At her intake at a shelter in April 2012, Bean was a pup with a familiar profile: a Pit Bull whose family could no longer care for her. But it wasn’t long before someone at the Humane Society of Silicon Valley in Milpitas, California did notice something unusual about her.

It was her lack of “boing,” says staff member Finnegan Dowling. “No Pit Bull puppy should be that mellow.”

Bean also had a stiff walk. When she was excited, she hopped like a bunny. They took her for x-rays, but even sedation didn’t relax her joints enough to get pictures, Dowling says, and the vet referred her to UC Davis for an MRI scan.

There, Dr. Karen Vernau, chief of the Neurology and Neurosurgery Service at the Veterinary Medical Teaching Hospital, discovered that her hip joints were improperly formed. Bean’s determined spirit wasn’t lost on Vernau, but her chances of adoption seemed slim.

The five month old pup was suffering from muscular dystrophy, a progressive and currently incurable disease that would affect many parts of her body.  

According to notes in Bean’s file at the Humane Society, she was scheduled for a procedure at Davis on May 25. By the 29th, she was diagnosed with myopathy, a neurological condition. But somewhere in between those dates, Dowling says, Dr. Vernau’s relationship with her patient “went from obligation to affection.”

Vernau and her family decided to adopt Bean.  As the vet told a reporter, “We didn’t intend to go down this path with her, but she just sucked us in.”

This happy ending was only the beginning of Bean’s harrowing medical story.

Gradually, things got worse. Surgery to correct her hips was followed by relief—then new problems. A massive hernia called for another surgery. Her swallowing improved, but the muscles in her esophagus were failing and there were bouts of vomiting so intense she would sometimes choke and pass out. Bean grew thinner as she struggled with aspiration (food getting into her respiratory tract when eating), which caused pneumonia.

Her vets sought help from colleagues in human medicine, a multidisciplinary approach the university encourages through its “One Health Initiative.” They included Dr. Stan Marks, a gastrointestinal specialist, and Dr. Peter Belafsky, an expert in human swallowing and airway disorders, and others.

With help from the biomedical engineering department, Bean had been fitted with a feeding tube that allowed her to eat several times per day. It worked beautifully, according to Dr. Marks.

But it didn’t stop the vomiting.

Since the vomiting put her life at risk, Belafsky concluded that they would have to stop it by removing her larynx.

Belafsky, who performed the second documented human larynx transplant, knew how profoundly such problems affect a person’s quality of life. And it was clearly true for Bean.

Her surgery, which lasted more than three hours, was the first ever canine laryngectomy. The procedure is typically used to treat human cancer. According to Belafsky, the separation of her breathing and swallowing tubes will prevent food from getting into her lungs when she eats or vomits.

The lessons learned in Bean’s treatment will impact human care, and vice versa, Belafsky said in a press conference after the surgery. Belafsky hopes she will inspire human patients who have also lost their voice and now breathe through a hole in their neck. She may just get a guest membership in the “Lost Cords Club” for people who have had a laryngectomy.

After all, Bean is only two years old, but has slept out more than 100 rounds of anesthesia and undergone eight surgeries and countless other procedures. Her “can’t do list” is long. Can’t bark, breathe or swallow normally. Forget gobbling down a treat, and she can’t swim without drowning due to the tracheostomy tube.

But the list of things she once endured, the choking and pneumonia, has been tossed.

Now when she accompanies Vernau to the hospital, she serves as ambassador and teacher, allowing students to experience canine tube feeding.

At home, Bean is learning new ways to enjoy life, which still holds plenty of the good old stuff – balls to chew, cushy beds, and a loving family that includes two other dogs.

Watch this video about Bean's surgery and recovery.

Years ago, my sister’s New Year’s resolution was to give up New Year’s resolutions, and she was one of the few people who stuck to her plan. (Success rates are generally less than 10%.) Her secret was resolving to do something that she wanted to do anyway. If your resolutions for 2014 are dog-related, make success more likely by choosing to focus on one or a few things that are of real interest to you.

Simple ideas for dog-related resolutions are plentiful. Here are 10 possibilities.

1. Leave that cell phone in your pocket on walks so that you are truly present and spending time with your dog. It’s the time you spend together that builds the relationship, and this is one of the easiest ways to enjoy each other’s company.

2. Try a new activity with your dog. Classes in agility, tracking, fly ball are common in many areas. Hiking, weight pulling, dock jumping, herding, lure coursing and canine freestyle are just a few of the other possibilities.

3. Provide better nutrition for your dog. This is a big task for most of us, but even a few simple steps can make a difference. Try a higher quality dog food, add fresh vegetables to your dog’s diet or vow to measure your dog’s food for every meal so there’s no risk of overfeeding.

