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Thursday, November 17, 2016

A Love Larger Than Loss

My soft-eyed sweetheart.

My beloved dog, Abbey, passed away on October 21st, 2016. This did not catch me unawares: I'd been preparing myself for her death since not long after I adopted her twelve years ago.

A little brindle dog in a big green world.

Here is the context for that decision: I'd had the utterly terrifying experience in July of 2004 of waking up suicidal one morning. It was like waking up to discover that I had been taken hostage in my sleep and that there was now a gun pointed at my head. I had no desire to die and begged and pleaded with the part of my brain that wanted to kill me. None of my impassioned arguments moved it whatsoever and as the day wore on, I grew more exhausted and less sure of my ability to resist. There was one thing that saved me: while I hadn't been able to convince my brain to live for myself or my family, I found that I could live for my boyfriend, who was nearer at hand. I knew it would devastate him if he were to find me if I attempted suicide and that thought gave me the strength to hold on until at last I fell asleep and the immediate crisis was averted.

After that horrifying experience, I no longer trusted myself. I was scared that the same thing could happen again and I knew, now, that I might not be able to live for myself or for my family. I clung to the idea that I had proof that I'd be able to live for my boyfriend, despite the fact that he was now lived half the country away because my parents had brought me home to care for me. But then the relationship ended. In addition to the grief that came with parting with someone I loved was the terror that I was now without a surefire reason for living that I could wield against my suicidal mind. I needed to find something new.

Abbey, December 2004, two
months after her adoption.
I chose Abbey. We adopted her three months after my scary brush with suicide and from day one Abbey had seen my vulnerability and stuck to me like glue. She made it her mission in life to watch out for me and never let me out of her sight if she could help it. I realized that I could not possibly betray this dedication and devotion to my well-being and knew, also, if there came a time when I was living on my own with just her for company and things got really bad, making arrangements for her care in the event of my death would enable me to ask for help for myself.

This was a huge relief. Except for one thing: dogs die. And I did understand that the only thing worse than me outliving her was for her to outlive me. Thanks to effective medication and therapy, by the time Abbey had been with us for a year, the threat of suicide was receding. In fact, her devotion was inspiring me to be braver and more confident than my anxiety had ever permitted in order to relieve her of some of the burden of looking after me. All of this meant that my love for Abbey was very intense, though, and I was worried about how vulnerable it could make me. The answer, I believed, was to start preparing myself for her inevitable loss. "Abbey will die and you will be devastated, but you will also survive it."

And so, for the next eleven years, I never once let myself lose sight of her mortality. In time, my bipolar II depression was so successfully managed that I no longer had any fear that I would be overcome by suicidal urges. However, I depended on Abbey in new ways because I'd been beset by chronic migraines and had to stop working and give up on a lot of dreams. She kept me company as I retreated into my little reduced-trigger cocoon and brightened my days and helped, I thought, in keeping me from growing bitter about my situation. Even with these changed circumstances, I still kept telling myself, "One day Abbey will die and this is okay and as it should be. You will be devastated, which is okay and as it should be, but you will also recover in time and that is okay and how is should be as well." I figured all of this was more an intellectual exercise than an emotional one, since it's one thing to tell your heart something and another for your heart to believe it, but I thought repeating the idea, even if I didn't fully embrace it on an emotional level, would make the reality less of a shock when the time came.

And then the time came.

There were twenty awful hours between the time I realized that she wasn't going to survive her illness (reported in detail in this post) and when I gave my mother the okay to finalize the appointment with the at-home euthanasia vet to take place in just three hours.

I'm so thankful Abbey got to pass away on my
bed where she always felt so deeply content.
My heart had been wailing, "No, it can't be time," but as soon as the appointment was made, the wailing stopped. Deep acceptance, acceptance that went all the way to the bone, that went down to the very depths of my being, took hold. It was time. There was no point in wishing it to be otherwise, in wasting energy on fighting against what I knew to be true. My dog was dying. I couldn't unmake that reality. What remained was how I handled her final hours and her passing.

I had, over the years, given some thought to what I wanted for Abbey when the end came. At-home euthanasia was important, for though she liked the vet himself, she was anxious at his office and I didn't want her final moments to be anxious ones. I wanted individual cremation for sure. I'd thought for years that perhaps the best place for her to be at the end would be in her beloved cozy oval bed with the raised sides downstairs, but after she took a wonderful nap on my bed with me when we'd brought her home from the animal hospital with all of our hopes of her recovery--hopes that would be dashed in mere hours by her rapid decline, necessitating in hospitalizing her again--I realized that my bed was the right place. I wanted to be sure that she did not see my pain, as it would worry her if I seemed distressed and I did not want her to be worried. The only thing I wanted for myself was to sing her my favorite lullaby as she parted with this life.

When we picked Abbey up from hospital, she was so happy and in such good humor that it became so easy to be happy and in good humor, too. She was clearly not suffering in the way she'd been the day before, but because I knew that her death was inevitable, and that the choice might very well be between ushering her out surrounded by her family and her passing away alone that night back at the animal hospital, her good cheer was something to celebrate. I was so happy that she seemed be loving all the petting she was receiving, just like she'd had when she wasn't feeling sick. It was easy to set the tone to be one of joyful reminiscence as we gathered around Abbey on my bed for that last hour because there was so much to be joyful about. It was a true celebration of life, first as she soaked up the physical affection and then as she napped snuggled up against me. She was so happy. How could I not be happy, when she was so happy? I freely gave her my joy and my ease in her final hour and it cost me nothing to do so because I was in a place of joy and tenderness and deepest affection.

