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Kalikiano Kalei

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Peary, a beautiful Siberian Husky/Malamute mix rescued male of about 8 years unexpectedly crossed over the Rainbow Bridge two days ago. He was a wonderful companion and we shall miss him deeply. This is both a fond remembrance of Peary and an attempt to explain how his abrupt demise occurred. Hopefully, it may help others in their own efforts to understand how unseen cardiac disease can suddenly take our dear companions from us without warning.






SUDDEN CANINE DEATH: REMEMBERING PEARY

by Kalikiano Kalei




I'm sitting here, alternating my gaze between a screen-saver image of ‘Peary’, my 8 year old Siberian Husky ‘rescue dog’, and his dogtags that are draped across the top of my PC. Peary, a wonderfully unique (aren’t they all?) and handsome gray/white Husky-Malamute mix with a pronounced muzzle stop and these huge snow-shoe paws, left us suddenly early yesterday morning on a gloomy, chilly, fog-bound Sacramento day.

He was curled up on the family room couch he took over the moment he first arrived at our house, just as he always does when he returns from a walk, and seemed to be snoozing peacefully when I left for work; I had given both of our guys an early morning run around the block, had my coffee and departed for the office on my bicycle. Only a few minutes after I arrived there, however, I received a call from my wife telling me that ‘Peary has passed away!’ I could hardly believe what I was hearing, but she quickly came to the office and we returned home in her car, where she gave me the details of what had occurred in the few minutes since I left home.

My wife had been in the adjacent kitchen, Peary’s couch viewable from her stance there at the sink, washing some dishes. Suddenly, her attention was drawn by two short, unusual yips from Peary’s vicinity. Walking over to him (he lay less than 10 feet away), she told me she observed him lying in his accustomed prone posture, but with his head down and his tongue slightly out. Placing her hand on his big chest, she said he seemed to have a strongly pounding pulse, but that this was quickly replaced by a much softer sort of quivering motion and then…abruptly nothing. It was all over in less than a minute, she told me with a look of indescribable sadness.

Trained as I am as an invasive cardiovascular nurse and technologist in human cardiology, this event seems in retrospect to have had all the hallmarks of V-tach (a sustained run of abnormally rapid, regular contractions of the left ventricle), followed quickly by V-fib (an equally sustained run of irregular ventricular contractions) and just as abruptly, asystole (complete cessation of heart contractions). An event like this in humans could be referred to as ‘Sudden Cardiac Death’. In dogs, it could be termed ‘Canine Sudden Cardiac Death’, since I presume the causative effects are roughly the same, whether in human beings or in dogs.

Although well used to such events in my former heart patients of the past 35 years, I have no veterinary experience of training in animal medicine (other than that acquired indirectly by association with my dogs) and to say that this was quite a shocking development is understating the extreme emotional grief that losing Peary has imparted by an order of magnitude. It all happened so quickly that all my training and background in human physiology tells me absolutely nothing could have been done to alter the fatal outcome other than that experienced in poor Peary’s event.

However, extreme emotions and effects of grief aside, the pedantic medical savant in me still struggles to understand how this could have happened to one of my dearest pack members! Fingering Peary’s dog tags and looking at his image provide no clue as to whether this is an accurate assessment of what occurred or not, since we elected to have no necropsy performed. After all, what’s done is done and there’s no return of that precious quality known as ‘life’ in almost every instance of physical death.

I’ve never done ‘death’ particularly well; throughout my life I’ve always managed to avoid death in all its possible forms quite adroitly. Death has always felt to me like a very badly tailored suit, awkward in fit, totally misproportioned and cut from cheap fabric. Since I harbor an admittedly irrational dislike of conventional men’s suits, this seems like a natural analogue to me to apply, although it probably strikes just about everyone else as somewhat, well…perhaps a bit odd? At any rate, I’ve always managed to keep death at a comfortable distance throughout my life, avoiding (especially) funerals, memorial services and just about anything like the plague itself that smacks even remotely of that unavoidable end that awaits all living creatures.

