Quality of Life Part Two

In Part One of this series, I discussed the difference between “black and white” decisions about a pet’s health (a situation where a tough decision is fairly obvious) and a long, uncertain gray area where the parameters are much less apparent. I experienced both scenarios with my own pets early on in my veterinary career, and I used the insight I gained to help clients navigate their own difficult journeys. It can be difficult to assess an animal’s quality of life.

Not only have I experienced the loss of many dogs over the years, I have also dealt with the long, gray struggle of making a decision about a horse. At the time, I lived in Illinois. While I had an equine vet I really liked in Kansas, I never found the right colleague in Illinois. I don’t like to make important medical decisions about my dogs, and I am a small animal veterinarian. While I obviously am very involved in the decision making, I want to be the client. I totally don’t feel qualified to call the shots on my horses, as veterinary school was a long time ago!

Serr Kari

The horse in question was an Arabian gelding. He was little, somewhat snarky and beautiful. He was awesome to ride. His name was Serr Kari. One day I was riding in Wisconsin’s beautiful Kettle Moraine State Park with several of my friends. Kari, who hadn’t shown any signs of illness at all, really struggled to keep up that day. My energizer bunny was really, really off. That was the only worrisome sign… his extreme lethargy, and it came on fairly fast.

I immediately called my current vet. He checked him over and declared he could find nothing wrong. I pushed. I insisted we do some blood work. For whatever reason, he tried to dissuade me but I wouldn’t hear of it. We ran bloodwork, and lo and behold, the results of the tests indicated a high probability of Cushing’s Disease.  

Kari didn’t have the thick, cresty neck often associated with this disease. Additionally, he had never shown any coat abnormalities. He was early in the disease process. Other than his lethargy, he was normal. Treatment is not necessarily curative, and I needed some time to process this information and decide how I was going to manage him.

Unfortunately, very soon after the initial diagnosis, he foundered. And it was bad. Once again, my vet and I argued over handling the laminitis. I found myself in regular communication with my trusted vet in Kansas.

Of course, for a long time I couldn’t ride him. However, one day at least a couple of years into this management nightmare, he was sound enough for me to ride him on a brief walk on lush green grass around our place. It was so awesome.

It wasn’t too long after that ride that winter weather was upon us. In the Chicago area, that means September. I was preparing to return to Kansas at the end of the year. We’d get rain, and then snow, which resulted in freezing and thawing. The dry lot would end up with ruts and mountains and valleys of frozen mud. I constantly worried about how that uneven terrain was affecting my boy. In addition to that concern, I had to face the logistics of transporting a badly rotated horse 650 miles in a trailer to Kansas.

I had my local vet shoot some radiographs and I sent them to my Kansas vet. When my Kansas vet called me, I was in Tennessee visiting a dying relative with my mom. I will never, ever forget that conversation, sitting in the car with my mom in the passenger seat. He said, “You are facing a catastrophic situation.” What that meant was that Kari’s feet were so bad, at some point I might go out to the barn and find his coffin bone sticking out of his sole.

He wasn’t living with great pain, as I was taking great care of him, but his options were extremely limited and a potential crisis loomed over us constantly. I decided I couldn’t risk transporting him. I scheduled his appointment to cross the Rainbow Bridge.

I have lost a couple of horses to colic. One was in so much pain, it didn’t matter how much medication we pumped into her. That was not such a difficult decision. She was 24 and her time had come. I lost another one at about the same age to colic. Obviously, I grieved them both but the decision was much more black and white.

Right now Kadeen is 16 and Finn is 7. Some Arabians can live into their 30’s. I don’t know where I will be in 15 years but I can’t imagine parting with my boys, especially Kadeen. We have many years of trails and bonding that we share. I suppose it is a good thing that I don’t have a crystal ball.

In Part Three of this series, I will discuss the case of a very old cat that I saw at the clinic recently. Additionally, my boyfriend’s mom has several serious medical conditions and was recently placed on at-home hospice. It has been very interesting for me to observe how human medicine handles situations versus the options available in veterinary medicine. Check back in a week!