One Tough Cookie

It's been a hard week.

I took this photo of Butch on Thursday, thinking it might be his last one. I am overjoyed to tell you it won't be.

The tumors on Butch's gums that I wrote about here and here continued to grow, and about 10 days ago they began to bleed. A lot. The vet had told me Butch might chew off the tumors if they grew long enough to catch between his teeth, but I had expected that to be a one-time event. I did not expect the bleeding to be a continual occurrence.

I was laundering his bedding (and mine that he touched and imprinted with his muzzle) once or twice a day, continually cleaning blood droplets and saucer-sized bloody drool stains from the carpet (hats off to Stainmaster® for performing as advertised), and washing Butch himself several times daily because he frequently wiped his mouth on his forelegs. Because of his blindness, Butch navigates through the house by touching his muzzle against familiar landmarks, such as walls and furniture.  With his bleeding mouth, he had become a walking ink stamp.

The only good news during that time was that those tumors must have contained no nerves, because Butch appeared to be feeling fine. He was enthusiastic about meals and snacks (his that he ate and mine that he begged for) and went about his business--as much business as a nearly 14-year-old dog can manage--in good spirits.

In fact, he seemed to be feeling well enough that I thought he wouldn't fall apart during a short car ride, so on Thursday I enlisted Kim's help in getting him in the car so the vet could take a firsthand look at what was going on with his mouth. She found more than we had expected. In addition to the tumors on his gums, there was a large, black mass on the roof of his mouth. The vet suspected melanoma.

We discussed options.

Doing nothing was not an option because Butch's continual bleeding was weighing more heavily on me than I like to admit. I've cleaned up my share of urine, feces, and vomit in the years I've owned dogs, and even some blood on more than one occasion, but this constant dripping from a roving source was beginning to feel like Chinese water torture. As much as I love Butch, I was starting to find the situation intolerable. I'm being as honest as I can here, even though I'm ashamed of those feelings and believe that Butch deserves better than that from me.

A second option was surgery to remove as much of the tumors as possible and cauterize the remaining blood vessels to stem the bleeding. I didn't think Butch was a good candidate for surgery. He's so old now, and he has a history of problems with anesthesia. Would it be fair to him to put him through the pain of another surgery this close to the end of his natural life span?

That brings us to the third option: euthanasia. A number of people told me after Butch's eye-removal surgery in 2005 that it would have been kinder to "put him to sleep," but he's had six and a half pretty good years since then, so I've never regretted that choice. At the age he is now, it's a different story, and I gave it serious consideration. My daughter Kelli summed up my ambivalence about this option when she said I was struggling with this decision because I wanted to be sure I was doing it for the right reasons and not as a matter of convenience. That was exactly it. And the truth was that all that bleeding was bothering me; Butch didn't seem to be the least bit concerned about it.

The vet assured me that the surgery would be fast and easy. It would quell most, if not all, of the bleeding. I asked about cost, and she quoted a price that was exceptionally fair and reasonable. She couldn't, of course, guarantee that Butch would survive the surgery, but she laid out her plan to give him the best chance possible.

The next day, Friday, we gave him that chance. I dropped him off tearfully, knowing the odds were against him.

The vet called after the surgery to tell me that Butch was awake, sitting up, and was trying, not successfully yet, to wag his tail. They had removed the epulis (tumors on his gums), which had also involved removing two teeth. That was the good news. The bad news, she told me, was that the mass in his palate was melanoma, and they couldn't get it all. She said the melanoma was quite invasive and there is a danger that it will grow into his sinus cavities. "That," she said, "will be it." She estimated that Butch might live as long as three to six months, though his time could be shorter than that. She said to give him a week to recover from the surgery; after that, we should have a better idea of the quality of life he'll have for the remainder of his days. If Butch does well, there are inexpensive medications that have been shown to slow the growth of melanoma, and they should also keep Butch comfortable. On the other hand, if Butch seems to be suffering at the end of the week, we can stop it then. She said they'd keep Butch under observation for a few more hours, then I could pick him up and bring him home.