Her death was a beautiful thing. I never thought it could be so beautiful. She was in my arms, so sleepy and content. The initial sedative did nothing more than deepen that sleep. I sang to her as her eyes closed and all consciousness slipped away. She may have been deaf, but I have no doubt that she heard my song. When the second sedative did its work and her heart grew still under my hand, it was simply a deeper sort of stillness. It was so peaceful. I had never imagined such peace, both her peace and my own.

To my astonishment, the peace lasted. I felt awed. I felt rather stunned, too. But I didn't feel grief. No tears came. No tears were needed. What I felt was not grief, but gratitude.

The days passed and still I did not suffer. At first I kept waiting for the other shoe to drop because how could I possibly be okay with the death of Abbey, who I had loved more deeply and purely than any other being, who had helped me through the darkest period of my life, who had been my constant companion and such an enormous source of joy for twelve out of my thirty-five years on the planet? I'd spent years planning for being bereft--why was I not bereft? As it became clear that the other shoe was not going to drop, that this state of wonder was in fact the whole of my reaction to her passing, I began to grow curious about my response. How could it be that one of the most important relationships of my life had come to an end and I was experiencing virtually no sense of loss?

It turns out, all those years of mentally preparing myself for the inevitability of Abbey's death had penetrated my emotional understanding, so I did not have to suffer through more than a few hours of the agony of denial. The role acceptance has played in reducing my distress in this situation cannot be understated.

Acceptance is not easy, especially not in our culture, where we are encouraged to always be wanting more, trying harder, shooting higher, looking for better. However, there are some things, like death, that no wanting or trying can alter. If you've had little practice or training on how to deal with things that cannot be changed, confronting them is very painful. Thankfully, I have received both theoretical and practical training in mastering the art of acceptance.

One of the critical factors that allowed me to bring my mental health under control was Dialectical Behavior Therapy. DBT, a type of cognitive behavioral therapy, is skills-based: rather than simply talking about your issues, you learned methods for changing your thinking to better tolerate distress, manage your emotions, communicate more effectively, and quiet your mind. Acceptance is a fundamental component for DBT--to effectively manage your emotions, you must cease denying or judging or fighting the facts of a situation and work from what simply is. You learn, in DBT, how to separate facts and emotions (you'd be surprised by how often what you think of as the facts are, in actuality, opinions), and while it takes a lot of practice, you can learn how to pare away all the excess and look at the naked truth. To do that, to say, "This is what it is," and to not fight to add back any of the emotions and judgments and opinions, is acceptance. Acceptance, however, does not equal complacency. The dialectical part of DBT is the belief that it is possible for two contradictory ideas or strategies or feelings to exist together in the mind, the primary one being that if you accept something, you can also change it. If you cannot change a situation, DBT teaches you how to change how you feel about it. My preparation for Abbey's death involved acceptance--Abbey will die--and three oft-contradictory beliefs surrounding that central fact: that this is as is should be (all things must die), this is heartbreaking (I love her and will miss her so much), and that I can be okay (in time my grief will lessen). Without DBT, I would have dwelled much more on how painful and unfair it is that I would have to lose her and likely resisted the very idea of getting over my grief because it would seem disloyal to be happy without her.

I responded very well to DBT, so well that in time I'd become so successful at employing the skills that I ran out of issues to bring to my therapist for her assistance--it's been years, in fact, since I've seen her. The methods have become so ingrained that I draw on them without any thought or effort, which is a fantastic example of the principles of cognitive therapy in action: I have, through rigorous training and practice, changed how I think, and by changing how I think, I have actually changed how my brain functions. It's cool stuff, but part of why I'm so good at it is because I've had plenty of opportunities to practice. Between lithium (plus a few other medications) and DBT, my mental health has been rock-solid for years. Prior to 2006 or so, such success would have been unthinkable. So hurray for all that! But what was also unthinkable prior to 2009 was that I would end up fully disabled by chronic migraines. In October of that year, I was in the best physical and mental health of my entire life. I was overflowing with creativity. Despite being free of depression for quite some time, I'd had to put longterm planning on hold because it took three unexpectedly long years of awful withdrawal to get off a mood stabilizer that not only didn't work but was threatening to cause permanent neurological problems. That debacle was behind me at last and I finally could make plans for the future. The possibilities looked amazing. I was so excited. And then, boom, just like that, from one minute to the next, I had to give everything up because my brain could no longer tolerate virtually any kind of exertion or stimuli, be it sensory, cognitive, emotional, or physical. My migraines responded very poorly to treatment, so I was left to face a lifetime of "managing" them. Because almost everything triggered migraines, I had to make a little cocoon for myself with as little stimuli as possible and leave it only when absolutely necessary. And it meant I had to give up. And give up. And give up some more. It sounds bad, to have to abandon not only projects and dreams and aspirations, but smaller things like listening to music, interacting with friends in person, and leaving the house after dark, too. But I can assure you, fighting against the reality of my limitations is far more painful, both physically and emotionally, than letting go, giving up, accepting. There are hard limits on what my brain and body will tolerate. That is the fact I must work with. And so I do. Physically giving things up is not terribly hard, since there are massive and obvious negative repercussions when I overstep. Much of the work of acceptance comes from acknowledging emotionally that things are beyond my reach. Some of it is easy. Some of it took months. Some of it took years. Some of it must be accepted anew on a regular basis. Some things I am still working on. I focus most of my energy on enjoying what I can do, but every day, I have to face the prospect that what my mind and body was able to tolerate the day before will be intolerable today. And so I accept. And accept. And accept.

The loss of one dog, however beloved, looms rather less large when compared to the fact that I've accepted the loss of whoever I might have been and whatever I might have done had my own brain not betrayed me.

