Cooking For Two

Last week I had to make a trip to Phoenix to see the cardiologist. Phoenix being the smouldering Valley of the Desert Smog that it is, I knew I’d have to be running the air conditioning non-stop, because this fancy sardine can that I live in concentrates heat like the dickens. I booked two nights in an RV park as close to downtown as I could get, figuring I’d leave Atina the Wonder Dog at “home” safely plugged into 30 amps (RVs can plug into electricity to run all their systems) while I caught a ride to the medical center. She’d stay nice and cool.

Quick recap: Atina, my 3 year old Belgian Malinois, was born without kidneys. OK, she had the physical organs, but only about 10% functioning tissue. And as she’s grown, her body has outgrown her functioning kidney tissue. Dogs, for some reason, do not do well with kidney transplants, and only movie stars can afford doggie dialysis, so Atina’s lifespan will be drastically shortened.

One of the things that is bad for kidneys is heat stress. It’s something that’s seen in humans, notably in agricultural workers, say, in California, where migrant workers are frequently affected by acute kidney failure from working in extreme heat without sufficient water. Turns out dogs are extremely susceptible to kidney heat stress. Every episode, even those that pass unnoticed by observers, kills a little more kidney tissue. And for Atina, who doesn’t have much to go on, a bad episode could mean the end.

With all of my good intentions, there was one thing I couldn’t control: potty breaks. We had to go outside. For pee breaks, not such a big deal, since Atina knows what “Go pee, quick!” means. But poop has its own timing….very few of us can conjure up a poop on command, especially on short notice (well, there are those of us who poop, like, every five minutes, but that doesn’t count.) So in spite of my best efforts to plan for minimal heat exposure, there were several ten minute treks around the impeccable white-paved park, its fields of white gravel radiating 100+ degrees in spite of the relatively chilly 95 degree day. It turns out that even these brief exposures took their toll.

By the end of the first day I started smelling old pee. I checked myself. Nope, hadn’t had any accidental leakage, so where the hell was the infernal stench coming from? Atina jumped up on the bed. Yeccch! I whiffed her fur. Oh goddess, please no. It was urea crystals forming on her skin because her kidneys have stopped excreting it in her urine. Now she is peeing pure water, and sweating pee. Soon the entire interior of my van reeked.

I quickly hooked her up to the IV bag that hangs from a hook in the van.

I put 350 ml under the skin, to slowly absorb into her bloodstream and help wash the toxins out.

The next crisis came at supper time. She flat out refused to have anything to do with her prescription kidney-diet dog food that she’s been gobbling for two and a half years. She refused breakfast too. This is no joke, as she’s already lost 15 pounds over the past year.

After two missed meals I pulled out the “sick food:” rice with chicken broth. She sucked it down and asked for more. I let her have as much as I dared to give her. Then I sat and thought about how to proceed.

The object here is twofold: keep Atina feeling as good as possible for as long as possible, and…keep Atina by my side because she keeps me alive.

That’s an old joke between me and my psychologist. When business owners ask me what trained task my Service Dog performs, I can tell them honestly: “She keeps me alive.” And it’s actually not a joke. How can I kill myself at this moment, when my Doggess has tucked my foot under her neck as if it were her sleeping puppy? She guards my life from moment to moment. In fact, hearing me sniffling a bit just now, she’s gathered up my entire lower body and is wrapped around my legs peering anxiously into my face.

So you see I must take the best care of her that I possibly can.

I thought first about getting the hell out of hot Phoenix. To tell you the truth, I thought I was going to be hauling a dead dog to my vet in Flagstaff, or maybe a dog who would need to be euthanized as soon as I got there. I thought of calling ahead, but there was no possibility of speaking without breaking out into sobs, so I put the pedal to the metal and blasted up the 80 miles and 7,000 feet of elevation to my second home town on the edge of the Coconino Plateau (my first home town is, of course, Jerusalem.)

There’s a place on I-17 coming into Flagstaff where you power up the steep grade of the Mogollon Rim, and just before it levels off, a breathtaking view of the four Kachina Peaks fills the sky. These peaks are where the Kachinas, the Holy People of the Hopi (and Navajo, under a different name), came out of the Earth to serve the People. They stand like 14,000 foot guardians over the land between the Mogollon Rim and the Grand Canyon. White people call them the San Francisco Peaks.

As soon as the Peaks came into view, Atina was all attention at my elbow, peering out the windshield. Not dead. Not a bit!

So I kept on driving, stopping to get groceries and top off the diesel tank before setting out into the Coconino National Forest to find a good spot to camp….and cook.

She loves potatoes, and yams, and rice, and cooked veggies. For protein, I add pretty much whatever I’m eating. I searched the veterinary Merck Manual and found critical information on nutrients in kidney failure, which I now use as a guide in my home hospice nutrition program. I did make an appointment with her vet to talk about nutrients and what to do when…..