I couldn't believe how good Butch looked. He seemed strong and tugged at his leash, ready to get out of there.  He came home without much fanfare except for enthusiastic greetings and all-over sniffs from Levi, Lucy, and Oliver, then made his way to the backdoor to go outside and relieve himself. By the time he came back in the house, he had reoriented himself, knew exactly where he was (well, as exactly as he ever knows), and began nosing around in the kitchen. It was suppertime by then, and he was obviously hungry.

Butch's first few post-surgery meals were limited to chicken broth and small amounts of rice. He ate every bite and was clearly unhappy about the meager quantity, so as soon as we knew for sure that one meal had settled nicely in his stomach, we fed him again. He cried a little that first night, but I was never sure whether he cried from pain or from hunger. His mouth bled a little that first night, too, but not nearly as much as it did before. I was encouraged.

By yesterday Butch showed no signs of pain and could eat a full quota of his new regular diet. He will never again in his lifetime be able to eat anything of a harder consistency than oatmeal. The tumor in his palate is fragile, and any slight pressure on it will cause it to bleed. That means the spoon-feeding has to stop, because the hard metal edges of the spoon can cause damage. Fortunately, Butch has been hungry enough that he hasn't hesitated to push his muzzle into the bowl and gobble for all he's worth.

Butch is what he can never have again: one tough cookie.

Today he is eating well, sleeping well, showing affection, and asking to go outside when he needs to. When he comes back in the house, he waits patiently for a treat, and he doesn't seem to mind that the treat is soupy or soggy. The bleeding hasn't yet stopped entirely (a certain amount is to be expected after oral surgery), but it has diminished to manageable, non-repulsive proportions. A short time ago, as he slept, I pulled out a tube of braunschweiger (liver sausage), which is what I'm using as both a disguise and a soft coating for his pills. As soon as I opened the wrapper, I heard his toenails hit the floor, and in seconds he was standing beside me, sniffing expectantly. If he's doing this well two days post-surgery, I think there are more good days than bad ones in his future.

As my daughter Kim pointed out to me, the prognosis of a three-to-six-month life expectancy for a dog Butch's age, especially if those months are likely to be comfortable ones, is not too bad.


(First published at Velvet Sacks on January 15, 2012.)

Update on Butch

Butch is once again celebrating suppertime, and I couldn't be happier. He won't stick his muzzle into his food dish (maybe it's painful?), but he happily lets me put food in his mouth one spoonful at a time. I had stopped feeding him crunchy kibble sometime last year, but now I'm softening his meals even more. If the next step needs to be mush, we'll do that, too. As long as he's happy and his gum condition isn't going to cause him to starve, I'll do whatever needs to be done to keep him comfortable.

If you can call this comfortable: Thanks to all of you who expressed your concern. He's doing well, and I am SO relieved.

(Partial reprint of a post first published at Velvet Sacks on December 30, 2011.)

Things that are dogging us

December 28, 2011 - 1:46 PM

Butch has been perkier in the last week than he's been in at least a year. He's been so stiff and arthritic that I can't recall the last time he was able to get up on the furniture, but I looked up the other day and was shocked to see him sitting comfortably on the futon in the den. I don't know what made him decide to give it a try on that particular day, but he's been up there several times since then, apparently happy that his attempt was successful. Here he is relaxing on the futon with Lucy:

Butch has also been more social lately, spending more time interacting with people and other dogs and less time off by himself sleeping in another room. He seems to be hearing better than he did for months previously, and if I so much as crack open the refrigerator, he is up and coming into the kitchen to investigate. I've used his interest in food as an indicator that he still finds something positive about life in spite of his blindness, near deafness, and painful joints.

All that sounds good, don't you think? But there's a problem. When I took him for a checkup early in November, the vet commented on one tooth that looked really bad, saying he wouldn't risk putting Butch under anesthesia to pull the tooth (because of his age). He said to watch for any swelling around Butch's mouth or any signs that he was having difficulty eating.