Another part of my acceptance stems from the fact that I believe in death. It sounds funny, but we are a culture that is very much anti-death, terrified of it, repulsed by it, seeking always for ways to try to defeat it. I do not agree with this way of thinking. I believe that death is not the antithesis of life, but part of life, and not just part of life, but crucial to life. I think it's important that we die. Thus, I have always believed that not only Abbey would die, but that she should die. As will I, and should I. This is not to say we shouldn't grieve, just that we could spare ourselves so much suffering if we didn't fight our inevitable destiny. Since I believe in death, I can also believe in dying well. One aspect of dying well means favoring quality of life over quantity. For example, I believe it is much more dignifying and humane to make the comfort of a dying patient the most important priority instead subjecting them to unnecessary medications and procedures that will not halt death's inexorable approach. A life made possible only by machines after the brain has slipped forever into silence is not, in my mind, truly a life. Better to live, unambiguously, and die, unambiguously, and to die well. That means something different for each of us, but I had no doubt that a good death for Abbey was one where she felt no anxiety, where she was physically comfortable, where she was surrounded by love, and where I was present. I could not give Abbey more life, but I could give her a good death, so I gave my dear Abbey the best possible death, a wonderful death, beyond everything I ever could have hoped for, and I am still awestruck as I type this, weeks later, by the how beautiful a good death can be.

(For those who are wondering how my acceptance of death and dying factors into my history of suicidal ideation, it doesn't. I still fear suicide because suicide is a form of murder, made more terrifying by the fact that the murderer dwells within myself. It is the act, or at least the willingness to do so, and the mind behind it, that scares me, much more than the death that might follow.)

Being mentally and emotionally prepared for the fact of Abbey's death proved invaluable, but the timing of how it worked out was very much in my favor. I'd always thought I would have wanted more warning, not a lot, but perhaps several weeks of advance notice that her time was near, but in retrospect, the swiftness of Abbey's illness meant she spent much less time suffering and I spent much less time worrying. There might have also been much less certainty about picking the time if I had been trying to gauge "quality of life" instead of "massive systematic failure." It was also not too short. It would have been ghastly if she'd died that first night when we rushed her to the emergency hospital, her body wracked with pain. It would have been awful if she'd died the second night, after she'd been so doped up on pain meds when I'd visited her that evening that I wasn't sure she even knew who I was. And it would have been gut-wrenching if I'd waited too long and she died alone, without me, at the hospital, because I'd hesitated. Any scenario where she might have died alone, without me, is appalling to even contemplate. Six days of thinking she was a little under the weather, five days of her clearly being very sick, and one day of knowing she was dying before I was able to give her the absolutely best passing possible seems like an ideal timetable when considering the alternatives. When you add to that that she was fourteen years old, had been my companion for twelve long years, and that she was in very good health right up until the last illness, I find it hard to protest that I should have gotten more.

Nose nibbles.

I learned a lot about love and loss from Oh Melvin.
To be honest, over the years I have had much more trepidation about the shape my grieving would take than the fact of her dying. I've lost some relatives and friends to death and have said goodbye to previous pets and dog-sitting clients, but never have I had to part with a soul that I loved so deeply and so intimately (and, in a sense, so maternally) as I loved Abbey. How does one bear such a loss? Fortunately, I had blueprints. I follow quite a few individual dogs and dog rescues and dog blogs on the internet. Over the years, dogs I've fallen in love with online have passed away and online I've followed the grief of the people they've left behind. I've watched people be devastated and I've watched people then become okay again and also, perhaps most crucially, watched people continue to love and remember and honor the dogs that have passed on. It was one blog in particular, Oh Melvin, that I thought of and drew upon as Abbey's death approached and then passed. Oh Melvin chronicles the lives of the dogs owned by a woman, T., with a very stylish home, a great sense of humor, and tremendous emotional honesty. Through her blog I fell in love with first Melvin and then Jake, followed the progression of first Melvin and then Jake's terminal cancers, and witnessed T. grieve for first Melvin and then Jake. Just as she loves, T. grieves with her whole heart and wrote about all of it, including being overwhelmed by tears long after each dog passed. And yet, in the midst of her sorrow, she held onto the belief that she must and would continue to choose joy. Melvin had chosen joy every day of his life and to cease to choose joy would be to dishonor his memory. So I watched T. grieve and choose joy (a very DBT outlook!) at the same time and it gave me faith that this would be possible for me, too. And if it was possible that the initial violence of T.'s grief tapered off over time, so, too, I believed, would my grief over Abbey. Not fearing my sorrow so much made it easier to face, and, I think, easier to bypass almost entirely.

In addition to choosing joy, T. embraces the philosophy that, "Love lives on." It has astonished me to the degree that this is true. My love for Abbey has not ceased with her death, which is no surprise, but neither has my sense of her love for me. I'd expected to feel empty, but instead I'm as full with Abbey's warm love as I ever was. Everything that Abbey taught me lives on. Everything that Abbey gave me lives on. I carry so much of Abbey inside me that my sense is not so much that Abbey is gone--she simply isn't here. Every inch of my house is thick with memories of Abbey and rather than this being painful, it means that anywhere my eye lands, Abbey can be conjured. Every memory of her brings me joy. Instead of feeling bereft, I have this ongoing sense of being enveloped by her and buoyed by her. I continue to love my dear brindle dog and that love is warm and fresh and freeing.

