Rather a week too early than a day too late.

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The past week has shown its darker side. A clear contrast to the many cute puppy pictures we often see. We do need the “baby pictures” to remind us, that life goes on. We need to remember, that with illness also comes great health and new beginnings.

All dedicated pet owners fear the day where it ends.

Unfortunately, only a few passes in their sleep in the basket, without any further illness. Rarely a pet gets struck by a heart attack and die. It means that in the most cases, we actively have to decide on the behalf of the pet when the time has come to say goodbye.

We are afraid to cross boundaries. We often postpone the hard decision about putting our pets to sleep too long, and in that way expose the pet to unnecessary pain and suffering.

We have given many promises to each other: When the day comes, and when we as vets judge it’s time, then we need to let the owners know.  We know when the sad feelings hit, then the common sense closes down.

We don’t have a week, not even a day where we don’t say goodbye to our beloved patients. Often not during regular opening hours, since when the time has come, it shouldn’t have to wait.

Many have been through a time where illness wastes the body, and at last there is only one right thing to do. We don’t put healthy animals to sleep, and it must hurt before we reach the time where we end life.

What makes it so hard is, there is no check list. It’s not science to judge “what is a good enough” life for a pet?

Animals can walk with a fractured leg, wag its tail even it is sad and eats until the end.

Because of that we can’t just judge from the obvious objective parameters. Of course, we need them, but as well need to see it as the whole picture. We are so privileged; we can do the very best for the animals. We can decide about saying stop in time ant not just let the animal lay there silent, with the sparkle gone from the eyes.

It’s okay to have a bit of doubt whether it is the right time to  say goodbye – if not, then maybe you waited too long?

The past weeks we have said goodbye to too many of the patients here at Artemis. Too many to be understood in the way that it also hurts us to say goodbye. Still, all the goodbyes were right.

Every time we say goodbye, we must remember that we do it out of love to the animals. It is the motivation and drive. It is the torch we always must lift together. We need to remember “rather a week too early than a day too late”.

Læs den danske version her!

 

 

 

Afterglow

/in ,

Yesterday the vet clinic  got a phone call. Once again it was time. A little dog called Mille, was to be sent on her final journey.

I had known the owner, Mrs Green, for many years, but she had not been at the clinic for quite some time.

She lived a little distanced away in a small apartment. Outside the apartment was a small terrace, where the dog had been let out for some time as there lately had not been energy to do more – neither for Mille nor Mrs Green. Mrs Green herself was very old.

Little Mille was lying on the sofa on a skye blue blanket with twinkeling stars on it. She slept heavily, when I came in.

I talked to Mrs Green about the fact that Mille, considering her illness, looked surprisingly healthy. She has had a good, long life.

Mrs Green told me, that she felt she could no longer care for Mille, as she herself was very ill.

Like Mille, Mrs Green looked quite healthy to me, but looks can be deceiving.

Mille got a wee injection for her to fall asleep. Mrs Green and I held hands as the dog dozed off. When Mille slept heavily, I gave her the medication to stop her heart from beating, and heaven received yet another little, shining star.

“Can I please have some of that as well?” Mrs Green asked.

For Mrs. Green there was nothing left to live for, now Mille wasn’t there any more.

At that moment I really wished I could do something for Mrs Green. The way she held my hand and the look in her eyes told me that when Mille was gone, Mrs. Green has not much left to live for.

The contrast between what we can do for our beloved animals, and what we cannot do for a beloved person, when life is at its end, seems huge.

Knowing that I cannot give Mrs Green the same medicine as Mille, maybe I can do something else?

Maybe the void after Milles passing can be filled with happy memories of her? Maybe talking about what the dog meant and the happiness, she represented right to the very end would make life more bearable for Mrs. Green?

It takes a particular ‘dog-heart’ to understand what kind of loneliness that strikes, when you say goodbye to your little shadow. Not all people have the privilege to be surrounded by friends and family when they need them.

Can we start up a network that can make a difference to some of our elders who lose their pet? You help by making a phone call, go on a visit, talk to them.

An action that can help keeping the memory of the animal. Other people may not understand how your fury friend has made life so much more fulfilling – and now that it is gone – nothing can replace it.

Within the framework of this story, Artemis’ Volunteer Visitor Service has been created. Read more here!

Read the Danish of the story here!

 

Follow up on Mrs Green

At last I got in touch with Mrs Green. The first three times I called her up after we had said goodbye to Mille, she didn’t pick up her phone. Finally she answered.

It took her a minute to find out, who I was. She told me that she normally didn’t pick up her phone. You never know who is calling. I had to agree; I usually didn’t pick up my phone either, so that was quite all right.

