Madeline slept through the night last night. I can’t remember the last time I slept through the night, unawakened by Madeline’s hacking, wrenching cough. I know I must have slept through the night in October, before this most recent descent began, but that feels like a very long time ago. Like sleep deprived parents, we’ve been shuffling through days, trying to make sense of symptoms, drugs, and doses; looking for patterns or ideas that might help us manage her illness.

The most recent conclusion from the Veterinary Internal Medicine Specialist: “Madeline appears to have an idiopathic pleural effusion. The cough is almost certainly related to this condition, and the fact that it’s been going on for so long. Given how many tests we’ve run, how many treatments we tried, I think it’s unlikely at this point we’re going to find a root cause. We should try to make her comfortable as long as we can.”

When friends and family ask “how’s Madeline?” the answer is never short, and is almost always unsatisfying in its ambiguity. In short, “she seems alright for the moment, but there’s this chronic condition hanging over our heads, and we don’t really know what or why”.

So we continue to treat her symptoms, dosing her with hydrocodone at night to suppress the cough, slipping her acetylcysteine from the compounding pharmacy to help her expectorate during the day. And I try to remember what life with her used to be like, before this became the new normal.