Aug 28, 2008

Sophie's Last Days

Sophie is a big friendly dog. A German Shepherd - Doberman mix, her tail was removed when she was a young pup, but she grew up to be mostly Shepherd, so she sort of resembled a small German Shepherd bear with a great black and brown mane. She'd been a great friend to us during our time in Kodaikanal, and she's been a valiant protector of both the family and the house. She's now over 9 years old, and just a few months ago, was still wrestling other dogs to the ground, and scaring off whole packs of potential adversaries to protect us and our baby. Once she got to know us, Sophie would often sleep on the cold cement outside the front door, because that was where we'd last been the day before. She would loyally wait until we arrived the next morning, at which point she'd beg us for a walk by pointing to her leash. To her, the leash was freedom.

(Rani holding Liam, John, and Sophie)

Starting about 3 months ago, she began to loose weight. She ate less and less, and became skinny and lost most of her energy. In the last year she'd had 3 rather large mammary tumors removed from her underbelly. After both surgeries the tumors came back. The vet, a Mr. Thankaraj who works in both Dindigul and Kodaikanal, is a nice man when he deals with humans, but his demeanor towards his patiences leaves much to be desired. A sloppy procedure, utter lack of bed-side manor, a general bossiness, and an obvious desire to avoid touching his patients as much as possible gave me the feeling that net time Sophie needed an operation, I'd learn what I needed, collect the supplies myself, and would actually do a more careful job than Mr. Thankaraj, who's loose stitches and poor sterile technique is maddening to watch when he opperates on someone you love. When we took her on walks, she would now slow us down, instead of the reverse.


(Sophie Tim and Liam enjoying the view from Cloudlands Peak)

Sophie was clearly nearing the end, just as our friend were arriving from the states for a vacation in Kerala, on which we were to join them. She could no longer manage the hikes, or long walks that we used to take her on, and even short walks had become difficult. We started having her sleep inside, where we made a little bed so she could sleep next to the fire to avoid the cold nights. We wondered if we should put her down before we left, in fear of causing her a painful last few days. Her eating had almost stopped entirely, and we'd seen blood in her urine. We assumed that her cancer hade spread (likely by a sloppy tumor excision) all around her abdomen, if not everywhere. I gave her a Darvon pill that I had been prescribed for severe gastrointestinal pain that I get infrequently from an old injury and subseqent surgery. She perked right up. It was good to see her on her feet again, even jogging around the grounds of Shelton. In the end we left her at Shelton with Rani and John, and went for vacation.

When we returned, Sophie had only further deteriorated. Now she didn't have the energy to get up, and spent most of her time lying as close as she could to where her people were. Once she managed to leave the compound when we'd gone out. Not noticing, we locked the gate. That night was the first real day of the Monsoon, and it poured rain for hours. The next morning we left for a walk, wishing Sophie had the energy, but knowing that she could never make it. When we got to the gate, there she lay, just outside. She'd been locked out all night, and like a loyal follower she'd stayed by the gate in the pouring rain all night instead of finding some shelter. The poor dog was freezing, but, bless her, she was happy to see us, and expressed it with all of the energy she had left. We immediately brought her inside, and started a fire, but she would hardly eat or drink. We knew it was time. We consulted with our friends, Kate and Ed, about it. Ed asked if the pills that I had would be an appropriate way to put a dog to sleep. Wikipedia told us that, indeed, Propoxyphene is the number one choice for people seeking a peaceful way to exit life. That gave us some sort of small, sad, hope for Sophie. It was Monday, and we gave her another pill, but getting them down her throat, even with two people and the pill encased in a ball of butter, was quite tricky.

Later that day we called Dr. Thankaraj, because Sophie had vomit that matched her stool, and we were afraid that her pain must be extreme. Being a stoic, courageous dog, though, she showed few signs of uncomfort and still chose places to lie down where she could survey the property, lest she need defend it, or her people. Monday night we heard something, and Sophie had moved to the door, but couldn't get up when we opened it. The next morning we saw that she'd needed to pee. There was blood in her urine, and she's slept in it. Tuesday came and went, and Katie and Liam gave Sophie a last bath. Usually we'd have to tie Sophie to a stake to get her to tolerate a bath, but this was warm water, and she didn't object the way she usually did, she just relaxed. We dried her off inside in front of another fire.


