Life is full of choices. Humans are not the only species that make choices. But we seem to be one of the few that will reflect on the choices we’ve made, and tie the reflection to our emotions.

On July 28, 2019, I made the hardest choice I can remember in my 54+ years of life. As I write this, I look at that statement with a large degree of amazement. Considering all of the choices I’ve made in my life, it took 54 years for me to single out one choice that was the hardest I have made. And although I know I made the right choice, that hasn’t stopped me from reflecting on the decision over and over again.

On Sunday morning, the doctor arrived. I’d called the day before, after contemplating for the better part of two years of how I might someday have to make the call. I’m usually not an optimist, nor am I a pessimist. I try to look at the big picture and react accordingly. But, for most of my life, I have also tried to keep myself in a realistic world. I’m not artistic in my mind, so painting fantasies isn’t among my stronger skills. This is why I was often contemplating this particular choice. This choice, I believed, was one that I had to get right; there was no margin for error. On this day, my thoughts converged to the only choice I could make. It was time to say goodbye to the only being that I could say was my “child,” my best friend, my support, and non-judgmental companion for the last eleven years. It was time to say goodbye to Diesel.

I am writing this for two reasons. The first is that I need to write about this. It isn’t that I doubt myself. I know I did the right thing. But, somehow, writing this helps me through this a little bit more. The second is that I hope that, someday, someone else will read this and know that it isn’t easy, but it doesn’t mean it’s not right. It is such an important decision, it is my hope that they will do exactly what I did for two years—do their research, understand options, and most importantly, embrace that this isn’t really their decision; they’re making the decision for a being that cannot make the decision itself. It is a responsibility one owns when bringing a “pet” into the home.

First, the background. Diesel had right-side heart failure a little over a year ago. This was about ten months after he was diagnosed with a heart-base tumor (a chemodectoma), nine months after he had major surgery to help him avoid a very-near certain death (removal of the sac surrounding the heart), and a close follow-up with a “proton knife” (targeted, focused radiation) to attempt to neutralize the tumor as much as possible. Sadly, heart-base tumors are inoperable. Diesel’s options were limited.

The first question people ask when doctors present a diagnoses and proposed treatments for situations like this is, “How long will this extend his life?” And, indeed, that was the first question that I asked. But, I quickly followed up with, “What will his quality of life be during that time?” The answer to the second question was the most important to me. It’s one thing to extend my boy’s life for the sake of my selfish desire to have him as a part of my life longer. It’s another to realize that living another X months or years, while leading a poor quality life, is not an acceptable outcome. I have had a very fortunate life, so the third question of cost wasn’t an important question for me.

As Diesel healed from the surgery and radiation treatments, his quality of life had improved pretty significantly from the months before we had the diagnosis. He wasn’t panting all of the time, he had energy, and he was perky. Diesel’s co-parent (Jiander) also saw the improvement. For us, life was fantastic. Then came the follow-up visit to the cardiologist the following January. Diesel’s CT scan and echocardiogram did not bring great news. In fact, it brought terrible news. Diesel’s heart was starting to grow, and the tumor wasn’t reduced as significantly as hoped. The prognosis was certain death—with a comment from the doctor that he would be surprised if Diesel could survive six more months. A second opinion didn’t bring differing news.

Although Diesel’s health hadn’t deteriorated significantly the first few months after the prognosis, he did start to show signs of fatigue. Then, one day in early July 2018, Diesel started panting pretty heavily. His breathing was very rapid. We immediately took him to the pet hospital at which his cardiologist practiced, and where he’d had his surgery. His heart was out of control. It was, at one point, beating close to 200 beats per minute (about 70-80 beats too fast)—and erratically. And, his heart was still getting larger. The medications they tried were not helping to get his heart rate under control. It wasn’t looking good for my little guy; it was certainly no time for me to lose my ability to think rationally so that I could make the right decisions. His diagnosis was right-side heart failure. The combination of an enlarged heart, and a tumor that was forcing the heart to work harder, manifested in the heart’s inability to work correctly.

