Things that need to be said about Kuma's death:
1. Kuma was seizing for 30 minutes while they fumbled trying three times to stop her heart.
2. I now regret what was done to Kuma. Kuma was clearly recovering. She should not have been killed.
Kuma’s last moments were in pain.
- Kuma's treatment was stopped abruptly which caused her to seize non-stop for 30 minutes before they were able to stop her heart.
- Kuma's charts were missing and when I asked for them, they said they could not find them. One week later there are still no answers.
Kuma arrived at the hospital Sunday at 11 am. Instead of putting her down Sunday evening, we decided to let the Phenobarbital take effect and see if she could be stabilized. Monday at 5 am was her last seizure and they were now under control. Monday evening I decided to wait until morning to see if Kuma would be stable for 24 hours and if she would start to wake and recover.
When I arrived at the hospital Tuesday, Kuma had not woken up yet. The vet on duty was the matter-of-fact, seen-it-all vet. When she spoke she told you of the worst case scenario and then looked at you with a smirk. The first thing she said to me is “if you have trouble deciding, then I can make the decision for you. Some people don't want to have to make the decision, so I will make it for you. She needs to be put done. Kuma needs to be put to sleep. The staff feel bad looking at her”. Cheryl later told me that she also said to Cheryl that Kuma has no hope at all of ever waking up and having a life worth living.
I told her I did not need someone to make the decision for me, I just need to know what is right for Kuma. I believe she has a 1 or 2 percent chance of coming out of this.
The plan was to stabilise Kuma by stopping the seizures and reducing the inflammation in her brain. Then we would work on waking her up.
Sarcastic vet jumps in, “She has point zero zero one chance of waking up”.
I asked, did you put water on her tongue, did she swallow?
“Yes, but only once.” “Anyway, I called Cheryl, and she said to put her down”.
I replied, Cheryl told me to decide.
“Cheryl paid the bill”.
My plan is to see if she can wake up today, I brought her purée and yogurt and water, if she can swallow. My plan was if she was a bit better to take her home and take care of her there or wait one more day. If Kuma is making no changes and no improvement, then we will have to put her down.
Then the vet says, “if you like we can move her to another room and you can spend all the time with her you like”.
It doesn’t matter to me, I can stay here with her or you can move her.
“well it may be better for you”.
Ok, if you like we can move her.
“yes, that would be better, thank you.”
I looked for Kuma’s charts to see what was done to her lately, but the charts were not there. Her bandages on her leg holding the catheter were removed. Looking back, I realize now that they had decided that Kuma was as good as dead and left her there like garbage. The glass doors to her cubicle were closed for the first time.
I felt rushed and pressured to move Kuma to somewhere I could be with her. They moved her right away on a stretcher and put her on the floor in a mourning room. A lady came in and right away asked me to sign permission to kill Kuma. I did. I had decided that even if Kuma could wake up, that her recovery may be too difficult for her and her life after will be a struggle for her. I decided that this same scenario may happen again soon and we would be in the same place and in between would just be more suffering for Kuma. I signed the paper.
But, I was not done. I picked Kuma’s head up and opened her eyes and told her, “Kumi, if you are going to pull off a miracle again, this is the time.” “let me know somehow what you want to do”. I kissed her many many times, Kuma took a deep sigh. She felt me there. I sat with her holding her and telling her I love her for over two hours. She was peaceful and was breathing the best yet, easy deep relaxing breaths like she was sleeping well. Before her breaths were struggles and irregular gasps.
Kuma then pulled her tongue back in her mouth. She swallowed a few times. Then, she yawned a big relaxing yawn, stuck her tongue right out and curled it and then licked both sides of her mouth clearing away the hair in her mouth. Kuma was responding. At this time, I was thinking I will stay with her and if she gets just a little better, I will take her home and nurse her back and if that doesn’t work, I can just bring her back here again tomorrow to be put to sleep. I needed to give Kuma every chance and not listen to the wolves at the door.
