Cancer sucks

A place of passing

“I’m never going back,” I have heard more than one pet owner say. They are talking about the office of their veterinarian, a person with whom they have built a relationship for years, someone they like and trust. But their pet died there, and the painful memories are too strong. So strong for some people that they go and find a new vet, even if they liked their old one just fine.

It’s one of the reasons I like having the option that I offer, of performing in-home euthanasia and pet hospice with Paws into Grace. Because I know more than anyone that as much as the client hated the office that one time, many pets hated it every time. That can be pretty upsetting for some families.

Which leads to the next concern, one I hadn’t thought of until a client voiced it to me. “I don’t want to go to the vet office, but I can’t euthanize my pet at home,” she said. “I can’t have that memory associated with my house.” So sometimes those clients end up decamping to a third party location, a park or a beach. And I respect that decision, though I would encourage those who feel that way to think on it a little while before making up their minds. Here’s why:

1. The precedent has been set in human hospice for staying at home.

The gold standard in human hospice, for those who have adequate support systems in place, is for people to pass at home whenever possible. That is by far the most comfortable place for a patient, in familiar surroundings. I was with my grandfather when he quietly died on a rented hospital bed in the living room he called his own for 40 years. He hated hospitals and I’m pretty sure had we put him in one, he would have haunted us all.

2. Moving an ill pet can be a challenge.

Pets who are very ill can be nauseated, painful, disoriented, and uncomfortable. This goes for people, too. How many times have we been down with the flu and known that we should probably go to the doctor but we feel too rotten to move? Same goes for pets. Add in mobility issues and it is just one more stress for owners, especially with very large pets or very upset cats- no matter the destination.

3. Your home is deafeningly, loudly, overwhelmingly a place of comfort.

This is the place Kekoa died:

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But unlike a vet office where I might only have a handful of memories, I see this place every day and I don’t look at it as the place my dog died. I look at it as my living room, the place we opened Christmas presents, the place Brody plops down while I’m writing. It also happens to be the place Kekoa chose to settle down and leave this earth, because she knew as well that this is a happy place.

And you know what? It still is. I am glad she chose our sun dappled living room. At home, when I administer a pet’s sedation, they choose where they want to be: outside, in the kitchen, in mom’s lap. People find comfort knowing their pet selected the place they are most at home.

home euthanasia pet hospice

I’ve only been in this house a year and it’s had more than its share of sadness. I am looking at the floor where Kekoa died while sitting on the couch where Apollo died. I actually drove him home from the specialty hospital as quickly as I could- after he got lots of pain meds, so he could curl up on my lap after everyone got a chance to say goodbye.

But right now, it’s the place my dog is chewing up a toy and my son is doing his homework. This is our home, where life happens. And I feel good about that.

Want more info or to know if anyone in your area provides this?

Not all veterinarians even know this service exists, and information can be hard to come by. Here are two national databases of veterinarians that offer this service:

The International Association of Animal Hospice and Palliative Care

Association for Pet Loss and Bereavement

Here in America’s Finest City of San Diego, you can of course reach me or my wonderful colleagues through Paws into Grace.

Filed: Blog, Cancer sucks, Daily Life, Euthanasia/Hospice, Featured Posts, Health, Musings, Picks of the Litter Tagged: , , ,

A Lesson in Love and Heart

One year ago today, we said goodbye to Kekoa. After a month of bucket list indulgences going from kale to turkey and then, that day, chocolate chip bacon ice cream, I said I love you one last time.

We pet owners talk a lot about heart dogs, that dog who just ‘got’ you, the dog who changed you and will never, ever be replaced (you can substitute dog for any pet, of course.) And once you have a heart dog, once you lose a heart dog, you may wonder if you will ever have another one again.

I’m here to say yes, you can.

Emmett was my heart dog, the dog who taught me fierce love and how to be a family and how even the best of us were allowed our jealous moments but we’d get over them eventually. He taught me forgiveness. I loved the other dogs I had before him just as much, Taffy and Mulan and Nuke, but he was the dog who spoke to my soul.

