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This is a story that should never have been written.  It is the story of good intentions, nonchalance, perhaps some professional error, and love.  I still beg sometimes when I am alone, and memories come back unbidden, that this story could be a fantasy.  Yet here it is:  real.  

My wish, or rather my mission for the foreseeable future, is that this story will become outdated.  My wish is that one day this will be archived, and the tragedy of 2009 will become historical reference only.  Here we go…

On July 6th, I took my 2 ½ year old Pug, Brando, to the first 4-H dog training class of the year.  Each summer I work with the 4-Hers as they prepare their dogs and themselves for the Antelope Valley Fair competition.  As I had done the previous summer, I took along Brando, who would be working with his junior handler co-owner.  Myranda and Brando had gone all the way to the top in 2008, winning Top Junior Showman.  Brando strutted himself at the end of the leash to the group of waiting kids, thrilled to be back at the park with “his” kid.  It was a great training session that night, with the partnership of Brando and Myranda in top form.  

As we packed up, I was reminded by the leader that all dogs had to be entered by the weekend, and current vaccination proof turned in.  I sighed, and promised to take Brando in the next day for his rabies shot.  He had received one at a year of age, but would not be considered current because of the labeling of that vaccine as 1-year duration.  

An aside -- I have been concerned for years about the effects of rabies vaccines, and indeed all vaccines, when given too frequently.  My concerns have been about long-term effects, such as cancer, thyroid disease, and other immune mediated health issues.  In my puppy packets I include the latest protocols from both Dr. Jean Dodds, DVM (an authority on immune disease and immunology) and the American Veterinary Medical Association.  With some variation, both now recommend infrequent vaccination after the initial puppy series, and caution that rabies vaccine is of particular concern.  And yet this did not cross my mind on July 7 when I took Brando to a vaccine clinic for his rabies booster.

As we waited at the clinic for my name to be called, Brando worked the room in the way only he (and Pugs in general) could do.  Greeting humans and dogs alike, he made a number of new friends, and even amused an Amazon parrot who was waiting next to us.  And then our name was called.  True to his nature, Brando jauntily led the way to the exam room, and one of the vet techs mentioned that his name was indeed fitting:  he looked exactly like Marlon Brando in his later years.

The vaccination itself was very quick.  The second vet tech verified that this was Brando, gave the injection between his shoulder blades, handed me my certificate, and sent us out the door.  In less than three minutes we were back at the car.

This is where the memory becomes a blurred nightmare.  I placed Brando in his crate behind the driver’s seat, and as I climbed in I heard him gag.  “That’s odd,” I thought, as this was not something I had ever heard him do.  I got back out, opened his crate to check, and immediately smelled something similar to fish.  Brando was sitting with his back to me, head down, not moving.  I said his name, reached in to touch him, and he looked at me with a clearly distressed expression.  An innate alarm started to ring inside my head at that moment, and I could only think one word:  reaction.

I grabbed Brando out of his crate and set him on the ground.  When his legs gave out under him, I picked him up and ran back into the clinic.  As someone held the door for me, I shouted, “He’s having a reaction” to the receptionist.  I was pushed into an exam room, and when the tech took one look at Brando she said to another, “Get a vet  --  emergency!” and led me immediately into the back treatment area.

As the vet listened to his heart, she told the tech to grab the epinephrine.  Brando had at this point released his bowels, a common first sign of anaphylactic shock along with nausea -- the gag I had heard in the car.  Thus began the treatment protocol:  epinephrine, steroids, fluids, and diphenhydramine IV.  Brando was put on an oxygen mask as well, and I was encouraged to talk to him.  

A second aside:  at no time was I asked to leave Brando’s side.  I did all I could to stay in his sight and hearing while not interfering with those working on him.  I am grateful for that.

As the minutes went by, Brando’s temperature was monitored for sudden rise or drop; his gums and tongue were checked frequently for color; his pupils and reactions were assessed every 30 seconds or so; his heart rate and breathing were continually evaluated.  For a little while he rallied -- he lifted his head, put his ears up, and looked at me.  I remember saying, “Hey, you -- welcome back.”  And the vets (there were now two of them with us) also smiled, relieved, but reminded me that we were not yet out of the woods.  He fought the oxygen mask, so it was removed, and his color was a good pink.

Somewhere in this time period, perhaps 20 minutes after the rabies injection, a third vet joined us for consultation.  The other two wanted to be sure that they were doing all that could be done, and had several reference books open on the tables as well as a phone call that had been made (I have no idea to whom).  The veteran doctor re-examined Brando, and was not happy with his color.  Indeed, as I looked I could see that his tongue was becoming a bluish tinge.  Oxygen was increased, and then the dominoes began to fall.  

It is difficult to write the remainder of this story.  And indeed it has been 16 days since it happened; only now can I force myself to finish.

