It's More Than Just Medication
Ralphie: September, 2006 - September, 2022
It was Fall Semester, 2006. I had just graduated from college, and was trying to decide between pursuing graduate school or Veterinary school. I was in an AmeriCorps program, while also working on my Divemaster certification through my University. It was time to get my first dog!
I picked Ralphie out at a shelter in Fresno, CA. He was 3.5 lbs when I got him home as a tiny, energetic, supremely adorable puppy. He went camping with me every weekend when I was away on my Divemaster training dives. He was there with me when I received notice that I had been accepted to UC Davis School of Veterinary Medicine. He was there with me when I left my college life behind, and started building my new life as a Veterinary professional. He sat patiently with me through 4 years of studying, practicing every hands-on skill I learned in school on him, while providing constant encouragement in my blossoming skills in the form of face kisses. He was such a good little patient, in fact, that during my senior year of Vet school, my friends would often borrow him when they were on Radiology rotation to practice during Ultrasound Fridays. Students were allowed to bring in their own pets on Fridays to practice their ultrasound skills, and Ralphie quickly developed a reputation for being a very good boy and lying patiently on his back while student after student practiced abdominal ultrasound on him, the only indication that he wasn’t sedated being his rapid, constant tail wags. I don’t know how many Fridays he spent in the Radiology department during my clinical rotations, but it was enough to be on a “french kisses acceptable” basis with every single Radiology staff member by the end of the year. Faculty members would come up and say hi to him when we’d be out on a walk, then awkwardly realize they didn’t know me. Yep, he was that dog, that dog who brought people together, and put a smile on everyone’s face.
After Vet school, I completed a year long internship working alongside various Specialist veterinarians to gain more competency in case management and advanced medicine and surgery. While there in 2012ish, Ralphie developed an intermittent lameness on his left front leg. The Veterinary Surgeon I worked with was fantastic and did a full workup, including gait analysis, awake musculoskeletal exam, sedated musculoskeletal exam, and x-ray imaging. Diagnosis? Not surgical! Yay! Great news! Try resting him and doing some anti-inflammatory medication for a week. It’s probably just a soft tissue injury.
I finished my internship and started life as a fully fledged emergency Veterinarian in the Monterey and Santa Cruz areas of California. I found myself with actual time to go hiking on the weekends and spend time being active with my dogs! Ralphie’s lameness came back. We visited another highly respected surgeon, this time in Santa Cruz. More great news! It’s still not surgical! It’s probably just a soft tissue injury.
Fast forward three more years. I’m now the Medical Director of a small general practice, and I’m noticing that Ralphie’s lameness is darn near constant, and he’s starting to have less fun on hikes. Let’s go see another Surgeon, Ralphie. This has been going on for 4-5 years. Surely you have some changes on your x-rays by now that will help us figure out what to do to help you. Right? Right?
You guessed it. It’s probably JUST a soft tissue injury! It was suggested that perhaps we stop doing our weekly hikes due to his advanced age. This was 2016 and Ralphie was a very young 10 years old, with a 1 year old puppy twice his size to keep him busy. There was no way he was going to sit on the sidelines while Chloe went out for adventures with the family. We promptly decided to ignore the “Ralphie stays home on hiking days” recommendation, deeming it far more important that Ralphie have the opportunity to be a dog in his senior years, lameness or not.
By 2017, I really, truly hated my life as a Veterinarian. Search NOMV if you’re unfamiliar with the severe mental toll that working in the Veterinary profession places on a person. I was physically, mentally, and emotionally ill, and drastic changes were needed in my life if I was to survive. Adam and I had talked about selling our house and moving away from California, and getting a completely fresh start with life. I redirected my focus toward self care, including learning all I could about how appropriate food and exercise could help me on my road to recovery. I put in my notice with our corporate Regional Medical Director at the end of 2017, telling her that I would be leaving sometime in 2018. I had Continuing Education funds to use before leaving my position (and my entire profession), so I went to a very large conference in Florida at the beginning of 2018. The very first talk of the conference that caught my eye was entitled something along the lines of “the dog is limping, x-rays are normal, it’s just soft tissue, so now what?” My interest was piqued. I was certain I would learn something at that talk that would help Ralphie!
