Things Are Never So Bad That They Can’t Get Worse: Part IV

I am about to describe the worst 14 hours of my life.

When Espresso went into kidney failure, I began to say goodbye. I dealt with the idea of packing up her toys, sending them home to be stored. I’d have to look into how to donate her extra kibble, some dog beds. I looked into pet memorial ideas. Most of all, I knew every single flight out of Ithaca by heart so after I had to make that visit to the hospital, I could get my sobbing, puppy-less ass back to California as soon as possible.

I never, ever thought it could get worse than this.

For the last two days, I got my morning call around 8 am from Hope. I’d then get a call around 10-12 with results from her blood test. I’d get an evening call from Hope around 8 pm as she left her shift.

When I got a call at around 6:30 that Monday, a few hours after coming home from my visit with Espresso at Cornell, I nearly panicked.

No news, thats good news. News? Never good.

Hello its Dr. Got-it-Right. I’m calling because Espresso has worsened, she has fluid in her lungs.

My world as I knew it had ended.

She went on to explain how the inflammation from the bacteria or toxin were causing her veins to not hold the excess liquid being pumped through her body to keep her alive. The liquid had been slowly leaking into her stomach, around her kidneys, even into her chest cavity as I saw with the lumpy edema on her chest during my visit. However my remark on her breathing prompted a further look - radiology confirmed liquid had now made its way into her lungs. Why I heard her breath was because she was

breathing through liquid in her lungs.

She wasn’t drowning, but was laboring to breath. At any moment she could go into respiratory distress, she could drown in her own lungs. She would die panicked and scared. I only live 5 minutes away, but it likely wouldn’t be enough time to get over there to see her go. I wouldn’t want them keeping her here in pain and fear and unable to breath.

However.

One of her liver values had improved Dr. Got-it-Right said. I had planned on having the come to jesus talk with you, but with the one improved value, I thought I’d give you the last option - a plasma transfusion.

There was one more option left. I could opt to a plasma transfusion. Plasma from a donor dog would not only potentially reduce the liquid leaking from her veins but provide the essential proteins that her struggling kidneys and livers were unable to make right now. It would potentially treat the immediate threat (the liquid) and help with the cure (treating the liver and kidneys).

I asked her about the risks of plasma, the risks of shock and allergic reaction. I asked about how labored was her breathing, how bad she was. How likely to die she was, was this just prolonging the inevitable.

Dr. Got-it-Right consoled me that she was a very sick little dog, without a lot of likelihood of recovery. Lettering her go now in a controlled manner where I could be there, was a very real option, one that would set her at peace.

So I had to choose. Extend the pain, increase the risks to take one last chance. Or let it all be controlled and planned and safe and as painless as possible for her.

In that moment, I took a deep breath and thought of my puppy.

She was dying, she was doped as to not be in pain. She had failing liver and kidneys and was so weak.

But she still had the strength to wag her tail when she saw me. She bumped her nose against my cheek.

When I looked at her, I did see fear and pain, but I didn’t see that look. That look of being so tired and saying “please let it stop.” I saw her normal stubborn self, I saw her looking to me to help, to understand, but not to end it. She had fight in her. She had wagged her tail.

Maybe I’m being very selfish, but I have to give her the one last chance, I said. Do the plasma, start the plasma now. I just...want to be there if it all does start going downhill. I can be there in 5 minutes, so please, if you think its even headed that way, just let me know so I can be there with her.

My voice started to crack. But if it does look like she’s in pain, suffering, don’t hold up just so I can be there. I trust your discretion to know what to do.

Okay, well start her on the plasma, Dr. Got-it-Right said. It takes about 4 to 5 hours, so she’ll be done around midnight. I’ll call you if anything starts to turn. Otherwise you’ll hear from us in the morning.

My voice was now 5 octaves higher. Thank you was all i could manage before needing to hang up. I had to turn to my mom and quickly blurt out before I broke down “She has fluid in her lungs.”

I would find out much later that Dr. Got-it-Right actually went to her senior who warned her that this dog was in all likelihood going to die. Now she had gone to him again, asked him what the options left were. All he had was what was already in front of me - plasma, or ending it. The two of them went by her kennel to see my puppy fight for her life. Apparently, even though she was yellow with a failing liver, had failing kidneys, and struggled to breath, she didn’t look like she was done. In fact, all things considered, she looked alert, with it. She didn’t have the look. She had fight in her. Dr. Got-it-Right had described her as “plucky” earlier that day. It was that character in her that kept us all fighting for her.

But I can’t stress enough right now, we all thought she was dead, before the lungs had hit. Now the tables had turned that her death would likely be unplanned, painful. But my dog was facing imminent death. All of internal medicine saw her death coming. I was beyond hope - there was no hope to be had at this point.

Knowing I had done everything possible for my baby puppy’s chance to live, i sunk into a living hell after hanging up with Dr. Got-it-Right.

I could barely breath, barley speak. I oscillated between quiet moments of practical planning and reflection - I packed my carry on down to the toiletries bag to go home. I reflected on what I would do with her ashes. What toys I wanted to save. How I never got to take her to the beach the last time she was home - she hates the cold ocean water but loves the sand and chasing sand flies I smiled and told my mom.

Other times, I merely sobbed saying “I want my puppy. I want my puppy.”

Because really, all I wanted in the world at that moment was for my puppy to be healthy and happy and home.

I doubt anyone reading this would really question why I felt like a part of me was dying when this was only a dog. Anyone I call my friend is someone who understands how animals touch your heart and add such joy and happiness to our lives.

But right now in my life, Espresso was as vital to my life as my own beating heart.