Ultimately, they found a medication that brought his heart rate under control. Though his final prognosis hadn’t changed, the doctor believed that a combination of drugs would help him live a comfortable life until his death. I am happy to say, he was right—for the most part. It wasn’t a perfect life, but the good days far outnumbered the bad. Again, this was an ongoing internal battle I had with choices. Would I be lucky enough to keep my selfish desire at the same level as doing what was right for Diesel? I think I was.

The next year wasn’t easy for Diesel. In fact the next year consisted of his cocktail of medications—two diuretics, a beta-blocker, a heart-rate modifier, a thyroid medication, and a bit later, pain medication for an unrelated spinal deformation that was tied to genetics and age. About a month and a half after he came home from the right-side heart failure, the ramifications became clear. When the heart doesn’t work as well as it must, it cannot remove fluid through the normal biological process. Consequently, the body retains the fluid. The one saving grace here was that right-side heart failure actually impacts this fluid retention differently than left-side. If the left side is impacted, fluid is more likely to build up in the lungs. This ultimately causes reduced lung capacity, and ultimately suffocation if a natural death is selected. Medications control this for a time, but not long.

With right-side heart failure, the fluid builds elsewhere. In Diesel’s case, it would accumulate in his abdomen. This required near-weekly visits to Diesel’s vet to have the fluid removed. The procedure itself is obviously not pleasant, as it involves piercing the abdomen with a needle, and draining the excess fluid. Diesel’s output was anywhere from a low of one liter to a high of six liters in a session. There was never any correlation that we could find with the varying amounts of fluid—and we desperately tried.

Through this, however, Diesel would come home about mid-day (after a morning drop-off), and he would be quite normal. He had energy, ate well, and would walk reasonable walks. In fact, Jiander and I were the ones to sanity check his walk decisions, as he (like most dogs) didn’t think through the fact that going one direction until tired didn’t account for the return trip home. This lasted until November, when Diesel had some level of a relapse. We never did figure out why. In February, Diesel had another relapse that coincided with a visit to his cardiologist. The doctor changed the dosages on a couple of his medications, which had limited success. From that point until late June, his energy level consistently started to decrease. He would have “on” days, but he was starting to show “wear.” I continued to monitor the “on” days versus the “off” days. I’d learned to read Diesel pretty well, which was an important part of trying to ensure that I wasn’t doing the wrong things. The most subtle changes were visible to me…rate of breathing, pupil dilation, energy level, etc.

Throughout this time I consulted my brother (a veterinarian) and Diesel’s primary doctor to understand if Diesel’s quality of life had fallen out of balance with our desire to have him next to us each day.  To be quite honest, the last seven months of Diesel’s life were months that I was praying he would die naturally in his sleep. He wasn’t suffering (that we could tell, anyway), and it seemed like a way that would be best for him. And I must emphasize him. Why? Because I had already started a mental checklist to determine if the quality of life balance with our selfish desires had shifted against Diesel.

Although Jiander and I both hoped Diesel would die a natural death, we felt strongly that, if we ever got to the point where that wasn’t possible, we would only consider an in-home procedure. It was important to both of us that Diesel’s last moments would be in his environment, with the two people who loved him most, and whom he loved. As important, our spiritual beliefs, though different in many ways, aligned with the belief that Diesel’s soul would need to be in a familiar environment to be truly at peace.

A week and a half before Diesel’s passing, I felt that the balance had shifted against Diesel. It wasn’t obvious, but there were enough “off” days that I had concluded that he was probably at a point where it was unfair to put him through any further discomfort. I arranged for a doctor to put him to sleep. As I said, the balance had shifted. It was increasingly hard to get him to eat, and options for medicating him were shrinking rapidly. The day before I’d scheduled the doctor to visit, Jiander convinced me to wait. Jiander wasn’t ready to let go. This was the day before Diesel’s normal procedure to remove fluid was to take place, so I reconciled that we could see if that made a difference, as there had been a direct correlation in the past. Maybe this was just another “down” week, and we would see improvement. And, honestly, I didn’t feel right about having him put to sleep. (I don’t like the word euthanize, which is why I reference the common phrase, “put to sleep.”) My gut told me it was the right time, but my head wanted something a bit more tangible.

