Goodbye Lettie

Today is Lettie’s Last Day.

She came into our lives November 30, 2002.  A year and a half old, she spent the year before in a shelter, and six months before that with her first family.

She had escaped or had been abandoned in the North Dauphin, PA area around that time.

Lettie is named after the Animal Control officer that saw her potential and took her to the No Kill Shelter that I found her at.  Thank you Paulette, I am forever in your debt as a result.

She has been with us for the last 10 plus years and now it is time to say goodbye.

She went from being terrified of other dogs to being one of the most well behaved, if not a bit wary,  dogs that I have ever had the privilege to know.

After having the thyroid problems for 2 years, and the chronic renal failure for around one, including 3 months of twice daily feeding via syringe, it’s time to end her suffering.

At 1pm today, I have an appointment to lead her “Across the Rainbow Bridge”.

Goodbye Lettie.  We’re done.

Advertisements

Chronic Renal Failure 1, Lettie 0. We’re Done.

If you are reading this blog for information on Chronic Renal Failure in Dogs, you will want to search for that tag here.   I’ve documented the last two years of my dog, Lettie’s life.  All the mistakes, all the trials, and all the triumphs in combating the disease.   I’ve been told I did better than most, a year past the formal diagnosis, three months of syringe feeding, and so forth.

While I am not a vet, I may be of help. 

Yesterday I made hard decisions.  

We all think they were the right ones.

What made it final for me was the feeding session yesterday morning.

I’ve been syringe feeding my dog, Lettie for the last three months.  I had a visit with the vet the night before, Wednesday.  The vet expressed shock that I had been feeding her with a syringe for that long.

Her reputation was that she needed “Caution”.  She’s fear motivated first, so if you scare her she will show you teeth.  And by “you” I mean, Me.   I’ve gotten growled and snapped at, and sometimes she even connected.  It’s fear. 

Take one extremely intelligent dog and surrender her at 6 months to a shelter.

Six months later at her first birthday she gets out and lives with me the rest of her life.

Sure, she’s going to be fearful.

The vet said we’ll have a longer life expectancy if we shift over from the prescribed “I/D” diet for Pancreatitis, to “K/D” for Kidney Disease.

He didn’t realize that there isn’t a dog on the planet that likes “K/D” food.   The consistency is like modeling clay, play doh specifically.   She fought me every syringe.

In fact, yesterday morning, when I went to feed her, it took me 20 minutes to get one syringe in her.

A Syringe is 1 1/4 ounces of food.

That’s 1/2 of a bathroom paper cup.

I realized after 40 minutes that she had given up, and now it was time for me to as well.

I had a discussion with Kevin about this, and initially he said that he thought maybe we might…

But he came around too.  It didn’t take much discussion really, maybe a sentence or three.

The 20 minutes a syringe was the clincher.   You see the first time I fed her that K/D food, she rejected it completely.  Pump a small bit of about 1/2 Tablespoon into the side of her mouth behind the canine tooth and wait. 

I didn’t have to wait long, she immediately spit it out.  

It was a grey brown blob sitting on my foot.

I kept after the entire syringe and reloaded those blobs that were all rejected and I realized that I just spent 5 minutes feeding a dog who completely rejected 100 percent of the syringe.

Try again.

I had the time after all, but it was almost the same story.   She only kept in about 5 percent this time.  This was on Cerenia, a powerful Anti-Nausea drug that you are only supposed to keep her on for 4 days.  She was on Day 7 of this.

Eventually after 40 minutes and 2 syringes I quit.  She should get 10 syringes a day plus a lot of snacks.

I was due for a vet visit later, and that gave me time to think about it.   The catheter in her leg had to come out.

When I got to the office I had decided that we should cease all treatment, and only provide Hospice Care.   Make her comfortable and see how it goes.

While waiting to tell the vet this, I weighed her.  She was down another .8 pounds.  

.8 pounds is not shocking except that this was in One Day.

In short, She was telling me “It’s Time” and I had to stop being stubborn.   It isn’t helping her.

We spent an hour at the vet, and everyone came to me and told me that we were doing right by her. 

Armed with some “A/D” food for “Anorexic Dogs”, three tissues to help me from tearing up, and minus one leg catheter I went on my way.   With plenty of goodbyes, and eyes teared, we got in the Jeep and went home.

Lunch with Lettie was different.   All the rules are off.  It’s like giving Grandpa that one last slab of Death By Chocolate when he’s in the hospice and has diabetes.  

I was grilling chicken and she was getting some.  Never mind that the salt would mess with her system from this frozen chicken breast, she wanted it.

In fact, I’m glad I grilled four because she had 1 and 1/2 of them immediately, and another 1/2 at dinner time. 

Real Food makes one feel better even if it is bad for your long term survival.

This morning, syringe feeding the A/D food took me under 10 minutes.   An entire can went into her in that time.  

She looked at me confused when I told her “We’re Done”.   The battle was over and she was expecting more fight.

So you see, she realized it too.  She stepped forward and put her head down and gently on my chest.  Whether it is to show acceptance or thank you I don’t know.

