Being a veterinarian can be a blessing and a curse. A blessing when you’re able to save a pet who shouldn’t have made it, a curse when you know a pet is going to die and there’s nothing you can do except hope for the best or pray for a miracle. It’s the worst when it’s a veterinary healthcare professional’s own pet who’s standing on a banana peel at death’s door.
Know that in my almost 40-years of practice, I’ve seen more than my share of pets pulled from death’s clutches by the hand of God. I’m not a bit ashamed to ask for divine intervention for a patient or one of my own when it seems earthly answers – in the form of high-tech, state-of-the-art veterinary medicine – aren’t giving the results we seek in our own actions, via collaboration or referral to specialists.
Quora was an approximately 13-year-old PomPeiCarrier (Pomeranian, Shar Pei, Cairn Terrier canine-cocktail, authenticated via genetic testing). While we know her breed makeup, we don’t know her exact age because she was relinquished to a shelter in Richland, Wash., where we adopted her from a PetSmart store during one of those amazing weekend adoption events. She was one of the over 8 million pets PetSmart has helped save since 1995.
“We adopted” is not quite accurate, as it was our 31-year-old daughter, Mikkel, who found Adora (her given name at the shelter), called my wife Teresa to see if she wanted a buddy for our little dog, Quixote (our beloved male Porkhuahua – Pomeranian, Yorkie, Chihuahua – again, genetics tested), ignored Teresa telling her, “No! I don’t want another dog right now,” and got permission from good old Dad to spring the dog from the cage and execute a surprise on Momma.
I was in on a special introduction that Mikkel had planned between Adora and Teresa.
Teresa and I were at the Davenport Hotel in downtown Spokane, Wash., for the night, and had brought along Quixote, who Teresa always affectionately called, ‘My Little Man.”
As usual, Teresa had him dressed up in clothes. That night, Mikkel joined us at the hotel, checking in after we were already asleep. Teresa went to exercise early the next morning and dropped Quixote off in Mikkel’s room, as Mikkel loves him and asked to babysit the little fur ball. With the animal actors in place, the fuse was lit for Mikkel’s ruse.
Since the two dogs were about the same size and color, Mikkel simply took the clothes off of Quixote and put them on Adora. After exercising, Teresa came back to my room to shower and get ready. When we went to Mikkel’s room mid-morning to go get breakfast, a cute, little, brown dog rushed straight at Teresa, and she said with both shock and confusion, “What did you do to my dog, Mikkel?!”
For a few seconds, Teresa thought they’d done an Extreme Dog Makeover on Quixote, and shaved him, but then Quixote was released from the bathroom and poof, Teresa now had two canine bookends; a son and daughter, if you will. A day earlier she’d said “No!”, but in an instant, it was, “Oh!”
And in that moment, sealed with tears, wet doggy kisses, and a wagging tail was the start of an amazing decade-plus of pure agape love between this special dog and her forever family.
Before we go forward, we need to look back at this special dog’s life. Adopted as a puppy along with two littermates, Adora had a great first year inside a family’s house in the Tri-Cities of Washington. But for some pathetic, unexplainable reason, at Adora’s first birthday, the family went out and adopted three new puppies from another litter, and put Adora and her siblings out in a cage in the yard.
For the next year she spent every single day locked in an elevated, small cage, like a puppy mill dog. The story gets even worse. At the end of year two, these scumbags (my words, not those from the shelter workers) took all th dogs to a local shelter. It was days later when Mikkel happened to go into PetSmart (God?), heard the story, held Adora (she was very subdued), called her mom, did the opposite of what she was told, adopted her, and took her north toward her eventual home at Almost Heaven Ranch in the very tip of the Idaho Panhandle.
From the first exchange of butt sniffs, Quixote and Adora became very close. Like brother and sisters, albeit ones who would hump each other. They ate together, played together, slept together, and eventually will be buried side by side.
How did Adora become Quora? Our family (Teresa, really) has a thing about always starting our pets’ names with the letter Q. We have had Quixote, Quora, Queen Gracie, QT Pi, Quin’C, and Quill’N. Doesn’t take the sharpest crayon in the box to put “Q” with Adora = Quora. While Quora was her given name, she quickly gained nicknames such as:
Imelda Barkos and Shoebacca. Lots of puppies like shoes, but Quora had a one-of-a-kind shoe fetish that didn’t need Jimmy Chews to satiate. She would get into closets or go to the mudroom and pick up shoes, pack them around the house, then go get the other shoe and drop it next to the first one, always, ALWAYS with the left and right in correct position. One time, when at Grandma Valdie’s house (Teresa’s mom), we came back inside to find that she’d drained her closet and had five pairs of shoes lined up like she was getting ready for Nordstrom’s semi-annual shoe sale. I have no idea why she loved shoes so much, and how she could line them up side-by-side, and would probably not believe it if someone else told me the story.
Doo. Remember when I said she was subdued when Mikkel first held her in PetSmart? While this might be chalked up to the fact she’d just been freed from two years in a backyard cage and a day inside a carrier inside of PetSmart, Quora was THE most relaxed dog ever when held. She’d lay statue-still, feet tucked up (we’d say she retracted her landing gear), unblinkingly staring into your eyes in an emotional duel she always won. So “subdued Quora” became simply, Doo.
