The Last Goodbye

How can you measure the love you have for a small little dog named Mack? He was my hero, my love, the spirit of my heart that held a huge piece of it in his little paws. That's why it's so hard to write the next words which are the final ones I will write in the journal of our journey together through the hellish disease called osteosarcoma.

My precious little dog was the epitome of fortitude, strength, endurance and devotion, because, despite what he had going on with him, he was the same little dog I brought home the very first time and who became the dog we loved to the very end of his life.

Wednesday the 30th of October was, just like what the other days of the last week or two had been like, a battle to get him to eat.  We'd tried literally everything in the book to entice him to eat and nothing up to that day had really worked.   We woke up with the usual hope that this day would find  Mack free of pain enough to want to gobble up his food. If he truly was unable to do that, then we knew that it was the end of the road.  If he could not eat, what was there to do? If he would refuse what he had loved his whole life and was hungry and still wouldn't eat, then we knew that we were going to have to make a terrible decision.  So that morning it was like the others, he would try so hard to come by the food and then veer away at the last minute.  Maybe once in the two to five times we tried that morning, he would grab at the food and then run from me and I knew.

I am not sure why that particular day seemed like the day to decide, but it was, because as the days had gone by with the introduction of new pain medications, we knew in our heart if it wasn't enough to get him to eat then there was little we could do.  He was getting thinner and more spacey as the days rolled by and it was becoming pretty apparent that whatever it was could not be overcome by the medications which were pretty powerful.

The last attempt to get him to eat was met by the sight of him running to hide from me and it was then that I made the call to the euthanasia vet group and we made the appointment to have him put to sleep that afternoon. Funnily enough the last question I asked of lovely,  sweet Rose was if anyone ever called and canceled and she said that there had been instances of it and it wouldn't be the first time. It was a funny question to ask when I'd just made the appointment but it just came to me in that instant.
So the time was set and it was early morning yet, so I grabbed my camera and decided to shoot some last photos of my beautiful little Mack and try to capture the moments that I felt would comfort me later on. I shot about 45 or so photos and then decided to put my camera down and give him a massage and that's when I noticed something in his mouth that looked like a bone that was stuck in his gums.  It was enough to take him to Bob and ask if he saw what I saw and it was then that I decided that I couldn't just let him go this way without really knowing what was going on with him. Up to that moment we had no real idea what it could be that was causing him to not want to eat and I hated to think we'd put him to sleep for a tooth problem, so right then and there I made the decision to take him to our vet. and have the X-rays done.  It was the last ditch effort to ensure I knew, without a shadow of a doubt, what was wrong with him.

The appointment was at 3:30PM and as I drove down to the office, I said a short prayer that our vet. would tell us what to do.  I needed her to tell me it was time, if it was time.  It was a quiet drive with Mack falling asleep as we drove to the office and me petting his little head and massaging his neck as we drove in silence.  We arrived and he perked right up and wanted to get out and as soon as I opened the door he was standing and ready to jump out of the car and we walked into the door of the hospital.
He wagged his tail at everyone and every dog and he was curious about his surroundings but he wanted up in my lap and I let him and we sat and waited.  Then they came out and took us to a room we'd been in before and our beloved vet. asked me what was up.  I went over what we thought and that we had made the appointment to put him to sleep that day but because of the tooth issue I felt we needed to know just what it was that was going on with him. She agreed and said she would check it all out once she had him sedated and hoped that her X-ray machine was working ok and then we'd have more information.  I actually didn't get to say goodbye because they took him from me and walked away and I left the room to go back to the waiting room.  I was assuming that we'd be back in the car not much longer from then and he'd be drowsy but with me and we'd be going home.

They gave him the light sedation and once that had taken effect they brought me back to where they were going to take the X-rays and she showed me the inside of his mouth and everywhere and she then asked me what had I seen and strangely enough, it wasn't there…weird I know, but truly it was there and Bob and I both saw it and it was not a small piece of bone or whatever it was and now it was totally gone.  But she couldn't see it and neither did I so she said, well let's get the X-rays done and once that's done come back and we'll have a look at them.