The Final Appointment for that trip across the Rainbow Bridge is scheduled for Wednesday 1PM April 10th, 2013. 

We wanted one last week to enjoy each other.  Eat bad food.  Bark at the plastic duck in the pool.  Sniff the Lemons on the tree.

Dog Stuff.

“We’re Done.”

Waiting on the Vet Day 4 – Not Good News At All

When I got to the vet at 5:30 last night, I got some bad news.

The number that was quoted to me was incorrect.  The nurse had read the wrong BUN number.  Since the right BUN number was almost unchanged from the first day, that basically says we need to consider our options.

We talked, and the conversation was basically a “You don’t have too many things you can try at this point” speech.  In other words we are pretty much on our own.

This morning I went to grab the food and feed Lettie.  A syringe took me about 25 minutes.   The second took 15 minutes.  That was for about a small paper cup worth of food or 2 1/2 ounces.  She should be getting 12 ounces of food a day minimum.  Doubled, I’m giving her 5/12 of her daily diet. 

It was a battle all the way.  Squirt in about a teaspoon.  She would grumble and almost immediately spit it out.  Keep squirting in teaspoons and sometimes she’d chew and swallow, but only about 1 in 10. 

This is a dog who has given up.  That is the nature of Chronic Renal Failure in dogs.  You can want them to last forever, but the reality is that they won’t.

So things don’t look good.   I have to bring her back to the vet today.  I’m really thinking that the best course of action is to schedule her end and stop treatments.

If things change, of course, I’ll let you know.

Finally, Some Good News From The Vet

This Chronic Renal Failure is a bear.  Especially in a pet since you can’t really do Dialysis or a Kidney Transplant. 

On the other hand, sometimes you get a pleasant surprise.

Lettie was in the Vet’s office for two days of fluid replenishment via IV.   When she first got there they did blood tests.  Her “Blood Urea Nitrogen” levels were three times higher than normal at 120.  

Today they were in Normal range of below 40. It wasn’t even listed on the “Exception” report I saw.

She snapped back.

Of course it still takes me 30 minutes to under-feed the dog.  That’s by her choice, not mine.  I’d give her cans of the stuff if she’d eat it.  My understanding is that there isn’t a dog alive that likes “I/D” food.

So today I get to bake a can down to “Dog Food Jerky”.  Slice the food down to under 1/4 inch thickness.  Roast at 350 until the thinnest pieces are crispy.

Only then will Lettie eat the damn stuff willingly.

That’s what Chronic Renal Failure does.  It makes you have to eat food that you don’t like.  At the end of it, you have to be forced to eat it.  One can is 10 syringes.  If it is roughly 700 calories per can, that’s 70 calories a syringe – about 1 1/4 ounces each.  She should get 5 in the morning, 5 at night.

Last night I managed to get 4 into her and 3 this morning.

If you are reading this because you’re researching feeding your older dog, that is why I am writing this down.  I’m also writing it down because I can be absent minded.

What happens is because the dog will starve themselves, literally, to death, you have to make allowances.   Push food at them.  When your dog is at the point that you are taking them in for IV Fluids, the gloves are off.

Today I got the following recommendation.   Since she’s starving herself, the “Creatinine” levels are high.  That indicates that she is “eating” her muscle mass.   To reverse that, feed lean meats – raw or cooked.   Just make sure that if it is cooked, it is cooked without salt.  If it is raw, make sure that it is clean.

Cook the chicken, cooked or raw meat from pork or beef. 

Chicken bones only if they are uncooked – Personally I will avoid that due to the risk of salmonella.

So Mrs Dog gets another day or so at the spa.   It will buy her some more time.  Maybe a month, maybe more, maybe less.  We just don’t know.

I strongly doubt I’ll put her through this again.  Her demeanor is much less “fiesty” than she had been.  Right now, on day three, she seems to be much more passive, as if she’s giving up.  This is an alpha dog, or a strong beta dog.   She’s also very fearful.  So to see her personality just “flatten out” says a lot.

For now, my friend will be sleeping next to my bed.  She will be waking me up no doubt since they’re
leaving the catheter in her leg and I’ll have to keep the blue “Cone Of Shame” on her.

But for now, we’re hopeful.

Waiting on the Vet – Day 2

This was the view when I opened the bathroom door this morning after my shower.

Mrs Dog, waiting on me, and our daily routine.  The problem is that the daily routine has been interrupted.

This is day 2 of the latest treatment regimen.  She’s been to the vet before, and generally doesn’t like it.  I can tell that she’s not feeling well because she’s a very passive dog about it all.

Yesterday’s results were very bad.  There’s a specific measurement of the “Blood Urea Nitrogen” levels.   It tells you how well the kidneys are functioning.  In my dog, they basically aren’t.  I was told “normal” is 34.  Hers was 120.

Four times higher.

While that was before any treatment, we do know she’s not feeling well and her kidneys aren’t working. 

What we’re doing is taking her to the vet for an IV drip of fluids to see if we can get the numbers down.  She’ll have her blood tested mid day today after a day of fluids yesterday and the morning treatment.  At that point we’ll see where she is.

