Hope did not prevail in the end. Our little blind Shepherd, the girl with the "perpetual puppy" look, died this afternoon. We made the decision to let her go gently and with dignity.
The MRI images showed that a tumor at the base of her brain had obstructed the flow of the fluid that normally bathes the spinal cord. With nowhere to go, the fluid had backed up inside her brain, creating a large reservoir and causing intercranial pressure to rise dramatically. Although the neurologists have seen this type of tumor before, they have not seen a dog in as bad a condition as Pepper. Usually the dog is showing much milder symptoms. In Pepper's case, she had somehow been able to compensate incredibly well while her brain was being flooded. Yet when her brain finally was tipped over the edge, she had nothing left to give ... which is why, even today, she had yet to come out of her coma-like condition.
Dr. Wininger explained that while it would be possible to do surgery and remove the tumor, we had only a 20% chance of her surviving the operation. Those are terrible odds but one we'd be willing to take if she could beat this thing ... but Dr. Wininger said the tumor would, in fact, come back. Even if she survived surgery and then completed a month-long radiation therapy, the tumor would still come back -- in a year at the outside. And at that point we would have no other treatment options -- a second surgery is not feasible -- and Pepper would be right back where she is today.
There are two possible types of tumor causing the obstruction -- a choroid plexus tumor or a meningioma. The first one, the choroid plexus, is the worst of the two, and after surgery and radiation it would be back within months. The meningioma is the "nicer" tumor that might allow a survival time of up to a year, but it too would still come back to kill her.
That one-year time frame is a median survival rate, so if you imagine a bell curve, a year would be at the top or center of the curve. A few survive longer and would be on the right side of the bell curve, and a few die sooner, putting them on the left side of the bell curve. In Pepper's case, given the severity of her symptoms, Dr. Wininger said she would already be starting out on the left side of the curve ... if she could survive surgery.
And that was only if it was a meningioma. It was more likely -- in fact, a 50% to 70% greater likelihood -- to be the choroid plexus tumor, meaning the survival time is measured in only a few months.
I talked through all this several times with Dr. Wininger this afternoon after reviewing the MRI images. Then I called Alayne to tell her everything I had learned. After three long, painful and tearful conversations, Alayne and I finally decided we wouldn't put Pepper through this. We don't mind the 20% chance of surviving the surgery, but then only to have the tumor come back ... we just couldn't see doing that to her.
Dr. Wininger said the surgery, intensive post-operative care, and month-long radiation therapy would have cost between $8,000 and $10,000 ... but I can tell you that the cost did not factor into the decision. Had it been a $2,000 operation, we would have reached the same conclusion. Because of the sanctuary's compassionate and generous donors, we are blessed that we don't have to make medical decisions like this based on cost -- only on what is best for the animal.
I told Dr. Wininger that we would let Pepper go. He left me alone in an exam room to cry while they went to get Pepper and wheel her in. When I saw her on the gurney, I knew we had made the right decision. She was still comatose, and more than two hours after the MRI, she still had not recovered from the anesthesia. In fact, she was unable to breathe on her own. I don't know if she knew I was there, but I stroked her face and held her paws in my hands while I cried over our little blind girl. And then I told her how sorry we were. I was still holding her paws when she slipped away.
Goodbye, Pepper. We love you, honey.
I'm sure she sensed, in some way, that you were there, Steve. Animals know these things.
You made the right decision.
Posted by: Janet | February 22, 2008 at 09:18 AM
Dear Steve,
I have no doubt that Pepper felt your presence as she left this life. My thoughts are with you and Alayne this week. I know how hard it is to let one that you love so much go. But know that Pepper is running and playing in Dog Heaven today. Big hugs, Kristi
Posted by: Kristi Gross | February 22, 2008 at 09:10 AM
Oh Steve and Alalyne my heart goes to you. Poor Peppe sounded like a very sick dog and she was ready to go a good place. As hard as though decisions are that we have to make for our animal friends - we know they are the right one because we don't want them to suffer any longer. Try to remember all the love and memories she gave you and she gave you back. Just alot at one time uh.
God Bless you for your love of all these animals and the wonderful care they get.
Run free Pepper and play alot.
Karen L.
Posted by: Karen | February 22, 2008 at 09:05 AM
I'm so sorry to hear about Pepper. We were praying for her recovery, but God had other plans. He needed another angel on his side. She will always be with you!
Posted by: Toni | February 22, 2008 at 09:03 AM
I'm so sorry. Be at peace, sweet little Pepper.
Posted by: Ali | February 22, 2008 at 09:03 AM
Endings are never easy...thank you for all the wonderful work you do! Pepper was so lucky to have lived at RDR and to have been treated with such caring love.
