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Butterfly’s Heart

 

Butterfly started coughing about a month ago. It was only on occasion and seemed to be in response to her rawhide chews, so I stopped giving both dogs those treats. But the coughing continued; it was a sort of hacking sound, like there was something stuck in her throat and she was trying to cough it up.

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“Mommy, Butterfly sounds funny.”

I was concerned because it was the one question her cardiologist always asked me when he gave me the results of her twice yearly echocardiograms: has she been coughing? Even if her heart looked the same since her previous visit, he asked about coughing, and I always said no, she wasn’t coughing much. She’d sneeze here and there, or cough when she tried to swallow too much kibble at once, but, no, coughing was not one of her things. He never really explained why he was asking, and after the first three times I stopped asking him.

So when I noticed that she was coughing almost daily, I got scared, and made her an appointment with her regular vet. I thought it could just be allergies, and that I was getting hysterical for no reason, but really, I was afraid her heart disease had progressed.

I’ve worried about losing Butterfly since the first day we brought her home, because not only was she already eight-years-old, but she had a heart murmur they’d just noticed when we adopted her. They hadn’t heard it when they were removing her bad teeth, or excising a lump under her armpit. If they’d noticed the heart murmur, the staff said, she wouldn’t have been out on the floor and up for adoption – she’d have been in a special foster program for heart patients. So I was very lucky that they hadn’t noticed.

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My Lucky Day!

Butterfly’s vet did a chest x-ray that showed no changes to her heart to go along with the coughing, but she said she wanted to try Butterfly on a heart medication anyway, to increase blood flow, and see if that would help. She said that the coughing could be caused by her enlarged heart pressing on her trachea, making it more difficult for her to swallow. But that was just a guess, really. Possible side effects of her new medication would be lowering of blood sugar and listlessness, but I already do blood sugar tests for her diabetes, so it wouldn’t be an extra burden.

Fortunately, or not, there was no significant change in her blood sugar readings, and no sign of listlessness. But, she’s still coughing, three or four times daily in short bursts. She coughs a little bit when she wakes up, she coughs a little bit when she eats, she coughs a little for no reason I can see. Her mood and energy level are still great, though, and she eats and drinks and runs and pees and poops like normal. And she’s loving the twice daily doses of peanut butter. But there’s the coughing.

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“Peanut butter?”

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“Yummmmmmmmmmmm.”

We have to go back to the vet and see what she says about the heart medication and the coughing. Maybe we’ll have to try a different kind of medication. Maybe she’ll tell us to redo the echocardiogram before the six month mark to make sure it really is her heart that’s causing the cough. But I’m worried. Butterfly came home as an eight-year-old puppy mill survivor, with a questionable heart, and then developed diabetes within her first year with us, so there’s always been a ticking clock over her head. I make sure to revel in her presence as much as I can and make sure that I don’t miss anything of the life she has left – but I still worry every day, and I picture my life without her as a barren wasteland. I need Butterfly to live to her full expected life span of twelve to fourteen years, but more would be better. She’s at eleven and a half now.

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My baby.

I’d like to find out that the coughing is something unrelated to her heart, like, maybe she’s trying to learn how to talk and this is the first step, or she’s decided to store kibble in her throat for later, and it’s more difficult than she expected, or maybe it’s just allergies. That would be wonderful.

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The Three Echos

 

Three of the four of us had to have echocardiograms recently. Butterfly had hers first. She’s an old hand at doctor visits at the clinic, and always tries to bolt when we get near the front door, but her doctors are friendly, and the women at the front desk think she’s adorable, even though she’s too anxious to take the treats they offer her. Butterfly has to have an echo every six months, to keep an eye on her prolapsed valve and enlarged heart, and she does not enjoy the experience.

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“Are we leaving yet?”

As soon as we checked in and sat down in the waiting room, my mostly non-shedding dog released hair all over my jacket and drooled on my shoulder and tried not to pee on the floor. She was curious about the other dogs sitting in various states of terror around her: the three month old Labrador who couldn’t contain her enthusiasm; an eighty-pound brindle Pit Bull who was hyperventilating under his owner’s legs; a cat hiding in her carrier. But the Chihuahuas seemed reasonable to her, and the floor itself was a potpourri of odoriferousness. She went adventuring for a few minutes at a time, and then asked to be picked back up for emotional refueling before making her next attempt to survey the territory.

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Butterfly believes that all floors must produce kibble, like the floor at home does.

She went in for her echo in the arms of a vet tech, trusting and blank. She trained herself to accommodate humans many years ago, living in the puppy mill, and still uses her old coping skills, pretending-she-is-not-where-she-is, as they slather cold goop on her chest and probe for pictures of her heart.

