Greyla

2014 Sept 27

 Mind Flotsam ~ GREYLA

Yesterday was a beautiful day weather wise, but an extremely heavy day emotionally. I awoke from a pleasant dream, feeling that something had worked toward resolution with regard to an old emotional wound. A good start to a good day, was my hope.

When I took Greyla out for a walk, the day began to turn emotionally darker. 

Greyla is 15 years, 5 months old, and has some neurological degeneration in her hindquarters, along with arthritic changes. Her vision is poor and her hearing less than perfect. However, her sense of smell and the pleasure she derives from sniffing is topnotch. We walked through the grassy area that she loves, out to the highway, where she always stands with her nose scenting the breeze from the Sound, which I am sure is rich with salty sea smells. Then we returned to our space and RV. 

As we walked the area between our Jeep and the RV, Greyla misstepped and fell down. Because her hindquarters are weak, I tried to support her as she attempted to rise. This resulted in her front legs giving out for the first time that I had noted, and her snout hit the concrete. 

When I finally got her inside the RV, and explained to R what had transpired, he seemed to think it was an anomaly.  My thinking was more dire, which set me on a path of wondering how we will know when the appropriate time comes to put our girl down.

With Blue, our first dog, I had the guidance of both our regular Vet whom I trusted implicitly, along with the Vets I worked with at the emergency Veterinary clinic, and my dear friend Carol, also a Vet. Blue had dual problems, in that she had a tumor on her liver, as well as renal dysfunction. It was the hardest decision we ever had been faced with at the point in our lives, yet we knew what and when it had to be done. 

With Jake, our second dog, the diagnosis was less clear, and we took the necessary step to gain clarity before making any decisions. Once we were relatively certain his 13 year old body was suffering from Leukemia, I was still unable to let him go. I loved that boy with my heart and soul, and so for a short time, while he was on steroids in massive doses, I slept on the floor of our sunroom with him, as his IV bag hung from the ceiling fan. He was unable to stand on his own. I remember awaking from a nap in the middle of the night, on the floor next to him. He had had a bloody bowel movement and attempted to scoot himself away from it, resulting in his beautiful face being inches from the poop. I am haunted by the look in his eyes. At that moment, in perfect clarity I saw that I was keeping him alive only for me.

Our third dog, Baxter, was a rescue who came to us at six years of age. We loved him for six years. At 12 he began to have problems with walking and balance. After x-rays and lengthy exams and observations, it was determined that he had a brain tumor, in the area controlling his balance. It would only exacerbate with time. It hurt, but there was clarity about the decision.

Katie was the fourth dog we put down. She came from a shelter and lived with us for 13 years, which made her probably around 16 when we faced her euthanasia. She made the decision easy for us. She stopped eating, gradually and then refused to drink. She communicated her need to move beyond this life very clearly. She was the only one of our dogs to that point, who didn't die at home, yet it seemed fitting, as she loved all the people at our Vet's office, so when the time came, she was among lots of people who loved her, in addition to her family.

Greyla is another story all together! There were those, including our trusted Vet, who counseled us to put her down in April of 2013, when abdominal x-rays showed the reason for her labored breathing to be a mass, extending from her diaphragm to her small intestine. But, because nobody could site the origin of that mass, we chose to have an ultrasound, ostensibly as part of the diagnostic process. From the ultrasound we discovered that the point of connection for Greyla's mass was her spleen, not her liver, as we had feared. After much consultation with both the Vet who did the ultrasound and our steadfast, caring Vet, Ed Bennett, we opted to go forward with surgery to remove Greyla's spleen and the mass, knowing full well all the ramifications. Greyla's recovery after the splenectomy slow, but steady. And there has not been one day when we have regretted that decision. 

I need to say, that all of that did not take place in a vacuum. Only three months before Greyla's surgery, I had received information that my Daddy had stage four lung cancer, discovered when he required emergency surgery for a bowel obstruction. I was not prepared to have so little control over so many events in such a brief period of time. Keeping Greyla alive at that point, gave the illusion of some control.

