Normally, when a dog experiences a stressor (or anxiety), it triggers a primal physical response. From deep within the dog's brain, a chemical signal speeds stress hormones through the bloodstream, priming her body to be alert and ready to escape or fight "danger." The increase in hormones affects breathing rate (which increases), heart rate and blood pressure go up [which we know definitively can cause nosebleeds], and digestion stops. Thought processes change; concentration becomes more focused and reaction time faster. Muscles are fueled, and strength and agility increases so the dog can fight or flee to ensure her survival. When the stressful situation ends, hormonal signals switch off the stress response and the body returns to normal.
I believe Pinuki inherited, through her genes, a stress system that tends to over respond to even minor threats. She can be described as "hypersensitive." I know for sure at least one of her litter mates has a similar disposition. So, I have a vulnerable dog who, starting in May 2010, began to experience several significant stressors including:
- Family member, Kipu, a Tibetan Spaniel (with Pinuki since she joined our family), had what appeared to be a mini stroke. It lasted seconds, Kipu was evaluated, there appeared to be nothing wrong and she seemed to return to normal.
- A little over a week later, while on our after dinner walk, Kipu collapses and was dead an hour later.
- Pinuki had a significant grief response (vocalizing as if crying) for days.
- Pinuki also had increased anxiety. She depended a lot on Kipu for security. Her confidence waned and she appeared lost.
- Pinuki also experienced a lot of fear during that time related to lights spontaneously tuning on and staying on for days and other electrical disturbances the two or three weeks following Kipu's death (I know how it sounds but go with it or skip to #6). She could not settle down.
- For sometime after the loss, I was unable to maintain our regular routine and provide the stability Pinuki needed (I did not realize that at the time).
- The arrival of a new family member, 9 week old Kalu, in September.
- New neighbors moved in above us. They create daily noise disturbances that scare Pinuki.
- In November we began the process of exploring the cause of Nuki's intermitant rear left-sided limping. Ultimately, I tried conservative management for a cruciate ligament injury (which I now know was old and had already healed). Pinuki's activity was extremely limited for eight weeks (out to eliminate only).
- In February, Pinuki had her first episode of excruciating pain triggered by what we ultimately learned was the large lipoma on her neck.
- It took her awhile to understand that moving her neck was triggering the pain and she was clearly not only in pain, but scared for days.
- Between February and March she had bloodwork, x-rays, needle biopsies and an orthopedic evaluation.
- And then on March 3, the MRI and the first nosebleed. An animal communicator said Nuki was terrified by the experieince; that she was not fully anesthetized during the procedure; she was scared by pounding noises and afraid of dying.
- Daily nosebleeds which clearly weakened and depressed her.
- Violent sneezing that threw her neck out again causing a second episode of excruciating pain lasting days.
- And more bloodwork, x-rays, medications, treatments, diet and supplement changes, emergency visits, blood transfusions, CT scan, rhinoscopy, nasal biopsy, ligation of her carotid artery, abdominal ultrasound, conversations with animal communicators. I am sure there are things I am forgetting.
- At one point during all this Kalu becomes sick and could barely move. For nearly a week she sleeps.
- And I am a wreck.
So, for Pinuki, the stress hasn't let up. Stress hormones continue to wash through her system in high levels, never leaving her blood and tissues. The stress response that gives her the speed and endurance to escape life-threatening dangers as been running constantly and has yet to shut down. The long-term activation of her stress system made her especially vulnerable to illness.
A malfunctioning stress system can cause inflammation. There is some evidence Nuki has been experiencing "low grade" inflammation for years, including clear, nasal, primarily left-sided, discharge. Intermittently. [Here is where I am really speculating]. I suggest that when Nuki experienced extreme metabolic disequilibrium, it increased the inflammation and manifested where she was already vulnerable, her left nostril.
And that is why, the Doxycycline worked some; not for its antibiotic properties, but its anti-inflammatory properties. And, if I am right, if my theory is possible, that is why the natural hydrocortisone may actually help Pinuki heal. Natural hydrocortisone a.k.a. cortisone is a man-made version of Cortisol one of the hormones of the stress system that helps to "swtich off" inflammatory responses. Giving cortisone will help Nuki's metabolism return to a state of equilibrium.
So, Nuki stays on the natural hydrocortisone for two weeks to reduce the inflammation and begin to restore metabolic equilibrium. Then we begin weaning her, ideally off, the hydrocortisone or to a minimal dosage that prevents bleeding. We decide what we should do about the Doxy. We treat Nuki's anxiety giving her a chance to relax and recuperate. I incur no more debt or expenses. I teach Kalu some manners. And we live happily ever after. The end...of the nosebleed chapter.
You can't say I haven't considered all the "scientific" explanations...It is as plausible as anything at this point.