Kekoa was brought into our lives furtively, a sneak adoption if you will. We were supposed to adopt a different lab, a younger one, one glossier and with better teeth, but as I didn’t realize until after she was gone, she spoke to my daughter’s soul, and there it was. She was the shoe that fit. That was a February as well. This is her month, the month of heart.

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Kekoa lived without a spiteful bone in her body. I think she growled once in her life, when Apollo tried to steal a bite of her food, and even then it was more indignant than menacing. She loved food, almost as much as she loved us.

When she died, when I made the decision to euthanize her when her bone cancer was causing her pain I couldn’t control, I wrestled with the same emotions every pet owner struggles with: uncertainty. Is it the right time? Guilt. I’m acting too soon. Pain. I don’t like seeing this. She was bothered by none of this internal turmoil, choosing instead to just trust us and sleep in my daughter’s room at night. I was so busy thinking of my own distress I really missed the boat on thinking about how the kids would be affected, but Kekoa stepped in- completely unaware she was even doing it- to be there for them.

Many things happened afterwards as a direct result of her death. I began working with Paws into Grace. In the midst of my mourning, her story wrote itself into the book proposal I was working on, which will be a forever monument to her. I committed to getting certified in pet loss counseling, which I completed last week, in order to give a voice to those who are sad and suffering so they know: NO, you are not alone and your grief is real. They don’t call them heart pets for no reason. They take some of it with them.

She was a heart dog too, and I never even gave her credit for it until long after she was gone. This sad, head hanging little black dog with terrible head/chest proportions and bad gas taught me how to take care of others just by being true to yourself. If that isn’t love, I don’t know what is.

koa2

Miss ya, girl. Thank you for everything.

Filed: Blog, Cancer sucks, Daily Life, Musings Tagged: ,

We Will Remember You- Tonight and Always

Yesterday, I was working on a homework assignment for a course I am taking on pet loss and bereavement. I was reading about the guilt so much of us feel after losing a pet, and one of the exercises they recommend we do is imagine a conversation with our pet. I decided I would try this with Kekoa, as I struggled- like so many people do- with knowing if it was the right time to say goodbye to her last year as she dealt with bone cancer.

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Me: Kekoa, I’m sorry.

Kekoa: I love you.

Me: I feel like maybe I let you go too soon.

Kekoa: I love you.

Me: Do you forgive me if I made the wrong choice?

Kekoa: I love you.

I kept waiting for her to say something else, but that was all she ever had to say. It’s been almost a year, which is hard to believe. February 10th. A Valentine’s Day with a massively broken heart.

But now, I can think of no better way to reflect on this anniversary than to be with all of you, my friends, who can all relate to the special sort of sorrow this kind of loss rains upon us. The first- and hopefully not last- online pet memorial candle lighting ceremony is tonight, February 5th, 6 pm PST. I will be joined by several wonderful friends and we are so honored to be sharing in this event together.

How to Participate:

This ceremony, and this hangout, is for you and all you find meaningful. I encourage you all to participate to whatever degree you wish.

1. Watch

If you like, you can watch the Hangout right here, no special account required.

YouTube Preview Image

(Crying along at home is fine, by the by. I wish we let ourselves do that more often.)

2. Write

You can also watch the Hangout at the Google + Event page here. You do not need a Google account to do so, but there are two ways you can participate there that will require an account.

Share a memory: You can click on the Q & A button and write a memory of your pet.

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Share a photo: You can post a picture of your pet by clicking on the camera icon next to the “say something” box. If all goes as planned, I can incorporate those into the ceremony too.

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Tweet a memory: If you post on Twitter using the hashtag #petcandle, I should be able to incorporate those tweets into the ceremony as well.

Above all else I want people to feel included. This is a group-owned event. Feedback after the fact is welcome as well. If you’re not up to watching, we’ll be sending much love to you. And if you know of anyone who might want to watch, I would love it if you could share this with them.

Filed: Blog, Cancer sucks, Daily Life, Features, Musings, Videos Tagged: , , ,

We Will Remember You: A Pet Loss Memorial Candle Ceremony

There is something vastly powerful about going through grief with friends. It validates, it resonates, it comforts. When it comes to losing a pet, too many of us are forced to endure the pain without that camaraderie of a circle of friends.

