Practical decisions

I remember the morning after Loki’s previous owners dropped him off at my apartment. He was just over a year old, and full of life and energy. I had been sleeping on a futon after having recently broken up with my then-fiancee. (She got the bed, which was no loss.) Loki was on the floor next to me, and I invited him up on the futon next to me by patting it. He jumped up and snuggled in next to me. I gave him a big cuddle.

He peed.

When you gotta go, you gotta go.

The only other dog I’d owned in my adult life was a grey Standard Schnauzer named Lucy, co-owned with the aforementioned fiancee. I had bought Lucy for “us,” but really for her. Lucy was rambunctious, and licked your face compulsively upon greeting you. Every time. I was more relieved to see Lucy go than the ex, though I bore neither any malice. Loki, a black Miniature Schnauzer, while superficially differing in appearance from Lucy only by color and size, was fundamentally more aloof. After a brief cuddle, and a lick or two of your chin, he was happy to move on unless you were going to scratch his ears or nose. After all, there were things to sniff, lawns (and futons) to befoul, scraps to gobble, and critters to chase. Given the choice between cuddles, in plentiful supply, and possibly scarce other pleasures, he knew what to pick. I always wanted more, but he made the practical decision.

Despite his practicality, he was always the star. He pranced when he walked, and he’d get lines of smiles when we walked by stopped traffic. I took him to Hawaii with me, laying over in Honolulu before continuing on to Hilo on the SuperFerry so that I could have him back as soon after the flight as possible. We took our evening walk, wading into a sea of smiles and coos, none of which were directed at his handler. He shone, and we hoi polloi basked. After gracing onlookers each in turn, he moved on to the next, distributing himself as widely and conveniently as possible, without a care for those in his wake. When there is fresh admiration and love to be had, the practical decision is obvious.

He very much enjoyed Cuban Red bananas. There was a stand of them growing in the hollow behind the ohana we rented in Hilo, the only place I could find that would allow a dog. When I asked the landlord if anyone had dibs on them, he looked at me as if I were high. I might as well have asked if I could pick the dandelions. I bought a machete, and determined which of the racks were nearly ripe, and got to cutting. I walked my rack of bananas home around the other side of the block, the hollow being too steep on my side to navigate out of with one free hand and 80 pounds slung over the other shoulder. Every day, I’d cut one up into my blueberry oatmeal before cooking, and save the last piece for Loki. When we moved back to the Mainland, I did the same with the grocery-store Cavendish bananas that were available here. He looked at me, betrayed. Written in his eyes was the question, “What the hell is this? Make with the good stuff!” After he realized this was as good as it was ever going to get, he gobbled it up. Just another practical decision under the circumstances.

As Loki got older, health problems cropped up. He had a seizure around age 6, and a few more minor ones in the ensuing few years before they seemed to go away on their own. The answer was to watch and wait, and monitor his quality of life. Even later, around age 11 or 12, he started getting urinary tract infections, and subsequent tests revealed kidney disease due to old age. A sonogram revealed ‘diffuse changes’ to his kidney tissue, and a mass on his liver. None of this was life-threatening when discovered, but they would both progress. Loki’s comfort and happiness were the priority. We started him on a food for kidney function and kidney stones, to which he was prone, but he found it unappetizing, so we switched to another. Whenever his mood waned, I’d schedule an appointment, and the vet would run tests. His kidney disease was progressing, but some other comorbidity was always to blame, and could be managed. Another urinary tract infection required antibiotics. A stomach bug warranted powdered bacteria on his food, as well as a course of another antibiotic. His health and mood would return, but each visit was another reminder of the many plates his metabolism had to keep spinning. Practically speaking, quality of life was the only concern. Treatment centered around that, and my education centered on watching his quality of life.

One time, on a visit a few days after Loki developed “Old Dog Vestibular Syndrome,” (which looked to me like another seizure, but was just his ears making him suddenly dizzy) I had the idea that it would be a good time to talk to the vet about end-of-life care for Loki, given that the likely date was far off, and the combination of my ironclad resolve and the anesthesia of the intervening years would make it an easy (and responsible!) discussion to have. Predictably, I bawled before I could finish the question. I console myself that I was quiet enough not to be heard outside the examination room. Loki would likely recover and be happy again, so a few days or weeks of managing his anxiety with medication was the course to take. However, my vet reassured me: Though I had uncertainty about Loki’s quality of life, he had long experience with these assessments, and would tell me when it was time. Through my tears, this struck me as very practical, indeed.

Subsequently, a new practical concern arose: How to balance between too many stressful visits to the vet and too few visits to monitor his condition and provide care. Loki was prescribed Trazodone, an anti-anxiety and sedative medication for animals. IIRC, this is the one that would have been great for humans were it not for the fact that it gave us disturbing hallucinations. We’ll have to take the vet’s word on that one, I suppose. I would give a half tablet to him before visits, as his kidneys weren’t efficient at removing the medication. He would be sleepy for 36 hours, rather than 12. This didn’t tax his kidneys. They just took longer to metabolize it. With this regimen, we could give care when needed by relying on my descriptions of Loki’s un-stoned behavior.