Abbey loved her crate.
I do not believe there is an afterlife and I do not believe that Abbey lives on in any other way than in my heart, but I've developed some rituals that have helped me feel like I remain in contact with her. Sometimes I check in with her by touching her crate or her pile of rope bones next to her bed in my study. Sometimes I give the urn containing her ashes a pat or a little squeeze. Sometimes I'll give her ID tag with her name on it a kiss. The most important thing, though, is my nightly chat with her. On the final night when we had to take her back to the hospital because she was too sick to be at home, I was frightened that she was going to die in the night without me there. I had things I needed to tell her before she passed, so I knelt down in front of the door of her crate, my forehead resting on my folded hands, and talked to her, aloud. It helped calm my soul somewhat, so I've continued to do it every night, and is not perhaps as odd as it sounds, since I talked to her all the time when she was alive. I tell her about how my grieving process is going, I mention the memories of her that came up during the day, I recall the ways she helped me over the years, I tell her what I miss about her and how much I'd like to pet her, and generally talk about how things are going. One of the things I've recently been discussing with her is the fact that her crate is rather stinky. Right at the end, she was leaking just a bit of fluid from her anal glands and it doesn't take much to create a strong and lasting odor. It's rather unfair, I feel, to keep her crate stinky, because Abbey was the least odiferous dog that ever lived, but the bedding in her crate is one of the few things I have left that she has touched directly and I am not ready to let that go just yet. But I've also begun to mention that I am no longer needing to talk to her as much as I did at first and may soon not need to talk to her at all. This is a good thing, too, I promise, and it in no way diminishes her standing in my heart.

This is the photo I picture when imaging Abbey as whole, well, and happy.

My nightly chat with Abbey has taken on another important function. After she died, I had several terrible, traumatic nightmares about her where she was horrifically hurt. It was unacceptable. I did not want my love for her to be used against me in ways to express my sadness, fear, stress, or anger about her loss or any other event. I decided I needed to come up with a method of intervention and have taken to repeating every night before bed that Abbey can only appear in my dreams if she is WHOLE, WELL & HAPPY. If she is not WHOLE, WELL & HAPPY, I am to know that I am dreaming and that I can wake up or stop the dream. Thus, if I ever see Abbey, I need to first check that she is WHOLE, WELL & HAPPY. I am extremely pleased to report that this has been a success. I have managed four times to use the WW&H guide to successfully identify that I was having a bad dream and, on three occasions, to stop the dream. On three another occasions, Abbey was WW&H and I was very pleased to see her and she to see me. It was too unfair to have Abbey being misused by my subconscious for metaphorical purposes when she had been whole, well, and happy all her life and had been a constant source of positivity. Establishing that Abbey will be whole, well, and happy in my dreams to come is a valuable pre-sleep ritual.

I've been hugging Humphrey, a stuffed
dog I've had since I was six months
old, when I'm really missing Abbey. 
Something that has also helped me cope with Abbey's passing is the outpouring of support I've received. While few met Abbey in person, she was well-known to many people online, both through her social media account and my own, where I posted many photos and documented her life and its overlap with mine over the course of eight and a half years. I took some 6,000 photographs of Abbey during our time together and because Abbey had such a sweet, expressive face, I think people grew to feel like they knew her. Even if they weren't interested in Abbey for her own sake, anyone who knows me knew what my dog meant to me and how large she loomed in my life. Those people mourned the loss of Abbey for my sake, but many also grieved for Abbey herself. I received so many condolences online, many of them beautifully written, all of them heartfelt. Others sent cards and gifts. People who never once met Abbey in the flesh shed tears when she died. It has been so helpful to be part of a community in mourning! Grief can be very lonely, especially when no one else knows that you've suffered a loss. Because I feel like so many are grieving with me or, at the very least, for me, I've felt free to share my ongoing thoughts and emotions about her loss, as well as to continue to share pictures and celebrate all that was wonderful about my dear dog!

(It's interesting how important a role photography played in my relationship with Abbey--one of the more wrenching aspects of her death for me is the fact that there will be no more photos. My love for Abbey may be infinite, but my ability to photograph her has turned out to be finite, and while I literally have thousands of wonderful photographs to remember her by, it is a point of some pain that I will never be able to add more to that collection.)

This is the it, the final photograph I took of her before her death.

There have been some sad moments--picking up Abbey's ashes was an emotional experience, reliving her death while writing about it has been draining, and I cried the other day for the first time since her death because I needed my dog and my dog wasn't here--but I'm thankful to have been spared the agony of regrets. I kinda wish I had gotten her teeth cleaned sooner so her breath could have been fresh for more than just the last four weeks of her life after years of old age halitosis, but I'd delayed getting that done out of concerns over anesthetizing her, so it wasn't as if I'd made a bad or selfish decision. I wish my health could have allowed me to socialize her more with both dogs and people, but that's just not how life worked out. I am glad that I told my dog-sitting clients this past year that I could only do short gigs because it had begun to stress Abbey to have me sleeping away from home for extended periods. Partly as a result of that request, I didn't do any overnight dog-sitting during the final three months of Abbey's life, so I have no regrets on that score. Abbey and I were always there for each other in the fullest whenever we were together and we were together almost all the time. She cared so deeply for me and demonstrated that daily and I did the same for her. Abbey was so loved and knew it.

Dog of my heart.

Over the course of this month, my overwhelming sense has not been one of grief, but of gratitude. I am so thankful that Abbey came into my life. I am so thankful that we had twelve years together. I am so thankful that she worked so hard to protect me and care for me when we first adopted her. I am so thankful that she gave me hope that I could triumph over suicide. I am so thankful that she gave me the inspiration to be stronger and braver. I am so thankful for how expressive she was. I am so thankful that her fur was so wonderfully soft and thick and not greasy or smelly. I am so thankful that she loved to be petted. I am thankful that she was brindle. I am very thankful for her tail, which was the best tail ever. I am so thankful that concerns about her possible breed mix led me to the wonderful world of pit bull activism. I am so thankful that she taught me so much about dogs, especially shy and anxious ones. I am thankful that she decided to take up swimming in midlife. I am thankful that she decided, in her old age, that visitors were actually okay and that it was exciting when company came over! I am very thankful that she was such a playful dog. I am thankful that she wasn't much of a barker, but when she did bark, it was a very deep bark, the bark of a dog half again her size. I am thankful for the many ways that she kept in touch with me throughout the day. I am so thankful for her joyful yodel. I am so thankful for the way she lined up with me, always ready to go where I was going. I am thankful that she never got arthritis. I am thankful that her sickness was short. I am thankful that we had enough time--not too little and not too much. I am thankful that I chose to have her passing take place on my bed. I am thankful that her death was so peaceful. But what I return to, again and again, when I chat with her before bed, is how thankful I am that she made me feel safe, that she helped me get strong, that she loved me with every fiber of her being, and that I know that I can carry on that love, that strength, that safety even though she may be gone.