It is not surprising that her heart has been damaged, or that her heart is bigger than it is supposed to be. I could have told you that without all of the fancy equipment. After the test, her cardiologist came out to tell me that she was the same as she’d been six months before – with a leaky valve and an enlarged heart and no need, yet, for medication.

He couldn’t see on her pictures that she has learned how to chase squirrels and run like the wind and jump for chicken treats. He couldn’t know that she has developed a full range of expressions, and only once in a while falls back into her blank stare of old. But he believed me when I said so, and he was happy for her, and for me.

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“I’m dancing!”

My echo was a different kind of experience. I’ve had a few in the past, and hated them all. One in particular, was both humiliating (changing into and out of the flimsy robe with the door half open and strangers walking by) and painful (half an hour of rib bruising pressure). This new doctor was specially recommended, and requested, by the new pulmonologist who is trying to figure out the possible causes for my shortness of breath.

The paper “gown” I had to wear was not much of anything, and the tech this time was male. In my three previous echo’s I’d only had female techs and assumed that was the norm. Stickers were placed above each breast and on my abdomen, and then wires attached. I was told to roll to my left, away from the tech, which was a relief.

I could hear the whoosh whoosh whoomp sounds of my heart coming from the computer behind me, but it was hard to concentrate because the probe was pressing hard against my breast bone. I could feel a black and blue mark forming and could only grit my teeth and tell myself it would be over soon. Whoosh whoosh whoomp, whoosh whoosh whoomp.

Because of the position I had been placed in for the test, on my left side with the probe at my chest and the tech leaning over my body, it almost felt like I was being hugged. It wasn’t sexual or disturbing. I did not expect this feeling at all. His hip and waist were pressed against my back, so that he could comfortably reach over and take the sound pictures of my heart. And despite the pain of the probe on my chest, the pressure of his arm over my side was a relief. I felt safe. I sensed no danger, no inappropriate or confusing energy from his body, just presence.

The doctor came in to look at the pictures, then, and he said that my leaky valve was, pfft, not much, and if you use an expensive machine like this you’re bound to see “something” but that doesn’t mean that “something” really means anything. He was annoyed that anyone would come for an echocardiogram and have a boringly normal heart to show him. Pffft. You’re fine, go home.

And normally, that dismissal is what would stay with me, but instead, this time, it’s the hug; the closeness and security of a stranger next to me. I don’t know what to make of it except to file it in the back of my mind, under surprising, and good.

Mom’s echo was the third in the series. She gets them regularly, though not as often as Butterfly, ever since her “minor” heart attack more than fifteen years ago now. It did not seem minor to me, or to her, at the time. The only explanations given were a leaky mitral valve and “stress”, which my doctor-brother pooh-poohed. The result, though, was that she started to take much better care of her health, and found a less stressful job, closer to home. The regular echos, and stress tests, and blood tests, are another thing she has accepted and rarely complains about, at least to me. I asked if it hurt. No. Or if it was humiliating. No. Or if the wait was long. No. She and Butterfly share this capacity, for going somewhere else in their minds when they need to not be with their bodies. It’s a skill I do not have.

Cricket has no such skill either. If she needed an echo they’d probably have to knock her out, like they do for an x-ray. Thank God, her heart is fine. Normal whoosh, normal whoomp. I know, because she likes to suffocate me in the morning, with her chest close enough for me to hear the sound pictures without any fancy equipment at all.

Pffft.

We’re all fine.

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Grandma and Cricket, whoosh whoosh whoomp.

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Whoosh whoosh whoomp.

Butterfly’s Echo

              Recently, we took Butterfly in for her six month echocardiogram. When we adopted her at the end of 2012, she was diagnosed with a heart problem that could, potentially, develop into congestive heart failure. I worry each time she coughs, because the original vet told me that coughing could be a sign of heart failure. And I worry about the lumps and bumps on her skin, because I don’t want to assume that something is benign and then find out that I left a tumor growing inside of my baby until it was too late. I just can’t believe that she is as healthy as she seems.

Butterfly's First Day Home

Butterfly’s First Day Home

The echocardiograms are subsidized by the shelter where we adopted her, and they also cover her wellness visits, so we scheduled both at the same time.

We took her for her 10:30 AM appointment and she was seen almost immediately by the cardiologist. He said, basically, that her prolapsed valve was a tiny bit worse, but she had no signs of congestive heart failure. I told him how much she had improved since November: she can run, and jump, and stand straight up on her back legs, to beg for food. He just smiled and patted her head, and the appointment was over.