We’re doing daily subcutaneous fluids now, and this has had the strange effect of taking away her sense of thirst. It frightens me that she doesn’t drink. The vet says the subcu fluids do her more good than what she actually drinks, and of course my medical brain knows that but it makes no sense to my human brain.

The temperature is a balmy 63 degrees in the daytime and in the 20’s at night. If you hadn’t seen my girl when she had a bit of kidney function, you’d never know she was sick. She’s hell on squirrels. If a squirrel comes into her perimeter, she’s off like a shot, hell-bent for the Ponderosa pine she knows that squirrel is making for.

Today she treed a bigger trophy: a lost hiker! Poor fellow, he had got himself turned around in the woods because he was trying to navigate with a dim photocopy of an outdated map and got on the wrong trail. Atina found him, though, and scared him witless by leaping up and staring into his face again and again. In the K-9 business this is known as a “silent hold-and-guard.” In the lost hiker business, it’s known as “out-of-body, where’s-the-toilet-paper!” I pointed the poor chap on his proper path and took Atina home for a few Milk Bones. I never gave her Milk Bones before (“doggie junk food”), but now that she is on hospice I don’t care. She can have whatever makes her happy, as long as it fits the ratios of protein, calcium, and phosphorus that rule her diet now.

She is the best Doggess.

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21 Comments

  1. Laura, what a recap of your Home Hospice Nutrition and Fluid Program for Atina, The Doggess. Obviously you’re keeping her alive and she’s keeping you alive. That’s an incredible bond! Don’t think you got to the cardiologist in Phoenix. How are you doing health wise? Seems the cooler national forest would be better for both of you. Happy mid-November. 🎼 Christine

    Reply
  2. After all those workshops and trainings, I’m finally “living in the moment.” Sigh….

    How are you doing?

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  3. Doing well, thank you! I’ve been promoted to great-grandmother so need to live until I’m at least 100 to see great-grandkids grow-up. Two granddaughters (sisters) had babies with a week of one another. Also, the book is coming along and I’m committed to finish it in a year. Love retirement, even though I loved being a nurse practitioner (in psychiatry). Live in the moment, Laura. that’s all we can do! Take good care of yourself. Pats and ear scratches for Atina! ☺️

    Reply
  4. 🙂 😦

    Sometimes happiness and sadness come like Siamese Twins, it is so difficult to distinguish where one ends and the other starts.

    Reply
  5. She really is a wonder dog! I’ll keep on praying because you both need a miracle.

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  6. My Border Collie Dera was our baby girl. I cooked for her too. Her last meal was chicken and rice.
    *head scratchies for Atina*

    Reply
  7. Oh Laura, I’m so, so sorry this is happening. We lost our previous dog to kidney failure, so I understand how this goes. I kept him alive for a couple of months with IV fluids every few days, and that gave us time to absorb and process the idea that he’d be leaving us soon. He was about 14 though, so he was already past his prime (all my dogs seem to live about 16 years).

    His leaving us turned into a spiritual experience. He let me give him one last infusion and pain pill to perk him up for the drive over the hill to say goodbye to friends and pick up Ryan after work.

    We finally had him put down late at night behind the vet’s office under a bright street light lying in the back of the car on his platform with us and several of the staff standing around him. It was like a Xmas manger scene and his release felt like a rebirth, not a death.

    That dog (another “special one”, like Atina) clearly had other places to go and other tasks to tend to. His time with us had just come to an end and we were sending him along on the next part of his journey, sad to lose him, but proud to have been blessed by his presence in our lives. Ryan and I both walked around in a daze, not sad, not happy, but just “wow-ed” for the next 24 hours.

    I’m still amazed that we weren’t crushed with grief as we’d expected. I don’t know if it will ever be like that again with our next dogs (I doubt it) but I sense that Atina also has that “special” quality. I hope that you too will feel the powerful spiritual quality of her impending departure.

    Reply
    • Wow, thank you for sharing this powerful story. What a lucky dog, to have you and Ryan for fellow travellers and co-guardians on his journey through time.

      I’ve been blessed with a series of amazing dogs who for one reason or another passed on, on my shift. Every one of them had special and specific teachings, not just for me, but for everyone who passed through our lives. Atina, as she’s matured through her third year, has become more and more attuned to everything in her environment. We’re getting even closer as her time grows shorter. I’m finding myself triggered by it, flashing on my father’s long journey to death, exactly three years ago. I’m working hard to stay positive. Not that helping my dad die wasn’t positive–it was. It’s just hard, no way around that.

      I really appreciate your support ❤❤❤

      Reply
  8. Dear God, what next? I had no idea that Atina has malfunctioning or malformed kidneys. It is a hard egg to swallow when a pet that is so attuned to one is not going to have a long life. While I’m here in this moment, I hope that you will get another dog when that time finally arrives. You need the company and love of another entity. It is sad to say but I feel more love from my some of my special pets than I do from either of my two children.