I was already struggling with the move to New York. I thrive on the familiar, stability. I am able to be the outgoing, vivacious

personality most people know me for when I have created a safe place of comfort in my home, with friends, people I love. I don’t make friends easily to be honest. I have trouble making that next step that brings people from acquaintances to friends. In New York, I feared the Friday nights I’d be alone without knowing anyone, really having no friend to my name in thousands of miles, pining for friends I couldn’t be with.

I managed to finally reconcile my worst fears about moving to New York - that I would be alone, friendless, single for my entire time here - by knowing I had Espresso. Espresso was my source of comfort, familiarity. She was home. I always joked the two luxuries I brought with me were my dog and my wine - the two of which could pretty much get me through any situation.

I realized I never had felt lonely even on those nights in Davis I spent alone in studio because I had Espresso. You aren’t home alone on a Friday night when you have the dog. You are home with your dog enjoying alone time. When you have a dog to go home to, its like you are choosing to be alone, choosing to take solace in your furry friend.

Without a dog, I’d have to face being friendless, dateless, completely alone in a town I didn’t know and honestly have realized I don’t like all that much. I’d have to face the fact I lost my security blanket, my furry family, my feeling of home. The only source of comfort I had left out here. I’d be left with certain freedoms true - I could visit the city whenever, stay out late. But those things pale in the comparison that the joy and love Espresso adds to my life.

I have raised Espresso since she was 8 weeks old, 3 lbs, and literally fit into one hand. She has seen me through the worst and best of times. Part of my identity has become being a dog owner - I write this blog, my friends know me and Espresso as a pair. Everyone always joked my significant other was Espresso. My last guy once made some slight at Espresso, to which I snipped “Hey, she has been around for a long time before you and will be here a long time after - don’t knock the dog.” She is a critical, defining, part of my life.

The death of any pet is devastating. The loss of a friend, companion, that loss of love that I think only animals can give.

The loss of a soul. But the loss of Espresso would be so much more than that to me at this point in my life.

Losing her would be losing part of myself.

I couldn’t sleep that night, I couldn’t even lay down in my bed. I wanted to go wait in the parking lot at the vet school since the waiting room was impossible (one of the many disadvantages of a large veterinary hospital) but realized that sitting in the car would be worse than sitting on my couch, and likely not to make much of a difference if she were in that critical of a condition.

I lay on the loveseat which is next to the door. I left my shoes ready, my purse packed with the essential paperwork, keys. I left my phone charging, on highest volume, all sleep modes off, and always in my sight. I brought to the bathroom with me, to the kitchen which is not even 5 paces from the loveseat. I changed into sweats and a tee, comfortable clothes that I could dash into the hospital in.

All night, I clung to a very special toy of Espressos. There have been several generations of this squirrel toy - its a favorite of my little monster - but this is baby squirrel. One of her very first toys, its worn thin from her biting and squeaking and digging and attacking. She loves it. All night, I clung to it. I also would allow myself to briefly hold onto a special brown fuzzy blanket I originally had bought for my couch but Espresso had claimed - for the last nights I had been sleeping with it instead of my baby puppy, but now I cherished it, carefully folding it and only letting myself touch it after I had showered. It smelled like her, and I’d never be able to restore that puppy smell.

My mom camped out on the blow up mattress on the living room floor next to me. When I’d be crying and saying “I want my puppy” she’d just touch my hand or stroke my hair. She knew I just was going to feel the worst pain of my life until I heard something from the vet.

During an episode of Buffy - the DVDs of choice for background noise because I couldn’t stand the silence - a phone rang on the show. My heart leaped out of my chest, my stomach tightened so tightly I almost vomited on the spot, the adrenaline surged through my veins. And that was after only a second of panic and the quick realization it was not my phone.

Around midnight, my stomach tightened and cramped so badly I started taking TUMS by the fistful. I forced myself to be drinking water and forced a banana down so I wouldn’t have to think of food or dehydration...later...but my stomach made me pay dearly for these attempts and I was in dire physical pain to accompany my emotional distress for the next few hours.

I watched my phone constantly. Instead of depression, my body started sinking into panic. My heart would start racing randomly. It essentially a full blown panic attack once every hour or so.

In between panic and sobbing, I would try to ignore the stomach pain and imagine my puppy.

I can imagine every single square centimeter of her little body. I would imagine running my hands down her little nose, touching the little white spot she has between her eyes, the small pointy patch of skin that has less hair on it at the tops of her ears and the velvety smooth flaps below. I could feel her little broad chest bones covered in short hair, I could touch each individual pad of her paws and how it feels where her nails join her pads. I could feel her skin folds and her vertebra and ribcage, I could see her scar from her spay and the little dimple she has above her tail on her but. I know every inch of the little dog and I mentally went over every single inch, petting her and loving every single inch.

If you have never heard of quantum entanglement, this non-physicist would describe it as two quantum particles reacting faster than the speed of light - when something was done to one, the other reacts instantaneously. Wiki more professionally describes “When a measurement is made and it causes one member of such a pair to take on a definite value (e.g., clockwise spin), the other member of this entangled pair will at any subsequent time be found to have taken the complementary value (e.g., counterclockwise spin). Thus, there is a correlation between the results of measurements performed on entangled pairs, and this occurs even though the entangled pair may have been separated by arbitrarily large distances.”

I am no physicist, no mathematician, I have the barest grasp of quantum theory that pretty much ends at the cat in the box...but quantum entanglement sure sounds like love to me.

Two things so tied they react to each other even at great distance? I don’t know how the universe works, let alone love, but I have a strong belief that there is some cosmic energy balance. I don’t believe in a divine, but I do think we can try and influence the energy around us even if we don’t understand it. That is why I begged everyone for their prayers, thoughts, hopes, well wishes for Espresso. All that love being felt for her, all that energy being sent her way, I want to believe it can only help my baby. I want to believe that love entangles us all, and that my entangled love for my little monster would let her feel how much I loved her.

