An ongoing dialogue on HIV/AIDS, infectious diseases,
October 3rd, 2025
Update on Louie and One Interesting ID Fact
First, I want to express my sincere thanks to all those who commented, emailed, and texted about our dog Louie. My family and I truly appreciate the concern and the feelings people shared about their own dogs.
And how about these selected bits of wisdom, posted by Dr. Gordon Huth?
“Dogs’ lives are too short. Their only fault, really.”—Agnes Turnbull
“The world would be a nicer place if everyone had the ability to love as unconditionally as a dog.”―M.K. Clinton
“Fall in love with a dog, and in many ways you enter a new orbit, a universe that features not just new colors but new rituals, new rules, a new way of experiencing attachment.” ―Caroline Knapp
“The only creatures that are evolved enough to convey pure love are dogs and infants.”―Johnny Depp
“A dog has one aim in life … to bestow his heart.”―J.R. Ackerley
“Dogs have a way of finding the people who need them, and filling an emptiness we didn’t ever know we had.”―Thom Jones
Now, for the update and the background for why I wrote such an alarming post. (For those who tried to read it last week, and the link wouldn’t open, I posted it over here.)
After a very difficult morning walk last week, I took him urgently to the excellent, local animal hospital, Angell Memorial. Well, it was hardly a walk ― he could barely get over the curb, and I had to carry him home. Scary.
The kind veterinarian admitted him overnight, they did an ultrasound and cardiac ECHO, and the next day discharged him home with a terrible diagnosis: a suspected hemangiosarcoma, leading to a pericardial effusion and ascites, along with likely metastases in the lungs. Here ― take a look at the discharge paperwork (I’ve highlighted some of the low points):
It was quite clear that they did not expect him to live much longer; they also verbally advised us to arrange for home euthanasia within a week. Through sadness and tears, we scheduled it, and I shared the information on this blog because, as I wrote, it was therapeutic.
This has been such a wonderful community all these years, and it didn’t disappoint! Wow, I even heard from non-dog people ― including my mother and my first editor on this site, Mimi Breed. We know you don’t get the dog thing, but we appreciate the sympathy nonetheless.
But guess what? Louie didn’t understand the discharge instructions. Hey, he’s not so great with fancy medical terminology. Plus, he can’t read.
So after the anesthesia from his procedures wore off, he’s pretty much back to his baseline self ― a little less perky, perhaps, but still happy to see us, still eating, still wagging his tail. That’s a new picture of him up there at the top, after he scooted up the stairs. No more of those scary walks, at least not yet.
Look, we’re not in denial ― at least not completely. We’re medical people, after all. The professionals clearly gave him a grim prognosis, and we accept that; he won’t be with us for long. But to quote my wise colleague, social worker extraordinaire Susan Larrabee, you know your dog’s time has come when “your dog can no longer do dog things.” Louie can still do dog things. And that’s good enough for us. Euthanasia on hold, at least for now.
And since this is an ID blog, here’s a closing fact: we literally carry pieces of our dogs with us. Studies show that people and their dogs exchange microbes through shared living space and touch, and that the dog gut microbiome is astonishingly similar to our own ― it’s much closer to humans than to pigs or mice. The study used a microbiome gene catalog containing 1,247,405 genes, which sounds like plenty to me.
So when someone says that a dog becomes part of the family, it’s not just sentiment ― it’s science.
(h/t to Paul E Terrill for sharing this song.)
15 Responses to “Update on Louie and One Interesting ID Fact”
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Paul E. Sax, MD
Contributing Editor
NEJM Journal Watch
Infectious Diseases
Biography | Disclosures | Summaries
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Hi Paul – Thank you for sharing these personal feelings and poignant reflections about Louie and his place in your family. I hope life can slow down enough for you all to enjoy your remaining time with dear Louie in all his wonderful dogginess. – Phil
It is so awesome , so wonderful, so life fulfilling , so enlightenment , so peaceful, so left comforting , so extraordinary , so life warming , so life full of optimism and wonderful promises , that some one like you and your wife , such important persons , so suprema scientists, teachers, mentors , extraordinary human beings have the same feelings and love for our pets. God bless both of you and your families . Please , continue to be the same, never change.
“Dogs are the best people!” Ricky Gervais. (If you haven’t watched “Afterlife”, you must.) Corny, maybe, but I’ve been praying for Louie. Dogs are proof that God is very real–after all, god is just dog spelled backwards. Have a blessed time with Louie–however long that time may be. Thank you for sharing with us.
So happy Louie is better, as so are also his parents. The brilliant novelist Ann Patchett in this week’s New Yorker writes movingly about losing Sparky. Sparky, too, had ascites near the end.
I was once dog person enough to get a German shepherd puppy for my 10 year old when she passionately wanted a dog and her dad wouldn’t hear of a small one. Kona was a dear (even though, distressingly, bit a few people in her territoriality). She was so intelligent I never felt I met her needs; her breed was “working dog” and she needed a job. When the family piled in the car to go somewhere Kona stared us down, clearly saying “You’re leaving me here AGAIN?!” She died suddenly and fairly young of intussusception, to which her breed was susceptible. It broke my heart. I can’t be a dog person any more. But her picture is out on the hall desk with photos of my other children.
I’d been wondering how Louie was doing, Paul. I’m glad he’s in the midst of a reprieve that allows some scoots upstairs and other dog things. I know you and Caroline will savor this time, as will he.
Wonderful news! So glad Louie is doing dog things and just being a good doggie. 🙂 I’m hoping for an extended period of doggy behavior for Louie. I’m sure you and your wife are cherishing every moment with him.
I’m so happy you get a little more time with sweet Louie. We have certainly seen patients “rally” near the end. It always seemed like a gift to their families. I hope this time with Louie feels that way for you.
PS Good to know his microbes will always be with you!
Thank you so much for that lovely song!
And thank you for telling us about Louie.
I am really not a “small dog” fan, but even I find him irresistible! 🙂
I am so glad Louie is doing better. However much time he can spend with you will mean that much more to you now. Been there, done that.
I lost a dog (a 140 pound Newfoundland) to hemangiosarcoma Fast and brutal for a big dog. I send pats and many “good dog”s to Louie.
I am so happy that you and Louie are getting some more quality time. I have experienced that relief more than once
And I hope that all of you, your wife, you and Louie and anyone else involved, can enjoy it thoroughly. Much love.
Dogs are the best
And I completely believe that they find you and not vice versa
My little it pipsqueak and I are holding you in our hearts.
My wife Alice died a couple of months ago. She loved our cocker spaniel Watson but she complained a lot about his barking, not at all about her fatigue or pain from metastatic cancer. Since she died, Watson barks hardly at all. His last gift to her.
Oh my what an amazing gift!
So happy to receive this positive update, Paul! Enjoy every day.
Deb
Oh Paul (and family),
Truly heartbreaking. I have been there. These beloved souls rally for us in the end. They give everything to us their entire lives. What a gift. All of the quotes above are 100% truth!
I wish for you all to hold Louie close, each other closer.