Monday, August 31, 2015

Dillon's Last Day, Our Nightmare with the ER Vet

This post is a memorial post for our beloved Dillon, who died unexpectedly last week.
We loved this dog tremendously.
This is a long post, about his last day, as a service announcement in some ways.
We had the joy of living with Dillon for 8.5 years, he was the best dog of all.
Handsome Dillon recovering from Mast Cell Tumor surgery sitting with his Pa.

This post is to advise all pet owners to have an emergency plan in place. Now. 
While your pet is ok.  Not later. Do this research now.  We wished we had.
If something suddenly occurs, you will have researched emergency animal hospitals, and picked the best one. The one with good Yelp reviews, the one that is highly recommended by friends,  the one that your everyday vet says is the best.  Find the hospital that has the experience, the expertise and emergency facilities to manage your critically ill pet when time is of the essence.
You don't want to go through what happened to us with Dillon.
A typical day with Dillon, he was so happy to just be wherever we were. 

 Dillon's last day began just like all of his other 3,100 plus days with us did.  We woke up with him that morning, and he followed us downstairs.  Dillon was a quiet dog with a patient and loving personality. He was our shadow....If we went upstairs, he would follow. If we went in the TV room, he would too.  So this morning was like any other, he waited for us to have our coffee then began wagging his tail to remind us it was his turn to eat and to go outside to do his business.  As our routine is, I fed him and then hubs took him out for a short walk until mission was accomplished.  
A regular start to another day for us all, it appeared.  
But that was not going to be the way things would go. 
Dillon could be found most often on our sofa snoozing or looking out the window

As he usually did, after a bit of hanging out downstairs, he went back up to our bed.  He loved laying in bed and looking out the window soaking up the rays of sun that hit the bed in just the perfect spot.  Pitbulls love laying in the sun.  I was always pulling blankets over him, to warm him from the air conditioning in summer, and the chilly air in the winter.  He loved to be warm. Hubs came back home for lunch, and as I prepared it, I did note and mention to Dave that it was odd that Dillon wasn't coming down to see what we were having for lunch. His sense of smell was as sharp as hearing.  If I was cooking an egg, or cutting up some chicken, I could hear his plodding footsteps coming down from the third floor. He would always appear when I was cooking.  Our kitchen floor always had dried drool spots, as this was part of what he did.  But I just thought, well its tuna fish, maybe he doesn't care for fish....and Dave and I had lunch.  He went back to work, and I went to do some errands. It wasn't until 4:30 after Dave came back home and my stepson, Scott, noticed Dillon was laying up on our bed but breathing very oddly with heavy panting while Dave was showering.  Dave checked him and noticed his stomach was really distended and it felt hard.  I was summoned upstairs by Scott and we all realized Dillon was in trouble.  Dave said a condition called bloating could be very serious.  I googled it and yes, it could be "rapidly fatal".  It advised taking your dog to the nearest ER vet. So we took him to the closest Emergency Veterinary Hospital, without hesitation.  Did we check the Yelp reviews? Yes I briefly did, but thought that the bad ones were just isolated incidents.  I didn't realize that there are "hidden reviews" which are largely unflattering, but you can access them on Yelp by searching for them.  Make sure you do. Read them all. Then ask for references from area daytime veterinarian's about the best hospitals to go in an emergency.  I WISH we had done this, when we weren't thrown into crisis mode.  So that decision is something that I have to live with, and its made losing Dillon so much harder.  
Dillon's adoption photo on the Pitbull Rescue site. This was truly love at first sight.

As briefly as I can describe the events from that point on:
Before we put him in the car, he did have another normal movement and a pee. That was reassuring to see.  We worried about his bloating or GVD (medical term) condition and quickly debated taking him to the closest ER vet or to the one in Boston that was well known for the best animal care.  If he had GVD it was rapidly fatal, and he had been laying in bed since around 11 am with the condition.
So the closest place won out, and off we went.  Upon arrival at 5:30 pm, they whisked Dillon into a back area to examine him, and then put Dave, Scott and myself in a private exam room.  
The doctor came in about 20 minutes later and said she didn't notice him having an extended belly
and said she did a quick ultrasound, and everything looked normal. He only had a raised temperature which she said she wasn't sure why.  Perhaps he had Lyme Disease she suggested.  She advised an xray to make sure the tummy was ok. Yes, we agreed.  She asked for his history. We explained he had Mast Cell Tumors that were  successfully removed last fall , with  clean margins and no lymph nodes involved.  Dillon was considered cancer free.  
No other issues, other than a knee replacement several years prior.
Our 2014 Christmas card with Dillon, front and center! 