To that end, and because I know so many people continue to hurt and feel alone in their grief over the loss of a beloved pet, The Tiniest Tiger and I are hosting a Pet Loss Candle Ceremony next Wednesday, February 5th, at 6 pm PST.

remember

What Will Happen

During this Google Hangout, we will be lighting candles to remember those who have left us, and to comfort those left behind. It’s open to all- kids can participate too!

 

How To Participate

1. Watch at home: at Google +, YouTube, or here.

The main Google + Event page is here. You do not need to RSVP to watch it, but if you do you will be sent a reminder through your Google account.

You can also watch at light your own candle at home without a Google + account. It will stream live, and also be up later as a recorded event, on YouTube. All you need to do is click on this link at the time of the hangout, or simply come back here and watch it here on this post.

Date: Wednesday, February 5th

Time: 6 pm PST (Click here to convert to your time zone.)

2. Watch and Chat

If you’d like to type in a question or memory during the Hangout, you’ll need a Google + account at plus.google.com.

3. Be an Online Candle Lighter

If you would like to be online with us as a candle lighter, we will have a limited number of spaces. You will need a Google + account as well as a webcam- and a candle :). If you’d like to be a part of that, please contact me here or through my Contact Page and I can give you more information.

We are very excited to be doing this event as so many of us have known this sadness recently- or even not so recently. We hope you can join us!

Filed: Blog, Cancer sucks, Daily Life, Musings Tagged: , , , ,

Minimizing the Stress of Euthanasia

I can’t believe Koa’s been gone over a month. Sometimes I still look for her around the corner or find some black fur stuck to a sock buried in the laundry pile. We are still adjusting.

I did a quick Google Hangout video talking about some of the lessons I’ve taken from my own dogs as well as my experience in the clinic. I hope it has some information people find useful, especially to those who have never been through the process before.

Filed: Blog, Cancer sucks, Daily Life, Musings, Videos Tagged: , , ,

I want to go where they went

I do not profess to know what happens to us after we die. Even those who have strong faith in what will happen to us after we go are sometimes unsure of what happens to our beloved pets. And to them, I quote the great Will Rogers: “If there are no dogs in Heaven, then when I die I want to go where they went.”

When someone close to me passes on, be it person or pet, I have a dream about them a week or so later. I don’t know why, if it is a quirk of my subconscious or an actual visit or who the heck knows; the theologians can debate it all they want, but these particular dreams always stick with me long after I wake and give me a good deal of comfort. And yes, I had a dream about Kekoa a week or so ago, right before the funeral service in our backyard arranged by our daughter and very kindly attended by all four grandparents.

But last night I had a different dream, and regardless of what it means it really struck me because it’s the only time I’ve had one like it. Those of you who have been around for a while may remember me speaking about my grandmother Mary, who passed away several years ago and is the person, I believe, who most set me on the path I am on today as a veterinarian. You may also recall my grandfather John, who passed away just under a year ago. It was from him, I later learned, that I got my obsession with adventure and the dream of climbing Mt. Meru, which I accomplished last year.

So in this dream, I am driving around on a grassy hillside and I pull into a driveway, quiet and remote. Another car pulls up, and it’s my grandmother.

“Open the window so I can see your face,” she says. “It’s been so long.”

But I get out instead, and look in her backseat. And there is my dog Mulan, who died of melanoma in 2009, right before I started the blog.

Not Brody! This is Mulan and Emmett, in 2008.

“Is she doing better?” I ask, reaching in as she licks me.

“Of course!” Mary says proudly. “I know how to take care of animals. She is doing very well.”

I peer into the drivers seat. “Is my grandfather up there?”

“Yes,” she laughs. “But he doesn’t want to come out.” Which is typical.

I pat Mulan, and I start to cry.

“What’s wrong?” she asks.

“I just lost another dog,” I said. “She had bone cancer.”

My grandmother takes my hand, and says, “I’m sorry.” She kisses me and I wake up with a wet pillow.

You know how some dreams are. Some are bizarre flights of fancy, some dreadful chasms of dark worries come to fruition. And others, in those rare and brief moments, sweep you up in their elusive beauty and show you something that stays with you long after you wake. They feel real. And of all the people for Mulan to find on the other side, my sweet dog who was abandoned by an owner who didn’t feel like treating her flea allergies and wanted me to euthanize her instead, I’m so glad that at least in my mind, she found Mary.

