On Convalescing A (maybe) Dying Animal
She seemed depressed, but I didn’t think much of it. Mark had been away for a month in India, and while he was there I had her at daycare every weekday afternoon. Monday through Friday as I wrote proposals and reviewed business plans, she romped with friends, barked in a dog chorus, and took naps on overstuffed leather couches. Now that Mark was home and able to take her on mid-day walks, the trips to the Hound Lounge stopped. I assumed her subdued attitude was her way of communicating that she missed her friends, sleeping on couches, and running laps in the back enclosure.
About a week after I noticed her changed mood, Mark called me at work: I think the dog might be sick. I might take her to the vet tomorrow. He called back an hour and a half later: The dog’s refusing to go for a walk. I’m taking her in now.
That was six weeks ago.
No vets at the clinic were available on such short notice, only techs, and one of them checked Dasha’s vitals. He noticed a fever, but noting else out of the ordinary, and sent Mark and Dasha home with an appointment to see the vet the next day.
After the visit with the tech Dasha stopped eating—even Mark’s scrambled eggs. I picked up a roast chicken on the way home from work and tried to hand fed it to her as she lay on the floor. She reluctantly obliged. (I’ve always been her favorite.)
Mark took Dasha to her appointment the next day and two blood tests later we learned that she had immune mediated hemolytic anemia (IMHA). Her body had decided to attack and kill off her red blood cells. This made her weak and generally unwell.
There’s two ways the sickness comes to be: primary or secondary. If it’s primary, the disease happens on its own for its own reason. If it’s secondary it’s a response to a different disease, most commonly cancer, and treating the IMHA won’t do much good because the cancer will still be in there doing it’s thing. Wanting to know what we were up against, Mark and I agreed to the vet’s request for an x-ray to look for masses. The photographs didn’t show any obvious tumors, but they did show an unually large — though not misshapen — spleen. After the x-rays came an ultrasound to get a good look at the jumbo organ, and it appeared normal. The vet aspirated it to confirm the visual results.
The vet kept Dasha at the clinic for observation and warned us that she might need a blood transfusion if she didn’t stabilize quickly. Mark and I talked about it, and decided that if it came to that, we wouldn’t consent.
A day later Dasha was out of immediate danger and it was time to take her home. We needed medicine from the vet pharmacy (predinisone), the people pharmacy (azathioprine), and the drugstore (aspirin, famotidine, melatonin, and live bacteria cultures). We fed her the pills with more chicken, put some kibble in her bowl, and waited.
The mortality rate for IMHA is 50% at one year. Not even the odds were willing to give us a hint about how this would end.
As I cut a baby aspirin into quarters, Mark and I reviewed the bills. At this point, the sum was just under $1,000. I noticed that the vet charged us $18 for the ultrasound — an almost unbelievably reasonable price — and launched into a rage at the cost of health care for people.
Her second day at home, Dasha started to improve and we got excited. A few days later, the side effects of the steroids started to obviously set in and the excitement waned.
Even though the vet pumped her full of subcutaneous fluids, she was drinking A TON. We assumed the wet spots on her hips and the floor were from the fluid leaking out through the needle holes. But after a day or two she wasn’t puffy with fluid any more and her hips were still wet in the mornings. Three nights later she urinated on three different spots in our bed. That’s when we realized she was so weak that she wasn’t waking in the night to urinate — she was going in her sleep. The carpet and her fur had been soaking up urine for days.
Mark rented a carpet cleaner. I brought the bedding to the laundry mat. The owner of the laundry mat argued with me about how much soap I should put in the machine. I tried to explain that it’s special soap for down (we bought it last spring for the sleeping bags and jackets) and the instructions on the back say to use half of the bottle. He wouldn’t believe me; he was adement. I cowered and used an inappropriate amount of soap. To compensate I washed the bedding a second time.
While the bedding was in the wash I took Dasha to the Pet Zoo to shampoo her in the you-wash-it tub. But first we made a pit stop at the scale. She weighed in at 83 pounds. Dasha has LOTS of fur so it was hard to tell, but she had lost 11% of her body weight in a week.
As I sudsed up her hind quarters the water that spilled off was the color of dark urine and it didn’t turn clear … well … for what I remember as a minute. It was so dark I checked to see if she was going to the bathroom while I washed her, but she wasn’t.
My dog was a urine sponge. I was a failure.
We had to set our alarms — and are still setting them — in three hour intervals so we can wake her and take her out. It’s exhausing but it works; we haven’t had any more nighttime accidents. The steroids make her very weak, and the stairs are a challenge. But the steroids also make her ravenously hungry, so she’s famished. I keep a bag of beef liver jerkey on my nightstand and the sound of the bag opening wakes her — no matter the hour.
My game face isn’t as good as I’d like to think; throughout this process I had to tell some people in my life that it was happening. The first few vet visits were during the annual week of corporate meetings, and I was committed to two days off-site. I teared up during a lunch at the Embassy Suites and my co-workers were sympathetic. Unbelievably sympathetic, in fact. It made me feel guilty because I didn’t think I deserved the attention.
