Yesterday morning, after watching Libby have a frightening seizure the night before, and after having had her diagnosed with liver disease last month, I took her to a new vet for a second opinion. Ella, my eleven-year-old niece, and I arrived at the bright and bustling office of this "Animal Hospital" and were impressed with the efficiency and amenities there. We were brought into a very comfortable exam room -- an overstuffed vinyl armchair for me to sit in and a thick foam rubber pad covering the metal exam table for Libby -- and since the last vet sent over Libby's recent blood work, the new vet was able to go over those results with me.
"The good news," she said, "is that these first numbers here don't indicate cancer. And here, while the liver enzymes are high, they're in the high-normal range, so I don't know if I would have made a diagnosis of liver disease as a primary problem. I'm more concerned about these very low calcium and glucose numbers."
"Well," said I, "Libby did have a bladder stone about three years ago, so she's been on a calcium-restricted diet ever since. She eats Urinary S/O kibble and she doesn't get cheese or even apples and carrots anymore."
"That's good, and absolutely what was indicated, but I want to talk about these numbers here." She circled the next set of blood results and said, "These are for her pancreatic function and they're quite low, and when combined with the calcium results and these thyroid numbers down here, we see a different picture. I would recommend a new set of blood work to see what's changed in the last month, and if required, an ultrasound to have a look at the pancreas." Here she took on a very gentle tone and said, "I appreciate that you've already made an investment in Libby's care to this point, and people have other priorities with their budgets, and as she's nearly fifteen, if you want to say 'I've done what I can and I can't spend any more on tests', then that's absolutely fair. I'm not here to pressure you into more tests."
I could barely croak out, my eyes leaking and my hands shaking where they were holding the frightened Libby up against my body, "What are we talking about? If it's the pancreas, is it fixable?"
"I have two answers for you. If it's the thyroid affecting the pancreas, then there are medications that can fix the problem. If it's her pancreas that's affecting her thyroid, then there might be surgery involved. At this point, I would recommend the new blood work, that's about $250, and if it's inconclusive, we'll need to do an ultrasound, and that's around $450. But if you're at the point in your budget..."
I could barely speak, but I half mouthed, "We're not at that point. If it's fixable..." I couldn't go on.
The vet handed me a box of Kleenex and said, "Okay, good. I'll just take Libby back for that blood work. We'll start there."
I nodded and handed Libby over, and trying to pull myself together, I started chatting with Ella, talking about how dumb I felt, blubbering over some blood work. A little while later, the vet came back and, looking at Ella and then at me, said, "I don't know if you'd rather have this conversation privately...?"
Stunned, I turned to Ella and said, "Can you handle some bad news?" She shrugged and I faced the vet again and said, "I think we're fine here."
The vet explained that she drew the blood, and on a hunch, decided to pass the ultrasound wand over Libby's belly, just to rule out the presence of another bladder stone. Showing me the ultrasound printout, she said,"This large mass here is a tumour, and this swirly area is blood. We could absolutely still do the blood work and the ultrasound, but that's a thousand dollars all together just to see if surgery is even possible. If it is possible, that's probably another two thousand, and there's no guarantee that it will fix Libby up. I don't know if I would recommend surgery for a dog this age, and if you decide against it, because of the rate of bleeding, I think you'll be seeing her deteriorate rather quickly."
I was nodding throughout; mutely; my mind racing.
"If I were you," said the vet, very gently, "I'd take Libby home and enjoy your time with her. Get her an ice cream cone. A piece of chocolate cake. At this point, 'toxic' doesn't really mean anything anymore."
I thanked her, keeping it together right up until the moment I could barely get out,"She's just been such a good dog."
Then I started crying and the vet came around and asked if she could give me a hug, and she did, and after some more comforting words, she told me to take my time in the room; no need to rush. I told her I'd be fine, I was just anxious to get Libby home, but once I reached the reception desk and saw all those people with their pets -- people who took one look at my ruined face and quickly turned away -- the tears started streaming down. I'm sure the receptionists have seen it all before, and they murmured all the right words as I paid for the exam (no need for the blood to be tested; no charge for the brief ultrasound), and Ella and I drove home.