While we were in Pittsburgh, both last year, and again briefly in late April, Greyla has had follow ups with her Vet. We currently have her on a combo of meds to ease her arthritic inflammation, as well as to ease any pain she has. We do not have a Vet here on the Island. However, All Pet Animal Hospital and their staff have been wonderful via long distance. 

The problem is, now that I see deterioration, and although she still enjoys going outside to sniff,and she has never peed in the house, although she does poop in the house in a laying position regularly, she still eats though with less gusto, and drinks normally, and we are mostly able to manage her pain, I'm not sure how to gauge when it is time to let her go. Add to that, the complexity of R's relationship with her. Greyla is technically R's dog. She was a gift to him for his 50th birthday, as he had expressed a desire for another female black lab. 

The other night I thought I saw just a shadow of the look that Jake gave me that haunts me still. However, I don't want to be the one who makes this determination. I don't fully trust myself ~ the past year has been a difficult emotional one for me, filled with loss and mourning, on many levels. And Greyla, although a sweet dog in many ways, is not the brightest bulb on the tree :) I'm not certain she has the depth of spirit that Jake had, so it could be that I'm allowing guilt to see things that don't really exist.

R's response to my queries yesterday regarding Greyla's health and general well being was, "Her life's not so bad right now". Is he correct? Or is he delusional? 

How do we know what is right and when it's right? Do we wait for her to be unable to walk at all? To pee in the house? To loose all interest in food? Does her dignity come into play? And does she even have the self awareness to have "dignity"? 

Yesterday, my conclusion was to wait it out until R sees and resolves that  the time has come.  Today I find myself wondering if he sees through eyes so blinded by love for her, as I was with Jake, that he is missing important clues to her well being.

I spend too much time crying because I fear the loss, yet cannot bring myself to say with certainty that now is the time to let her go. This sucks.

The Waiting Continues

2013 April 23 - 24

The Waiting Continues

On Monday, Dr Bennett called after Greyla's splenectomy was finished,but before she was fully out of anesthesia because he knew how worried we were. I was so happy to hear that she survived the surgery! My deepest fear had been that she would die on the OR table, and my extreme superstition would not allow me to voice that fear! They had removed the mass and spleen and ligated all bleeders. The mass was a whooping ten pounds! And as impressive as that is, the thing ruptured shortly after they removed it! Her liver looked "beautiful", to quote Dr Bennett. Her PVC, post surgery, was 34. Not out of the woods yet, but all in all, good news. 

[A splenectomy and removal of such an enormous blood-filled mass, is an equally enormous risk,especially in a dog who is broaching her 14th birthday. We were fully aware of the risks, but elected to do it anyway, because the alternative was to watch her slowly ebb away, in increasing discomfort, with the very real possibility that the mass would rupture causing her to bleed out and die. But the decision was not one we took lightly, for so many reasons, including the financial hit, with no guarantee of success. So, when Dr Bennett called, post surgery, my relief that she had not died on the table was palpable. Unfortunately, we perhaps failed to calculate the full cost of such invasive surgery on the sweet old girl, and we neglected to fully realize how long the recovery process would be.]

Later on Monday afternoon, Dr Person called to say that we should come out to Allpet around 7:30 to see Greyla and to decide where she should go for further post op care, since Allpet does not offer 24 hour monitoring. 

Seeing Greyla that evening, in her still anesthesia induced stupor, we knew that she needed much more care than we could offer her. Our choices were PVSEC or VCA Northview for continuing care. We opted for Northview, basically bc it was the closer place. Allpet kindly offered the use of their stretcher, provided we promised to return it. 

The drive to Northview, through the northern suburbs of Pittsburgh was stressful, but we arrived without mishap and Greyla seemed a bit more aware. They settled her into a double cage, with loads of quilts and blankets, and even a folded towel as a pillow for her head. She, for the first time since the surgery, lifted her head and looked at Raymond & me with possible recognition. The road to recovery was beginning. The doctor, Dr McKlveen, assured us that us that we would only hear from her during the night, if there was a problem, and/or Greyla needed a transfusion. She also told us that Dr Threadgill would be coming in at 7 and he would be in touch sometime around 9AM, to report Greyla's progress. We drove home cautiously optimistic.

