Monday, May 16, 2011

Saying Goodbye To Tanti


Two weeks ago, I again said goodbye to a dear animal companion.  This time, almost exactly a year after Sparky, it was my cat Tanti.  This time it was not the peaceful, idyllic experience that I had with Sparky’s death.  It was difficult.  I was second-guessing myself and on the verge of seeking euthanasia for Tanti daily.  She did die a natural death, but it was not comfortable for me, though I do not believe that she suffered.  Unlike Sparky, she just did not seem to be ready to go.

I think one thing that I have learned this time is that each death is an individual experience as unique and individual as those involved.  I do not think that any two people or animals live this life in exactly the same way, nor do they exit it in the exact same fashion.  Each death is, itself, a direct expression of the unique life that was lived.

Tanti was an annoying, ferociously loving cat that was always in my face  Whatever she made her mind up to do, she would not give up, no matter how many times I tried to deter her or distract her.  It did not matter if it was getting on the counter to drink water from the sink or kneading her claws on my back.  If she wanted it, she was going to do it with an unequal zeal and joy, and she persisted until she got what she wanted, every time.

It was no different in her dying.  Unlike her sister Mesa, she had not settled gracefully into old age.  She was as spunky as she had always been.  One day, seemingly overnight, she began to lose weight and became disinterested in eating and playing.  She started coughing and soon after went into a serious decline. After a week, I thought she was dying and decided that I should shift my philosophy of care from a cure to comfort care for her.  I tried to do everything I could do to make her comfortable and pain free, but it was very hard to watch her have a progressively difficult time breathing.  She never complained, she took it in stride, but she was clearly increasingly exhausted by her laborious efforts to get air into her lungs. 

It took, though, about ten days of this before she seemed to give up the idea, herself, that she was going to live on through this and persevere.  Eventually, instead of fighting it, I sensed her resignation as well, and it was a relief for me.  Death suddenly became the objective, the reward for both of us as a team and we could accomplish that in her time and with as much comfort and closure as possible.  As a veterinarian, I thought that she could not continue to live given the damage to her lungs, but as her owner that was difficult for me to accept.  One of the biggest difficulties was my panic that she did not understand how sick she was and that she was trying to continue to live despite how unrealistic I thought this had become.

It took Tanti about two days before she actually passed from this life.  She had been lying on the floor for a day, near the edge of my bed without moving around very much.   I spent much of the day lying beside her on the floor.  Suddenly, she struggled to get up and seemed to be trying to get in my lap.  It almost broke my heart because if I tried to pick her up her breathing would become much worse and she seemed to be entering the active immediate process of dying.  I would lay her back down, and only when I did let her struggle to breathe her last in my lap did she actually die.  I felt so conflicted, and did not know if the act of picking her up killed her, or if she was waiting to die to get in my lap!  I will never know except that I know that against my own comfort, I did what she was asking me to do ultimately.

In retrospect, her actual death was not nearly as difficult for me as the days leading up to it.  I felt I was suffering and at cross-purposes to her wishes to continue living, and I was giving her terminal, palliative care.  This was completely the opposite of the experience with Sparky, whose slow, gentle progression to death was easy and without conflict.  I have learned that my inability to remain peaceful through Tanti's death was a reflection of her tenacity and deep bond we shared.  There was not much peaceful about Tanti in life, and I guess I know now that her death reflected her life.  It was very difficult for both of us to let go and accept that our long integral journey together was ending.  It also was difficult because she was suddenly ill.  She seemed vibrant and healthy one day and weak and sick the next.  Once she died, I was able to examine her mouth and throat and saw a large tumor way back in the back of her throat with small nodules all over the very farthest part of her tongue that I could see.  This tumor must have quickly strapped her strength and weakened her immune system.  The virus and bacterial infections she had were only secondary. 

I buried Tanti next to Sparky in my backyard.  My house seems very empty, and yet, despite the difficulty of this experience, for me I am still glad that I was able to maintain hospice care for Tanti.  I am glad she died at home.  I can, though, never judge for anyone else when euthanasia is a gift they choose to give their pet.  Not all of us can spend the time at home, as long as it takes.  We have to be able to afford the luxury of both time and resources to offer the appropriate hospice experience.  We have to have support from our friends and family, and have understanding professionals to aid us in this journey.  I hope that with time, hospice care for pets will become a reality that is available to those who can offer it.  The availability does not always make this an ideal and peaceful process, though the result is usually gratitude and a much greater understanding and appreciation of life from our experiences with death.

Thursday, March 31, 2011

Saying Goodbye To Sparky: One Year Later

One year ago I said my final goodbyes to my dear twenty-three year old cat Sparky; or so I thought. I sat next to him and offered him comfort care as he approached the end of his life. I was fortunate enough to take care of him at home and give him Hospice care until he chose when to make his transition from this world we shared for so many years.  I was able to keep him comfortable and he seemed happy and peaceful right up to the very demonstrative way he made his exit.  (He demanded to go outside for the first time in ten years and died peacefully a few moments later on his blanket in the sunshine.)

Contrary to what you may think, Sparky's and my hospice experience was one of the most joyful times in my life. That was a very positive surprise. I was blessed to be able to set aside a few weeks of my life to be with him and tell him how much I loved him, tend to his every need and help him as his focus shifted away from this life. Experiencing hospice with Sparky taught me more than I could have imagined about my life, not just death. Instead of wrestling now with my grief and guilt, as I have for all the other pets I have loved that have died, I am instead, at peace. I am more comfortable with my life and the certainty of my own death. I even enjoy each day more.

How are all these positive benefits possible from an experience I dreaded and expected to be gut-wrenching and traumatic? My dear friend Dr. Ella Bittel teaches a course entitled Spirits In Transition (http://www.spiritsintransition.org/) that I took a mere six months before Sparky died. She taught me about the dying process itself: breaking it into stages just as we know from human hospice. We are most afraid of what we do not understand. By learning more about death I was freed from my overwhelming fear of the unknown. As a Veterinarian, I have seen death as the ultimate failure. I have advocated for Hospice, practiced it, as well as helped my animal clients make life and death decisions about their beloved pets, and I have euthanized thousands of animals.  Hospice does preclude euthanasia, but does not assume it is always the best option.  I have learned that Animal Hospice can teach us to accept death as part of life, not dread this process, and say goodbye to our dearest animal companions a different way.  We can allow them a comfortable, natural death.

I have come to cherish this time I had with Sparky, and it has truly rewritten my life.  Instead of saying a final goodbye to Sparky, his death has become a part of my life.  His lesson has left me daily with a new gratitude for each moment and every small experience of the deepest love that we can share; especially with the animal companions of our lives.  My personal hospice experience with Sparky left me most of all with an overwhelming experience not of mourning, but of abiding joy. He remains with me now each day, and he taught me that our dearest pets really are, always,eternally, and right now, here with us.