Even in the cardiac surgery suite where we performed daily cardiac bypass procedures and cardiac catheterizations I was able to successfully isolate myself from the occasional death that resulted from extreme cases of irresolvable cardiovascular illness, donning a sort of impermeable protective emotional membrane over the lead apron we always wore to block effects of fluoroscopy radiation. Death in those terms was merely a sort of perplexing problem in physical mechanics that had undergone a virtual sterile scrub to remove any vestige of emotional attachment or involvement on my part. I regarded myself as a mere cardiac mechanic, as much to protect my somewhat tender emotions as to simplify things while we performed hazardous procedures on heart patients.

My father passed when I was only four, sparing me any direct memory of that event. When my mother passed at age 93, she had succeeded so perfectly in distancing herself emotionally from me (to ‘protect’ me from becoming a dependent personality, she carefully explained) that her passing was not so much a matter of grieving as an exercise in cold, impersonal logistics. Consequently, the only real experience I have ever had with the pale specter of mortal death has come through my beloved dogs, and only then in recent years.

Over the past three years my wife and I have lost no less than four of our huskies in as brief a period. Two succumbed to terminal malignancies, one expired from effects of severe diabetes and now Peary seems to have expired from what in a human we would casually refer to as a ‘heart attack’. If there’s any good news associated with this latest death, it’s that Peary didn’t suffer long. It was all over in less than a minute, quite unlike our other two losses from prolonged metastatic CA, a process that involves cruelly slow wasting away and much pain. But this fact still does little to cauterize the profound sense of loss my wife and I feel over Peary’s shockingly unanticipated passage. All I can do now is try to use that most acute sense of hindsight and try to make some sense out of what has happened: try to find some of the perhaps overlooked clues that I may have stumbled ignorantly over and ignored.

Peary came to us as a fully grown adult of about 8 years. We had just lost one of our other dogs to CA and were looking for a companion for the surviving one of two litter-mates named ‘Sooka’ and ‘Walter’, also saved from certain euthanasia in the Los Angeles pound by NORSLED (our Northern California husky rescue group). Sooka and Walter had been abandoned, again by ignorant uncaring people in the LA area, and because they were both middle-aged adult dogs (although pure-bred), the decision had been made to put them down due to shelter overcrowding and an assumption that no one would ever want a pair of fully grown, adult dogs!

At that time the last of our original Sibs (another wonderful B&W rescued male named ‘Raki’, but sadly afflicted with severe diabetes) had crossed over the bridge. Fortunately for both Sooks and Walter, we were ready and able to take them both in to our home immediately. Not long after this, Walter contracted a particularly virulent cancer of the brain that aggressively overwhelmed him and that left us with Sooka, who clearly needed a companion to help keep him amused and engaged.  When we found out about Peary, we jumped at the chance and took him in almost as soon as he arrived in our vicinity from LA.

Peary was a gorgeous, large adult male Siberian Husky/Malamute mix. Possessed of a very distinctively (one could almost say ‘noble’) stopped muzzle, he also had what seemed to be huge snow-shoe sized paws, more characteristic in my experience of Malamutes than of Siberians (who often have somewhat smaller paws). With his dark and light gray colored fur and thick bushy tail, he was quite an impressive guy and we loved him immediately. The only visual evidence of his previous 'bad luck' could be seen in the shaved patch of fur around his left ear (where the benign mass had been excised) and a distinctive nick at the very top of that same ear (evidence of some nips by other dogs he had had to contend with, somewhere in his past). That was all we really knew about Peary when he arrived, but could well imagine the unhappy experiences he must have had in the LA Pound!).

Peary gradually settled into our family 'pack’, as one would expect, and adopted the leather loveseat in the family room almost the same day he arrived. While we’ve always discouraged our other guys from lounging on the furniture, Peary took the couch over with such perfectly natural assurance and aplomb that we just stood back and allowed this, struck as we were with a combined sense of whimsy and bemusement over this 'turf claim'. It became Peary’s couch from that day forward, about a year and a half ago.

