(E-mails to Caleb)
February Ô04
Caleb,
This is the situation. I brought EZ home with me to Minnesota. As you know she's been suffering another bout of her jaw infection/tumor. She seemed to do well traveling. SheÕs perked up a bit the past week or two. But, she was obviously hurting and continuing to hurt. Merilee suggested we take her to Carl, the veterinarian our family has employed since I was a kid. He's wise and has had a lot of experience and, what would it hurt to get a second opinion? I made the appointment over the phone and explained EZ's history and diagnosis so far.
I brought EZ in. She smiled at Carl's wife Margaret behind the counter and that was a big hit for everybody there. Well actually nobody else was there but Margaret and Mere and me, and of course EZ, who drew a lot of attention to herself by being such a happy girl with a smile, even though she was in severe distress. (Carl is semi-retired and does his work only for special cases or for people he loves.)
I'd told Carl that EZ would probably need anesthesia in order for him to look inside her mouth. (Carl is in his late 70s, has had a lifetime of experience, and is considerably respected in the veterinary field. He even has a couple of patents on procedures for veterinary care.)
I lifted EZ onto the scale so he could weigh her. 54 pounds. Down from her usual 60 pounds. He asked me to carry her to the examination table. I did. He said he wanted to draw blood first, to study for infection under the microscope. He shaved EZ's foreleg, I cuddled her head and whispered sweet affection into her ear while he punctured a vein. She didn't notice his hurt to her vein but enjoyed being massaged and talked to lovingly.
Carl kicked a stool toward me and told me to Òsit for a few minutesÓ while he examined the blood.
He came back after five or ten minutes and prepared to sedate EZ; tubes and narrow nylon belts with clasps on them. He tinkled bottles of Demerol and Ringer's Lactate and jumbles of other medicinal importances while he gathered the necessary utilities to carry out EZ's relaxation. Margaret dithered nearby, keeping track, licking envelopes out by the front counter and exclaiming over business matters known only to her and, maybe vaguely, Carl.
Carl told me to brace against the examination table as EZ, who was trembling and vibrating with excitement as she usually does when people, especially new people, are nigh and poised to possibly give her praise and attention, would soon be slumping. Carl inserted a syringe filled with white fluid. I watched as the fluid drained to half-full, then empty. He installed another chamber of white fluid and plunged it slowly away.
EZ softened and stopped vibrating. She relaxed against me. She relaxed quickly with her head at an uncomfortable angle. Carl said to move her head around so it was at a more natural angle. I moved it, then went and sat on a stool by a counter where I could watch EZ and he without interfering.
Carl called for a something and Margaret brought him a yellowish length of tubing. He opened her mouth and slid it down into her throat, pulled out her tongue, and pushed the tube farther. Then he clipped a clip of some kind to her tongue, squeezed a bellows on a machine, and barked at Margaret to bring over the "machine," which she did after a few moments of uncertainty which machine it was he wanted her to fetch. Margaret asked Carl something--all I heard was "waiting room." Carl said "no."
Carl squeezed the bellows and performed a lot of other technical procedures as EZ lay motionless in the bright operatory lights. Carl squeezed the bellows and I saw EZ's chest rise and fall. He worked fast but calmly. He squeezed the bellows a few more times then asked Mere and I to wait in the waiting room.
Whether routine or rare, I don't know. But EZ had stopped breathing and he was having some difficulty getting her to start breathing again on her own.
I went out and sat in the waiting room. "It's okay. Let her go. This is the best. We are trying to help her, but if it doesn't work out as we hoped and she dies now, it's okay. Let her go. Most appropriate."
"She's breathing again," Carl called a few minutes later.
Margaret said we could go. We could check back in an hour or two when Carl would know more.
So Mere and I drove away from EZ, attended by a dearly trusted man who cared about us and EZ, and who knows infinitely more than me about veterinary medicine.
We drank coffee and got Mom a birthday cake. Carl called the cell phone to say that he, at first, was sure that EZ's problem was most certainly a tumor and that we should euthanize her. Then as he looked through the microscope further he saw cells that could be nothing other than blastomycosis, a treatable fungal infection. "Blasto" is customarily a lung disease of dogs. It is picked up in swampy humid places, like riverbanks and river sloughs and rivery places where "blasto" spores live in the soil and wait to pounce on happy smiley dogs that romp and roll care freely there. It is a fungal infection that, when it gets into a dog's lungs and is untreated promptly, can kill a dog quickly.
I asked Carl about that. He said it is much more treatable now than 15-20 years ago. He also said it is not limited to lungs. It is more successfully treatable when it attacks a dog's bloodstream and sets up housekeeping in, say, a dog's jaw that has been punctured by cheerful chewing of sticks while laying in a boat on a river or while chewing sticks while laying on shore in humid swampy places that EZ dogs favor most keenly.
"How much will it cost to treat her? How is she treated? What is the success rate? She's an old golden, is it worth treating her at her age?"
"I'll know more later. I just wanted you to know, so far, what I've concluded," said Carl.
I thought it best to just finish it for EZ and let her go with the memory of me holding her close as she went unconscious and the myriad memories of how much we had savored each other through our many years of healing our wounds together. And that is what I expected to tell Carl when we got back to his office later.
So Mere and I went to celebrate Mom's birthday. We had lunch: Salisbury steak with brown gravy, baked potato with brown gravy, peas scattered but not disheveled, a half-slice of bread with yellowish spread on it, and a black plastic dish of apple sauce. The other three elderly ladies at the table eyed me curiously with a modicum of suspicion because I was not sociable and had tears in my eyes.
