So this is not a fun post, but I do promise one little funny bit before it ends, if you’ll hang in there with me. Okay? Okay.
Six years ago we added Duncan to our family, and he has been an inordinate pain in our collective backsides ever since. He was older than we were told, he was sicker than we were told, and while I firmly believe I could pick Licorice up and twist her into a pretzel without so much as a single growl from her, Duncan has never, ever hesitated to show you displeasure with his (freakishly strong) teeth, and in the first two days he lived with us, he’d bitten three out of four family members hard enough to draw blood. He has allergies. His skin is sensitive. He’s hypoglycemic and prone to growths and no, I absolutely will NOT add up what this dog has cost us over the years because it defies my frugal sensibilities, defies any logic whatsoever. This damn dog has been sick and/or worrisome for most of the time we’ve owned him and just a few months ago capped it off with a you-could’ve-bought-a-car-instead level stay at the local vet hospital.
Through it all, I’ve said he was on borrowed time. I said I’d be happy with whatever time he has left, because he was, after all, our undead zombie dog, the dog who came to us having had a hard life, but learning the magic of being spoiled rotten, and whatever we could give him, however happy we could make him in whatever time he had, that would be enough. But I’m a liar.
I really thought I’d be okay. It turns out that I’m okay with it in THEORY, but not quite so much in PRACTICE.
It went like this: Duncan has been slowing down over the last few months, sure. Dude is around 13, now, so that’s not unexpected. He stopped playing with toys, but he’d only really ever played for short stints, anyway, so okay. Then came the nightly borkening and subsequent vet visit while we tried to figure out if he was sundowning or what, and the steroid taper the vet put him on did wonders, so then we knew there was some sort of inflammatory SOMETHING happening. I mentioned in that post that the longer we came out from the taper, the more he was returning to his old behavior, so clearly we needed to do something else.
But then… he stopped barking so much at night. He started sleeping more, which seems impossible when you consider that he was already sleeping most of the day. He went back to that weird gaggy cough any time you picked him up. But he didn’t seem to be in distress…? So I kept saying “I should take him back to the vet sometime” but I didn’t call because reasons and busy and then after a few days it was Friday and I thought “Well heck, if I don’t bring him in today, it’ll be the weekend and something will happen, I should call.” So I made him an appointment for Friday afternoon when he seemed a little lethargic on Friday morning. I went about my business and by the time it was time to bring him in, his breathing sounded funny. Labored. Well, good thing he had an appointment, and good thing Monkey was here to help me with him, too. Off to the vet we went.
The vet listened to him a bunch with his stethoscope and then he brought in a couple of students to listen to him, which was when I knew this was going to be Not Good. “I just need to go check my notes real quick,” the vet said, and I said WHY? more sharply than I maybe intended to, and he said, “His heart murmur sounds worse to me but I want to see what I wrote down before.”
He came back and said yes, it was definitely worse, he’d like to do some x-rays to look at his heart, was that okay? I said sure. They took him away and after a while they called us back and the vet started talking to me about the films while one of his students held Duncan, who had just been held down for scans and was Pretty Pissed. Halfway through pointing out something, the vet glance at the student and then said in the CALMEST VOICE IMAGINABLE particularly given what he was saying, “Hey, he’s looking kind of blue. Go give him some oxygen.” I turned around and Duncan’s tongue was indeed blue. He was panting heavily.
I am not calm, in fact my fantasy band name is Don’t Tell Me To Calm Down, so I commenced freaking out, whereupon the vet was all “It’s fine, he’s pinking right up, I can see him from here” and that was true (in spite of Duncan trying very hard to move away from the little cup blowing oxygen in his face) so I tried to calm down and listen to what he was telling us about the x-rays, which basically boiled down to “I see a lot of fluid here, it’s compressing his lung function, P.S. this looks like congestive heart failure but let’s schedule you at the speciality vet next week to find out more.”
Our vet also gave us some meds that should help, and he said we should be able to see “pretty quickly” if he was responding well to them. I did ask, before we left, “What do I do if he turns blue like that again?” and the vet’s answer was “Oh, just try to keep him calm and unstressed. Probably won’t happen, but if it does, really just being still and relaxing should bring him back to normal.” On the one hand that makes sense but on the other (in retrospect), he’s just told me Duncan’s lungs are compromised and when people turn blue do we say “just relax” as a solution? WE DO NOT. (DON’T TELL ME TO CALM DOWN.)
Mind you, on Thursday it was “I should call the vet sometime” and Friday morning it was “he seems to be breathing a little hard” and by appointment time he managed to turn blue, so this was a Very Rapid Progression and perhaps (again, in retrospect) we all should’ve paid more attention to that, but hindsight is 20/20 blah blah blah.
Chickadee came home to see Duncan. She didn’t have time, and I told her to stay at school, but she insisted. Licorice is hands down her favorite but it turns out that she isn’t nearly as indifferent to Duncan as I might have thought.
On Saturday, he slept in. Duncan never sleeps in. His breathing was still audibly labored, but he toddled to his food when called and then back to napping and Otto and I made worried eyes at each other over his back and said we would take him back to the vet first thing Monday morning if nothing changed. He took the pills but that whole “working pretty quickly” thing didn’t seem to be materializing.
The good news is that Sunday, things changed! The bad news is that these were not good changes. He stopped eating. Never in the history of the six years we’ve had this dog has he refused food. NEVER. Not even when he was experiencing intestinal distress. Refusing food meant we couldn’t give him the meds. And his breathing got even faster/shallower/harder. I had a bunch of couldn’t-be-changed stuff scheduled on Sunday so I left Otto and Chickie looking over Duncan while I went on my way, trying not to think about the fact that my dog was dying, knowing that he was in good hands and besides, we were going to take him to the vet first thing the next morning.
