RIP

Metal Harmony was born August 10th 2005, and I held her as she died, May 23rd 2017. She was 11 years old.

You were a better friend and dog than I deserved, and I am so very sorry I failed you.



In the last 2 days I couldn't tell you how many times I called the animal hospital that did the surgery on my dog Metal Harmony 2 weeks ago. I've practically been in contact every other day with them, but on Monday & Tuesday I had to have called them more times in those 2 days than during the rest of this entire ordeal.

About a month ago my dog had 2 teeth pulled, and they discovered cancer. Squamous cell carcinoma to be exact, on her lower left lip. They were going to operate, and just over or just about 2 weeks ago they operated, and there was a bit of a complication. They found more than they expected. Not only was more of her lower left lip removed, but as was almost the entirety of her upper left jaw. From pretty much the cheek to the k9 tooth was removed.

The surgeon who did it, I'm going to call him "good vet," or even "GV" for short, who was wonderful. Very calm, very supportive. Very intelligent. Chose his words carefully, but more importantly sounded hopeful. They did some biopsies as well, because this kind of cancer is aggressive and can spread. Unfortunately there was a 2nd complication. Metal was a bleeder, and she lost a lot of blood, and had to stay in intensive care. This was a 24/7 animal hospital as well as a sort of cancer specialist. I actually had a childhood dog who got a rare blood cancer, and it was the same group, though a different building who did everything they could for Rudy, my childhood dog, at the time.

She wore one of those cones, of course, to make sure she didn't hurt herself. And didn't like it. But the next day after surgery she came home. We had a routine. She had "1 chew and 2 blue" in the morning and at night. The chew was a chewable tablet which was an anti-inflammatory as well as a pain reliever. The blue were 2 blue pills of antibiotics. She also was given an anti-anxiety prescription, to help with the post surgery as well as, well, anxiety of the cone. Funnily enough my father, who has PTSD from Vietnam, actually has the -exact- same prescription. This actually proved useful, as I eventually called them asking about it when it ran out, and I wasn't doing the usual twice a day dosage (as she was good most days,) but was giving her 1 or 2 (instead of up to 4) to help sleep at night. Good Vet offered to write up a prescription, and I mentioned my dad had the exact same pills, down to the same mg.

Anyway, her face looked so deformed from the surgery. It wasn't just the missing sections of her jaw/lip but also the swelling in her muzzle and face. Her eye on that side even. It was so painful looking. She was actually recovering faster than expected. There was a steady back and forth with the surgeon, and we were going to say the non-surgical vet Monday, the one that just passed, but unfortunately there was yet another complication.

Metal had a blood clot, actually several, in her nasal cavities. This was considered normal, expected even. I just didn't realize that it would look so horrible. There was blood damn near up to the ceiling, hell there was actual blood on the ceiling. It was just streaming from her muzzle, her nostrils and mouth. She was covered so badly in her own blood that she shook like a dog in the rain. Naturally call the specialists and go in. So yeah, Good Vet believed this was normal. He even said that it would have looked like a crime scene. He commented on how far the swelling went down and how alert she looked. However if it gets worst call back, and if there are concerns then call back. There was a warning that she probably would have a few more attacks, like this, but that the hemorrhaging blood clots would become smaller. Sure enough they did, the 2nd attack lasted so little, the third was barely anything. I still called every time after the third one she had, mind you. Alone that would be 5 calls. I'm noting that number specifically. That's five times I called over this on Monday and Tuesday combined.

So that was Sunday, she had that initial attack in the afternoon, and 1 more Monday morning at 1:45 am I believe it was. Or 22 after. Something like that. She was going to see the regular vet specialist lady thing, we're gonna call her "Bad Vet" or BV for short. Really there are so many more words I would rather use instead on Monday, so that's why I didn't call during the 2nd attack in the wee AM hours of said Monday.

So Bad Vet sees her, inspects. There is of course mentions of the blood and difficulty breathing now that there's blood in her nasal passageway. Bad Vet tells us she's in pain. Bad Vet prescribes an opioid. I'm going to rant on this later, just keep that in mind. Bad vet also gives us something called yunnan baiyao. I am so going to rant on that later too. She says that Metal is in a lot of pain and also gives her a dose of the new medicine. Metal practically conks out. She can't walk up stairs now, she's so sedated. And it doesn't even look like a good high. She looks panicky. She's scared. She can't understand whats going on, she's a dog, this is a weird concept for her to understand. I can't just tell her. So I spend all of Monday on the floor petting her.

When Metal was a pup she was spayed, but there was a complication there too. It caused her to have less control over her bladder, and without the right medicine, Proin, she can't actually control herself well. When she came home from the surgery the first day she had an accident, but it was kind of expected, but not since that one accident that very first day had she had an inconsistency problem. She was having them again with these new medications. So I spent Monday on the floor cleaning up blood and urine while my dog kept passing out. It was rather troubling, honestly. So that night I called the hospital again.

