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With the hope that the experiences related in this article will be of
benefit to others, I am compelled to share the trauma and heartbreak
that my husband and I had to endure during the illness, treatment,
and subsequent loss of our beloved German Shepherd Dog, Opean's
Panzer Shadow. I am sharing my feelings with the dog fancy because of
the helplessness I felt, the desperation with which I had to cope
and, ultimately, the decisions I had to make.
I have loved the German Shepherd Dog for as long as I can remember and have owned German Shepherds for thirty years. My dogs are my life; I would do anything to see that they are properly cared for and that they receive the best veterinary medical attention possible.
We purchased Shadow in July of 1989 at eight weeks of age, and we could immediately tell that he was very intelligent and could readily learn whatever task was set before him. We later came to realize that he was sometimes too smart for his own good, as you will read in one of the events related later in this article. Shadow was bred from a very good line, had training in both conformation and obedience, and had received lessons from a well-known animal behavior consultant and trainer. We had high hopes that he would live a long, happy and productive life. He was, however, somewhat shy, which caused behavioral problems in certain situations, especially in his relating readily to strangers and new situations. This compounded my anxiety in dealing with his illness.
Having gone through this experience, I have learned a great deal about his medical condition and want to share with others my thoughts and concerns. Many people are apparently touched by this little-heard-of problem.
Shadow was diagnosed in January of 1993 as having perianal fistulas, which are open, draining tracts and sores in the skin and mucus membranes surrounding the rectum. I was familiar with a fistulous condition in human beings but I had not thought of my pet having this problem. My first hint that something was wrong with Shadow was when I noticed that he had a problem with defecation. He also began licking the affected area almost constantly. On an immediate visit to our veterinarian, I was told that this condition is very hard to treat, in fact, perianal fistulas usually are not responsive to simple treatment and that there in no universally effective method for their prevention or treatment. I must tell you at this point that from the time of diagnosis, without the intense concern and support of my veterinarian, I could not have gone through all those months feeling as confident as I came to feel - that we were doing the best that we could in caring for Shadow. I had the utmost confidence in her and trusted her recommendations and judgement.
I learned that perianal fistulas are most common in German Shepherd Dogs, although other breeds, including English and Irish Setters, Labrador Retrievers, and sometimes Collies, are affected. The exact cause of perianal fistulas is apparently not known. It is believed that they could be congenital or develop from infection and that the broad-based, partially depressed tail of certain breeds permits too much fecal contact with the area around the rectum, thus encouraging superficial pyoderma and resulting in fistula formation. I was told that a fistula usually begins with a formation about the size of the point of a pin, by the time you notice that something is wrong, it has progressed to a great extent.
The condition is usually very painful for the affected animal. Inflammation around the anus usually occurs, and fistulous tracts form in the skin around the anus and sometimes in the rectum. Further research in to methods of treatment lead me to discover that many surgical procedures have been used for treatment, ranging from mild excision of a small fistula to complete excision of all the tissue surrounding the anus. Cryosurgery has also at times been advised. Research has shown that all procedures often relapse and sometimes create strictures and incontinence. I further learned that the only procedure that has an acceptable success rate is the close amputation of the tail, which I promptly put out of my mind with no intention of going to this extreme. To me the tail of the German Shepherd is one of the most beautiful parts of the dog, and I would not think of having this type of surgery for Shadow. This was in January, at the onset of our long journey.
After being informed of the history of the treatment of perianal fistulas, I had to make a decision about what method of treatment to begin for Shadow. Something had to be done; without treatment the fistulas continue to worsen, and the tracts spread muck like roots from a plant or shrub do in the ground. It was recommended by my veterinarian that Shadow have surgery to try to get a grip on the fistulas. I felt that there really was no other choice because of the extent of his condition and because of his personality. He would not tolerate conventional treatment and medication well, such as chemical cauterization of the fistulous tracts, which is often advised, and it would be with difficulty that my husband or I could treat him, as would be necessary, on a daily basis.
However, we decided to watch his condition for a month and try to treat him as well as possible. I dreaded the thought of putting him through the surgery and follow-up care. During the next few weeks we made several trips back to the veterinarian, which for us involved a forty minute drive into Little Rock and then the return trip home. I often had to take leave from work, and I am very grateful for the consideration and understanding from my employer throughout Shadow's illness. During the month of February, Shadow's fistulas only seemed to get worse; therefore, his surgery was scheduled for March, when I would have a week off from my job during spring vacation.