So even though it almost pained me, knowing she had tubes in her nose and neck and was dying and struggling to breathe, I thought of Espresso as much as I could. I sent my love, I sent my caresses, I sent my thoughts.

I slept for about 30, 40 minutes around 4 am, then again around 5 am. I remember sitting on the loveseat, slowly seeing darkness become a pale blue.

I never got a call. She had survived the night. My worst nightmare of having to rush to the hospital while she couldn’t breathe was over. At least now her death could be calm, quiet, peaceful, planned and with me present. She could go in my arms. That one solace granted me some peace. My baby would be go peacefully. I was able to get up and function.

That morning I took my mom to the airport around 8. We had thought about extending the flight longer but we wanted to save the money for the vet bills than fees to change the flight and really, I wanted to be alone with Espresso at the end. She has always been my dog and its been just the two of us for almost half her life, it would be just the two of us at the end.

I knew saying goodbye at the airport would be hard, but...not like this, my Mom’s voice trailed off.

I know. Not like this.

We hugged for what felt like forever and no time at all, and said goodbye.

I drove in the truck taking the most convoluted way possible back - I get lost easily when I’m stressed. I was driving by the back way to the hospital when I realized the orchards were right across from the vet hospital. As a grad student, we can get away with parking at the orchards (shhhhh don’t tell) when campus parking, even the vet center, is otherwise carefully watched and regulated. When you charge over $800 for a permit and need to win a lottery to even be granted one, parking is a big deal. So I pulled the truck into the orchard parking lot and sat. I know some grad students wondered what I was doing. I had my backup story - that I was checking on the buffer crop for the organic vineyard block for my professor - at the ready in case anyone bothered me, but no one did. I just sat, staring at the building across the street that held my baby. That held the future of my happiness in New York.

I began to plan out how my day would go. I would get Hope’s call about how she was resting comfortably, doing the same. Dr. Got-it-Right would call sometime after explaining how given her worsening kidneys, liver, her trouble breathing, it was time to end it. I would go in wearing my same clothes I spent all night in so I smelled very strongly - Espresso was drugged and I wanted her to know for sure it was me, be surrounded by my scent. I’d bring a blanket from home for her to be in so I could bring it back, so she’d have a bit of home for the end. I’d bring a few toys. I’d say my goodbyes, the I love yous, and cuddle her body until it went cold. I knew every flight out of Ithaca so afterwards I’d just go home and book the next one available back to Sacramento where I’d stay with my friends who had supported me through this whole thing. There I’d grieve and have friends to make sure I took care of myself. I’d fly back right before classes where I’d deal with what to do with her belongings, pick up her ashes, and how I’d begin my lonely life in New York.

The call came around 8:40. I would never be ready for this call, I’d never be ready to let go of my baby Espresso, but I was ready as I’d ever be. I took a deep breath, and picked up the phone.

Things are never so bad that they can’t get worse.

I just never realized that things are never so bad that they can’t get better either.

Things Are Never So Bad That They Can’t Get Worse: Part III

Espresso held throughout Sunday, but this would be the first day I didn’t get to see or hold Espresso.

I was told no news was good news, but that my vet student assigned to the case would give me a morning and evening update. I was a nervous wreck, waiting. My mom did an amazing job, trying to keep me eating, keep my busy or at least functional. My mother had originally only planned on visiting through Sunday, but given the crisis we paid to extend her stay until Tuesday morning. By that point Espresso would be recovering and I could handle it...or I’d be booking my own visit back to California anyway. But in the mean time, my life was spent counting down the hours till my 8 pm call from the vet student.

The vet student assigned to my case was as critical to Espresso’s experience as Dr. Got-it-Right. I am going to call her Hope - because it was her words of comfort and reliable updates that sustained me during a trying time...and for a critical role she’d play later on.

I got a call from Hope that evening - essentially she couldn’t give me any news, Espresso was pretty much the same. I unfortunately can read through that kind of talk - it essentially means “I can’t really tell you anything because your dog is still dying.” She did tell me how she created a nice little nest of blankets in her kennel, that she was resting comfortably. It was some solace that Espresso could be buried in blankets, her favorite spot to be in the world.

I couldn’t rest comfortably that night. In fact I barely slept. I felt like I couldn’t breathe. I would cry, panic, toss and turn. The reality I was losing her had caught up with me. I think I passed out from exhaustion around 3 am.

It was Hope’s call around 8 am that Monday woke me. I took it. Once again, she was much the same. I felt bad, I think I was terse on the phone. But there was nothing she could say that would comfort me knowing she was the same. Like the last days, her blood work was submitted - I would later find out she was a rush case that day - and I would get a call from Dr. Got-it-Right when it was in.

I didn’t realize I had fallen back asleep until a call around 10:30 woke me. I grabbed the phone.

“This is Dr. Got-it-Right at Cornell Animal Hospital, is this Lindsay?”

Yes.

How are you doing?

I’ve been better. What’s up.

So we got the results from her bloodwork in from this morning. It shows her kidneys are failing.

We talked about since her condition had held, she went ahead and her ultrasounded again - her symptoms had matched a bile duct obstruction but the small organ in such a small dog may not show inflammation till up to 4 days after the original blockage. However the second ultrasound showed a clear bile duct, a clear stomach, a same sized pancreas...but enlarged kidneys. The fluid build up had increased and now reached her chest cavity - she had an edema on visible on her chest. She was only continuing to deteriorate.

