Vet care in Ecuador, Maya's near death experience.

 The average life span of a Bermese Mountain Dog is just 6-8 years.  The average life span of a Newfoundland is 10 years.  These are the 2 dominent breeds that make up Maya.  So it was not a huge surprise last spring when we noticed Maya slowing down more and losing weight, shortly before her 11th birthday.

I agreed to a basic work up, just some lab tests.  Maya's liver and kidneys were slowing down.  Her weight went up a bit, then back down to the underweight catagory, and I was told to increase the protien in her diet, as she was not absorbing nutrients as well.  I had already been increasing the amount with little effect.  Increasing the protient did the trick for a bit, and she rapidly regained.  Knowing her time on this Earth is limited, we nonetheless made plans to bring her to Ecuador.  There was no way in hell I was abandoning my senior dog, who had helped me raise Thomas, the last months or year of her life.  It took 2 months of my salary and an 8 day car journey to bring her here.  

She adjusted to life on the beach just fine, completely enjoying beach romps, and running in and out of the waves.  However, again, we noticed she was sleeping even more, and just slowing down in general.  Still she appeared completely stable as we left for the States, to see our kids at Christmas.

And she remained so for the first week.  Our neighbor's Ecuadorian girlfriend took a good long time to chose the absolute perfect caregiver from her large extended family.  Acutally, 2 caregivers, mother and daughter, the mother a little older than me, the daughter a bit younger.  They had their own pair of 12 year old dogs and doted on them.  I got regulard updates of Maya frolicking about, and being bathed and coddled by her new amigas.

And so it went through Christmas night, we got a text saying that Maya was very depressed and "missed us".  Not sure what to make of this, but the next morning, it was obvious something was terribly wrong.  Maya was down, unable to stand on her own volition, and unable to eat.  We prepared for the worst.  

The caregiver was extremely worried, even as we tried to reassure her Maya was a very old dog, and ultimately, her fate was in the hands of our Creator, who had already blessed her with a long life full of love and adventures.  My main hope at this point was that Maya might live long enough for us to return, both so we could say goodbye properly, and so the kind caregiver did not have to deal with her death.

The caregiver called the vet, who had not yet seen Maya.  The vet eventually responded, he was on vacation, and recommended a colleague.  So the colleague, Dr. Maria was called, and promptly came.  After doing a thourough exam, taking blood work and giving some medication by injections, we were charged $90.  We explained our neighbor would pay this, and we would reimburse him electronically, but instead the caregiver paid out of money that had been left for her own services.  She contined to buy food and medication for Maya (Instead of asking our neighbor, who is affluent enough to assist, plus we had an easy way to reimburse him) until she ran out of money.

I just want to say that I'm pretty sure our American vet charged $90 just to walk in the door.  A simple ear infection cost me at least $400.

Anyway, the vet appeared I think 5 days in a row in total.  $30 for the housecalls, plus the fees for labs and medications, some of which we purchased over the counter at a human oriented pharmacy, including steroids and antibiotics.  The diagnosis was a paracite transitted via tic that ate up Maya's red blood cells, and rendered her dangerously anemic.  She actually qualified for a blood transfusion, which we declined, due to the stress is would have caused her, plus we didn't want to take from a healthy dog, who would have had to donate, for our very elderly girl.  By the time we arrived back, her blood count had returned to normal, thanks to infusions of iron, and oral iron.  By the second day of medication, she was eating pretty well, and able to get to the street to tend to her doggie business.  At her most pathetic, on the first day, she still refused to soil the floor and crawled out to the balcony to relive herself, even as she was unable to walk.  This broke my heart.

When she was able to make it to the door, the doorman noticed her change in demenor, and thought she was very depressed.  Soon the building was abuzz, as residents messaged Brian, offering their dogs for play dates, and to try to cheer Maya up.  Since Maya needed a ton of rest with her severe anemia, and we didn't know if she was contagious, we declined.  Later, the vet explained the illness is only blood bourne and if Maya refrains from injecting her friends with her blood, we should be good :)

The whole time, we honestly did not know if Maya was going to survive, and we kept trying to reassure the caregiver that we were at peace with whatever happened.  The caregiver is a very devout woman, who insisted she had enlisted the assistance of angels to watch over Maya and care for her, and that when I returned Maya would be jumping up and down in joy.  All communication was going through Google translate, as we had long exhausted my very  basic Spanish.  Two things struck me - one - my hispanic patients I noticed often conveyed optimism even under very grim circumstances, as if acknowledging a bad outcome might bring it on.  This seemed in the same vein.  The other thing was the presence of angels, I proclaim a Christian faith myself, but honestly I don't think of angels much in day to day life, where as for this caregiver, she communicated with them regularly, and seemed to have an intimate relationship.  She did not speak of Christ nearly as much, although she did mention God from time to time.

Under her care, which included lovingly prepared stews of fresh chicken and carrots, Maya did improve.  By the time we returned she was still short of breath with any mild activity, but she was able to meet us at the door, and try to follow us around.  She eats, although refuses her kibble, used to a more luxurious fare.  She has continued to improve to a certain degree, but her organs, which were borderline to begin with, have not fully recovered, especially her liver.  She is currently getting weekly injections to boost her liver function.  Her long term prognosis remains very guarded.

But the most upsetting thing started when, the day before our return I asked the caregiver how she was doing "I am doing OK with God's help" was the reply, which sounded a little ominous.  When we returned, and had greeted Maya, who was happy to see us, if somewhat subdued, it was obvious all was not well with the caregiver.  She then relayed the cruel irony that while tending to Maya, one of her one beloved dogs had passed away.  The dog was 12 and had a weak heart, she explained, but the death felt very sudden, and she was devestated.  We all cried.  The day before our return, I had purchased a pretty angel statue at Cracker Barrel of all places.  I gave it to her.  After confirming it was indeed an angel and not a fairy or a Virgin (not sure if she was referring to the Virgin Mary or the Virgins referrenced in Revelations) she kissed it and took it home.  Later I received a photo of it surrounded by tiny white lights.  It took a little convincing, but we were able to pursuade the caregiver to agree to be reimbursed for the money she had spent on Maya's medications and special food.  She would not agree to an increase in the fee to look after Maya, even though it took a lot more time than had orginally been agreed to.

I've checked in on her (and she has regularly checked in on Maya) and we went to Mass together yesterday.  It is interesting to overcome a language barrier by having communication completely grounded in Christian faith.  I truly wish her the best, and mourn her little dog with her.

PS.  I totally believed an angel was looking after Maya.  She was in my kitchen, cooking chicken stew and using her own money to buy medication.