Katelin’s Adventures in Hospice Care

So my 16 year old dog, Katelin has been dying on and off for about the last six months now. Shortly after my dog Scully died of kidney failure two years ago, Katelin apparently decided that looked like a pretty good way to go & proceeded to go into chronic renal failure herself. I did a little blood testing to confirm the diagnosis & rule out the slim chance that it was Leptospirosis (a treatable, bacterial cause of kidney failure), put her on Hills K/D diet (prescription kidney diet) & called it good.

I love this picture of Katelin, taken by my friend Lauren.
I love this picture of Katelin, taken by my friend Lauren.

She held her own for a good year and a half, even getting a little thick on that good fatty food, I usually keep my dogs pretty trim, but I figured I’d fatten her up in preparation for the inevitable time when the disease worsened and her appetite started to wane. Things started to change around last December, she started to decline a little. She was sleeping more, and had gotten picky about her food.

Then we began the remodel from Hell. (A 4 month process that involved ripping about half of my house apart and putting it back together). The dogs spent a lot of time either boarding or in their cages. I think for Katelin, it was about the equivalent of taking a content old person out of their house and sticking them in the nursing home. Her eating habits got more sporadic and she started to lose weight.

Oh and a week or two into the remodel, we lost her. We couldn’t find her anywhere, I thought she had slipped out via one of the workers. I had heard her barking like she was trapped in a bedroom, but couldn’t find her anywhere. After a frantic search, as a last resort I went to ground zero of construction: upstairs in the attic/former game room, which was generally behind a closed door. While looking around for her, I noticed a hole about a foot in diameter that the workers had cut into the floor. Surely she didn’t fall in there, I thought. Sure enough, one look with a flashlight, and there she was, wandering around aimlessly…inside the wall, two stories down. Miraculously, she had slid twelve feet down an AC duct to land safely on the cement floor below. The contractors had to cut a hole in the downstairs wall to get her out, unharmed.

Here's the hole in the floor where Katelin had her adventurous slide down the AC vent into the wall.
Here’s the hole in the floor where Katelin had her adventurous slide down the AC duct into the wall.

We took Katelin with us to Galveston over Spring break. Scully decided to die while I was on vacation, and I wasn’t too keen on going through that again, so she got to go see the beach for the first time (we thought it would be a good idea to kick some things off of her bucket list).

It's cold, wet and sandy. She wasn't thrilled, but was happy to hang out with us.
It’s cold, wet and sandy. She wasn’t thrilled, but was happy to hang out with us.

It was during this trip to Galveston, that Katelin decided that life’s too short to eat dog food. Specifically: her new mantra is  “human food or nothing”. Not just any human food, mind you, I actually looked up and formulated a particular home made diet formulated especially for kidney failure. The diet was a mixture of rice, hamburger meat, a little bacon grease for flavor & some vitamins and stuff. I am now a crazy person who cooks for her pet.

“Screw that”, said Katelin, “I want steak.”

Sometimes it's just nice to be at the beach and feel the wind in your ears.
Sometimes it’s just nice to be at the beach and feel the wind in your ears.

We started “watering the dog”, as my husband describes giving her Sub Q fluids (fluids under the skin to keep her hydrated). Part of me just wants to let the disease run its course, but she’s my favorite dog, so I cave to family demands to keep her going. She’s basically on life support.

At this point, Katelin is officially in hospice care. She rallied once the horrible remodel was over, she felt better, but still wouldn’t eat dog food. She mostly eats, within reason, whatever we eat for dinner. Her default meal is spaghetti and meat sauce. I do not recommend this diet to clients, she is under the care of a trained professional who understands the potential outcomes of this particular diet lifestyle (pancreatitis, gastroenteritis, etc.). However, we pretty much figure that every meal could be her last.

I do try to keep things not too spicy or fatty. We did have one accidental breach of this guideline one evening when I wasn’t present to supervise feeding time. I arrived home from my meeting and asked my son what Katelin had for dinner. He happily responded “chicken fetuccine alfredo! She loved it!”. Something in my expression of horror cued him that this may have been a bad idea. “But I thought you brought it home for her?!” He exclaimed. “No!” I responded: “It was for your brother!”