Kuma started to wake, her eyes started to move and see me, and then she started seizing. I held her and massaged her and tried to make it stop. It did for a bit but then started again and again. Kuma did not seem unconscious like she does in a seizure. I saw her convulsing, so I picked up the phone and called to send the vet in right away.
Kuma was seizing for 30 minutes while the vet and his techs were fumbling around. Some guy came in and asked if it was ok if he was the person to put her down. I asked if he is a vet, he said yes like he wasn’t sure. He brought three syringes, said the first was to test the catheter, the second was the sedative and the third would stop her heart. I told him to please hurry, Kuma was convulsing and I didn’t know if she was in pain, it looked awful. Kuma stopped for a few seconds, licked her mouth, turned her head towards me then went back into convulsions. The vet tested the catheter and said it was no good, not working. He went out and in came two more young girls. They took Kuma’s other front paw and shaved it and put in another catheter. All this time Kuma is in and out of seizures and I am holding her head and looking in her eyes and kissing her to make them stop. Then, back comes the vet and he tests the second catheter and says it doesn’t work. By this time I just said to him firmly, “just stick the needle in the vein, you don’t need a catheter. Get it done, she is suffering!” He said, yes, I need to get more sedative, the first two didn’t work. By this time, Kuma is lifting her front paw in the air and waving it around. I am panicking just not wanting her to suffer. Finally, he comes in with another young girl and he takes Kuma’s back paw and finds a vein and puts the sedative in. Nothing changes, the sedative does nothing, Kuma is gasping for air now, breathing loud. Then, she stops and no more loud breathing. I ask, “is she breathing”, they say no, she stopped breathing. He was supposed to tell me when he injected the chemical to stop her heart but he didn’t tell me. Kuma’s eyes opened when she died, and she peed out a lake of pee. Her eyes stopped moving. Kuma was dead. Her neck got loose and her whole body was limp. I held her and kissed her and cried. I called her name. I thought “what have I done?”
I stayed there with Kuma for three more hours. I wished I had come earlier in the morning and spent more time with her while she was still breathing and alive.
Then, I started thinking, why was Kuma seizing? She was under control and had not had a sezure in 37 hours.
The night before, I talked with the vet on duty and she said that she gave her the minimum dose of Phenobarbital because they didn’t have a blood test and were not sure of her liver values. I told her I had a previous blood test in the car and would she like to see it. She said yes. When she saw the blood test, she said Kuma’s liver values were very good. I told her to go ahead and give Kuma the maximum or regular dose that she needed and not worry about her liver, we can test it again later. She said she would.
So as I sat there thinking about this, in came the receptionist wanting to know what I was going to do with Kuma’s body because Cheryl had not paid for her cremation. I asked her to give me some more time but also asked her that I would like to see Kuma’s charts. She said she would send the vet in to talk to me. Instead, a tech came in. I asked to see Kuma’s charts and she said, they couldn’t find them, but the information was in the computer. I said that I just want to know when was Kuma’s last dose of anti-convulsant given and how much was the dose (earlier she was given 2.5 mg and she stabilized on that but then after seeing her liver values, she was supposed to get 5.0 mg). She said she would go in the back and check on the computer.
I waited 20 minutes. Finally, the receptionist came back and said the tech was busy in an emergency. She said the vet had now left for the day (before her shift ended at 7pm?), but she would have her call me tomorrow. She also said that she recalls the vet had spoken to Cheryl in the morning and Cheryl closed out the bill.
The next day, I receive a call from another receptionist telling me the vet can’t call me today, but she will call me sometime next week because she is away. I asked if they could have the original vet who admitted Kuma call me. She said yes, but please talk to the vet that was on duty yesterday first that was Dr. Lefebvre. I said ok. Don’t know why but they are stalling for some reason. It is a simple question and the answer is in the computer and on Kuma’s charts. And how did they lose Kuma’s charts and why were her charts not with her when Kuma was still in the hospital?
