The past few months hasn’t been great for us. As you might know by now (especially if you follow us on social media), our favourite old lady is dying. She was diagnosed with Grade C Heart Murmur last year, the week before Christmas.
In simpler terms, her heart is failing.I hate to admit this, but the countdown has started.
For the past year, we have been walking Pecan separately as she could no longer keep up with the younger folks. We had just gotten back from our last walk that night, when she started coughing in the lift. The coughing had lasted longer than usual. I tried to open her mouth and patted her chest to allow more air in. By the time we reached our floor, she was almost breathless and it sounded as if she was choking. The next few moments went by in a blur. Before I knew it, she went limp and fell to her side. It was the most dreadful feeling ever (an all too familiar one too. It reminded me of Pips limp in my arms) I seriously thought I had lost her for good as I tried desperately to clear her airway, while shaking her and screaming for her to wake up.
Thankfully, she began to regain consciousness and started to breathe again.
It turned out to be a syncopal episode caused by a lack of blood to her brain, a common symptom in heart murmur patients. From now on, Pecan will need lifelong medication to manage her heart. Unfortunately, the medication comes with a major side effect – kidney failure. At 16, Pecan’s kidneys ain’t great already. Managing her heart condition would mean that her kidneys will be strained. So, in other words, I am either gonna lose her to heart failure, or kidney failure.
We started her on the medications immediately, and the side effects were quick. She started peeing and drinking more (a common effect of furosemide). That meant more accidents, more toilet and water breaks. It is really real, but I have not slept through the night since she got diagnosed as this stubborn ah ma has decided that water tastes the best at 4.30am.
We consulted with a visiting cardiologist, Dr Geoff Nicholson at Landon Specialist Clinic for a second opinion (with the support of our primary vet). While the appointment cost us almost an arm and leg (okay, I exaggerate, but it wasn’t cheap), Dr Geoff was really assuring and emphasised that it wasn’t our fault that this was happening. It is just genetics and ageing. He was also really honest and said that the day will come when we will need to make the decision of letting her go as she is more likely to suffer from ‘drowning’ due to fluids accumulating in her lungs than the heart actually failing. By then, her quality of life would be so poor as she would be constantly choking and coughing and struggling to breathe. This is a decision I will make, just not at the moment.
Moving forward, Pecan will become increasingly dependent on her heart meds and we would need to increase the dosage periodically as her condition continues to deteriorate. After some trial-and-error (and fainting as well), we managed to obtain a good equilibrium for her medication. This will remain status quo for as long as we can and as long as she doesn’t exhibit any other symptoms.
It has been a hell of a roller coaster ride. There were days when she would do amazing it almost felt like I had my spunky old lady back. And then the down days would follow. Days where I would wonder if it might be better to just let her go. She had since had two other syncopal episodes. While I had learnt to cope with the situation without panicking, it still makes me really sad to see her go limp and struggle with her disorientation when she comes around.
Unfortunately, we are also struggling with her weight and muscle loss. She weighs just 3.9kg (from 5.3kg just a few months back) and has almost no muscles left. This is cardiac cachexia, a common condition for dogs with Congestive Heart Failure. It really doesn’t help that she is fussy with food, and kidney damage also meant that her appetite will becoming increasingly worse.
We had to stopped all swimming for her condition, but we are certainly pushing on with acupuncture.
I’m not kidding when I said it was a roller coaster ride. Just when I was thankful that she was doing well, eating well, and was even starting to growl at the others for stealing her food, we hit our lowest point since the diagnosis.
We nearly lost our Pee-Kee when another syncopal episode occurred in the middle of the night. This time, she displayed unusual symptoms (her eyes were darting, gums were paler and it took her longer to come around). I rushed her to the vet (I am so thankful her regular vet was on night shift). Within the span of the next hour, she collapsed. Her breathing rate went off the charts (as high as 96, the ideal count is 20-30) and she was shaking uncontrollably. It turned out that one of her heart valves prolapsed, causing a sudden influx of fluids to her lungs.
She was struggling to get rid of the fluids. And yes, she was drowning.
We didn’t think she would make it through the night. I made some calls to gather the very people who love her dearly to come down to say their goodbyes. I told her that it was okay to go.
But this stubborn old lady had other plans.
An hour in, she started perking up and responding to the meds. She spent the next two nights in the ICU and is now resting at home with me.
While I am just so glad to be able to have her in my arms again, the toll the disease is taking on her is absolutely heartbreaking. She looks so tired, beaten and confused. I’m struggling to find her behind those weary eyes.
I know there will come a time when I will need to make the decision. Am I prepared? Absolutely not. But I also know that the time is near. In the meanwhile, we will put in our best to make this final journey a comfortable one for her.
At least I know I will be here for her. I’m sure she knows it too.
I love you to the moon and back my Pee-Kee-Kee. I really do.