Last night Butch didn't want his supper. He accepted a treat I offered him later, but promptly dropped it on the floor and left it. I pulled his lips back to check the appearance of the bad tooth, and I couldn't even find it. Since that veterinary visit less than two months ago, Butch's upper gum tissue has grown and hangs down to obscure all of his upper back teeth.

I have looked on the Internet for pictures of dogs' mouths that look like Butch's, and I believe what he has is an epulis. An epulis is a non-malignant tumor that occurs fairly commonly in older dogs. Treatment consists of the surgical removal of the epulis. In Butch's case, however, surgery is not an option.

Butch needs to go to the vet, but riding in the car has become pure torture for him. He fights me when I try to get him into the car, and his whole body shakes until he is out of it again. I don't want to make him suffer more than necessary, and I am afraid he may not come home from his next trip to the vet.

I have taken a photo of the growth on his gums and will take it with me when I take Levi today to see if they will/can identify it from the picture. 

If it is what I think it is, and if surgery is the only option that will enable him to eat, I have a decision to make. Should I have Butch put down now, while he's in a relatively happy state of mind, or should I wait until he's in so much pain that death is the only way to make him comfortable? I don't want to deprive him of a single happy minute, but this brave animal has already suffered so much in his lifetime. Is it fair to keep him alive when a long, hard winter may be all the future that lies ahead of him?

I'm praying for answers. What would you do?

UPDATE December 28, 2011 - 4:26 PM The vet looked at the photo of Butch's gums and said the growth does appear to be an epulis of the non-malignant variety. Fortunately, there are some non-surgical treatments that might help, the first being antibiotics to eliminate any possible infection. She gave me a prescription to start him on tonight and said he should be eating better by tomorrow. If not, then infection isn't what's keeping him from eating, and I will have to take him in tomorrow afternoon so they can get a good look at what's going on. She said that without surgery these tumors sometimes grow so long that they completely encase the dog's teeth. Most dogs, when that happens, will simply chew off the surplus. That's gross, I know, but it's an alternative Butch and I can live with.

I'll keep you posted.

(Partial reprint of a post first published at Velvet Sacks on December 28, 2011.)

Timeworn

Butch

(First published at A One-Pic Pony on October 9, 2011.)

Poor, patient pooch

If I fail to close my bedroom door before I get on the computer at the other end of the house, Levi makes a beeline for the bedroom. He loves to rip chunks out of foam rubber dog mattresses, and all he needs is five or ten minutes' worth of opportunity.

Here's a picture I posted exactly two weeks ago today of Butch sleeping happily on his unblemished bed (the second bed he's had exactly like this):

Well, last night I forgot to close that door, and I got online and stayed there a while.  While I was on the computer, Butch lay on the floor beside me, and Levi was in and out. I realized later he was more out than in, because when it was time to go to bed, I went into the bedroom and found a carpet strewn with foam rubber and a dog bed about one-third of the size it had been earlier.

I've shown you that kind of stuff before, so I didn't even bother to take a picture. And, as it was quite late, I decided cleanup could wait until morning. Levi was locked in his crate by then, so I left Butch alone and went to brush my teeth. When I returned, I found this scene and decided it was photoworthy:

Poor baby! Bless his little put-upon heart.

In spite of that pitiful photo, there's another part of this story that makes it at least a little bit funny. You see, even though I hadn't cleaned up the mess, I had taken a minute to retrieve the last, mostly-intact dog bed in the house and put it in the spot where Butch's bed normally is. And I'd watched him sniff it, climb on it, and begin circling and pawing the bed like he does every night before he lies down. He was circling and pawing when I left to go brush my teeth.

That means that at some point in the going-to-bed process, Butch changed his mind and made a choice to sleep on this ragged little piece of a bed bunched up in a corner.

Hmm. I guess it's still pitiful, any way you look at it.


