For some reason he hadn't been on the blog very much, and I don't know why. Bentley was a star, and I just never seemed to have the camera ready when he was giving us another wonderful moment. He was one of the sweetest, funniest, most affectionate little dogs we've ever had the privilege to know and love. And then, tragically, he was gone.
He died suddenly on Saturday, just six months after coming to us, and only three months after we were able to restore his vision.
Bentley was always the first one I would take out of a crate every morning, and whenever I would open the door to the dog room, he would be bouncing up and down in his crate, looking at me, jumping with excitement. I'd pull him out and set him down on the floor. Then he would dance a quick jig, run in circles across the floor, come back and jump up on me, then twirl and take off again in circles. It was just how he celebrated each new day. Alayne called him "our own little Fred Astaire."
So on Saturday morning when I opened the door, I instantly knew something was dreadfully wrong. He wasn't standing in his crate, waiting for me, bouncing up and down. He was laying on his side. Even before I got to his crate, I yelled down the hall to Alayne, "Something's wrong with Bentley!"
I reached in to pick him up, and there was no resistance. His body was limp. There was black diarrhea and red blood in the back of his crate. Bentley was breathing, and he'd blink, but that was the only sign of life in him.
In a couple of minutes I was in the van and rushing him to the
emergency veterinary clinic in Littleton. Alayne had already called to let them know we were on the way.
On the road I called our internal medicine specialist in Burlington, Dr. Tanya Donovan, who was working that day in her clinic. She had just treated Bentley the previous week for the final stage of his heartworm treatment. I told her what had happened, and that he had been his usual happy, buoyant self the night before. I asked if there could be some connection to the heartworm treatment, but complications usually manifest themselves in respiratory issues and what we were seeing just didn't mesh.
Tanya told me to have the emergency vet call her and she would help in any way she could. Ideally I would have taken Bentley to Burlington, because Tanya's clinic is an emergency hospital as well, but that was two hours away and I didn't think he could make it that far without medical intervention.
At the Littleton clinic, I was just walking through the door with Bentley in a crate when the doctor, Dr. Christine Nau, rushed up and whisked us to a treatment station. Over the next eight hours she tried valiantly to save Bentley's life. Here's a photo I took with my phone shortly after getting there:
Her initial assessment was HGE, or hemorrhagic gastroenteritis, which we had experienced before with Widget. But his blood panel came back with his ALT, a key liver value, literally off the chart and unreadable. They ran another screen just to isolate the ALT, and it came back at 2,052 -- when the high end of normal was only 100. That was shocking, and couldn't be explained by simply HGE.
She had a hunch there was a blood problem, and then ran a more specialized test to determine his clotting factors, called a "coag" test. This came back also as off the charts and unreadable. There was simply an ">" at the end of the bar under "High." Now I knew Bentley was in real trouble.
During this entire time Dr. Nau and Tanya were in frequent contact. Dr. Nau told me that Bentley's case was exactly the kind where it really helps to have an internal medicine specialist involved to make sense of complex and sometimes confusing symptoms, so she was delighted to have Tanya to consult with throughout the day. And after one of the early calls, Tanya came back on the line to tell me, "You're in very good hands with Dr. Nau." I knew it at that point.
The coag test results suggested this might be disseminated intravascular coagulation, or DIC:
Disseminated intravascular coagulation (DIC) is a rare, life-threatening condition that prevents a person's blood from clotting normally. It may cause excessive clotting (thrombosis) or bleeding (hemorrhage) throughout the body and lead to shock, organ failure, and death.
In DIC, the body's natural ability to regulate blood clotting does not function properly. This causes the blood's clotting cells (platelets) to clump together and clog small blood vessels throughout the body. This excessive clotting damages organs, destroys blood cells, and depletes the supply of platelets and other clotting factors so that the blood is no longer able to clot normally. This often causes widespread bleeding, both internally and externally.
A simpler explanation for his symptoms would have been rat poison, but we don't have any here and never have, so that couldn't have been the cause.
Dr. Nau gave him a plasma transfusion over the course of the next four hours. Our plan was to get him stable and then transfer him to Tanya's clinic late Saturday, where she could take over his treatment. But when I returned later that afternoon to pick him up and head to Burlington, I watched him in the medical cage and could tell there wasn't any real improvement. He was breathing hard, which was a change that had occurred in the previous half-hour. He had continued to ooze bloody gunk from his rear end throughout the day, which suggested to Tanya and Dr. Nau that his intestines were sloughing off the lining -- presumably because clots were choking off the blood supply to his GI tract.
Dr. Nau was concerned about whether he was really stable enough to make the trip, and I had to agree. We called Tanya, who concurred and recommended leaving him there for the rest of the night and then re-assess in the morning.
We ran his coag test again, after the plasma transfusion, and the readings had improved -- still far too high, but it gave us a little hope. But in the next thirty minutes, his heart stopped ... then restarted after a couple of seconds. His breathing continued to be labored and rapid, an indication that his lungs might be also compromised by clots now.
At this stage Bentley was in the oxygen cage. Suddenly he tried to sit up, went rigid, and cried out. Then he sank back down.
That's when Dr. Nau and I decided it was time to let him go. In tears, I called Alayne to tell her what we needed to do. She said, crying, "Just tell him I love him so much." After getting off the phone, I reached out to stroke him and said in a quavering voice, "Honey, your mommy loves you so much."
I was bending over him, sobbing, with my face resting on his body, when he slipped away. I couldn't believe he was gone. We'd only had him in our lives for six months, but it felt like ten years. And he was just getting his new start in life. It ended far too soon.
On Sunday morning there was no bright-eyed boy dancing his jig across the floor. The room, full of dogs, felt empty. Because one adorable little fellow was missing.