I honestly barely remember the conversation after that. I remember she asked me a question, and in a voice 3 octaves higher than my normal tone, I squeaked “Just a second please.”

I sobbed as silently as I could all the while screaming to my brain “GET IT TOGETHER THE VET IS ON THE PHONE YOU HAVE QUESTIONS GET IT TOGETHER.”

Dr. Got-it-Right could just say “I’m so, so sorry.”

After regaining the ability to speak I asked a few questions and hear about her treatment.

What was the treatment?(essentially the same fluid regime she was already on...hence why it was a bad sign to see her deteriorate).

The hardest question was “When do I call it?”

If it was a human, you never would, Dr. Got-it-Right explained. We would keep her on the fluid treatment, we had drugs and a stronger fluid regime we could do to support the kidneys. There was some hope as long as she kept peeing - peeing denotes that the kidneys are still maintaing their essential bodily function and are not in complete failure. If she stopped peeing...the game was over.

She told me I should come see Espresso today. In case I didn’t know it was that bad already.

“When are you available?”

“I can come” my voice trailed off as I started to feel the tears coming out. “I can come any time”

We arranged to meet in the afternoon when she had time. I thanked her and hung up.

Still in my bed, I laid my head down and sobbed. Uncontrolled, unrestrained, I sobbed. God knows I’ve cried hard before, but I never cried with such grief, such pain. Not when my grandfather died, not when my Dad was diagnosed with skin cancer, not during a breakup, not even during my recent move to New York where I felt like my heart was being ripped in two.

I explained her kidneys were failing to my mother who came in after hearing me. It was one of the only times she lost it too. She stood so strong or me this whole time but seeing her cry with me now almost just made things worse - it really, really was that bad.

This whole time I had been texting, calling people. I began to make the calls. I began to ask for comfort to help to prepare.

I barely managed to get dressed. But I had to look half way okay to visit my baby puppy. I had to look like happy and strong Momma, not the bedraggled, sleep deprived zombie I was becoming. My whole morning felt like it was in slow motion, but somehow went by faster than I thought and I was soon going to the vet hospital.

I sat in the waiting room. I actually smiled seeing doggies in cones, cats in crates being toted home out the front doors. I took some solace that even though my world was crashing down, other people’s were healing, recovering, going back to normal.

Lindsay?

Two people in white coats came out a side door. I finally got to meet the people fighting for Espresso’s life.

Dr. Got-it-Right was a brunette with a no-nonsense appearance. I almost called her Dr. KickAss in these entries because she just gives off that vibe of I know my shit and I’m going to get shit done and done right. Exactly what I wanted from my vet. That was comforting.

Hope was petite and cute and redheaded - she looked kinda tired and emotionally invested like most the vet students I’ve seen around Davis honestly. Her sweetness comforted me that Espresso was in caring hands for her treatments and her concern in the days to come comforted me.

They led me to a private room - originally I was going to go to the ICU to see Espresso (another indication of the severity of her case) but someone was having to be ultrasounded, so we talked while we waited.

They reaffirmed the prognosis given on the phone, but there were small comforts. We could be very sure it wasn’t an obstruction - 2 different ultrasounds with 2 different radiologists and both confirmed no obstruction was present.

I know ultrasound is as much an art as science, I said, so I appreciate having had the two done.

However that meant it was either a toxin or Leptospirosis, a bacterial infection. The kidney failure ruled out the less severe possibilities like pancreatitis.

They told me about the IV fluid that was saving her life by treating her liver and kidneys was becoming a concern since it was obviously accumulating - hence the edema in her chest and the fluid that was in her stomach and around her organs from the first ultrasound. Since her veins were leaking this fuid into her body, they had switched her to a less polar, colloid based fluid to hopefully allow ti to pass through to the kidneys where it was needed.

I asked a lot of questions which Dr. Got-it-Right fielded respectfully and in detail. She had remarked in a previous call that I seemed to understand the scientific terms so she used the real language to describe Espresso’s condition. I may know plants better than animals, but I have taken enough biochemsitry to understand most of what was going on and appreciated the intellectual respect.

After I was out of questions, I turned to the doctors.

I just want to put it out there, that I want to know if you think its time to end it. I know you want to comfort me, but keep your priority of keeping her comfortable your priority. Don’t hold back about the severity, about her condition, for my sake.

Dr. Got-it-Right assured me that Espresso’s comfort was her priority. I figured she was that kind of vet anyway, but it never hurts to put it out there when I could be rational and face to face, not when I’m sobbing over the wish I could do more for my baby puppy as she was crashing.

Deciding not to wait any longer, they just brought my baby - IV bags and all - to the room for me to see.

A critical moment happened right then, a moment I didn’t realize would determine Espresso’s future.

So weak she couldn’t lift her head, Espresso saw me and wagged her little tail - the only part of her protruding from her blanket.

She wagged her tail.

She was bundled up in blankets and Hope gently placed her down on the examining table. I bent over, wrapping my arm around my baby and using my other hand to gently pet her face.

Technically, since it could be a dog-to-human transmissible bacterial infection, I shouldn’t have let her mucus membranes touch me...

yeah right. she was too weak to do much, but she did slowly lift her head and partially close her eyes just like when she goes to lick my face. Too weak to do that, she did manage to gently bump her nose against my cheek.

She bumped her nose against my cheek.

My mom and I were left alone in the room to just be with my puppy.

Momma loves you. Momma loves you so much. You are so loved. Auntie Rachel loves you. Auntie Amanda, Auntie Alison, Auntie Nicole love you. Auntie Jen loves you. Uncle Zach loves you. So many people love you baby. Daniel, Christine, everyone at Mumm - Stephanie and Lindsay and Jessie and I’m sure even Doug because he likes me and Tami - Linda and Jesse and friends you haven’t even met are all rooting for you and praying for you and thinking about you. Momma loves you...