(First published at Velvet Sacks on July 27, 2011.)

Curmudgeon

I used to tell you stories regularly about Butch's courage, his loving nature, and his antics. Butch has changed a lot in the past couple of years; anything I'd write about him now wouldn't be as funny as some of those earlier stories. He's 13-1/2 years old now, and the years haven't treated him too kindly. He still shows moments of incredible sweetness or great heart, but his senior years have brought out new aspects of his personality. He is stubborn. Bull-headed. Demanding. Those in my family would probably know what I mean if I said that Butch now reminds me of Daddy.

My stepdaddy, in the latter years of his life, could be charming when he wanted to be, but he didn't often see the need to turn on the charm. Butch is the same way. Daddy complained a lot, and Butch has adopted a shrill whine as his means of communicating when he wants a treat or when he wants me to let him outside or inside. If Daddy thought Mother's cooking was a little too salty, he was sure to tell her about it. If the treat I give Butch isn't the kind he had in mind when he begged for it, he spits it out, whines some more, and waits for me to try again. Now, don't misunderstand me: I loved Daddy, and I love Butch dearly, but both of them fit clearly into the category of "grumpy, old men."

Like Daddy, Butch sleeps a lot now that he's older. If I were to guess that he sleeps 20 hours a day, I wouldn't be far off. He gets up for mealtimes (his and mine) and when he needs to go outside. He usually gets up when we have company, and when that happens, he acts like his sweet, old self for a little while. It's rare that he stays awake much more than an hour at a time.

The whining began near the end of last year, back when Kadi was so sick. For every trip Kadi took to the vet, Butch took another one. I thought then that the whining meant something was hurting him. We checked out his ears, because ear infections have plagued him since he was a pup. We checked out his arthritic hind legs and began medicating him in case they were the problem. We checked his behind, where his anal-gland surgery had left him with some residual problems. Even though no new health issues were discovered, everything that could be medicated was medicated, just in case. Still he whined.

As Kadi became sicker and sicker, I began to read everything I could find about how to know when it was time to euthanize a dog. Almost every one of those articles stated that the dog's quality of life should be the determining factor. That threw me for a loop. Kadi was obviously sicker than Butch, but she was also happier than he was. Until her very last days, she was pleasant and engaged. Butch, on the other hand, had begun to isolate  himself in the bedroom and to whine through many of his waking hours. What kind of life is that? I didn't know which dog I would lose first, and the thought of having to put down both of them at or near the same time was horrifying to me.

In Kadi's final week it became clear that her illness had reduced her quality of life to an unacceptable level, and seeing her that way helped me to see a clear distinction between her health and Butch's. I knew then what I had to do.

In the days after Kadi's death, I concentrated on Butch and started Googling "why does my dog whine?" I expected to find information about hidden medical conditions that might be troublesome to an animal. What I found instead were training techniques. It hadn't occurred to me until then that Butch's whining might be a behavioral issue. I realized then that I had been rewarding his bad behavior by fussing over him when he whined.

So, I made some changes in my own behavior. Butch's whining hasn't stopped, but it has decreased to a point that no longer drives me insane. I also changed my expectations once I connected the dots between Butch's whining and Daddy's complaining. That helped me to understand better where Butch's attitude is coming from. He's old and he's tired. He's achy sometimes.

It's been six years since Butch lost his eyesight, and in the past year or two he's gone almost completely deaf. He can hear the phone ring, and if I speak loudly, right in his ear, he seems to hear that. He gets disoriented more frequently, but he thinks he knows more than he does, and he thinks he knows more than I do. He thinks he knows exactly where he is and what he needs to do to get from Point A to Point B, but he's often wrong about that. If he's about to walk smack into a wall and I grab onto his collar to steer him in the right direction, he digs his heels in and refuses to budge until I let go. Then he walks into the wall, corrects his course, and sets out again, often in a different wrong direction.  Sometimes he bumps into every piece of furniture between the bedroom and the back door rather than let me guide him.  He usually bumps them gently, though, as if he expects them to be there and "test bumps" to be sure. The only way he will let me lead him is if I put him on the leash, but even then, if he doesn't want to go (outside, for instance), he digs in his heels and stands his ground.

