pet connection

(Cross-posted from my personal blog at GoodFaithRanch.com)

A few weeks ago my 14-year-old Sheltie, Drew, started to increase his drinking and decrease his eating. Shortly after, my veterinarians confirmed my sad suspicion: My dog’s kidneys were shutting down.

As deaths go, kidney failure isn’t a bad one. A couple years ago my father faced the choice of dying of kidney failure or liver cancer, and after being completely informed about them both, he chose the former and refused dialysis. He passed peacefully at home a few days later, and I’m still in awe of his brave decision to choose the time, place and manner of his demise.

Of course, that’s what many of us do with our companion animals, and I’ve seen enough people bungle the decision to know how difficult it is. Over the years I’ve made the decision for all of my own animals and a few belonging to friends and family. I’ve come to believe that I won’t personally make a Hail Mary pass for myself or anyone else, animals included, and that I would rather help an animal to the other side a week early than a minute too late.

That said, I truly believe in hospice. For people and for pets.

I recently wrote for Vetstreet about the hospice movement in veterinary medicine, focusing on Nancy Hurley, a woman who had cared for her own 14-year-old Sheltie for months after a diagnosis of cancer in the dog. She and her husband had to have Savannah euthanized on the day Drew entered a state of hospice, a situation which I found incredibly powerful, as if Savannah’s fight had moved across the country to my own dog.

Hospice is often about managing pain, and I’m glad that I’m not having to do that with Drew. I went through it with my retriever Heather a couple years ago, and it wasn’t easy for either of us. Like Savannah, Heather had cancer, and like Savannah, I had to let Heather go when we couldn’t control the pain any more.

For Drew, hospice is considerably less stressful. Every morning he gets 500 ml of IV fluids, delivered from a bag hung from my dining-room chandelier through a needle to a spot under the skin and over his shoulder blades (top picture, but you have to squint a little to see the clear IV bag). Drew usually falls asleep on a towel on the table while getting his fluids, a process which, thanks to a nifty product called a pressure infuser, takes just a few minutes. A couple weeks after starting with daily fluids, Drew’s kidney values are normal. It won’t last, I’m told, but it was very good news indeed to get last week.

While Drewbie doesn’t mind the fluids at all, we are having one hospice difficulty: Getting him to eat. Pets (and people, for that matter) with end-stage kidney disease typically don’t have an appetite, and not eating can hasten their deaths — rather quickly, I’m told.

Drew is on a prescription appetite stimulant, but it doesn’t seem to help much. He is also getting a little medicinal marijuana (legal here in California), which appears to help with nausea but not with appetite, at least for Drew.

Typically, he’ll eat a little of something really yummy for a couple of days, then stop. Rare roast beef, deli turkey, yogurt with peach slices, beef lasagne, pasta with beef balls, cheese, baby food, apple slices with peanut butter … I’ve been rotating through them all. I’m afraid the other dogs and I will put on some weight snarfing down the leftovers when Drew walks away from something he ate happily the day before.

Friday night, my housemate (Ed Murrieta, who’s a writer and a trained chef) made him a special meatloaf, after Drew showed enthusiasm for store-bought meatloaf from the Whole Foods takeaway counter. That’s a picture of it. It’s made from ground turkey, Honest Kitchen‘s Embark dehydrated raw food and Nuzzles treats, eggs, and my friend Jill Gibbs’ JillCookies, chopped fresh tomatoes, grated apple, and cheese.

Today, Ed’s experimenting with some sort of baked liver puree.

So far, so good …

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IV fluids are amazing. Just a few days after I started giving Drew fluids at home he started feeling much better, and his lab values improved dramatically. Eating is still a problem, and I suspect it will become THE problem as time goes on. So far, all he’ll eat is cheese, yoghurt, slices of peaches or apples, bread with butter and, occasionally, a little chicken and pasta. He’s going to the alternative med veterinarian next week to see if she can help him as well.

In the meantime, he’s truly enjoying his life. Yesterday my friend Ann and I went to the barn to give my two horses a spa treatment. Drew got to hang out, and loved it.

Image: Ann and Bentley, with Drew.

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This morning I woke up realizing that this blog and my 14-year-old Sheltie are in the same place: Dying gracefully, and not in any real hurry to go.

