"In order to write about life, first you must live it." ~ Ernest Hemingway

Category: euthanasia

A Story Of Euthanasia

I was alone at my favorite restaurant today and the waitress had just set my meal down in front of me. I started to eat and all of a sudden, memories rushed into my head; memories so powerful that the tears threatened to come.

Eat, I told myself.
Hurry up and eat and you can cry in the car.
So I did.

And I cried all the way home. As I was driving home, I realized that the second I got home, I needed to finally write about this. I promised myself that much at least.

It’s been a little over 9 months since my dog, Molly, died. And while I’ve wanted to write about it, I haven’t.

I couldn’t.

I’m not exactly sure what makes today different. Maybe because I promised myself I would. Maybe it is because I have this nagging little voice in my head that is telling me that it has to be written today because soon, someone else is going to need this story….a story that I wish I could have read 9, 10, or 15 months ago.


Molly was my almost 16 year old basset hound/black lab mix rescue. She was my constant, faithful companion for 13 of those years. She was more than a dog to me; she was my child. I couldn’t imagine a life without her.

But this story isn’t about her life. It is about her death and the process of having to make the decision to end her life.

I had noticed one day in the Fall of 2016 that Molly’s breathing seemed labored. In addition, she was more fatigued than usual. Our vet couldn’t see her that day and recommended we take her to the E.R. After many stressful hours, she was diagnosed with probable heart failure.

For me, that was the beginning of the end.

My husband and I talked and decided to proceed with medication to manage her heart failure. At this point in her life, at 15 years old, she had slowed down considerably and had some hearing loss. To be honest, I had been mentally preparing myself for years that her advancing age meant we would soon have to make some difficult decisions.

We started with two medications and then took her to see a veterinary cardiologist. She said that yes, she had heart failure and when I asked, said that she thought Molly would probably be able to be managed on medications for roughly 2 years. We left there with several more medications and in addition to medications she was already on for arthritis and a thyroid problem, her list totaled 8 different medications.

Molly actually improved for several months but then her breathing got worse again. The cardiologist told us her echocardiogram showed worsening of the heart failure. Medication doses were increased.

At this time we also started to notice some changes in her behavior that indicated she may have dementia. And, her hearing was getting worse. I had a conversation with our regular vet about when we would know that it was “time.” She talked about how many people make the decision to euthanize when the dog stops eating, appears to be in a lot of pain, or isn’t enjoying life anymore.

Molly didn’t seem to be in pain; she was on a pain medication for years for arthritis. She was eating, although not as much as she used to. However it was becoming obvious that she was starting to struggle. The dementia was getting worse. Her breathing, at times, was getting worse, and her quality of life was worsening.

I remember one afternoon, a few weeks before she died, I was lying down on the couch, on my back. Molly was always an affectionate snuggler but she did something new that afternoon. She got up from her spot by my feet, climbed up on my belly and chest, and rested her head so that we were practically nose to nose. She looked me right in the eye. It was spooky.


I can’t really explain how I knew.
But I did. 
I knew she was telling me she was ready to go.

So why did it take us several more weeks (2? 3?) then to euthanize her? I think there were many reasons. I was waiting for my husband to say, “it’s time.” (this is something we only discussed very recently…about how I knew before he did that it was time). He would point out that she still enjoyed being outside sometimes or that she was still eating. At times her breathing wasn’t as bad. I was waiting for one of our two vets to say, “it may be time.” Neither ever did.

I was OK with euthanizing Molly. Well, as OK as anyone can be I suppose. The last thing in the world that I wanted was for her to suffer. But I was caught up in the thought of, “what if I am wrong…what if it is too soon?”

I was afraid of murdering her.

But I couldn’t get rid of that nagging feeling from that day on the couch when she looked at me. And I was actually thinking about that as I walked into our house one day after about 2 hours of running errands. Something didn’t smell right.

I walked into our living room to find several small piles of stool. Not even diarrhea. Just regular stool and it seemed like she thought she was outside. She had been incontinent of urine on and off for many, many months, but the stool? That had only happened one time in all the years I had her and it was due to her getting into something outside when she was 4 years old and not being able to get outside to the bathroom in time.

And that did it for me.
I knew.