She told me, that she was sad, and that she had no heart for anything, since Mille passed on. Now she had no reason to open the door to the terrace. No little muzzle woke her up in the morning anymore. No little shadow who followed her around, just an empty mirror.

We discussed this. She would really like to have company, but these days she wasn’t in the mood for visitors. A call would be better. We arranged that I should call her back in a couple of weeks. I told her, I had not given up hope to come and see her.

The challenge is big, but not an impossible one. The people, who need to have you call on them, are also the ones who don’t have the energy for it. 

Nobody wants their loneliness exposed. How is it possible to resolve the matter with dignity? For Mrs Green to feel that we are here for her because grief is universal for us all, when we love our pets? Both the ones we have, and the ones we have lost?

An effort has to be made to share the knowledge of this project. So that you know throughout the dog’s life, that when the time comes and you have to say goodbye, it will be followed up by a little visit and thereby the acknowledgement of your sorrow.

As powerlessness is not rational, people grieving their pet’s illness or passing can be very unreasonable. It can easily lead to the surroundings withdrawing or getting upset.

Have you given your pet a letter of intent?

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A wonderful ten year old Labrador named Futte came into the clinic – an old friend which we had been following for years.

Over the past few months there had been a change in Futtes behavior. He seemed more fatigued and had trouble settling in at night. His abdomen had become bloated, but he still seemed to want to eat, play and go for walks.

Could this behavior “just” be the body’s natural way of aging? A dog of his age cannot be expected to have the same energy it once had, especially when battling arthritis and a low metabolism.

What seems to be the problem?  

The owners still had a sense that something wasn’t right.

Futte was examined and his abdomen did look bigger for a typical food-loving Labrador.

Bloodwork were done to screen his organs. While waiting for the result to come back from the laboratory an x-ray was taken of Futtes abdomen. The x-ray was clear; an enlarged spleen, which was confirmed by the laboratory.

Futte had cancer of the spleen.

Cancer of the spleen or a spleen tumor can occur as a result of changes in the spleen itself, or could have spread from other parts of the body to the spleen.

This type of cancer usually affects larger dog breeds and is typically seen in dogs past the age of 5. The course can be very varied depending on the extent of the cancer and how advanced it is.

As with all types of cancer, the symptoms may come in many different disguises.

The most typical symptoms are; a subdued behavior, increased drinking desire and need to urinate, enlarged abdomen, pale mucous membranes and sometimes the dog might even collapse.

If you experience any of these symptoms in your dog, you should consult your veterinarian immediately.

 Is an operation the right course of action? 

Futtes owners had a tough decision to make of whether to operate or if Futte should be euthanized and laid to rest.

It is possible to remove cancer of the spleen or a spleen tumor with an operation.

During the operation, the veterinarian will investigate whether the cancer has spread to other organs. If the cancer has spread, it is very unlikely that the dog will come out of surgery.

If the cancer is localized to the spleen, the spleen will be removed and many dogs can live a long and normal live without a spleen.

Although Futtes case was a bit more difficult, we must always asses each case individually.

How far should we go to keep our dogs alive? This is a question of ethics in many cases and Futtes case was no different.

Should Futte be put through an operation? Especially considering that Futte already has other health issues.

If he was younger and without arthritis, would it have made a difference in making the decision?

Letter of intent!

Was love, the motivation for letting Futte undergo the operation? Or is it a greater love to be able to say goodbye and thereby let Futte be laid to rest, as to not put him through unnecessary suffering.

When to let go of a beloved pet, is the toughest decision an owner will ever make!

We know – that when we get a pet, we also get a sorrow in knowing that a pet rarely outlives their owner. When is a live no longer worth prolonging?

Facing such a decision it is very difficult as an owner to remain objective, because we wish to keep our beloved pets with us.

This is why it is important to keep in mind when enough is enough. It is therefore important to talk about the subject throughout our pet’s life.

Through this difficult process it’s important to remember the letter of intent we gave to ourselves and our pet when they came into our lives.

Facing the tough decision of euthanasia our emotions can sometimes get the best of us because the thought of losing our pet is painful.

I had a long talk with Futtes owners and they looked at each other and told me that they had made a promise to themselves that they wouldn’t prolong Futtes life unnecessarily. His age and health issues made it clear.

Futte went home with his owners to spend a last weekend with his family and on Sunday afternoon Futte came back to the clinic and was laid to rest surrounded by his family.

In my book it was a”good” euthanasia. Futte have had a wonderful life and his time had come.

If you as an owner don’t have any doubts whether euthenisia is the right desicion, then you have been putting it off for too long.

