with a reputation for adopting them instead, I kept saying to everyone else he was just a foster, but he and I knew he was all mine and that I loved him beyond words.

Eventually he was taken off of both the doxy and the pred to be neutered. He'd ran out of both and couldn't take NSAIDs while on the pred. During that time he went downhill extremely fast. I called the vets and they got him back on the Doxy, which worked for a day or two, then it didn't. Turns out his condition was one that would wax and wane. Meaning he'd sometimes have unexplainable good days but more often than the good days were the bad days. So once again he was put back on the prednisone as well and for the most part, his health returned.

Eventually though he started limping even while on the prednisone, especially in his hind legs. By this time you could also see his front ankles had started dropping. I asked Bev and Bogey Hills if we could have more tests ran to figure him out as a whole and they agreed. We scheduled an appointment with an internal medicine doctor to run more tests. He met Dr. Buss at MVRC, still looking all happy because he'd been put back on the prednisone and doxycyline. The doctor looked him over, squeezed and twisted his knees, saying all he could really see wrong with Gizmo were his luxating patellas, but that his ankles also looked hyperextended. I told him what Bogey Hills had said about an autoimmune disease and was crying, because I knew it was much more serious than just Gizmo's knees. His response was "You should be happy. I really don't think he has an autoimmune disease" later stressing to me "autoimmune diseases are BAD"! As if just saying that should relieve my mind without any tests ran or radiographs taken.

On his official diagnosis, Dr. Buss wrote "we see no signs of polyarthritis at this time". Without running any tests, this one visit to MVRC cost All Paws Rescue $90. He then recommended radiographs and surgery on both of Gizmo's luxating patellas.

Next Gizmo and I saw Dr. Ragan at the Wentzville Animal Clinic to discuss surgery and to have radiographs of his hind legs taken. The newest part of our plan that scared me most was taking him off of the prednisone again. I explained how badly he did while off of it before, but we still arranged for his surgery about 2 weeks later. Once being weened off of the prednisone, Gizmo went downhill again. Refusing food. Lethargic. Painful to the touch, everywhere, including his muscles. He would jump in painful anticipation of being petted. So I called the vet's office, insisting I wanted him to be tested for an autoimmune disease using the ANA (anti nuclear antibody) test and our appointment was made. Once we came in, I was told they couldn't run the test until he'd been off of the pred for 30 days. Nobody had told me this on the phone however, when they knew that's what we were coming in for. So I asked him to run a CBC and to do a urinaylisis, since I'd read online that both of these tests could point towards an autoimmune disease answer and if nothing else, we'd know just how anemic he still was. He never ran any tests that day, despite my persistence Gizmo couldn't be taken off of the prednisone. He insisted that we still do as we'd discussed earlier and as I was leaving they asked "is All Paws paying for this or you" and I said All Paws, angry that NOTHING I asked to have done had been done once again.

Everybody just kept saying "trust the vets, Cassie" and "you're not a vet, Cassie" to all of my concerns for Gizmo, who while finally weened entirely off of the prednisone had begun dragging his hind legs. He was in extreme pain. When he had the knee surgery done, I was hopeful once again that I was wrong and for about 5 days he used the casted leg. After that things took a terrible turn for the worst again. When we returned to have the bandages removed, his knee didn't look right to me at all. Instead now it faced inward, but who was I to say? The vet said it looked good, while stretching the knee and making Gizmo scream. The next visit was even worse, because Gizmo's knee had started locking up and the Dr. wanted to force it to work so bad that Gizmo wound up urinating on the table and screaming at the top of his lungs. I insisted that day he have the test we'd been waiting for done finally. He told me to continue doing the stretches at home and we also tried water therapy.

A couple of weeks later the results were in. Gizmo's ANA test had come back positive, but Dr. Ragan said they didn't feel it should factor in. So I asked "well what about everything else? him refusing food, being lethargic, anemic and the shifting leg lameness". He said I really don't know. Suggesting I try the Columbia University.