Miss Quora. Always such a little lady. Never wanting to leave the house, get dirty, or hang around with other dogs. She always stayed clean, wore “girly” collars, and wore dresses and fake furs upon occasion.
Speaking of sharpest crayon or brightest bulb, Quora was neither. We think her abnormally large heart might has necessitated a smaller brain. While the other dogs were easy to trick-train and know dozens of tricks they could remember even if they hadn’t done one of them for months, Quora knew two. We always said she had two marbles rattling around in her skull, one for sit, and one for dance. She always looked so darn proud when it was her turn to strut her stuff, with tricks so simple, it makes me smile writing this.
I was away at a veterinary meeting talking passionately about Fear Free in early August 2017, when Teresa called saying that Quora was very sick with vomiting, diarrhea, and inappetence. When I asked her if there was anything unusual that had happened (thinking she’d got into the garbage can, eaten too many litterbox crunchies from the barn cats, etc.) Teresa lamented that the day before, she’d let Quora out of the house in the early morning to do her business (we called it ‘dooing the doo’) and when she went to the door to let her back inside, Quora was standing there, hyper-excited with all four feet moving like she was standing on a hot plate, with a dead ground squirrel in her mouth.
I guess it was a slow ground squirrel, or Quora had fired the booster rockets and found a new speed, but the ambush had been successful. Grossed out, Teresa yelled, “Quora, DROP IT!” and the bloody, partially eaten, limp squirrel fell to the deck as a crestfallen Quora walked into the house, where she turned and looked back at the meal that was not to be finished.
With Quora’s advanced age, her metabolic condition (she had Addison’s Disease, also called hypoadrenalcorticism, which occurs when the adrenal glands aren’t functioning properly in producing enough corticosteroids or mineralocorticoids; the tiny glands located near the kidneys have a critical role in regulating the way a dog’s body controls levels of water, sugar, and salt. Clinical signs include a slower heart rate, weakness, and depression.
With her symptoms of persistent vomiting and diarrhea, I told Teresa to not wait until I returned home but to immediately take her to a local veterinarian, Dr. Rolan Hall at Bonners Ferry Veterinary Hospital in our hometown.
Dr. Hall is an amazingly talented colleague and good friend (also one of Teresa’s old boyfriends; hmmm). At the veterinary hospital, they ran blood chemistry tests and found her levels of amylase, lipase, and alkaline phosphatase were not normal, indicating severe inflammation and leading to a diagnosis of acute pancreatitis.
Quora was given a drug (Cerenia) to stop the vomiting and diarrhea, a long acting antibiotic (Convenia) and started on IV fluids. In 24 hours, Quora had perked back up and even wanted to eat, so they released her to Teresa to take back home.
I came home a few days later on Tuesday, August 1, to find Quora full of energy (chased the wild turkeys out of our driveway at Warp 10) and with a hearty appetite (it was hard NOT to give her anything with fat because of the pancreatitis, as she loves the bites of Teresa’s famous homemade vanilla and chocolate chip ice cream), no digestive upset, and normal bathroom habits.
But that night, as Teresa and I took our positions on opposite ends of the couch to watch TV, Quora got up between us for some lovin’, and in stroking her body I felt something abnormal in her abdomen. It was large enough that even an untrained hand could feel it (Teresa felt it, too), but I knew that a mass probably meant a tumor. Because it appeared to be on the liver or spleen (I could feel smooth contours of the lobes leading to masses), that meant we’d most likely left the sunshine side of the mountain where you feel she’s got a diagnosis and treatment plan that’s working, to the darkness that creeps over you when you instantly hope for the best while planning for the worst.
Teresa and I both let out nearly simultaneous long sighs, our hearts raced and our breathing became shallow thinking about what the future held for the girl who was safely tucked in our arms.
What did Teresa and I do next? We stuck our heads in the sand, I guess in a way scared to confirm in our heads what our aching hearts were telling us. For the next 10 days, Quora seemed in Nirvana. She chased black pine squirrels up trees, snowshoe rabbits in their brown summer coats into their warrens, ground squirrels into their holes, and chipmunks deep inside the rock walls that border our house. Quora wolfed down her regular food and used her chocolate Tootsie Pop eyes (how Teresa described them when they’d bulge while begging) to coerce extra treats from us.
I left for an animal shelter conference in Lexington, Kentucky, on Wednesday, August 2, and Teresa left a couple of days later, dropping the three Qs (Quixote, Quora, and QT PI) off at their favorite place to visit and stay, in the arms and on the bed of Kate Turner, Auntie Kate to us, who owns Happy Tails Bed & Biscuit in Bonners Ferry.
I arrived home Wednesday, August 9, and Teresa’s mother, Valdie, and brother, Rockey, along with their in-home care person and chauffer, Judy Baruth, picked up the Qs from Auntie Kate and brought them up to Almost Heaven Ranch.