I can think of no greater gift.

I miss her. Of course I miss her. But I do not mourn. It is not for lack of love, but because of love, a love that has not diminished, that death cannot diminish. It is not, one might say, for lack of suffering, but because I have already suffered so much that I have learned to accept what cannot be changed and to find gratitude in what remains. It is for lack of fear, because I taught myself not to fear her death and not to fear my grief, and for a lack of regrets, because I have none. What I do is celebrate, celebrate the life of my tenderhearted, sensitive, intelligent, playful, soulful, easygoing, engaging, communicative, brown-eyed, brindle-coated, velvet-furred, funnily-proportioned companion of so many years who enriched my life and changed me forever for the better and whose love lives on.

In memory of my beloved Abbey

Abbey's Last Days

In a recent post celebrating the twelfth anniversary of Abbey's adoption, I wrote,
The vet, when he did Abbey's most recent exam, said, as he's had in the past, that she's in great shape for her age and he never would have guessed at a glance that she's fourteen. He made me extremely happy by saying that as long as we kept on top of her care, it is quite possible that she could live to be as old as seventeen or eighteen. Having cared for a number of geriatric dogs in recent years, I can attest that she is doing well. I know cancers can arise at any time and act swiftly, but despite UTIs and a couple of little rotten teeth and medication-induced seizures that have had to be dealt with this year, she's still my vibrant Abbey, always at my side, eyes alight.
 Little did I know that the ending had already begun.

Abbey passed away at 4:30 in the afternoon on October 21, 2016, little more than a week after her adoption anniversary on October 12th.

*     *     *

The following is a detailed account of Abbey's final illness. It is written as much for me as it is for anyone else, as I want to preserve these facts without necessarily having to keep them in my mind. For those who do not want to know all the details of the six days that passed between when she first got seriously sick and when she exhaled her final breath, I've written a second post about my remarkable emotional journey since Abbey's passing that can be found here.

*     *     *

Abbey may have thrown up before dawn, but she seemed perfectly fine later!

Abbey had woken me at 5:00 a.m. on the 12th by vomiting up some of her partially digested dinner from the night before. This was not wholly unusual--Abbey's always had a sensitive tummy and sometimes she vomits in the night after excitement or stress the day before. We had gone to the vet on the 11th for a followup to her dental work and while the vet had been very impressed by how great everything looked, Abbey was rather less pleased to be back at the vet's and it was plausible that it had triggered her upset stomach. The only thing that was at all out of the ordinary was that she hadn't eaten all of her dinner at once the night before, though she'd licked her bowl clean by bedtime. I gave her rice for dinner Tuesday night just to be sure and everything was fine. Wednesday she didn't eat all of her dinner at once again, so I picked it up, not wanting to repeat the whole 5:00 a.m. upchuck thing if possible. Not much later, she had another partial seizure that temporarily disabled one of her back legs and then she vomited after it was over. I was bummed, since it meant that the seizures in August had probably not been caused by the flea meds and made a note of this to tell the vet. Thursday and Friday, she didn't eat all of her dinner at dinnertime, so I put her bowl up and fed her the leftovers for breakfast. She devoured it all hungrily and without any negative consequences. I was watching all this closely, wondering why her appetite was shifting, and planned on making an appointment to see the vet on Monday. Saturday, after putting her half-eaten bowl of dinner up on the counter, she made such a convincing display of being hungry again a short time later that I put it back down and she ate it right up. She dry-heaved that night, though didn't bring anything up. I didn't sleep very well, listening for any sounds of imminent vomiting. I gave her rice for breakfast, which she consumed hungrily. I then gave her rice again for dinner.

Her appetite was off, but in all other ways, Abbey seems like her regular self.

That was on October 16th, 6:00 p.m. She ate her dinner eagerly enough, but immediately afterward urgently requested to go outside, where she had some diarrhea. She didn't want to go back inside right away and tried a couple more times to have a bowel movement, though nothing happened. Then she started vomiting. She vomited up all of her dinner and continued to vomit after was nothing to bring up. Finally, she wanted to go back inside, and while her tail was up in an alarming way that suggested that diarrhea might still be on the immediate horizon, I let her back into the house, keeping her on the kitchen floor, though, and put down a towel and spread newspaper behind her just in case. She was hunched and miserable and not wanting to move. Then she started having waves of intestinal cramping so massive that I could actually see them squeezing her sides and belly as they rolled through. Eventually, she decided to lay down. The cramps continued, wracking her whole body. She was in terrible pain. By 7:00, we knew that she needed to be taken to the emergency vet.

As we waited for her to be admitted, Abbey tried pacing and hiding behind the furniture and laying down to get away from her pain, but there was no escaping the horrible spasms, each one causing her to extend her neck and hind legs in agony as they gripped her gut. As someone who has had plenty of experience with GI pain, I could understand all too well the misery she was in! I'm thankful that the torrential bloody diarrhea didn't start until after they'd taken Abbey back to X-ray her abdomen. It had been hard enough to watch her suffer the pain; witnessing blood being wrung out of her intestines would have been unbearable.