I had a few weeks in the interim to think about whether or not I was doing the right thing, even though I knew there was really no alternative at this point. I talked with fellow members of my dog club, the German Shepherd Dog Club of Little Rock, and made many phone calls to try to find someone who had been through a similar situation. I found no one. It seemed as though no one knew much about this; indeed, most had not even heard of perianal fistulas. Some of my phone calls were to member of the German Shepherd Dog Club of America. I thought perhaps they might have knowledge of the condition or know of those who had suffered through it. It would have been of comfort to me just to talk to someone about what they did in a similar circumstance. Everyone with whom I spoke was very kind but, I am sorry to say, not very knowledgeable in the area, even those in positions whom I thought should have been able to provide information or direct me to a source that could. I was only told about one other person who had experienced this condition with her dog, bit it had not progressed to the extent we were facing. It seemed as though perianal fistulas were uncommon for our breed. Why then, do records indicate that German Shepherd Dogs are very often affected?
After speaking with two veterinary teaching hospitals, one located in the North and one in the South, I was informed that they see many German Shepherds with perianal fistulas and perform numerous surgeries to try to alleviate the condition. Everyone was very sympathetic to my situation, but offered no hope for helping Shadow other than what I already had been advised. I was just hoping that something would turn up, something that someone had tried that was unfamiliar to me. Nothing did. I think it is very natural to hope for a cure and to try to seek comfort among others who understand what you are feeling. You just reach out to seek every possible avenue for treatment, whether it be for your animal or a human member of your family.
During the week of Shadow's surgery in March, we made a trip to the veterinarian each day because I had brought him home, feeling that he would be more comfortable in familiar surroundings. We had never been separated; he was my constant companion, making every step I did throughout each day. Perhaps I was thinking of myself too much in being without him, for I now realize that I should have left him in the vet's care for a few days initially. Although we make it fine for the first few days, I knew it would be best for him to return to her office to stay for a while. I checked on him by phone each day he was away from home, and it was a very joyous occasion when I picked him up after five days. We would hope for the best now. He felt good, and I was optimistic that all would end well, knowing all along that it was not likely. It wasn't long before he began to have a problem with stool elimination again, and it was noted that strictures had begun to form in the anal region, which is not uncommon.
We made many trips back and forth to our veterinarian over the next six months. On several occasions Shadow was left overnight for observation and follow-up care. The anal area was cauterized when it became apparent that fistulas were again beginning to form. The anus tract was stretched to try to alleviate his problem with elimination. During these six months my veterinarian had consulted with colleagues in her field as well as with the medical staff at Louisiana State University School of Veterinary Medicine.
The situation did not look good, but we were hoping to give him a few more good years if we could just keep his condition under control. By October it was apparent that the fistulas were recurring, or new ones were forming. I was advised that consideration of tail amputation should be given due thought. Here I was faced with this alternative which might help; but I had put this out of my mind early on. I had planned not to give it another thought. But when I was told that my choices were to put him down now or to take him to a specialist, preferably at a veterinary teaching hospital, for evaluation and possible tail amputation, I began to consider just going for an evaluation. This route was advised because of the number of similar conditions that such a place comes in contact with and due to surgical experience in the area by their medical staff. We wanted only the best for Shadow. I agreed to give this some thought.
Tail amputation is advised for certain animals who suffer from perianal fistulas, depending on the extent of the condition and the problems that the animal is having. Removal of the tail allows the anal region to heal more readily, with more air being able to reach the area; and without the tail, fecal contact would be eliminated. Fistulas also sometimes form under the tail itself, as was the case with Shadow.
After discussing our dilemma with fellow dog club members, friends, and most of all, our veterinarian, my husband and I decided that we should give Shadow this chance. Shadow did not want to die; he deserved to live if there was any hope.
An appointment was set up for us with a surgeon at Louisiana State University School of Veterinary Medicine in Baton Rouge. I chose this veterinary college because of their excellent reputation, because my veterinarian had been in contact with their staff, and because we do not have one closer to our home in central Arkansas. Baton Rouge is an eight-hour trip for us, so both my husband and I took days off work to make the trip. We left early on a Thursday morning for a 3:30 pm appointment that same day, driving in the rain all the way to Louisiana. Shadow was tranquilized before leaving home, because he was not used to riding crated for such a long time and because he would be in strange surroundings upon arrival, with unfamiliar persons, which usually caused him concern.