The story on our blog moving  you know already. The story of Drew … here you go:

Drew, a/k/a Drewbie a/k/a The Drewbinator, came into my life about a decade ago, after the death of my 15-year-old Sheltie, Andy.

I had figured Andy for the last of a long line of Shelties.  While I had shared my life with Shelties for many years and had run the local Sheltie rescue for a time, I had long since migrated towards the sporting breeds by the time Andy died. But then I met Drew.

He’d come back to my friend Tami, who bred him, after bouncing through a couple of homes for reasons no one could ever figure, since Drew was — and is — perfect in all ways. He’s friendly to all (not a given in this breed, which tends to distrust strangers), beautiful and well-mannered. I was visiting Tami when Drewbie danced over to me, put two perfect white paws on my knee and looked me right in the eyes.

“Who is this?” I said.

“Drew. I need to find a home for him,” said Tami.

“You just did,” I said.

***

Drew hasn’t set a paw wrong since. He has charmed every person who has ever met him, behaved beautifully in every situation and been a healthy, happy and well-loved member of the family here since the day he arrived. The worst health problem he has had until now is going deaf. That happened so gradually I can’t even tell you for sure when it happened. Drew is so bright and observant that although I guessed he was hard of hearing, I had no idea that he was completely deaf until he went to stay with my friend Susan Fox while I was on the national book tour. In his own home, Drewbie could “fake it.” In a new environment, however, his disability was more obvious. Not that it mattered to him and everyone who loves him … which is to say, everyone he meets.

About a month ago, Drew started getting picky about his eating, and his thirst increased. After a couple rounds of veterinary visits and diagnostic rule-outs, the only thing left was bad news: Kidney failure. Terminal.

The grim diagnosis came on the day when another 14-year-old Sheltie died, one I’d written about in relation to the idea of home hospice for pets to sustain a high quality life for those who can be treated but not cured. The day Savannah crossed the Rainbow Bridge, Drew took her place on the riverbank.

So far, so good. Drew gets IV fluids at home twice a day, and an appetite stimulant to get him to eat a little more. After a couple of days the fluids had a profound impact and now Drew is feeling very, very good, and although still very picky about what he eats, will happily eat enough chicken, pasta, tripe and peaches to prevent death from starvation. He doesn’t mind getting hydrated at all, especially since it’s a chance to be the absolute center of my attention for 15-20 minutes twice a day. The IV bags hang from my dining room chandelier, and I’m feeling optimistic enough about Drewbie to order a case of supplies.

It’s a sweet time for us both, really.

I don’t know how long this site will be here, and I don’t know how long Drew will be here, either. For now, that’s just fine with me.

In the meantime, the Lorem ipsum is up on my new personal site, and blogging of a more personal and generalized nature will start there soon.

Top image: Drew from a few years ago. Bottom image: Drew this week, with the IV bag hanging from the chandelier behind him.

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In the epitome of irony, I was writing an article about post-op care that includes the Dostoyevsky-spun line “Inadequate restriction of activity is the most common cause of post-operative complications and increased veterinary visits and costs” when I had to restrict my dog’s activity after a wee bit of his paw pad was removed last week.

Three sutures on a foot equal 10 days of hell.

He’d been licking the bottom of his right front paw for too long, licked it right into a staph infection that took two courses of antibiotics to clear up. A week later he was licking it again.

“Let’s take a look,” said my vet.

And for some odd reason, in no corner of my brain did that translate to “biopsy” or “sutures” or “we’re going to take a chunk and maybe look at it under a microscope.” The only thing my brain received was “we’re going look at it.” We can register last Thursday as one of my low IQ days. We’re all allowed to have a few.

Given that he is certain that every visit to the clinic is another opportunity for them to remove his spleen without anesthesia while he waits in the lobby, he cannot go near the clinic without falling apart. He shivers as we pull into the parking lot. He assumes they will remove his spleen without anesthesia. Had I realized there was a possibility of his being restricted to a leash for 10 days, I would have been appropriately prepared. I would have been neurotic and gnashing my teeth with worry, not about what’s wrong with his foot, but about how the heck we would get through 10 days without running 27 miles a day in the back yard plus going to the dog park for a “real” run.

