Our dog Clyde is 11 years old and has been more fatigued recently. We brought him to the vet and they did a “senior screen” labs and found he had hypothyroid and started him on thyroid replacement and he’s back to his usual self (still sleeps plenty, but more alert and playful again). However, there was an incidental finding of proteinuria. I work in human medicine and I am wondering about reasonable next steps for this senior pup who is otherwise doing fine.

Specifies: dog Age: 11 Sex: neutered male Breed: terrier mix Body weight: 33lbs Medical history: - allergies/atopic dermatitis on apoquel for many, many years; in the past two years switched to Cytopoint injections q2-3 months - 9/2021, splenectomy d/t hematoma, benign

Recent hx: fatigued x1 month, no localized symptoms, low T4 and started thyroid med with improvement of symptoms

Proteinuria: Serum Labs: Cr 0.7, BUN 17, BUN/Cr ratio 24,

No CBC (except platelets 534 and mono 1400), renal, lft, CPK, amylase, Negative heartwom, borrelia bergdorferi, ehrlichia spp, and Anaplasma phagocytophilum

UA: specific gravity 1.051 (borderline high), Ph 7.5 (high), Protein 4+; UA otherwise bland (negative glucose, ketones, bacteria, casts; 1+ bili, WBC 0-1, RBC 2-3, struvite crystals 2-3).

Spot UPCR ratio 1.7, Protein 425 mg/dl, Cr 252 mg/dl

Vet is recommending telmisartan 15mg/day ($100/month) and low protein diet and follow labs ($200 for per/UPCR) to monitor.

He is pretty healthy but 11 years old. How significant are these labs, is treatment with both meds and diet changes indicated? Especially with a normal serum Cr? What would you do if it was your pup?

*I can share any other specific labs if helpful

My husband and I opened our marriage 2.5 years ago because we stopped having sex due to his low libido. Our goal was primarily to find other sex partners. I (40 F) am much more active in dating than my spouse (46 M). I want to move more towards a poly approach but he does not.

Currently, I am limited to go out once per week, home by 1030pm, no sleep overs, no weekends. We approach as a “don’t ask, don’t tell” (his choice) so he knows nothing about my other partners. I love him and many aspects of our life together and I have been trying to be ok with how things are, but I’m just not happy with this and I feel trapped. When we discuss it he claims I’m “always pushing his boundaries” and “he’s just not comfortable.” I’m afraid we aren’t going to be able to find a place where we can both be happy.

Has anyone successfully navigated this type of poly challenge?

I am in an open marriage, with the goal of finding other sex partners, but than a connection formed that include emotions. And then it ended. He was kind, no lies and no broken boundaries, but still a broken heart.

A SECOND HEART

March 2022 I’m vibrating. A river of stars that fills my mind. And flows out, spreading into my heart, my breath, my limbs. It glows. Stars pool in my toes, dancing. Slowly climbing the scaffolding of my body, filling my cells with lust and love. Warming my skin. Spilling from my eyes, cascading down my cheeks. Pulsing in my ears. Escaping across my lips. Trickling through the cracks in my heart. Dripping between my legs. Reaching for water and sunshine and oxygen. Growing.

April 2022

Constellations exploding, stars everywhere. I’m crawling on the carpet, hiding them in my pockets and swallowing them whole. My lips glow with stardust. My pockets sparkle.

My heart shatters. Emotions scatter across the room. I desperately try to collect them; stuff them down. Back into the neat box. Deeper. They pop out, skitter across the floor. Uncontainable.

= a second beating heart, delighted

Stop the clock, set it on a shelf. I need more time. To explore the length of your body, to trace your freckles, to kiss your scars. To feel your breath. To hear your strumming heart. To taste you.

May 2002

I had a dream. I saw myself standing alone in the grass. I was glowing from inside. And I genuinely wondered how the glowing got there. It was not a food. It was not a pill. It was not a drug. My body had created it all on its own. I was amazed.

….

September 2022

The air is crisp, the sky its brightest blue. Acorns fall, a harsh sound amid rustling leaves. Like a breaking heart, below a smooth and smiling surface. This is a breath. I miss you. - a second heart, breaking