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Butterfly’s Last Illness

 

Four weeks ago, on a Wednesday night, Butterfly vomited white foam until she was empty. We had no idea what set it off. She’d been wheezing for a few days, instead of her regular coughing, but otherwise she was in the pink of health; especially since her hernia surgery two months before. Suddenly she was panting all night on the pillow next to my head. We were able to get her an emergency appointment at the clinic the next day and ended up seeing a doctor we’d never met before. She asked if Butterfly had eaten anything strange and we couldn’t think of anything she’d had access too, so she took an x-ray, and did blood tests, but she couldn’t find any explanation for the vomiting. She didn’t seem especially worried, though. She had the vet techs give Butterfly subcutaneous fluids and anti-nausea meds on the spot, and then sent us home with more meds in liquid form. She said, as we were leaving, that we could come back in if Butterfly vomited again, and then she sent us on our way. I was surprised. I was used to Butterfly’s previous vet, at the same clinic, who was much more thorough. I didn’t know what else should have been done, but it felt like something was missing.

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Butterfly didn’t have much of an appetite for the next few days, but she didn’t throw anything up. We managed to get her to eat two or three small pieces of chicken at a time, hiding her pills in those small pieces, because she wasn’t up to eating peanut butter. She wouldn’t even eat her chicken treats. By Monday, though, she was eating more chicken, and even ate a few pieces of kibble, unprompted. So when I heard her retching in the hallway at two am I was surprised, and when I turned on the light to clean up after her and saw a puddle of red, I was terrified. I Googled dogs-vomiting-blood and found what I expected to find – go to the hospital immediately. So I woke up Mom and wrapped Butterfly in a towel and we drove over to the emergency veterinary hospital a few towns away.

A vet tech scooped Butterfly out of my arms as soon as we arrived and took her into the back to be examined. I tried to watch the TV on the wall, but the chipper early morning news anchors got on my nerves quickly. Eventually, two doctors came out to speak with us in the waiting room, a man and a woman. They said that Butterfly was dehydrated and her blood pressure was very low, too low even to take blood for testing, so the first step was to put her on fluids and plump her back up. They asked again if she’d eaten anything strange and we tried to think of anything she could have gotten into, almost a week earlier when the vomiting started in the first place. My first and most persistent fear was that this was all aftermath of Butterfly’s hernia surgery, even though she had healed well and seemed to have bounced back beautifully. I just couldn’t make sense of a life threatening illness coming up out of nowhere. Maybe she got into some dirt, or licked a slug or a splotch of bird poop on the walkway? The female doctor smiled occasionally and took notes. The male doctor seemed to be incapable of making eye contact, but fully capable of giving us worst case scenarios about Miss B not surviving the night. When I asked my follow up questions he answered them like he was taking an oral veterinary school exam, rather than talking to a worried Mom. For the subsequent consultations throughout the night we only met with the female doctor, which was a relief.

By five am we were able to go home for a few hours of rest while Butterfly continued to receive intravenous fluids and wait for the internist to come on shift. Cricket was in a panic when we arrived home, and I took her out to pee immediately so that her shrieks wouldn’t wake the neighbors. As soon as she’d finished her business she raced back inside to see Grandma and attached to her side like Velcro. They were at least able to sleep for a few hours. Me, not so much.

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Later in the morning, the internist at the emergency veterinary hospital did an ultrasound and more blood tests on Butterfly, but the findings were still nonspecific. We were allowed to pick Butterfly up around noon, in order to transfer her to her clinic, where we hoped for more personalized, and much less expensive, care. The plan was for her to keep her IV catheter in place and go back on fluids as soon as we arrived at the clinic, but somehow the message got garbled between the hospital and the clinic and we had to sit in the waiting room for two hours, with my panting dog on my lap, her IV catheter bandaged and waiting for a fluid hook up, and the staff behind the desk telling us they had no idea what we were talking about and they were very very busy.

Eventually we were sent into an examination room, to wait again. The expeditor, or maybe just the nicest person on the staff, came in after a while with apologies. He brought us stools to sit on, and water to drink, and even offered coffee and chocolate if we needed it. The vet came in soon after, another doctor we’d never met before. She was a very young woman with long black hair and a piercing over her lip, and she was kind to Miss Butterfly and even laughed at my strained jokes. Butterfly was skinny and listless, and when the doctor tried to stand her on all four feet on the table, she was shaky. The doctor said that an overnight stay would be necessary, and she’d probably have to be there for a number of days, in order to stabilize her symptoms and do more diagnostic tests to see what was causing all of this.

This is when I started wishing I’d invested in a vet tech course, so I could take care of Butterfly at home – administering fluids, cleaning her IV, and doing whatever else necessary. A full-on veterinary medicine degree would seem like overkill, just to take care of my own dogs, but then again, maybe not.

We went home without Butterfly that afternoon, and worried. Cricket was upset. She would only eat really special food (aka anything but kibble) to help manage her anxiety-induced nausea. She spent most of her time attached to Grandma in one way or another, except when I took her out for a walk, during which time she kept turning back to our front door, looking for Grandma.

By the next day, we were told over the phone, by yet another doctor, that Butterfly was able to eat her dog food, and even licked the bowl clean. But she would not be coming home yet, because none of the tests were clarifying the cause of the problem. We were allowed to visit Butterfly at the clinic for a fifteen minute scratchy massage and a few kisses on her head.

