Molly’s owners were a wonderful, caring, elderly couple. They loved her dearly, to the point of harm to Molly. You see, Molly was a Yorkie and obese. She should have weighed no more than 5lbs, but she was pushing 9. Almost double her ideal weight. She also had lived to the ripe old age of 14. She was beginning to have a myriad of old dog problems; cataracts, arthritis, and early stage renal failure.
One morning, Molly’s owners called, explaining that Molly was coughing a lot and was acting like she couldn’t catch her breath. We told them to bring her in quickly and they were at the clinic within 30 minutes. When I entered the room, I lifted Molly’s lip and saw her blue tongue and gums. I explained that a doctor would be in to talk to them, but I needed to get Molly into our oxygen cage immediately.
I ran her back and turned the oxygen on as high as it would go, then closed her in. The cage was clear plastic on all sides, so we could monitor her. Then, I found the veterinarian and explained what was going on. She told me to get Molly stable and get the rest of her vitals without exciting or stressing her. Meanwhile, the vet was headed in to talk to the owners.
It turns out that Molly had been having breathing problems for a few days, but her owners just thought it was due to the hot weather. They consented to anything and everything we thought would figure out was going on and to any treatment necessary. It took about 10 minutes, but Molly finally stopped panting. We knew it was going to be tricky to get blood and her vitals, but it needed to be done. Another technician and I moved quickly, multitasking by getting simultaneous vitals. We saved getting the blood for last. Luckily, she didn’t seem stressed and sat still while we collected three different vials of blood. Then, we placed a blanket in the oxygen cage and a small bowl of water. She settled back in to her cage, got a drink, and laid down in the middle of the blanket.
Her bloodwork didn’t look good. Her kidney values were off the charts and she also had elevated liver enzymes. We needed to get radiographs of her, but we knew it would probably stress her, so we had to move fast. I went back and had the machine and computer completely set up, while the other tech brought her into the room. We measured her with the calipers and set the machine for her size. We quickly took the first x-ray with her right side down. Once it processed, we took the second with her on her left side. Again we had to wait for the machine to process the image. The last image required her to be on her back and still, which might stress her and cause her to become cyanotic again. The second the machine was ready, we flipped her over, got her into position under the beam, and pushed the button. By the time the machine beeped, Molly was panting again and the other tech rushed her out of the room and back to her cage before the machine had even processed the image.
The news was bad: congestive heart failure. Her heart was gigantic compared to her tiny chest cavity and was obviously not pumping efficiently. The doctor was concerned that she was also retaining fluid, a combination of kidney and heart problems would cause a build-up of fluid that would also make breathing difficult. We gave her an injection of Lasix and started her on an inodilator and an ACE inhibior for her heart. Treating her was going to be tricky. We needed to start her on IV fluids to flush her kidneys, but we risked adding to the fluid retention caused by the CHE. Monitoring her closely was going to be key. We let her relax for about 30 minutes, then placed an IV catheter in her leg and began running fluids.
The first day was hopeful. Her owners came and visited multiple times, but whenever they did, Molly would get too excited and stressed. We knew it was tough for them to see her like that, but we asked them to view her from afar, without approaching and getting her excited. She seemed to be responding to all the treatment positively and she was able to sleep, something she hadn’t done for a few days due to her respiratory distress. We did her evening treatments and settled her in for the night. She would be monitored by the night assistants and doctor for any changes.
The next morning, I came in and she seemed ok, not as perky as the night before, but still doing ok. She ate some of the canned renal-specific diet we gave her and took her morning medication. I had her out of the oxygen cage while I was taking her vitals, and she immediately became cyanotic. I quickly finished taking her temperature and placed her back in the cage. When the veterinarian came in for the morning, I let her know that Molly was still unable to be out of the oxygen. We both knew that didn’t bode well.
The morning progressed and got busy. I was taking care of other animals in our treatment area and we had a few surgeries to preform. Molly’s cage was positioned strategically in the middle of the treatment area so we could monitor her while doing other things.
Late morning, I noticed a change. She was laying sternally in the center of the cage, head down, panting. It was the first time she had been panting while being on oxygen without having been taken out of the cage first. However, that wasn’t the most concerning symptom; her eyes were glazed over. I stopped what I was doing and tapped on the outside of the cage. She didn’t move. I opened it and petted her back. She raised her head slightly, but immediately put it back down. I called for the vet. She rushed over and listened to her chest. We made eye contact and I knew, Molly was leaving us. The vet rushed to the phone and called Molly’s owners. They had called that morning and were to be coming in mid-day, but Molly wasn’t going to make it that long.
She told me they were only a few minutes away. I had wrapped Molly in her towel and hugged her to my chest. I gently bounced with her, as you would with a new born baby to quiet them, and hummed gently to her. I wanted her to know I was there and she wasn’t alone.
Death isn’t pretty. It isn’t like it is in the movies. Death is ugly and sometimes takes a few minutes to fully take hold of a being. For Molly, she started to stretch and began agonal breathing- a gasping, reflexive type of breathing. I gently laid her on the treatment table and listened to her chest with my stethoscope. Her heart had stopped. I began chest compressions on her tiny frail chest. From my vantage point, I could see into our parking lot and saw her owner’s car pull in. The doctor took over while I ran outside to get them.
I met them at their car and told them Molly was leaving us. They moved as fast as they could into the clinic and I lead them back into our treatment area where the doctor was listening to Molly’s chest. They were a minute too late. Molly was gone. We brought them into an exam room and wrapped Molly in her blanket so they could spend time with her.
They stayed with her for more than an hour, reminiscing and telling her they loved her. I came and went in between my obligations to other pets. Finally, they were ready. Molly was cold and her bladder and bowels had expressed when her muscles had relaxed after death. Luckily, the blanket had concealed most of it. They had decided to have her cremated and have her ashes returned to them in an urn. I had already filled out the paperwork for the crematorium and prepared the cadaver bag for her. We clipped a tuft of Molly’s hair to place in the sympathy card and I gently placed her in the cadaver bag. I gave her one final pet and told her goodbye, a habit I had gotten into with any pet who I helped over the rainbow bridge. She had been very loved, and I smiled knowing she was out of pain now.
Every pet I have been there with has taken a little piece of my heart. It’s a blessing and a curse to be able to euthanize, but it’s much harder to have them die in your arms, knowing you can’t do any more. To feel their hearts stop beating, their chest stops breathing, their body relaxes as life leaves them. Sometimes it’s tragic. A life taken too soon due to an accident or a sudden illness. Thankfully, most of the ones who I held until the end were in the end stages of life and death was a welcomed friend.