Great Dane: DaDane 06/24/02

ONE LAST JOURNEY
By Nan English

"Danes are a heartbreak breed, you know?" My vet has said that to me many a time. As with most people who have Danes, I know the meaning of this statement all too well. You see, I was the second child. The first child in our family was a Great Dane. It has been such in my family all of these many years.

My heart has been broken again. I lost my dear friend, Phlash, to a dastardly disease: Dilated Cardiomyopathy (DCM). This disease is devastating to dog, owner, family and friends.

I would like to tell you all about my very, very special Dane named Phlash. But instead I will write about our last journey together. My hope is that our story can help the Dane community in its fight against DCM – and help others like me and Phlash who find themselves faced with this horrendous terminal disease.

What is DCM?

Dilated cardiomyopathy is a primary heart muscle disease usually characterized by enlargement of the left ventricle. The muscle wall of the ventricle becomes thin and stretches, resulting in an enlargement and weakening of the chamber. The weakened heart muscle can no longer pump blood effectively. This causes a buildup of fluid in the lungs and elsewhere. It eventually leads to heart failure.

In the beginning, it was just a cough

Our story began in the wee hours of a Saturday morning in late January, 2002. I woke up to hear Phlash coughing. It sounded like he had a hair or something caught in his throat and he couldn't clear it. When the coughing ended, I thought,"Good!" But it had been a troubling sound, so later I emailed several people I knew to be knowledgeable about the breed, one of whom is a vet who owns large dogs. The responses were about what I expected... not to worry. One response, however, had an addendum which caused me concern. In addition to some other comments, my friend said that the only other time she observed such a cough had been with a DCM dog.

The next week rolled around and all was well. No coughing. All normal. Five nights later things changed. Again there was coughing. The next day, Phlash and I headed to the vet. A series of tests were run and the results forwarded to a canine cardiac specialty clinic for evaluation. After some waiting, my veterinarian came out of his office. I knew from the look on his face that it was not good. I listened to the bad news but I was in a fog. All the time I was stroking Phlash. Here stood what appeared to be a healthy and strong Dane. He was highly muscled from all the running that he did daily. His weight was great. He had never had a sick day. But looks can deceive. I was informed that Phlash's heart was in very bad shape. It was Black Friday for us... and that was an understatement!

Basic Medication

The base medications that are usually prescribed for DCM are diuretics, digoxin, and ACE inhibitors. Diuretics are given to relieve the fluid buildup in the body. Since the diuretics tend to leach potassium, potassium supplements may be necessary. Digoxin (or other digitalis medicines) is given to help the heart beat stronger and to control some types of abnormal heart beats. ACE (angiotensin converting enzymes) inhibitors improve cardiac output. They widen the blood vessels and lower blood pressure.

Living with DCM

The next day, we began a new daily ritual: pills, pills, and more pills. Morning and night, it was pills. Phlash was taking Lasix, Digoxin, and Lotensin. The first week was no problem. While Phlash was a bit "off," he was eating, swallowing his pills, coming for loving and, as always, checking the fence line.

The second week, Phlash lost his appetite. Little enticed him. Understand, this boy was an "easy keeper." He was never a picky eater. This was the beginning of an enormous weight loss. I began racking my brain for all the things I had heard about getting picky eaters to eat. What I was not "getting" was that this was not a case of Phlash being picky. Nothing tasted good to him and he had virtually no appetite. Hamburger would taste okay for a couple of days – and then he would refuse it. The same was true of other things that we tried: cheese, ice cream, etc. It was at the end of Week 2 when I began giving him Coenzyme Q-10, an enzyme that is found naturally in the cells of the heart walls. (Age and illness can suppress the generation of sufficient quantities of CoQ-10. Giving CoQ-10 can help to strengthen the heart cells and lower blood pressure.)

The third week was probably the worst. I was quite concerned about the small amount of food that Phlash was eating and the weight he was losing. At this point he was not always steady on his feet. I knew that I needed to get some proteins into him – and fast. At the end of the week we discovered the wonders of cat food. This seemed to be the one thing that always tasted good to Phlash. His eyes would dance when he saw me grab the can opener. I cannot remember a time when he turned down a bit of cat food.

By the fifth week, Phlash began to eat a fairly consistent amount of food each day. It would vary from just under 4 cups of kibble a day to a bit over 6 cups. In addition, he would get hamburger, tuna, cat food, etc. I also added a food supplement given to young lambs that need sustenance to survive. It gave Phlash good protein and calories without a bunch of fat for his body to process. Still, the weight kept dropping off. Later I learned that DCM is a "wasting" disease. Phlash's body was needing more protein and it was using that which was in his muscles.

Mid-March came, and along with that, Phlash's 5th birthday. Wow! A few weeks earlier, I doubted that we would find ourselves celebrating. Well, let me tell you, the boy's feet and eyes danced when he saw what he was getting. Thanks to our dear friend Dorris, Phlash enjoyed filet mignon and ice cream. What a happy day!

The next few weeks continued about the same. Phlash was eating again. And while he rarely did more than a trot, he still did the ritual fence check. Only occasionally now did he roll in the grass on his back. By this time, his belly was full of fluid and he could no longer lay on his side. The burden of the extra fluid was making his heart work even harder. Little by little, things were becoming more difficult. Sleeping was not easy until I thought of body pillows. You see, when Phlash relaxed, he would fall over on his side and that would wake him. The body pillows kept him upright. He slept well after that. Despite his increasing problems, one thing about Phlash did not change – his demeanor. No matter how bad he felt, Phlash was still the boy who loved people and felt the joy of life.

Letting go

On a crisp morning in early May, Phlash and I enjoyed a picnic breakfast of bacon, egg and cheese biscuits. My boy was full of joy. He was so, so happy to greet his friends and he enjoyed conning just one more bite. I will never forget that look of pure happiness. I gazed at Phlash and saw my handsome boy – not the wasted skeleton in front of me. (Earlier I had told Phlash that we couldn't let anyone who didn't know us see him. They would think I'd starved him. He was so very thin, you could see every bone.) I am convinced that Phlash's joy of life is the only thing that kept him by my side towards the end. But I knew that it was time to let him go. Later that morning, I held Phlash and told him how much he meant to me and how much I loved him. Then he was gone.

One journey ends, another begins...

Thus ended one phase of our journey. The journey is not over. There is work to do. We need to learn more about DCM, how it is passed, its marker. We need to support those owners and dogs who find themselves facing DCM. (I know that I could not have made it without the help and support from those who had passed the same way before me, and my Dane friends.) Breeders must learn more about this devastating disease. We cannot hide from it. We can beat this by supporting research, learning what must be done if we find a DCM dog in our offspring, and being open and honest. We can – and MUST – win this battle.

Please note, this is but a brief diary look into our experiences and emotions as we faced DCM. It is only a small peek at our life after the onset of DCM and how we muddled through. It is not meant to have any function other than to tell our story and encourage people to learn more and help in the fight against Dilated Cardiomyopathy.

– Nan English