"Chris! My God!Ó said Mom when she noticed my plate nearly empty a few seconds after it had been put down full in front of me. That didn't make me laugh. But it does now, just a bit. It was deliciously vacant food, but food nonetheless and I liked the distraction from EZ's business at hand.
The staff served the birthday cake. It said "Happy Birthday" or something like that, with a minimum of gaudy thick frosting florets which Mere had ordered removed specifically, so no one in residence at the residence would have to vomit it back up because the sugar was much too disgusting.
Everybody ate theirs.
"We can save this dog," Carl said from behind the counter. We talked for a while. He showed me pictures of what a blastomycosis cell looks like and how, if it was a tumor that EZ had, it would not have waited more than two years to kill her.
"When I tore into her (cheek) and I saw the mass of mass cells I thought for sure it was a tumor and knew that she needed euthanizing quickly. But then I saw these blastomycosis cells and had to back up. The more I saw the more convinced I am now that it's blastomycosis. Her body is trying to rebuild bone around the jaw and cheek. The crystalline structures I broke through are evidence that it's not tumor but the body trying to localize and restrict the infection of blastomycosis cells.
"She can be saved."
"Okay. Let's do it," I said.
Carl went away to find the best price on serum. (Margaret yelled at him continuously about vendors and price and "what-about-Hazel's-dog-who-got-better-with-RoadRunner's-drugs?")
I asked if I could see EZ.
"Oh, of course," Margaret said and led me through the operatory and through an orange door. Cages lined the left side, heavy iron grates, rusty hinges, old mechanisms from the 60s, but so what? Empty cages except for the large one at the end on the bottom where EZ looked out at me with a very pleased expression. I went there. Margaret unhooked the latch and EZ lunged out.
Oh, Christ!
EZ's face was bloody, the left side of her face, her cheek. Blood everywhere, smeared on her face, blood dappling the newspapers of the kennel where she'd been, and blood draining off her lips, her face sunken on the left side where most of her personality had been sliced away.
"Jesus Christ," I said as she came out to me, wagging her tail, where the real essence of EZ lives.
"Okay," I said to myself crouching down to embrace a new paradigm of life from now on.
Margaret, sensing my discomfort at being forced to adjust and learn a new way of seeing life, ran to get a spray bottle of hydrogen peroxide and paper towel. She sprayed EZ's cheek where blood and puss were draining, telling EZ how, "we're all used to this but not everybody is, just yet." (I love Margaret and Carl. I adjust quickly to new paradigms. Okay? I'm just telling you how it was and how it was for me.)
So, we ordered anti-fungal medicine for EZ. It will be delivered to my house, hopefully, by the end of the week. I took EZ out of the kennel and out to the car. She peed first, then jumped up into the back of the car easily because that is her place and she was glad to be back where she knows her life is still in order.
She spent last night in Mere's basement by the door, on a blanket. She rode home in the back of the car today. She has not eaten for two days. She has not had anything to drink for at least two days, probably more. Carl said yesterday that she is dehydrated. She has a large hole in the side of her face. It is draining blood and puss. The blood and puss are drying and caking, becoming, to me (though Carl has said "let it drain") a liability for infection.
We arrived home today mid-afternoon after a hellish 7-hour drive. EZ mostly lay silently in the back. She rose up only to whine and whimper and yelp on occasion, to show me her violent ugly wound and her face sunken severely on one side. Then she sank out of sight. And I was glad that I didn't have to see her suffering but I knew that she was suffering all the while and it has not been a very good day.
Presently:
EZ is still breathing. I called EZ's vet (here in Rhinelander) at home and left a message that EZ is in a severe dehydrated condition and needs an emergency appointment tomorrow. She cannot open her mouth wide enough to lap a watery concoction of broth, or even liver food mixed lightly into water. She yelped when I quite slowly tried to open her mouth to put a syringe of water into her throat.
The vet called an hour ago to say to bring her in in the morning, early at 7:30, when he can install an intravenous feeding tube into her and get her re-hydrated.
This all seems to be a bad dream, how we are lead from possibility to possibility and abruptly diverted from doing what we sensed it was time to do finally very long ago. It's a madness we humans are equipped with, to hold out hope every time hope is dangled before our eyes, that "just maybe" what we know instinctively in our heart does not really have to be the dread we hoped to avoid for now.
And, you know, there are many things that will get funny someday. But this is not one of them.
Next dayÐ
Dear Cabe,
EZ died today. She went away peacefully with Dr. Goodroad's assistance at about 5 p.m.
Chelsea was there with me.
I brought EZ to the vet's office this morning so he could re-hydrate her and, against hope, maybe she would be able to open her mouth wide enough for me to feed her the medicine and, so, she could drink. Through the day he made her life less hideous through intravenous fluid and pain medication. But, there was nothing to be done to relieve her symptoms and suffering.
So, I found Chelsea at dance team practice and together we went to see EZ off. She was still EZ as we knew; she rose to greet us, though she hoisted herself in ghastly condition.
We held her and cooed to her. I got in a final "goit girl" as the doctor injected life’s end into her vein. She relaxed her head down onto our hands. And then she was gone, and her wag and her grin were tiptoeing on the front of a motorboat on a river somewhere with her ears flipping festively in the wind.
Ah, she's not hurting anymore and neither am I.
Dad D.