Frustrated and scared for Gizmo I messaged Bev to say we'd take over the financial burden so that he could see my own personal vet. Scheduling an appointment the very next morning. Dr. Schulte saw Gizmo and was in complete shock at his condition. The knee that was repaired wouldn't budge at all and was completely frozen into place. Also by this time Gizmo's ankles had collapsed a great deal more. I asked for a CBC to be ran and radiographs to be taken, but because the knee couldn't be stretched to show what was impeding it's movement, he had to be sedated and the following day we got back all of his results, along with the added radiographs Dr. Schulte took of Gizmo's ankles, being extremely nice, given the situation. Those radiographs revealed erosive polyarthritis in both carpal joints and even Gizmo's toes. The CBC was also covered in flags.
Just that one little test that should have been ran eons before... shed a lot of light. Because of all of the tests and radiographs, our doctor was pretty certain Gizmo suffered from IMPA "immune mediated polyarthritis".

So next we discussed what to do. Gizmo's knee required a corrective surgery to allow it to move again. Without it, I was told he wouldn't ever be able to use that leg. I cried and was petrified for him, but what else could we do? So Gizmo had yet another knee surgery and afterwords, Dr. Schulte said he'd never seen anything like it. Gizmo's knee didn't resemble any knee he'd ever seen before. The cartilage was terrible eroded, lacked color and shine and also contained a staph infection, with synovial fluid that was thick and discolored.

By this time Gizmo had been off of the prednisone for months and now because of the staph infection, he had to be off of it for 6 more weeks, or the staph infection might kill him while taking an immune suppressant. He needed to be on the immune suppressants too however, because the rest of his cartilage was being attacked by his own immune system. In just 4 wks his ankles had completely collapsed, while I was searching for carpal supports and had scheduled a visit to VSS to have them made.

Then just two days before his appointment to see VSS to be fitted for carpal supports, while we were sleeping, Gizmo let off a terrible scream at 2 am. I hopped up like the house was on fire and I found him pushing his right front leg out like he was having a terrible muscle cramp/spasm, with his jaw doing the same. It would stop and then it restarted again three times in a row. Me not knowing what to do for him or what was causing his body to contract in such a way, I got him into VSS by 3 am and they gave him a pain patch and some gabapentin. I should have let him go right then, but my love for him had me determined this wasn't happening and instead I took him back into my own doctor the next day. Still foolishly asking if carpal supports would help and clinging to the idea we could overcome this too. He'd survived so much already and the light in his eyes never everrrr left him. They all knew he was suffering that day, but wouldn't say that everything for him had come a moment too late, while I took him and his long awaited bottle of prednisone home. We started him back on it right away. He didn't get better right away though. He appeared to have pulled out his shoulder and also suffered from a pinched nerve in his back.

A good friend of mine and an awesome vet, Dr. Connoyer at County Veterinary Hospital in St. Charles offered Gizmo free lazor therapy and took x-rays of his spine that revealed the arthritis had also moved into his back. I was still hopeful for a moment about the lazor therapy and prednisone, but by the next morning I was painfully aware how selfish I'd been. I told hubby it was time to do what was right, even if just saying that killed me. We'd planned months in advance a party the following day and hubby wasn't ready to let Gizmo go either. In our defense, just four months earlier, Gizmo seemed healthy, so we both were at odds with ourselves, especially with all he'd been through to stay alive.

The night of the party, Gizmo was alert and really seemed to enjoy seeing everybody. He was a born fighter and from the neck up in his little carrier, you couldn't even tell how broken down his little body was. It was our last night together. I cried my eyes out over him, then we fell asleep together. 

The next morning when we were going to take him back to VSS to be put to sleep, Gizmo woke up wagging his tail and scarfing up his food. The prednisone had finally kicked back in, only now it was much too late and the damage to all of his joints couldn't be undone. He was feeling better than he had in over 4 months and the sunshine was back, only now all of his legs were completely shot and he looked so disfigured that all we could do was curse at the ceiling. He couldn't even get up to pee. He could hardly lift himself to sit up and everything he tried to do looked like it posed a threat to break whatever was even left holding him together.

