(Cross-posted from my personal blog at GoodFaithRanch.com)
A few weeks ago my 14-year-old Sheltie, Drew, started to increase his drinking and decrease his eating. Shortly after, my veterinarians confirmed my sad suspicion: My dog’s kidneys were shutting down.
As deaths go, kidney failure isn’t a bad one. A couple years ago my father faced the choice of dying of kidney failure or liver cancer, and after being completely informed about them both, he chose the former and refused dialysis. He passed peacefully at home a few days later, and I’m still in awe of his brave decision to choose the time, place and manner of his demise.
Of course, that’s what many of us do with our companion animals, and I’ve seen enough people bungle the decision to know how difficult it is. Over the years I’ve made the decision for all of my own animals and a few belonging to friends and family. I’ve come to believe that I won’t personally make a Hail Mary pass for myself or anyone else, animals included, and that I would rather help an animal to the other side a week early than a minute too late.
That said, I truly believe in hospice. For people and for pets.
I recently wrote for Vetstreet about the hospice movement in veterinary medicine, focusing on Nancy Hurley, a woman who had cared for her own 14-year-old Sheltie for months after a diagnosis of cancer in the dog. She and her husband had to have Savannah euthanized on the day Drew entered a state of hospice, a situation which I found incredibly powerful, as if Savannah’s fight had moved across the country to my own dog.
Hospice is often about managing pain, and I’m glad that I’m not having to do that with Drew. I went through it with my retriever Heather a couple years ago, and it wasn’t easy for either of us. Like Savannah, Heather had cancer, and like Savannah, I had to let Heather go when we couldn’t control the pain any more.
For Drew, hospice is considerably less stressful. Every morning he gets 500 ml of IV fluids, delivered from a bag hung from my dining-room chandelier through a needle to a spot under the skin and over his shoulder blades (top picture, but you have to squint a little to see the clear IV bag). Drew usually falls asleep on a towel on the table while getting his fluids, a process which, thanks to a nifty product called a pressure infuser, takes just a few minutes. A couple weeks after starting with daily fluids, Drew’s kidney values are normal. It won’t last, I’m told, but it was very good news indeed to get last week.
While Drewbie doesn’t mind the fluids at all, we are having one hospice difficulty: Getting him to eat. Pets (and people, for that matter) with end-stage kidney disease typically don’t have an appetite, and not eating can hasten their deaths — rather quickly, I’m told.
Drew is on a prescription appetite stimulant, but it doesn’t seem to help much. He is also getting a little medicinal marijuana (legal here in California), which appears to help with nausea but not with appetite, at least for Drew.
Typically, he’ll eat a little of something really yummy for a couple of days, then stop. Rare roast beef, deli turkey, yogurt with peach slices, beef lasagne, pasta with beef balls, cheese, baby food, apple slices with peanut butter … I’ve been rotating through them all. I’m afraid the other dogs and I will put on some weight snarfing down the leftovers when Drew walks away from something he ate happily the day before.
Friday night, my housemate (Ed Murrieta, who’s a writer and a trained chef) made him a special meatloaf, after Drew showed enthusiasm for store-bought meatloaf from the Whole Foods takeaway counter. That’s a picture of it. It’s made from ground turkey, Honest Kitchen‘s Embark dehydrated raw food and Nuzzles treats, eggs, and my friend Jill Gibbs’ JillCookies, chopped fresh tomatoes, grated apple, and cheese.
Today, Ed’s experimenting with some sort of baked liver puree.
So far, so good …
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