She had developed tremors. She couldn't stand at all, and kept falling down, and she had yet another blood clot hemorrhage. It wasn't nearly as bad as the first, but was mildly more excessive than the 2nd attack. The surgeons were not in when I called, but I did speak to a tech. This is when the secretary, I'll just call her secretary but if there was a 2nd secretary this would be good secretary on account that she was amazing, starting to recognize my voice, that's how often I was in contact during this time period. So anyway, she offers to let us speak to a tech & the tech does advice us to bring her in. She might have to stay over night, and I'm okay with that. I would worry immensely, but at least she'd be in good hands, I figure.

As I wait for my ride, cause I don't drive (I live in NYC I don't have any need for a car at all outside of taking dog to the vet,) I get a call from the hospital. It's Bad Vet. Advising me it would be a waste to come in. She sounded to genuinely believe I was over reacting. She was actually calm, and listened to my concerns but was quick to point out a reason to back off. I listened to her. I even gave her two of those new pain pills, the opioids.  Metal couldn't make it upstairs, and she is very diva-ish. She does not like to sleep anywhere but in her bed in the bedroom and that's that. She will claw and crawl to the stairs hoping to get up them somehow. So I picked her up carefully, and walked her upstairs.

So I had a terrible time sleeping that night. I was afraid I made the wrong decision. Tuesday rolls around, and Metal can't walk down the stairs on her own, but at least if I help her she doesn't need to be carried. She wants to go out and pee, a good sign since she didn't do that at all the day before. She instantly falls on the stairs. She can't make it up the stairs and practically collapses instead of laying down, but has her head up and just breathing hard. I'm worried. She ate her breakfast though. No more processed dog food, mostly because of the jaw surgery at first, but she just started liking special home made recipes, and this was going to be the norm. Making several days worth of breakfast and dinner on Sunday. I have chicken and spinach meatballs, with rice, in my fridge right now that I had made for her.

Anyway she isn't doing well and I called again. I left a message, this was fairly normal and I'd get a call back soon. The Good Vet called. I was happy! We got awesome news, her biopsies all came back clear. The bone they removed, the check on that came back good. It was, to quote "exactly what we like to see." She could be in the clear. She might very well be cancer free.

Do I have any questions? Well yeah actually, I have lots. I ask about the new prescriptions that Bad Vet gave, and the effect it's having on Metal. I get the feeling he doesn't agree 100% with her, but clearly respects her opinion. I trust him more, and so when he says to cut back I'm very glad that that's exactly what I did. We're going to have a meeting with Good Vet very soon later this week, and I'm happy about that. Metal is asleep, she's kicking her feet dreaming, it's a good day.

Not a good afternoon though. Metal got weird again, and had another bleeding attack. I'm getting tired of typing hemorrhage. So I call, leave yet another message. She has 2. Bad Vet calls back and I explain what's going on. She's dismissive of it. I don't like Bad Vet, I'm sure you guessed that by me calling her "BAD" vet. She's dismissive of it, doesn't think much of it, this is all normal. Doesn't like that the dosage of her drugs were cut down. Now this is why I call her bad vet.

The pain medication she prescribed is an opioid that can cause anemia. The dog is already losing blood like nobodies business. I ask about this. She tells me I'm wrong. She's not personable like Good Vet. Good Vet sounds like a pilot, that "Ehhh.... If you ehh... look out your ehh window you'll ehh see whatever" kind of pilot, but he clearly cares, he lets you speak. He listens. Even if he wants to interrupt he clearly doesn't. He never tells you you're wrong. I had a question, really about an assumption, he didn't say the words "wrong" or "incorrect" but instead used "misnomer" and "misunderstanding" <- this might sound childish, but little touches like that in a bedside manner make me listen, and make me ask more questions. He never seems to be bothered by doubts or questions at all. He encouraged questions, and encouraged dialogue.

The second thing about Bad Vet is when I asked about the yunnan baiyao I was actually laughed at. I asked about reading about "toxicity" and she interrupted me with a haughty "Ahahahahah really? Where'd you read that?" as I was saying she interrupted me again to tell me that she never read it. And laughed. Again. This was obviously the funniest thing she ever heard in her life. "Trust me, I know -EXACTLY- what I'm doing heheheh. I wouldn't prescribe something that was bad. Heheh... Ha."
I'm not being factitious there btw, she literally laughed. With the pause. Then gave a "ha."

I was so disturbed and angry and put off my train of thought by this reaction, I completely felt just so completely dumb and stupid for like the first time since like I was in 5th grade. See, Good Vet, he's the surgeon. A specialist, he's only there on specific days at specific hours, I understand he can't be there 24/7. Bad Vet was the, as Good Vet called it, the one who was designing the "moving forward plan" and was to be in charge of Metal's post operation treatments and care. From medication to nutrient plans and so on. This was her job, to make sure Metal Harmony was going to be alright, and to make sure I could take care of her.

