The year 2020 was challenging for everyone, even for my little one as she started developing respiratory issues that progressed throughout the year. This page is a year in review. It may help those going through the challenges of having a senior dog.
I started writing this as an homage to Betty. Her last year of absolute stoicism and strength was beyond comprehension. She had an ongoing chronic nasal infection (rhinitis) that was impeding her breathing and lung function, possibly due to canine tooth decay which is connected to the nasal passages. In mid-January of this year, she was admitted to the hospital for five days and kept in an oxygen kennel to help her breathe while they performed various diagnostics that her little body would allow. During her stay, an echocardiogram revealed that she had developed pulmonary hypertension which restricts blood flow from her heart to her lungs. She had a history of arrhythmia and a heart murmur. This, combined with the rhinitis, was a battle that she and I tried hard to overcome.
During the last year, I was her caregiver, and she and I fought the good fight right up until the end of her beautiful and adventurous life. I was so grateful for her love, and she definitely knew I loved her with all of my heart. This is her story.
Betty—my little mascot, my fierce fighter
11/11/07 – 2/2/21
In February 2020, I took Betty to the vet because of coughing and congestion.
Betty had thoracic X-rays taken, diagnosed with bronchitis, and antibiotics were prescribed. They helped for several months, but during the summer, her symptoms returned with a a bit of a runny nose and more coughing. However, it never stopped her from being the sassiest little spitball that she’s always been. She was given Clindamycin.
August arrived, and even though we couldn’t enjoy our favorite dog-friendly beach due to Covid, we had fun at a nearby lake where we could have a picnic with chairs, a cooler, and a big ol’ blanket. Betty was happy to sit in my lap as we watched kayakers and swans float by. However, symptoms showed up again, and we returned to the vet. More X-rays were taken along with a comprehensive senior dog blood panel with urine sample. Listening to the vet read the results over the phone just seemed to go through one ear, swirl around my brain, and get stuck there. Blood and urine seemed fine, lung X-rays seemed cloudy, deposits were seen in her gall bladder, her heart showed concern, and a cardiac ultrasound was suggested with a specialist. More antibiotics were prescribed, but at this point, it seemed to mask a greater concern.
As the year wore on, the nights were tough for Betty. She would wake up several times and wander around the house, mostly to the kitchen. Her vision wasn’t great due to cataracts, but she could see shadows and knew the path from here to there. I would get up several times when I heard her get out of her beanbag chair and roam to the kitchen. I’d follow her and gave her what she wanted—treats and water. I had piddle pads strategically placed around where she would use the bathroom as the days of scratching at the door were over. I’d carry her back to the bedroom until she decided to get up again. I believed she was sundowning.
Betty used to sleep on the bed. She would jump off of it and my heart would stop for an instant. She was a kamikaze girl, she’d jump off and get as much air as possible and land perfectly, but as she got more feeble I wondered what to do. Those stairs to the bed were a joke to her or even an ottoman that she could jump onto was a waste of time. I tried to teach her, but those were just obstacles. We had this beanbag chair that we were going to use in the living room, but it was too small and difficult to get in and out of. I put it in the office and Luke got in it and took a nap, well that didn’t last long because Betty climbed into it and sat on Luke eventually shoving him off of it. When she claimed it, I decided she would sleep in that by the bed, full of cushions and her favorite blanket. Once she formed a habit, she would stick with it. I loved watching her climb into it so independently. It was low to the ground so she got out of it safely.
One day in October, she just seemed tired. Her breathing was labored, so we drove to an emergency services facility close to home. They took her in, however, I waited in the parking lot for four hours. Due to Covid-19, entering the building is not allowed. Instead you call, a tech comes out and takes your pet, and you wait until a vet calls with a diagnosis and treatment plan. The diagnosis was basically respiratory issues and rhinitis (inflamed nasal passages, a stuffy and runny nose). A tracheal wash and nasal scope was suggested at a later time. We went home with Doxycyclene, not only is it effective against the Lyme bacteria, it’s also used for respiratory issues.
Her symptoms stayed the same, but she tolerated it.
Dr. Todd holds a an unhappy little Betty when she was about two years old. Luke poses with Betty when she was 11 years old.
Betty’s original vet and my friend
In November, I had an email conversation about Betty’s ongoing condition with Dr. Todd, her original vet from day one, until he retired several years ago. In fact, he saved Betty’s life during her first year from a bacterial pneumonia. We were also discussing the blog that he contributes articles to for this website.
I’ve known Todd for 18 years. I took my dogs to his practice when I moved to Eastern Connecticut from San Diego, CA in 2002, and when I moved to Providence, RI, about an hour away in 2010, I continued to drive through the CT countryside for vet care. He was so grateful for my loyalty and our visits. We always got along so well, and I admired his gift of wisdom mixed with humor, a little ribbing here and there, his dedication, his thinking out loud, his determination to figure out and treat against the odds, and also his friendship through the years.