This was a hard trip for us; a hard choice, for I knew in the back of my mind that the matter of tail amputation was going to have to be dealt with. The doctors at LSU were very kind and explained their findings after an initial examination upon our arrival. I was told that tail amputation was the only thing that might help alleviate his perianal fistulas, but that there were no guarantees. I felt that the surgeon and her resident were very knowledgeable in this area, and I could only rely on their good judgement. I asked what she would do if Shadow were her dog. Her reply was that she would have the surgery done in a heartbeat. I was worried about what he would be going through and the pain he would endure. I was told that it would probably bother me more than it did him; that it would not be any worse than what he had already experienced. I was again told that my only other choice was to put him down. What do you do? Your dog is four years old, healthy otherwise, with a real zest for life even after all he had been through. When it got right down to the bottom line, I had to give him another chance at life.
I gave my permission for the tail amputation surgery and left Shadow for his surgery to be performed the following day. I was told that, in addition, they would do very aggressive laser surgery on the fistulas. I planned for him to remain there for about ten days for recuperation.
As I left Shadow, I told him I would be back, for he knew what I was saying; he understood more than most. I left the hospital with tears in my eyes, dreading the ordeal, but knowing there was no other choice. My husband and I returned home the following day, at which time I had a message to call the surgeon for a follow-up report. When I spoke with her, I learned that Shadow's condition was worse than the brief, initial examination showed. The fistulous tracts reached into the colon, and part of the lining of the anus was destroyed. I again asked the doctor what she would do if he were her dog. She would give him time to see what would happen, even though the prognosis did not look good. I took her advice and again began to hope for the best.
The LSU staff was very kind to call me each day to report on Shadow's condition. Even though he did not relate well to new surroundings and to strangers, they were coping well with him. He apparently had caused no problems. I, of course, was very anxious for him to return home, but realized that it would be at least three to four weeks before we would know if the surgery was going to be of any help.
I was apprehensive about leaving Shadow in this strange place because of his personality, but I had begun to relax a bit after learning that he was adjusting well. Or so we thought. After he had been there five days, I received a phone call and learned that every dog owner's worst nightmare was happening to me. Shadow had disappeared from his chain-link run. Not only this, but he had disappeared from the veterinary hospital building and was lost somewhere in Baton Rouge. You cannot imagine the trauma I felt when I received that call. Here I was, 350 miles away, and there was nothing I could do. I had to ask - Why me? I try to be so careful not to let my dogs run loose or put them in any circumstance where they might get lost. The LSU staff had already alerted the local law enforcement and animal control agencies of his disappearance. An article was run in the Baton Rouge paper; the public was made aware that he had just had surgery and was not the type of dog who would just go up and make friends with someone he might come into contact with.
Shadow was smart, I knew; he was too smart at times for his own well being. But how did he open his gate to the run, as well as that of another chain link enclosure, plus an outside door of the hospital? I have no doubt that he used his time following surgery to think about how he could get out and head for home. He had always been able to figure out how to get out of doing what he didn't want to do. In this case, he did not want to stay in Louisiana; he wanted to come home.
For the next 36 hours, we were certain that we would never see our beloved pet again. Every worst thought ran through my mind: Had he been run over; had he been abducted and taken God knows where? I contacted friends in Baton Rouge and members of their local German Shepherd Dog Club. Everyone was more than concerned, and they did all humanly possible to help find Shadow. After thirty-six hours with him on the run, we received a call from the resident at LSU in charge of his care. Shadow had been found, returned, and was unhurt and unharmed. A member of their staff had been able to capture him in downtown Baron Rouge on a dock on the Mississippi River, following reports that he had been spotted in the area. I was told that he had the choice of plunging into the river or allowing his capture. He was smart enough to realize what his choice had to be. You can't imagine the joy we felt when we received this call. Immediately, we made plans to travel back to Louisiana to bring him home. This we did, and I can't describe the joy both Shadow and I felt when we were reunited. It was again raining, and we made the eight-hour trip home in fog and a constant downpour, but we had our Shadow back again. God had answered our prayers; he was safely returned to us, and after this ordeal, he just had to have a good recovery from his last surgery.
Even without his tail, he seemed in very good spirits and had no problem with his sense of balance. I had worried about this, although I had been told that tail amputation would not affect his balance in any way. He did not seem to be in any pain, except from some type of chemical irritation on the scrotum which, we believe, he came in contact with during his time on the run.
We had called our veterinarian in Little Rock and set up an appointment for the morning after our arrival home. The area on which Shadow's surgery had been performed had to be washed daily and kept clean and free from infection. So the next morning we headed for Little Rock for follow-up care. The anal area involved in the laser treatment and additional fistula surgery was left open and unbandaged. It had to heal from the inside out. During the next few weeks, we made many trips back and forth to our vet. We were keeping our fingers crossed that everything would heal properly and that no new fistulas would appear. His stool elimination was not good, but he was on a daily dosage of stool softeners and a diet of soft food which, we were told, he would have to remain on the rest of his life. He was making it okay, though; the tail amputation area healed very nicely, with no problems. He didn't seem to be concerned in the least that he no longer had a tail. And it did not look that bad to see him without it.