Abbey was admitted, of course. The X-ray ruled out bloat or blockages, but a brief glance at her insides with the ultrasound wand had revealed fluid in her abdomen, the cause unknown. More tests would be run overnight to figure out what was causing her severe GI distress and the fluid accumulation. She'd also be receiving pain meds and medication to stop the nausea and diarrhea. When we went to say goodnight to her, Abbey's hindquarters had already been bathed free of the bloody diarrhea. It was some comfort to know that she was in good hands. It was late when we returned home. I went to bed, trying not to let my fears get too far ahead of me.

We were relieved to learn that she had stabilized in the night and that medications were controlling her pain, vomiting, and diarrhea. A more rigorous ultrasound had revealed an intestinal tract so inflamed that it was impossible for the doctors to make out any details and the rest of her abdomen and the organs therein were also experiencing some inflammation. The fluid in her abdomen was clear, which was a good sign, but the most worrisome thing was the low blood protein level revealed in her blood work. In short, it meant that she had not been absorbing sufficient nutrition through her intestines and this resulted in imbalances that were was causing fluid to seep out of her blood vessel and into her body, which was where the fluid in her abdomen was coming from. At that point, the internal medicine veterinarian said it was too soon to rule out an acute issue, like eating something that violently disagreed with her (unlikely) or a reaction to the antibiotic she'd just finished to clear out dental infections (plausible), or something chronic, like inflammatory bowel disease. The only way to know for sure, the vet said, was to have her anesthetized to do an endoscopic bowel biopsy. The vet had difficultly justifying why we should do this, since the treatment approach would be the same as what we were already doing. We were highly reluctant to pay $1,800 to risk sedating our sick dog just so we could learn exactly what dose of steroids would be most effective. Start the steroids, we said, and give it a few days and see if Abbey would start to improve.

A very out-of-it but pain-free Abbey.

When I visited her on Monday evening, Abbey was so out of it from the fentanyl they were giving her for pain that I honestly don't think she knew who I was. When she looked at me, there was no change in her focus, no sign of recognition. She briefly rested her chin on my knee, but she spent far more time staring blankly at the sides of her pen. It was hard to see her so woozy, but it was preferable to the horrendous pain she'd been in the night before!

Once removed from the fentanyl, Abbey again recognized me and can be seen wrapping her paw around my shoe as I sit with her in her hospital pen, tempting snacks at the ready.

The next thing the doctors wanted was for Abbey to eat. I was glad to hear that they'd stopped the fentanyl, since there was no way Abbey was going to eat while that out of it. We'd delivered some of Abbey's kibble and a few of her favorite Rice Chex and oyster crackers in hopes of tempting her appetite, but on Tuesday during the day she wouldn't eat for the hospital staff. I was not surprised, but convinced I could do better. Abbey was much more alert and happy to see me because she wasn't drugged to the gills and while she didn't eat a lot, I got her to eat some Rice Chex, oyster crackers, and special bland baby-food-like dog food. What she REALLY wanted were the peanut butter pretzels I'd brought for myself. I let her have some of those, too, but not too many, since I didn't think peanut butter was likely ideal for a dog with a horribly inflamed GI tract.

Abbey at the veterinary hospital.

Since Abbey had eaten better for me and could control her bladder and bowels and wasn't having bloody diarrhea and was no longer in terrible pain, we requested that Abbey be discharged into our care, figuring she'd be better off at home in her own bed and own environment with her own girl taking care of her. The vet was willing to try it, since she was stable (though her blood protein level was still very low and had in fact dropped slightly lower during the time when she was in the hospital), making us promise to bring her back if she still wasn't eating after a few days. We were very ready to have her home, enthusiastic about taking over her care--after all, I'd spent weeks hand-feeding her and giving her water through a syringe last summer when her mouth and tongue were too weak for her to properly eat or drink because of her disastrous response to being given acepromazine after getting her ears cleaned. Also, seeing as it was costing $1,000 per day to have her treated at the hospital, we didn't want to keep her there any longer than was absolutely necessary. So we stocked up on chicken baby food and cream of rice cereal, one of the techs taught me how to give Abbey her steroid injections, and we brought her home on Wednesday evening.

Once she was at home and not confined to her hospital pen with her IV, Abbey looked much sicker. Her back legs were so weak she could hardly support herself and she swayed and wobbled terribly when she walked. She drank water and ate a bit of the proffered mix of chicken baby food with rice cereal, but she didn't want to eat a marshmallow. Abbey will ordinarily do ANYTHING for a marshmallow and it's how we give her pills--you stick 'em in, toss the marshmallow to her, and down it all goes. I quickly found that trying to get a dog who doesn't want to swallow any sort of food to take pills is really awful, especially if there are seven different medications and some of them are so big that they have to be broken down into multiple pieces. I finally managed by coating the pills in a bit of peanut butter, sticking them as far down Abbey's throat as possible, clamping her jaws shut, and then squirting water into her mouth with a puppy-feeding syringe, forcing her to swallow. By the time she'd taken all of her medications, both Abbey and I were exhausted!

Abbey at home.

