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Maggie was a street dog, pure and simple.  She may have lived with a human in a loose association at some point in time but that was many miles ago.  And now she felt tired, old beyond her years and hungry.  Mrs. Vitale was a feisty old lady who didn't feel so feisty lately.  She lost her husband of many years suddenly to a heart attack.  And now she felt tired, older than she ever felt and lonely.  They met one afternoon in a parking lot in Lakeland.  Mrs. Vitale saw a thin sorry-looking stray and the white dog, soon to be called Maggie, felt soft hands and smelled food. It was love at first sight.  Mrs. Vitale walked into our office, a novice pet owner. We didn't know each other and neither she nor I knew what to expect from each other. I introduced myself and asked her to tell me about Maggie.  She could offer no information since she had only found her the day before.

I examined Maggie and estimated her to be about four to five years old but she looked very rode worn.  She was thin coated and dirty.  She had a pronounced heart murmur and two breasts had tumors in them.  A heart murmur in a middle aged stray dog is a good sign that the dog has heartworms.  Heartworms are spread by mosquitoes and if dogs are not on the preventative, there is a good possibility, especially here in Florida, that the dog will become infected.  The juvenile heartworms then make their way to the heart where they mature and reproduce.  The adults live in the right side of the heart and in the artery leaving the heart.  They end up plugging the artery causing backpressure on the heart making it work harder to pump blood.  With time the chamber on the right side of the heart becomes enlarged and the valves begin leaking and the circulation becomes poor.  The heartworms can live for 5 to 7 years and during this time the dog is constantly being reinfected with more heartworms and the heart continues to degrade until it eventually it kills him/her.  Suspecting heartworms I asked permission to do a heartworm test and the result was a strong positive.

Next I needed to address the breast tumors.  If the breast tumors were cancerous and had begun to spread, then the lungs may show signs of the spreading and this would show up in chest X-rays.  The chest X-rays would also show the heart and I could get an idea of how much damage had been done by the heartworms.  She gave permission for the X-rays and they did not show obvious signs that the tumor had spread or metastasized but they did show a dramatically enlarged heart.  With all the data in front of me, I couldn't believe Mrs. Vitale would keep the little dog.  She hadn't been an animal lover in the past and this poor stray required a lot of time, effort and money.  I went back into the exam room with apprehension because I had been in this situation too many times.  People willingly take an animal in off the streets but then when confronted with health problems, often they are overwhelmed and decide to put the animal to sleep.

I sat beside Mrs. Vitale and told her of Maggie's problems.  Heartworm disease had damaged her heart and although heartworm treatment would get rid of the worms chances were poor that the severe damage done to her heart would get better.  Also, after the heartworm treatment, she would have to have surgery to spay her and remove her breast tumors.  I gave her a ball park cost for all the medical treatment and surgeries and I still could not guarantee a good outcome.  Mrs. Vitale took my hand and with tears in her eyes told me that this was God's doing. She had just lost her husband. She was feeling sorry for herself and useless and then she found Maggie.  It had to be God's will. No matter what it took, she was going to give this little street fighter a chance.  She asked that I explain to her what had to be done and she would do it.  And in that moment I knew that this was a special lady and that this little dog now named Maggie, had won the doggie lottery.  And somehow I had to fix this little dog for both their sakes.

It was a catch-22 as to what to treat first.  Her heart disease was critical and made anesthesia quite risky but to wait on the removal of the breast tumors would increase the risk of the tumor spreading if it were malignant or cancerous.  The best thing for Maggie would be to have her heartworm disease treated first.  The chemicals we use to kill the heartworms also damage the liver.  We would have to wait four to six months to allow her liver and heart to recover somewhat before performing the spay and the mastectomy.  Mrs. Vitale agreed.  She actually wanted to do everything at the same time...she didn't want to wait but she understood the need to protect Maggie's heart.  We ran blood tests to make sure everything else worked fine and the results were quite favorable.  Her heartworm treatment went well although because of her heart murmur, we had to use additional drugs not normally used to help stabilize her.  If she could ever go off her special cardiac medicine was still in question but just the fact that she responded as well as she did after her treatment gave me hope.

