A Dog's Life

The Story of My Best Friend

Halfway through my second year of residency, my med-school boyfriend and I split. Lots of medical school partnerships don’t survive the grueling years of residency. In retrospect, of course, it was for the best.

Katie was an intern during my second year; supporting herself on our meager residents’ salary in a 1 bedroom apartment in downtown Baltimore. I had moved across the country to be with a man who would no longer be covering his half of the rent. Katie and I both needed roommates because life is expensive. So we decided to team up.

“What do you think about me getting a puppy?”, I asked.

“What do you think about me having 2 cats?”, she said.

Some dog people have certain breeds that they just identify with. To me, beagles are my pack. They’re silly, docile, portable, good with kids and generally good with other animals. They’re not known for their intelligence but the big brown eyes and floppy ears make up for it in charm. There’s a reason Snoopy was drawn as a beagle and not a German Shepherd. No offense to Shepherd people.

On a snowy February evening, after my Friday continuity clinic, I drove from Baltimore to rural Virginia to pick up my new best friend. He shivered on my lap through the entire drive home. Refusing to ride shotgun as I shifted the gears of a Jetta that had a manual transmission on purpose. This was a perfect introductory experience because we’ve spent our lives together traversing dicey circumstances across the United States and Canada. He’s gotten used to riding shotgun as he’s grown.

Our very first night as family.

Riddle grew up in a house of chaos. In addition to Katie’s two Maine coons, he shared a home with two busy doctors, one part-time resident boyfriend, and an extended family of co-residents who provided assistance with walks, feeding, and general affection during the long hours of training. Our home was like a remix of Friends, Grey’s Anatomy and Harry Potter.

When I was accepted into fellowship on the opposite coast of the United States, Riddle rode shotgun across the country. We went from Baltimore to Dayton, Kansas City, Denver, Salt Lake City and then to Portland, Oregon. Along the way, he befriended everyone he met. During my darkest days of medical training, this floppy-eared little soul was my reason for staying alive. I simply didn’t trust anyone else to give him the life that I thought he deserved. That was reason enough for me to hang in there.

Riddle has been pretty healthy, with the exception of a puppy parasite infection and a nasty bout of kennel cough after an unfortunate boarding incident. To this day I still refuse to board my dogs because of that experience. So I was alarmed last week when he started shaking, limping, and appearing distressed.

One thing I learned in pediatric medical training is how to listen when the patient doesn’t have words to explain what’s wrong. Animals and non-verbal children are unreliable historians. Clinicians have to assess them in ways that are somatic rather than articulate. I called up Riddle’s neighborhood vet late on a Tuesday afternoon and begged them to see him in their very last appointment for the day. They were gracious enough to let me escort him to the examination area to hold him while they did their work.

He looked like a creature on the edge of oblivion but his vital signs were stable. His labs were all normal and the rapid ultrasound didn’t show an intra-abdominal process. I even got to look at the flapping of his heart valves as the vet examined his cardiac function. They ran a toxicology screen using a cleverly collected urine sample, but that was also negative. Evidently, shaking, lurching and a general appearance of misery is a common constellation of symptoms for dogs who have accidentally ingested drugs. They didn’t have the ability to run advanced neurological imaging, so they made the assessment that it was probably an ingestion that just hadn’t shown up in his urine yet. They treated him for pain, told me to monitor him and advised that a nearby referral center had a neurology department if his symptoms failed to resolve.

He did improve for several days. But the following week, he took another turn. The same frightening symptoms returned but he seemed to be even worse this time. He was shaking, drooling, walking with his head held low and cowering under the bed. I was worried he was having a seizure. The referral center has a 24-hour emergency department, advanced imaging, neurology and surgical specialists. I scooped him up and whisked him across town to have him seen emergently. The triage nurse took one look at him and assessed that it wasn’t seizure. She listened to my story and said with confidence that he appeared to be in pain. I gratefully handed him over to her and took a seat in the lobby.

Some time later, around 10pm, I was called into a room with a senior veterinarian and the equivalent of a veterinary resident. The senior vet explained that the differential diagnosis included herniated disk, autoimmune disease and possibly malignancy. They don’t do neuro imaging overnight but she explained that I could schedule an appointment with the neurology team in a couple of days. At that point, they would decide the best imaging option for the suspect diagnosis. In the meantime, they would treat Riddle’s pain and send him home to rest.

After doses of gabapentin, meloxicam and methadone, I brought my gorked-out beastie home. We slept through the night but the following morning, he was back to looking like a disaster. When a beagle refuses Tylenol gratuitously wrapped in cheese, you know you have a serious problem. I called the ER to let them know I was bringing him back. I arrived thinking the worst; convincing myself that he had a tumor in his brain or compressing his spinal cord and that today might be his last.

The daytime triage nurse collected him and deposited me into a private room to sob. Seeing my best friend in this condition was more than I could bear. He could barely walk, refused to eat and was trembling in agony. This creature who gave me the will to keep going through my darkest days was suffering in a way that I had no power to resolve.

After a while, the daytime attending vet came to talk to me. I explained again the course of his condition and listened as the vet explained the work up. They would get some basic labs and have the neurology team assess him. Then they would sedate him to undergo X-rays, ultrasound and if those tests were inconclusive, a CT scan. A CT study is usually able to confirm a herniated disk or tumor but can miss autoimmunity or microscopic malignancies. Both CT and MRI are eye-wateringly expensive but I wasn’t going to let my buddy suffer through a condition that could be diagnosed and treated.

The team let me cuddle him while he waited to get his IV. I held his head in my hands and stroked his ears. Telling him how much I love him and what a good boy he is. He was terrified to be there and I had crawled halfway into the cage with him to try to reassure him. He settled a bit before the tech gently pried me off to take him for the tests.

It’s a miracle I made it home through the veil of tears. I tend to catastrophize so I imagined a metastatic cancer impinging on his spinal cord. Not wanting to see him suffer, I played out the worst case scenario. Our entire life together flashed through my brain that afternoon.

The silliness, devotion, patience, petty larceny, road trips, disappointments, frustrations, anxieties, recoveries and unconditional love washed over me in waves. I sobbed until my face swelled shut. I waked Dobby to the beach to distract my mind. Then I came home, showered, cried some more and waited for the vet to call.

The diagnosis was 2 herniated discs in the cervical spine; a condition that’s pretty common in beagles. The nerve impingement causes pain and weakness but the vet indicated about 70% of dogs recover with conservative management. She reviewed the treatment plan thoroughly including round-the-clock pain management, steroids to reduce inflammation, gut protection with a PPI and strict bed rest for 4 weeks. No jumping. No stairs. No leash walks. But with adherence to this protocol, he stands a good chance of making a full recovery.

When I picked him up in the evening he was a little stoned but grateful to see me. His belly was shaved (for the ultrasound) and they did us the courtesy of buzzing down his nails. We came home, snuggled into bed and slept soundly.

He’s done well since coming home and is taking his meds with peanut butter. I set up a playpen in the living room to protect him from his basket-case brother. His tummy is upset from the stress but we’re managing with frequent trips outside.

I want to express my gratitude for the outpouring of support on Substack this week. Those of you who shared stories of your animal companions truly touched my heart. In a time when humanity seems so inhumane, relationships with animals restore a kind of tenderness. Riddle is going to be big mad about the lack of walkies over the next few weeks but I’m going to do my level best to hold on to him the way he’s spent his life holding on to me.