I knew that she had to be really confused to do that inside the house. I could live with accidents in the house. Hell, I had been dealing with urine for a while. But it symbolized how much she was struggling, and likely suffering. Things were just going to get worse.

I called my husband at work and told him we were putting her down. I called our regular vet and told them I wanted to make an appointment to have her euthanized. I was shaking so hard, I dropped the phone at one point. We chose a day the following week  when neither one of us had to worry about going to work for a few days afterwards.

Since we first found out she had heart failure, we were making the most of our time left with her. We got 7 months of appreciating every single moment with her. But after I made the appointment, I told my husband I wanted to take her to the beach one last time. Years ago that would have meant a full day trip with several hours of exploring.


We had a glorious 30 minutes with her on that beach. She was almost like her old self again, until then she wasn’t, and we decided it was time to go.

Two days after that beach trip, it happened again. It was a Tuesday and she was scheduled to be euthanized on Friday. She was lying on my bed and I had been checking in on her a lot because it seemed like her breathing was more labored. The beach trip, which included 4 hours in the car, was probably too much for her but I was OK with that because she enjoyed it so much.

I laid next to her on the bed and she turned to face me and it was there again…that look. The look that said I’ve had enough.

I cried and stroked her head.
I called the vet.
I called my husband and told him I moved up the appointment to the next morning.
He asked if I was sure because it was my birthday. I told him that I couldn’t prolong her suffering just because it was my birthday. It was the right thing to do.

Molly died on May 3, 2017.
The events of that day are for another time, another blog entry.

So what’s the point in writing all this? Sure, it’s a bit cathartic but God knows I’ve had plenty of people to process this with since last year.

This is about more than that. It’s about letting whomever reads this know that if you are in this same situation, the situation of choosing death over life, or mercy over suffering, or even compassion over selfishness, you can do this.

Know that there is no “right” time.

If you are taking the time to find your way to this particular post, I know you love your pet. And when you make this kind of decision out of love, you cannot be wrong. You are not giving up on your pet. And for God’s sake, don’t buy into the whole, “I’m murdering her/him” thing.

You WILL NOT be wrong.

Since last May, I have beaten myself up several times about if maybe we should have put Molly down sooner. Maybe we should have done it when she was first diagnosed with heart failure. That was actually some of the memories that revisited me today during my lunch.

But then I stopped to think about my motives. Did we keep her alive all those months because we couldn’t bear to let her go? No. It was a process of trying to give her a good life while managing a significant illness.

What I will say to someone who is wondering when the right time is to euthanize a pet: listen to your gut. Don’t overanalyze because it just makes the situation worse. Pay close attention to your pet. You know him or her better than anyone. If your pet gets sick with something that will eventually kill them (heart failure, liver disease, cancer, etc.), make some tentative decisions about how far you are willing to go with their treatment. Think about the kind of life you want for your pet, and for you and your family. And lastly, don’t let a vet, family member, or anyone else push you into decisions that in your gut, you know are not in the best interest of your pet.

I know, it’s hard.
Hard is an understatement.
I won’t lie.
It’s an agonizing process.

But in the words of my hero, Glennon Doyle,
“We can do hard things.”


Molly around 8 years old
Molly at 14 years old

The Jumbled Mess That We Call Life

I signed a DNR  (do not resuscitate) order for my dog, Molly, yesterday…

Life has gotten so messy and complicated so quick, it’s a bit staggering. One minute we’re having the time of our lives in Ireland and Northern Ireland and the next, the shit is hitting the fan. It’s almost like the world is playing a cruel joke on us by saying, ‘Here, go have the time of your lives, but be prepared because I am going to chew you up and spit you out when you get home!”

The reality is though, the world (or God) isn’t playing a cruel joke on us, that’s just life: highs, lows, and everything in between, all mixed up into this jumbled mess that one minute has you laughing and the next, has you crying.

As previously mentioned, shortly after we returned home, we got some disturbing news about a member of our family. And then we got hit with some unexpected financial expenses. Can someone please tell me why dental work and car tires cost SO much?? But, my husband and I still had our heads above water.

