Nora At Rest

On Thursday, November 9, 2017, we said a final goodbye to Nora. She was almost nine years old and died of kidney failure after living with Cushing’s Disease and blindness for more than two years. Even with these health challenges, her quality of life was quite good until she became sick a few weeks ago and declined like a roller-coaster car. We had hoped to let her pass at home, but when it became clear that she was suffering, we took her to the vet and stayed with her while he and the staff helped her peacefully along her way.

It was just over six years ago that Nutmeg and Nora came to live with us. They had been adopted by a husband and wife, and when the wife died, the husband could no longer care for them. He asked their veterinarian to euthanize them, but the vet refused, and a friend suggested that he place them with a rescue organization. We discovered them on Petfinder.com. They had been living in a kennel for two months and had forgotten any training they may have had. Our first few months with them were certainly a challenge.

Nutmeg and Nora never stopped being a challenge, but we loved them instantly and will love them forever. We had fallen into a nice rhythm when in the spring of 2015, Nora started acting differently. She was having accidents in the house, was panting, her belly was bloated, and she was restless. It turned out that she had a serious bladder infection, but worse than that, she had Cushing’s Disease.

Cushing’s Disease is caused by a tumor on the pituitary gland or an adrenal gland. The net result is that too many hormones being produced and this makes the dog anxious, while creating many other symptoms. Cushing’s can be managed with medication and requires periodic bloodwork to determine if the medication needs to be adjusted. Dogs can live out their normal lifespan with the disease. That’s what we hoped for our pup.

Then, just a couple of months after her diagnosis, Nora went blind. After doing lots of research, I discovered that blind dogs can manage very well, and that sight is not their most-important sense. They can “see” with their ears and noses.

In the more than two years after Nora lost her sight, she adapted very well. It was amazing how she could zig zag her way through the house, traveling inside and outside, with just a few mishaps here and there. We would direct her with our voices when she headed toward a wall or a piece of furniture. This would usually occur when she had just awoken or was tired.

A month or so ago, Nora’s legs seemed weak. It was subtle. After observing her and trying to determine which leg was giving her trouble, I took her to the vet. It didn’t seem that there was a problem with the legs themselves, so we did some bloodwork and found that many of her values were off. Another batch of blood was analyzed to see if something was going on with her kidneys. We also did an ACTH stim test, to see if her Cushing’s medicine needed to be adjusted.

The word came back that the Cushing’s wasn’t the issue. Nora was in end-stage kidney failure. Even with a dire prognosis, we had no idea we’d lose her within two weeks’ time. She started getting sick to her stomach and was given something for nausea. She was prescribed something for her kidneys, which wouldn’t cure her disease, but would make her feel better. Unfortunately, that medicine made her more nauseous and had to be stopped. She then started with lower GI symptoms, and we talked with the veterinarian and staff about signs that a decision might need to be made instead of letting her pass at home.

When Nora started with lower GI issues, the poor thing would have to go out every two hours or so. She’d squat over and over with not much happening except the evidence of bleeding. She’d hop back in the door, hesitate a moment, and then go back outside for more. It must have been exhausting for her to repeat this so many times a day. It was heartbreaking for us to watch.

On Monday, November 6, we took her back to the vet. She wasn’t eating or drinking very much. She was given meds for nausea again and an antibiotic for the lower GI symptoms. She had already started refusing her Cushing’s meds, so it was hard to get her to take the nausea medicine. I never did get her to take the antibiotic.

Over the next three days, we were sometimes able to get her to drink water, but she was not hungry. She tried to eat the hamburger/rice mixture the vet recommended, but after one small meal, she refused that, too. She became uncomfortable because she wasn’t taking her Cushing’s meds, and one time, I dissolved one pill in water and squirted it into her mouth with an eye dropper.

I slept on the floor in the living room with her three nights in a row, thinking/hoping each would be her last, so that we could be spared the ultimate decision. I asked Happy, Scout, Tina, and Easy to meet her, but they didn’t come. I asked her previous owner to meet her, but she didn’t come, either. I wanted to let her pass at home, the way my cat had done in my arms when I was a child.

Nora became so weak that it was difficult for her to walk anymore. Her body was tense and she had started to shiver. She refused water as if it were an insult.

On Thursday, November 9, finally called the vet’s office and told them I thought it might be time to let her go. I gave her a warm bath, which I think gave her comfort. She laid on the bathroom floor while I ran the warm blow dryer over her soft fur.

A few hours later at the animal hospital, her veterinarian reviewed Nora’s symptoms and prognosis with my husband and me, and we all agreed that helping her along her way was the best thing to do for her.

I’ve been present for three other pets’ euthanasia. One was a hamster with a huge tumor whom I couldn’t watch suffer anymore. One was a dog who went peacefully, and one dog not so peacefully. I was afraid for Nora, and I had wanted her to die in the night. The vet said everyone hopes that, but it rarely happens.

Nora slipped away so gracefully. Our vet’s procedure involves starting an IV and administering a strong sedative first. This is like when you go under for surgery. All awareness stops. When he was certain that she was completely sedated, he administered the second drug through the IV. Her passing was so subtle that I didn’t even realize it was over until he told us she was gone.

It was so hard letting her go, but to keep her with us would have caused her more suffering.

When we got home, Nutmeg was restless and barking. She and Nora had never been the best of friends and had some pretty nasty conflicts over the years, but they went through a lot together before we got them, and they expected each other to be near. That first night, Nutmeg’s attitude seemed to be one of resentment and she isolated herself from us. I think she realized this wasn’t one of Nora’s absences due to her Cushing’s, and that she was not coming back.

It’s easy to say that we should remember the good times. I’ve said that myself. I think it’s easier to do as time passes. I still have heartache over the previous pets we’ve lost, but I’m better able to remember the good times and not dwell so much on the end.

So, when I see one set of food bowls instead of two, when only four paws follow me down the hall instead of eight, when only one voice howls, I’ll try to remember the good times. Maybe I’ll think of how she loved to play in the snow or how she hiked with us on every one of the trails in the Let’s Move Outside project. I will remember that we still have Nutmeg and she is healthy.

We miss Nora so much, and our hearts are breaking. Jim and I are so honored to have known and cared for her, and we know that we will cross the rainbow bridge together someday.

“For one hour of keen joy out-does pain.” W.E. Dimorier

Ann Silverthorn