I can't say why I knew when I walked in, but the looks on the faces of all the people there looked like masks of sadness that screamed oh no…it was almost palpable and I knew it wasn't good news.  Shockingly it was not good news and we had NO idea. Once she could show me the actual X-rays, there was a true visual truth staring at us that the bone in his jaw and in his face was nearly all GONE. It had been destroyed by the cancer that had lurked there all this time. It had taken what was bone and turned it into nothing.  His teeth were sitting in gelatinous tissue and nothing supported them and it was so devastating to me to see this that I almost couldn't breathe.  He had endured such pain and suffering without an obvious outward sign other than not being able to eat and I couldn't believe it.  As he lay there I put my hand on his soft body and I asked should we let him go and she said yes. That was the answer to my prayer.  We knew then that it was the only thing left to do for him and that was to let him go to be free of pain and suffering. There was no point in waking him up just to let him go again in a day or two.  This kind of pain could not be controlled by pain medications and probably he had endured this for so long that I felt bad that we'd waited so long to decide to let him go. It was heartbreaking but I knew it was the only thing we could do for him. So as I said my goodbyes and told him that I loved him, I left and as I opened the door to go to the waiting room he must have heard my voice and lifted up and was coming out of the sedation and I was in a panic that he not see me and I rushed out of the room so he wouldn't see me leaving.  I couldn't be brave enough or strong enough to be there for him as he took his last breath but as my husband said, he probably wasn't aware that I was not there but knew I was still in the building and they quickly administered the final anesthesia that would take his life.  They asked me if I wanted to see him and I said, no, I was ok not seeing him. I couldn't manage that either. It broke my heart later on that I chose not to,  but it was the way it felt to me that prevented me from doing it. My heart and my mind were numb and I was too distraught to manage much but just move in space.

There was a lady in the waiting room that had been waiting for an appointment with Dr. O. and she had been asked a few times if she really wanted to wait and she said, no I'm fine, I'll wait and I know that God sent her to be there for me.  She didn't have an appointment and had just decided to drop in so Dr. O could see her little dog's ear and she was going to be seeing her after me.  She and I talked and we shared stories and she actually got me through the time when I know that Mack's life was ebbing away. I know I sat there showing little emotion but it was so unreal that I had a hard time wrapping my mind around it and all I wanted to do was be gone from there. It was unreal and nightmarish but I was lost in denial that it was happening at all…it was unreal looking back on it. I was not able to be there to know for sure what he was going through, but for some reason I knew that I was led there to have it happen the way it did. The very vet that loved him like family was the one to let him go and to hold him when he left this earthly world and that was ok.

For me, I loved him like no other pet I'd ever owned, they all were wonderful but he was my heart. Save Oreo who passed in September and Gale who was our family dog, he held that special place that will never be filled.  I could not have asked for more answers to prayers than what happened that day. If I'd not seen the mystery bone in his mouth, I might not have had the X-rays done to know for certain what was going on and if the lovely lady in the waiting room had not been there, I don't think I could have gone through with it and if I had not made the appointment with the vet. that day, she would have been off the next day and we would have had to wait another day or so and it would have been too hard for poor Mack and the level of pain he was experiencing.  It all worked towards the end that was meant to happen. They handled everything for us and arranged the cremation company to pick him up and expressed their regrets for our loss.  They handed me his leash and harness and I almost wanted to throw it away right then but I held on to it for dear life.  I couldn't believe I was leaving without him but one day in the next few days we will receive back the remains of his physical form and it will be a form of closure.  His urn will sit next to our beloved Oreo's and a photo will be made to testify to his existence and a testament to the love we had for this little brave, wonderfully strong dog who endured more than we ever would have asked him to do, but did.  He hung on for us and he was my hero. I can't imagine the pain he must have had knowing the devastation of his bones, but even on the day of his passing, he wagged his tail, he ran with me from room to room, he sat on my lap and rested, he tried to jump up on the window seat on the patio and looked out over his domain, he tried to jump down from the counter when I did his last pain medication application and he tried to jump out of the car when we arrive at the vet.'s. He wagged his tail at the little dog waiting in the waiting room and he came up to someone at the counter and let her pet him.  He was light in his step and his eyes shone brightly and with that memory I will close this post with heartache I knew would be a part of this story. I knew when we took him to our hearts that his time would be only as long as was meant to be, it was the way he was meant to leave us as well, with his strong heart beating to the end.

We loved you with everything we had our sweet Diggie Dog and you took a part of our hearts that we will never be able to replace.

Rest in peace

Mackenzie Foster

Born November 1999 left us on October 30, 2013 at around 4:00PM.

We Are In Dark Places

It is a dark place that seems to have glimmers of hope like a flickering candle off in the distance, but yet you know that one breath of air and it will be distinguished and you will be plunged into darkness again. The fear is unrelenting since we're now in an unfamiliar place and there is no road map to follow, especially in the dark.  It is beyond comprehension when you look to his little face and see light shining from his eyes and you know he is still there wanting us to do something, anything at all...