    But you love your beautiful dog with all your heart and she loves you. That is all that matters at this point in time. However, I did not phrase that quite right. What matters most to all of us that follow you, is that you will be alright. We care very much. I don’t always comment but I do when things are going ok for me.

    I see that you are using Ringer’s Lactate I always have on hand at least one full box of Ringer’s . My vet orders it for me. I have two cats and sometimes more on f;uids, most days. We do what we can to keep our pets going. After all it is more than worth the effort.

    Be well, Dr. Laura and hug Atina extra tight for as long as you can. Atina is quite a dog and each of you are lucky to have each other.

    Reply
    • Yes, we are very fortunate ,Atina and I, the savage bitches that we are….the evil criminal woman who sold me this dog, knowing she was deathly ill but not exactly why, insisted that she was doing the right thing by refusing to take her back and refund the $12,000 I paid for this fully trained Service Dog. Well, in a way she was right. I am passionately in love with this girl who has taught me more about love and patience than any human. Yes, I’m already thinking about how to raise another savage beast, when the time comes…

      So you’re also doing the subcu infusion thing with your crew! The dear beasts, what we do for them. My vet charged me $16 for my first bag…uh, nope. Found it for $6 online. I could get it for $3 from my medical supply place, but they won’t ship to me outside my state of licensure. Fair enough…

      Yes, I’m harvesting lots of Malligator hugs and kisses! Fortunately she loves good squasher hugs from me.

      Take good care and snuggle those kitties!

      Reply
      • Oh my God! Atina was 12k. That bitch woman should fry in hell if not sooner than later. She’ll get her due one day. My vet orders from MWI or one of those places and my last box of 10 bags cost me $75. The price had gone up. If your vet has any compassion at all he/she should be ordering for you if that would be easier/cheaper. My vet had no problem when I told him that my previous vet of 30 years ordered a good many of my meds. Dr. B. seemed happy to comply because I am his top client. I wish that were not a fact. 🙂 I am also a dog person, Dr. Laura. I have a pack of rescue dogs, 4 of them are 12 plus years. I cook oatmeal, carrots and green beans and or broccoli daily to add to their Purina One just to hopefully make them healthier and live longer.

        Reply
        • Oh you do have a houseful (and your hands full!) They like oatmeal? Good to know. So far the potatoes, yams, and rice are doing the trick…the most important ingredient, the one that keeps your pack going strong, is the one you’ve got the most of: love, of course! What lucky critters to find your den.

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        • Oh, and don’t worry…when the curse I threw at the dog broker takes effect (and they always do, at the proper time), she’ll know that even though there was an element of right, it was wrapped in a package of wrong, and crime may pay in the short term, but in the end the piper must be paid.

          Reply
  9. Loretta Melnychuk

     /  December 2, 2017

    Hi Laura. I’ve been thinking about you and Atina so much; sorry I waited so long before posting a comment. I’ve cooked for my dogs since kidney disease (from the made-in-China melamine-contaminated dogfood) stole my heart and soul beagle from me in 2007. Chicken soup is their absolute favourite – no onions though! I cook a blend of brown rice and quinoa to bulk up the canned wild salmon or grass-fed organic ground beef or other good quality protein mixed with cooked and mashed up carrots, celery, broccoli, cauliflower, and other assorted veggies. No onions, no avocado, no grapes or grapeseed oil, no macadamia nuts – they are all poison for dogs. If you’d like to email me directly I’ll send you the dogfood recipes that I use; you might get some ideas for feeding Atina. I’ve written you a few notes over the past couple of weeks but couldn’t quite post them; I know this is going to look trite when it’s written out, but… I know what it is like to love a dog so hard that it hurts. And to love them so much you do what is kindest for them, no matter the cost to you. You and Atina will cram years of love into however much time she has left… I learned this from my very first beagle when she developed an inoperable bladder tumour. I asked the vet how I would know when it was time to let her go, and he told me that it would be the day that she would be unable to urinate when she got up in the morning. I lived with a mix of joy and dread for almost 3 months before that morning came. I cooked a ribeye steak that morning and fed it to her in chunks, then we went back outside. She sat in my lap, the sunshine and the cold March breeze on our faces for a full hour before we drove to the vet. I believe in reincarnation now, but I’ll tell you that story later, when you need to hear it. Hugs to you and Doggess.

    Reply
    • Hi Loretta,

      Thanks so much for your kind letter. I also lost a dear friend to the Chinese scourge in 2007. We love them so much…

      I would love to have any recipes you’re able to share! I’m finding that the vets are clueless about home cooked dog meals. How far we’ve stayed from simplicity…

      Reply
  10. Simply, WOWW!!!

    Reply

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