. On March 28, 2016 our beloved Lakota left the physical world. This blog entry contains a detailed description of the decisions that were made leading up to our final decision to help him out of his body with euthanasia. While it may be sad to think about these things, I deeply believe that it is our most profound obligation as pet guardians to see that our pets do not suffer. I am not talking about convenience here—I am talking about suffering. I believe that in sharing this experience, I am opening up a dialogue for all who read it. Please don’t shy away from this—prepare yourself so you will be able to make the best decisions for your pet. Age does not guarantee you will not have to deal with this: it can happen at any time. You will be prepared to handle it better if you have given it thought before a crisis arises. When the time comes, one of the few things that will light the darkness will be the knowing you put your animal first and did not let him or her down.
LAKOTA-MARGO’S SHADOW
JANUARY 25, 2004-MARCH 28, 2016
. In 2015, we began doing book talks to promote WALKING WITH THE SHADOW OF LOVE. Since Lakota came with me everywhere I could bring him, I decided to have him be a part of the book talks. What I never expected is that he LOVED performing. He was off leash, and went and politely greeted everyone who came in the room, frequently flashing his big smile at them, to their delight and surprise! Then he did his “chores” that he did at home: fetched the newspaper from a mailbox Bill made for the events, went and got my slippers for me, and found and retrieved my gloves that I dropped on the floor. He totally upstaged me! Everyone in the room fell in love with my beautiful boy—and how could they not.
. In January, we celebrated Lakota’s twelfth birthday. But all was not well. It started with him waking up at night, panting loudly. It was cool in our room. Something was wrong. I took him to the vet the next day. X-rays of his lungs revealed them to appear freckled with black dots. My vet did not like the looks of it. We sent the x-rays to be evaluated by an oncologist. He said it was nothing to worry about—just old dog lungs. We accidentally discovered that lying on a cold gel mat stopped the panting attacks, so we put one on the bed and one in the living room for him. But it was a mystery why it helped, because we kept the room chilly at night.
. Lakota started having serious digestion problems. We treated it palliatively to avoid anything invasive or painful. Then one day he stopped eating—Lakota had never refused food in his life— again, right to the vet. She gave him medication. Next he started occasionally, loudly gagging for no apparent reason. When he finally resumed eating, he vomited. When he didn’t respond quickly to treatment, we were referred to a specialist. In order to find out what the problem was, Lakota had to be put under anesthesia and scoped. I didn’t want to put him through something like this at his age, but we had no choice: he was losing a pound a day of muscle. He was wasting away before our eyes in a week!
. The diagnosis was inflammatory bowel disease and lymphangiectasia. (I know—I had never heard of it either.) Lymphangiectasia was a horrible disease where dogs eventually starve to death because they can’t digest or absorb food. It was secondary to the inflammatory bowel disease and in early stages, so, since the I.B.D. was more treatable, we should still have some time left before the unthinkable would happen.
Our specialist got the digestive issues under control quickly, despite Lakota’s sensitivities to various medicines. We had a third vet—a veterinary nutritionist—formulate a home-cooked diet. We were making massive amounts of food, because now Lakota was ravenous and needed to gain weight. He was consuming ten cups of food a day, and we were working full time to make it; Bill was roasting turkey breasts with the skin removed and roasting eye rounds of beef, cutting the fat out of them and grinding them. I was cooking, peeling and mashing massive amounts of sweet potatoes—and getting really strange looks at the supermarket and Costco, checking out with nothing but enormous quantities of sweet potatoes. I was also spending half a day a week fixing his meds: I cut all his pills with a pill splitter and stuffed them into capsules I got at a compounding pharmacy. This way I could hide them in his food without him tasting them, and not have to shove way too many pills down his throat. While it was a tough regimen, we were thrilled because Lakota was “all better”…or so it seemed. We set limits with the specialist: we wanted to keep Lakota with us as long as possible, if he could have a good quality of life. However we made guidelines clear to the vets: no invasive or painful treatments.