My suspicion is that they did not give Kuma her anticonvulsant medication and stopping that cold would in itself cause Kuma to start having seizures. In other words, they stopped treating Kuma even though the day was paid for and treated Kuma like she was dead already without any regard to what would happen to her. The vet had decided herself that Kuma should be put down. She called me in the morning and said that Kuma had not changed. I said I would be there in an hour and she said not to hurry because Kuma was still the same. And, the bill is $1800. I said that is fine, I will be there soon. I prepared the bed for Kuma in case she came home, and I puréed her dinner to take with me in case she could swallow. Then, I drove the 45 minutes to Kuma.
Kuma was seizing for 30 minutes in the end. I don’t know if she was conscious or not, I think she was. The top of her head started to get very hot from the seizures. Her breathing got loud and very laboured. Her body was twitching and shaking. Her paws were moving. Her left paw went up in the air and going forward and back. When I saw this, I was hurting for her. This is not the way she should go out, possibly in horrible pain. I wanted this to end as fast as possible, but the idiots kept fumbling around with their protocol like they had never done this before. Kuma was flailing away possibly in horrible pain up until her heart was stopped. Her head was swelling up. I feel horrible for the way Kuma died. She didn’t need to die like that.
I now feel I made the wrong decision to end Kuma’s life.
In looking back and seeing things in perspective without the pressure of everyone telling me to put her down, I realize that we were on the right track to what was planned and we just needed a bit more time. The admitting vet first said it would take three to four days and would cost $2000 to $2500 before we could see if she had any brain damage.
The first day at the hospital, I thought there was no hope for her recovery and I stayed with Kuma up until 9 pm. Three times that day, I had decided that I would end her life. At the end of the day, Kuma was still having seizures, but they were very muted and only lasted about 10 to 15 seconds, not like the full violent seizures that lasted 4 minutes and were spaced about three hours apart. I came in for the last time and was going to ask the vet to end her life and the vet said that the problem was they could not stop her seizures. But, she said that she had hope. Hope? I asked why. She said that Kuma had never been on anti-convulsant medication and if they could stabilize her now and stop the seizure the anticonvulsant medication could possibly help her return to normal. She had given her major loading doses of Phenobarbital and said it needed time to start working, that we needed to give it time to take and then see. I was surprised but glad that the vet was optimistic. She said the continuous seizures were from something that caused a flare up in her brain but that if the inflammation was reduced and the anti-convulsants worked she could be returned back to normal. I left Kuma there and went home with hope. I went home to an empty place without Kuma for the first time ever but it was possible still that she could come home with me. I ate and went to sleep thinking of Kuma. I woke at 6 am and got ready to leave for the hospital.
At the hospital on day 2, now October 5, Kuma’s birthday, I encountered the sarcastic vet, Dr. Lefebvre. She said that it would take Kuma two weeks to wake up and thousands of dollars. I said but the goal was to stabilize her first then decide. Kuma had seizures at 3 am and then at 5 am but mostly they were three hours apart. Now it was 10 am and 5 hours without a seizure. I went for breakfast and called our regular vet Dr. Amanda Glew. She just said, “Ross, put her down.” But, she has been saying this since Kuma was 13. She told me then that Kuma would not make it past winter that she would die within 3 months. I told her Kuma was healthy and loved the winter, it’s the summer that was hard for her. She said that Kuma would become incontinent and pee and poop without control and then would not be able to walk. 4 years later, none of those things happened. Kuma up to now was holding her pee for 12 and 14 hours and she would tell me when she needed to get up to poop. And, Kuma was walking, up to two hours a day. In the cold weather, Kuma walked up and down hills in the park and walked around the whole park over a kilometer around. She was curious and sniffed everywhere, this was her socialization. Her regular vet was also the one that prescribed Valium (Diazepam) for Kuma, suggesting 4 in the morning and 4 at night. But, one pill would knock Kuma out for hours, it was too strong, it would have turned her into a comatose zombie. I did not give her that much valium. Instead I gave her one to two per day. What I didn’t realize was that the valium was only effective in preventing a seizure for less than an hour in the brain even though it knocked her body out for 4 ot 6 hours for each tablet. So, it was not an effective method of preventing Kuma’s seizures. Instead, Kuma needed to be on an anti-seizure drug, Phenobarbital as a first step. Last week, Dr. Glew gave me Phenobarbital tablets but the side effects would make Kuma dizzy and weak for a few weeks and once started she had to stay on it forever or seizures would come just from the withdrawal. I decided to wait because I thought I could control the seizures and Kuma was already 14 days without a seizure. My mistake.