We were breathing a sigh of relief as it was not a bloated gut, just a strange fever.  
She returned and told us that the xrays on tummy showed everything to be fine. However she noticed his lungs in the corner of the xray showed some spots, or nodules.  She thought they could be cancer, and asked if we wanted her to xray those.  YES, please check him for cancer, of course!
She returned to say that the xrays of the lungs showed what the radiologist on staff considered to be signs of older damage from perhaps chronic bronchitis.  So he didn't have cancer, just this "fever of unknown origins".  That is technical term, when they don't know what is causing a fever.
Wow, we were so relieved.  He was just sick, and it may have been from a tick bite.  The doctor gave us a prescription and told us to cook up some white rice and feed him a bland diet for the next few days.  We prepared to take him home.  We had been in the exam room for 4 hours as Dillon was in the ER kennel cage.   During the course of the 4 hours as we waited for the doctor to come in and update us, we chatted together to while away the time. Our mood was good as we were no longer worried about Dillon being in a crisis.  Every now and then, we heard a thumping of a tail against the wall.  It was a loud and hard thumping, like one his tail could deliver.  We started to wonder if it could be Dillon's tail?  His hearing is out of this world amazing, and indeed, when we asked the Doctor where he was kept, she pointed to the wall of our room, and said, "right behind that wall".  When he heard us, he would thump his tail!  I am so grateful he realized we had not left him, and that he knew we were there waiting for him those 4 long hours. But it made me question why they sequestered Dillon in the back.  Our other vets would examine him right in front of you in the private exam room, and we would discuss symptoms with transparency. This felt all wrong having Dillon in another room.   We realized in hindsight that the ER was slammed with other pets, and this doctor was running from room to room, with little time to properly notice his symptoms. Ordering xrays and the like, it was clear she never gave his breathing troubles a second thought as there was no note in his discharge papers about it, which was troublesome and the smoking gun of her missing his ailment.
A portrait event at Pioneer Goods.  Of course our family portrait included Dillon. 

When we got home it was 10 pm.  Dave carried Dillon inside and put him in our family room.  Dillon walked over to a corner and laid down with his head to the walls.  I went in the kitchen and started the white rice.  I took chicken out of the freezer so I could boil some up for him for tomorrow.
When I went back to check on him, his stomach was still sticking out and he was still panting heavily. The doctor didn't mention his labored breathing at all.   I took photos and videos of him.  He was panting and wheezing with a rattling noise.  Then he started having mucus slobber, which he never ever had in his life.  Tears or fluid dripped from his eye, so I wiped it all back and had a thought~maybe he had the rare canine flu! I called the ER Vet place and was told someone would call me back.  I asked for the doctor who had examined him to give me her opinion, is this something that maybe no one thought of?  He clearly was feeling very sick.  Dave took Scott upstairs to get ready for bed, and I stayed with Dillon. We brought in his large kennel, as he loved to go in it for peace and comfort, like he did after his surgeries.  Dillon immediately crawled inside.  He would sit up then lay down, trying to get comfortable, panting harder all the time.  I laid down on the floor next to him and stroked his head to give him comfort.  I wished it was tomorrow and we could give him his antibiotic and he would start to improve.  The rice was all cooked and in the fridge for his first bland meal, per Doctors orders. 
Our end of summer pose, 2011, New Hampshire

 Another half hour passed and now Dillon's breathing started getting more labored.
All of sudden he coughed up a bright red spot of blood the size of a nickel.  
From that moment on, I knew he was in danger of dying.  How do I describe the 
horror?  It wasn't a tick bite, or a fever of "unknown origins" at all. 
All the white rice and antibiotics in the world were not going to help our boy. 
I called the ER place again and told the phone answerer, that our dog had now
coughed up blood. I needed to have that doctor call us back! I hung up and ran upstairs to get Dave and we both came back downstairs and gathered around Dillon.  We knew he was in grave danger.
The doctor had missed the mark by a mile.  Dillon was in respiratory distress, and given his
mast cell tumor disease and his lung xrays and his heavy breathing, well wouldn't any competent veterinarian be able to tell something was horribly wrong?  And wouldn't there have even been a mention of his labored breathing on his two pages of discharge notes?  Instead it was all guessing that maybe he had an infection from a tick bite and that the antibiotic should be given.
We were in  a frantic mode now.  Dave and I decided to throw on our jeans and get him back in the car and take him to the Boston ER, Angel Memorial.  I was kicking myself we didn't take him there in the first place,  but second guessing our decisions weren't of any help now.  Still no call back from the ER Vet place.  We were clearly on our own.  Dillon stayed quietly panting in his large plastic kennel.  I had his soft white blanket cradled around his head, the same one he slept on at the foot of our bed.  Anything I could do to give him comfort and take away his suffering would be done to the best of our ability.  I ran upstairs to throw back on my jeans as did Dave.  When I ran back down
to Dillon I found him bleeding heavily from his mouth.  His big brown eyes looked at me, and my heart was breaking with despair.  Dave and I lifted him up in his big kennel and carried it out as quickly as we could to my SUV.  We pushed it all the way in so his face could be near us.  I jumped in the back seat and Dave took off for Boston.  It was about a 20 minute drive, maybe 15 if we could hurry.  We called Angel Memorial to tell them we were bringing in our critically ill 10 year old Pitbull.  We told them he had chest xrays 3 hours earlier at a ER Vet place and could they call and take a look at them as it was clear his lungs were failing.  They said they would wait for our arrival.
My face next to Dillons, I rubbed his soft white head and told him what a good boy he was, too many times to count.  He locked his eyes onto mine, and he never looked away.  We were frantic and desperate for help, our poor dog was suffering and was dying before our eyes.  Dave blew threw a light as he sped for help.  Blue lights came up behind us, and we had to pull over, loosing precious time.  Dave explained the situation and we were motioned onward.  Tears were flowing softly as I continued to offer as much comfort as I could.  He really was such a great dog, even in this horrible situation, he was nothing if not graceful and noble.  At this point my cell phone rang.  I was finally getting a call back from the ER Vet place doctor.  Her call back to us was only because Angel Memorial had called for his records.  She was trying to cover her ass.  She told me she thought I should bring him back in to which I replied that we were taking him to Angel Memorial. I told her she misdiagnosed him, that he was in respiratory failure and that we would be lucky if he wasn't dead on arrival.  I told her I couldn't talk as I had to be with Dillon.  I knew in my heart of hearts he was dying, but I couldn't face it.  It was too much of a shock.  We were told he had a fever. That was all.  And then we were left to watch him suffer and spiral towards death while the clock ticked towards midnight with no additional call backs, despite our frantic pleas.  
Our handsome Dillon and adorable Tobey, who both died a few months apart this year.