For me, my head started rapidly dropping below water when I went to my orthopedic appointment yesterday morning and I was told there are no other options to treat a severe problem (an osteochondral defect…if you have experience with this, e-mail me!) with my left ankle, except for surgery…a surgery that has a recovery period of up to six months-three months before I can even work or do anything resembling normal day-to-day physical activity.

I signed a DNR order for my dog, Molly, yesterday…

Surgery is a nightmare for me. I had my gallbladder out last year and I cannot believe I even have to consider the thought of going through that again. To start with, I will have to come off the low-dose naltrexone I take for my Sjögren’s symptoms because it cannot be mixed with narcotics. And we all know I am definitely going to need narcotics, at least short term. Secondly, there is my previous history of blood clots. I am guessing that a pending surgery will require discussion with my hematologist, especially since I will be in a cast post-op and my blood clot risk will be high. And that means blood thinners, frequent blood work, and a lot of worry for me.

So I am doing what every patient who is trying to avoid surgery is doing: postponing scheduling the surgery until I can get a second opinion. Hopefully that will come soon since walking is quite difficult at the moment.

I signed a DNR order for my dog, Molly, yesterday…

This morning’s doctor appointment had me subsequently going to the hospital for multiple x-rays of my back. Right after we arrived in Ireland, I started getting episodes of numbness on one side of my upper back. That was in addition to the pain I’ve been getting in my tailbone and sacrum for months now. Pain that the doctor keeps telling me will eventually go away. We went back and forth about cortisone shots this morning. She wants me to get more shots, this time under fluoroscopy, so we can get deeper into the small areas around my tailbone. I want an MRI to see if we can find out if something scary is going on in there. She says no. But, she does agree to x-ray the part of my back having numbness and sends me off to physical therapy to try and straighten my crooked sacrum out.

I don’t have the energy right now for physical therapy.
But, I’ll go because I think it might help.

So many decisions to make.
So many complicated conversations to have.

Does anybody appreciate how hard it is to stay focused in these long medical conversations when one is feeling overwhelmed? I know some of you certainly can.

But see, I can typically handle all this medical drama. And I can handle it pretty well, with a lot of grace. I am warrioresque like that.

I’m out of grace this week.

Why?

Because I had to sign a DNR order for my dog, Molly, yesterday…

Two nights ago I was sitting on the couch with my husband watching TV. Molly came over, put her head on the couch, and looked at me in a way I haven’t seen before. A look that said, “something is wrong with me.”

She’s fifteen years old. I was told about five years ago that she has a leaky heart valve, tricuspid valve I think it is. My husband and I both knew that she hasn’t been feeling so hot recently. She gets more fatigued on her walks and the heat/humidity we have had lately here in New England has been tough on her. She was panting more than usual. But overall, she looked content and I had made a promise to her, and myself, that I would not go to extraordinary measures to keep her alive at this point.

But what exactly does “extraordinary” even mean??

Yesterday morning I woke up and noticed my husband and Molly weren’t in the bedroom. I got up and my husband, Chuck, came upstairs with Molly. He had taken her down to our spare bedroom during the night to sleep because she was breathing too heavily and he was up most of the night with her. However it was one of those things where it came and went.

Because I had that doctor’s appointment about my ankle I could not miss and he had to go to work, he took her to work with him. She initially looked better, but then every time he took her outside, she would be short of breath and excessively panting again.

I met him at his work after my appointment and called the vet. She was in surgery all day and I was told to bring her in the next morning or if I thought she couldn’t wait, to take her to the E.R.

And that was where I spent the rest of my day.

It was hard, really hard.

They took her right in and checked her out. I got to fill out forms while I waited. I took my forms, sat down, and saw the form where I have to decide if needed, if I wanted her to have CPR. But at least they respectfully put the price of the CPR in parentheses next to the word “resuscitate.” There are different prices depending on how much life support you want them to perform.

You have to be kidding me.

And then the tears came. I knew we were going to face this eventually, but no matter how much I have tried to mentally and emotionally prepare myself, my heart started to slowly shatter into little pieces. A kind looking woman handed me tissues. Her gentle act of kindness was enough to help me pull myself together long enough to check the box for DNR.

Breath, Chris, breathe.

You promised you wouldn’t let her suffer or keep her alive just for your own sake.

Have I mentioned Molly has been my constant companion for twelve years and one of the two loves of my life?