Early this month, Loki became even more lethargic, spending entire days on the couch. I called to schedule an appointment as soon as possible, but the vet couldn’t see Loki until the next day, and then only via a drop-off appointment. His usual doc wasn’t available. The next morning, a half-Trazodone administered after breakfast, I handed him off. After his examination happened, the vet called to discuss his condition. A UTI was suspected, given his dilute urine, and blood and urine tests were in order. We could switch to a more appetizing canned food for a couple of days, to get his weight back up while we waited a day or two for the results. He could even have extra dried gut flora (beef flavored!) to make it even more appetizing; no harm would come from that. A practical course of action.

The blood results came the next afternoon. His blood had high levels of urea and phosphatase. His kidneys were failing. Loki was not feeling well. The new doc talked about certain measures we could take. There was a phosphate binder you could apply to his food, but the readily available kind was mint-flavored, and a chicken-flavored version would have to be compounded, which would take a day or two. Loki didn’t like mint, and he wasn’t going to have to take medication he didn’t want at this stage on my watch. The vet agreed. Phosphate binder was impractical.

“How is his appetite?”

“He’s had a can and a third of the EN (canned) food in the last two days, so improving, I think.”

“He should be eating about a can to a can and a quarter per day.”

“Oh.”

I could feel, not the evasion in her voice, per se, but the delicacy. I would have to force the issue. If it were her dog, what would she do? “I would support your decision to euthanize him at any time.” A jarring return to practicality.

Loki wasn’t feeling well, and he would never feel well again without the binder, and then only for a short time. We agreed I would see how much he ate that evening, and gauge progress from there. Loki ate as much as was practical, but it was not enough. The balancing act reasserted itself: A local emergency vet could do the procedure, but it would be strangers, and a strange place. Instead, I enviously gave him is nightly dose of 10 mg diazepam early, and we turned in. When I awoke at 5 a.m., I knew what had to be done, but had to search for practical ways to do it. First, a full Trazodone pill. He needed to be calm, happy, and uncaring. After that, I remembered that I had the cell number of the office manager. (She was second in a line of three of their employees to take care of Loki for an upcoming month-long trip; His star power never faded!). I imposed on her before dawn, telling her I wanted to bring Loki in ASAP, and could she arrange things, as I knew I’d be useless on the phone. (I was barely useful in text. I broke down when I typed the word “euthanized” about Loki for the first time in my life.)

I could bring him in right away, she typed back after the expected condolences. We went into the comfortable room. We’d been there once before, shortly after I had made that mess of myself asking about end-of-life care. They must check a box in your file: “Acclimate the client to the comfortable room. He’s realistic and ready. Keep it light.” Or some such. It’s amazing how effective that the deception of tacitness can be. I set Loki down, and he sniffed and sniffed and sniffed. He was high, had no worries, and there were smells. Eminently practical.

His usual doctor came in early when he heard the news. (First in line for caring for Loki during my trip. See? A star!) After a shot to make Loki really happy and calm, and a short wait, the doc and a tech returned. I’ll spare myself the retelling of events from there on, except to say that ‘peaceful’ is both the most and least appropriate way to describe it. ‘Smooth’ would capture it better, if not for the connotation of convenience. First a sedative, milky and white. Then pink stuff, then clear stuff. One of them must have been to flush the line, but I don’t know which. One second four days ago, the mass on my right hip was breathing; the next it was not.

There was no practical way back.

Immediately, there were new practicalities, now that my friend was gone. Let go for a minute, as if I had a choice, for example. Then, I had no attachment to his physical remains, now I knew he wasn’t there. He would be cremated, and his ashes disposed of. (I needed the closure of him really being gone.) Next, I had to drive home. No use driving through tears and endangering others.

Since then, I’ve decided to be deliberate with my grief. Even this post is a risk. I know my grief is ordinary, but I don’t want to indulge in rumination; I don’t want to spiral. Practically, this means that if I do stray too near to a painful memory to the point where I’m sobbing, I repeat the imagery until I’m numb to it. Well, numb for the time being. Might as well use the tears to good effect. I took pictures of his final hour, right up to a folded towel, large enough to hide an 18.4 lb. Schnauzer. It’s useful for my friends who don’t speak English very well, or if I otherwise need to tell the story but can’t. You can just count the pictures in your phone so that you know how many times to blindly swipe. Practical.

I deeply know that I did the right thing. That his quality of life was gone was possibly more painful to me than losing him, at least up until his last breath. Still, it’s impossible not to want a do-over, to go back in time 14 years and start him on a better grade of food. To be more gentle with his discipline. To go back 5 years and not move to a neighborhood with so many dangerous strays, so we could go on more walks. Or to go back a week or two to euthanize him earlier, sparing any discomfort at all. Or, even, to go back a few days and try the mint-flavored phosphate binder, and to run the risk of selfishly sustaining him until his health crashed disastrously. None of that, of course, is practical.

So, I have to let myself feel it. I have to remind myself that he was 15-1/2 years old, and I had 14-1/2 years with him. I took the best care of him that I knew how, and my care of him grew wiser and kinder as the years wore on. I have fond memories of him jumping from the ground up into my arms, eager to please and be (briefly!) cuddled. I remember him at the dog park, bringing up the rear, chasing the pack, and barking for joy, and everyone at the park laughing, and someone shouting, “Look at that little dog go!” I have to focus on the good and remember to cherish it. His smell. His fur. My stained futon and my frantic cleaning. How he grunted with supreme pleasure when you folded his ears onto the ear canals and rubbed. He had a much better life than his previous circumstance was shaping up to be.

Focusing on all that would be the practical decision, and I do try. To be completely honest, however, I’m a little mixed on practical decisions right now.