Dear Isaac, Maia, Dog Lovers and Virtual Wanderers,

I woke up October 1st hoping against hope that Cimarron’s cough was gone. I looked down to see her cuddled with her sister, waiting for me to awaken, as always. I was releaved until I heard the cough. I put her in next to me, but I couldn’t let her snuggle under covers any more. So, I tented them up for her. I read, she enjoyed my bed. That was our normal routine.

Normal, not normal. I got out my phone to video the cough for her upcoming specialist visit. Something in Cimarron’s spirit had been left behind with the first collapse at Hovenweep. I felt like I was walking on egg shells – for the first time, I felt like my little fighter was fragile. But, I got up and did my aerobics. I kept checking to be sure she was breathing OK. But, I was dreading the pill battle.

In my first blog on this topic, about Cimarron’s earliest red flags, I talked about how she no longer wanted breakfast. She needed her heart med (Vetmedin) no matter what. So, I would “pill” her. Likely, her lack of appitite was a signal that her heart valve was beginning to struggle. It was a catch-22. I hated it as much as she did, but once I pilled her, she relaxed. I tried everything to make the pilling easier. I searched the web. I gave her favorite treats after each pilling. I tried liquid (she really hated that). I tried grinding pills in butter so I could just smear it on her tongue – she seemed interested in licking it – for about a week. I used peanut butter on trips. I had just started trying cream cheese. Mind you, she loved all of these if I was eating them, but not if her pills were in them. So, it still entailed holding her mouth open and rubbing the pill mixture on her tongue. And, no, giving her a plain one first didn’t work, either. What did work was mixing them with human food for her evening dose, but it didn’t work in the morning.

Cimarron always had to fight any time she wasn’t in control. She had min pin in her, and she was a little fighter. She was such a weird shape and size, that when I first adopted her I had big issues getting a harness that both fit and was secure. She fought when I tried to measure her or try on harnessess. I said it was like trying to hold on to wiggling snakes because of her long legs and acrobatic skills. I finally hired a trainer to help me get her past her fears of things most dogs just surrender to doing. It got better, but it never went away because she was a little fighter. I say this because if this were not true, I would carry crazy guilt around forever about what happened next.

That day was the first time she actually ran away from me when she knew it was pill time. My approach was to be as quick as possible. That day, I tried cream cheese, again. She fought like never before. I was shocked she had the energy! She screamed and of course, I had to smear her pill twice because some fell out. At first, I thought maybe it was a a sign she was feeling better – I felt horrible that it had been such a fight, through.

She jumped down to get a drink from her bowl that is about 10 feet away at the same time I stood up to walk 10 feet into the kitchen to set a bowl down. I was just in the doorway to the kitchen and I heard two honks. My heart sunk. I immediately turned around to check on her and she was down, collapsed by her water bowl. I pulled out my phone to record (because I felt like the vets needed to see it in order to diagnose it) – and just then Tiara Rado (the specialty vet) called the day before to schedule the appointment. So, I couldn’t video until the call dropped. Here is what she looked like about a minute or two into the collapse.

This time, I watched and took notes because I felt like I was too stunned to really watch during the first collapse. I wanted a log for the specialist vet visit. She was spacy, again, standing and staring. Then, like the last time, she headed for me. She took the final leap from her cushions to the couch – but then she just laid where she landed and shook. I covered her and comforted her, but I also sprung to action. I called her local vet and they said to take her to the ER 1.5 hours away. I called the specialty vet, Tiara Rado, to see if they could get her in sooner – they moved her to the next day. I called Animal ER of the Western Slope to tell them we were headed up. By then, she was beginning to take interest in some chicken I laid by her, and I decided that we might as well just spend the night in Grand Junction. I packed up and off we went on our next vet journey.

I figured her ER exam would be pretty normal. And it was. The vet asked what I wanted out of the visit and I said documentation for the specialist the next day. After that, we headed to the motel. Cimarron’s cough seemed to bother her – she didn’t want to walk much but enjoyed a bite of my Wendy’s with her meds. The next morning, I ordered DoorDash so I could get her pills down without a fight, and it worked. We killed time at the park until the specialist appointment.

When I first met the vet at Tiara Rado, I felt a ray of hope. He was listening to me. I said her airway followed by her heart were my priorities. He agreed. We talked about collapsing trachea and he said little dogs like her were poster children for that. There was treatment. Then came the echo. I wasn’t prepared at all for what came next.

The vet said her heart size had remained stable, but her heart disease was advanced. Then he said her chordae tendineae (the strings the hold the was the heart valves in place) were the thickest he had ever seen, it could rupture any time. He explained that when it did, she would progress to congestive heart failure quickly and it would be time to say goodbye. He gave a prognosis of 2-6 months, but added it could happen in 5 minutes. I was stunned. Two months? Oh, I thought, she will make it to 6 months! I sent a quick update text to the owner of the rescue where I got her – Harley’s House of Dreams. (I love that place and it comes with quite a support network.) She said how sorry she was about the diagnosis – and my heart felt stabbed, again. I sensed she had seen this before and it wasn’t a happy ending.

We arrived home with meds in hand. I was still determined to get her cough under control. She still was not in congestive heart failure. Her respiratory rate had been stable and well below 30. She was hungry and pretty engaged with life. I would have her through the holidays, I thought. Maybe even camping season. We finally had a diagnosis, and while I didn’t like the prognosis, we could still have some quality adventures. The next day, things changed.

More to come soon . . . Doc Cathy

• Cimarron’s Final Journey (Part 1): What Cimarron’s Summer Taught Me About Subtle Respiratory and Cardiac Decline
• Cimarron’s Final Journey (Part 2): The Trip, the Morning Collapse, the 2 AM Honking Cough, and the Long Road to Urgent Care
• Cimarron’s Final Journey (Part 3): The Good Days, a Missed Diagnosis, and the Cough Returns

• This is a series of blog posts discribing my 6 pound soul dog, Cimarron’s, final life journey. I am sharing this to help other dog owners recognize early signs of tracheal collapse and mitral valve disease (with or without congesting heart failure). I may be Doc Cathy (Doctor of Nursing Practice), but I had a lot to learn during these final weeks. I learned a lot about navigating the rural, ag-focused vet system that I will take forward to my future rescue work.