Could it be wrong for us to have one more day together and for us to take him in to see his regular vet on Monday to be put to rest? We did. Gizmo and I spent Monday together laying on the couch cuddling. Me crying uncontrollably and Gizmo looking up at me like "what are you crying about? It's going to be OK". When hubby came home from work that day, I put him in his carrier on my chest and we drove to North Main Animal Hospital. Gizmo was so happy to see his friends. His tail was wagging the entire time. He was so happy. He was HIM again and that was the end. 

Here are a couple videos of Gizmo's life with us, because he had to have continued living for a reason besides my own selfish love for him. People should know about his disease. Something from this experience might hopefully help some other poor animal. This is of Gizmo's journey from day one. http://youtu.be/IqAikMk6K8o

This is the day before we let Gizmo go. There were no solutions offered, or we'd have taken them. He couldn't have anymore surgeries, because he would have needed once again to be off of the prednisone. http://youtu.be/fPHlgidhvgg

I've never lost a dog in such a way that every ounce of me couldn't find a restful place. All that he went through to survive another 7 months, when his life had truly come to an end when I'd met him. I wouldn't take back our time together, because Gizmo was my canine soul mate. We were meant to find each other, even if knowing me in the end wasn't helpful to him at all, there has to have been a purpose. I was loved by that little boy more than I've ever been loved in my lifetime by any other creature on this earth. He gave me so much of himself and he tried so hard to get better for me. I'll never get over Gizmo or be content with anything that happened in the last four months of his life or even be able to love my other pets in the same way again, because they aren't him. I don't feel it's even possible to love another dog again like I did Gizmo. He became a significant part of my own existence. He was what inspired me. Now I just feel like I'm doing everything out of habit. I miss him terribly and no amount of days could make me forget his beautiful little spirit or how much it hurt to say goodbye to him.

I really want to hold grudges and be mad at the vets who didn't listen to me, but I'm mostly mad at myself because I got to see him at his worst and knew there wasn't an easy answer. I'm not innocent and my own guilt has been kicking me since before that very fist knee surgery. In the end, I helped in hurting him too, because I knew that wasn't the answer. Today though, that's not good enough. I just want others to know and to never do the same.

This was Gizmo before being weened off of the prednisone.  http://youtu.be/CIFFIhkPAK4

Moral of this blog: Trust your gut! When you know your pet is sick, don't leave the vet's office without getting answers. Gizmo's many veterinarians couldn't see everything I was seeing at home, even by vivid description. Most of his symptoms were either down played or completely disregarded. If you're paying for your pet's vet visit, there shouldn't be any argument when it comes to running tests like a CBC. You also shouldn't have to second guess yourself or the veterinarians in the end. There shouldn't be any argument.

Gizmo wasn't ever just a simple case of neglect, like we'd originally thought and he didn't suffer from a simple disease either. Simple just wasn't in Gizmo's vocabulary.

 I've learned because of him there are several diseases that mimic what Gizmo suffered from that very few people (including myself) know anything about. Awareness is key in getting the proper treatment for these diseases from day one. Of course you can't believe everything you read online or hear, but doing your own research, especially in his instance, was vital. Had I just listened to my own gut or what I'd read? Pressed a little bit harder and insisted they were wrong? Had I not just taken their word that everything would be alright? Had the focus not switched from finding a diagnosis for his over all health to his patellas, my Gizmo MIGHT still be here? If they'd just listened to me? If they'd have ran the tests I'd asked for? If they hadn't let their ego get in the way of hearing HIM, Gizmo might still be here? There are so many regrets and apologies I've been making to him now, without the "fog" of hopeful thinking and love to make me think it was OK. It wasn't ever. I'm mad at me too. I miss him terribly and regret he ever went off of the prednisone. He could have had braces made, instead of surgery. I've read surgery, especially knee surgery on dogs with IMPA is discouraged. I only found that out after the fact though. http://veterinarycalendar.dvm360.com/impa-immune-mediated-polyarthritis-dogs-proceedings?rel=canonical

http://www.joondalupvet.com.au/pdf/General/erosive%20immune-mediated%20polyarthritis.pdf

http://veterinarymedicine.dvm360.com/vetmed/Medicine/Recognizing-and-treating-IMPA-in-dogs/ArticleStandard/Article/detail/712031