Posted by: Brenda | February 22, 2008 at 09:01 AM
Steve and Alayne, I understand your deep pain, but you absolutely made the right decision. My condolences. RIP, sweet Pepper girl. You were so loved.
Posted by: Janet | February 22, 2008 at 08:59 AM
Dear Alayne and Steve,
I'm so sorry you've had another sad loss with Pepper. All who know of you and RDR are grieving with you.
God bless you.
Nancy Longfield
Posted by: Nancy Longfield | February 22, 2008 at 08:59 AM
Dear Steve & Alayne, we are so sorry about your loss.God bless Pepper. I bet there is a little life just coming in the world that needs Rolling Dog, that may help you cope with your loss of Pepper. We love you.
Posted by: Mary Young | February 22, 2008 at 08:47 AM
Steve and Alayne,
I am so sorry about Pepper. You gave her a safe, loving, happy home that she could count on -- because that's what you two do, in spite of knowing that there will be far too many days like this. What a gift the three of you gave each other.
Jamie
Posted by: Jamie | February 22, 2008 at 08:46 AM
Dear Alayne and Steve, You do everything to care for the ranch's "family". It shows the depth of your love and commitment to give them all a joyful and comfortable life while they are on this earth.
Posted by: Regis Dalton | February 22, 2008 at 08:41 AM
Steve and Alayne,I am so sorry for about sweet Pepper. I know you did your best to give her loving care and I know it was the right decision to let her go peacefully and gently. Her death is very hard as it is with any of the precious loved ones that come into your lives....even if you haven't met them yet. But you gave Pepper such a wonderful life while she was with you and that is why you do what you do through good times and bad.
Take care my brave friends
Mary W
Posted by: Mary Ware | February 22, 2008 at 08:37 AM
Dear Steve and Alayne,
I'm so sorry to read about Pepper. You've been through so much in just these two months this year, I can't imagine what you must be feeling right now.
But each and every animal you've had and lost has been better off for your presence. Each one has had the opportunity to live and leave with more dignity and compassion than many of their peers.
You're all in our thoughts right now and always.
Posted by: danielle | February 22, 2008 at 08:36 AM
So incredibly sorry for yet another tragic loss!!! She was afforded the BEST possible medical treatment in her later years-quite a change from the deplorable conditions she survived in her early years before she found her second home. May you and Alayne find comfort in knowing that Pepper is greeted by Dillon and all the others who've gone before as she crosses that glorious Rainbow Bridge and now knows no pain. Again, my deepest sympathies.
Posted by: Carolyn Kupferschmid | February 22, 2008 at 08:20 AM
As I read of Peppers passing I look over at my foxy asleep on my bed knowing that his time to will come, and the tears begin to well. Steve & Alayne I don't know what to say really other than that which I have written before, I admire what you do and pray one day that I will be able to tell you so in person. Rest in peace Pepper you were, you are, loved!
Posted by: Andrew | February 22, 2008 at 07:43 AM
We are holding your hands.
Posted by: Lalla and Sasha | February 22, 2008 at 07:39 AM
She knew you were there, never doubt that. And even now she is looking down on you all and thanking you for letting her go.
My vet, a wonderful man, has always maintained that most people wait way too long to let their animals go to a better place. You did the right thing in making sure she would never suffer again.
Posted by: G in INdiana | February 22, 2008 at 07:08 AM
I am so sorry for your loss.
Pepper had a wonderful, blessed life with you and the rest of the animals in your keeping.
Thank God for people like you in this world..
Posted by: Cathy Chambers | February 22, 2008 at 06:49 AM
I'm so sorry about Pepper. She was a lucky dog though -- she was loved and given excellent care, and when she got to the point where her quality of life was not going to be good, she was allowed to go gentle into that good night. We should all be so lucky.
Posted by: eek | February 22, 2008 at 04:47 AM
Ofcourse she knew, and thanked you for it... Her spirit was probably holding you as you were holding her body. What a week.
You and Alayne and all the people and animals at the ranch are in my thoughts.
Posted by: Jessica, NL | February 22, 2008 at 04:28 AM
Dear Steve, Pepper may have not known you were holding her paw until the very end, but I'm sure she was well aware of all the love you and Alayne have given her at RDR, love she certainly reciprocated.
I'm also sure that Uncle Dillon, Luke and all the others have cheerfully welcomed sweet Pepper at the Rainbow Bridge, and are now running and playing around, free of pain and forever young.
Posted by: Carla Polastro-Nigro | February 22, 2008 at 04:15 AM
Our thoughts and prayers are with you. I know Pepper is in a better place running free from blindness and illness. God bless you all for your hard work. May you find comfort in God's Grace.
Posted by: Bebop | February 22, 2008 at 03:33 AM
Oh, I am so very sorry for yet another tough week and very sad loss to you. I never knew any of the animals that has passed this last while, but every time I cry with you.