Since his retirement, Betty has seen a few vets at the practice. One in particular, a very compassionate woman, who had seen her since a dental cleaning and extraction in February 2019, was a favorite. However, she left the practice in late fall of 2020. Our last visit with her was in August.
There was a void to fill, and in his email he mentioned that he temporarily stepped out of retirement to fill in at the practice. I could tell he was happy to be back doing what he loves.
In our emails, he mentioned tooth decay, stating that longterm, chronic rhinitis could be the result of a decay in the root of the canine tooth, and possibly cancer, but not so much from respiratory issues as they tend to resolve with antibiotics. The only way to see what was going on was to sedate her to get a clear picture. Betty has a history of arrythmia and a heart murmur. She was evaluated by a cardiologist in 2019 before having a mass cell tumor removed. I was torn as to what to do since sedation was risky. He was there to help when I was ready.
Betty’s vet visit in December was $750. Her overnight stay at the hospital was $1,100. Her five-day hospital bill was $4,100. These numbers are rounded to the nearest $100.
I reluctantly created a Facebook fundraiser because I didn’t have the funds to cover all of the costs and was so grateful for a donation of $1,100 from my friends and supporters who know how much Betty means to me.
Orders placed in the online store were also extremely helpful. I appreciate every customer, offering a personal touch when it comes to each order, and making sure everyone is happy with our products.
A trip to the hospital
During the last week of the year, she seemed distressed. She had trouble breathing, the runny nose, and a tired expression on her face, so I took her back to the vet. This time, a visiting vet saw her who was filling in at the practice. I didn’t know her. Although she sounded a bit alarming over the phone—I can only have a conversation with the vet on the phone in a parking lot thanks to Covid—I have to admit, her objectivity brought a fresh perspective to Betty’s case. She was dehydrated, and as much water and food as she consumes, it just doesn’t seem to be enough. She was sick, and the dehydration was a result. The vet ran several tests: blood, urine, X-rays, as much as she could do at the facility.
She wanted to admit her to the hospital, the same emergency services facility that I have taken her to before located near me. Because the emergency care has a full load, they do appreciate whatever services the local vet can do before being admitted, not to mention that it’s cheaper. Betty needed an abdominal ultrasound that couldn’t be performed at my vet, but was available at the hospital along with so many other services and care that Betty needed. So we drove her to the hospital where she was admitted for at least an overnight stay. I felt for her as she didn’t understand all of the chaos, but my little girl is a fighter, and in this situation I put my emotions aside and just let it play out. I left her at the hospital, went home, and basically retreated into a corner.
Betty had an abdominal ultrasound performed. She received IV fluids, and her blood pressure was monitored. Her urine was sent out for culture as there was a discharge. She spent the night wrapped up in soft blankets. The ultrasound showed various issues in Betty’s little body like a small stone in her gall bladder, an enlarged adrenal gland, a cystic and nonfunctioning kidney, and thickened walls in her small intestine suggesting irritable bowel disease. The vet also concluded that Betty had pneumonia and/or a respiratory infection that was resistant to current antibiotic therapy. She also showed signs of a urinary tract infection. She was given Clavamox to help with both pneumonia and the UTI. One of techs sent a photo of Betty. Her eyes were bright, and her expression was as attentive and curious as always. I picked her up on New Year’s Eve, together we quietly rang in the new year at home on the couch.
Back to the hospital for a little longer
For several days at home, she seemed to be improving and in good spirits, and enjoying a prescription hydrolyzed protein diet. A little over a week later, her symptoms were back. The medication didn’t seem to be helping. I called my vet’s receptionist about going back to the hospital, and Betty was cleared to head back to the hospital for more treatment.
At first assessment, it was clear she was not oxygenating properly (cyanotic), was dehydrated, therefore Betty stayed in an oxygen kennel with 60 percent oxygen for five days and four nights. On her second day, an echocardiogram was performed showing moderate pulmonary hypertension. She was given medication to treat the hypertension (Viagra), and prednisone, as well as two antibiotics, to treat possible lung disease. On the last day she was weaned off the oxygen and was stable.
The doctors working on Betty assessed the runny nose to have three possible causes:
- Inflammation (rhinitis) triggered by some type of autoimmune response to allergens.
- Infection due to viruses, bacteria, or fungal, noting that tooth root abscesses can also impact the nasal cavity and cause symptoms.
- Cancer, common in the nose of older dogs.
Dr. Todd had mentioned the last two issues a month before, but believed the tooth decay may be the reason for her nasal discharge.
To determine what was really going on, a CT scan, or at least an X-ray, both taken under sedation where she would be perfectly still, was the best diagnostic to get a clearer picture of either decay or a tumor, and with Betty’s heart condition and hypertension, they did not feel that she was a good candidate for such a procedure.
She was due for a follow-up visit with my vet two weeks later.