When they saw me, the three of them raced to me, with QT Pi jumping up and down like a Mexican jumping bean, Quixote doing his woo-woo bark where with every exhale both front feet come off of the ground, and blessed Quora standing tall on her thin back legs (which always reminded us of a colt’s tall, slender legs), raking the air like a tiny, fawn colored Lipizzaner stallion with a face bleached and wizened with age.
I picked her up under her front legs, holding her like a baby, and kept saying to her, “Shoebacca, you know you’ve a bad, bad girl” as she first stuck her tongue in my right ear, deep cleaning it, before giving me a kiss so deep it felt like I’d had a tonsil swab. I believe I got to taste my own ear wax – at least, I hope that’s what it was.
The rest of the day was uneventful, the usual, which includes:
- Alarm barking at any sound or no sound. I always called Quixote, Quora and QT Pi my 15-pound doorbells.
- If I moved, they moved in tandem, from room to room, upstairs and downstairs, inside to outside.
- When the refrigerator, kitchen drawers, or any ziplock opened, they were right there to see what was on the menu. Even though they should know the one kitchen drawer just contains silverware, maybe this time it could have a treat inside. Teresa always gets a piece of gum out of a drawer in the kitchen before going to do her exercising in our basement gym. No matter how quietly she would open that drawer, the Qs, and especially Quora, would hear it and go running to the kitchen. Quora’s ears would perk up, her head would swivel, her feet would hit the floor and she would bound like a gazelle down the stairs to the kitchen. They knew that when Teresa would go downstairs to do her fitness routine she always gave the Qs a treat.
- Going outside, doing dung-shui – the careful placement of a fecal flag, by finding the perfect place to be #1 in the #2 business, plus draining the radiator. Chasing anything with four legs (rabbits, squirrels, voles) or two (turkeys) off of our property.
- Sleeping the usual 20 out of 24 hours.
- Pestering me to pet, rub, stroke, and massage them. This is really hard for me when I’m the solo human slave to the doggy masters, because the chief servant of the pleasure pigs is Teresa, who can pet two dogs with each circling foot and massage a third dog with her hand while she’s left with one hand free to type or drink tea. She was gone, and the Qs expected me to pick up the slack.
The morning of Thursday, August 10, started early and ended late, and it truly was one of the single best days of Quora’s blessed life. I’m completely honest in saying this.
It started out at about 5:15 am when I was awakened from a dead sleep by QT Pi’s whimpering and whining. Grunting like a little white pig with brown spots (don’t you dare tell him I said this!), he would not stop, despite me telling him to shush and go back to bed, until I got up.
I thought he had to go to the bathroom (or throw up, because in Teresa’s absence I’d thrown dietary discretion out of the window and had given all of the dogs some of her homemade ice cream plus shared some Bush’s Baked Beans with them). But no, Weasel Nuts (as I sometimes call QT), just wanted to play.
When I went to the door (which has panes of glass top to bottom) to let the dogs out, I could see a rabbit in the early morning light enjoying the tall green grass in the lawn that needed to be mowed. Quora spotted the “wiley wabbit” first, and chased it out of the yard and into the forest in a delighted blur-of-fur.
While the other two Qs scratched at the back door after about five minutes, wanting back into the house for breakfast, even after calling and calling, Quora was nowhere to be seen. I wasn’t alarmed as this happened from time to time when Quora went rogue, chasing we can only imagine what in the woods. This particular time I knew it was Bugs Bunny.
After about 30 minutes, a panting Quora was at the back door whining, scratching, and wanting inside. Inside now! It was truly time for the first meal of the day. I don’t know if it was the early morning workout that really revved up her engine, but Doo was really full of it all day.
Speaking of full, with the food police gone (Teresa is a very careful cook and healthy eater) and with not enough caution for Quora’s presumptive diagnosis of pancreatitis, I let her spend the day like she was on a doggy cruise ship, with too many food options to ignore and no bikini season to worry about. I honestly don’t know what got into me; maybe she did a Vulcan mind meld on me, but she had the following to eat from the time she woke up until she went to sleep at about 10 p.m. PT (please don’t judge me – I swear this was NOT a normal day)
- Purina Pro Plan Focus for breakfast and dinner (1/8 cup precisely measured out for each meal and fed using food puzzles) in the kitchen
- Part of my bowl of Kellogg’s Cracklin’ OatBran. Shhhh. Don’t tell Teresa but it was quite a bit of my portion
- A hickory smoke flavored Greenies Pill Pocket (she was begging while I loaded up Queen Gracie’s meaty shot glass with her anti-itch medication, Apoquel) in the laundry room
- Pieces of Triple Meat Lover’s Pup-Peroni tossed into her mouth, along with the other dancing dogs at the horse barn, after finishing the chores. Quora also licked around the top of the big jug of molasses we use to top-dress the horse’s feed bucket mixture of Omolene 100, rolled corn, and beet pulp
- A couple of spoonfuls of my Chobani peach yogurt back in the kitchen. Note: Quora’s tongue could empty a spoon with one slurp
- Part of the Planters Trail Mix I had for lunch at my work desk in the loft. She got some peanuts and a couple of M&Ms. (Don’t worry, tiny amounts of milk chocolate are harmless for dogs if they get it by choice of chance from time to time.)