At this point the illness and the experience were fresh, so I was fielding the first round of questions. Most everyone’s questions were the same: What is it? How old is she? How long does the breed typically live? Is it a breed specific disease?
It’s an autoimmune disease. Her body is killing off her red blood cells.
Ten to fourteen years.
No. It’s most typical in middle-age spayed females. And that’s exactly what she is.
That second question — the age thing — came up a lot when my dad died, too. In that case when people asked I would hem a bit and pretend I was fuzzy on the specifics. I’d roll my eyes up and to the left and say: He was fifty … (pause) … And most times before I could get to: … he was born in ‘48 so I guess that makes him … (pause) … I would hear: Oh! I’m SO sorry. As if the experience would have been different if he was 20 years older. With Dasha, there wasn’t any extra sympathy when I told people her age.
Time pushed on and Dasha’s spirits improved. After a week hiatus, she started to wag her tail — just a little bit — and it made us cheer with relief. But after that, progress was slow.
A few days before Thanksgiving my maternal grandma died and I decided to fly home to Minneapolis for the funeral. In the days before I left, the situation with Dasha was grim, and when Mark and I went out for dinner the night before my flight we were silent. The server brought our beers and I looked down at the glass and spoke quietly: I think our dog will die soon. Mark agreed.
JT: When I’m back in Minneapolis, if you have to make a decision, I want you to know it will be the right one. Whatever it is. Promise.
MM: That’s tough, isn’t it? How do you know?
JT: I don’t know.
MM: What about logistics. Last time we talked about it you said you wanted to bury her in the back yard. Do you still want to do that?
JT: No. But I thought about it and I thought I was okay with the vet taking care of her remains, but it’s not okay if she ends up in the dump. We don’t have to keep her ashes forever in a creepy way like that Phillip Roth novel … we can scatter them up the south fork in the spring … but she can’t go to the dump.
When I was home for the funeral Dasha didn’t die. In fact, she improved.
During the past few weeks close friends and coworkers have continued to ask about Dasha’s health. I’m thankful for this, but secretly wish there was something more dramatic to report. Each day is physically and intellectually a lot like the one before, so a simple she’s in good spirits and not getting worse is my standard response. I say it with a smile. Sometimes I elaborate, She’s in good spirits, but is really weak from the steroids, so she can’t jump in the car or get in the bed. Both responses are accurate, but neither communicate the constant stress that’s hijacked my body. I want to tell people: I’m stuggling. I’m exhausted. This sucks. I want her to be better or worse. She’s weak and losing her fur and the farts are enough to suffocate us. One way or the other I want it to end. But saying that seems too dramatic and needy. So I don’t. And really, what if I did? Nothing would be different.
Mark and I have been married for 13 years, and at this point I’m pretty sure we’ll be married for quite a few more. Before Dasha was sick, I would have told you that Mark and I will grow old together — and the visual in my head would have been of a happy couple with grey hair and wrinkled faces, sharing a meal of soft foods at the kitchen table. Now that visual has changed. When I think of the future I see Mark with a pot belly and thinning hair. He’s weak and sick and I’m tending to him. I imagine the ways convalessing him will change our relationship, and then I stop imagining because it scares me.
At work we have a fantastic office manager: She’s great at her job, makes every employee feel like they matter, and never complains. She checks in regularly on Dasha’s status. Two weeks ago I told her that the steroids were making Dasha lose her fur, and that earlier that morning I noticed a bald spot on her chest and it made me cry.
The office manager sympathised and said, You should talk to our intern about that. Really. Two years ago she was sick and on steroids and lost all of her hair. You know how thick her pony tail is? She had nothing.
Suddenly I felt like a total ass hat. Our beautiful, amazing, friendly intern had been sick — I’m assuming very sick — at the age of 20 and lost her mop of gorgeous blond hair while her friends were healthy and strong and living like college kids. That sounds AWEFUL. And I’m crying over a bald spot on a dog.
That’s the thing about convelessing a dying animal: No matter how much you love your pet, or how much the experience of tending to illness overtakes your life, an animal is not a human. You don’t get permission — from others or from yourself — to feel it in the same way. Feelings for animals are supposed to be intense, but less intense than the feelings you have for people. That’s true even when you love your animal more than you love most people.
At this point, I probably don’t need to tell you that I love Dasha. Or that she’s been my constant companion for the past seven years. We’ve hiked mountains, drank from rivers with bears, and romped in the snow. She once protected me from a charging cow moose with a calf. And one time I held her close as we forded a swift river that was up to my chest — her body was caught in the current, and as I clenched the scruff of her neck her hind legs and body were pulled down the river behind me.
Dasha is my friend. And there’s a decent chance that in 10 months she’ll be dead. And that sucks.