Riding in the car, something Butch has always hated, has become almost impossible to get him to do. I needed to take him to the vet last week for another ear check, and he wrestled me so long that I had to stop trying at one point and call the vet's office to let them know we'd be late. He's heavy enough that it's difficult for me to pick him up, but even after I managed to do that and get him on the backseat, he jumped out before I could extract my arm and shut the door. Do you know how dangerous it is for a blind dog to jump out of a car onto a concrete driveway? I finally lured him into the car by sprinkling the seat with his favorite treats. He refused to eat them, but they distracted him long enough for me to get the door closed.

Fortunately, Butch's sense of smell is still strong. He can sniff me out anywhere in the house and is quick to do so when he wants something. Then, when he finds me, he whines. If I'm at the computer, he uses his nose to bump my hand off the mouse. Usually when he seeks me out it's because he wants a treat. He still tries to con me by asking to go out and back in several times in a matter of minutes. He gets a treat the first time he comes in, and I'm willing to let him go out the second time just in case he forgot to do part of his business while he was out there the first time. He gets a little treat the second time he comes in, too. But that's all. I've learned to be firm when he asks the third time, to stand between him and the door and make him back away so he knows the jig is up.

Butch used to spend whole evenings on the sofa beside me with his head in my lap. Now he's too stiff-legged to get on the sofa by himself and too hard-headed to let anyone help him. If I try to pick him up, he panics and fights me. My own bad knees make it difficult for me to get on the floor to give him the doggy massages he used to love, but I try to give him as much stroking and petting as I can when he's awake and erect. Sometimes he'll lie down in front of my chair, where I can rub his belly with my feet and enjoy the kind of sweet moments we used to take for granted. Last night he ate his supper, then stood right next to me for half an hour, not whining, while I ate mine. I suspect it was the scent of the  chicken on my plate that kept him there, but I enjoyed his company regardless. Still later, instead of retreating to his bed, Butch followed me to the computer and napped on the floor beside me. I feel so honored when the interaction between us is his idea instead of mine.

As Butch's personality has changed, so has his physical appearance. Both of his ears used to fold over, but for the last few years the right one has always stood up straight. There's a little bump in the middle of his forehead that we think might be a cyst formed around a bone chip, possibly from one of his harder head bumps. It's never seemed to bother him, and the vet doesn't think it's anything to worry about. His left eye socket bulges with fluid that stretches the skin tight, fluid from a gland that has apparently reactivated itself in the years since his surgery. The vet who did the eye surgery told us ahead of time that that could happen someday, and the vet who treats Butch now agrees with me that draining the fluid for aesthetic reasons could unnecessarily open the door for infections.  The swollen area is ugly, but it doesn't cause Butch any pain. He doesn't mind at all when it's touched or rubbed.

Butch has several new skin tags, including the big, black, mole-like one on top of his head. Last year one of his top front teeth began to turn grey and receded behind the other teeth. Last week I noticed that the tooth was no longer there. It, too, may have been a casualty of one too many bumps.

Butch is heavier than he's ever been, though I can still feel his ribs, so I'm not worried about him. It seems to me that his pleasures are few at this time of his life, and while I'm willing to cut back on his food and treats a little bit for health reasons, I'm not inclined to cut back so much that he notices.

These days, when I think about the quality of Butch's life, I know it isn't an easy one, but I think he's okay for now. He's had more than one dog's share of troubles and has faced his struggles with a lot of courage and character. His life isn't as interesting as it used to be, nor is his body as strong and resilient as it once was. I think he has reason to complain about his current state of affairs. And, remembering how long Daddy lived as a grumpy, old man, I believe Butch will be okay for a while longer. He's making an effort to live with the hand that's been dealt him. If he's a little disgrunted about it sometimes, maybe he has a right to be.

