Last week, I was 100% sure I would be having Otto euthanized at today’s appointment with a veterinarian who provides hospice and home-euthanasia services. I won’t beat around the bush; he’s still with us.
There was one important difference between last week and this: The “heat dome” that has kept California roasting for over a week finally broke, and temperatures dropped all the way down into the 80s, a welcome relief from a week with daily highs over 110°F. As dawn broke this morning, we even got a little spotty rain – bizarre for this area and this time of year, but welcome just the same.
As I said in my last post, Otto has never liked heat, and as an old guy, set in his ways, he was super grumpy about not being able to lay in his damp, shady sandbox outside. He didn’t want to be kept indoors (protected from the heat); he wanted to be outside, but outside was just awful! So he was extra miserable.
The veterinarian who came to my home today was impressed by Otto’s insistence at joining the scrum of dogs to greet her at my home-office door, even as young Boone and middle-aged Woody were knocking into him in their effusive greetings. She also was impressed by his intense interest in the treats I gave her to introduce herself to him. He’s also completely continent, in contrast to many of her other patients. Apparently, a lot of the dogs she sees in this type of practice are much closer to the end before their owners call her in, to the point where they won’t get up to greet someone, aren’t eating much, and are in diapers.
That made me feel a little bad; was I being over-anxious, pulling the trigger too soon? Maybe it’s the fact that I’ve been at the deathbed of loved ones – humans – who were in hospice care as well as those who were unable to receive hospice care for some reason; I just don’t want anyone I love to suffer before death. I’ve seen deathbed suffering; it’s ugly and unnecessary.
The doctor put some of my fears at ease. We discussed Otto’s panting, which I have interpreted as a symptom of pain and anxiety. She agreed that pain and anxiety could be a factor in his almost non-stop panting, but said something I’ve never heard before, that a lot of old dogs have enlarged livers (as I have been told Otto also has) and that as the liver enlarges, it pushes up against the diaphragm, and requires a little more forceful breathing.
She agreed that his front paws and elbows appear to be paining him quite a bit, and she could see how he has altered his posture to compensate, but thought that the amount of difficulty he shows in getting up from laying down is not too bad. As skinny as his thighs feel to me now, she thought his muscle tone was decent, given his age.
She also made me feel a bit better about the panic I was in last week. She said that a lot of old dogs have good days and bad days, and even good weeks and bad weeks, but that she often sees old dogs who look like they are death’s door bounce back when minor issues are addressed – and that the heat of last week was just pushing him past his ability to tolerate his chronic arthritic discomfort.
We reviewed his medications; he’s currently on omeprazole (for acid reflux), Galliprant (a non-steroidal anti-inflammatory), and Tramadol (a synthetic opioid). She suggested I add gabapentin back into the mix. I have had him on gabapentin before, for many months while he was also being given the Galliprant, but I could not say I ever saw any difference in either his discomfort or sleeping patterns when he was on it. But she thought the third medication might complement the Galliprant and Tramadol together, so I’ll give that a try again.
All in all, even though he seemed so much better today than he did last week, I’m so glad I brought this vet in for this examination and consultation. Given Otto’s lifelong aversion to slippery floors and most dogs’ apprehension to going to a vet’s office, it’s understandable that when I take him to see one of his regular vets, he always looks worse than he does as home, wide-eyed, trembling, and shaky. A month ago, I brought him to see his internal medicine doctor, and she seemed more dubious about his ability to go on than even I was last week. This morning, on his home turf, Otto seemed, for the most part, like a creaky, limpy, lumpy version of his usual unfailingly well-mannered and friendly self – if a little more unselfconscious about begging for treats than he ever used to be. Now this veterinarian will have an idea about his current baseline – where he is now, and what “too much” might look like. And I got some reassurance that I’m not doing to wrong thing by trying to keep him around at least a little longer.
A final note: Thank you all for your comments with support and advice. I read and appreciate every single one. I feel truly honored to be able to share my magnificent Otto with you, and I am grateful for your care and feeling for him more than I can possibly say.
Thank you for writing this. I needed to see and read this. My Gunner will be 14 in November and it’s an emotional roller coaster between thinking he will be here for a lot longer or gone tomorrow.
Oh Nancy! I just read your blog and with tears in eyes for both you and Otto I send you hope and care and even a hug ( even though we’ve never met). Our time with our dogs is such an incredibly bittersweet gift. I know that you cherish each moment with Otto and Woody and Boone. Please know that there are many of us who understand the rollercoaster of emotions that comes with caring for our dear older friends, and the indescribably devastating sense of loss when we finally have to let them go. We are here, we know your pain and want to to know there are others who care.
Nancy, Even though I write this with tears as I remember my precious pups that I have lost over the years, I want to thank you for sharing your journey with Otto. As a long time subscriber, I remember when you got him. It is so very difficult going this as it never gets any easier, does it? It sounds like you have an amazing vet who helped guide you and that is so fortunate. I will keep Otto in my thoughts. Take care.