It was almost a mantra for me. Just saying names of people who were helping me and loved me and loved Espresso.

However. I couldn’t be selfish here.

My arm was around her as she lay on the table, my thumb gently stroking her back. She had lost so much weight I could feel her vertebra. My other arm was rested so she could lay her tired little head on it.

I leaned in close and while petting my baby said -

Momma loves you. You are so loved. Momma loves you. Momma is so proud of you, you are fighting so so hard. Fight as hard as you can, as long as you can baby. But its okay if you need to just rest. You fight until you just need to rest. Momma is here, Momma loves you, and you just do what you need to. Momma loves you and will always love you and will always be here.

I then just sat in the quiet with my puppy.

They eventually came in and had to take her away. Right before, I stroked her ear and said Momma loves you and you do what you need to do baby. Momma loves you.

I couldn’t watch as they took her out the door. As she was taken, Dr. Got-it-Right asked me about inserting a central line - currently to test her blood, blood sugar, enzyme levels, etc -Espresso was being poked almost every hour. Also, it would have been 5 full days since she ate her last real meal so she suggested a feeding tube to help get her some nourishment. She even suggested putting in a catheter, so we could carefully monitor her urine output, our only signs that her kidneys were hanging on. I agreed to all, even if it meant my baby would now be tangled in tubes - it would help her long term comfort I hoped.

Right before leaving, I mentioned how Espresso's breathing was much more audible than normal. It wasn't wheezy per say, but even when she is excited her breath doesn't normally carry such a noise. The vet said she'd listen to her chest and lungs again and appreciated my comment.

Dr. Got-it-Right walked me and my mom to the door. This was my Mom’s last day so she told the doctor it would just be me from now on.

I left feeling so lost, so scared, so in love with Espresso. With her kidney failure, I was likely going to have to come in tomorrow and euthanize my puppy when her body just couldn’t function anymore.

But things are never so bad that they can’t get worse.

Things Are Never So Bad That They Can’t Get Worse: Part II

Even though Espresso was hospitalized in worsened condition, one of the advantages and one of the reasons I chose the private vet hospital was because I could call day or night for updates.

I called once at 9, then again at 2 am. They told me she was much the same, but had eaten a little bit at midnight. She was resting comfortably.

She had eaten something! Maybe this really was going to pass in 48 hours or so. I went to bed somewhat hopeful. It would be the last time I slept well in a week.

I woke up early on Saturday morning to call for an update - I was left with hold music for a long time, I was nearly shocked when I found Dr. Pathetic talking to me. He must have had the morning shift.

He told me how she was basically doing the same, lethargic, not eating, and that she was still receiving fluids. He sounded very concerned, very solemn.

The damn bitch was feeling pretty damn guilty I’m guessing and thats why I talked to him personally and not a tech like I had for the other updates. He sent me home with no plan, no diagnosis, and there she was in worsened condition the very next day, under careful observation and another vet’s care. Someone done fucked up.

I got off the phone as quickly as possible with him - I had nothing to say and he was next to useless about making me feel any better. I waited impatinetly to call again after noon when Dr. Competent would be back in. I called in saying I wanted to come visit - we arranged to have me swing by around 2. They told me the vet wanted to talk to me and she may be able to fit me in when I visited.

When we were escorted to a private room, I had my suspicions things may not be normal. A tech came in and handed me my beloved puppy - she was completely lethargic still,

but gave me a kiss and showed she was happy to see me. She lay in arms. I looked at her eyes and noted they were red, discolored, different. My mom said she looked jaundiced and I scoffed - in retrospect realize it was denial. Dr. Competent herself walked in to meet us, no appointment or anything, and I knew it was bad.

She explained how the jaundicing indicated that Espresso’s liver was failing. They were in the middle of running another blood test - it would be about 30 more minutes or so - and then they could fully assess the damage. It was either a serious obstruction of the bile duct or other type organ, some serious disease that was causing liver failure, an infection like pancreatitis, or a toxin. We had moved beyond hopeful recovery on her own. Whatever it was, it was serious, and life threatening.

She left me and my Mom to be with Espresso. I looked at her eyes which had a tint of off-white, but it was when I flipped her ear that I saw her normal pink skin be a vivid shade of dandelion yellow. It was the first time I cried about Espresso. I sat there, tears leaking out, holding my sleeping, dying and jaundiced puppy. I could barely catch my breath. My mom did her best to comfort me, but there was nothing she could say, or do, that made this situation fair, okay, livable.

I just sat there holding my beloved puppy not knowing what came next, waiting for the blood tests. What felt like an eternity - or maybe just a millisecond, its hard to tell - later, Dr. Competent came in with my test results. Her liver enzymes were through the roof indicating a high level of liver failure. Her bilirubin, the bile that makes you yellow, was highly elevated compared to her normal levels yesterday. She was deteriroating, and fast.

At a private vet hospital, they couldn’t get the radiologist to ultrasound her gut until Monday. I could wait and hope she made it. Or I could transfer her to Cornell where she’d be admitted to Emergency, but with no promise of ultrasound until Monday either. They never guarantee that they will call the team in or if they will make you wait. I could hope maybe they team was already there for some other trauma and she would be seen before Monday. Or if she looked so serious, so on the brink of death, they would call in the team for her.

At Cornell she would have a chance to be seen sooner, and if she did start crashing, they would bring in whoever was necessary, and option Colonial did not offer. The choice wasn’t hard. Dr. Competent said she’d been talking to the head of Emergency, explaining the case, campaigning for the ultrasound team to be brought in, but she would call again, fight again for me, and call ahead so they would be expecting me. I bundled my puppy up, IV insertion in her arm and all, and handed her to my Mom so I could discharge her and get her ass to Cornell.