Indeed, after Diesel’s procedure, he came home and was near “normal.” He was eating—eagerly, had energy, and seemed relaxed. That lasted one more day. Then, he suddenly stopped eating. Regardless of what we tried with the variety of food, none of the stand-by foods worked. He would look at them, smell them, turn his head to the side, and put his head down. After the second day of this, I called a different doctor to come the next day to put Diesel to sleep. My choice was very obvious to me. It wasn’t even a choice in my mind at that point; it was a promise I made. Diesel was telling me that it was time, and for months I had promised him that I would listen. The past several months I whispered to him that I needed him to find a way to tell me when he felt it was time. Not eating was his way. Without getting too far off track, I should state that Diesel’s history of eating was well-known with Jiander and me. There was a point where Diesel had a complete blockage in his tummy due to something he had consumed—I believe he was two. (I still don’t know where he got the object…it wasn’t at all recognizable after it was surgically removed.) Nonetheless, he still ate. The food wouldn’t stay down, but that didn’t bother him. He would still eat. Whenever doctors told us that Diesel would not likely have an appetite after a procedure (he’d had a few during his life), both Jiander and I would laugh. And, we were always right. Until now.

Even with all things clear in my mind, the choice to end Diesel’s life was the hardest choice I’ve ever made. There are two shots that are given to a dog when they are put to sleep. The first shot is a sedative that will relax them to the point that they are in a sleep-like state. The doctor told me it was like “morphine for dogs.” The second shot is the barbiturate that is essentially an overdose, which causes the heart to stop, and other organs to cease to function shortly thereafter. Between the first and second shot, I had the thought in the back of my mind that I could tell the doctor not to administer the second shot—we weren’t ready. “Sorry you came all this way, but I’ve changed my mind. How do you reverse the effect of the first shot?” But, it was time to stop having that level of selfishness. I had to transition to doing solely what was best for Diesel. I know he’d given me his signal, as I’d asked. He wasn’t going to eat again. And if I didn’t do this, he would literally starve to death—with all of the ramifications that come with that action. And, since he wasn’t taking his medications, his heart rate would likely climb again, and the fluid retention would cause organ failure and unspoken pain. No—there was no other choice.

On Diesel’s last day, despite his suffering, he still thumped his tail for Jiander and me. Diesel died while I was scratching him behind his ears, which he loved me to do. Jiander was petting him around his head. We both kissed his head, and we both thanked him for giving us eleven great years, telling him that everything would turn out great for him. And I know we both believe that. After the second shot, the doctor eventually told us that his heart had stopped. And, I am certain that for a brief moment, Jiander’s and mine had stopped as well.

For the next three hours after his death, Jiander played Buddhist music that helps the soul leave the physical body, and we both continued to talk to him. This time was important, and is the reason that I waited to have his body taken for a private cremation. This was important to Jiander’s religious beliefs, many of which I adopted for Diesel’s sake (and to some extent, Jiander’s).  For seven days beyond his death, Diesel’s spirit is in our home. As it has been explained to me by Jiander, his spirit still doesn’t understand that he has passed. We must continue to talk to him, as this helps his spirit—and frankly, eases things for us. It isn’t until the seventh day that his spirit will go to the heavens. Forty-nine days after that, Diesel’s spirit will be re-born in some other being—potentially human. My belief is that a part of his spirit will wait for both Jiander and me to join it after we have passed.

It’s only been four days since Diesel’s passing.  Each day is consumed with grief. A lot of tears, constant self-questioning of my choice, and stark realities that remind us that Diesel has moved on to a better place. This is not at all my first experience with death. And none of them have been easy for me. But this one cut to the bone, which is ironic since my logical mind knew that he would not likely outlive me. I never had children, so Diesel was my child. And that is how his passing feels to me; it’s as though I’ve lost my child.

I made the decision to not have another dog. I actually made this decision long before Diesel died. The eleven years with Diesel can never be repeated with another dog, and I know I don’t have it in me to go through the cycle again. I have about 1,400 pictures of Diesel over the years, which pales in comparison to the 10,000+ that Jiander has accumulated. That is plenty of memories to cherish, laugh about, and in some cases, cry about. And, for my life, that is fine. I’ll always miss him. But I know that he is always by my side, until we can once again be reunited.