About an hour later I got an update. The doctor thought her breathing was stable. She didn’t see the breathing distress that my husband and I had witnessed. I told her it comes and goes. She tells me her oxygen levels and vital signs are good. Can she have my permission to start an IV, just in case? I give it to her. She also asks for permission to do a chest x-ray and some blood work. I give her that as well.

How much is too much?

When do we decide enough is enough?

I sit there and decide we need to know what is going on and what we are facing. Maybe this is simply a case of pneumonia that can be adequately treated with antibiotics. Yes, let’s do the chest x-ray and labs…see what happens. Maybe even a cardiologist to further figure out what exactly is wrong so we can make her as comfortable as possible with medications. But it’s OK I tell myself, it won’t come to that. The doctor said her physical exam was unremarkable.

It comes to that.

Three hours later, I am brought back in. I am shown the x-rays. Her heart is enlarged, very enlarged. Possible congestive heart failure is mentioned. There are shady areas on her lungs, not tumors, but possibly pulmonary hypertension. I’m a nurse. I know what terms are bad and which ones still contain a shred of hope. To add insult to injury, the doctor took a quick peek at her heart valves. They don’t look none too good either, but I am told that they only way to know for sure is to see a cardiologist and have an echocardiogram done.

How much is too much?

This doctor is amazing. She explains everything in a way that I think should be a model for every doctor and vet in this country. She is not overwhelmed with my questions. She is patient. And she is kind. She asks me about starting Molly on two different medications for her heart and I agree. That was pretty much the point of me bringing her in, to make her comfortable.

I run through my checklist in my head. I developed this checklist sometime last year when I saw how much Molly was slowing down. It’s a guide of sorts to help me (us) determine when we are at the endpoint…

* Is she in pain or distress? No to the pain and the heart meds should help with the breathing distress.
* Is she eating? Yes, very well.
* Can she walk well? Yes.
* Does she enjoy something in her life that she’s always done? Yes, playing with her babies, going for car rides and to the park, spending time with us, cuddling.
* Can we afford her vet bills? Yes, despite the fact they are a killer and we will have to re-prioritize some things.

So, a plan is developed and we are homeward bound, both of us much more fragile than when we arrived. As I am driving home I think about one of the owners and his dog who were in the waiting room with me. I am pretty good at reading people and the read on this man was that this dog was everything, and everyone, to him. You could see it in the way he handled him. There are infants that I haven’t seen handled so gently and talked to so lovingly. If I couldn’t see and was in another environment, I would have thought it was a baby he was talking to.

I overheard the man talking to another woman. I couldn’t believe the amount of serious diagnoses the poor dog had. He sees NINE different specialists. Then I looked over at the dog and I actually had to watch for his breathing because otherwise you couldn’t tell he was alive. He was so listless and it appeared to me, he was barely existing.

Certainly not my place to judge, but it made me realize that was not the condition I wanted Molly to live in. She sees a cardiologist Friday and I am hoping she does the echocardiogram the same day so we can get a handle on knowing what is going on and so we can have conversation and make some decisions what how far we want to take her and at what point we will say enough is enough.

That is life, one big jumbled mess. You never know what the next day, or even hour, is going to bring you. It may bring you to the most beautiful mountains and valleys of Ireland. It may bring you to the heart wrenching decision of checking off that DNR box. Sometimes, you just have to hang on tight and pray your way through the day. Or, stay present in the moment you are in and remember to do the next right thing.

Life can hit us in a way that requires us to weave through it one important decision at a time….one moment at a time.

As I finish this up, I realize that after  a ten hour day, I am done for today. There is nothing else so urgent that it cannot be looked at tomorrow. So I am doing my next right thing for myself and curling up on the makeshift dog bed in the living room with Molly. And, I am going to hang on tight.