Meanwhile back home
I brought her home, and once again, she seemed to be doing well with the new medications. Until a few days later, I noticed discharge from her left eye. I had seen that before and thought it was related to the nasal discharge. One morning I woke up to see that her eyelid was sagging and becoming a little swollen as the day wore on. Having cataracts for two years has not stopped her at all. She manages to get around quite well. Her hearing is a bit compromised, however, Luke, our younger French bulldog, guides her if she needs it. However, on this day, not even a week out of the hospital, she wasn’t her perky self at all. I called the vet’s office, and had spoken to the receptionist, who has been a very supportive friend throughout this journey. She was trying to fit me in for a follow-up appointment the following week. I emailed Dr. Todd, who was scheduled to to be in the next day. I felt like royalty when he said that he would make room for me.
Her eye was sagging, and the other eye was dim. I felt that her little body was failing. I went into every kind of dark space thinking I would have to say good-bye that day during the vet appointment. When I had spoken with the receptionist that morning to confirm a time, we discussed having the quality of life conversation. The hour drive with her wrapped up snuggled in my arms was tender, yet excruciatingly painful. And like a strong wind that blows open the door, he walked into the waiting room where Betty and I were sitting and brazenly said, “Betty Davis! W.T.F.” He totally bypassed all my sorrow, my doom and gloom, and we talked about Betty’s case and all that she’s been through lately. Seeing her eye, he put some liquid in her eye and then a test strip. Her eye turned green and showed an ulcer. He asked me if other vets even mentioned this, I said no. When our visit was over, he told one of the techs that I was his friend until I moved away, and I quipped that he was my friend until he retired. I miss our banter, but was glad we could pick up where we left off.The root of the problem
After examining her eye, Dr. Todd asked me if I was willing to take a risk with her that could possibly, but with no guarantee, stop this nasal congestion. He examined her mouth and saw the canine was most likely the real cause of her chronic rhinitis. He explained that the canine root is even longer than the tooth itself and connects to the nasal passage. If the root is decayed, it causes infection in the nasal passage. The tooth looked decayed, and the one behind it was loose. He asked me if I wanted him to perform a surgery to extract the tooth. It was a risky surgery, but he had a procedure in mind that he would perform to safely sedate her, with her heart condition being a factor. He started to think out loud how he would proceed with the sedation and then explained his approach to me. I decided it was a risk I wanted to take, because her difficulty breathing with a stuffed up nose is very troubling. She was a tough girl. I’ve seen her strength and have always been in awe of her.
We scheduled it for the following Monday, but of course the weather had other plans. A Nor’easter developed, and most places closed including the vet’s office. The surgery was scheduled for Tuesday. There would be no surgery on that day—only rest.
The last two days with Betty were tough on her, and so was the past month for that matter. She didn’t show it, nor did she want you to worry over her. She kept busy as usual. In her last months, she suffered dementia or sundowning—wandering around the condo, running into things, getting caught in a corner that I’d pull her out of. In her last days, she melted into a brand new plushy bed I had waited weeks to arrive. It put her right to sleep. She sat in my lap often as she’s done for 13 years. I bought months, weeks, and days with her. I’m so grateful that I had the weekend with her, although she wobbled around and bumped her ulcered eye causing it to bleed. I couldn’t imagine the pain she was feeling. Early Tuesday morning she showed signs of respiratory distress mostly due to the pulmonary hypertension which I was warned was fatal. She was in pain. She was in her beanbag chair full of cushions and blanket that usually envelops her at night. Around 2am, I heard her coughing, sitting up trying to catch her breath. She would curl up only to sit up again. Her heart was racing. She was gasping for air and making a gurgling sound.
There was a snow storm the day before, and I drove her to the vet Tuesday morning in time for Dr. Todd’s arrival. She was uneasy and still gasping for air. He met me in the parking lot, and we decided that today was the day she would rest. She was wrapped up in soft blankets that she slept with day and night. Her favorite foods are printed on the blanket— hamburgers, pizza, and fries. For her birthday she would get a basic burger as part of a decades-long tradition.
She was dehydrated and tired, yet squirming in my arms. I held her close to me and spoke to her softly. Once she was comfortable, we placed her on a table with layers of towels. I wrapped her up in her blanket and held her head in my hands as he looked for a vein. Her eyes were dim, and she began to snore, a sound I grew to love. I poured my soul into her, and in a quick moment, she released hers. It was surreal. She was truly at rest, for the first time in a while.
I am heartbroken. My heart is heavy. The house is quiet. Her little things are scattered everywhere. Her blankets are sitting on her beanbag chair. If only I could have the strength that she had.
I carry your heart. I carry it in my heart. I am so grateful for our life together…13 beautiful years. Rest little girl. I gave you all of my love, and you have carried me all of your life. Your love and devotion was my strength. My love for you was unfathomable.
Thank you sweetheart.
February 2021