Another day at the “Day Spa” for elderly canines.

Chronic Renal Failure is not an easy thing to treat in a dog.  If it were a human, she’d get dialysis or a kidney transplant.   For an almost 13 year old dog, that just isn’t going to happen.

Waiting for the Vet to Open

All weekend, we’ve been busy.

Some was good.  I had a good friend finally show up from Key West for a long weekend visit.  Never mind that this should have happened back in 2011, it happened and it was good.

Some has been quite bad.  

Lettie is going through another relapse of her Chronic Kidney Disease.  She’s been refusing food all weekend.  It’s been a battle to get her to keep some of the food down.

She’s supposed to get a can of special diet a day.  That breaks down to 10 syringes of food.  Five in the morning, five at night.

I’ll give her a squirt of around 1/6 to 1/4 of a syringe, about 1.25 ounces per syringe.  She’ll spit out more than half of it.

So needless to say the feedings take forever.  It took me 30 minutes today to get two syringes in her.  That’s basically 5 tablespoons of food for a dog that should be around 45 pounds.

Not enough.  That is the kind of feeding I’ve been going through all weekend.   If a dog will get sick, it’s bound to happen on a Friday, and especially if there is some sort of holiday going on. 

Trust me on that.

I’ll be calling the Vet shortly.  I’m sure they’ll want me to bring her in.   She’s not easy to handle any more.  A dog who’s main motivator is the avoidance of fear results in all sorts of adjustments.

Keep things calm and quiet.  Watch for her tail to tell you if you’re going “too far”.  Talk to her, which is difficult since she’s profoundly hearing impaired.

Life is tough when you are an old dog.

Wish me luck.  This basically is here to remind me of what we’ve been doing so I can repeat it back for the vet when I call in 11 minutes or so.

8 AM.

Brother, Can You Spare a Pizza? – Picture

Lettie is on a very strict diet.

Everything has to be on the Approved List, and the Approved List is really very small.

With her Chronic Renal Failure, twice daily Thyroid pills, creaky bones, slow walk, and general Old Age, Mrs Dog is on her Bonus Time.

It doesn’t stop her from getting her point across.

Being a fearful dog, she’s got a very gentle way of getting that point across.

She still wants anything that Dad, that’s me, has.  She now will beg from anyone that has anything that she thinks she can get something from, anything that she thinks she wants.

Since she’s incredibly intelligent, more so than many people I know, she also knows how to get that point across.  She was taught a long time ago the concept of Show Me.  That is, to say, she will lead you to what she wants and crook her head at it.  Then she will look back at you directly. 

Doggy says Gimme.

If she needs out, she’ll take you to the door.
If she needs water, she will walk you to the bowl and look at it.
If she is hungry for a treat, she walks you into the kitchen and looks up at the cabinet above the oven.

I just finished making a couple pieces of pizza warm and crispy, since nobody here in South Florida knows how to make a pizza.  At least nobody I have found…

Walking over to my chair, that was when the fun started.

She knows she is not supposed to beg, but she started.   Staring at me.  Two brown eyes.  Intensely melting through my soul like a laser beam, she was telling me that she wanted some of what I had. 

That piece of pizza.  Or one of three.  Doesn’t matter, Lettie was looking for a handout.

Unfortunately, the Chronic Renal Failure Diet means No Salt, No Phosphorous, Low Fat (Bad Pancreas too), and a host of other Noes.  No table food for Mrs Dog, at all.  I’ve had to dive for a piece of cold cut that fell onto the floor before she’d attack it.

She assumed the position in view of me, all the while she would stare at me with my shaking my head.

As I started piece number one, I saw Billy walk across the street with a handful of things to return.  He needed help with his computer.

By the point when Billy was inside the door, Lettie had assumed the position between the couch and the coffee table and stood, stock still, immobile.

The brown laser beams never stopped.  In fact, she just glanced back at Billy and then went back to staring me down.

Billy had the onerous job of trying to convince her to move so he could sit down on the couch.  Who knew a 42 pounds dog could take up so much room.

Nudge her gently, I said, She’ll move!

It didn’t work.

Try it again!

Nope.

No such luck, she wasn’t moving.

So Billy nudged her down one paw-print at a time to allow him enough room to put himself on the couch.   She wasn’t giving way easily.

But since Billy was seated, I was able to keep eating my lunch.  At least I DID offer him a beer.  I’m not a total waste of a host!

She migrated past me, to her mat.  The entire time I was shaking my head, the Universal Signal for No.  It didn’t work.  She didn’t stop until those three pieces of Mushroom Pizza with Sopressatta were firmly down my gullet.

None of us had seen her quite that intense.

I walked the plate to the kitchen and she calmed down but never stopped staring.

After a half hour of visiting and necessities, I could finally bend down to her ear and ask.  She wagged her tail knowing the ritual of Show Me was upon us.

I asked “Show me, do you want to go outside?”.

That would be a big fat no.

I was lead to the kitchen where she demanded retribution for not giving her that pizza.

Having given her a couple treats that were on the approved list, finally, the job was done and Mrs Dog could rest, happily, on her mat.