It was the longest 10 minute drive of my life. She just rested peacefully in my Mom’s arms, even looked out the window a little bit. Thank God I had driven by the vet hospital a few times in the last week - it’s not really on my way to much, except a back scenic but longer way to Target. I enjoyed the drive and had taken that route several times, seeing the signs for the Companion Animal Hospital on my way.

The picture is of Cornell Companion Animal Hospital - just a googled photo, but I figured I should show what would be the home of Espresso for the next days.

Cornell was open only for Emergency care- we had to push a red button in the hallway to be let in.

“Hi, I’m Lindsay with my mini dachshund Espresso, Colonial Animal Hospital called ahead, they should be expecting me”

“Yes we are, come right in.”

The doors opened. I took her to the receptionist who opened a glass window. I signed her in, signed for my truck in the parking lot. I held my baby. A friendly ER nurse came out and asked me a few basic questions and told me take of Espresso’s harness so it wouldn’t get misplaced. I placed it in my purse and cuddled my puppy. She told us it was a good day to have brought her in at least - the night before had been made it but it was very quiet that afternoon. At least she’d be getting lots of attention from bored vet students. The ER nurse then took her, still bundled to the back.

A vet student then took me and my Mom to a room to get her history. I gave the whole spiel I had given Dr. Pathetic and Dr. Competent again - about how I had just moved and we had traveled across the country, how we’d stayed here a week, how she had the roam of my yard which had all sorts of wildlife, how we had done a day trip to New Jersey and the progression of symptoms. No, she hadn’t eaten anything strange that I saw, no we hadn’t had a change of diet. No, we weren’t in contact with any other dogs.

My mom and I sat in the room. It was the first time I felt...relieved. I did everything I could do by taking her to one of the world’s first class veterinary hospitals. We talked, about everything and nothing. I even laughed about something I remember.

The student came back with the ER vet - let’s call her Dr. Reason. They told me that they had admitted her, started her on fluids again, and that they were going to call in the ultrasound team for her. They didn’t know what it was - it could be surgical and an obstruction - likely a bile duct obstruction explaining the excess bilirubin and elevated liver enzymes - in which case after the ultrasound showed what was up, they would bring her straight to the operating table. If it wasn’t surgical, she would be transferred to Internal medicine and kept in the ICU and be treated forthwith.

I asked all the typical questions - what were the risks, what was the worst case senario. I signed all the paperwork and the cost estimates. I was escorted out to pay the deposit.

Espresso was in the hands of the best I figured. I would get a call after the ultrasound and otherwise be updated in the morning.

They were calling in the ultrasound team for her. It was so bad, that she was the emergency case that would bring the team in. I was relieved my life wasn’t on hold waiting, but terrified I was such a critical case. I went home feeling the best I had been since the start of everything though. I knew she was in good hands, she had every faculty science could provide her at Cornell, and I live 5 minutes away from the vet hospital (I really did pick the perfect apartment).

The call came sometime later. Dr. Reason told me there was no obstruction as was expected - her pancreas, stomach, liver, and kidneys looked fine, were of normal size. However, there was some fluid that was found in her stomach, around her kidneys and bladders. It would be sent to the lab for further analysis, but there were no obvious bacteria or cells or even discoloration of any kind in the samples. Since she wasn’t an emergency case needing surgery, she would be transferred to internal medicine where she would be treated and cared for. I thanked Dr. Reason for her time and prayed that my puppy would be okay overnight.

A surgical problem would have been a relief - maybe not financially, but it would mean there was a tangible, easy to identify problem that could be fixed by a doctor immediately. Yes, surgery means introducing a series of other risks, but it meant there was an obvious source of Espresso’s failing liver and other symptoms. But she had no diagnosis. She was worsening but with no evident cause in sight. I had to start considering the worst. I had a deep feeling in my gut that I couldn’t get rid of that this was serious - gravely serious. I was having to face that I may seriously lose my puppy.

On that Sunday morning, I got the call from who would be the internal medicine vet to follow me through the rest of Espresso’s journey. I am going to call her Dr. Got-it-Right for her determination, panache, and veterinary skill. Although I really should call her Dr. House.

She told me about Espresso’s serious condition. She explained that a group of internal medicine had met and discussed her case. Basically they still didn’t know what was wrong with her, but they were damn sure going to treat her for everything. Instead of taking the time to test more extensively or see which treatment worked, they put her on everything for anything it could be. She was on pain medication for her increasing abdominal pain, anti-naseua medication to encourage her to eat, fluid support for the liver, steroids in case it was Addison’s disease, antibiotics in case it was infection...you get the idea.

A team of Doctor’s meet to discuss a medical mystery and then treat her for everything to see if anything works? Very Dr. House.

All we could do was hold out to see what treatments would work. Dr. Got-it-Right righty pointed out that a mere night of treatment wouldn’t be a long enough time to see if anything helped. At least she was on pain medication and being treated for everything. Espresso held throughout the day, showing no real improvement. Still no eating, still yellow, still ouchy.

But things are never so bad that they can’t get worse.

Things Are Never So Bad That They Can’t Get Worse: Part I

My family has always had a dark sense of humor. My grandfather always had a saying, “Things are never so bad, that they can’t get worse.”

In the span of about 2 weeks, I had left everything and everyone I knew and loved. I had gone through a breakup. I had said goodbye to my best friends having no clue when I’d see them next. I had the roadtrip from hell that included getting pulled over and staying in sketchy parts of town. My well meaning landlord did not have my apartment ready for me, even though I had been paying rent to hold the empty place for 2 months. I was so homesick, I was barely capable of eating.