I resigned myself to the fact that I had just nursed her through a year and a half of kidney failure, only to kill her with pancreatitis. I gave her a dose of fluids, the family gave her extra hugs, went to bed, and hoped for the best. For whatever reason , she was better than ever the next day. Another bullet dodged. (NEVER feed your dog fettucini alfredo, I absolutely do not recommend this).

Summer travel has been challenging, finding a pet sitter willing to watch a dog who could die at any moment is tough. Not to mention  the addition of cooking and portioning a vat of spaghetti and meat sauce to my already lengthy list of pre travel chores. My pet care instructions are the lengthy diatribes of a crazy person.

Kathleen accompanied us on a few road trips this summer.
Kathleen accompanied us on a few road trips this summer.

Katelin had another setback this summer, when after a 4 day trip to San Antonio with friends, I was informed by my college-age pet sitter that he had forgotten to come feed the dogs. Thankfully, they had free access to water and a dog door, but Nixon and Katelin starved for 4 days.

Katelin looked like hell. We thought “this is it”. Perry, my youngest had to go to a 4 day Cub Scout sleep away camp.  I wasn’t sure the dog would be alive when he got back, but he made me promise to try and keep her going. We all said a tearful goodbye when we left to drop Perry off, we weren’t even sure she’d be alive for our return. Perry took pictures of her with his iPad before he left, one of the saddest things I’ve ever seen.

I got this wild idea in my head, to make Katelin a vat of “Jewish Chicken Soup” out of some roast chicken leftovers in the fridge. I learned about the “miraculous” healing powers of this soup from binge watching Nurse Jackie with my friend Jennie earlier this year (granted, the guy in the show, who ate the soup ultimately died, but he died happy).  I didn’t have anything to lose and a spare chicken carcass, so what the heck. I’d like to mention, that I have never made chicken soup for my family, but here I am making it for the dog.

The princess gets her soup, presentation is everything. She leaves the veggies for the young dogs to eat.
The princess gets her soup, presentation is everything. She leaves the veggies for the young dogs to eat.

Once again, for whatever reason, Katelin rallied.

My friend Amy said that it Katelin was a human, she’d be an old lady who wears a red hat and reads Nitsche. I love that.

So I am currently embroiled in the old dog emotional roller coaster. The anguish of the bad days and the joy of the good ones. The selfish wish that she would just die in her sleep one night, so I don’t have to decide anything.

There is a point to all of this rambling. We, as veterinarians have a huge role in the end of our patients’ lives. We’re there at the bitter end, with our syringe of “pink juice” (AKA: euthanasia solution). We usher those beloved souls to The Rainbow Bridge & try to help our clients at that time.

However, there is a lot more to losing a pet than that final moment with the vet. There are last days, months or weeks, that are both sweet and heart rending. Your vet can help you during this time too, hospice care is a “thing”. Discuss it. The goal here isn’t to do a bunch of heroics or diagnostics, but to keep the pet as comfortable and pain free as possible.

When fortunate enough to get that “hospice time”, while it does suck, it’s also nice to just unabashedly love and spoil that old dog until the time comes to say goodbye.

The hardest part is letting go.

Update: Katelin passed away on September 12, 2015. She was a good dog & will be missed.

There's nothing like loving an old dog.
There’s nothing like loving an old dog.
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3 thoughts on “Katelin’s Adventures in Hospice Care

  1. Thank you!! having nursed an old guy for 2 years with Diabetes and Cushings’ who was also blind and deaf, I moved him across country, driving a truck and trailer stopping at truck stops to get his insulin and feeding times right with the time changes. There is so much more to his final story that his first winter with ice and snow, my new Vet said it was time. The story like yours is full of love, toughness and humor, thanks for the wonderful portrait of Katelins voyage.

  2. chicken soup is the cure all! katelin truly is the princess of the home! she is the calm that helps center the family through all the rough seas; even trying to get in a couple of adventures on her own. i think about that sometimes, you know, how much do they need us or is it how much we need them?

  3. I’ve often thought it was unfair of Mother Nature to have us nurse our critters because we get SO close to them…. and then we lose them.

    I’m a firm believer in “give ’em what they want to eat” when in hospice care and it sound like you’re doing a great job of it.

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