Peary had this unique way of lying on the couch with his head draped over the end of it facing the adjacent kitchen area; it afforded him a view of that area my wife considered her ‘office’ (since she’s Chinese, the kitchen is the heart of the household, naturally enough). The only thing that seemed a bit unusual about Peary was the fact that he had a sort of tendency to bump into things that were on his left side. The huge benign mass that had been surgically excised from the internal aspect of his outer ear had left him with a shaved area there, thanks to his surgery prep, but apart from that, all the vet visits, exams and laboratory tests he underwent seemed to show negative results (normal). We put Peary on the usual range of prophylactic meds (heartworm, rabies, flea & parasite control, and Giardia meds as a preventive measure) and he went on the Blue Buffalo dry dog food for seniors, as with all our adult dogs. there was absolutely no indication that Peary would not be with us for a good, long time.

Peary was full of delightful little surprises, as anyone who has any experience with canis lupus breeds can affirm is typical of the Husky and Malamute dogs. Within a week after his arrival, we got up one morning and found him sprawled immodestly on his back, atop ‘his’ couch and paws splayed out in four directions, a posture with which he would frequently amuse us with some regularity. To my reckoning it was a clear indication that he was feeling totally relaxed and at home in his new surroundings, unmistakable evidence that he was settling in to his new ‘forever’ home normally.

With a generous sized back yard, both Sooka and Peary had plenty of room to roam around at whim, since the patio door at our home is fitted with a large husky-sized pet door that allows them access any time they chose. On both sides of our back yard the neighbors have a great number of trees, some bearing fruit (oranges, lemons, kiwis, grapefruit, etc.) and some producing bushels of acorns annually (from a couple of large old oak trees). The oaks being a perfect hangout for squirrels, there was endless opportunity for that familiar husky predator drive (with regard to small scampering animals like cats and squirrels and even decidedly slow moving critters like possums) to kick in. Normally not a problematic trait unless taking place at Zero-Dark-Thirty in the wee morning hours, we had our share of unexpected alerts from the back yard at 2 AM telling us in short, excited barks that some small nocturnal beast was making its nightly rounds again! I well recall that Peary bagged his fair share of rats and once even dragged a possum off the fence that had made the rather bad decision to play dead with his tail hanging over the upper railing (fortunately, the possum lived to tell the tale to its numerous offspring).

We soon got into a routine of keeping a high-intensity police grade flashlight by the patio door so as to be able to quickly identify the source of all the commotion and would then roust ourselves and dutifully pull an excited Peary back into the house, closing off the doggie-door for the rest of the night so as to allow the poor squirrels and possums to gather a few goodies undisturbed. Sooka for his part, was much more staid about such excursions and would merely go out to see what Peary was up to, then come back to the patio and lay down to observe the predictable sequence of subsequent events that characterised such alarms and excursions. The sight of us spilling out of the patio door in our nightclothes must have really been something to see, but Sooka took it all with a grain of watchful disapprobation while Peary steadily coursed the back yard with all the adrenalin-prompted enthusiasms of a prison camp guard during an escape attempt.

On walks, which occurred three times daily (admittedly NOT enough exercise for two large huskies!), Peary would dutifully acknowledge Sooka's role as lead-dog and faithfully followed him like an obedient sled team wheel-dog, stopping to cover Sooka’s scent with a squirt of his own whenever something smelled particularly odorous! I well recall that some of Peary’s squirts were absolutely prodigious in their prolonged duration. I remember once watching him let loose a stream that must have continued for a good 30 seconds or so!

It was on these frequent walks that I first began to notice Peary’s tendency to bump into things that were on his left side, perhaps explaining why he preferred to walk on the left of Sooka rather than on the right. We also noted that from time to time Peary’s pupils would be remarkably dissimilar in size, an alarming indication, based upon my medical training, that there was some serious neurological problem afoot. When we brought this up to our vet on a check-up visit after the first such unequal pupil incident, the vet examined Peary’s eyes and expressed some surprise when he observed that Peary seemed to lack any vision at all in his left eye.