- One Beggin’ Strip (Bacon & Cheese flavor) in the early afternoon when I went outside to water the flowers and stopped by a stash hidden in a drawer in the garage
- One Dingo and one Red Vine licorice stick on the couch in the loft for a watching TV snack
During the day, I took three large 2’ x 2’ square pillows and stacked them up in a big leather armed chair, like saltine crackers, and Quora, after scratching them with her front feet to position them just right. We loved to watch Quora as she always did this ritual scratching before lying on the big pillow. She looked like a meerkat digging, hunching up, using her front paws to fluff the pillow and always made us break in to laughter) and then she would scale the marshmallow-soft mountain for a nice multi-hour snooze.
That night, when we had all found our places in the loft on the couch or chair to watch TV, Quora got a massage with a Kong Zoom Groom on her favorite spots on the side of the neck, chest, and base of the tail. Quora moved sloth-slowly and moaned with pleasure. An hour later I felt the sensitive mass in her abdomen. It was still there. Bigger? Probably, but I didn’t linger there, but instead went back to soft scratching with those soft rubber teeth.
When it was time to shut off the TV, do a bathroom break, open the bedroom window to let in the cool Northern Idaho air, and shut off the lights, Quora joined me in the master bedroom having had an incredible day, and got a goodnight massage under her neck and a kiss on her head. (We kiss the Qs A LOT, even knowing they eat carrion, horse apples and use their tongues as toilet paper. Your pets, too?)
I was jolted out of a dead sleep about 3 a.m. on Friday morning, August 11, with the sound of violent retching. All of us who have pets know the sounds of an impending “yack attack,” and the lip licking that follows. At first, I was confused because the sound was coming from the floor just off my side of the bed. We have blackout blinds and I need glasses to see, so I struggled to figure out which Q I had to avoid stepping on as I got out of the bed. I missed the dog, but did graze the pile of vomitus as I worked my way to a lamp close by. Standing there, head down, licking her lips, with lifeless eyes, a pained countenance, and sawhorse stiff, was Quora. The sun still wasn’t up, and neither of us knew that she wouldn’t live to see the sun set.
I know some of you were shaking your head and rolling your eyes when you read all of the things I gave Quora to eat on Thursday. When I got on my hands and knees to clean up the mess, I saw the detritus of my dietary indiscretion in front of me with intact peanuts, a couple of baked beans, and a piece of rawhide. Looking back, I’m so glad I gave her taste buds a celebration for one final, special, day. Quora loved food, and eating was one of her most delightful experiences.
I knew I was going to take Quora on the four-hour drive to the Washington State University College of Veterinary Medicine (WSU CVM) just as soon as I could get the house chores done, animals fed, arrangements made for somebody to take care of the cats and other Qs, and stop by the local veterinary practice to get a copy of Quora’s medical records. I was on the road by 9 a.m. and arrived in front of the teaching hospital by 1:00 p.m. In five hours almost to the minute, Quora would still be inside this building, but would have left this earth.
I stopped once on the approximately 90-mile winding drive through mountains and wheat fields between our ranch north of Bonners Ferry, Idaho, and the WSU campus in Pullman, Washington. I wanted to get Quora some water and a chance to go potty. She drank but groaned with pain and sank with lethargy as I started to pick her up, so I decided that if she needed to go, she could do it in her blanket. A couple of times during the drive she lifted her head up over the rim of the sunken quilt and vomited on the floor of my Chevy pickup. I couldn’t care less about the smell or cleaning it up; I just wanted to get her the expert help she needed, and was especially interested in her getting some IV fluids.
Quora never slept the entire drive. Her body was almost invisible in the bowels of the quilt, but her head faced me from the passenger seat, and we talked. I kept telling her what a good girl she was. That her family loved her and was praying for her, as were hundreds of thousands of other pet lovers we’d asked for prayers. That we were going to battle for her life with every weapon available to us and that she’d back on the sunshine side of the mountain again, very soon. I lightly scratched the sides of her neck telling her hundreds of times, “You are loved. You are loved. You are loved.”
As I looked down the road, I wasn’t really driving. Having gone to both undergraduate and veterinary school in Moscow (U of Idaho) and Pullman (WSU) and with a daughter who went to WSU for four years and a son who went to U of I for four years, we’d traveled that same road hundreds of times. Not exaggerating here: I know every town, speed trap, game crossing, good and bad mobile signal areas, billboard, and wide spot in the road. But on this day, my subconscious drove as I don’t remember a thing. Instead the journey was with my mind’s eye.
I thought it ironic that in the approximately 12 years we’d had Quora, she’d never been to the veterinarian’s office a single time for anything, other than the trip a few weeks before for suspected pancreatitis. Her teeth were perfect (thanks to Teresa’s amazing oral care program), she was vaccinated at home, kept at her ideal body weight, fed a healthy diet, given probiotics, and exercised regularly. Quora had lots of enrichment activities as one of our Almost Heaven Ranch testers in our Fear Free push to bring more enrichment to all animals.
