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Sammy's last weeks

Sammy's illness

Sammy passed away on April 1, 2007. He was just three years and 86 days young. He was a vibrant, energetic little dog who had a heart and zest for life so much greater than his small size. He loved to pal around with his friend Buddy (also a toy poodle) and "patrol" the back yard. He was super smart and intuitive. He knew the "names" of his toys. He loved to lay on my lap in the car. He loved to visit PopPop and Dot, his grandparents.

I am posting these details so that everyone who reads this can understand how quickly something can happen, and to be vigilant about the care of their cherished dog.

Sammy became ill around St. Patrick's Day. Before this, he was walking, playing, eating, and sleeping normally. He became lethargic and didn't seem to have his normal appetite. A trip to the vet found that his platelets were extremely low, but all other numbers seemed more or less fine - he had a normal temperature and had lost no weight since his last visit. Sammy was diagnosed with immune-mediated thromocytopenia (ITP), an immune system disorder that seems to result from the body's own immune system attacking the platelets in the blood. He was prescribed a steroid and I was told to bring him back in one week to have his platelets counted again.

Several days later, he developed horrible bruising on his left side. A trip to the emergency vet found his platelet count had risen, and the bruising was attributed to being a part of the disorder. He exhibited excessive thirst and some panting, both of which were deemed side effects of the steroid.

In less than a week, I took him to the emergency vet, as he had what appeared to be blood in his stool (it looked like coffee grinds). After he was seen by the most amazing ER vet, I was told that Sammy was VERY sick and that he would need to be admitted to the hospital. I was devastated. I had been taking him to the vet, having blood tests done, administering medications, and following the instructions of his regular veterinarian to the letter.

That day was the last day that Sammy was home. He was admitted to the emergency facility, and within a few hours the ER vet said that in her honest opinion Sammy had some sort of cancer, and that his was "a disaster of a case." She could not believe he had not had a better work-up done in the beginning, including x-rays and an ultrasound. He had now developed anemia (IMHA, immune-mediated hemolytic anemia) and was in distress. When I was first allowed into the treatment area of the ER vet center, Sammy was in a special oxygen capsule and was on a heart monitor and receiving IV fluids. The ER vet said he may benefit from an infusion of fresh frozen plasma and red blood cells, to which I agreed. The vet was brutally honest and said she feared he had less than a 50% chance to survive. He was also in desperate need of an ultrasound, as the x-rays they took were black because his belly was full of fluid/blood.

I was willing to do anything and everything to find out what was wrong with him and give him the best treatment possible, regardless of cost, assuming he had any chance of recovery. However, as Sammy was being treated on a Saturday night, there was no one to do an ultrasound at the ER facility, nor at ANY facility within a safe driving distance for Sammy. Not even at the Veterinary Hospital at The University of Pennsylvania, a supposed state-of-the-art facility. An ultrasound was desperately needed in order to help come up with a diagnosis of just what kind of cancer Sammy had and where it was located in order to figure out the possible treatment options for him.

Sammy seemed to do a bit better after the plasma and red blood cells were given to him. He even looked at me and wagged his little tail. However, just a few hours later (3:15 a.m. Sunday morning), he was in severe distress. He was struggling to breathe. I had to make the hardest decision I have ever made for myself, but the easiest decision I ever had to make for him, given my love and respect for him -- I had to let him go.

I know it helps to write about this and talk about this, but my tears would say otherwise. The lost of my best friend has broken my heart. I am still in disbelief as to how he seemed so well just before he got sick, even though his belly was filled with tumors (the ER vet offered, and I agreed, to make a small incision after he passed to see just what had destroyed his belly. She found tumors, large and small, in his abdomen, apparently from an aggressive cancer). I am in disbelief that the standard of care is so incredibly different, from facility to facility, even from one vet to another. I am in disbelief that no emergency vet facilities within an hour or so from Philadelphia have the means (staffing) to do an ultrasound on any given weekend. Though it would not have mattered in the end, given the number of tumors in his belly, perhaps I might have spent my last two weeks with him differently had I known just what was wrong with him in the beginning, and that he was not, in fact, on the road to recovery.

However, I cannot live with bitterness -- Sammy would not want that and was never about that. I know that I did everything for him that I could have done. I cherish the few years that I did have with him, and I urge everyone to do the same with their beloved dog. I also urge everyone to be VERY proactive at the first sign that anything is wrong with their beloved companion, and push for answers to any and all questions you may remotely have, whether you think they are valid or not. Only then can you truly make the best decision for your dog, and for yourself.

Thank you for taking the time to read Sammy's diary.