Looking at Peary’s eyes directly there was no indication of any impairment in the left eye discernible, but covert finger-waggling close to that eye would produce no expected reflexive response; the only reasonable conclusion to draw was that although the eye structure itself appeared normal, there was no neurological communication between the eye and Peary’s brain, via the optical nerve plexus. No further diagnostics were attempted after that, but the logical question arises: Was this caused by the large benign mass that had been excised from the interior of his outer ear? We’ll never have an answer to that question, of course, but from that time on we took pains to keep Peary appropriately positioned on walks and were careful not to make any sudden movements near him on his left without talking to him first, as a sign that we were near.

Curiously, I have noted in pictures taken of Peary in which the camera flash has caught both eyes that the characteristic ‘red eye’ effect of the light bouncing off the retina can only be noted in his right eye; his left eye reflects a decidedly different blue effect, instead of red. If this is indicative of a possible neurological defect, I can only speculate (not having any training in ophthalmology), but it certainly seems to be at variance with the expected red-eye effect that a camera flash normally produces in BOTH eyes.

Although we bought several toys for Peary as his own, he never seemed to understand what a dog-toy was all about, evidence of never having had any toys as a pup perhaps, but Sooka did not help things with his habit of grabbing all the toys for his own. Whether this may all be attributable to dominance interactions or not is open for any guess, but sadly Peary never seemed to know what it was to be playful purely for the sake of play. That said, towards the end, there were one or two instances in which he seemed to be getting caught up just a little bit in Sooka’s occasional manic ‘dancing’ gyrations (Sooka has a habit of occasionally whirling around as if playfully chasing his tail when excited, but his tail isn't long enough to catch up to; it's always most amusing to watch!).

Among his little quirks, Peary had a pronounced tendency to pick up anything that smelled even vaguely of food and would often mouth discarded napkins, food wrappers and so forth during our walks. This was a habit we both had to constantly be alert to prevent, but invariably he would sniff out something before we could keep it from being mouthed and chewed on the street. At home, another of Peary's little habits was licking. He would start licking odd things and keep this up for many minutes (including doors, floors,walls, and even the couch). Also, as Peary settled in over the past half year or so, he began to become demandingly vocal at suppertime, anticipating his dinner by ‘begging’ with the most amazing series of plaintive, wheedling cries and vocalizations. Initially cute, this display gradually increased in intensity until it began to lose a bit of its whimsy and became a bit irritating, but aside from the fact that both Sooka and Peary were terribly spoiled with plenty of treats (a clear violation of Siberian Husky Behavioral Rule #2: “Never spoil a husky!”), I simply interpreted this as latent evidence of habits picked up in the pound, or perhaps on the street where competition for food is keen and anxiety over available meals is easily acquired.

I soon learned to 'guide' this vocalising by leading our two guys in spontaneous group howls and we spent many amusing minutes raising our voices in fascinating harmonies, soon associated by the 'boyz' as a prelude to the passing out of doggie treats. At such moments I'm sure a pack of real wolves would have been suitably impressed by our combined enthusiasms.

One thing that immediately struck me about Peary was that fact that he seemed to be fascinated by the television. Almost from the first day he was with us and right after claiming the couch as his own (it was positioned right across from the TV), he would seemingly watch the play of TV images with apt and avid fascination whenever we had it on. Watching him at these moments, one could almost swear from his focused, intent gaze that he knew what was playing on these programs. It was truly an amazing thing to see. Whether the actors were people, animals or dogs, his response was always exactly the same: total fixation.

Any little irritations Peary may have created from time to time were more than offset by some of his more delightful little mannerisms. Among them was the way he was so careful to select his objects to 'squirt' with such studied intensity. After analysing the tree, pole, post, bush, or hydrant from every possible angle, Peary would then gaze earnestly upwards at the top of whatever he was about to baptise as if praying and begin a series of directional switches...back and forth and left and right...until his senses told him he had selected just the right range, angle, distance and leg lift posture for loosing a flood on his chosen target that would doubtless have scared Noah and his wife half to death!