I’d been praying all day from the time I pulled out the paper towels to clean up, on the drive, and especially as I carried Quora into the veterinary teaching hospital at WSU on a super-thick, handmade quilt. Quora was NOT going to be examined or resting on a cold stainless steel table.
I’d called ahead and they were expecting us to arrive about that time, so it was less than five minutes of waiting before the senior veterinary student and an intern from Japan were the first to greet me and take me into the exam room for our initial exam. This senior veterinary student is what we call a retread, meaning that veterinary medicine was not her first career choice. Or her second. But it was always her heart’s choice, and she did an amazing job as a veterinary student who will be a DVM in about six months.
Quora’s exam was done on the exam table tucked into the quilt, and the student examined her front front-to-back, top-to-bottom, and did a great physical exam while also looking after her emotional wellbeing. When she finally palpated her abdomen she looked at me with a mix of surprise and sadness, and said softly, “Even I, as a veterinary student, can feel the mass.” And with her voice rising, “And it’s large!”
She left to go to the back to download the veterinarian who was on faculty on her exam findings, and soon the door opened and I was delighted to see my colleague and friend, boarded veterinary oncologist Dr. Janean Fidel, who I first met about nine months before when I took Quin’C (a shelter dog we’d recently adopted) to WSU CVM for a mass on his head. Quin’C ended up having a malignant melanoma that had metastasized and was untreatable, but Dr. Fidel was amazing through the process and I felt heartened to know that Quora was in the hands of somebody with a big brain and a big heart.
After a hello and hugs (anybody who knows me knows that I’m a hugger!), Janean’s hands were on Quora’s abdomen. These experienced, skilled hands had felt thousands of abdomens of pets with masses and she got “the look” on her face. The brow and eyes spoke of apprehension of what might be inside the place we couldn’t yet see. Will Quora be okay, or not? I’ve given the same look; it’s just what you do when you have education, training, and experience with thousands of pets in regard to the diagnosis, treatment plan, and a cure or a goodbye.
We agreed that we needed an ultrasound of the abdomen, radiographs of the lungs, and blood work as next steps. Are there masses on the spleen and/or liver? Are the growths smooth or irregular? Have tumors metastasized to the lungs? And because we were a group of veterinary healthcare professionals, each of whom had seen a lot of elderly dogs with these clinical signs, Dr. Fidel addressed the elephant in the room and brought up the possibility, even the probability, that we’d end up finding that the diagnosis would be hemangiosarcoma.
Hemangiosarcoma = darkness in vet med, for the pet, pet owner, practitioner, and the profession. Hemangiosarcoma is a rapidly-growing, highly invasive variety of cancer that occurs almost exclusively in dogs. A frequent cause of death is the rupturing of this tumor, causing the patient to rapidly bleed to death. As the three people in white coats (senior student, intern, and faculty) left the room with Quora wrapped like a brown burrito in the multicolor antique quilt, I didn’t know that I’d only have about five minutes more to personally be with this beloved four-legged family member… ever.
They had my mobile phone number and said they’d call me when they had the results of the diagnostic tests. They encouraged me to go downtown to Starbucks, but I went outside the front doors of reception and lay across the hood of my Chevy Pickup, folded my hands and prayed to God for a miracle. Like I’ve told thousands of pet owners over an almost four-decade career, we can always expect one thing but hope for another. Or in the case of those of us with faith (and like soldiers in foxholes, there are a lot fewer atheists when their pet has been diagnosed with a serious or potentially fatal problem), we pray for another.
I’ve been on the blessing end of miracles, both personally and professionally. With my head alternately looking up to God and down in desperation and sadness, I didn’t go to Starbucks, but instead went to a building on the veterinary school campus called Bustad Hall. It’s named after my veterinary school dean, Leo Bustad, a WWII prisoner of war in a German concentration camp who came out barely alive, but full of an appreciation of the human-animal bond (based on his amazing interaction with a German Shepherd guard dog) and a vision of the human-animal health connection.
Inside Bustad Hall was a section celebrating his life and that of his wife, Signe, with his medals from WWII (including the eagle surrounded by barbed wire to show he was a prisoner of war) and a photo of Leo, Signe and their German Shepherd. It took me back to the first day of veterinary school, where Leo’s introductory talk on the human-animal bond caused me to change my focus and career goal from being a dairy practitioner to companion animal. At the end of his talk, he also educated and inspired us with his explanation of the People Pet Partnership (PPP) and its mission of matching elderly people with homeless pets. This was August 1976, and I went from being a potential dairy practitioner in the very back of the room to racing to the front of the room as an inspired veterinary student, destined to be a small animal veterinarian. And I also volunteered for the PPP (which still exists today).
Leo, I begged, if you’re able from up there to intervene down here, please do and do it now. I looked at the electronic images of the Veterinary Class of 1980 on a 65-inch landscape monitor, and found myself in the top left section as a 26-year-old with a lot more hair and a lot less stomach, and wondered silently, have you done all you could do for pets, people, and the profession?