I arrived home after Chickadee headed back to school to find Duncan and Otto lying on the floor of my office together. Otto reported that there had been a few coughing/gagging incidents that had all resolved in about a minute or so. But when I walked in, Duncan was happy to see me, so he tried to sit up and started coughing and coughing and a minute passed and he was still going. Then another minute. It seemed like he couldn’t catch his breath. Finally we looked at each other—we’d already had the discussion about How Much Heroics and Money Will We Do and agreed that we were not going to put Duncan through anything invasive, but the problem was that he was suffering. He couldn’t catch his breath. In an instant we knew there was no choice, and up we popped, one of us grabbing a towel, one of us grabbing him, we piled into the car and Otto drove faster than I’ve ever seen him drive. By the time my amazing softie of a husband drove into the DO NOT ENTER side of the vet hospital ER driveway, Duncan’s whole tongue and muzzle were blue and I wasn’t even sure he was still breathing. His mouth was going but I couldn’t feel his sides moving. I was crying. I ran inside with him and yelled I NEED HELP like I was in my very own terrible Hallmark movie. And the girl at the desk leapt up and smashed the giant CODE button on the wall and two people fairly flew out a nearby door and grabbed Duncan while I sobbed HE NEEDS OXYGEN.
Really not how I’d seen my weekend going.
Might I recommend, if you own animals, that you live close to one of the best vet hospitals in the country? I thought he was dead. I really, truly, thought we had waited too long and he had died in my arms in the car in terrible pain and distress and it was somehow all my fault and I’d be haunted forever. But we filled out paperwork and gave a history to the vet who came out to get it (by this I mean, Otto gave the history while I sniffled and sobbed) and we gave permission for bloodwork and then sat there and waited a looooong time. On the one hand, it felt like forever, but on the other, every minute we sat there and no one came out and said, “I’m so sorry,” that meant he was still alive.
Finally we were moved to a private room where they have you do the financial paperwork, and told us we could see him after that was done. “Is he… okay?” I managed to squeak out. I mean, we’d been there for an hour and I had only just stopped crying about five minutes before that.
“Oh yes, he’s perked up considerably.” This was baffling to me, but good. We finished the paperwork and were led into another room, whereupon we discovered that if a dog needs continuous oxygen, you simply put him in a special box. An Oxygen Box. OxBox!
We got to open the little portal door there and give him some scritches before we had to leave. He kept opening and closing his mouth like a little goldfish, and I finally asked the vet why he was doing that. She said something about how even though he’s getting enough oxygen now they tend to “gulp” when they’re having trouble breathing. I liked my explanation better, which was that he realized he was in a fish tank and just wanted to play the part. (I did not share this with the vet, but I did tell Otto, later.) Duncan would be having a full cardiac workup later that night or first thing the next day, and they would call us if anything changed, but in the meantime the box would help keep him oxygenated and we shouldn’t worry.
The good news is that Duncan’s worsened murmur is NOT due to congestive heart failure. In fact, we were told his heart looks “remarkably good” and he’s not in congestive heart failure at all! (ROLLERCOASTER! DON’T TELL ME TO CALM DOWN!) The bad news is that he has a severe case of pulmonary hypertension, meaning the blood pressure in his lungs is way, wayyyyyy too high, hence the breathing difficulties.
There are multiple possible causes for pulmonary hypertension, and we don’t know why it happened to Duncan. Here’s the funny bit you’ve been waiting for: the first-line treatment for pulmonary hypertension is… Viagra. No joke! Except ALL the jokes, because if you think we haven’t been cracking up over the notion of little doggie boners for days, you don’t know us very well. When the vet called on Monday they said they wanted to try the Viagra to see how he would respond, and they’d let us know. His response was good and they were able to turn down the level of oxygen in his box, so then by the NEXT night the challenge was to see whether he was okay with just room air all night. He was! On Wednesday they called to say I could pick him up and bring him home, and I couldn’t believe it.
Of course I had like an hour of waiting/paying/waiting before a vet came in to talk to me, and I was just wanting to see my dog, you know? But there were things to go over and of course that metaphorical needle-across-the-record screech when the vet said, “This is an end of life condition.”
“But he’s responding to the meds. He’s coming home,” I said, stupidly, like maybe if I argued he would change his mind.
“The meds will work for a while. And we may be able to do some adjusting, plus there are other meds we can try. But this is a condition where you’ll need to make some decisions ahead of time.”
Maximum life expectancy post-diagnosis: 1 year. Typical life expectancy post-diagnosis: 2-6 months.
So we talked about options and end of life care, and I didn’t even cry (probably because I was sort of in shock) and when he got to the part about how we should come in for a follow-up visit with him in 3 months, I looked at him and said, “Is he going to be alive in 3 months, do you think?”
He said he didn’t know. He reiterated that his case is severe.
We are home. Duncan sleeps in ZOMGTHEBIGBED with us now, every night he asks (so far he has asked every night), and Otto—who has never liked having a dog in the bed—is the one who gently lifts him up and tucks him in. The first day home he wouldn’t eat a thing, and yesterday we tempted him with bits of his favorite people food, to mixed results. Of course I’ve discovered that he’ll eat bacon no matter what, which led to another issue (ahem) and now I’m trying to get him to eat rice flavored with broth, but the dog who once ran off with a banana peel and ate half of it while we wrestled it from his maw never takes more than a bite or two of anything, so far. We’ll see how today goes, but his hypoglycemia diet is 1/4 cup of kibble every 4 hours from 6:00 am to 10:00 pm, and currently it’s nearly 11:00 am and I practically had to shove the morning piece of bacon laced with meds down his throat to get him to take it. Maybe he’ll eat at 2:00.
I think he knows. I think he’s ready.
I sure wish I was.