4. Give back to the canine community. There are so many ways to help out such as walking an elderly neighbor’s dog, volunteering at a shelter or rescue, fostering a dog, or giving money to an organization that improves the lives of animals.

5. Teach your dog something new. Practical training skills such as walking nicely on a leash, waiting at the door or a solid stay all pay big dividends. Other possibilities are to teach your dog a new game so you can play together more. Fetch, tug, find it, hide and seek, and chase games are all options, though depending on your dog, not every game may be a good fit.

6. Make plans for your dog in the event that you die first. Financial planning so you can provide for your dog when you are no longer here as well as making arrangements for someone to be the guardian for your dog are two important steps.

7. Give your dog more exercise. This can be daunting so plan to make one small improvement to start. Perhaps add 10 minutes to a weekend walk or set up a play date with a dog buddy a couple of times a month. When it comes to increasing activity, every little bit helps, so taking one step in the right direction is a wonderful goal at this, or any, time of year.

8. Take better care of your dog’s teeth. Consult with your veterinarian about a dental cleaning or about brushing at home. Dental care helps improve overall health and can make your dog’s breath more pleasant, too.

9. Make plans in case of a medical emergency. Whether it is putting aside a little in savings each month or investigating pet insurance, the peace of mind that you’ve got it covered in the event of an emergency is worth a lot.

10. Go new places with your pet. Novelty is great fun for most dogs, so try to go a few new places this year. Perhaps a new pet store or a new hiking trail will provide your dog with an experience that is really enjoyable.

Love them or hate them, New Year’s resolutions are common this time of year. Do your plans for 2014 include any dog-oriented New Year’s resolutions?

A slice of Oregon forest, a fragrant eight-foot noble pine, reigns over our living room in Southern California. I drape the boughs with a final string of lights—silly plastic teddy bears I’ve had for years—and step down from the ladder. It’s growing late on a Sunday afternoon. Our favorite Frank Sinatra carols are playing, scalloped potatoes are bubbling in the oven and the sun is going down over the Pacific Ocean. I’ve been looking forward to this: relaxing in front of the fire, the room lit only by the tree. I should have known better.

Recently, as the days shorten and the curtain of light falls earlier—at four o’clock, now three—Fromer, our 15-year-old Yorkie, goes bonkers! It’s as if the dark sets him off. Now he’s on the floor between my husband and myself, and his ballistic barking drowns out even the roar of the surf.

Five months ago he was diagnosed with terminal renal failure, and given two weeks to live. The vet said I should consider myself his hospice worker. (I don’t know about you, but a hospice worker to a dog was a new one for me.) I gave him subcutaneous fluids, fine-tuned his medications and administered pot roast aromatherapy. By October, my little hospice patient was skipping through the house. The vet cautioned me that Fromer still had renal disease; he was just “temporarily stabilized.”

So, our days were OK; the evenings were something else.

Like a young child squalling over a bogeyman only he can see, at night Fromer got spooked. On this December evening, I forego the pleasure of enjoying the room lit only by the Christmas tree, and switch on every light inside and out. He seems to calm down, but he is licking his paws so feverishly they will be raw if he keeps it up. His tommy- gun barking starts again. Night has turned him into Fromster-the-terrorist-terrier, an impossible-to-please elderly relative.

I poke at the embers to keep the fire from dying out, while Fromer totters off, whimpering in and out the dog door—flap! flap! out, flap! flap! in—the rest of the evening. Until we pack it in and head upstairs. Then he peters out.

When I originally mentioned these symptoms to Stephen Ettinger, our vet, I didn’t get much satisfaction. Dr. Ettinger is an internist, cardiologist and co-author of The Textbook of Veterinary Internal Medicine, said, “Maybe it’s neurological, or he’s cold, or it might be his eyesight.” He reminded me that Fromer’s eyes were failing, making it harder for him to see when the light goes. He didn’t offer any therapeutic help to deal with the situation.

By accident, I stumbled on a Newsweek article (Jan. 31, 2000), “Coping with Darkness,” revolutionary new approaches in providing care to people with Alzheimer’s. The article described how Alzheimer’s patients can become increasingly agitated at the end of the day, and how light is especially important to them in the late afternoon and early evening. Although Fromer hadn’t been diagnosed with Alzheimer’s—dogs also suffer from this disease—the early nights of winter had brought on a behavior in my dog that exactly matched the symptoms of some Alzheimer’s patients.

Now I had a name for what I’d been observing: sundowning. And a definition: According to Harvard Medical School, Department of Psychiatry, sundowning is a syndrome in Alzheimer’s patients of recurring confusion and increased agitation in the late afternoon or early evening. A sundowner is a patient who sundowns.

One antidote to sundowning is increasing the light to eliminate frightening shadows. Except increased illumination only helps patients with intact vision. That explains why flooding rooms with light did not soothe my geriatric friend.