We are in that dark place.  I will have to start at the day we went to the oncologist. I called our vet. trying to reach her because I truly felt I needed guidance and perspective about doing the x-rays. It goes without saying that when you hear your dog snuffling and snoring when he sleeps that there is obstruction to his breathing and to imagine putting him out for even 10 minutes scared the heck out of me. I woke up at five in the morning saying, NO, we can't do this, so it was imperative that I hear from our trusted vet. She finally called about a half hour before our scheduled appointment with the oncologist and having the x-rays done and we talked. It was good to talk with her, I have felt that I could share just about anything with her from the very first day we met and she loves our dog.  If she spoke from a place of love for him then I knew I could trust her judgement. I told her my concerns and she agreed, what we would find would just confirm what we already knew, that he had suffered some kind of traumatic issue within the face and that the jaw was canted off to the side for a reason. The two reasons for this were catastrophic, one, the cancer had weakened his bone structure and it just broke or the cancer was back and was forcing the malformation, or both were true. Of course these scenarios were not good. They could not be fixed.  So as I walked into the appointment, I was relieved.  I felt a sense of peace about my decision and I told the oncologist we were not going to do the x-rays or the CAT scans and we were going with what we surmised to be an issue that cannot be fixed.

 It was then that little Mack became a hospice patient, he was given the final diagnosis, terminal.  It was not as dramatic as that, but it was like giving up.  It wasn't as dramatic again like that, but I felt that we had done as much as we could do for him and we were not going to find a miracle in doing more.
Hospice is really not about dying as much as living the best life you can live. I experienced that first hand with my father who really wasn't a true hospice patient because he didn't really need what they had to offer for much of the time he was under their care. It was pretty funny back then because when they would come by for a visit which was every week, he would more than likely be gone and they would say, oh, okay, well, we'll see him next time! He was off driving to his old town about a ninety minute drive away and did this up until a week before his death.

So hospice patient Mack met the hospice veterinarian, Dr. Barry and he was what you would expect from a doctor who does this kind of thing for a living. Kind, attentive, compassionate, saying the right things, explaining the things we might not understand to a tee, expressing that we were doing the right thing and we heard all of it through the ears of what we thought were pretty receptive ones, but when he suggested we consider doing it that day, we both backed off, took a step back and said no.  It's not today.

I think to some degree he is right about some of the things he said, but in some ways as my vet. said when we talked the same day we met the hospice people, it's easier said than done.  We can't just snap our fingers and think, yes, we will do this now.  It is not an intellectual decision. It is made with our hearts and minds and spirits. We are not paper mache people with nothing making us up but paper.  We bleed and cry and mourn.  There is no easy answer to this and we have tried to ignore his illness for so long we just can't get past that this is the same dog we thought had beaten bone cancer.

It wasn't a shock to hear that they did not get clean margins though...I still remember her saying it and I tried not to hear it with my heart.  It would have broken if I'd let it sink in.  Now we are faced with too many issues to absorb and we can't get to that point where we say enough is enough. But I think we are fast approaching the end of the game.

So this morning, at the very early hour once again of 5:30AM, I'm awake,  holding my little guy.  He is restless and goes to the side that he never goes to and lays down but he can't get comfortable so I take him outside and we go out and he runs to pee and then he leaps up on the deck with such agility that it's amazing when you consider he hasn't really eaten much in the last few days.  He slowly walks inside but then runs to the door to be let back in and yet he doesn't want me to stay out and he doesn't want to be in.  Finally I put him on the bed with me and lay down to hold him again.  Soon he is fast asleep and I'm trying so hard to put my arm down but can't and I'm awake now, so I get up and make coffee and leave him there to sleep.  He finally gets up with Bob and then we start the game anew of what will he eat today.  I manage to get him to eat a vienna sausage and I find that so weird since that happens to be the only thing my Dad could eat when he was in hospice and the last days of what he could manage to get down. I find it to be strange yet comforting...We are giving it one more go with some very expensive custom compounded pain meds for which we will probably not use much of, but that will bypass his mouth and be given transdermally.  Dr. Barry suggested it as the middle ground to go on and we are hoping against hope that it's still the pain which is preventing him from eating, but I feel it's something else and can't put my finger on it and can only guess because we didn't go all out to find out the definitive diagnostic reason.
The sausage is a hit but we know it's not enough to exist on and we are concerned he will only go down hill faster given these circumstances. Hospice is really just about doing the supportive things we can do given the circumstances and as far as fluids go we can go to our vet. to have that done...but we can't do that forever and expect a good outcome.