After a minute of melancholy, I walked back to the teaching hospital waiting room and took a seat to wait. Wait. Wait. What was actually 90 minutes seemed like nine hours. Then, while looking at the floor…thinking…praying…I sensed the movement of a scrum of people walking toward me at about 3:00 p.m. When I looked up, there was the senior WSU student; the Japanese veterinary student; oncologist Dr. Janaen Fidel; Dr. Sandy Chen, a small animal veterinary intern from Taiwan; and Dr. Boel Fransson, who is both a PhD and a diplomate of the American College of Veterinary Surgery. Everyone had “the look” of reduced hope and increased reality for Quora.
Dr. Fidel took the lead explaining the diagnostic results:
- Low red blood cell and platelet counts, meaning transfusions were necessary, which also meant matching blood types
- An abdominal tap showing large amount of bloody serum (leaked from the masses)
- Ultrasound showing splenic masses – and it couldn’t be determined if the liver was involved as well
- Chest radiographs were clear (masses hadn’t metastasized to the lungs)
- Early signs of Disseminated Intervascular Coagulation (DIC – a REALLY bad sign)
Then Dr. Fransson explained the surgery, risks, and chances. Taken together, along with the age of the pet, these were not the results or odds we’d hoped for.
The huddle of veterinary healthcare professionals was disappointed, and I can say with the experience of having been in many of these focused masses myself, dejected. We discussed options from doing nothing to doing everything. I chose everything. It didn’t matter that the surgery to do a splenectomy at the minimum, could be up to $5000, or that expected additional transfusions were $300+ each; we were going to give Quora every possible chance. She’d been let down early in life, but in the end, she had family on her side who had her back. In this medical Hail Mary we could only hope to return a portion of the blessings she’d given us over the years. We would always be in her debt.
As the huddle broke and they left to enter the bowels of the college to prepare for surgery, I was comforted by some lady from the staff and asked to initial and sign things that I neither read nor remember. I wasn’t a veterinarian focused on the clinical and professional, I was a pet owner whose daughter (yes, we call ourselves our pets’ mom and dad, and call them kids and treat them as such) was in trouble and I was having trouble keeping it together. I wished Teresa was with me, but unfortunately (for me) or fortunately (for her, as she doesn’t handle life-and-death with pets very well), she was on a girl’s trip to Arizona with our daughter and her best friend, Mikkel.
I never left the same chair I’d been in all afternoon, the chair to the immediate right as you enter the front door to the teaching hospital, at the 5:15 position if the lobby were a clock dial. My amygdala has stored that chair in memory, always to be noticed and remembered on future visits, whether in person or in my mind.
I waited and waited. Two hours seemed like two weeks. I tuned out my mobile phone pinging and ringing, not even caring if it was the hospital trying to reach me. I knew, they knew, where to find me. I picked up a Smithsonian Magazine and tried to read about the history of salt water taffy, but what I saw on the pages were not taffy pullers or piles of chewy treats, but visions of Quora in my mind including:
- Our beloved granddaughter, Reagan, getting her finger nipped by Quora when she misjudged a juicy morsel of meat, and Reagan saying that Quora was no longer a favorite (a day later she was back in good graces and on her last visit was Reagan’s #2 out of six dogs with only her own dog, Willy, in front)
- Quora in full stride after a wild rabbit and keeping pace like a Greyhound down the homestretch at the track
- Quora being petted at night by Teresa, every time she got up to go the bathroom – which is a lot when you’re older
- Quora following Chops (one of my nicknames for Teresa) around the house and sleeping in a plumped-up dog bed at the foot of the Step Climber exercise machine, her head only inches from the protective cover over the noisy gear mechanism
- Quora, with what my Dad used to call a “shit-eating grin,” standing at the door with the ground squirrel carcass in her mouth, her stance a prance (like when we used to run in place in football), her eyes alive with excitement
- Quora in our small fishing boat on the lake, back feet in the bottom of the boot, front feet on the seat, happy panting as she surveyed nature
- Quora catching a Beggin’ Strip or Dingo in midair
- Quora letting her boyfriend, Quixote, lick her endlessly, or hump her when he got too excited. She’s return the favor by humping him, too!
Quora doing her one trick – literally a one-trick-pony, as she would stand on her back legs like a miniature Lipizzaner stallion racking the air with here front hooves (paws) when we said, “Dance Quora, dance!” - Quora slinking off at bath-time (she knew before any of the other dogs) and hiding under the bed in the guest bedroom. Very poorly hiding, I might add, as two-thirds of her would be under the foot of the bed with her back one-third still sticking out to see and latch onto when it was her time for the utility sink
It was 5:30 p.m. (I was still in the 5:15 position) when I sensed movement toward me. I hadn’t looked up, answered or checked my phone, had my mind wander (my mind is always chasing squirrels), or gotten up to get a drink, stretch,or take a bathroom break for over two-and-a-half hours. The people in the group moving toward me were still wearing surgery caps and gowns with masks pulled down.