Anyone with a common sense would agree that a tremendously weak and sick animal should be laid to rest.

It is much more difficult making the decision in situations where the pet’s illness isn’t at a point where life is unworthy.

This is the point where I as a vet believe that we should let the love for our pet prevail and let them be laid to rest with dignity.

Have you given you pet a letter of intent regarding a worthy passing?

Have the talk with your family members about what you consider to be a good life for your pet and a worthy passing, should it ever come up.

A letter of intent might spare your pet from unnecessary pain in the end.

The grief will not be any easier but it will be easier to bear knowing that you kept your pet’s best interest at heart.

The night sky burned a bit brighter on Sunday as Futte took his place amongst the stars, representing both the beginning of life and a final farewell.

When the sky got 3 new stars!

/in

A bag containing a harness, food bowl, blanket, toys and various treats is standing in front of me by the stairs.

It is going to the basement for storage until it is picked up along with other things, to be brought to a shelter somewhere in the world. I have not carried it down there yet, maybe because the bag testifies a week not like the usual? If I carry it down, it’s definite.

When Monday morning started, I already knew what was waiting.

However emergencies can never be anticipated. We had just opened the doors to the vet clinic as one of my dear patients stood in the door with his owner by his side.

It was time for the last journey. Other surveys were planned for the upcoming days, but the light in the eyes of the little white dog was gone and what would the coming diagnostic workup benefit?

Our diagnostic workups should always be used to help the dog forward and should make the treatment better.

Some people reach out to scientific facts when the difficult decisions need to be made. If we have a clear diagnosis, it may support the impossible act of the last farewell.

In this case, a last weekend with the dog had made the decision clear – he should not be exposed to anymore. There was no idea in waiting until there was no doubt about euthanasia.

If you no longer have doubts about euthanasia, you have been postponing your goodbye, which doesn’t benefit the dog.

The owner told me he could see it in the dog’s eyes. I knew from looking at the owner, that he knew his dog, and that he was right.

Afterwards a new patient walks through the door; a wonderful brown Labrador.

I have followed her for most of my life and a call from the owner very early that morning, and I immediately knew what the call was about.

She had lived a very good life and had suddenly become poorly.

Starting a treatment would only prolong the inevitable and would not benefit the protagonist.

We said our goodbye knowing that the dog had a life filled with love and the joy of food, now once a Labrador’s metier in life, intact on the death camp.

Then straight to another consultation where a very special little dog, was sitting with its loving owners. It is not always age that determines when the stars are waiting.

The owners had taken over the dog a little while ago and had put all the love and care into the little creature as possible.

I have had a close dialogue with them along the way and we agreed that enough was enough. She should be allowed to have peace so that her body finally could get some rest.

It feels very different saying goodbye to a dog, knowing it has lived a long life, than one who is still very young. It feels as though it never got a chance but this little heart did get the best chance against all odds, thanks to some very special people. Their caring and patience has been beyond ordinary.

Everything was arranged in advance, and nothing more needed to be said. However, the things we do not say are often the strongest, and the tears behind the dark sunglasses said more than a 1000 words.

I will always be very grateful to these people because they gave the little dog a loving home and because the owners above all, were strong enough to let the love of the dogs needs exceed their own deprivation. That’s something we can all learn from.

A quick glance at the time and it is not yet 9 o’clock. A long day followed by the joys and sorrows that are now part of it.

There are many aspects to being a vet that needs to be controlled in fear of overseeing something. Therefore, most veterinarians have a systematic approach to a patient. “I have just taken a temperature at home, why do you do that again?” an owner might ask.

We do our examinations from a-z, because if we miss something we fail, and we will lose both patients and clients.

People just can go somewhere else and if you’re lucky you’ll be hanged publicly online. Fortunately, we have the world’s cutest clients!

Many of my colleagues and I, usually go to bed very early which benefits the animals. You do not go to work with shaking hands or lack of faith. Everything needs to be done right!

Now the week is coming to an end and soon we will go home with the stories of the week, carrying them with us in our hearts, and we will never forget!

I cannot help but think that you never know what hides behind the people you meet in the street.

Do not they smile? Are not they happy? Perhaps they carry some stories that are currently filling up in the mind, so the attention to the outside world for a while is gone?

Perhaps due to a job filled with strong emotions, they are just people where experiences and impressions of the day are being processed, so that there’s room for them to be there, for those who need them.

Before I go on, I will go to the basement and put the bag into storage. Reminded of a person in the midst of his own sorrow, had the strength help other animals.

The forecast promises clear weather for the evening.

Look up and send the 3 new bright stars a loving thought!