Peary was a big drinker (as noted earlier), but also a very sloppy one. He also had a most amusing habit of laying down to drink, paws draped over the bowl. Whenever he hit the water bowl, we could count on about half of it ending up on the floor, since his manner of slurping with that big tongue of his swept lots of water over the edge of the bowl. Sooks, by comparison, was almost dainty in his manner of drinking, hardly ever spilling a drop. Despite all the wasted water, it can’t be overlooked that Peary consumed an extraordinary volume of water each day. Whether that was indicative of an underlying health problem (kidney or liver?) is open to speculation, but since his excessive thirst didn’t seem to fit neatly into any recogisable disease or health syndromes at the time, this aspect of his behavior was never isolated out as being significant, or seized upon by our vet as having any remarkable explanation. With normal liver enzymes and otherwise unremarkable labs, it was hard to disagree with this assessment.

Over the last 6 months Peary’s habit of eating grass seems to have increased, however, as I reflect back on all these things. Each morning, while on walks, Peary would regularly stop by several patches of grass that must have seemed particularly appealing to him, since he would linger there gulping whole mouthfuls of Crab Grass and Johnson’s grass, that he chewed and swallowed. Over the course of these months the effects of his grass chewing started to become quite noticeable on our neighbors’ lawns, almost to the point of embarrassment. It’s one thing to have your dog lift his leg on the neighbor’s prize rose-bushes, but another altogether to have him engage in daily lawn ‘redecorating’ by tearing out big patches of someone’s lawn to eat! Unfortunately, Peary pulled out about three times the amount of grass he actually could chew, so the remaining clumps of dislodged grass left a tell-tale trail of evidence behind, in his wake.

This habit of obsessive grass-eating seems to have gradually increased just before Peary’s last days and it was something that we tried very hard to understand from a logical standpoint, but without much success. Any search for ‘canine grass eating’ on the web will quickly produce the immediate conclusion that almost no one agrees on exactly why dogs do this, although various veterinary theories range from ‘stomach upset’ to ‘canine neurosis’.

It was after thinking this whole thing through dozens of times that I started to develop my own hypothesis of what exactly that grass eating may have been all about. Since dogs lack the ability to engage in finely tuned rational reflection on things like we humans can, they of course don’t understand the concept of pain the way we do as a very broad and potentially complex process. To a dog, abdominal discomfort (whether of cardiac or digestive origin) might therefore prompt him to eat grass in a simple reflexive response to alleviate the pain. Since lack of food or the ‘wrong’ food to a dog might seem the logical cause for stomach discomfort in their little doggy brains (I am assuming), it might be an instinctive curative response that a dog would undertake to relieve discomfort.

However, as any person with cardiovascular training readily knows, cardiac pain can and often does masquerade as indigestion or gastric distress. For this reason (among several) we cardiology folks habitually reminded our patients that chest pain should always be evaluated by a doctor, regardless of whether or not a bad pizza is felt to be the real culprit. In a surprising number of cases, that ‘indigestion’ turns out to actually be cardiac in origin!

Given this fact, could it possibly be that Peary was having episodic chest pain that we weren’t aware of, thus prompting him to try to sooth the pain by eating grass? If this hypothesis is apt, Peary was telling us in the only way he could that something serious was going on with him that needed to be evaluated by a vet! The fact that there’s so much lack of consensus among veterinary authorities as to what ‘grass eating’ is actually attributable to made it easy for us to simply dismiss this behavior as meaningless, with a puzzled shrug and not weight it inordinately; a big mistake, so it would seem, looking back on all this.

Reflecting now on these developments, it seems as likely an explanation of what was going on with our poor Peary as any I can think of. Certainly, some professional papers written on ‘canine sudden death’ in veterinary literature show the underlying preponderance of causes to be principally cardiac in origin (22% of a total of 151 cases studied by a team of veterinary pathologists at the Western College of Veterinary Medicine, in Saskatoon, Canada in the year 2000). Toxicity, the next leading cause in that study, was pegged at 17%, with gastrointestinal causes causing 13.2% of the studied morts and simple trauma taking 13% (the rest of the 12 possible causative factors were all below 6% or lower).

