The phone rang--it was my mother. “Harry passed away.” Harry was a family friend, familiar from my early childhood, part of a core group within my parents’ circle. In later years, Harry was almost like an uncle, often present at the dinner table on major holidays. He was quick-humored but a little odd, and had a penchant for paisley shirts and large rings. He was an artist who was quiet about his work, though he loved to share it with those who appreciated it.
“Allo needs a home--do you know anyone who wants a dog?” I knew Harry had loved his dog, a 55 pound Eskimo dog mixed with Treeing Walker Coonhound, somehow crossed with Corgi. Allo was an old dog, a fluffy, auburn girl with stubby legs, warm brown eyes, and a big smile. When we gathered for family holidays, he frequently talked about her. She was always the reason he needed to return home.
“Sure,” I said, “Send me a photo. I’ll get a message out to see if someone can take her.” As a clinical psychologist working in a large academic department, the periodic mass email from a soft-hearted colleague seeking a home for an animal in need was not unusual. With new faculty and graduate students moving to town every year, we had a pretty good hit rate. I was confident Allo would have a new home in no time.
“That would be great. Except… Whoever takes her should know that she is anxious and pretty timid--when a stranger comes to the house, she hides in the corner. And she sometimes pees inside. She uses training pads, but her aim is pretty bad. And she has to go for a walk every night around 3 am.”
The mission grew tougher by the sentence. My confidence shrank. I wasn’t just looking for a new family for Allo— I needed to find someone who would bring an unadoptable dog into their home. Meanwhile, Allo’s world was upended, her human gone, routine vanished. Her loneliness broke my heart. My husband and I knew we could offer her the love and stability she needed. That day, the unadoptable Allo came home with us.
Never in my life had I met a creature with so much anxiety. From the moment I secured her in the back of my car, until 48 hours later, when I brought her to our regular veterinarian, Allo panted, whined, paced, and barked. A 20-minute break from all of that anxiety was impossible, and so was sleep—for everyone in the household. Allo also drank water constantly, and either sat by the door asking to go out, or peed right where she was every 30 minutes. Anxious and incontinent in her prior life, we thought maybe a new environment was just too much for her. But pharmacological relief seemed to be in order, so I brought her in to see what could be done. At the time I didn’t realize that first appointment for Allo was just the beginning of a saga that would change my life.
As luck would have it, we had a great veterinarian. With more than 30 years of experience and the cat-scratch battle scars to prove it, Dr. Mark Carlson is adored by his clients and patients alike (except, possibly, for some of those cats). Practical, genuine, and blazingly competent, he has a reputation for being one of the best veterinarians in town. Oddly enough, you might not hear his name until you’ve lived in the community for several years. A coveted resource, his clients actually avoid referring their friends to him in effort to make it easier to get an appointment for their own pets.
My memories of spring that year are a blur of tests and work-up for Allo’s problems. After ruling out some obvious possible causes of her problems, Allo initially started on medications for anxiety and incontinence. But Dr. Carlson also discovered a small tumor-- an adenoma, which led us further down the garden path. He ultimately diagnosed her with Cushing’s disease, most likely caused by another adenoma in her pituitary gland—the region of the brain that controls the stress hormone cortisol. The source of her anxiety, urinary frequency, and crazy water consumption was identified. Allo started medication to target Cushing’s disease. Her symptoms improved, and she turned into a happy and energetic old girl. We reached a plateau and stayed there for the rest of spring and into the summer. Things seemed to be okay.
Until they weren’t. Late that summer, we noticed that she was asking too frequently to go outside, including several times per night. But now she wasn’t just urinating and coming back in. She was urinating a little bit, waiting 30 seconds, then trying again--seven to ten times in a stretch of five minutes. We brought her back in for a work-up, and this time a new garden path led to a diagnosis of transitional cell carcinoma (TCC)—bladder cancer.
Surgery was not possible, and the diagnosis was terminal. Our options at the extremes ranged from euthanasia to oncology referral with courses of chemotherapy. My husband and I both work as clinical researchers--after talking with our veterinarian and reading the published clinical trials in TCC, we determined that specialized oncological treatment wouldn’t extend our old girl’s life in a meaningful way, as she had also developed worsening cognitive dysfunction. But we thought she still had many good months ahead of her. We opted for a less aggressive anti-inflammatory treatment, deciding to keep her as comfortable as possible for as long as she was with us.
Looking back, I still believe that was the right decision for us and for Allo. In the early months after her TCC diagnosis, treatment brought her back to that happy plateau from the previous summer. She was straining to urinate less frequently and she often slept through the night. She was strong and active, playing with our other dog, eating well, and loving her daily walks.