I don’t know what it means, or if it means anything. But I am so glad it was a dream I got to have.

Filed: Blog, Cancer sucks, Daily Life, Musings, Photography Tagged: ,

Muscle Memory

Scientists have long been fascinated with the concept of “muscle memory”, that subconscious part of our brain that controls movement without us having to think about it. It’s what allows us to do complicated tasks such as riding a bike or typing “the quick brown fox jumps over the lazy dog” without having to stop and say, OK, I need to contract my left hamstring while extending my right quadricep and all those tricky things that go into motion. It’s what allows me to tie a knot during surgery without the laborious thought process that takes place during learning “around the forceps from the front? or the back?” After a while, it just happens.

It’s funny how it pops up in the most unexpected places. For the past 3 years, Kekoa has been my footrest. I literally could not sit in the house without her wedging herself beneath my feet. Now, my feet head toward the floor, expecting a mass to bring them to a halt about 12 inches off the ground. I don’t think about it or calibrate their momentum, they just go with the intent that they will hit fur. Without her there, they crash repeatedly into the floor, each time a jarring reminder of what is no longer there.

It’s odd to me how strong those tangible physical reminders can be. For some reason, I can’t remember the exact timbre of my individual dogs’ barks- and I know they were all quite distinctive- but to a one I can tell you how their heads felt in my hands. Taffy, light as a feather, ready to nip at the slightest provocation. Nuke, needle-nosed and gently, resting into your palm. Emmett, like a solid football, sturdy and reassuring. Mulan, like a brick, wide and solid.

Kekoa’s head was disproportionately small compared to the rest of her body. She looked somewhat like an engorged tick, but in a nice way. She would lumber over and plop on your feet, her manticore tail smacking into the wall with such force you’d think someone was cracking a whip on the drywall. She never seemed to notice. Such was her excitement that she would hover over you, massive, looming, and then with the gentlest motion ease her tiny head into your hands and cover them with kisses. You’d try to push her head away when you had enough but then she’d kiss that hand too, so eventually you’d just give up. Her tail wouldn’t stop wagging the whole time.

She had a terrible wail. A piercing bark so heartbreaking and eardrum-wrenching that she lost two homes because of it. We used our baby monitor to listen in while we were away, and eventually I had to stop because it was too much to listen to.

That sound I can’t bring up. Already, I’ve forgotten it. But the sound of her tail hitting the cabinet, and the feel of her head in my hand- those will be with me forever.

Are there any strangely strong memories you carry with your pets who have moved on?

Filed: Blog, Cancer sucks, Musings, Picks of the Litter Tagged: , , ,

Please God, let me go with my face in a plate of chocolate chip ice cream

Friday things were getting bad,

Kekoa’s leg was aching.

So you know, it’s time to go,

But not without some bacon.

 

Saturday was super great,

All day long we ate and ate,

Venison, rabbit, gator too,

All day feasting through and through.

 

And when Sunday came around,

Gray and rainy, under cloud,

I sat down and then I cried,

Cause it was time to say goodbye.

 

When the doctor gave the shot,

My dear dog, she felt it not

Because she had – don’t get me wrong-

In her paws, a treat filled Kong.

 

As she slipped away to dream,

She was slurping down ice cream.

Chocolate chip with bacon too.

When I go, I want that too.

 

I am sad and I will cry.

No one wants their dog to die.

But this gift I had to give-

Before she died, she really lived.

 

 

Sweet Koa, in our family for three wonderful years, in our hearts forever.

Feb 10, 2013

Filed: Blog, Cancer sucks, Musings, Picks of the Litter Tagged: , ,

Buckets of food: Tramaducken

Tramaducken: A turkey, stuffed with a duck, stuffed with a chicken, stuffed with assorted pain medications. Merrick makes a Turducken canned food that allowed me to get all three in there in one shot.

Did not have any problems getting the dogs to eat this, lick the plate, lick each other’s plate, then beg me incessantly for more.

