For the third time in the past 18 months I’ve had to hold hospice here at home. First Janet, then our little silky terrier, Oscar, and this past week it was our cairn terrier, Mac Duff. I had to euthanize the pup this past Thursday night.
This all unfolded rather suddenly. About four weeks ago Mac Duff started limping on his front left leg. He reluctantly put weight on it and would hold his left paw in the air when he was just sitting. Pick him up wrong and he would screech in pain. Not a good sign. Detailed blood tests, abdominal ultrasound, MRI, a lump biopsy, $4,000 and four vets later the answer came back as very aggressive malignant lymphoma.
Mac Duff was a rescue dog. We got him at about 6 months of age. Janet wanted a third puppy and I grudgingly acquiesced. She had been through some rather difficult chemotherapy and surgery and wanted some puppy energy in the house to help boost her spirits and had wanted a blond cairn terrier for a long time before that. Mac Duff provided all this in one tiny nuclear package. He never slowed down and had the best temperament of any terrier I’ve ever known. He was Janet’s puppy.
Phyllis Glawe, the oncology vet at the Veterinary Referral Center of Colorado (VRCC) was clear and detailed with the facts. I’d asked for that up front given my history of supporting Janet in her fight with cancer. Smoke, mirrors and candy coated prospects are a bad thing. A very, very bad thing. If I’m to make a decision, I need to know what I’m up against, what the options are and what the likely consequences of any decisions might be.
A vet, or a medical doctor, earns a great deal of my respect from me if they are capable of acknowledging when they don’t know something. The valuable piece of knowledge contained in that acknowledgment is that I need to look elsewhere for an answer. Feigning knowledge for egotistical reasons, presenting speculation as fact and the like is also a very, very bad thing. It was that kind of attitude that put Janet is such a difficult situation before we even knew what was going on.
So, given that Mac Duff’s cancer was very aggressive and already quite advanced, if I had opted to put him through chemotherapy the cytolysis of the cancer cells would have flooded his little body with buckets of dead cell material, further taxing his already struggling liver and immune system and making him even sicker than the chemotherapy drugs would already make him. He could die from the treatment. Then there would be the side effects of the drugs: fur loss, vomiting, incontinence, risk of infection. God damn it, this is all too familiar. Not only this, but after six months of treatment, Mac Duff would have another 3-6 months cancer free after which the likelihood of a recurrence is very great and we would be right back where we were this past week. Only after much suffering and another $4,000+ lighter.
As Mac Duff’s owner/caretaker, the tough decisions are left to me. When Dr. Glawe showed me the protocol Mac Duff would be on, I knew what was in store for him when I saw words like “Adriamycin”, “Anzemet”, “Cytoxan” and “Cycloposphamide”. I could hear Janet’s voice screaming at me “Don’t torture the puppy!”
After the awful experience of having to put Oscar down and the way his last week on the planet unfolded, I wanted to find a vet who would make house calls for euthanasia. After speaking with several contacts, I settled on Dr Ann Brandenburg-Schroeder who specializes in pet euthanasia and calls her business “Beside Still Water“.
What a find! Dr. Ann is an angel. I had expected the house call vet would pretty much do what they do at the vet office except they would give the shot to put Mac Duff down at home. Not so. As soon as Dr. Ann stepped in the front door, she sat on the floor with Mac Duff and worked on setting a friendly rapport. There was nothing about Dr. Ann that said “vet” to Mac Duff. She had tasty biscuits from Great Harvest Bakery, spoke softly to him and scratched his ears. Even my other cairn terrier, Jasmine, took biscuits from Dr. Ann. Jasmine never takes treats from strangers. While doing this, she explained the process. She did this several times during the two hours she was there at the house, no doubt to remind me of what would happen.
Basically, she used four shots over about 15-20 minutes. The first was a strong pain killer, which made Mac Duff relax (first time in 4 weeks) and made him a bit sleepy. The second shot relaxed him even more. He was still aware and Dr. Ann said a loud noise or such would cause him to take notice. He was still tracking me with his eyes. The third shot was basically anesthesia and put him into an unconscious sleep. The fourth shot was an overdose which stopped his breathing and heart. Like Janet, when Mac Duff left, he jetted out of the galaxy.
I have a clear sense Mac Duff didn’t know what was about to happen. At no point was he afraid or agitated. He was comfortable and certainly enjoyed the treats. Unlike Oscar, who I had to take to the vet at 3:00 AM. As much as Oscar was suffering, he knew where he was – that place where people hurt him. So he fought and struggled. And the animal hospital vet didn’t get the euthanasia drug dose right and had to give him two shots. So he didn’t die right away. It still troubles me thinking about how he left. With Mac Duff, I have a much better feeling about his last days and moments. Dr. Ann is the main reason I’m doing better after Mac Duff’s death than I was after Oscar’s. The overall cost of using Dr. Ann’s services are not that much more than taking one’s pet to the vet to be euthanized. But the benefits to both you and your pet are an order of magnitude better.
I have one ding against VRCC for the record. It needs to be said to help readers who may be in my position. First off, understand that the vets at VRCC are very, very good. We refer to VRCC as the “Mayo Clinic for Pets.” They are also very, very expensive. And that’s not my grudge. I love all my pets and consider them a part of the family. Not in the perverted sense that some pet owners do who think it fitting to dress their pets up in people clothes, feed them human food, take them to pet psychologists and pet psychics, etc. Not in this house. We know our dogs are dogs and we care for them according to their nature. My dogs are on a raw food diet for the most part and they thrive on such food. They are given plenty of room to play and frequent walks. What ever care they need, if I can at all afford it, they get it.
My ding is how the tests were triaged. With obvious multiple lymph nodes that had had swollen to the size of plums in just one week, the sensible thing to do would have been to run the blood tests and biopsy first and deferred the $2,500 MRI until after the less expensive and, frankly, more appropriate tests results were available. But VRCC tends to go for the full buffet. They did this with Oscar but I put the breaks on that when they presupposed my instant answer to his potential glaucoma problem was to remove the cataracts in his eyes and replace his lenses with artificial lenses.
When it’s one of my dogs that is suffering, it’s difficult to keep the caveat emptor attitude. I trust the vets to make the correct call and not act as if they have a blank check with which to work. VRCC has my vacation for 2007. I hope they enjoy it because I likely won’t be traveling far.
[Edit History]
2006.11.22
Add more information in second post regarding Mac Duff.
The next day I met a friend for lunch at a Chinese restaurant. Marie and I feel the same about our dogs and loosing one is no small thing. At the end of the meal, the fortune cookie for me was “Time heals all wounds”. I had written quite a bit about this particular phrase in a notebook I’m using to collect such thoughts which will eventually end up in the book I need to write.