(Katie and Liam give Sophie her last bath)

Wednesday morning Dr. Thankaraj arrived on his motorcycle. We called Alice, who'd taken care of Sophie for most of her life, and Rani and John, and Katie and I all sat around Sophie as she lay on the driveway that morning. She was exhausted, but she made a heroic effort, and held her head up, on the look out to the last. Thankaraj first wanted us to bring a table for him to opperate on. We said no, Sophie can lie right here. She needs no more pain. He cut the hair off her leg, and filled a large syringe with a clear liquid. She stirred briefly, and kept breathing. We petted her lovely mane. Her fur was just as rich and beautiful as it always. Thankaraj touched her eye to test for reflexes, and she flinched. He told us to move away. We said no. Sophie deserves to be loved in these last minutes. He then injected more into her rear leg, and old us to take our hands off of her. We said no, Sophie had been faithful to us and others her whole life, at least we should stay by her side at the very end. He aske us to flip Sophie over to inject yet another leg, because it seemed to be taking more than usual. He injected a third dose, and Sophie stirred, raised her head, and looked around. She was clearly disturbed. We waited. She stopped breathing, and soon her eyes no longer flinched, and soon they glazed over in a light white. We sobbed, and bid her the best of possible afterlives, and peace, and no more pain.

John and I carried Sophie up the hill behind the house on a towel to a hole that John had dug the day before. We made sure that Liam was there because we figured that even if he didn't understand what had happened to his favorite "Bobow" he should at least watch her being burried, and would that way understand where Sophie went. We layed her down, and arranged her head so that it would be comfortable, in case she might still feel anything. John grabbed some leafy bush branches and laid them gently on her. We all did the same. Then I carefully laid the first shovel full of dirt on the branches. John and I shoveled dirt carefully, covering her head last. I wanted her to turn, to bark or squirm, so that we could take her out and she could run again. We covered her head, then the two of us worked furiously to fill the grave. We piled rocks and sticks on top so that her grave would stay unmolested.

Finally, Sophie had gone. Our loyal, valiant, stoic. Sophie.

Katie was kind enough to deal with Thankaraj, and pay him. As he left I asked him what he'd used to put her to sleep. You really want to know? he asked. I assured him that I did. Magnesium sulfate, he said. Okay, thanks. I waved him out the gate. That night I searched the web for magnesium sulfate and euthenasia. It would be fine, of course. Then I saw this:
Other injectable agents
Magnesium sulfate, potassium chloride, chloral hydrate, strychnine, nicotine, and curariforms are not acceptable as they are not considered humane when used alone (Lumb, 1974; AVMA, 1993).
and this:
Magnesium sulphate
Magnesium sulfate has three actions; neuromuscular blockade, cardiac irregularities and anaesthesia. Depending on the route of administration it is suspected that cardiac arrect and neuromuscular blockate can precede anaesthesia (Lumb and Jones 1996). It is not recommended as a euthenasia agent.
and this:
Magnesium sulphate does not depress the central nervous system and causes death by asphyxia resulting from complete neuromuscular block. Use of these drugs separately is not acceptable.
And I was crippled. Knowing what I'd known about Thankaraj's work, I should have asked him. I should have done it myself. I happened to have the medicine most favored by right to die societies, and I let HIM come. He made her last few moments ones of panic, instead of the peace she deserved.

Dear Sophie, I'm sorry that I didn't like it when you liked my face, or my baby. I'm sorry that I would step on you when you got underfoot on those walks where you would wander across our paths incessently. I'm sorry for every time that we left the gate, and had to leave you behind. And, dear Sophie, I'm sorry that your last few moments with us were of pain and panic, it is not what we meant. We love you, Sophie, and we always will.