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On Playing God

Picture of a sign indicating two directions: one is More Difficult, the other Less Difficult.

Damned if you do, damned if you don’t.

People make choices every day—lots of them, in fact. Pizza Hut, Subway, or that new Thai place? The solid blue shirt or the plaid? Some are so simple they don’t require much thought; others will haunt you for the rest of your life.

I adopted an adorable 8 month-old cocker spaniel named Sugarbear in 2008. I already had a 14-year-old cocker named Murphy that was in failing health and I knew he wouldn’t be with me much longer. Sugarbear was an adorable, loving, and somewhat mischievous companion who left a trail of shredded magazines, CDs, a treadmill, and a living room couch in his wake. I loved him dearly and he loved to be with me. A month after adopting him my other cocker died, and five months afterward I rescued a shepherd-collie mix named Rusty from a friend who’d lost some of his good sense. Both Rusty and Sugarbear were pups, and I thought I’d have many good years with them.

One evening when Sugarbear was just over four years old, he and Rusty were chewing on rawhide flips. Rusty decided he wanted Sugarbear’s as well. The scuffle only lasted a few seconds and was over; there was a loud burst of growling and snapping before silence fell again. I scolded Rusty and called Sugarbear over to me. I noticed a drop of blood on his foot. A closer look revealed a tear in Sugarbear’s lower lip. I grabbed a roll of toilet paper and my styptic pencil and tried to stanch the bleeding. I was eventually successful and took him to the vet the next morning. By then his lip had become swollen and the vet determined it was infected. Sugarbear received a shot of antibiotics and I was given some pills to take along. For some reason that particular event stuck in my head as the marker for what was to come.

I soon noticed that Sugarbear would occasionally bump into me when I walked on his right side. At first I didn’t think much about it. His eyesight quickly grew worse and he was diagnosed with SARDS, or Sudden Acquired Retinal Death Syndrome. His pupils dilated and he didn’t respond to visual stimulation. The disease has been suspected of being related to Cushing ’s disease but that exact relationship is uncertain. He also had problems with constant ear infections, and ear canal ablation surgery was recommended. The goal was to eliminate the long, golf club-shaped ear canal by reshaping the flesh to provide a shorter, more direct opening to the inner ear. That would provide better airflow and help prevent further infections. I waited a bit to give topical medications a better chance at working, but was told that waiting too long might allow the ear tissue to harden, or calcify. I approved the operation but in the following months he continued having problems. X-rays determined there was some calcification in the ear tissue and his ears hadn’t healed right. The ear tissue swelled, pushing his normally floppy ears out a little from the sides of his head. One ear canal swelled shut while the other remained open but smaller than normal. Powerful, expensive antibiotics were administered over a period of months, although I was told there was minimal blood flow in that part of the head so they wouldn’t help much. His ears seemed to get better though and the swelling went down. He had occasions where his eyes scanned rapidly back and forth, out of control, and it caused him to walk unsteadily. These events came and went.

I was advised after seeing another specialist that the next thing to try was a complete removal of both ear canals. The infected tissue would be cut away and the remaining area carefully cleaned to remove any lingering infection. The area would be closed over with skin and there would be no openings to Sugarbear’s inner ears although they’d be intact. I was told that, in most cases, dogs undergoing surgery could still hear as well if as someone were holding their hands over a normal dog’s ears. There were risks—major facial nerves traveled through each surgery site which could result in facial paralysis if they were nicked or damaged. If any diseased tissue was missed the infection could reoccur and result in more surgery. He had a pronounced heart murmur, which meant he could die on the operating table if his heart couldn’t take the strain. The surgery also cost $4000, which was $3500 more than I had. I left the office feeling trapped–there seemed to be no good options for my pup. After talking with my regular vet, a person I’d worked with for over fifteen years, I decided to keep him comfortable. I’d been told on previous occasions that if a sick pet lost its appetite and drank less, became lethargic, and lost interest in everyday activities or personal attention that it was time to consider putting them to sleep. Those would be my guideposts, along with vet’s determination of his overall condition. In the meanwhile I turned to my Christian faith for help. I believe in miracles and thought I might be able to get special help for Sugarbear since the doctors hadn’t given me much hope. That didn’t mean I stopped seeing the doctors—I prayed in addition to following doctor’s orders.

After a period of months I’d noticed some loss of fur around his lower lip and a skin irritation that seemed to be spreading. Antibiotics were again called for, as well as an appointment with a dermatologist. After a nearly six week wait for an appointment, during which time the condition worsened, he was diagnosed with a food allergy and a case of demodex. The demodex had no doubt been caused by antibiotics nuking his immune system. His thyroid levels were also way off. Sugarbear’s food was changed to a limited ingredient formula and he was prescribed two medications for the demodex and thyroid issues. It took almost seven months of monitoring and rechecking blood values to determine that the demodex was mostly under control and his thyroid levels were normal. His skin irritation stabilized and there was some scarring under his chin, but some hair had also started to grow back. After the demodex infection his ear tissue swelled out again, more so than before. He was also losing weight. Diagnostic x-rays showed some heart enlargement, although congestive heart failure didn’t seem evident—yet. There was no fluid accumulation in his lungs. The weight loss was attributed to a loss of muscle mass from heart disease.