So imagine my low- IQ surprise when he walked out with a bandaged paw and instructions not to let him outside without a leash for 10 days. She found some slightly thickened, inflamed flesh that was probably an ingrown hair follicle, and removed it, resulting in the Three Sutures from Hell. I would have been right to be neurotic.

At first he wouldn’t pee or poop on a leash. That was fun. There I was at 11 at night and then 6 in the morning, 12 hours since he’d last peed, and no leg lifting was in sight. Isn’t this one of the reasons you get boy dogs? You’re supposed to have business done and over with in no time, get urine samples the moment you lift the thingie (technical term). I thought their peeing was an involuntary behavior, like breathing: if you’re outside, you pee.
He finally peed in the back yard while on a leash.

Then there was that bag on the foot thing. Of course it rained like crazy for the next few days. The bandage only had to stay on a couple of days, but they said to keep bagging it to keep the sutures dry. He was terrified of the plastic bag, and we had one rather unpleasant discussion about it, but he finally got used to it. His bandage got wet because the first time we went out I looked behind me and the plastic bag was 40 feet away.

I know the sound of a hollow laugh, and I’m pretty sure it’s coming from me.

So here’s what I learned.

1) Use a ziplock bag over a foot. Don’t put it on until just before you go outside.
2) Keep it on with a rubber band; remove the rubber band immediately after you come back in to prevent damage.
3) Some pet “experts” don’t know squat because it’s all intellectual knowledge rather than hands-on experience.
4) Some boys just won’t pee when you want them to.
5) It’s not right to sedate him just because he’s bouncing off the ceiling, but Valium really, really works for me.

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Picking up from the comments for an open thread …

Since we’ll be around a bit longer, I’d like to know: What are your all-time favorite posts here?

I have a few. Off the top of my head I like this one of mine:

If only people knew what good breeders do

And this one of Christie’s:

Poop in food: What’s up with that?

I’m going to go through and pull some others to put in the comments, but I bet those two are the ones I’ve linked to most often.

You?

***

And you want controversy? OK, here you go:

Faith is wearing an electronic collar in the picture below. Doesn’t she look miserable? This is about 30 minutes into a two-hour ride this morning, poor thing. (And yes, I bought a horse. I’ve desperately wanted my own horse since I was three years old, and now I am kicking myself for having waited 5o years. He’s an 8-year-old gaited trail horse gelding, name of Patrick. Well-trained and well-mannered. An absolute pleasure to ride. I love him.)

No, I’m not training Faith with an e-collar. It’s there to remind her of what she knows, if she needs to be reminded.  She knows “here” perfectly well, and responds to it 99.99 percent of the time. But when we’re on the bridle trail, that’s not good enough. A failure to come when called .01 percent of the time on a bridle trail that’s 500 yards from a street could be deadly. So …there’s an e-collar on her and it’s turned on to a very low setting. She understands the command “here,”  and she had been nicked a couple of times in the last two months for not responding, but not recently, and not since I started taking her out to ride with me.

Choices:

1) Leave her home. Sure, but she loves going out on the trail, and she really, really needs the exercise to stay sane.

2) Put a long line on her. That ruins the ride for all three of us, and it’s dangerous: It could get her, me and the horse hurt or killed when Patrick trips over it or gets otherwise tangled.

3) Use a very low-level “nick” from an e-collar to remind her if I need to that there are consequences for ignoring a command she damn well knows and knows well.

Seems like a no-brainer to me. But then, see, I am one of those people who believes an e-collar is a tool, not an instrument of torture that should be banned and its proponents sent to jail for animal cruelty. I believe that someone who knows what she’s doing with this tool is perfectly fine in using it. And that someone who doesn’t bother to learn how to use it or who uses it incorrectly is not.

I also believe that someone who uses a head halter and a reel-type leash — which I see all the freakin’ time and no one ever says a thing — is putting a dog at more risk of pain or injury than I ever have or ever will. Tools used incorrectly are dangerous, no matter now well-intentioned their design or intended use.

This morning the three of us were on the trail for two incredible, beautiful hours. We had the greatest time ever and not once — not once — did I need to do anything more than ask Faith “here” in a normal voice one time and one time only when she ranged a little too far afield. She turned and happily raced back every time I asked. I’m not even sure she remembered after a little while that she had an e-collar on, although she knows what it does and when it does it.

She also responded beautifully to “sit,” “down