I was not expecting that talk to change the entire trajectory of my life, but that’s what happened. I discovered this relatively new field called Canine Rehabilitation, in which exercise and physical medicine are used to induce the body’s innate healing mechanisms to engage. I learned why anti-inflammatory medications and “rest” hadn’t actually helped Ralphie heal at all, I learned basic information about various soft tissue injuries affecting the front leg of a dog, how to diagnose them, and what to do for them. But so much more importantly, I learned that there were Vets out there who spent actual one-on-one time with their patients and their clients, who enjoyed building relationships with their clients, and (*gasp!*) actually enjoyed going to work every day because of those relationships. This was the first time I had been emotionally optimistic about my future in the Veterinary profession in years, quite possibly ever. Adam, being the ever-supportive life partner he is, immediately worked out the finances so I could pursue certifications in Veterinary Acupuncture and Canine Rehabilitation.
Enter student mode. Again. This time though, when I was practicing on Ralphie, I was learning actual hands-on techniques that resulted in noticeable improvement in Ralphie’s lameness, his stamina, and his overall quality of living. When Ralphie would be coming up due for a treatment, Adam would often notice and tell me that Ralphie was having a Ruff day and he needed my help.
The more I learned and the more I practiced, the better Ralphie felt. He started enjoying longer and longer hikes again (as a 13 year old!), and he went back to playing with his toys with the toughness and vigor he displayed in his younger years. He helped me develop my hands-on skills as an acupuncturist and rehabilitation therapist, constantly reinforcing my confidence. He helped me develop something really special - something I knew other dog owners would actively seek out, and find just as special as I did - a single mobility service that applied both acupuncture and physical rehabilitation techniques to minimize pain, maximize mobility, and improve function in our canine companions. Armed with my new skill set and enthusiasm for my career, I started Ruff Day Veterinary Services in 2019 as a housecall practice serving Tacoma and Gig Harbor.
As Ralphie continued to age, I learned more and more about optimizing his quality of life at home with supplements, dietary additions, and even more specific exercises. Around the time of his 15th birthday (end of Summer 2021), Ralphie stopped eating breakfast with his normal enthusiasm, and was diagnosed with severe liver inflammation, kidney failure, and intestinal cancer. Knowing his little body couldn’t handle major surgeries, we elected to enter palliative care mode for however long he had left, and I was prepared for weeks to maybe months. We added only therapies that would help him feel good (fluids, anti-nausea medications, increasing his acupuncture frequency), and wouldn’t you know it, maximizing how he felt actually helped him fight his diseases. Ralphie spent a year in “palliative care” mode, so much longer than any of us anticipated, and he had a GREAT year! He went hiking, spent whole days at the beach, was introduced to nose work, played in the snow, played with toys, played with the other dog, played with the cat, went on road trips, ate delicious treats, and overall just really loved life for his last year. I continued to learn so much from him about how we humans can help our beloved aging pets do so with comfort, grace, and fun. Don’t get me wrong, Ralphie’s medications were of the utmost importance in keeping him happy, but there was so much more to keeping him feeling good than just pills.
Last Spring, about 6 months after Ralphie’s collection of terrible diagnoses, I was sitting and chatting with Ann, Ralphie’s K9 Nose Work® instructor and local canine behavior consultant extraordinaire. We discussed that there’s so much we can do to help stimulate the aging dog’s mind and body to help promote happiness, fun, and actual physical health. The average Veterinarian doesn’t have the time or resources available to talk to pet owners at length about many of these environmental, non-pharmaceutical interventions that really make a difference for the patient and the caretaker alike. Ann and I wanted to share our cumulative expertise to help other families through the process of caring for an aging dog, so we created an online education platform to help us spread knowledge to those who want it. Our Super Senior is our first course, and the entire motivation behind the creation of this platform (called WAGSniffAScent, of course…what else?). For my part, I am looking forward to sharing all of the ways I helped Ralphie to live his very best life in his senior years.
I miss Ralphie so much. But I find immense comfort in knowing that Ralphie’s legacy will live on in countless ways. There are doctors out there from the UC Davis School of Veterinary Medicine who are competent in ultrasound because of Ralphie. Every patient I help through Ruff Day Vet + Pet Gym is touched by a little bit of Ralphie’s spirit. And if I can pass along just one little tidbit that will help improve the life of a senior dog, and/or their dedicated human caretaker, through our Ralphie-inspired Super Senior seminar, I know I’ll be doing him proud.