But eventually the food refusal, likely a side effect of her anti-inflammatory medication, began. The vomiting was next. After a few stops and starts to give her insides a break from the medication, and trials of other medications with similar anti-inflammatory properties, the decision to stop cancer treatment became clear. Yet even with treatment for her gastrointestinal tract, she vomited daily. Moreover, with the anti-inflammatory discontinued, the cancer raged in her bladder—we now needed to let her outside every 90 minutes, even through the night. My husband and I started taking shifts, aiming to each get two three-hour blocks of unbroken sleep. We were unsuccessful. Then the recurrent urinary tract infections began, with attendant agitation. Back to day one—panting, whining, pacing, and barking--all night long. When Allo didn’t sleep, nobody slept. Medication refills, trips and phone calls to the veterinarian, further tests. Costs piled higher.
At this point, you may be asking why we did not choose to euthanize. On paper, I agree, that sounds reasonable. Every time we visited Dr. Carlson, he patiently listened to the laundry list of her problems and would say “Oh, Allo, you’re not doing great, are you, kid?” But he would examine her, take her for whatever test was next in line, and return her to me with a look of mild consternation—“Well, the tumor is progressing, but she seems like she’s doing pretty well.” My sentiments, exactly. I was constantly assessing her quality of life and had the same thought. She was still running, playing, wagging her tail, and smiling her Allo smile. The symptoms she experienced didn’t outweigh her happiness. Quality of life was not poor—at least, not for Allo.
At first, when Allo needed to go out every 90 minutes, we didn’t sleep well, but were grateful that we could often work from home and let her outside throughout the day. Eventually we decided we needed to sleep more, and that our colleagues would think we had taken jobs elsewhere. We transitioned her to diapers, at night putting her bed, covered with training pads, in a child's play yard. Five weeks of agitation from the ordeal of that change, and she had settled into the new routine. Recurrent urinary tract infections were solved with urine cultures to determine which antibiotics might work. Agitation was soothed with medication. Food refusal was addressed by cooking her different meals until she deemed one edible. When that didn’t work, spoon feeding came in handy. Vomiting was not a big worry since she never seemed to notice it—it didn’t stop her in her tracks. Did you know that puddles of vomit from a running dog can be up to 3 feet long, uninterrupted?
No—Allo’s quality of life was not a problem… we were subsidizing her quality of life with our own.
I couldn’t bring myself to euthanize our generally happy dog, just because she made my life difficult. I was exhausted and stressed out beyond capacity from the lack of sleep and frustration over new Allo problems springing up daily. I was calling or bringing her to the veterinarian at least once per week. Every time she started a new medication, she improved, at least for a little while. That ray of hope was like an addiction.
Doing some online reading, I stumbled upon a social media group for owners of dogs with TCC. The immediate relief of being accepted into a group of people facing and solving the same daily crises was overwhelming. Those last months of Allo’s life I spent clinging to the end of my rope, but I was not alone. I had support at home from my husband, from our veterinarian, and through this group of people I had never met, all of us coping with the same stress and trying to help one another.
For months after we stopped the anti-inflammatory treatment, I felt like I was flailing. I didn’t understand why I found it so difficult to take care of my dog—why I resented her sometimes. Was it because she was still new to us, and had health problems since the beginning? We didn’t have the long-term bond that many people have with their pet before old age and illness sets in. Did I just not love her enough?
Once I joined the social media group, I could see that the problem was not just me—feeling on edge was part of the experience. But even though we were all working to handle changes and problems with our dogs, we infrequently acknowledged that as a whole, the process was exceptionally difficult. We were spending hours every day providing care for our pets. We were exhausted, cleaning up vomit and urine, coaxing our dogs to eat or take their medication, walking them at all hours of the night and checking with flashlights to make sure they had emptied their bladders. We second-guessed our treatment choices, some feeling guilty that they opted for a treatment with too many side effects, others for choosing a treatment that in retrospect seemed not aggressive enough. We watched our relationships suffer, we compromised our lives at work and at home. By putting one foot in front of the other, we were coping. But I could see that many of us were hanging by a thread.
I attribute this bird’s eye view of the distress we all experienced to the research I did during my training as a clinical psychologist. Before finishing my PhD, and in the early years of my career, I worked on a federally funded project examining family members providing care for people with dementia. The everyday struggles, challenges, and problem-solving inherent to caregiving-- identifying and measuring that stress was part of my job. Researchers call it “caregiver burden." I knew that in human relationships, caregiver burden is very real—it is linked to stress, depression, anxiety, and poor quality of life. I was a burdened caregiver.
As a researcher, my response to this discovery was to turn to the scientific literature on caregiver burden in pet owners. I found… nothing. That discovery set the course for this research to ask how we can better support pet owners caring for a sick pet, and share the answers with you.~
The information offered on this website does not constitute psychological or veterinary medical advice. Please consult with an appropriate professional who can make recommendations for your specific situation.