This was written YEARS ago to a L-Server List on Bernese Mt. Dogs … still on of the best I’ve ever read.
Blessings and Bright Lights to Guide and Comfort each of you during this Time of Transition
Transitions©
These are factors I considered long ago when I knew that at
some point I would be making that decision. I did a lot of reading and
spoke with folks who had been through it themselves. These are listed
randomly.
1) Decide in advance what defines a good quality of life for your dog.
2) Don’t call the vet after one “bad” day. Instead look over a week
and when the bad days outnumber the good, it may be time to help them
along.
3) Realize that often the dog is ready to let go before we are. Look
for signs of withdrawal from you and others in the household.
4) I read this and it made a big impression on me: A “natural” death
is not always a compassionate one. When my Nellie was close to the
end from osteosarcoma, I asked my vet what could happen before I
intervened. I was taking time off from work so that she wouldn’t be
alone as long as when I worked a full day. But I dreaded coming home
& finding that she had died alone & in distress. He told me that she
could develop a severe bleed in her liver and gradually lose
consciousness; OR she could start bleeding from a mass in her lungs
and that was a horrible way to go. So after a few bad days in a row,
no tail wags, no appetite for pizza or oatmeal cookies, and seeing
her opt to be outside by herself instead of with me, we made the
final trip to the vet.
5) This is an excerpt from a tribute Eugene O’Neill wrote to his
Dalmatian, Carlotta; (written as her last will & testament)
“It is time I said goodbye, before I become too sick a burden on
myself and on those who love me. It will be sorrow to leave them, but
not sorrow to die. Dogs do not fear death as men do. We accept it as
part of life, not as something alien and terrible which destroys
life. What may come after death, who knows? … But peace, at least
is certain.”
It’s never easy, no matter the circumstances nor how old the dog may
be. It’s part of our responsibility when we decide to share our
hearts with a being whose life-span is far too short.
Lisa Seretto
Littleton, MA
Transitions©
“The bond with a true dog is as lasting as the ties of this earth can
ever be.”
(Konrad Lorenz)
Thanks so much for sharing Otto’ s story. My husband and I have a very senior dog, and we struggle to make sure we are keeping him comfortable and his quality of life is still good!
O ver the hill yet youthful in spirit
T ime honored pup who does things his way
T ried and true your everlasting friend
O pen hearted soul whose love has no bounds
Many blessings to you and Otto,
Amy Beth
That’s beautiful and perfect! Thank you! — NK
Both Ramses and Candy were on a combination of Galiprant, Tramadol and Gabapentin. The trick if finding the right combo and then then right dosage. I think Gabapentin is the one that alone doesn’t really do much, but when you combine it with one of the other two at the right dosage, there is a difference. You just have to find the sweet spot.
So glad when the weather broke Otto bounced back. Now you know. No need to hurry the inevitable because of a weather report.
Have you considered installing misters over Otto’s favorite sand box, like they have in Palm Springs? There are misters all over out doors to keep people cool. Not sure if it would work for dogs but something could be rigged up easily with domestic irrigation systems available from big box stores.
Our animals keep teaching us things right up to the end, don’t they? We had a wonderful dog with inoperable cancer who relished every possible moment to the very end. Through an animal communicator, she made it clear that was what she wanted to do. She spent her final hours in the shade of her favorite “squirrel tree” in our backyard. Those last few hours were an absolute lovefest among the people who knew her and came by to wish her well on her journey. Let Otto lead the dance he’ll be clear about his wishes. Thank you for putting all the effort I know you do into Whole Dog Journal. I wrote for Cindy Foley at The Chronicle of the Horse and Horse Journal and am so glad for the deep dive journalism without ties to any advertising. Keep it up! Have long wondered why the dogs in my youth lived such long and healthy lives while cancer and other issues are so prevalent today. So your article about copper levels really caught my attention. I interviewed a number of AFFCO officials “in the day” and now wonder if some of their recommendations followed by animal food manufacturers are in need of rethinking. Enjoy the time you have left with Otto.
Thank you for writing this story about Otto. I can totally relate. We have a 15 year old Welsh Terrier and about a month ago we called our vet because we thought it was close to the end-and how do we know when it’s time? He referred me to a great article by The Ohio State University Veterinary Medical Center
https://vet.osu.edu/vmc/sites/default/files/import/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf
It was very helpful. Needless to say, “Teddy” is still with us. I swear he heard our conversation and decided to perk up. He is on similar medications, so we will love him as long as we can-as long as he has some quality of life. Thank you again and we are sending hugs and prayers in your journey.
Enjoy every minute you can spare with Otto. When it gets to feel like it’s too much, just remember all the heartwarming greetings Otto gave you. Uncountable special times you shared. Now is time to pay it forward, simply give him whatever he wants. Everything will fall into place. Just love him.