I'd arranged for Abbey to see her regular vet the next morning. I trust him completely. The animal hospital provided excellent care, but they never met a test or procedure they didn't want to undertake--and then bill you for. The internal medicine vet had been so vague about the necessity of the various things she had suggested and everything she said was said with rising inflection, making it hard to get a read on what was actually necessary and what was her trying placate us for some reason and what was being suggested to in order to pad the bill, etc. Also, he has roughly twenty more years of practical experience. I knew the regular vet would give me straight talk. And he did. He looked at Abbey's test results and said, "You only see these values in a dog with a chronic condition and there are really only two possible diagnoses for this set of numbers: cancer or inflammatory bowel disease." The reason to get the endoscopic bowel biopsy (which he recommended as the next step), he explained, was so we knew which we were dealing with. Inflammatory bowel disease could be managed with the medications she was already on, but if she had cancer, there was nothing more for her that could be done except make her comfortable. (The hospital vet had said, "I don't think she has cancer?" and didn't mention it again, though it hadn't been ruled out by any of the tests or scans.) In ten minutes, he managed to explain everything more clearly than the internal medicine vet had over the course of three days. He also cut the medications for Abbey to be taking by half, eliminating redundancies, gave her an anti-nausea injection that would take up any of the rest of the slack from the eliminated medication, gave me some cans of special intestinal protection food for once she started eating again, and a bunch of different size syringes to help feed her. (He also mentioned he'd had a lot of communication issues with the internal medicine vet and said to feel free to consult with him if Abbey had to be hospitalized again and we were confused about our options.) Abbey, who'd spent the last few days being handled by a wide variety of strangers, was the most at ease with the vet she's ever been, sniffing him all over and asking for petting as he and I sat on the floor discussing her care. I left feeling much encouraged, despite the fact that he'd just told me my dog might have terminal cancer.

Abbey ate and drank a bit when she got home, and after I'd taken care of a few tasks, the two of us settled in on my bed, where she took a long, hard nap snuggled up against me. I was glad to have her home, seeing her sleeping there in her usual place, and felt good about what we were doing. A couple hours of hours later, I noticed she was shivering in her sleep. Then she got up and changed her position multiple times before finally coming over and pressed her head against me, making me wonder if she needed to go out. And she did. She held it until she got to her regular bathroom area, but once there, she had diarrhea. I'd been expecting dribbles. This was like the spray jet from a hose. It was pure liquid. Whether or not there was blood in it, I couldn't tell, but it was shocking enough as it was and definitely not the product of a well dog. She settled in okay once she was back inside, but she only ate just a little bit of peanut butter. Whatever you offered, she'd politely turn her head away. She stopped drinking her water, too. She'd approach her bowl, put her muzzle down to drink, then decide against it. I didn't realize how worried I was until my mother called in the late afternoon to see how Abbey was doing and I burst into tears. That's when I knew what my subconscious had been slowly piecing together: Abbey was dying.

So I cried on the phone and so did my mom and then she got home and we both cried some more and we decided if Abbey still wasn't eating by the end of the weekend, we would know that it was time. At this point, she was refusing all food and water and it didn't look good. I couldn't believe my dog, my dearly beloved Abbey, was dying, and yet I could believe it. And just weeks after the vet had said that she might make it another three or four years! It was a punch in the gut. It was a stab in the heart. I'd always thought I'd have more warning. I wanted more warning, more time to get used to the idea. I felt dazed, bereft, agonized. I tried to collect myself, though. My sister was coming over for her birthday dinner in a couple of hours. Abbey and I went upstairs to my study, where we spent so many of our days together, while I tried to distract and collect myself. Abbey, I noticed, didn't settle on her pillow like she normally did. Instead, she stood in a place where she could see out of the study door, her weak back end listed to the side. It eventually dawned on me what she wanted, so I moved her pillow to that spot and she immediately lay down where she could watch family members going up and down the stairs, though it wasn't long before she fell asleep.

It was right around the time that my sister and her husband arrived that Abbey woke up and started vomiting. When she wasn't vomiting, she was retching and coughing and sometimes dry-heaving. When dinner was ready, I brought Abbey's pillow down next to my chair, but the first thing she did was throw up without any warning. Before long, she decided that she wanted to be upstairs and she threw up on the stairs themselves. I spent the rest of the evening sitting on the floor next to her bed, reading and holding a bucket under her muzzle. In the past, when Abbey was going to throw up, it would be preceded by a certain amount of noisy heaving, but this time when she vomited it just burped out of her without warning. As I sat with her, I came to understand that she needed to go back to the hospital. There was no way I was going to be able to give her her evening medications and it looked like that without IV medical intervention, she might vomit and gag all night. She was sick beyond my capacity to care for her. This was likely to be her last night on earth.

We took her back to the hospital and she threw up twice more as we waited for her to be admitted and had an accident for good measure. We explained to the hospital that we just wanted her stabilized and made comfortable, that we didn't want more tests, that we weren't looking for her to be cured. She wagged her tail when we said goodbye to her. It was late when we got home. It was later yet before I felt settled enough to go to bed and before I did, I kneeled before her open crate door and said all the things I was terrified I might not get to say to her if she died in the night. The thought of her dying in the night, at the hospital, with me not by her side, was agonizing. I was awake a long time in the early hours, too, and I tried to read to keep being overwhelmed by my grief. I was still reading when the hospital called to give the first morning report: she had made it through the night and rested comfortably. I slept then, finally.

I woke up at 12:30 to face some hard decisions. While I'd slept that morning, my mother had done the hard work of calling our vet to see if they recommended an at-home euthanasia service. That service had an appointment available at 3:30, just three hours away. I did not feel ready to put down my dog in three hours. Would it be better to wait one more day? What if that was too late? I knew it should be done that day, but so soon? While I felt so exhausted? We spoke to the hospital again and while Abbey was still resting comfortably, they said that her protein level remained so low that fluid was going to start filling her lungs. There was absolutely no doubt that her body was failing and fast. That helped me make my decision. I had a list of things I wanted to accomplish to prepare for the final goodbye and two and a half hours (it was now 1:00) still seemed awfully tight. My mom called the home euthanasia service if they could do something just a little later and we got confirmation that they could come at 4:00. We called for my dad to come home and let my sister know the time and I got to work.

First and foremost, if we were going to having Abbey put down in our home that day, I needed to have all signs of our hopes for her recovery removed. That meant all of her medicine and the papers from the hospital and the jars of baby food and every bit of paraphernalia that went with our brief effort to help heal her at home. There was to be no healing. I needed those things out of sight. Even now, the thought of those vain hopes makes my throat tight.