When we asked at the front desk about Butterfly’s wellness visit, they said she was scheduled for 12:45 PM, in two hours, so not at the same time, as we’d been told. We were wondering if we should go home for lunch and come back, but the woman at the desk said there was only one dog ahead of us and it would be a short wait.

We sat on the wooden benches against the walls of the waiting room, which were comfortable for the first twenty minutes, and then not. Butterfly was stunned from her ordeal. She still had goop on her belly from the test, and she was almost dead weight in my arms again, the way she’d been way back when we first adopted her. I held her on my lap and gave her scratches and talked to her. We tried the dog cookies they had in a jar on the counter, but she wasn’t interested. I hadn’t thought to bring chicken treats with me.

I felt awful leaving Cricket home alone. Cricket found it shocking herself. But she didn’t need to sit in a waiting room swirling with various diseases. And, as we sat there waiting, I was relieved to have left her home, because she would have been barking her head off.

My poor lonely Cricket

My poor lonely Cricket

The waiting room was full. There were a lot of newly adopted puppies getting their shots or being treated for kennel cough. There was a Cocker Spaniel with a big, red growth on his ear and a cone on his head to keep him from biting it, again. And there was an Australian Cattle Dog mix, named Bandit, who jumped up and shed all over me and gave me kisses. He had epilepsy and was there to get more medication for his seizures. It was an odd coincidence, because I’d just been told that my abnormal EEG could mean that I was having partial seizures. I tried to ask Bandit what it felt like to have epilepsy, but he was too busy giving me kisses.

An hour along, Butterfly was back to full strength and up to visiting the other dogs, and peeing on the floor, but Mom was getting antsy. She went up to the front desk to ask when we’d be going in and they told her there had been twelve emergencies, and they all took precedence over a wellness visit. But, the woman at the desk told her, there was only one more dog ahead of us.

Our choices were to believe her and stay, or be circumspect, reschedule the appointment, and go home. I really wanted to take Butterfly to Cricket’s vet instead, but it was so much more expensive. The shelter’s medical care was subsidized, so instead of paying $350 for an echo, we paid $50 and there was no charge for her wellness visit. We decided to wait.

There was a pug in the waiting room with her dad, and she was there for an echo too. She already had congestive heart failure and took daily meds to help control it, but her dad said that if he saw her trying to run after a squirrel in the yard, he’d run screaming, “No!” because if she exerts herself too much, she faints.

I felt guilty, and lucky, that my Butterfly wasn’t in her situation, yet.

After the pug left, more puppies came in for their shots, including two white toy poodles, with their ears died pink and blue to identify which one was the boy and which one was the girl.

The long wait was starting to get to me, but I felt guilty for complaining when all of these other dogs were coming in with emergencies, and I wasn’t paying much for help. I do okay with feeling worthy of care when I’m alone, but when it feels like someone else might need things more than I do, I struggle. I almost lose track of myself, and disappear. I couldn’t force myself to go up to the front desk and ask about Butterfly’s appointment, even after two hours, and then three. I left it to Mom to be the assertive one.

It’s been a relief to see Butterfly finding her voice lately. She barks when her sister leaves the room, or when she thinks she’s missing something exciting. She demands attention and expresses frustration when it is not forthcoming. I wanted this for her, but I’m not the one who taught her, Cricket did. Maybe I can get Cricket to give me lessons too.

My assertive girls

My assertive girls

By the time we went in for the wellness visit, we’d been in the waiting room for four hours, and when the general veterinarian looked at Butterfly’s chart, she found out that she only needed one booster; the rest weren’t due until November.

Since we were there anyway, I took the opportunity to point out to the vet all of the various lumps and bumps on Butterfly’s skin. She did a needle aspiration on the largest lump and showed me how the pus came up through the needle. It was a sebaceous cyst, she said, and nothing to worry about.

We were done within minutes of stepping into the examining room. We were exhausted, and starving, but relieved.

When we finally got home, Cricket was crazed and jumping all over us as if we’d been gone for months. She sniffed Butterfly for signs of where she’d been and then carefully sniffed my pant leg for the smells of other dogs, of which there were many. My clothes, covered in dog hair, went straight into the laundry basket and I went into the shower. After we’d all calmed down and eaten a late lunch, we settled down for a nap. Butterfly fell asleep at my side right away, but Cricket ran back and forth from Mom’s room to mine every few minutes, to sniff her sister for signs of where she’d been, still shocked that Butterfly had dared to go on an exciting adventure without her mentor.

Butterfly and her suspicious mentor

Butterfly and her suspicious mentor