During this time we had a daily ritual. When bedtime came I’d put him on my bed and flip him on his back at the outset. He’d lie there belly-up with his legs splayed to the wind. First I’d clean any goop from around his eyes, apply eyedrops, and cleanse his outer ears. Next I tended to his mouth and chin, carefully cleansing the area and removing any debris. By the time I wiped his pubic area (which had become leathery-looking due to the demodex and thyroid issues) and his butt (which had developed several small lesions) Sugarbear was usually snoring and deeply asleep. I’d lie down with him and go to sleep as well. Any time he stirred I knew it, and usually got up at least once to help him outside so he could urinate. Despite all his health issues he never lost his appetite, he drank well, and loved to keep me company. If I was working in the kitchen he’d lie on my feet; on the couch he’d lie beside me and occasionally turn to lick me enthusiastically on the leg before settling in again. He was a pup that was fully alive and, although blind, tuned in to his surroundings.

On Sunday, June 1st, I’d stepped out for a while. When I came back Sugarbear was wandering frantically in circles around my kitchen and bumping his head into the furniture. His head was held low, his mouth open, and his eyes were scanning like mad. As soon as I touched him he stopped moving around, and I carried him to the living room couch. We sat for fifteen minutes or so and he seemed better. I sent my vet an email with the details and asked if separation anxiety might be to blame. This question might have seemed dumb, but I’d caught him crying loudly on several occasions when I’d return from stepping out. When he knew I was back he’d stop, so I thought he might be getting himself worked up at my absence. Her reply wasn’t what I’d hoped—she thought the ear infection might be spreading into his brain. She wondered if he was in pain and suggested a pain medication. I had some from a previous treatment regimen and gave him a dose. I also determined I’d take him for a vet visit the next morning.

Monday morning he seemed fine when I was shaving and getting ready to take a shower. Suddenly he jumped up, all his legs locked straight, body trembling, mouth open again. He was whining a bit. And when I saw him my insides clenched up—I knew it was time. Sugarbear’s body was betraying him and the vet’s suspicions were most likely correct. I threw some clothes on, abandoning the idea of a shower, picked up Sugarbear’s rigid body, and loaded him into the cab of my truck. I’d called to let them know I was on my way. Fortunately they were only two minutes away, and I carried him straight into an exam room when I arrived. The vet did a preliminary exam and said she felt it was time. He’d most likely been having micro-seizures for a while and was now suffering from a full-blown seizure. After two injections Sugarbear’s struggle was over. He died in my arms while I blubbered like a baby. I had told him over and over in the months prior that I’d fight with him as long as he wanted to fight, and when he got too tired we’d call it a day. The little guy never gave up; his body forced him to abandon the battle. It was my job as a responsible guardian to end things before he died painfully.

I went back out to the lobby, still in shock, and ran into one of the male vets in the practice. He looked at me with a grimace and said, “Sorry to hear about Sugarbear. I know it’s rough.” I thanked him, and then he said something else while looking away from me. “You sure waited a long time.”

The implication of what he’d said didn’t sink in until after I left the office. Several days later when I returned to pick up Sugarbear’s ashes, there was a weird vibe in the reception area. One of the vet techs wouldn’t even look at me. Of the other two one seemed normal and the last one was reserved. Perhaps I was being hypersensitive, or maybe I was reading something that wasn’t there. But two weeks later I still have the feeling that I had been condemned in the eyes of some people there as a monster who kept my dog alive far longer that he should have been, for my own selfish purposes.

They can never know what the two of us went through together, and will most likely never know that my vet and I had charted out a baseline for what constituted a minimum quality of life. I struggled daily with my choice as well as whether or not it was yet time. I didn’t want my best friend to suffer unnecessarily, but we loved each other and I didn’t want to sever that bond a second sooner than I had to.

A lot of readers will make snap judgments about whether or not I did the right thing. Sugarbear had so many strikes against him that his premature death was almost assured. If I had a do-over I might put him to sleep a week earlier than I did, but not much more than that. I’m sure that would still make me a monster to some people.

If there was anything to be learned from the ordeal, it was this: don’t judge others. Even if you know the facts you can’t prescribe what someone else should do in a given situation. Be kind–you’ll have your own difficult choices to deal with someday.

 

The photo for this post, “IMG_1362” is copyright (c) 2012 by Sasquatch I and made available under a Attribution-Noncommercial-Share Alike 2.0 license.

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