But things are never so bad, that they can’t get worse.

The best way I can fully describe what has happened is to go as chronologically as I can. I can only give you how I saw things, how I felt things.

Wednesday I drove my mom and Espresso to Paramus New Jersey for an epic IKEA expedition. While my apartment came “furnished” I found I had too many clothes for 1 dresser, and too little patience to deal with seeing what my landlord had in storage (and reminding him again...and again..what I needed). I was very excited about a Mom-Daughter-Dog overnight trip to shop, get what I needed to settle into my awesome apartment.

Everything was pretty damn normal that day, except Espresso was...well, quiet. The last two days since my Mom had arrived had been filled with squirrel chasing, furniture climbing, many walks, and we assumed she had finally just tuckered out. We also noticed her, what my mom called, “vibrating.” It was’t her normal small dog quiver of excitement, fear, anxiousness, etc. It was more subtle and in sync with her breath. I just figured she was maybe cold or excited still. But it had us both observing her more carefully...starting to wonder what was up.

My mom and I only even noticed these mild signs since we know her so well and because we were in the car for 4+ hours with her and merely resting in a hotel with her that evening. Few distractions, lots of intimate time with her.

I knew something was wrong when Thursday morning, she wasn’t all that hungry. She ate a little but walked away from a half full bowl of kibble. I started freaking out a little bit. But she finished some more when I hand fed her and just took it that she wanted a smaller breakfast. I was deeply concerned, but was more thinking she was stressed from travel (although she handled 10+ hours of a cross country trip fine) or that she had some residual car sickness (not that she had ever before...).

She slept in her crate quietly in the truck in IKEA’s shaded parking garage. She barely moved on the drive home. My mom and I got home, and decided to postpone unloading our haul and go straight to dinner. Espresso plunked into her crate like any other day and we went off to enjoy a very nice meal at a lakeside grill.

The nightmare began when I came home.

I will never get over the guilt of these next few moments. I walked into my place like any other day, opened her crate, and walked straight to the kitchen and put kibble in her bowl.

It was my mom who noticed the vomit on her blanket and pulled it out. We then saw the tons of vomit on her cratebed. I don’t know how long it might have taken me to notice otherwise...one of my worst mommy moments.

I panicked when she sniffed her kibble bowl and walked away completely not taking a single bite. She did drink water, but refused to eat even at my goading.

I held my baby. She was hot to hold, hotter than my little hot water bottle normally is. And the “vibrating” was like what I do when I have a fever with chills I realized.

I almost didn’t bring my UC DAVIS Dog medical reference book to New York - I was parring so much down and while it was a thoughtful gift from my folks the first Christmas after I had gotten Espresso, I had never actually used it. But the tome fit into a box I had already filled with books, so what I figured what the hell and brought it.

I ran to my bookcase and looked up vomiting - I immediately started googling vet hospitals after I read “...vomiting is a sign of severe disease when it is seen in combination with other signs such as lethargy, inappetence, pain or fever.” She had a trifectra of serious symptoms.

We took her to honestly the first place I found that was still open at 8:30pm on a weekday -Colonial Animal Hospital.

Why not Cornell? To be honest, I HATE the way most university veterinary hospitals are run. What do I mean? I mean you don’t get a single doctor, you get a team of students or even student, singular, who refer to their higher ups as needed. Staff changes completely with different shifts and there is no ability to contact for updates, easily make visits, and I always feel like when they take your dog away you don’t really know whose hands they are in, where they are, and honestly if you’ll ever see them again. I thought Espresso had some mild stomach inflammation - like a stomach flu right? - and I wanted direct, simple care with people who k

now her case and my name. I chose a local emergency animal hospital that would offer me personal care and not overwhelm me, an already terrified Mommy.

Well, or so I thought. It will always be my biggest regret, letting my fears of not knowing what to do impede me from taking her to Cornell.

The animal hospital we did go to itself was great - cleanest facility, great front desk staff, kind vet techs.

But god did I get the worst vet - lets call him Dr. Pathetic for our purposes. When I found his bio online later that explained how HE JUST GRADUATED VET SCHOOL THIS MAY, it explained so much.

All I want from a vet is an assessment of my dog’s current state, a judgement of what is the matter or range of possibilities to the best of his ability, and what are my options for treatment and follow up care.

I mean, really, that is kinda the minimal standard for veterinary practices right?

Apparently not anymore. He was a Cornell graduate and obviously scientific minded. But so quiet, unconfident, skeptical and honestly kinda self righteous I wanted to punch him in the face with anger and fear for my dog.

He explained she had some slight stomach tension. My mom saw he wrote on his report “alert and awake” essentially ignoring my descriptors of her lethargy. I had to point out the vet tech find her to have a fever (102.5) and he replied “well, only a very slight one.”

He never considered a toxin. He threw out the idea it was a blockage since “she is not continuously vomiting.” He never stated what he did think it was nor did I even fully understand what he thought we should do.

Thank god it was me, a take-no-shit, strong personality on defensive Momma mode. I only regret I was as upset and worried for my dog as I was because honestly, I should have taken him to town for his lack of bedside manner and patient-relations skill. I only had the energy to pry so many answers out of him.

I insisted finding out what were my diagnostic options. He, rather reluctantly, I could do a blood test to see where her metabolic state was at ($150) or do an xray to be sure there were no blockages ($230). He almost outright stated that they were both probably unneccesary.

She didn’t seem to have an obstruction, from what I know and have seen of them. I was worried it was something much more serious going on inside my pup metabolically- my dog book had warned me after all. And while I could tell Dr. Pathetic was probably largely waving me off as an overprotective blonde Californian small dog owner, I know fever denotes infection/inflammation and god damn if I was going to be sent home with some doggie antacids and his nonchalant attitude.