Three weeks after treatment, Maggie began to cough and we had to recheck her.  Amazingly, even though Maggie was coughing slightly her heart murmur had decreased to only half as bad as it was just four weeks earlier.  She had a mild fever and her tonsils were a little puffy so we placed her on antibiotics and again, she responded well.  We were all extremely encouraged with the way this tough little dog came through and Mrs. Vitale didn't like the idea that we had to wait to do her surgery.  The thought of cancer in her little companion worried her, understandably so but the risk of anesthesia was still too great.  It took two months for her liver values to get back within normal limits.  Two days after we found out, we spayed Maggie and removed her breast lumps.  Two additional days of waiting followed for the anxious Mrs. Vitale until the biopsy results came in.  And again, Maggie beat the odds.  All the tumors were benign, which meant the breast cancer was not the kind that would spread and someday kill her.  And also at this time, her heart murmur was so mild that it was actually hard to hear.

Over the years, the thin frail little streetfighter became a plump and utterly spoiled lapdog.  In fact, Maggie hardly walked anywhere.  She was always in Mrs. Vitale's arms and went everywhere with her.  Mrs. Vitale would always come into the office around lunch time to pick up heartworm medicine or to get Maggie's nails trimmed.  She almost always brought cookies for the staff and sometimes she would even bring us lunch.  Often times she would stop by on her way home from Home Depot where she would walk down the aisles with Maggie in the shopping cart and Maggie would be decked out wearing her best shopping hat.  Around Easter she would bring Maggie in wearing her finest Easter Bonnet.  Over the next couple of years Maggie continued to gain weight.  I had little discussions with Mrs. Vitale about this and soon it became kind of a joke around the office.  When she would come in Mike would say "lets weigh Maggie" and Mrs. Vitale would respond "only if you don't tell Dr. Eger".  Of course she was spoiling Maggie and each time we weighed her, she was the same or heavier than the previous time. No matter what I said, it did not help.

It was a Tuesday like any other Tuesday and when I came back from lunch and I had a message on my desk.  The message said that Mrs. Vitale had died of a massive heart attack the week before.  My heart dropped.  It seemed like we had just seen her and now I could not believe she was gone.  The message continued, her daughter (who lived in another town) made an appointment for Friday for Maggie to get an exam and vaccinations and she wanted to pick up a copy of Maggie's records for her veterinarian.  The entire staff was very quiet that afternoon as we all thought about the tragic news we had just heard.  I felt bad that we did not know soon enough to at least send flowers to the funeral and I also felt bad about giving Mrs. Vitale such a hard time about Maggie's weight.

I was anxious to talk to Mrs. Vitale's daughter about what had happened.  When she brought Maggie in, she told me that her mom had suffered a massive heart attack and was taken to the hospital.  Her daughter was with her in the hospital and all Mrs. Vitale could think about was who would take care of Maggie.  Her daughter assured her that she would take very good care of Maggie and that she should not worry.  Soon after, Mrs. Vitale passed away.  I asked her how Maggie was coping and she said that Maggie was doing fine.  Mrs. Vitale often visited her daughter and of course Maggie always accompanied her.  So Maggie did not feel out of place at her daughters house.  However, when she took Maggie back to Mrs. Vitale's house, Maggie became anxious and was looking all over for her mom.

Had Mrs. Vitale not given Maggie a chance, I would not have had the knowledge that I do now...that serious heart murmurs caused by heart worm infestation CAN improve dramatically with cardiac medicine and proper treatment.  And I would not have had the honor of knowing both a wonderful lady and a tough little dog.  There are no guarantees in life.  We all begin dying from the moment we're born.  It's what we do in the years that span birth and death that matter.  And who's lives we touch. Maggie brought a lot of joy into Mrs. Vitale's life just as Mrs. Vitale brought joy into all of our lives here.  We will miss her.

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