Nobody had ever suggested that Lyra might have Addison’s disease. It hadn’t occurred to me, Kat, or her regular vet. But the question made me wonder. Lyra had never been a high-energy dog. Could the “Sloth,” as we called her, simply have been fatigued and weak? Those would be classic symptoms. The intermittent vomiting could have been a sign too. I didn’t know.
Kat arrived and we all went back to see Lyra in the ICU.
She appeared to be sleeping. I was grateful that she didn’t appear to be in any pain. Several bags of different fluids were hung on an IV pole. Helen lay down beside her and stroked her head with the tenderest of touches. The vets were giving her steroids, presumptively assuming that she had Addison’s disease, but it was all guesswork. There wasn’t anything more we could do by staying at the hospital. Lyra appeared stabilized, and our presence could potentially excite her, which could send her into shock again.
I hugged her gently and whispered in her ear, “I love you, Lyra,” and wiped my tears on her fur. The vet promised she would call if anything changed.
The five-minute drive back to the house felt like it lasted an hour. None of us said anything.
The phone was ringing when we walked in the door. It was the vet. Right after we had left, Lyra vomited blood and started hemorrhaging from the other end too. If we didn’t do something right away, she was going to bleed to death into her digestive tract.
“She has DIC,” said the vet. I repeated that to Kat.
Disseminated intravascular coagulation, or DIC, occurs for unknown reasons following trauma or shock. The body goes haywire, clotting in places it shouldn’t be and using up the clotting factors in the process. The end result is uncontrolled bleeding, which is what was happening to Lyra. When it happens in people, only the most aggressive care can save the patient, and even then, the prognosis is poor. In the world of veterinary care, DIC is grimly referred to as “dead in cage.”
Kat started to cry.
The vet wanted to give her a transfusion of dog plasma, which would contain clotting factors to stop the bleeding.
“Do you think it will work?” I asked the vet.
“I don’t know,” she said. “Lyra’s condition is grave. If we can stop the bleeding, she has a chance.” I gave the okay.
“If anything changes, please call us right away.”
Nobody wanted to sleep that night. To distract ourselves, we stayed up and watched TV until midnight. Maddy wanted to be alone, and Helen slept with Kat and me. Callie curled up at the end of the bed, confused.
In the morning, I waited as long as I could before calling the hospital. The doctor on call for the day reported that Lyra’s lab values seemed stable. Her blood count had not dropped much, indicating that she hadn’t lost too much blood. But her clotting factors were still out of whack, and she was still bleeding out of her GI tract. The plan for the day was to try to keep her blood pressure stable.
Around noon the entire family piled into the minivan, and we drove to the hospital. Even Maddy, who normally shied away from intense emotion, seemed to realize that this might be the last time she was going to see Lyra and agreed to come. Her face was twisted up as she tried to contain her feelings.
At the hospital, Lyra was in the same pen as the previous night. She was still sleeping and appeared comfortable. Helen curled up with her, and Lyra sensed her presence. She raised her head and sniffed Helen. The corner of Lyra’s mouth turned up ever so slightly in a smile of recognition, and she went back to sleep. Helen covered her up with a blanket that the two of them slept with.
We each took our turns. Watching the girls hug her, knowing in the back of my mind that this could be the last time with Lyra, was the most awful pain. I grieved for Lyra, and I grieved for the girls.
After thirty minutes, Lyra seemed to perk up a bit. She stood up and looked around. Helen’s face brightened. But then Lyra shifted position, revealing a bright red stain where her butt had been.
Helen rushed to me, sobbing. I started to cry too.
The vet tech cleaned her up quickly. But since our presence wasn’t helping Lyra, we all agreed that it was time to leave.
We tried to have a semblance of normal life at home. Callie seemed out of sorts, wandering the house looking for her big, fluffy pillow. I took to walking her around the block. Usually we walked in the morning and evening, but neither of us could get enough walking while Lyra was in the hospital. By the afternoon, we had been around the neighborhood four times.
I waited until the evening shift at the hospital to call again. Dr. Martin was coming back on duty, and I wanted her opinion of Lyra’s condition over the last twenty-four hours.
“She’s having runs of v-tach,” she said.
Ventricular tachycardia, or v-tach, was a heart arrhythmia. Her heart was racing out of control.
“We just gave her an injection of lidocaine,” Dr. Martin explained. “It stopped the v-tach for now.”
There was no denying it. Lyra was slipping away. Her heart was racing because her blood pressure was dropping. But when the heart beats that fast there is no time for it to fill with blood, and blood pressure will continue to drop. Maybe she would go on like this for another day or so, but we had to confront the reality that her body was shutting down. Trying to save her would mean multiple drugs, transfusions, and being hooked up to a ventilator. Both Kat and I had seen this happen with people in the ICU, holding off the inevitable while the family held on to unreasonable expectations of recovery.
It was time.
I told Kat what the vet had said. Then we called the girls to the kitchen table and explained Lyra’s condition.
“Girls,” I began, stifling tears, “Lyra is not doing well, and her heart is struggling to keep beating. It would be wrong to let her go on suffering, just for us.”
There was nothing more to say.
It is a heavy burden for an eleven- and twelve-year-old to make a choice between having their beloved dog come home or setting her free from her suffering. To spare them that guilt, Kat and I made the decision for them and simply framed it as the right thing to do. Even if I wasn’t sure myself.
I called Dr. Martin and told her that we didn’t want Lyra to continue treatment when the prognosis was so poor. She understood and assured me that we were making the right choice.
At the hospital, Lyra looked the same. I was relieved that she still appeared to be sleeping, even though mentally she was probably out of it, bordering on being comatose. Her heart monitor told the story. She was in v-tach, and her heart was beating two hundred times a minute, too fast to maintain blood pressure.
While Kat signed the forms, Dr. Martin explained what would happen next. Helen absorbed the information without expression. We all sat on the floor around Lyra, each of us laying a hand on her. The first injection was an anesthetic. There was no discernible change, confirming that Lyra was already, in effect, asleep, and this knowledge lessened my guilt a little bit. The second injection, a cocktail of chemicals, was just as unremarkable. No shuddering, no movement. Just a cessation of Lyra’s shallow breathing. The slight upturn of her mouth—her doggy smile—remained permanently in place.
For the last time, I whispered in her ear so that only she could hear: “Lyra, I’m sorry I let you down. I’m sorry I was deaf to what you were saying. And I’m sorry I didn’t understand what Callie was trying to tell me. If only I had taught you to go into the scanner too, maybe I would have known there was something wrong. I will miss you, always.”