Then the other shoe dropped. A routine blood test turned up a shockingly low red blood cell count. His bone marrow had stopped making red blood cells. The specialist tried two immune suppressing drugs to help–both made Lakota sick–and a hormone that should have stimulated his bone marrow to start working, but didn’t. As the non-regenerative anemia worsened, we reached the point where soon, Lakota would have incredible weakness and shortness of breath. A lot of people aren’t aware of this, but shortness of breath is ranked higher than the highest level of pain on the animal hospice pain scale. It creates such a horrible anxiety/panic that it is used for torture. That was the wall our back was up against. Our only options were:
1. a bone biopsy to diagnose the problem–a procedure done under general anesthesia, but still producing pain—sometimes intense pain—afterward. Lakota had a condition called “wind up”—a pain syndrome that made it likely he would have terrible pain from this procedure. I refused to let them do it. This meant they had to treat without knowing the cause, but Lakota was getting too sick from the meds anyway. I urge all pet guardians to think through how much medical treatment is humane to subject their animals to. They haven’t signed off to do this—would they choose these painful, sometimes terrifying procedures? I was not going to put him through hell. Period.
2. transfusions-probably 24 hours or more hospitalized in a cage, dangerous for dogs, he would feel sick and it could be life-threatening. He could die alone in a cage in the hospital without his family to comfort him. Not my dog—no way! And it would only last for a week or two and have to keep being repeated.
. Lakota was at the top end of the average life of a Labrador Retriever, which was 10-12 years. I wanted him to be with me another freakin’ hundred years. But that was not going to happen, because something awful was coming at us very fast. None of the alternatives were acceptable or even promising. I had to protect him from suffering. I believe we owe animals that. So I did the thing I most didn’t want to do–the thing I would have done anything … that didn’t hurt my dog…to prevent. I made an appointment with a veterinary home euthanasia specialist. I wanted Lakota to have the most loving, peaceful, gentle passing I could give to him; yet what I wanted most was to not have to let him go. But, I could not be selfish and keep him here and watch him struggle to get air. I made the appointment for the following week, hoping to time it so it would happen just as the symptoms of the low red blood cells hit. I booked a home euthanasia appointment with Eleos Veterinary Service (www.Eleosvet.com 973-699-5739). I had stellar reviews for this service from several excellent sources. If it got bad before then, I would have to take him to the vet.
. On the day that was to be the final day, our regular vet came by before work to say goodbye to Lakota. She stayed with him, massaging him, for a long time—he was that special to her. She told me that he was no longer himself—that I was making the right decision. I didn’t know it then, but she was saving my sanity, because Lakota wasn’t going to make it easy. She is one special person.
. He was in bad shape. He was now tranfusional, meaning his red cell count had dropped so low he should be given a transfusion. He would start having those awful symptoms if we didn’t give him blood very soon. He was slipping in and out of an unusually deep sleep. I actually had a feeling that he might pass naturally before the other vet came at noon. As long as it wasn’t painful, it would have been so much easier on me than to have to make that agonizing decision.
. Our vet said her goodbye and left. At noon, right on time, the euthanasia vet and her tech arrived. They set up in the bedroom while I stayed with Lakota. I wanted Lakota to be in the place he would feel most comfortable when he “left”—on our bed where he slept every night. I had specially prepared the bed ahead of time for this. Every last detail of how I did this was about what was best for him—period. He deserved no less than that.
An hour and a half later I was still struggling* to give the command for Lakota to follow me into the bedroom. We had given him a last meal of all his favorite foods that he hadn’t been allowed for a long time. The vet had been very patient and kind, but I just couldn’t let this go on any longer. I had decided I would stay calm even if it killed me, so Lakota would not be scared by my emotions. Feeling like I was going to get sick, I calmly called him to come with me into the bedroom. He sat up, smiled, and gave me an “I’m fine—we can’t do this because I’m-not-leaving-you-look.” I called him a second time. Same thing-he held his ground. It was unbearable—he didn’t want to go. I called him a third time and said, “C’mon, baby—we have to do this. There will be terrible suffering ahead and I can’t let that happen to you. I love you too much.”
. Lakota obeyed. He got on the bed. I held him in my arms and looked into his eyes and gave the vet the go ahead. I told him how much I loved him, and I thanked him for all his love and help. I stayed calm for him as my heart broke. I loved him with all my might, as we helped him leave his sick body.
. When Zeak was put down, I was practically begging the vet to do it because of the serious suffering that was occurring. Here, I was doing it before the awful suffering. It was much kinder for my dog, but hell for me. I was now very glad that my vet had come and supported this decision, or I might be second guessing myself. Looking back, I know this was both the most gut-wrenching, and the most unselfish thing I have ever done, but that did not ease my pain now. Even with that, what was going to happen, in a little while, was to reassure me that what I had done was the right thing, beyond a shadow of a doubt. Because something else was going on in Lakota’s body—something none of the tests had detected.
