I’m sitting in the waiting room of the emergency vet clinic at the University of Minnesota. The hum of the vending machines. Folks typing at the reception desk. Sneet falling on the skylights above my head.
Last night The Big E and I went out in search of Chikoritas. (More about that in a future post.) We were gone two hours. Ace reports that Rafa stood at the back door the entire time. Barking. By the time I got home, Rafa couldn’t breathe. Two hours of riled-up barking is bad for a guy with congestive heart failure. I gave him extra hydrocodone for cough and two doses of sub-Q furosemide. Then we sat and panted and coughed and peed until 1 am. I went to bed, hoping he’d make it through the night, wondering if I was a bad mother for not taking him to the ER at 0100.
The pointer puppy wags her whole body while her human dad pays up. “Can I pet the baby?” I ask. He warns me about her sharp puppy teeth. She climbs me with her lanky freckled paws, trying to gnaw my hair, my jacket, my hand.
We’ve known about Rafa’s heart failure for close to a year. One of the valves in his heart is shot, so blood can’t pump efficiently. If you feed the guy a hot dog, the salt load makes him drink excessive fluids. And because the pump isn’t great, the excess fluid winds up in his lungs. Just like in a person. To confound the issue, his enlarged heart pushes on his trachea, making it even harder to breathe.
I wonder why vets haven’t banned branded materials from their facilities. The clock, the calendar, the poster of ideal body weight, the model of heartworms threading between the cardiac chambers. Free advertising for Big Pharma.
In November, Rafa went into acute respiratory distress. Most of the details are fuzzy. I clearly remember carrying him into the U ER. “He can’t breathe,” I say, tears streaming down my face. The receptionist calmly takes him from me – “We’ll take care of him right away.” She fastwalks him into the back room, into an oxygen box.
He’s in the box again now. It’s a small-dog Japanese style oxygen bar, a wall of 2x2x3 boxes. I want to sit with him, reach my hand around the Plexiglass, scratch his head. The vet thinks the excitement will be suboptimal. So I sit in the waiting room, the sneet turning to drizzle above my head.
Rafa has a cardiologist. Rafa, the Pomeranian, has a cardiologist. Dr. Stauthammer is a lovely man – warm, smart, funny, pragmatic. After the scare last fall, we meet with him a couple times. I ask him to prognosticate, look into his crystal ball, see into the future of my fluffy boy. Maybe Rafa has a year. Maybe more, maybe less. We’ll see.
Today I tell the receptionist, then the vet student, then the vet attending: Rafa is Comfort Care. I do not want him hospitalized. I want them to help him be comfortable and if he can’t be comfortable at home, I want them to euthanize him. Sometimes my words are accompanied by tears. By the third time around, my words are stronger. Less wet.
How do you measure a dog’s quality of life? Rafa has it pretty good. He races up and down the fenceline, barking at the neighbor dogs. He gets his pills in yogurt or peanut butter or a meatball or rice, whatever I think he might like at any particular moment. We go on family walks, Ace, The Big E, Chester the Lab, Rafa, and I. Rafa walks for a bit, sniffing and marking. Then I put him in his baby jogger. Yes, I’m one of those people.
A family comes in. The parents carry a white box, the top tapered like a coffin. In the box rests, I presume, a medium-sized dog. The mother walks backwards, the father forwards, the pajama-ed children swirling around their legs. Messages of love are scrawled across the box in multi-colored ink. The vet techs load the box onto a red wagon and wheel it away down the hall. The eldest daughter stands in her mother’s arms.
I, privileged. When I check Rafa in, the woman asks “Are you aware of our emergency exam fee?” Yes, I’m aware. I’m aware that my geriatric Pomeranian gets regular primary care including dental work, that he has his own cardiologist, that he goes to Uncle Dennis for in-home dogboarding when we’re out-of-town in a dogless locale, that his seven-day am-pm pillbox holds an impressive, expensive array of diuretics, inotropes, and narcs.
The attending and student visit me in the waiting room. Rafa is doing well in his oxygen box. They gave him a couple doses of IV furosemide and a stronger cough-suppressing narcotic. Stadol. We debate whether a chest x-ray will alter their treatment plan and I eventually consent. Diuretics strain the kidneys. Do you want to breathe or do you want to filter your blood and balance your electrolytes and fluids?
Several weeks ago, I left Rafa in the car with my purse. He opened the purse, removed the ziplock bag containing an unknown amount of dark chocolate, shredded the bag, and had himself a nice snack. I found the evidence much later. Rafa seemed fine – chocolate is toxic to dogs. I decided to leave him be, not induce vomiting. Death-by-dark-chocolate wouldn’t be a bad way for him to go.
I’m in hour three of sitting in this waiting room. My sweetheart sits in his oxygen bar, mildly stoned, comfortable. I’m cautiously optimistic that I’ll get to take him home in a form other than elemental carbon. I find an email from The Big E, a photo that he took of Rafa. My sweet human boy.
Over the years I’ve grown better about setting boundaries with certain “friends.” Cost-benefit analysis is a helpful construct. The intricacies of human-human relationship are so much more complicated than the normal simplicity of human-dog togetherness. If I tidy up the relationships in my life, dump all the people, the animals, the institutions into a pile on my floor and evaluate them one-by-one. When I KonMari these relationships, I can state one thing with absolute certainty:
Rafa, you bring me joy.