Chester in happier times

It all started when Chester, our 12-year-old pug, walked out onto the back deck and vomited. 

Chester had always had a sensitive stomach but, like most pugs, he lived to eat and would wolf down just about anything that could be chewed. So an occasional abdominal eruption wasn't all that unusual. This felt a little more serious, though, particularly when he refused to eat the next morning.

As the day wore on, Chester continued to refuse food and treats but began slurping huge amounts of water. Anyone who reads the thousands of pet food complaints on our site will know where this is headed -- nowhere good.

But unlike the consumer accounts that blame a change in their pet's diet for their illness, Chester had been eating the same food -- Royal Canin Dental Diet -- for years. We usually added a dollop of yogurt and some thin slices of turkey but never gave him or his sidekick Tater any of the jerky treats that are prime suspects in so many dog deaths.

Whatever the cause, Chester's sudden illness had all the pawprints of an attack of pancreatitis, a serious and potentially life-threatening illness for dogs and humans alike.

Rather than fumble around with different diets, we took the advice we routinely dispense to ConsumerAffairs readers and hustled Chester over to the vet -- and not just to any vet but to the emergency department of a large and elaborately equipped animal hospital that caters to pet lovers in the Northern Virginia suburbs of Washington, D.C.

On vacation

There, after a quick examination, a technician told us Chester would have to stay overnight for tests, with preliminary results expected the next day. The vet, let's call him Dr. V, who had cared for Chester for years, was on vacation but someone would get back to us, we were assured.

Sure enough, the next afternoon a veterinarian named Mickie called and said that it was hard to tell what was going on deep within Chester and exploratory surgery was called for.

I balked at this.

"Chester is twelve and a half years old," I said. "I don't want to put him through a bunch of heroic measures that will make him miserable and do nothing but prolong the inevitable."

Dr. Mickie was not pleased with this. Her tone turned frosty and she said that "at the very least" Chester needed an MRI. It was too late to do it that day but it could be done the next day, which meant another night in the hospital. I agreed.

Sure enough, the next day the results were in: Chester had an abdominal mass of unknown origin. If we weren't willing to go for exploratory surgery, a needle biopsy might yield some clues. Again, I agreed. It would, of course, mean another night in the hospital. 

The next day's results? Inconclusive. Chester was sent home with a bagful of meds and a carton of "critical care" food, which could be liquified and squirted into his mouth with a syringe if he refused to eat it. He looked a little perkier, having been on IV infusions during his hospital stay.

Pill spitter

Chester at a dog park in 2012

We spent the next day or two picking up pills that Chester skillfully spit out and mopping up after the syringe feedings, which went about as well as you'd expect. Taking in no food, spitting out his pills and slurping up gallons of water, he was soon shedding pounds and looking worse than ever.

In the evening of his second or third day home, Chester vomited a large quantity of blood and mucous. We bundled him up and returned to the hospital, where Chester was admitted on an emergency basis again (extra charges apply).

After a bit more drama, including another inconclusive needle biopsy, I caved in and agreed, reluctantly, to the exploratory surgery. We were now trapped in the industrial doggie healthcare system with no visible means of escape.

The surgeon, Dr. D, called the next day and reported that all had gone well. He had "excised" the mysterious mass, which was located in the duodenal region, between the stomach and intestine, being careful to preserve the bile duct, without which all hope is lost be you canine or human.

Chester came home a few days later with a huge stapled scar that stretched nearly the entire length of his abdomen. Again, he was somewhat perky after a steady diet of IV painkillers and fluids. But his condition deteriorated quickly and in a few days, we were back at the emergency entrance.

The doctor working the overnight shift -- a very affable and knowledgeable young man -- noticed that Chester was jaundiced; his eyes, ears and face were yellow, something that can happen when the bile duct is blocked or compromised. Tests showed he was also becoming diabetic as the embattled pancreas failed to produce enough insulin. 

Little rascal

By this time, Chester's longtime doctor, Dr. V, had returned from vacation and invited us to come in for a chat. I had never met the elusive Dr. Mickie or the surgeon. The only veterinarian I had seen face-to-face up to that point was the overnight doctor.

Dr. V was his usual affable self when we visited the next day, rubbing Chester's ears and referring to him as a "little rascal." He admitted Chester's blood work and vital signs were terrible but said he didn't act as sick as his blood chemistry would indicate.

Maybe so, I said, but what was a realistic prognosis at this point? The answer was obvious and Dr. V was honest enough to leave it at a shrug and a handshake. 

We took Chester home on a Thursday. Our daughter, who reminds me that Chester was officially her dog, was visiting from Los Angeles and burst into tears when she saw the pale, skin-and-bones wreck that Chester had become.

Call in the angels

Chester is comforted on his last day.

I finally did what I had been wanting to do for the better part of a month and called a veterinary hospice and euthanasia service called Lap of Love. Dr. Christine Shibly agreed to come and visit Chester the next morning for a consultation.

On a springlike Friday morning, Dr. Christine examined Chester and discussed openly and frankly the slippery slope that he was on.

"When you get this pattern involving the pancreas, gall bladder and liver, it's difficult to think you'll have a good outcome," she said. I considered this the first honest thing anyone had said during the entire miserable affair.

Our son, having caught wind of what was in the works, had asked that we wait until he could drive down from New York to see Chester one last time, so we scheduled a Saturday afternoon euthanasia.

But by Friday afternoon, Chester began trembling and grew too weak to walk more than a few steps at a time. Again, he stumbled out to the deck for a round of bloody diarrhea and vomiting. I called Dr. Christine, who graciously agreed to turn around and come back. We set up a quick Facetime chat between our son and Chester -- not great but better than nothing.

Late Friday afternoon, we gathered on the deck, where we had been taking turns holding Chester and comforting him, as Dr. Christine injected a tranquilizer followed by a powerful anesthetic that took Chester peacefully out of a life that had gone on a few weeks longer than it should have. 

Adding up the cost

Final destination

Humans and dogs aren't really much different physically. It takes the same skill set to minister to sick animals as it does to care for ailing humans. The cost is also comparable, although most of us don't have insurance to cover veterinary care. 

In Chester's case, the animal hospital's tab ran to about $9,000. No doubt it was worth it, in the sense that the services billed were actually rendered. But whether it was worth it to add a month of agony and misery to what had otherwise been a life well lived is questionable.

Humans, after all, give their informed consent for surgery and other invasive treatments. Dogs trust us to protect them, which can sometimes mean knowing when to say no.

As for Dr. Christine, she charged us for only one visit, even though she had driven to our house twice. Her tab, including cremation and a handsome box to hold Chester's ashes, was under $500. Her heartfelt empathy with Chester's suffering and the loving care and relief she granted him were worth many times that. 

Oh, and that exploratory surgery that Dr. Mickie insisted would provide the answer to what ailed Chester? The mass that Dr. D removed was sliced, diced and analyzed multiple times. The results: inconclusive. 

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