Please know that you did everything humanly possible to help, and please take care of yourselves too. Be kind to yourself.
I hope you have a restful and emotionally calm weekend.
Posted by: bregda, south africa | February 22, 2008 at 01:17 AM
I just got the last couple of posts about Pepper. I am truly sorry to hear that Pepper has moved on. What a sweet pumpkin. My gosh, you guys are going through the ringer with all your losses. I pray for healing and comforting light to wrap around your hearts and all at the ranch who will miss dear Pepper girl. LuAnn
Posted by: LuAnn | February 22, 2008 at 12:41 AM
Oh Steve/Alayne...you have had so much heartache this last couple of weeks!!! I am crying right along with you!! As always you have done more than most would. Know that you did all you possibly could. You both always have the animals best interest at heart!! Uncle Dillon was there to greet her as she crossed over. Great big hugs to you both!!!
Posted by: Laura | February 22, 2008 at 12:36 AM
Oh Steve and Alayne, I'm so sorry. To lose Pepper after such a valiant, heroic struggle to save her is heartbreaking. But from your descriptions of her condition, it did sound as if her time was near. Even if she had recovered from the coma, she might well have suffered brain damage, which could have had a terrible impact on her quality of life. You did the right thing w/o question. She trusted you to take care of her and not prolong her suffering. And even if she wasn't conscious, the sense of hearing still continues. I strongly feel on some level, she knew you were there with her and she was loved.
You deserve a rest and a respite from too many tragedies in such a short time. Please take care of yourselves.
You're in my thoughts.
Posted by: Debbie Burke | February 22, 2008 at 12:23 AM
Steve and Alayne,
I am so sorry you lost your sweet baby girl. You all are angels.
Heather
Posted by: Heather | February 22, 2008 at 12:21 AM
I, as I'm sure your other supporter, feel a deep seeded ache and loss to the extent of which no words can describe after reading about Pepper. As with many of the animal's who have passed on, it is especially difficult I think; because first...of their disabilities and second; the cruelty of humans who could not except them fully in their homes. And yet, I wonder if they leave us it is because they have been granted and earned entrance into that wonderful place where there is no disability or hatred and only happiness and good. I'd like to think that. It is us who are left here in a sometimes cruel world and us who are left here to mourn Pepper's loss and deal with the void without our dear friend.
See you again Pepper; have fun with all your friends there from Rolling Dog Ranch!
Posted by: Cora | February 22, 2008 at 12:17 AM
Steve and Alayne, I wish there was something I could say to ease your sorrow over Pepper, Luke and Dillon. It hurts so much to lose even just one of your fur kids. Thank you for giving Dillon and Pepper a second chance at a happy life. (((HUGS))) to you at this said time.
Posted by: julie | February 22, 2008 at 12:14 AM
My heartfelt sympathy to you and Alayne, thankyou for giving her a wonderful life while she was well enough to enjoy it.
You gave her the best possible care and a load of love and she would have known that.
RIP dearest Pepper. You were loved.
Kae Norman
Rescued With Love
Australia
Posted by: Kae | February 22, 2008 at 12:07 AM
I'm so sorry to hear about Pepper. This was not the outcome anyone had hoped for, but you made the right choice in the end. With the odds stacked, prolonging her suffering would have been unfair. Just remember that she had the best time at the Ranch, with people she loved and who loved her. Those alone were worth the time with her. Remember her as the happy puppy she was.
Posted by: Anna | February 22, 2008 at 12:01 AM
Pretty Pepper, we will all miss you. Such a sweetheart, little girl.
Steve and Alayne, I am so sorry for your loss. My beloved golden retriever Rocky died 2 months ago from a brain tumor; his, too, was a meningioma, and he had been having seizures. We decided we would try the operation bc he was still a happy puppy with a lot of life and love left in him, but then he went downhill very suddenly right before the surgery. He told us it was time, but it was just so unbelievably difficult. It still is. I'm so sorry to hear about Pepper and everyone else who is gone but never ever forgotten.
Posted by: maggie | February 22, 2008 at 12:00 AM
My sympathies to you and Alayne. Both of you gave her the best that she could have here on earth and did everything within your abiities to help her. Your dedication to all of those at RDR is without a doubt an inspiration, and the unconditional love you offer is an example of what makes your mission as rewarding and heart-breaking at the same time. All of you are in our thoughts and prayers.
Posted by: Lynn | February 21, 2008 at 11:56 PM
I checked back here three or four times today hoping to read good news about Pepper. After a number of hours, I knew it wasnt good. I am sad for you all losing another sweet pup. I only wish I was close by to give you all big hugs.
Tomorrow will better...it has to be.
Posted by: Allison | February 21, 2008 at 11:55 PM