I emailed Dave to tell him that I had a diagnosis for Libby and he called right away. As I told him the story, he grew more and more upset, and we were agreed that it was a good thing to at least have a definitive answer for Libby's strange and worsening symptoms. He had called me as he was driving between meetings, and he had to get off the phone in order to calm down and psyche himself up for the next customer.
I picked up Mallory from work, but since she wanted to be dropped at the gym, I didn't tell her the news until I had picked her up from there an hour and a half later. When we got home, Mal spent some time with Libby, feeding her bites of chicken and sharing a cheese string. Not long after that, Kennedy came in the house, and she was already crying: as she was getting out of her car, Ella had said, "I guess you heard about Libby, eh?" And even though Ella clammed up once she realised that Kennedy hadn't heard anything, Kennedy forced the story out of her, and she came in knowing that Libby was terminal. I told the story again anyway, but it turns out that Ella had gotten all the details right, and I put the question to the girls that Dave and I were wondering about: When? Do we put Libby out of any discomfort she might be feeling right away, or maybe wait until Sunday; have a dog's dream day and then properly say goodbye? We agreed on Sunday and then ordered pizza for dinner: I had a headache from crying off and on throughout the day, and pizza crusts are one of Libby's favourite foods.
Dave got home a little earlier than usual, and Libby went to him, wagging her tail and asking for scratches. Around that time, I realised that Libby had been pacing around in circles for a while, and as time went by, I pointed out that Libby couldn't seem to settle down. We sat down at the table for dinner, and Libby kept pacing around and around, and she refused any crusts, or even whole chunks of pizza. We thought that maybe we could wear her out if we went for a walk, so Kennedy and I took her out to the park. As we were walking, Libby had small seizure-like episodes -- stopping and jerking her mouth open and shut, with drool dripping out -- but then she would snap back into herself and keep walking. We got back home, and as soon as the leash was off, she started circling around and around the house again.
The girls had planned to go to the mall, so I waved them off, and as Dave cleaned the pool, Libby paced around the back yard. At one point Libby got out of the gate, and with Dave chasing her, she started circling around and around a bigger circuit through people's yards. Lolo saw them, and when she came over to see what was going on, Libby stopped and had another small seizure. Dave brought her back home and I picked her up to try and settle her -- if pacing for hours didn't eventually wear her out, I didn't want to wait until she dropped dead of exhaustion. As I held Libby, she kept twitching her head, and when I looked in her eyes, she just wasn't present.
Suddenly, I said to Dave, "Do you smell that?"
"What?"
"Like, dog poop."
We both looked down at the same time to see Libby emptying her bowels all over me and herself. Dave wiped us off, but Libby was still smeared, so I had to give her a bath; her least favourite experience. Even though she stood still for the bath, Libby still seemed spacey, and after we wrapped her in a towel, she started making regular twitches of her head from side to side, the drool still dripping.
Dave and I looked at each other and knew that suddenly it was time to say goodbye. Dave called the girls and told them they needed to get home. Not long later, Mallory and Kennedy -- who was bawling her eyes out already -- came in, and then Zach trailed behind. Kennedy said, "I hope that's okay...?" And I said, "Of course. Libby loved Zach, too."
Even looking at Libby, the girls knew that it was time (Mallory said she looked like a "broken robot") and Dave called the vet and was able to make an appointment for just a half hour later. Dave asked Kennedy if she wanted to hold Libby, and she had her for the rest of the evening. We all drove together to the vet, but Mallory and I couldn't make ourselves go in; it may make me a coward but I didn't want my last memory of Libby to be her laying there dead. It took longer than I expected, but when they came out, Dave and Kennedy agreed that it was a very peaceful passing; the twitching finally stopped and Libby went to rest. On the way home, Dave stopped at Menchies, and we five red-eyed and dishevelled mourners ate a toast to the little dog who never got her ice cream cone; her slice of chocolate cake.
