Thursday, 31 July 2014

Saying goodbye to Sunshine...

Our first real end-of-life story is a lovely heartwarming story of healing - and a real tribute to Annie and "Sunshine", a 15 year old German Shepherd, the last of Annie's small herd of five lovely Shepherds she had brought over from Belgium a few years back. This is their story...

So this month, my practice manager Alex and I here at Vets2Home, are very sad to have had to - fairly urgently but also very peacefully - send our longest standing and also first true long-term hospice patient "off to Devon" (= dog heaven):
We have lost our lovely Sunshine - a stoic, 15 year old "blonde", sweet and gentle German Shepherd, and also had to say goodbye to her owner Annie (equally lovely, sweet and gentle) who have been with us for an over three year long uphill journey of parting with no less than the whole "clan" of her five elderly shepherds - all related as two generations of littermates.

We first met Annie and her lively furry shepherd family living in a small cottage in the beautiful and pittoresque Sussex countryside, when we were urgently called out to peacefully let her first (with us) shepherd, Indy, go as he was the first to catch what I call the "Shepherd plague" - meaning he went off his back legs - and also caught a nasty infection taking away all of his quality of life, making a gentle home euthanasia the only option for him to not suffer unnecessarily. Ever since we helped Indy peacefully go at home, we have supported Annie and her remaining Shepherds at home - with medication, advice and support - through a long, testing journey of saying goodbye to a house full of life and lively activity.
Sunshine, or Sunny as she was also called, was the last one standing - although she was also the oldest and the mum of Annie's two younger ones, Beeper and Lulu.

On the most beaming of sunny days on the Sussex coast, with lovely blue skies and at the peak of this atypically warm British summer, Annie calls us late in the afternoon with an unusual amount of worry in her voice.
Annie has been attentively and lovingly caring at home for Sunshine, 15, who she has had ever since birth as she just couldn't make herself part with this little bundle of joy and also kept two other, Indy and Teddy, out of a litter of eight, as she at the time also was a friend of the shepherd "mum's" owner and owned the "dad" herself.
Over two years ago, Sunny however suffered a huge "doggie stroke" which happened just a couple of days after Annie suddenly lost Beeper (one of Sunny's puppies) and Teddy (Sunny's "brother") only one day apart - to the devastatingly acute "bloat" also called a twisted gut. Both Annie (and maybe also Sunny?) were so clearly deeply traumatised experiencing this sudden loss and which may very well have triggered Sunny's stroke episode as I do believe - although surely not easy to prove "scientifically" - animals are sensitive and receptive on a level far beyond our human comprehension.

The "stroke" had sadly - despite various medication and supportive treatment - left Sunny in need of constant human care and assistance to support many of her doggy needs - not to mention added to poor Annie's anguished state of mind with the sudden and traumatic decimation of her clan from five shepherds to just barely one.
Annie at 66, as Sunny's devoted "mum", is luckily always at home, and has these last two years since the stroke and her sudden loss, been taking care of Sunny's every need to a 5* star top notch level including assisting her "outside needs", hand feeding and cooking her top grade meat and fish while keeping her super clean after unavoidable "accidents" and last but not least keeping her constant company by always being by her side also as she at the very end had lost most of her sensation in her hind legs.

Now over these past two intense years, Annie would normally call us a few times of month with a repeat medication order or just a little "progress report" and a little chat. Today is different though... Annie describes - with a clearly tremble in her voice - how Sunny's stomach suddenly has blown up as a big balloon over just an hour and she is burping and passing wind like a Jersey cow first out on spring pastures.

At this stage this is indeed very bad news - and we both know it - Annie being the seasoned Alsatian owner and remembering too well having suffered from the sudden losses just two years prior, to this devastating and very acute illness - a twisted gut is no laughing matter and is a dire, fatal emergency that if left untreated, will leave the dog to die in severe pain. Sadly this scenario won't take very long to develop very unlike what many owners think. As Sunshine is so old and already a hospice patient, surgery certainly is not an option so Annie and I both know what this means: this is the end for her.

I grab my big medicine bag (actually a builders tool box as the only thing roomy enough for all my kit) and throw myself down the metal pole that leads straight to the driver's seat of my waiting car with the keys ready in the ignition.... well not really - but it feels a bit like that trying my hardest to get to Annie's house as soon a possible.
I arrive within the hour as it is rush hour on the rural but busy Sussex roads and I still have not got those darned blue roof lights that I keep wishing I had when getting calls like this. Annie is sitting with Sunshine who is now lying on her side and resting her head on a carefully arranged pillow, with a blanket over her and on a collection of duvets that would leave the princess on the pea very envious.
She looks peaceful as Annie and her daughter has managed to take her outside to relieve herself which has taken off some of the pressure - but this is just buying a little bit of comfort time.
There is no doubt though - Annie seems surprisingly collected and calm as if she is ready and very much aware she must make a really hard but also kind decision for Sunny: she cannot let her suffer and she has to finally let her go.  At least this time she can do it peacefully as planned, at home and in her "sleep" as this is the last thing Annie can do for her after all they have shared and been through over these many years.
As I get her sedation injection ready, I ask Annie to find her a lovely tasty treat she will enjoy as she has never given up her love of food at any point - maybe due to Annie's gourmet buffet offerings and hand feeding regime - who can resist that? And Annie doesn't disappoint on this last occasion - she brings out an old favourite: a whole tin of Pilchards in tomato sauce and starts handfeeding this to Sunny - all the while I sneak the injection in behind her, in the abundant loose skin of her skinny neck and she never notices a thing.

Annie & Sunny - sardines fed by hand so taking no notice of the sedative injection
Annie and Sunshine is lovingly share this last moment of intimacy around a yummy favourite treat and soon after, Sunshine puts her head down and gently drifts off into a deep sleep where there is no pain or worry of a stomach blowing up to balloon size, causing immense pain and suffering. Annie as her loving "mum" has spared Sunny the stress and upheavals of a car journey at this time (Annie doesn't have a car) not having to make way to the clinic half an hour away...instead Annie has shown Sunny the last gesture of love by letting her die at home - in her sleep - helped by a quick injection she didn't even notice.
Sunshine is blissfully unaware of the noise of the clippers as I gently shave her blonde fur on her front leg so I can give her the last injection with the overdose of sleeping medication directly into her bloodstream, and Annie is sitting gently stroking her head as she takes her last breaths and as she passes over, her face seems to suddenly relax with a big sigh of relief.

Sunshine is finally at peace - having a gentle ending as she has also been fortunate to live her last months at home with her own "top private nurse" by her side to serve her every need. Knowing Annie well by now, I can't resist to ask if perhaps it would be possible that I can come and move in and receive such generous care ...  Luckily Annie gives me a big reassuring smile as she knows exactly what I mean and how lucky I think Sunny has been with the exceptional care and attention she has been receiving for the past many, many months.

But most remarkable and what makes my chosen path as a hospice vet so truly rewarding, is I have again had such beautiful confirmation - and affirmation - of just how amazing animals are. Seeing just how far Annie has travelled through this process from losing two shepherd in two days and almost another one (Sunny) in the same week to the devastations of a doggy stroke and watching up close how bravely Sunshine has fought since - for herself and for her "mum" - like a true warrior she has made sure to hang in there precisely long enough to see Annie safely through this long journey of emotional healing and letting her gradually come to terms with losing no less than all of her whole four-legged family of five lovely shepherd companions over a relatively short time - and they are now both finally set free to seek new pastures, holding forever in their heart only happy Sunny and Annie's case - from the very first breath to the very last!

SUNSHINE 1999 - 2014