I went back into the hospital and talked with Dr. Lefebvre thinking that ok, we should do this. But I stayed with Kuma, kissing her and being with her for a while longer. I talked to the doctor and said it was now 3 pm and 10 hours since Kuma’s last seizure. The original vet said that if we could get to 24 hours then we could say she is stabilized. This vet said sarcastically, “yeah, I’ve seen them seize on the way out the door while they carried them out after 24 hours”. But, she said Kuma was fine and I said I wanted to stay with the original plan and give her time for the Phenobarbital to take effect and stabilize her. She said, “yeah it could take her two weeks to wake up and it would cost you thousands”, That’s not the plan, I would like to give her one more day to get to the 24 hours.
The evening vet that came in was much more caring. She told me that the loading dose was not given all at once because they didn’t have blood tests, so even though she was still seizing, they were careful because that is their policy and they gave her the loading dose in 4 smaller divided doses spaced apart. This is why it was taking so long to stop her seizures. She then got onto the techs to take care of Kuma, to make sure they changed her diaper and turned her to the other side. The techs were just a bunch of young people, six or seven standing around not knowing what to do with one or two actually working. They went to the dogs they liked and talked to them like puppies. Funny, the dogs were calm and just looked back at them like they were silly, which they were. I showed this vet Kuma’s previous blood test results and a history of when she had her previous seizures. She said this was good information and took copies to put in her file. She said that Kuma was on the minimum dose of Phenobarbital and it was working. Again, I changed my mind and decided to wait another day to make it to 24 hours and see if Kuma would wake up.
Why was Kuma still unconscious? Because at home, although one valium would make her unconscious for an hour and then keep her asleep for 6, not able to walk, when she started having the continuous seizures, I gave her two valiums every hour until I used up all I had left. I gave her 14 Valiums. The seizures alone make her unconscious normally with her tongue hanging out the side of her mouth, but then add 14 valiums, then add all the valium and Phenobarbital loading doses that they gave her at the hospital plus all the seizures that she had, it is no wonder that she was knocked out for a very long time. In her last seizure at home 14 days ago, I had given her 2 valiums and she slept for 20 hours and took 4 days to recover fully. At home after a seizure, she looked exactly the same as she was looked now in the hospital. But she did recover fully and got as strong as she ever was, walking all around, walks in the park and a huge appetite.
Kuma was lying in the hospital still knocked out. When I arrived the third day, October 6, that is when I got pressured by the sarcastic vet to put her down and take her out of there. “yes please, and thank you.” I didn’t even have time to just sit with Kuma for a bit. And, her charts were not there so I could not see what was done to her throughout the night and morning.
We were bum rushed into the mourning room. But, I had not given up hope yet. I was hoping I could revive Kuma still. She was responding to me and I knew she would wake up shortly. I opened her eyelids and her eyes moved. I am not sure if she could see me, but she started taking deeper more relaxing and steady breaths. It all seemed better. I kept talking to Kuma even though she cannot hear because I know she understands somehow, she feels and senses without hearing. I sat there on the floor with her peacefully for two hours and was building hope.
Then Kuma started seizing. I called the vet to hurry up and end her suffering.
But, I did the wrong thing. I should have given Kuma one more day. I should then have brought her home and helped her recover. I could have gotten the medication from my regular vet and left the catheter inside and administered valium and phenobarbital intravenously. If anything happened then I could bring her back to put her down.