When we got home, I convinced Dave that it would be a kindness for him to call his parents and let them hear the news from him first -- they have been very good to Libby throughout her life -- and he made the call (which turned out to be very frustrating for him since their first response to "I had to put my dog down tonight" was "I remember when we brought Jake to put him down"; they both had the exact same first reaction and then they both went off on other tangents; poor Dave; it was still the right thing to do). He then called his sister to let her know and got the comfort that he needed. And then to bed with the persistent sick headache.
I woke up this morning to the alarm, not Libby's scratching at my door 15 or 30 minutes early as had been her annoying habit; I woke to no diarrhea on the tiles of the hallway, as had been her recent and uncontrollable routine; I woke to no happy little doggie wagging her tail and leading me to the back door to put her out to pee, as she had every morning for over fourteen years. I drove Mallory to work at 5:30 am, and when I got back to the still sleeping house, there was no merry little soul jangling the tags on her collar as she ran up to greet me. It was quiet. And so lonely.
Kennedy looked destroyed when she eventually came down -- in nearly fifteen years, there haven't been very many nights that Libby hadn't curled up in her bed with her. And even though Libby had spent the last full night of her life pacing on Kennedy's bed and keeping her awake -- even though Libby eventually had a rather noisy freak out that pulled me and Dave from our bed -- I'm certain that Kennedy found her bed last night to be too quiet. Too lonely.
Libby was such a good dog.
Libby was such a terrible puppy.
We got Libby back when Nan and Pop still lived up here. Nan had taken the girls to the mall one day, and as she later reported to me, Kennedy and a puppy in the pet store window had mutually fallen in love. Dave and I hadn't really talked about getting a dog, but Nan worked on me (an easy sell) and when I told Dave that I thought it was a good idea, he agreed. (There's a family myth that Libby just appeared one day and Dave was told to deal with it -- I think that this was teasingly told to the girls at the time, as though we were pulling a trick on their Daddy -- but he was definitely consulted first. This led to years of people thinking that Dave didn't like Libby, which was never the case.) Nan couldn't make it back here until the Friday, and even though she called the store to try and reserve the puppy in the window, they couldn't do that, and we had to take our chances: if it was meant to be...
On the Friday, Nan picked us up before the mall opened and we were waiting outside the pet store when they opened their doors. Over the course of the week, this puppy's littermates were all bought one by one, but Kennedy's puppy -- the overactive dynamo who jumped up against the store's window whenever Kennedy came near -- was still waiting for her, her price dropping day after day until, by Friday, she was a bargain basement clearance special. Perfect.
Nan got everything a puppy would need, handed the leash to Kennedy, and said, "What are you going to name her?" I had had some ideas and figured that I would probably have the final say anyway.
Kennedy said, "What do you mean? The sign says her name is 'Libby'. That's her name."
I explained that that is just a sales gimmick and we could call her anything we liked. "How about 'Piper'?" I said, leadingly.
"Her name is Libby," Kennedy said, firmly. And Libby it was.
Immediately, Libby was trouble. She had the sharpest little needle teeth, and any time she wasn't being played with, she was chewing on someone's fingers or toes. Puppy Libby had the highest-pitched, ear-splittingest bark, and any time she thought she was being ignored, she would plant herself in front of me (or more likely Dave) and bark so long and loud that a one-way parcel to China was contemplated more than once. On her first vet check, Libby was given a deworming dose, and she left steaming piles on the deck that looked like sentient spaghetti in turd sauce.
Although Dave insisted from the start that that dog did not belong to him, Libby fell in love with him hard and refused to leave Dave alone. Anything that belonged to Dave was fair game to Libby as a puppy and she found and shredded his socks and underwear, dragging anything with his scent from the laundry bin that towered over her. She ate his glasses once. One Halloween, Dave had sculpted a chimpanzee makeup (based on Planet of the Apes, of course) on a plaster mould of his own face, and when he rendered it in latex, he was so pleased with the appliance he was able to make that he left it on the dining room table where he could admire it. One morning, right before Halloween, we discovered that Libby had climbed up on the table and chewed the appliance in the middle of the night, ripping it in several places. Dave was devastated, but with quick thinking, turned his costume idea into a turfwar-scarred biker ape (which I nicknamed "Furious George") and I think that was probably the best costume he ever made.