We went for another visit with Butterfly on Thursday, after finding out that she still wasn’t ready to come home. This time I had to go after work (internship), still in my dress clothes, starving and exhausted (I have a tendency to skip lunch at work, which is very stupid of me), and then we had to sit on a hard bench for an hour and a half, overwhelmed by the smell of pee. For a few moments I thought I should just leave. What was the point of visiting with Butterfly for a few minutes if we couldn’t take her home? Would she even notice, or care? It was a bitter, apathetic sort of feeling, and it worsened when we finally got to the visiting room, because Butterfly was not herself. She was in self-protective mode, hiding her real self in a far corner the way she’d learned to do growing up at the puppy mill. She almost seemed like a stranger, and I found myself wondering if she even knew who I was. But once I had her in my arms, she was my baby again, and I had to clean out her one waxy ear, check her lumps and bumps, whisper to her, and sing the Jewish prayer for healing to her like a lullaby.

The latest theory was that Butterfly was on too much insulin, creating a rollercoaster reaction in her blood sugar that led to the gastro-intestinal difficulties, so they cut down her insulin to see if that would help. They also gave her anti-biotics and a B-12 shot, just in case.

We went to visit again on Friday and I finally remembered to bring Butterfly’s doggy comb with me. Her tongue was pink, and her muscle strength was much improved, and she let me comb her hair until it shined. But she still wasn’t coming home. I was starting to doubt the clinic in a way I never had before. Why were we talking to different doctors every day? Why couldn’t they figure out what was wrong? I wanted to take Butterfly home, but I also wanted her to be healthy, and those two desires seemed to be in conflict.

When we asked one of the secretaries at the front desk why everything was such a mess, we were told that the clinic was in transition, with some doctors leaving, other doctors arriving and many doctors on vacation. They had new students rotating through, and the office staff was in transition, and they were building a new wing for the cats. None of that information made me feel better, still having to leave without my baby. The apartment was so quiet without Butterfly. She was supposed to be the quiet one; Cricket was the barker. But we were all so anxious and distracted, there wasn’t much playing or joy, or even barking, going on. I almost felt like we were practicing for when we wouldn’t have Butterfly home at all anymore. But I couldn’t think that.

We were finally able to take Butterfly home on Saturday afternoon. By then she’d been away from home for almost five days. Butterfly sat on my lap in the car, but she still seemed distant and not quite herself. I was worried that I’d been wrong to leave her in the clinic for so long, retraumatizing her with memories of her life at the puppy mill. But when we got home and her paws hit the walkway at the back of our building, she lifted her tail, smiled, and began to jog towards our front door. She was herself again and ecstatic to be home.

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She raced towards the food bowls as soon as she got inside the apartment and ate a handful of kibble, which she threw up on my bed ten minutes later. I was instantly worried that we’d have to take her back to the clinic, and I really didn’t want to do it. She hated being there. And I hated her being there. She was still lively and energetic and looking everywhere for food, so I tried not to think about any possible complications and fed her one kibble at a time, by hand, and gave her all of her meds in their proper order and crossed my fingers.

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With each day, she seemed happier and healthier, and able to tolerate more kibble at each small meal. Her bark was as bit off, kind of high and squeaky, maybe from damage to her throat from all of the vomiting. I went to work on Tuesday morning, confident that Miss Butterfly was on the mend and had overcome whatever had set off the vomiting in the first place. Even her blood sugar seemed to have stabilized, with four blood tests in a row landing in the same range, instead of the ups and downs we’d been used to for years.

Her smiling face greeted me as I came in the door that afternoon and she put up with all of the medications and kibble by kibble feeding with good humor. On our way out for the last walk of the night she coughed a little bit. We’d stopped giving her the medicine for her cough, because she hadn’t been coughing in the hospital or at the clinic and they took it off her list of medications, so I made a note to myself to check with the vet to see if we should add it back in, or wait for her follow up appointment on Saturday. It was such a relief to have her home and acting like her usual self, pausing ever few steps on her walk to listen to the katydids or a low flying plane, and then jogging to catch up with her sister. She was still a little skinny and easily tired, but otherwise she was recovering beautifully.

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We went through our usual bedtime routine, with scratchies for Butterfly and an extended period of digging at the end of my bed for Cricket, and then Cricket was off to Mom’s room and Butterfly ambled down her doggy steps to survey her territory and find the perfect sleeping spot.

And then, at six thirty in the morning, Mom brought Butterfly into my room, because she’d heard her making strange noises. Within a shockingly short period of time, stretched out on my bed, Butterfly died. There was nothing I could do, no medicine I could give her, no magical spell to say or song to sing. She was just gone.

I still wake up every morning wondering where she is. The grief still hits me in waves, the bargaining, the denial, the anger, at the doctors but mostly at myself. The reality is that we did everything we knew how to do to keep her alive, and so did her doctors, but she still died. I didn’t have the power to save her, and that’s what sticks with me most, the powerlessness. It’s so hard to accept that there was nothing I could do for her in the last moments of her life, except to be there and witness her last breath.

In Jewish custom, the first stage of morning is a seven day period of intense visiting and sitting with the grief, called Shiva. We made it through that process with the help of the blog and messages of comfort and kindness from strangers and friends and family. The second stage of mourning is called Shloshim and is thirty days of still remaining somewhat separate, but beginning to integrate the loss into everyday life. This is the stage I’m in now. I’m not sure thirty days will be enough, though. It’s going to take a while to accept that all of this is real.

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Cricket and Platypus.