The saddest part is watching him wanting to eat and not being able to and having him going from one end of the house to the other standing near or by his water dish or his food bowl and not being able to make the leap of eating.  I've tried not to give him rich and terrible foods because it will prevent him from getting a balanced diet and he won't eat the dog food we used to use.  So we know this is not supportive care that is leading to a good quality of life and as Dr. Barry said, it won't get better.

It is hard to make that final decision.  It seems like a date with death. As much as I know intellectually I'm letting him be free to be happy and whole and healthy again, it is the selfish part of me that says I can't let him go.  It was not ever supposed to be that way, but the last dog and the love of my life will be gone.  It tears at me from all angles and I'm not sleeping.  And in the dark of night I wake up and I know it's not about the pain, it's about breathing and that is what is causing all of the anxiety for him. Not the pain, just the breaths and what is that doing to him?

I will go to the pharmacy and pick up the pain meds and we will go through the motions of applying it to his little ears and we will wait and then we'll make a decision. It will be either the hospice vets we call or the regular vet. but we will have to make a decision. Even my own husband is waffling back and forth and we are at odds at times as to the time frame or the reasons.  But no matter what we will have to decide for the good of the dog and not us.  We will have to say our goodbyes when he's not stressed and having issues.  That will be the only thing that is right about this whole thing.
We love you little guy.

Hating Bone Cancer and Crying All Day Long

Mack and I were just sitting together on the porch that faces the prettiest part of our yard. It followed  an attempt to feed him a new food and hoping that he would be so hungry he could overcome the pain for just that little bit I gave him. It wasn't a good experience. He ran again as if I was hurting him and it broke my heart.

So we went outside and said let's sit on the window seat and we did...looking out on nature and the beautiful and gorgeous day it is today and trying to wrap my mind around deciding when I will need to let him go.  I can't be prepared no matter how hard I try and I even spoke with the hospice people this afternoon and felt like, no, we don't need you now, we can deal with this another time, but knowing in my heart of hearts that isn't true, that we are facing it much sooner than we want to admit.

But if I can't commit to them coming over and talking to us now, then I know I'm not ready to put him to sleep but he really isn't doing well at all and I know this and I know that when they go in tomorrow and do x-rays that it will be living, black and white proof, digitally that he is not going to be with us much longer.  And to top it off I caught sight of him, as if for the very first time,  in the mirror this morning,  and it looked like a fun house mirror of his face, because there was a huge distortion to his jaw that has taken place in such a short time. I never noticed it until today. His little jaw has gone side ways and we are actually seeing his little lower jaw jutting out where the upper jaw used to be...it is beyond tragic to know this is what is happening to him and how uncomfortable he must be.  There in lies the sadness I'm feeling at this moment and beyond, because even though I am not ready to let him go, this decision may be out my hands by Thursday. How can we let him suffer with the pain that he must have? Can it truly be controlled by just a simple pill every day?  It can't happen and it won't be for his best interests if we make him suffer through another few days of trying to get him to eat something.  It won't matter if it's filet mignon, if he can't eat it, it is shear torture for him and we have to acknowledge that much sooner than we expected to ever have to deal with it.

So it's a goodbye of such epic tragic proportions that my heart literally aches. I used to say there goes my heart and with his passing it will feel as if it's being ripped out of my chest and I once said, I want to go where he goes...It is a terrible feeling that my life is nothing compared to what he means to me.  I have tried so hard to think positively and to consider I was so lucky to have had him this long, but no matter what amount of time I've had him it will never be enough in my heart of hearts. He is my heart, simply put, we made a connection and he is my love. A love of such great sweetness and tenderness that without it I will be left adrift and alone.  Even though I have my wonderful husband, for some reason this loss will feel as if a huge part of my life has gone cold.  It is a horrible feeling and one I have fought to not experience and yet being human we will have to go through it one way or another.

So my little Mackster is my heart and with his passing I will lose a huge part of it and the hole will be huge and painful and horrible and all the adjectives you can think of that describes loss.

I hate cancer and I hate this with all my being and there is nothing anyone can do about it and I am mad and sad and angry that this is what he faces and we lose.

We love you Diggie Dog and we will for the rest of our days and beyond.