In November and December the visits to the vet continued. The affected area looked okay, then began to need further cauterization. My veterinarian was in contact with the surgeon at LSU, to keep her informed of his condition.
By January 1994, we knew that fistulas were again appearing, and it seemed as though we were traveling in a never-ending circle. Where to go from here? I knew the inevitable was upon me. I had made up my mind that I would not put Shadow through any more trauma. On our visit to the veterinarian in the latter part of January, I was told that his condition was not improving; in fact, it was worse, and by this time Shadow was again having a real problem with stool elimination. Strictures were hindering any progress, as they had almost from the beginning. They were caused, we believe, not from the surgery, but from the fistulas themselves. I could not take him back to LSU for another evaluation, but through my vet and her contact with the doctor at LSU, we decided that it probably would not help to go through this all over again.
I left him with my veterinarian to give her an opportunity to confer one last time with his surgeon at LSU. Upon receiving a call shortly after arriving home, I gave my permission to have her put him down. I had decided that I did not want to be there; I felt I could not handle this in any dignified manner. And I trusted her completely to make his final minutes as peaceful as possible. By this time, Shadow had become friends with all of her staff and was not uncomfortable there with them.
Shadow died on January 27, 1994. Of course, I miss him more than you can imagine, but in my heart I know I made the right decision. It is with tears in my eyes that I conclude this article, but Shadow is at peace now, and he is no longer suffering or under any stress. I will never forget him - such a wonderful companion, yet a dog with a very different personality. To give your heart to a dog to love can bring joy and pleasure, even with traumatic situations which may develop along the way. The pleasure far outweighs the pain.
I have no regrets. I know that we did everything humanly possible for Shadow, spending hundreds of dollars along the way. I know that I could not have prevented his condition from forming - that its occurrence was not the result of anything I did or did not do. If I had it to do over, I would do the same thing. This gives me comfort in our loss.
Since Shadow's death I have been fortunate to have been contacted by many others who have either been through the same illness with their German Shepherd Dog, or who are at this time facing the problem. I have corresponded with and spoken with persons all over the United States who feel as I do: that this is a devastating illness. As I look back on my own experience with the problem of perianal fistulas, I believe that early diagnosis is imperative for any hope of recovery. However, every situation must be dealt with individually. What method of treatment works for one may not necessarily work for another. I am convinced that it is very important to keep watch for any formation of fistulas and begin treatment as quickly as possible after diagnosis.
All cases do not have to end like ours did. If caught early enough, there may be a chance of recovery. You must trust your veterinarian and/or surgeon and let them help you with your decisions in the event you ever must go through treatment for your dog for perianal fistulas.
From conversations with others since Shadow's illness, I believe that most dogs' owners are willing to try almost any method of treatment that might work to cure the fistulous condition. You feel very helpless as though you are sitting on a time bomb just waiting for the result. But you must have patience and optimism that all will end well. Owners of dogs with perianal fistulas want to know what to do for their pets. They are frightened when they realize the seriousness of the condition, but more times than not they do not know what to do - what the best method of treatment to follow is. They will try many methods they think might help.
If I am ever faced with the same situation again, I will deal with it anew on the basis of the individual dog. And perhaps new methods of treatment will be available. Perhaps more research will have been conducted, with good results for a good prognosis.
It is my hope that some type of unified effort can be made by the American Kennel Club, as well as national breed clubs, to organize some type of system whereby persons such as myself can reach out and be put in touch with others who have had similar problems with their pets, not just those with perianal fistulas, but other heartbreaking conditions as well. This would help emotionally, even if not physically, for the animal. It is my further hope that more be written in order that owners of breeds most often affected by perianal fistulas may become aware of how devestating this condition can be, for they do exist, and apparently in quite large numbers.
The German Shepherd Dog Club of America was kind enough to allow me to share my experience with Shadow in their publication. Since then many interested persons are working with me to help others, and it is our desire to form a support group to give moral support to pet owners facing the problems with fistulas.
Perhaps you will be glad to note I again own German Shepherd Dogs. Of course they do not take Shadow's place but they do fill a void and help me continue in my love for the breed. Each dog is different but you love each for itself, and you give the new puppies all the love that you have felt for all its predecessors down through the years. I cannot imagine life without a German Shepherd Dog.