I killed a little old lady's only companion

By "killed," I mean "humanely euthanized." By "little old lady," I mean the cutest 90-year-old woman you've ever met, who loves to tell hilarious stories. And by "only companion," I hope I'm wrong.

Ever-talented and CCU-loving student that I am, I managed a feat that few cardiology students ever achieve: I had a CCU inpatient while on cardiology rotation. (Yeah, I'm that good.)

My patient, a 13-year-old Beagle, arrived as a referral from a local clinic for what the rDVM felt was a cardiac arrhythmia (3rd degree AV block), with the intent of having the dog evaluated by the vet school's cardiology department for the feasibility of placing a pacemaker.

However, upon arrival Mr. Beagle was laterally recumbent, breathing quickly and shallowly, and had bluish purple gums and tongue. So, good student that I am, I immediately brought Mr. Beagle back to the cardiology department for some wonderful oxygen, then headed up to take a history from his owner.

Mr. Beagle's mom was the aforementioned elderly woman, accompanied (and driven, thankfully) by her son (who doesn't live with her). Mr. Beagle had started coughing several months ago, was diagnosed with an enlarged heart a month prior by his rDVM, and was placed on a diuretic that hadn't improved the cough at all. The night before presenting to the vet school, Mr. Beagle had experienced an acute onset of respiratory distress, which improved slightly overnight but not much, so Mr. Beagle headed to his rDVM that next morning.

Long story short, Mr. Beagle ended up in CCU in an oxygen cage overnight, along with several other treatments, none of which did anything to help his breathing. It turns out that his cardiac disease, while present, was rather minor. His arrhythmia was actually atrial standstill, not AV block, and was most likely incidental. His real problem was very severe respiratory disease, and we couldn't figure out the cause. Mr. Beagle's chest x-rays looked horrendous; a variety of diagnostics failed to show why. The next step would have been general anesthesia with airway endoscopy and possibly a bronchoalveolar lavage, but Mr. Beagle was just too unstable and probably would have died under anesthesia.

So Mr. Beagle's owner elected to do the unselfish thing and euthanize him. Tears were shed by all involved, but Mr. Beagle went peacefully with his owner telling us stories about the time he brought a live rabbit into the house and chased it around, how he once scared off a raccoon in the backyard, how he sleeps by his owner's feet in the living room every night before bed. When Mr. Beagle had passed, the cardiology resident and client counselor escorted Mr. Beagle's owner and her son out of CCU while I stayed behind to escort Mr. Beagle's remains down to necropsy. It broke my heart.