Secondly, I'd decided that Abbey should pass in my bedroom, where she'd spent so many hours sleeping blissfully on my bed, and I wanted it took look nice. I cleaned it, moving haphazard piles of books to another room, and cleared miscellaneous items from the top of my dresser and stowed them in my closet. I dusted all the surfaces. I remade my bed so that it was tight and crisp and smooth. I was sweaty from my exertions, so I took a shower. During the shower, I cried one last time, a few sobs and a silent, gagging, agonizing scream that bent me double with its grief. Once showered, I selected my outfit with care. I wanted to look nicer than my average sweatpants and sweatshirt, but not TOO dressed up, because then Abbey would be wondering if I was going somewhere or if company was coming over. Like every dog, she was alert to all the nuances of everything I did and their potential meanings. I wanted her to feel like I was my normal self.

Abbey was so happy to see everyone and be surrounded by her family!

By then it was two. My dad and I went to the hospital to pick Abbey up. It took forever, both of us waiting tensely. It was almost three when finally the nurse brought Abbey out. My dad had been prepared to carry her to the car, but Abbey was alert and seemed comfortable on her feet. I rode in the backseat with her and Abbey couldn't stop licking my face and my hands. She seemed truly happy. We arrived home just as my sister pulled up. Abbey was utterly delighted to see her--the whole family was together! With light in her eyes and pep in her step, Abbey even cruised the kitchen to see if any crumbs had fallen. I wanted a few last photos of and with Abbey. Abbey was overjoyed to have me down on the floor and a great deal more enthusiastic licking ensued. She even nibbled my nose, which was my very favorite of her affectionate gestures. My sister got down on the floor to be in photos, too, and Abbey could barely contain her delight. That task taken care of, my dad carried Abbey upstairs and put her on my bed.

Me and my dog. She's gazing into my eyes as she gives me a kiss.

Abbey and I had some time alone for a few minutes, so I petted her and sang some of the songs I'd made up for her over the years. My mom joined me and petted her, too. Soon my sister was on my bed as well. Abbey was loving it. In the days prior, I hadn't been sure Abbey had really enjoyed being petted because she wasn't feeling well, but she was clearly enjoying this epic rubdown session.

After about half an hour, she got tired. Abbey had been laying between my legs, facing the door, but she got up, gave me another lick on the nose, and then settled herself against my right side, her head facing toward the pillow, one leg draped over my legs, as was so often her habit. She snuggled her belly up against me and fell asleep, using one of my arms as a pillow. As she napped, the four of us started telling stories about Abbey and all of the things we loved that she did. It was a joyful half an hour, one spent in smiles and laughter, not tears.

Abbey positioned herself for a nap beside me, a leg slung over mine. It was one of her ways of being connected to me.

At the appointed hour, the vet and her assistant arrived. They were wonderful, bringing calm, gentle energy with them, though they themselves remarked on the lovely atmosphere we'd built around Abbey during that final hour. We could tell just from how they moved and spoke that they were the right people for the job. Abbey, catching their scent, woke up briefly, but after being handled by so many people in scrubs in recent days, the presence of two more vets in my bedroom didn't seem to surprise her any. She settled back into a doze as they explained the process and asked a few necessary questions. And then it was time. Everyone else was crying, but I was not. I didn't need to. I was where I was supposed to be. They gave Abbey the sedative in a quick injection in the loose skin at the back of her neck. I wiggled down so that Abbey's nose was just inches from my own and sang her my favorite lullaby as her eyes closed and she sank into a deep sleep. I whispered a few more words of love. The vets carefully rolled Abbey over so they had access her legs. They had some difficulty getting a vein in her hind leg ("Is her blood protein low?" they asked), but Abbey had no awareness of any of this. I had my arms wrapped around her, one hand over her heart. It was her breath that stopped first--her exhalations ceased to puff against my cheek. I felt her heart slow, and then go quiet.

It was 4:30 p.m., October 21, 2016.

She was gone. My Abbey was gone.

She looked so serene, so sweet, so utterly at rest. My dear dog, my brindle baby. I held her for a while longer as the vets put their things away and carried their equipment out. At length, I sat up and gave my family members a chance to say goodbye. The vets pressed one of Abbey's front paws into a bit of modeling clay for a paw print to remember her by. Then, the head vet came in with a carrier. Calmly, gently, she moved Abbey on to it. She admired Abbey's soft brindle fur and speculated that Abbey might have had a bit of border collie in her. (According to the DNA test we did, Abbey was 25% border collie!) Every move she made was done with quietness, competence, and reverence. It made it easier to let Abbey go, seeing her handled in such a way. We all walked down the stairs together. In the open doorway, I had to stop the vet so I could give Abbey one last kiss on her velvety forehead. And then she was borne away, half-wrapped in the green carrier, her dear little face resting on the crook of the vet's arm, my last view of my beloved dog in her corporeal form.

Abbey's paw print.

My father closed the door and I drew one deep, shuddering breath, exhaling sharply. My whole family wrapped their arms around me and one another.

We all sat together for some time afterward, talking about the beauty of the thing that we'd just seen, how much we loved Abbey, how glad we were that she had passed in such a peaceful way. I was feeling slightly stunned, but okay. My primary feelings were of gratitude, amazement, but most of all, peace. And thus, one journey with Abbey ended and a new one began.

Bed is too small for my tiredness
Give me a hill topped with trees
Tuck a cloud up under my chin
Lord, blow that moon out, please

Rock me to sleep in a cradle of dreams
Sing me a lullaby of leaves
Tuck a cloud up under my chin
Lord, blow that moon out, please

For Abbey, dog of my heart