Filed: Blog, Cancer sucks, Daily Life Tagged: ,

Buckets of food, Day 5: Pizza

Every bucket list should include a good bit of pizza, I think. So I sliced off a little dog-sized piece of a cheese pizza for Koa, just enough for her to get what all the fuss has been about these last few years.

Brody’s getting to play along just because I feel sorry for him being left out. That being said, if he wants in on this, he’s gonna have to work for it. He has no bucket list excuse.

Filed: Blog, Cancer sucks, Daily Life Tagged: , ,

Pain, masks, and the longest hike

It’s weird how the universe works in parallel sometimes.

About 10 days or so ago, I broke my toe. And just so you know I’m not making this up:

I really did. Not doing anything heroic, unfortunately. I broke it by running too enthusiastically into an unpacked box that was filled with some as-of-yet unknown substance, probably cement, or maybe iron bars or something. Nonetheless, what I thought was a stubbed toe turned into that mess within a day or so.

It’s not bad. It’s taped up and I can get around just fine, but that doesn’t mean it doesn’t hurt.

Bone cancers are known to be one of the more painful types of cancers. This is what I struggle with, with Kekoa. She was not acting particularly painful when she was diagnosed, though we know how a pet acts on the outside doesn’t mean they aren’t actually experiencing any pain. So the second I realized what was going on with her, I started her on pain medications. She has a little more pep in her step now, an indicator she was feeling better than she was.

I almost cried when I found this today:

Heaving herself up onto the couch is not something she usually attempts. It’s good to see her feeling well. I know it won’t last, so I am happy with what I can get.

So back to me and my inflated cocktail weenie of a pinkie toe. This weekend, there was a local meetup group that was hiking a trail called Mt. Woodson. I’ve always wanted to go, and this was the first time it’s worked with my schedule. I’ve missed being outside, my hiking routine cut short during the hassle of the move and the holidays. I really wanted to go.

Part of me knew that after two months off, I should start on a flat 3 miler, not a hilly 8 miler.

Another part of me knew that my toe was probably not ready for any hiking, regardless.

But I’m nothing if not impetuous and prone to occasional bursts of Type-A ness when it comes to competitive challenges, particularly when I’m competing against myself. So I stuffed my foot in the boot and went.

The good news is, the trail was choked to the gills with New Years Resolution types moving uphill like spawning salmon, so had I fallen, I was a mere 2 seconds away from salvation in the form of a high schooler with a cell phone.

The bad news is, I did indeed jam or inflame or otherwise brutalize my toe. The fact that no one in the group stopped to ask me if I had accidentally stepped on a rattler is an indication that mind over matter indeed works and my outside demeanor in no way reflected what was going on with my neural pain pathways. I made it, but man it hurt.

Pets are notorious for doing the same thing. Dragging themselves way beyond the normal limit, not wanting to disappoint us. I was distraught to read the Yelp reviews of the exact trail I was on and read people say that dogs were getting carried off the trail routinely, having pushed themselves to exhaustion trying to keep up.

I suffered the throbbing pain gladly, knowing there was an end in sight- though I did have to grit my teeth when I felt the bones grind against each other. Guess it was a break and not a sprain after all. I could take a rest when I needed, catch my breath, and go on. And shortly enough, I’d reach the end of the hike, and with some rest, the toe will heal. As long as I stop doing stupid stuff like this.

Kekoa, on the other hand, is on a perpetual hike with a broken limb, an ankle that, I know, pains her, though she, like me, is content for the moment to soldier on because the view is still worth it.

So when she stops to rest, I will know what it means. But as strange as it sounds, I’m grateful to have had this personal reminder of the power of pain, and be reminded of my responsibility to her to manage it as intensively as I can.

And of course, feed her lots of snacks along the way.

Filed: Blog, Cancer sucks, Daily Life Tagged: , , ,

Buckets of Food, Day 4: Sliders

Now this is what I’m talking about. Trader Joe’s super lean slider patty with a blob of ketchup.

I’m not sure that Koa has ever tasted ketchup, unless she stole something with ketchup on it at one point.

This bucket list thing is going over pretty well, I’d say.

Filed: Blog, Cancer sucks, Daily Life Tagged: , ,
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