Libby was simply a terrible puppy.
But by the time she was about four, she settled down, and she became fun. She loved to run and play, and any time a man would come to the house, she was a full-on flirt, wagging her bum in their faces and licking and showing off. (My brother Ken found this amusing; my brother Kyler did not.)
By the time Libby was four, Mallory was starting school full time and that little dog kept me company every day, curling up beside me if I was on a couch; at my feet if I was on a chair. She patiently waited every day as I ate lunch, knowing that she would always get the last bite of everything. Most Sundays, Dave would make us a pancake breakfast and Libby would only start to whine as we finished eating because she knew that she would eventually get her own dish of cut up pancakes and bacon -- once she heard the scrape-scraping of her food being cut into bite-sized pieces, the anticipation would start to get to her and that was the only time she whined.
About five years ago, I started to feel like a lazy slob, and Libby and I started taking a daily walk. Before long, our walk was usually 6.5 km/day (5 if I felt lazy), and this hour and twenty minutes was a good time for listening to audiobooks. Libby went from a 10-year-old, creaky old lady dog to fit-as-a-puppy in no time, and no matter the weather, Libby would waggle that bum whenever she heard her leash (and often would stamp and snort impatiently if I made her wait much longer than nine in the morning to get going). She really didn't like other dogs and too many other walkers wouldn't recognise that, no, my dog doesn't want to be sniffed by yours, but always, Libby was well-behaved on the leash (no tugging or lagging or stopping to sniff everything). There were many humans who got to know Libby, too (especially the old man who said, "There's my buddy" every time he saw us), but she didn't feel the need to submit to their attentions either; she was on her leash and just wanted to walk; head down and marching through sun and snow.
In June of this year, Libby just kind of collapsed as we were arriving back at our house from our daily walk. It had been a hot day, so I wrote it off as heat stroke, and didn't think too much more of it. It happened again a couple of days later, and a couple of days after that, it happened sooner in our walk. Again, I assumed she was just getting older, and I figured at 14, maybe she was done with strenuous exercise.
A couple of weeks after that, Libby collapsed inside the house and couldn't get up. I couldn't be in denial any longer: I knew something was wrong. I called the vet and my voice was shakey as I said, "I'd like to have my dog looked at please." I explained the problem and the person said to me, "I'm afraid we're booked up until Saturday."
I said that I thought I had an emergency, and if they couldn't help me (after nearly 15 years of taking my money) then I would have to call around. She wished me a nice day. (I do realise that this was just a receptionist and maybe an actual vet would have made the call to squeeze me in, but it was still the experience I had.)
I googled veterinarians and chose the first one that promised "same day and emergency appointments". We were soon on the way to an appointment, and after an exam, he was thinking arthritis. That sounded reasonable to me (it's what I had been hoping to hear, actually), so I bought the medication he recommended, and also went along with ordering a blood panel. Those results were in by the end of the day, and that's when he diagnosed liver disease, assuring me that after 4 - 6 weeks on the right medication, Libby would be fine. He also noted her very low glucose and recommended I bring her in for an emergency iv treatment.
We went back with Libby the next day and were bemused that an "iv treatment" meant sticking a needle under the skin of her back (not into a vein) and forcing in a bag of Ringer's Lactate that eventually pooled down from her ribs, wobbling back and forth until her body absorbed it (we were warned not to touch the skin around the injection site in case the solution all started leaking back out). That wasn't terribly confidence-inducing, but the vet had assured me that the blood work pointed to liver disease, and with the medication in my hands, I was prepared to see what 4 - 6 weeks would bring.
Pretty soon, Libby was turned off her Urinary S/O kibble and I started buying her canned food. When she started having uncontrollable diarrhea in the middle of the night, I blamed the switch in diet, and was just grateful that she always chose the hallway tiles to relieve herself; it was gross but totally cleanable.