We Know Now

This couldn't be worse...or could it be? It is the nightmare that is the truest of all nightmares.  We had so hoped that this would not be related to his osteosarcoma.  We believed in our hearts that this little guy was going to beat this thing called bone cancer. Period. End of story.  And then there came the"but". We didn't want to know the outcome of the surgery, we asked specifically not to be told and now looking back I wonder if we were just being foolish and unfair to him and maybe at that particular time in space, we could have done more to have avoided the issue we face now.  It appears the bone cancer may have spread to the upper area of the bridge of his nose and now it could very well be broken...or so the oncologist we spoke with said.  We spent a good deal of time talking.  It seemed like hours when it was just about an hour and we looked down on this little guy and thought what have we got here? She suspected it right away and knew what we were dealing with and had the compassion to give it to me straight without quibbling.  I knew we had asked her not to let us know and she didn't and yet we wonder now if we were just denying the fact that the surgeon couldn't get a clean margin.  When he had the surgery the tumor was large.  It was a large part of his jaw, but we thought we had clean bone and yet the pathology report said otherwise.  So it's had this time to grow and be what it is, bone cancer and it's probably destroyed the bone that was his nose.  The poor little guy has a hard time eating, his breathing is different, his little nose can go from side to side...which the doctor was able to do and shouldn't be able to do and he runs from us if we try to feed him.

It's not looking good for our little Mack.

So on Thursday we go to the oncology department again for x-rays and we'll see what is going on with the area and if they need to,  they'll do a CAT scan, but it may not be necessary. They may be able to see it without having to put him through anything else.  He came home with pain medications and when we find out on Thursday what we're dealing with, it may be time to contact the hospice vet and discussing pain management issues with her.  But we'll also be picking a time and that seems so unreal to me because basically we'll be putting to sleep a pretty healthy dog because he can't eat...seems so unfair to me and to him.  They discussed feeding tubes and Bob is not a fan of the idea but I might consider it if it meant that he was in a good place with no pain and could tolerate it.  If the only thing wrong is the broken bone, and no sign of cancer, the oncologist said they can't fix it...so it would again mean putting to sleep a dog who has no sign of cancer but a broken nose? How can we do that? I have to ask myself what is best for Mack, but when he looks at you with life in his eyes, how can I put him to sleep?  How do you put him to sleep when the only thing wrong is a broken bone?  Of course the vet. did say we could inject him with Fosamax which is a drug to build bone back up and they have done that for dogs with bone cancer fractures...so we could go for that if there is no evidence of cancer or discernible cancer that is.  I believed in my heart that he was free of it, but I was deluding myself I know.

My little Mack is my heart and I can't even begin to imagine or consider letting him go and we are beside ourselves now with the loss of his sister and now this.  It is breaking my heart in two.
Can there really be this much pain when you lose a special pet like Mack?
I am dreading and hating this day and the days after and the day when we say our last goodbye.

I keep praying for a good outcome and I know that God listens, I just know that it's not always going to be what we want.

What is the issue!!

I wish we knew what was going on with him, but now we're back with him not wanting to eat and acting like he's afraid to take anything from me.  It is frustrating and mind numbing when we realize it's so much like what Oreo began to do when she didn't feel well.  It is so hard to know what the issue is with him. You so wish they talk!! They could just look at you and simply say, I don't feel well here, I don't feel well here.  It is mind reading and you are guessing at the reasons why they are acting like they do.  He is acting like he doesn't feel well and we are at Tuesday and we still need to make it to Thursday or sooner.

I even asked Bob should we take him to the ER? Do we know what to tell them when we do? That he is not acting like himself? That he seems desperate to tell me something but I don't know what it is? That we are at a loss as to why he is doing what he's doing, even though he slept ok last night, that he seems to be restful for the most part except after giving him a bath this morning?  It seems as if he can't find the spot he needs to go to, and he keeps telling me to find it and let him know!

So this is where we are after so many relatively good months and November 11, 2013 will mark 11 months since his surgery. But it's also the month we finally made a follow up appointment with the original surgeon who did the removal of his jaw and now another oncology appointment on Thursday of this week so we can follow up with the doctor who showed us such compassion and concern.  I fear we are seeing something so similar to Oreo that we are facing another long goodbye...how can it be that he would have the same thing?? But he sits here shaking like she did and trembling...it's like a nightmare and I can't get out of it.

So we will face another bad thing and we have no idea what we'll do...put him through the hell that was oncology? Or surgery? Or just let him go?  What is the answer again...

We will check him in tonight if we have to at the ER and we'll be praying for a miracle either way.

We love you Diggie Dog.