An hour later we got the blood results back. Now, it all makes so much sense. Hindsight is always 20/20.

Everything is fine, except a couple of her liver enzymes were abnormally high.

Now, in recent days, I have learned a little something about liver enzyme levels. Guess what elevated enzymes typically mean? LIVER DISTRESS. I don’t think that took an Einstein brain leap. I feel like that should be covered in vet school.

Guess what Dr. Pathetic said? “Well her liver could be somewhat stressed from stomach inflammation, but it could be a sign of Cushings disease...but that normally only happens in much older dogs.”

Essentially, Dr. Pathetic has the diagnostic skill of the woman Dr. House brought back from the FBI and had to promptly fire for her inadequacy. Or you know, less diagnostic skill than my NOT veterinarian educated 22 year old self. Or you know, a hamster.

What else was I going to do? He didn’t even offer to hold her overnight for fluids, he didn’t suggest more than the xray. He did however, give her an injection of antivommiting medication and (I think...some details are hazy through all this) an antibiotic. They didn’t carry antacids small enough for Espresso so I was even going to have to go the grocery store for those.

We took my sick puppy home, hoping she would just improve on her own.

I slept with her that night and knew things weren’t okay. We tried getting up at 9 or so, but both of us just fell back asleep until noon.

She was so hot, she pushed her way out from under the comforters, and actually crawled down to the end of the bed to be near the fan. Except it was on too high a setting so her ears would flap wildly when the fan rotated directly in front of her, so she crawled back up to me. I knew something was seriously, gravely wrong. This was the photo I took of that morning, me worried sick about Espresso, and Espresso sick, but still absolutely adorable. I never realized this may have been the last photo I'd ever take of my beloved baby puppy.

She didn’t willingly move the whole day. She refused breakfast, but I had a glimmer of hope when she licked a smudge of avocado off my finger. But that was the last thing I could get her to eat.

It was nearing the evening and she was showing no improvement, and had not drunk since a few laps from her bowl in the early am. I knew things were getting worse.

We took her back to Colonial.

Dr. Pathetic was not on call, so instead we met with another vet of the practice - a very nice and serious woman I’ll call Dr. Competent. We saw the fever was finally gone, but she even noticed the lethargy in my pup who was mostly just laying quietly in my arms. She felt the stomach - once again, only slight tension. But without Espresso drinking, we all knew she would be admitted for the night - an IV would provide the critical hydration she needed while we tried to see what was the source of the problem. The doctor was clear that she didn’t know what was up, but that generally dogs either improved or started deteriorating in 24-48 hours. If she improved, great. If she deteriorated, we’d at least begin to know what was going wrong. She didn’t think it was an obstruction, and knowing the elevated liver values, suggested it may be a toxin or infection, and supportive care was all we could do for that anyway.

I asked what we would do if things were the same - She told me that at that point, we would probably do an ultrasound of the abdomen and surrounding areas to ensure there wasn't an obstruction or anything else obviously wrong.

So I left my baby girl at the hospital. She had never been away from me or a close friend she intimately knew for a night before. She wasn't eating, drinking, and didn't have the energy to move. I was nervous, anxious, and so worried.

But things are never so bad, that they can’t get worse.

Pup and Circumstance

So I graduated this Saturday. A time to celebrate with family, friends, and the important people in your life.

And of course, the important puppies in your life.

Unable to smuggle Espresso into the ceremony, she instead made a critical appearance at my graduation party. And

even my 14 year old Lab was able to join the festivities.

Espresso was amazingly social and quite popular. The aunties of course doted on her, but sh

e also made a lot of fans of the parents. My "second father" Brett probably held her for an hour. As he put it, "She likes the view up here." I took that a step further by demonstrating my skilled Dachshund lifts. What gets me is she really DOESN'T mind being up there. She must like the view.

Espresso will also never turn down the opportunity to lick carpet that may have once in its history had food on it.

Brandy was even...brought into the festivities by a loving, yet over zealous Auntie Nicole.

This is after all an event where I wanted to be surrounded by family. And these dogs help define my family.

Baby Puppy Dinner Time

So a few weeks back when Espresso had dental surgery, I bought her several cans of wet food. While she has long since healed, I was left with cans of wet food. Since my whole life is now spent thinking about how to get rid of most of my worldly possessions before I leave for New York, I figured I may as well treat Espresso with some wet food until it runs out.

I had also been considering trying to mix up her diet a little bit, having read somewhere at sometime that a mixed diet is good for dogs, giving them different nutrients etc.

I made Espresso what I call a "super dinner" tonight. On the menu chez Espresso tonight was:

AvoDerm Chicken and Rice wet food

1 T/D dental Kibble (yes, that is a single HUGE kibble)

1 Month Heartgaurd tablet

Some dry AvoDerm Chicken and Rice kibble.

Espresso was getting very impatient with me taking photos.

Finals Care Package

I love my mother so so much. She is the proudest puppy-Grandma I have ever seen.

My wonderful Mommy often sends me care packages during finals week...I think in part so she knows I'll consume enough calories to not die. This package included lots of sugary treats for me...and of course some treats for Espresso.

I always feel bad for Espresso. I know she is a little neglected during finals. When I'm too busy pounding out a thesis or the like, I tend to feed her cows' ears or give her new toys or do anything to stave

the guilt and keep my little monster occupied. My mother is amazing and knows this so she beat me to the punch by sending a cow's ear and a package of squeaky balls.

I haven't given her the cow's ear yet, but she has loved one of the balls, squeaking-it-till-it-squeaked-no-more.