Dr Threadgill did indeed call in the morning, around 8, with the update. Greyla was not yet able to stand or walk. Some of that inability may be a result of her old arthritic limbs and joints. She exhibited some abdomen tenderness. Her liver enzymes were down a tad. The white blood count was elevated slightly. Her pack cell volume was stable. She was alert, aware and responsive. We could visit around 11. She could probably be discharged when she was able to arise and walk.

Our visit to see Greyla went well. She was brought into the room on a stretcher, but was alert and responsive. After a time, we put the rubber backed rug we brought with us on the floor and coaxed her to try and get up, hoping the rug would give her purchase that the floor alone did not. Her initial attempt was a failed one, but her second try got her onto the rug, under her own power, where she walked a single circle, then laid back down on the gurney. It wasn't a lot, but for us it was an extremely BIG deal! We also offered her several varieties of wet food, but she wanted none of them. When we return to visit in the evening, we'll bring other things to try and tempt her to eat.

Upon returning home, we each set about our tasks for the day. Mine included at trip to the laundromat. AS I was finishing up there, my phone rang. It was Dr Threadgill. He reported that one of the techs told him that "his friend" was standing up in her cage & had made a couple of circles. They got her out, and the tech then walked her through the treatment area, out the back door and outside, where Greyla peed, then walked back! All on her own! No coaxing and no assistance! I was beside myself with joy! And, Dr Threadgill, bless his Tennessee heart, was too! He said, " I was so happy and I knew you would be too, so even though I'm almost ready to leave, I knew I had to call and let you know." I called Raymond & we were both happy! The plan was to visit sometime after 7:30.

We called Northview to be sure the timeframe for visiting was good and the tech we talked to suggested bringing any food we thought she would eat, regardless of it's nutritional value. So, on our way, we made a stop at McD's and got nuggets, which she usually loves, as well as a plain burger, to compliment the assortment of bread, treats and dog food we were bringing from home.

I was expecting Greyla to be similar to how she had been in demeanor earlier in the day, with the added benefit that she could get up and walk. So, when the tech walked her into the room to visit with us, although I was thrilled that she was walking, I was disappointed by her demeanor. She seemed dull eyed, compared to earlier in the day. There was no attempt to make eye contact. She whimpered. To me, her gums seemed pale. She had 2 small areas of fresh pale blood on her blanket. We offered food, she refused it. Although, at one point in the vista she opted to eat 2 or 3 very teeny bits of one nugget. When Dr McKlveen came in, I asked about her gums and the whimpering and the blood, and was told that her blood values were stable, the blood from the incision site was not a concern and that Greyla whimpered when she needed to go out to the bathroom. I do not think it was the Dr intention to be dismissive, but that was how I took it. The difference between Greyla at 8pm and Greyla at 12 noon was crushing to me. And had I had my wits about me, I would've shared the pictures I took when we visited earlier in the day with Dr McKlveen, and perhaps she would've seen it too.

We left and in the parking lot, I broke down in tears, yet again. This time tears of lose for what little progress had been gained and now seemed gone. Yes, I want my girl to be able to get herself up from a resting position and walk, but I want her to do it with a light in her eyes and spirit. 

So, we wait a bit longer…

This morning we got a call from Dr Sisk, the daylight Vet today, reporting that he is changing Greyla's pain meds to address her arthritis problems better. He said she is still able to rise and walk and go outside. She is still refusing food. He feels that she will progress, but due to her age it will be a long rehab period. We will visit around noon. We will allow her to stay until Dr Threadgill comes on duty at 7PM and reviews her condition. We will visit agin in the evening, talk to Dr Threadgill and depending on why he has to offer, either leave her another day, or bring her home tonight.

In either case, we will try and get some kind of ramp together this afternoon, because when she does come home, we're concerned about how to get her into the car, as well as in and out of the motorhome.