When Metal was acting funny I did research on the mediation that Bad Vet prescribed, which is what she found so funny apparently. See the opioid she prescribed can cause anemia, particularly there are warnings I saw about giving these medications to dogs who are already bleeding. It can be used post-surgery, but isn't considered as good as the one that the surgeon prescribed for such things. It's better at joint pain and the sort.  The dosage as recommended by EVERY veterinarian website I could find is practically 1 mg for every pound the dog weighs. Metal at her healthiest weighed 75-85 pounds she was a big dog. Now it does mention in all of these places that the dosage can be increased higher than that, if needed, but to be careful of over dosing. The dosage prescribed was 150 mg. More than once a day. Concerns over this were funny enough to warrant an audible laugh apparently.

The yunnan baiyao I mentioned earlier? One of it's ingredients is a chemical called aconitum. It's derived from the Monkshood plant. Yunnan baiyao has a history as a blood thickening and clotting agent, and is apparently an excellent emergency medication prescribed to people and manufactured in China. There's just the problem that it's great for people, but because of that aconitum it's not so good for dogs. Aconitum is toxic to dogs. I did not cut down on this dosage and already gave her that day's dosage/s by the time I read this. The symptoms of aconitum poisoning match Metal's condition. So does anemia, which the opioid could have caused. Then again the blood clots bursting could have also been the cause. But she knew enough to laugh and point out how smart she was when telling me to give her the dose she assigned, and that everything was fine.

"I guess, if you really couldn't handle it, you could bring her in. I suppose." was an actual quote. I was so taken aback by this just, mockery I don't know what else to call it. I didn't know what to do. Like I said I felt like an absolute idiot. I'm so worried about my dog I'm not thinking straight. The conversation ends and I don't know what to do. Not long later Metal has another blood clot burst. This time it's actually bad again. I've got tears forming.

My dad agrees to drive me to the hospital in New Jersey, but along the way I freak out and tell him to go to a closer one. One I wanted to go to Sunday, but was talked out of because of a bunch of silly reasons that really weren't right I feel. We're on the highway and I'm freaking out because my dog stopped breathing, and is convulsing and I'm actually trying to do everything to get her to breath again. She went still and urinated, and relieved her bowels and I knew she was dead, or right next door to it then, but I'm freaking out like I said, and even started trying to do chest compression and I have no idea how to do that with a dog. I'm covered in her blood and urine in the backseat of a van on a highway begging for her to breath.

We arrive at the closer emergency animal center. They come out with a gurney and I help them put Metal on it and they immediately wheel her back into a room, and this Vet, who I'm going to call Nice Vet, came in and explained she didn't have a heart beat. The chances were low, but it was our decision to say if they should stop attempting CPR & attempting to revive her. Low chances aren't zero. Please continue. He accepts and leaves and he comes back five minutes later. The chances are now practically nothing. Should they stop. If it's nothing, then yeah, you can stop.

He tells me he's sorry for our lose, and that if we'd like they can clean Metal Harmony up and wheel her in and we can say goodbye. I was so worried that this was an avoidable death that maybe it was the blood clots that if I had held her up or tried to do something with them, maybe they were blocking her air way. He said there was a significant amount of blood, but he doesn't believe that was the cause, doesn't think that was enough. Her air ways were clear when they got her. I was kind of relieved, in a sad way, because then it wasn't an easily avoidable death.

Until later when I realized it was completely avoidable. If the vet had listened to me, or if I had listened to my own doubts and fears and urge to go elsewhere, to not back down and instead demand the assistance I felt, then she would alive right now. She might be in a hospital over night, but she'd be alive. I could have saved my dog's life.

I kinda let myself get bullied into that and I feel absolutely horrible over it because Metal Harmony died in my arms not 2 hours after that conversation with Bad Vet in the highway with blood and thick clots just streaming from her nose and mouth having convulsions and possibly a seizure as I tried so had to get her to breath, and all because I let myself feel inadequate and dumb.

I shouldn't have listened and I should've just gone to another vet. The surgeon, the 'good vet' isn't there at all times, and isn't really a check in vet, but I should have asked for him, or I should have just gone to another hospital. And I knew that, and I wanted to, but I was so worried I just accepted what I was told and my dog is dead now. So if you read this, don't ever do that please cause it feels horrible knowing you could have actually done something. If you have someone, pet or person or whatever, and you don't trust the physician and everything is just yelling to do something else, don't listen. I mean yeah, if the 2nd vet says the same exact thing, okay, but when there's a discrepancy or at least a chance just take it. I'll never pet my dog again and it's my fault, so don't do it please.