There were also a few mornings in the past few weeks when Peary would seem to show no interest in taking that early morning walk; his reluctance was quite puzzling and my wife expressed the opinion that it was simply a display of willfulness. Now, it is relatively easy to view this in a different light: Peary obviously wasn't feeling well and those reluctant looks he gave us at such moments were an expression of pain or illness, NOT willful resistance. And yet we completely overlooked that very possible interpretation of his reluctance to go for walks, on these occasions.

Given that Peary passed so abruptly (in less than a minute from the first onset of acute symptoms) and given both the observed circumstances (by my wife, who actually witnessed Peary’s demise) and the daily behavioral events described above, it seems more than a little likely that our wonderful Peary succumbed to sudden-onset cardiac arrest, very likely the result of an underlying and continuing but undiagnosed cardiac problem. If this is the case, his demise certainly appears to be logically explained as ‘Canine Sudden Cardiac Death’.

Naturally enough, all of this speculation will do poor Peary no good at all and it is far too easy to sit here and feel somehow guilty of failing him in his moment of acute need. This is a well known aspect of human behavior and feelings of guilt or responsbility well after the fact, whether fairly warranted or not, are common following a loss like this. Hopefully, thanks to the dispersal of information throughout the internet these days, Peary's story may come to the attention of others in the field of veterinary medicine and thereby add to our understanding of frustrating and often misunderstood events like this. Although it's admittedly an amateur hypothesis offered here, there may yet be something of value to learn from this sad experience of ours, involving Peary.

The fact that animals cannot express themselves directly using language as we humans do means that the burden of understanding falls on us creatures equipped with extraordinarily developed frontal lobes to try to bridge the yawning communications gap between animals and people. this must be done by means of applied empathy, informed intuition, astute analysis and logical deduction, if at all possible.

Within the setting of today’s overburdened health care environment, given increasingly diminished resources for treatment, facilities and staffing, providing meaningful health care to human beings at a level adequate to need is already extraordinarily fraught with complication and frustration. Taking that process down to the level of animal health care, where one deals with creatures that lack the ability to clearly and precisely articulate the nature of their problems, it isn’t too difficult to understand that errors in judgment, presumptive oversights, insensitivity and/or erroneous interpretations can and likely do have far more serious and widespread consequences for pets than we care to admit.

Our wonderful Peary has now left us to cross, as that wonderfully wistful allusion has it, the ‘Rainbow Bridge’ that all beloved pets pass over to frolic in beautiful green fields, while awaiting the ultimate arrival of and reunion with their human friends and companions. For my part, I’ll remember Peary every day with a fond tug at my heart-strings, taking some small comfort in knowing that regardless of what caused Peary’s passing, he is in a far better place now than any of us wretched creatures left behind to live out the allotted time before our own departure occurs. Regardless of my apparent failure to recognise Peary’s silent pleas for understanding in the throes of his medical problem, he freely gave both my wife and I far more love and affection in his undemanding doggish manner than either of us had a right to expect. I prefer to think that Peary is therefore now up there in those beautiful green fields playing with our other dearly departed pack-members...Laika, Deejay, Raki and Walter...and that someday we'll all be reunited.

Mercifully, Peary left us quickly and there is at least some reassurance in knowing that he could not have suffered long before his spirit left that earth-bound physical part of him remaining, to join the great, unknown Universal Matrix of Spirit all creatures are a part of, both in life and in death.

Finally, Peary's passing leaves me with this single thought: Despite the heart ache of losing them, what would life be without our wonderful animal companions to help ease our own burden of being human?     

Web Site NorSled Sled Dog Rescue of Northern California
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Reviewed by david king (Reader)
Thank you for you story about Peary and I am so sorry for your loss. My sweet dog Ginger just died suddenly this last Memorial Day. I have been devastated wondering What? How? Why? Your article helps me believe it was probably a heart condition. This doesn't make Ginger's passing any easier but feeling like I know the "why" helps immensely. Thank you.
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