We were only two minutes away from Angel Memorial when Dillon's chest heaved about 5 or 6 times.  His eyes never stopped looking at me.  He was gone.  Our boy, who we adored more than anything was suddenly gone.  Once in the driveway of Angel, Dave and I cried our hearts out over him, in a state of utter shock and heartbreak.  Did this really just happen? 
In the driveway at Angel Memorial, a gal with a gurney came out for Dillon.  I waved her away and managed to say through my tears, he's gone.  
  I couldn't believe he was gone.  Then I  thought I felt a pulse, but Dave said he didn't feel anything. I had him try again, but no, he couldn't feel it. Maybe Dillon was in a coma?? I ran back inside...
  I had run inside to ask could someone please check him with a stethoscope? 
A doctor came out in her green uniform and climbed into our tailgate to listen to Dillon's heart.
Then she told us he was gone.  And so he was.
 We drove home slowly with Dillon and brought him inside the house.  We would plan for his burial the next day, where we buried all our dogs, up at our friend's farm in New Hampshire.  He came to us in this very kennel when we rescued him from an Oklahoma facility 8 years ago.  Oh how Dillon hated this kennel back then. He had tried to chew his way out of it and the marred plastic still bears the marks.  But after his first surgery for a new knee, he found refuge and peace inside it, as he did in his final hours.  
 In the early morning, after only 3 hours of sleep, hubs said he wanted to make Dillon a casket and he said I should paint Dillon's name on it.  It was a wonderful idea, and gave us something to do.  They say that funerals are for the living, and its the same for a very special pet.  Scott and his dad built Dillon a final bed, and picked out hardware for the pall bearers to hold.  I found some stencils and used them to put his name and dates on the top of this simple pine box. Dave bathed Dillon and placed him in his last bed. We said goodbye to him that day too many times to remember, a hundred last pattings of his soft fur and gentle kisses on his check and head before we could let him go. 
A final gesture of love and affection, a forever bed for Dillon.
 We drove to New Hampshire and met other family members who all came to say their goodbyes.
 He is buried along a stone wall under a stand of tall pines, next to our other dogs.  We gave him the most dignified burial we could.  Our sadness over his sudden passing and all his suffering on his last day was just beginning.  We were all still in shock, and the burial process helped us tremendously. We read poems for our boy after he was lowered into the earth.
 We will hold him forever close.  And hope that the good memories come back and trump the awful ones we have in our minds from his last day.  He could have been spared the pain and suffering.  We could have given him a gentler way out if the vet had recognized that he was in critical condition and not guessed it was from a tic bite. We could have eased him out of our world, and although it would still be shocking,  it wouldn't have been terrifying and filled with pain for Dillon. 
Dillon brought us so much joy.  I loved this dog immensely.
Please have a plan in place if you have a dear pet, so if you find yourself
in need of good emergency care you know what to do immediately.
We were refunded the $1000 we spent that night by the ER Vet place.
That is another story that will never be told, than what you can read between the lines here.
But please.  Get a plan in place.  Now. You never know what is going to be your pet's last day.
And then drive the few extra minutes to a place with a great reputation, 
you won't regret that decision, I promise.

In closing, this poem was edited to reflect the life that our 13 year old
  (my stepson) had with his dog.
Dillon came into Scott's life when he was 4, and now Scott at 13 1/2,
 read this to Dillon at his grave.  

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