Ch.211 Critical Decisions: Pat and Levi

Ch.211 Critical Decisions: Pat and Levi

Aug. 2023 

          For almost a decade my collie Levi has carried a fluid-filled sac that hangs from his mid-section. Every time a veterinarian examined it the advice was always the same: just leave it alone. Sensible advice, even though the sac kept enlarging, until four days ago, when clear liquid began seeping through the thinly stretched skin on the underside of the sac. This time the veterinarian told me that if we didn’t act the sac would soon split, creating a huge mess but more critically opening Levi to repeated infections.

          My choice was to wait for the split and hope the veterinarians could stich Levi up to ease the threat of infection, or to approve surgery to remove the sac, at the risk that my 13-year-old dog wouldn’t survive the necessary anesthesia.

          I remember facing decisions like that near the end of Pat’s life. Two difficult choices in particular: Strong pain relievers or not, trying to balance lessening suffering against risking permanently increased cognitive impairment; Accepting hospice or fighting to keep Pat alive as long as possible. I decided to say yes to pain meds and hospice. I’ll never know if they were the “right” choices, of course, since in these situations there really are no right selections. My belief is that Pat would have agreed with my choices if she had been able to concur.

          There is another parallel here, I believe. When I looked up the actual risk of an older dog dying from anesthesia, it turned out to be minute. I remember reading and hearing all the time about how dangerous certain medications could be for people with Lewy Body Dementia, but never being told that the actual risk of a negative reaction was very small. If I had known that there was little danger, I would have approved Pat’s pain medications much sooner and she would have had fewer moments of suffering. (I am not medically trained so I am offering my own personal thoughts and not medical advice here).

          I had a little help this time around. I remembered my brother-in-law Kevin ministering to his dog Buddy, who had several similar sacs that had opened. Kevin was incredible as he wrestled with Buddy’s recurrent infections, pain relief pills, and near-death episodes. Kevin and Buddy lasted almost two years, until Buddy passed away.

          As much as I admire and respect Kevin’s effort, I realize I cannot do the same, not after my five-year journey with Pat. I can’t envision the two of us slogging through Kevin and Buddy’s ordeal. Nor can I foresee myself having enough psychological margin to handle that situation. I’d likely end up severely depressed or anxious, or both. I recognize that I am not making a heroic statement here. But sometimes knowing and admitting one’s limitations is necessary. I cannot devote two more years of my life to extreme caregiving, at least not now and maybe never again.