Unrelated to her other issues, but just one more thing, I noticed Libby licking at her leg one day, and by the evening, I could see that it was bleeding. We wrapped it up in gauze and medical tape (happily Ken's house is filled with such medical supplies after Ella's recent accident), but in the morning, Kennedy pointed out that Libby had bled all over her duvet in the night. I figured it just needed to heal -- assuming that the licking had caused a sore -- and I rewrapped the leg and bought Libby a head cone. The next morning, Libby had bled on Kennedy's duvet again, again I washed the bedding, and since this was the day of Libby's grooming, I gave her a bath before rewrapping her again. This was when I noticed that Libby had snagged a dew claw and that's what was bleeding. I called the groomer (to see if it made more sense to see a groomer or a vet first) and the groomer thought that she could fix Libby up, and she did.
Then a couple of weeks ago, on the Civic Holiday weekend (August 2nd), the girls went to a triple-feature drive-in, and as they were to be out 'til dawn, Dave and I took Libby to bed with us. She couldn't get comfortable, and as she paced around the bed, I could sense her wobbling at the edge, so I put her on the floor. I was vaguely aware that she was circling around the room, but I eventually got to sleep. At some point, Dave and I were awoken by Libby scream-barking and she started racing around in circles; running into the walls and furniture. Dave dove onto the floor and he grabbed Libby, trying to calm her down.
"What is it Libby? What is it?" he pleaded and I asked him if he thought she had gone blind or something; that was the only thing that I could think of that might have scared her so badly. Dave was nearly crying as he brought Libby back to bed, and this time, she settled down and went to sleep. In the morning, she was fine.
And still, I was waiting for that magical 4 - 6 weeks until improvement; the blood work numbers couldn't lie, right? This was definitely liver disease and she was getting the right medicine/ .7 mL/ twice daily.
Last week, Libby had one of those scream-barking episodes in the middle of the day, and I panicked as I saw her tearing around the house, smashing into the walls and furniture, trying to climb through impossibly small spaces at high speed. I picked her up and soothed her, and the Libby I knew came back to me.
It hadn't quite been 4 weeks yet, and those numbers couldn't lie, right?
Two days ago, Libby had a full-on classic seizure just as Kennedy was coming in the door from work. Libby was laying on her side beside me, her legs were pawing through the air, her mouth was chomping side to side -- looking as though she was barking although she was making no sound -- and drool was building into a ectomplasmic pool on her beard. It lasted only a minute, and as Kennedy was trying to soothe her, she said, "What's that splashing me?" We looked, and Libby had emptied her bladder all over the couch. With a bit more soothing, Libby was back to normal; the only evidence a bit of blood on her mouth from a presumably bitten tongue.
It was then that I googled "dog seizures" and learned that her scream-barking/running around blindly were simply another form of seizure. That night, Libby had a rather noisy and frightening freak out that pulled me and Dave from our bed, and yesterday morning I wanted a second opinion. My dilemma was: Do I call her original vet and take a chance that they would see me the same day? Or go to the new vet who had underwhelmed me with his care? In the end, I chose the brand new Animal Hospital (based on a recommendation from a friend) and from the minute I entered that bustling and professional-looking practise, I felt reassured that I was going to get some answers. And it was never liver disease.
Libby was such a good dog.
We are grateful that we had a new diagnosis before Libby's last seizure; it was terminal before she showed her first symptoms and we couldn't have done anything different (I am also relieved that even the new vet, looking at the blood work, had immediately ruled out cancer; this tumour wasn't obvious from the information at hand). We really did want to have that one last good day with Libby, but we can't deny that she gave us thousands of good days already. I'm feeling very sad for myself right now, but not for the full and happy life that Libby led. For a dog that, to be clear, was not his dog, Libby was always very special to Dave, and I am so appreciative that he did the difficult job of seeing her off when I couldn't do it. Mallory was affected in her own way -- making jokes about avoiding watching Marley and Me through her tears as we waited in the car -- and although Libby rarely slept with her and only sometimes chose her to cuddle up with on the couch, Mal doesn't remember a time in her life before Libby was around, and that leaves a hole. It's probably hardest on Kennedy: I don't think she was exaggerating the other day when she said Libby is her best friend; I wasn't exaggerating when I replied that she's my best friend, too. I honestly thought we'd have three or four more happy years together, but I remain thankful for the nearly fifteen years we did share.
Just such a good dog.