There was Dr. Fransson, Dr. Chen, and a senior veterinary student who scrubbed in. Their looks were telling. With a sensitive tone and manner, Dr. Fransson described a complicated surgery during which they struggled to control Quora’s blood pressure (precipitously low), keep her blood clotting (despite transfusions), and the constant worry about DIC. What appeared to be with almost certainty hemangiosarcomas seemed to be confined to the spleen, which had been removed via a splenectomy.
We alternately talked and were silent for a few minutes, going over options, and it was clear that only one option was the correct one for us: to give Quora the final grace and let her go to a better place. I asked if I could say goodbye, and they said compassionately and with understanding, “Yes, of course, just give us a few minutes to prepare Quora.”
Quora had just been closed up (final sutures closing the abdominal incision) and bloody gloves taken off when the surgery team left the operating room to see me. So our blessed girl (Teresa and I always said she was our daughter, and Mikkel and Lex called her their sister) needed to be disconnected from the tubes and wires that gave her fluids, transfusions, IV injections, oxygen, and gas anesthesia, and monitored her heart rate, EKG, blood pressure, breathing rate, and blood oxygen levels.
While waiting those painful moments for them to come take me to Quora, I thought how many of you have mental images of reality TV veterinarians working alone, barehanded or with just surgery gloves (with no cap, mask, and gown), with no surgery team, heated blankets to keep the animal warm, or nurse anesthetist. Know that in veterinary hospitals that are state-of-the-art like many practices including WSU’s Veterinary Teaching Hospital, the equipment, supplies, protocols, procedures, and professionals mimic those of top human hospitals. In fact, we often boast that if there was a zombie apocalypse, you’d want to have a DVM with you rather than an MD. To us, a human is just another species, and we know how to do internal medicine, surgery, ophthalmology, dentistry, radiology, pharmacy. You name it, we do it.
The Three Wise Women (I’m not sure why I had that thought in my mind at the time) came back to get me with warmth and compassion I’ll never forget. Together like synchronized swimmers, they nodded it was time, and extended a hand to lead me to the hospital’s comfort room that was in a quiet area and featured subdued lighting, warm earth tones, a water fountain, and one-way glass. As the door opened, I could see Quora on a gurney (like a surgery table on wheels), sandwiched in a thick blue blanket that was folded like a taco shell. The table was just above my waist height. I asked if I could have some privacy, and the three left the room.
At first I just admired and studied Quora’s face. Although her golden brown hair of youth was now quite bleached out (like the Sun-In I used to put on my hair in high school), her nose was still jet black. She always had a receding chin-line that to me looked just the front of a U-boat in WWII. I traced its line with my finger clear down her neck to her jugular vein, where I found her heart beating at a rate of about once per second. I flipper her lip and looked at her teeth, and told her that I was so proud that those fang teeth had snagged a ground squirrel just days before; her dental health was exemplary. I checked the color of her tongue and gums, and was surprised how pink she was and how fast her capillary refill was, knowing that she was almost dead on the table less than an hour before and would have needed multiple transfusions if we’d have tried another option.
Still anesthetized, Quora was lying on her left side, I opened her right eye and saw nothing and everything. The normal light in her eyes had dimmed to something just short of total darkness. The pupil didn’t respond to light as I opened the lid; there were no tears, just the antibiotic ointment we put in pets’ eyes during prolonged surgeries.
With my left hand resting on her chest and feeling her heartbeat, I kept her right eye open; it was like looking in both a telescope and a microscope. I looked at every aspect of her eye, the sclera (white part), cornea, iris, lens, and deep inside – with my mind not an ophthalmoscope – at the optic nerve, tapetum lucidum (the reflective part behind the retina that makes dog’s eyes shine at night with a flashlight and allows them to see in low light). I followed that optic nerve into the parts of the brain that control vision, eye movement, and wake/sleep cycles. I hadn’t thought about the minute specifics of vision (like the cranial nerve II, fovea, and the Meyer’s Loop) for probably 40 years since passing National Boards. Why was that information still in my increasingly forgetful brain, and why was it in my mind’s eye now?
I think God wanted me to marvel at the complexity of the canine body, this incredible formerly utilitarian instrument (to detect threats, protect, hunt, herd, kill rodents, detect, flush, and retrieve game) whose complicated interactions would make the world’s most complex mechanical watches seem like Tinker toys.
In following the path from cornea to cortex, now I could see everything. There were both snapshots and videos of being trapped in a cage outside while her first family lived inside. Seeing daughter/savior Mikkel for the first time, resting in her arms, and preparing for an amazing first meeting with her new momma as Quixote’s apparent clone.
Quora’s first steps out into 150 acres of pristine mountain wilderness at Almost Heaven Ranch (what a change from a 2’ x 2’ wire cage), and finding her favorite napping areas in the three levels of our log house for the first time. What each dog’s favorite activities were with her from kisses, and eating horse apples together, to wrestling in the bedroom, to chases around the ranch. Going from dreams of squirrels as a little puppy to a regular game preserve of tree squirrels, ground squirrels, chipmunks, wild turkeys, and snowshoe rabbits to detect, pursue, apprehend, kill, and eat. Actually, the last three parts (apprehend, kill, and eat) were parts of a successful hunt imagined but never actualized, as the only animal we ever saw her with was the lone ground squirrel she found (we think a neighbor had shot it) days before her passing.