The brief rally was over.  Brando’s breathing became labored and slow.  His heart was racing, but with irregularities.  As I watched helplessly, his head dropped, and his breathing stopped.  Immediately the team started CPR, a tube was inserted into his trachea, and oxygen was started again.  He may have been unconscious at this point -- it was hard to tell -- but I stroked his head and talked to him anyway.   His heart was beating, though faintly.  Minutes later, Brando’s body contorted in a gruesome stretch, and the vet shouted, “He’s going!”  She snatched him from the table, ran with him into the surgery room, followed by two other vets and several techs.  I stood outside, watching what followed through the window into that room.

Brando was put on a heart monitor in addition to the oxygen, and the team began to watch.  Six pairs of eyes alternated between Brando and the monitor -- and my eyes followed theirs from outside the room.  Twice the beeping stopped, and CPR was administered.  A vet came to me, with an EKG strip, and showed me what was happening.  Brando was throwing abnormal ventricular beats, but no regular heart rate was present.  He told me that they would give an injection of lidocaine in hopes that the heartbeat could be regulated -- but that he did not have much hope.  Those words were like a razor -- all I could do was stare at my dog on that table.  And then more CPR.

When the people in the room all stopped looking at the monitor and two of them turned their eyes to me outside that window, I knew.  I was called into the room.  Not a word was spoken.  I stood next to my Pug, my hand on his chest, and looked at the heart monitor myself -- there was only a horizontal line -- nothing more.  I said to the tech who was still valiantly pressing the air bag to manually give him oxygen, “Just stop.”  And she did.

I could only hold him, for how long I don’t know.  I stayed with him as long as I could, until I knew that he was gone from that room.  And still I could not pull myself away.  This could not be happening. This must be a dream.  How could I have arrived an hour before, with a healthy, confident, indeed cocky Pug leading me into the clinic, and be going home alone?

Leaving him there was the hardest thing that I have ever experienced in 32 years in this sport.  His charm; his wit; his devotion to me; my adoration of him.  It was so suddenly, and so pointlessly, gone.  

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Anaphylactic shock.  It occurs in roughly 1 in 10,000 dogs in the general population.  Rabies vaccine is one of the most virulent and dangerous for dogs who are predisposed to this reaction.  The type of fatal reaction that took Brando from me is rare to the extreme, though one important fact was unknown to me when I took him to that clinic:  Pugs are one of a short list of high risk breeds for vaccine reaction.  There is some disagreement among veterinary professionals as to what that increased risk is, but a study at Purdue University found that Pugs have a 4 times higher risk of severe or fatal reaction than other breeds.  The only breed with a higher risk is Miniature Dachshunds, whose risk is 5 times greater.

Other breeds have been identified by Dr. Dodds in her research as at risk for autoimmune hemolytic anemia associated with vaccination:

“Among the more commonly recognized predisposed breeds were the Akita, American cocker spaniel, German shepherd dog, golden retriever, Irish setter, Great Dane, Kerry blue terrier, and all dachshund and poodle varieties; but predisposition was found especially in the standard poodle, longhaired dachshund, Old English sheepdog, Scottish terrier, Shetland sheepdog, shih Tzu, vizsla, and Weimaraner, as well as breeds of white or predominantly white coat color or with coat color dilution (e. g., blue and fawn Doberman pinschers, the merle collie, Australian shepherd, Shetland sheepdog, and harlequin Great Dane). “

The list may very well continue to expand as more statistics are kept on adverse reactions.

In my pain, I have begun to research the topic, just scratching the surface of what will continue to be a quest.  Although I do not advocate stopping all vaccination of dogs, there are changes that must be made in the way that these vaccinations are given.   Brando’s legacy is this:  I am committed to education of veterinarians and their techs regarding high risk breeds, anaphylactic shock, vaccine schedules, alternatives to yearly vaccination, and the protocols that should be followed for vaccination of those high risk dogs; creation of a website for owners, breeders, and vets regarding adverse vaccine reaction; and the launching of a research study on the possible links between Pug Dog Encephalitis, vaccines, and anaphylactic shock.  Dr. Dodds will help lead this project, and Brando’s breeder, Jean Ettinger, will work to disseminate the call for participants as well as the results in the future.  

I loved Brando.  His death deserves a response that will assure that fewer dogs over time will lose their lives in such a manner.

For more information on anaphylactic shock and adverse vaccine reactions, consider the following websites:

http://www.rabieschallengefund.org/

http://www.itsfortheanimals.com/Adobe/AdverseVaccReactions.pdf

http://www.itsfortheanimals.com/DODDS-CHG-VACC-PROTOCOLS.HTM

http://www.2ndchance.info/vaccinereactions.htm

http://www.peteducation.com/article.cfm?c=2+2082&aid=507