This is now our second Christmas without Fromer. As I untangle those silly teddy bear lights, I remember those awful winter nights, and wonder what I might have done differently.

A half-dozen vets I have spoken with since then say they have never come across sundowning in veterinary literature. They offer replies similar to Allen M. Schoen’s, D.V.M., author of Kindred Spirits, “I am not familiar with the syndrome.”

Until I reach Nicholas Dodman, Director of the Behavior Clinic at Tufts University School of Veterinary Medicine. Dr. Dodman says, “I think you’ve struck on something.”

He explains that this behavior has sort of been recognized but under the global term of sleep disturbance, which is one-quarter of the diagnostic criteria for canine Alzheimer’s. “Did Fromer have canine Alzheimer’s?” asks Dodman. “I would say from what you’ve told me—I never examined him—almost certainly, yes. Since sundowning is a part of Alzheimer’s in people, why wouldn’t it be in dogs as well?”

Johnny Hoskins, a small-animal internal medicine consultant with a specialty in geriatrics and pediatrics, agrees. “I believe dogs go through similar changes as humans as they age.” Dr. Hoskins explains there are certain triggers in older animals when they start having behavioral–mental changes. “In your animal the trigger just happened to be when it was getting dark.”

Dodman says this is the first time he’s heard of this association with dogs and the day/ night junction. He thinks it’s helpful because it adds another layer of detail to nocturnal disturbance syndrome. “It makes it easier for people to recognize and it’s a very clear- cut sign: As light is fading, some dogs, not all dogs, because not all dogs do everything with any disease, but some dogs with canine Alzheimer’s may, when light falls, become even more confused, and upset, and that can lead to this hysterical behavior: barking, pacing, inconsolability. Sundowning. I think that’s a very nice addition to the canine Alzheimer’s syndrome, which previously was just painted as a late-night, throughout the night, problem.”

Dodman explains that vets don’t have a good handle in this area. “They know there are sleep disturbances. But what precisely are they? Vets think that means when the owner goes to sleep at night the dog wakes up and barks and paces. Sundowning makes it more subtle, and more akin to the human syndrome, and it sounds perfectly reasonable.”

Now that we have a definition and a basis for diagnosis, is there a treatment in the canine population? Dr. Hoskins cautions that since there are so many neurotransmitters in the brain, a dog owner should not expect that one single medication will handle all the behavioral-mental changes in his animal. It’s way too late for Monday morning quarterbacking with Fromer, but perhaps others who are currently caretaking an elderly dog will find that these medical suggestions (see sidebar) can make sundowning more understandable and less of a downer.

Canine compulsive disorders (CCDs) take many forms and are generally considered to be behavioral issues. However, recent studies suggest that at least two of them—“excessive licking of surfaces” (ELS) and “fly-biting syndrome,” in which a dog appears to stare at something and suddenly snaps at it—may be related to underlying health issues. Both studies were conducted by researchers associated with the University of Montréal Veterinary Teaching Hospital.

The first set out to investigate surface-licking behaviors to see if there was a medical component: “The objectives of our prospective clinical study were to characterize ELS behavior in dogs and to examine the extent to which it may be a sign of an underlying gastrointestinal (GI) pathology as opposed to a primarily behavioral concern.”

Researchers looked at 19 dogs, 16 of whom exhibited this behavior daily. This group was compared with a control group of 10 healthy (i.e., non-ELS) dogs. Complete medical and behavioral histories were collected for all dogs. The medical evaluation revealed that 14 of the 19 ELS dogs had GI abnormalities; treatment of the underlying GI disorder resulted in significant improvement in a majority of dogs in the ELS group.

The second study examined seven dogs with a history of daily fly-biting behavior. As the researchers noted, “Fly-biting dogs are generally referred to neurologists or behaviorists because the abnormalities are often interpreted as focal seizures or as obsessive-compulsive disorder (OCD).”

As in the ELS study, these dogs were given complete medical examinations and were filmed to determine if the behavior was perhaps more prevalent after eating. The video analyses revealed a significant finding: all of the dogs demonstrated head-raising and neck extension, which can be an indicator of esophageal discomfort, prior to fly-biting.

All of the dogs in this study were found to have a GI abnormality, and one was also diagnosed with Chiari malformation (a brain/skull disorder). The dogs were treated for their medical conditions, and four had complete resolutions of the fly-biting behavior. The authors of this study concluded, “The data indicate that fly-biting may be caused by an underlying medical disorder, GI disease being the most common.”

As Marty Goldstein, DVM, observed in a post related to this research, “These studies don’t mean that primary obsessive/compulsive behavioral issues don’t exist, because they do … [But] if you have a pet with obsessive/compulsive disorders, don’t jump to psychoactive medications before exploring the use of food-allergy testing, changes in diet, and digestive enzymes and probiotics that can repair a damaged GI tract.”