I took special time to tell her how lost and lonely Quixote was before she came into his life. And how Quixote was always bossy and a little crabby with every other dog of ours, or anywhere, except for his sister/girlfriend. I reminded her that while she was “sleeping single in a double doggy bed,” Quixote always pushed the master bedroom door open about 2 a.m., crawled into bed, and spooned with her until it was time to get up.
I could reel through videos of Quora boating with us, dressing up for holidays, opening her Christmas presents, begging for treats, jumping up into visitor’s laps, and spending lots and lots of her time with Reagan, who made her tea and served her food from the pretend kitchen. Our son, Lex, who prides himself on being stylish and put together, was especially loving and forgiving of Quora; when excited she exploded in a delighted frenzy of fur – literally and figuratively – and Lex wore her fur coat with graciousness and pride.
For some reason, I thought of the time that then- five-year-old Reagan wanted a baby to play with, and found the perfect participant in Quora, who lay still on a baby blanket, covered with baby blankets, as we sang her lullabies.
I let go of Quora’s eyelid, and it was slow to close. Like a camera shutter frozen and closing glacially show. Other than gravity working and the reflexive closing of the eyelid, the only movement of Quora was her steady heart beat and slow breathing. She was unconscious from the remnants of the anesthesia in her body. And this left me really unsettled. I have helped deliver the final grace (euthanasia) to hundreds of pets under anesthesia, but have never personally said goodbye under these circumstances. It hurt. It still really hurts, as I haven’t been able to empty my head of the tears that remain inside.
For every other pet I’ve lost in my life, I’ve cried the tears of a professional mourner. I’ve cried more tears for a new client’s pet’s loss than for Quora. Troubled by this, I’ve asked colleagues, friends, and family about it. Is this loss different because her passing was so quick and unexpected? Was it because she wasn’t conscious? When will the floodgates of grief open? It’s been a month. I’ll come to that stage of grief, won’t I? I pray for the release and the relief.
Speaking of floodgates opening, we’ve had a very odd summer in Northern Idaho. Lots of smoke from fires in British Columbia, Washington State, and Oregon, but no rain. Northern Idaho is very green, which means we get a lot of rains in the summer, but not this year. At the very minute I said my final goodbye to Quora and opened the door to the comfort room to walk out of the veterinary teaching hospital, I looked at the clock and it was 5:59 p.m. PT. At that exact minute, about 175 miles north of Pullman at Happy Tails Bed & Biscuit where the Qs stay with Auntie Kate when we travel, it poured down rain for a few minutes. Kate and I spoke later than night, marveling at the providence of this event, and agreed it was like the heavens wept for the loss of a special soul. By 6:01 the downpour stopped and the sun came back out.
The night of her passing I was at an airport hotel in Spokane, getting ready to board an airplane the next morning and jump back on the hamster wheel. I had a very vivid dream that woke me bolt upright, breathless and wide-eyed. I saw Quora running through tall, wet grass looking back at me repeatedly, encouraging me to follow. I wanted to stop her running and get her to come back to me, but my legs wouldn’t move, and even my arms felt stuck to my sides. When I spoke with Teresa and Mikkel the next morning, we agreed it was my getting a glimpse of Quora passing through green pastures and across the Rainbow Bridge, where she’s with all of the other animals we’ve loved and lost, who will be waiting at heaven’s gate for us to join them.
Mikkel, has faith as large and strong as the Rock of Gibraltar, and always goes to bat for family and helps hold us all together during trying times. I often think of her last words the day of Quora’s passing: “Until we meet again, may Jesus hold you, Quora. You deserve a special place right in someone’s arms, and until we can do that again, we hold you in our hearts and will never, ever let you go. We love you, Miss Quora Shoe.”
——————————–
Addendum:
As I write this, it’s been three months since Quora was given the final grace. I definitely haven’t gone through the five stages of grief as described in the Kubler-Ross model (denial, anger, bargaining, depression, and acceptance), nor has Teresa. In fact, I could be on Forensics Files on HLN and be hooked up to a lie detector and answer than I don’t think I’ve gone through even the first step. This has never happened before with the loss of a pet, friend, or family member, and it troubles me. Why? What? When? How will this eventually play out?
Our five senses are still filled with her. Beyond the many photos we’ve always displayed of our pets in silver frames around the house, scrolling electronic photo montages, or literally thousands of pet photos on our smart phones (I have over 12,000 photos on my phone alone), we seem to catch glimpses of her on her normal napping spots. Teresa has reached down to pet her at night on her way back to bed from the bathroom; we take the dogs for a walk and still get out her leash. When counting out Beggin’ Strips treats for the dogs I find myself holding five, even though we’re down to four dogs. I hear her excited yips when we return from short trips, and put the key in the door, and even smell her Frito feet when I’m watching TV. I swear, Quora’s still near. Thank you, God.
