Otto is still here

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.