(First published at Velvet Sacks on July 13, 2011.)

My purpose in life...

...at least from the perspective of Butch and Kadi, has been made clear to me: I am their maid.

Judging from their recent behavior, it's a good thing I retired when I did. They adapted so quickly to my being home all the time that I suspect they may have had previous discussions about their need to hire additional staff. Part-time help just wouldn't cut it anymore.

For example, Kadi has always loved to have her belly scratched, and I've always loved to do that for her. But she used to wait until I'd sit down on the sofa to roll over at my feet and expose her belly. Now she's just as likely to race past me when I walk through the house, hurl her big body across my path, flop onto her back right in front of me and stretch all four legs into the air as if to demand, "Stop! Scratch me now." I don't think this has as much to do with the itchiness of Kadi's abdomen as it has to do with my increased availability.

An issue that's bigger than the belly-scratch-tripping-hazard is the way they manipulate me for treats. Especially Butch. Years ago I thought it made sense to give each of them a treat when they came back in the house after taking care of their doggy business in the yard. I wanted them to be happy to come in quickly when I called them. This was especially important when I was working and their outside time was often a quick trip in the morning or sandwiched into a lunch hour.

Once I retired, though, Butch, began asking to go outside many, many, many times a day. He's always had a bladder like a bathtub. Unlike Kadi, he still does. So I've tried to ignore him when I know he's been out only a short time ago. But he's persistent. He'll stand at the door and scratch it every ten seconds or so for as long as it takes to wear me down. My daughter suggested that if I let Butch stay outside longer, he might not ask to go out so frequently. But for Butch it's not about being outside; he's an inside dog through and through. The whole bunch of us can be outside, and Butch will ask to go in by himself. It's all about coming back in. It's about the treat.

It's hard to relax with all of the extra interruptions. I mean, come on, Butch doesn't just pop outside and pop back in again. He's blind. It takes him a while to find the perfect spot to squeeze out two or three drops to prove he needed to pee and another little while to find the back door again. I often have to stand in the door and clap my hands to help him navigate. I'm trying to figure out how to communicate to Butch that it would be easier on both of us if he'd just learn to ask for a treat and stop the whole fake in-and-out thing.

I know Butch is faking it because I can predict when he's going to do it. Example: Both dogs stand at my knees while I eat my meal, and usually, if it's something that isn't bad for them, I will give the last two bites to them. Kadi considers her bite a treat. Butch considers his an appetizer. He'll wait about one minute before he goes to scratch on the back door. Every. Single. Time.

But maybe Butch is getting tired of the charade, too.

The other morning I woke up about five-thirty and let the dogs outside. As soon as they came back in, I gave them each a dog biscuit, then went back to bed. Usually, they'd go back to bed, too, and maybe they did, for a while. All I know is that just before seven I heard a little whine and there they both were, tap-dancing eagerly beside my bed. I knew they couldn't possibly need to go outside again so soon, but I stumbled out of bed and headed to the back door anyway. I opened the door and stood waiting, finally realizing I was alone.

I turned around and there were Butch and Kadi, twenty feet behind me, standing side-by-side with their noses stretched upward to the package of rawhide chews I'd left on the dining table. Because they did this together, I can only assume they had discussed their plan beforehand and agreed between themselves that it was perfectly fine to wake me up to to give them rawhide.

If I'm being honest, the unnecessary interruptions bother me, but it's the manipulation that bothers me more. It's the fact that Butch thinks he's so much smarter than I am. And Kadi probably is smarter than I am, but it hurts my feelings that she uses that against me.

Seriously, although I've groused about some of their annoying habits here, I am loving spending more time with these two old dogs. Butch turned twelve in March, Kadi will be thirteen in June, and I'm no spring chicken myself. I consider it a privilege to grow old with these two sweet souls.

Even if they do take advantage of me.

(First published at Velvet Sacks on April 18, 2010.)