For the love of Molly

“A person can learn a lot from a dog, even a loopy one like ours. Marley taught me about living each day with unbridled exuberance and joy, about seizing the moment and following your heart. He taught me to appreciate the simple things-a walk in the woods, a fresh snowfall, a nap in a shaft of winter sunlight. And as he grew old and achy, he taught me about optimism in the face of adversity. Mostly, he taught me about friendship and selflessness and, above all else, unwavering loyalty.” ~ John Grogan

December 27th 4:15pm:

I just saw one of the most heartwarming reunions ever. I am sitting in the MSPCA Angell Animal Hospital waiting room. A beautiful Newfoundland was being discharged from the hospital. I got the feeling that he has been here for a while. His family was waiting in the reception area. The double doors opened and the big Newfie (as they are nicknamed) came barreling through the doors and literally into his family’s arms. You could hear then cry with delight as he bounded toward them; there was no doubt in anyone’s mind who witnessed this reunion that they were his and he was theirs.

I am sitting in the waiting area next to them as a anxiously wait for a neurologist to exam my dog and then come talk to me. We already saw a regular doctor and I am exhausted. My dear Molly has had one hell of a time the past several days and to be honest, so have I; thought I had it all pulled together until I saw the Newfie and his family back together and now, I am a mess.

Anyone who has spent even five minutes with me knows how crazy in love I am with my basset hound mix Molly. We have been to hell and back together and I was just commenting to people recently how well she has been lately. She has had quite a year with multiple health issues including surgery for an ear hematoma, a laceration repair, and some hind leg problems. I should have known that this calm in our lives, both with her health and my own, would not last very long.

It has been a nightmarish past five days getting the run around from other incompetent vets and watching her suffer a lot of the time with piercing cries due to the agony she was in. They think she may have intervertebral disk disease based on her symptoms. I am so angry. I kept telling these other vets (including an ER one) that something wasn’t right. I didn’t know what was wrong but I knew something was. She has too high a pain tolerance to be this vocal…she must be hurting so bad. I can’t stand to see her suffer. I know to some people she is just a dog. But imagine having a connection to a living being, any living being, and having to watch their agony; but yet not be able to get them the help they need. It is heartbreaking.

December 27th 8:45am:

I am home. Molly was admitted to the hospital last night. I am devastated. She was seen by the neurologist and he said that they will do an MRI in the morning, but they are certain she has a herniated disk in her spine and it has caused nerve damage. They think she will walk again and have adequate pain control, but she has most likely lost bladder and bowel control for the rest of her life. She is about 9 ½ yrs. old. They did not present this to me as an option verbally, but I have to decide now if I should put her through a painful surgery with a long recovery and possible complications. The option is that I don’t and she is put down because I cannot take her home like this and let her suffer. Am I physically and emotionally able to care for a dog who needs to have her bladder expressed 4 times a day, not to mention managing the fecal incontinence? They say you cannot put a price on a pet but the reality is, I am looking at about $6000 this week in bills and I am on disability. That does not include what it will cost me to manage the incontinence issues as well as the vet bills to deal with bladder complications, medications, etc. They found she has a heart murmur as well which is caused by something called mitral valve prolapse. It has not caused any heart damage and does not require any medications right now but the reality is, I am sure it will be an issue at some point. I can’t even believe I am thinking of putting her down. What is the best thing for Molly? How do I make a decision like this? I feel like I am playing God. I feel like I am being selfish.

December 30th 1:50pm:

Molly is laying quietly in front of me on the rug. She had the surgery. There was more disk material to remove from her spinal cord than they anticipated. She must have been suffering so much. To the amazement of the vet staff and myself, she is not only walking already, but is going to the bathroom on her own as well. To me, it feels like a miracle. They say she is not out of the woods yet and her post surgery recovery will be long but we should know more for sure as the weeks progress. She is amazing.

There was something very powerful emotionally about going into Boston to pick up the dog you thought you might never take home again. It changes things. It made me stronger because now I know when the time does come for Molly to leave me, I will be able to make the right decision for her.

So how did I finally make the decision to do the surgery? I guess it came down to asking myself the important questions. Is she likely to have a good quality of life afterwards? What constitutes a good quality of life for her in particular? Will I be able to take care of her? If I run into a crisis with my own health issues, will I have support? Once I pay the vet bills, can I still pay my own basic bills/medical costs? Because of the positive outcome she has had so far, it is easy to sit back and say I made the right decision but really, there was no right or wrong decision. At the time, it was a no-win situation that I could not predict the outcome of. So I had talked more with the vet, researched her condition (for hours and hours!), and prayed. And in the end, I made the decision I thought was best for the love of Molly…