. As the vet and her tech put Lakota on a stretcher to carry him to the SUV, something unexpected occurred. A fluid tinged with blood began pouring out of Lakota’s nose—a lot of fluid. The vet told us—in a surprised tone—that this was NOT normal. Days later, I spoke to my vet and the specialist, and they agreed. They could only guess, but the best guess was cancer—in the lungs or sinuses or maybe in internal lymph nodes, undetectable —that had rapidly spread through Lakota’s body and into his bone marrow, causing the anemia. At that moment I remembered something from when Zeak had lymphoma: I remembered that at the end, cancer cells can fill the lungs with fluid in minutes, causing a horrible death by suffocation. If that was what was happening here, it is possible that we averted that right before it happened, and the scenario was very likely.
For the next week I was hit will the full brunt of grieving for my beloved family member, partner, and best friend. The loving presence that was at my side every minute was gone. It was devastating. I was too sick to my stomach leave the house for a week. But little things started to happen—synchronicities—that reassured me that Lakota was OK and even around!
. The next week we brought his ashes home. On the evening of my birthday, after I got home, as I sat in my living room, I received the best birthday gift I have ever received: a breathtaking “visit” at a level of detail I had never experienced before! I was dozing in my chair, when something woke me up. It didn’t startle me, but I was aware something had interrupted my sleep and was looking around to see what it was when I saw the image. I had experienced incidents like this before, but this was the best visual I had ever seen. It was Lakota, young again, and so beautiful and detailed and perfect that it filled my heart with peace and comfort. There was no hint of sickness. He was right on the arm of my recliner, floating about a foot from my face. I could see every feature of him, and the only hint of him not being “of flesh” was a slight transparency. It lasted about three or four seconds. Gratitude and awe overwhelmed me.
. I wish I had some control and could initiate these incidents, but if I did, I would be greedy and want them to happen all the time because I miss my dogs so deeply. I know I am very fortunate to have these comforts, and I also know I am not alone. More people have experienced these types of incidents with departed loved ones—humans and animals–than those who have not experienced these occurrences, would expect. That is mostly because people who have them, keep the “visits” to themselves. It does not take away the terrible pain of the loss, but it is definitely a great comfort. That is why I have made the decision to be candid about my experiences, hoping that it will encourage people to be open to the possibility—hoping that then more people can have these “gifts.”
In closing, I offer a final caution: make sure you thoroughly investigate whom you choose to euthanize your dog, and where his or her body will be processed. It is not unheard of for animals to be sedated and then wind up in the wrong hands—terribly wrong hands. I would like to think it is uncommon, but it should be unthinkable that it could happen at all.
As for me, I am putting one foot in front of the other, trying so hard to go on, despite feeling lost, sad, and broken without my companion. One thing I know for sure: this is not the time to get another dog. It would not be fair to inflict this painful energy on a new dog. Dogs are not replaceable or interchangeable, any more than beloved human family members are. I have now reached the point where I am going out with my friends, welcoming their love and support and grateful that I have people in my life who “get it”. I have no idea how long I will walk this earth, but I know full well that now, as long as I do, I am walking with two shadows.
. Margo
. *Because I was having such a difficult time recovering, I went to a grief therapy session. I learned something very important that I want to pass on. If you go back to the asterisk in the article, you will notice I said I “struggled” with giving the go ahead for an hour and a half. Well it turns out that getting “stuck” in a highly stressful situation like that is a trigger for trauma. I am also dealing with having to overcome trauma as well as grief. Whether you decide to do a home euthanasia or one at a vet’s office, spend time and say your goodbye with your animal before, but once the vet arrives or you arrive at the vet’s, do not delay—proceed immediately. The vet cannot rush this decision for you– but it is better for you psychologically if you do not allow this time to drag on and linger. People underestimate the severity of a situation like this—it can even cause PTSD. Avoid putting yourself in a situation where you have an unspecified amount of time before you “give the order”. Prearrange it that way with your vet. The vet is in a difficult position and can’t appear to be rushing you at a time like that, so be proactive and both, protect yourself, and do the kind thing for your animal.