I went home and looked at the pictures and watched the videos of Kuma just a day before she went into hospital. I read all my diaries that I kept of every hour of the day for the last few months of what Kuma was doing and how she was feeling. From the diaries I saw that it was a struggle for her, but I only recorded the hard parts. From the videos, I saw how well she was doing. This was after 9 really hard seizures and a bunch of pain medication that made her unbalanced and still she was walking fine, a bit unsteady but interested in life and not in pain.
Looking back, I think she could have recovered from this, it would have taken some time but she could have walked again and got stronger than before. These were multiple seizures but they were not as strong as those that she already survived. She was given a ton of drugs which had to clear. If her seizures could be reduced with Phenobarbital then she actually could have come out of this better than before.
But, I let myself be pressured into it. And, stopping her medication and causing her to seize forced the issue.
Kuma should be here now. She would be waking up now. I should have stood up for her. I didn’t. I caved in. I had no money to keep her alive. I would have given any money I had. I would have sold my gym equipment in a day and given it all to keep Kuma alive long enough to give her a chance to live. If she didn’t want to live anymore, I would have seen it in her eyes.
Kuma never gave up. She fought to the end. Them taking 30 minutes to put her down was a sign that it should have been aborted and she should have been given a chance to live.
Kuma should be alive now. I killed her. She was not ready to die. She was too strong and too healthy. I know Kuma and she was not ready. Instead, I decided for her. I took away her life. She had another year to live at least. Another year to walk around and sniff things and bark at me when she wanted something.
Kuma would bark at me when she wanted to go to sleep. She wanted me to lay down beside her and put my arms around her, then she would breathe a big sigh and go to sleep. She wanted to be held when she went to sleep.
Kuma, I would give anything to bring you back and hold you while you sleep. I am so sorry I did this to you. I love you Kuma.
Friday, October 9, 2015
Kuma should be alive today. Knowing that I did not give her a chance to recover and stopped her life before she was ready is unacceptable in my mind.
Death is final. Absolute. There is no going back. After quieting down and reviewing what happened and how she was, I realize I made a mistake. I should not have killed Kuma. Knowing that she is frozen and cannot come back is the worst feeling.
Kuma died because I had no money to keep her living in the hospital and to give her a chance. I still should have fought them and told them to give her one more day. I should have been strong for Kuma.
Kuma definitely was waking and would have recovered this.
What I needed to do was stay the course that we planned. Kuma was stabilized and then I needed to wake her up. I did not mind giving her time to be in a coma because it gave time for her brain to heal and the inflammation to go down.
Next, I needed to get a brain scan or MRI to see what was wrong inside her brain and how bad it was. I needed to ask them to have their Neurologist look at her.
If Kuma had a brain legion, or blood clot, or infection in the brain, then this needed to be fixed either through antibiotics or through laser surgery or brain surgery to cut it out. Kuma would have survived this because her body was so healthy.
My basic priority plan for Kuma which I showed her vet last week and the vet at this hospital was to identify the cause of the pain on the side of Kuma’s face and to remove it. Then to reduce or eliminate her seizures. The third was to change her routine to sleep at night and be awake in the day so we could go places now that the weather was cool.
I now believe all this could have been done and Kuma easily would have enjoyed at least another year or two of her life before her arthritis would have gotten too bad.
Kuma had more life to live. I know this. This is what is so wrong. It was because of the money that her life was shortened. She should be alive today.
I was very angry yesterday and I am even more angry and frustrated today. I cannot breathe. I don’t know what to do with myself. I want to explode from the inside with the thought that I cannot change what I did and didn’t do for Kuma. I scream, I cry out her name as hard as I can. I feel like I will burst. Kuma should be alive and I should have her here taking care of her. I know, I absolutely know that she was not ready and that she would have recovered this and walked.
Saturday, October 10, 2015 – 4 days after Kumi’s death
I cannot deal with the fact that she is not here. She should be here. Kuma was not dying, she was sleeping and recovering like she was supposed to. She should not be dead, she should be here alive.
This was all done wrong. Kuma paid the price for our mistakes. She only had me to stand up for her. Kuma did not have money or even know about money. She just knew how to keep trying to live.