How will I know it’s
time?
Dr. Dani McVety
April 2012
Dr. Dani McVety
April 2012
An interesting trend that I did not expect when starting my hospice practice is that the more times families experience the loss of a pet, the sooner they make the decision to euthanize. Owners experiencing the decline or terminal illness of a pet for the first time will generally wait until the very end to make that difficult decision. They are fearful of doing it too soon and giving up without a good fight. Afterwards, however, most of these owners regret waiting too long. They reflect back on the past days, weeks, or months, and feel guilty for putting their pet through those numerous trips to the vet or uncomfortable medical procedures. The next time they witness the decline of a pet, they are much more likely to make the decision at the beginning of the decline instead of the end.
Pain in animals is another
important topic that all pet owners should be well versed on. It’s the main topic I discuss during my
in-home hospice consultations. Myself,
and many other professionals, believe that carnivorous animals, such as cats
and dogs, do not hide their pain… it simply doesn’t bother them like it bothers
humans. Animals do not have an emotional
attachment to their pain like we do.
Humans react to the diagnosis of cancer much differently than Fluffy
does! Fluffy doesn’t know she has a
terminal illness, it bothers us more than it bothers her. This is much different than prey animals like
rabbits or guinea pigs, ask your veterinarian for more information. If you’re interested in learning more about
pain and suffering in pets, grab Temple Grandin’s book “Animals in Translation”
and read chapter 5.
When
discussing the decision to euthanize, we should be just as concerned about
anxiety in our pet as we are about pain.
Personally, I feel that anxiety is worse than pain in animals. Think about the last time your dog went to
the vet. How was his behavior? Was he nervous in the exam room? Did he give you that look that said “this is
terrible!”? Now think back to when he
last hurt himself. Perhaps scraping his
paw or straining a muscle after running too hard. My dog rarely looks as distraught when she’s
in pain as she does when she’s anxious.
It’s the same for animals that are dying. End stage arthritis makes up about 30% of my
cases. These animals begin panting,
pacing, whining, and crying, especially at night time. Due to hormonal fluctuations, symptoms can
usually appear worse at night. The body
is telling the carnivorous dog that he is no longer at the top of the food
chain; he has been demoted and if he lies down, he will become someone else’s
dinner. Anti-anxiety medications can
sometimes work for a time but for pets that are at this stage, then end is
certainly near.
As a
veterinarian, my job is to assist the family in the decision making, not do it
for them. There is not one perfect
moment in time in which to make that choice.
Rather, there is a subjective time period in which euthanasia is an
appropriate decision to make. This
period could be hours, days, weeks, or even months. Before this specific period, I will refuse to
euthanize since there is clearly a good quality of life. After this period, however, I will insist on
euthanizing due to suffering of the pet.
During this larger subjective time, it is truly dependent on the family
to make whatever decision is best for them.
Some owners need time to come to terms with the decline of their pet
while others want to prevent any unnecessary suffering at all. Everyone is different and entitled to their
own thoughts. After all, pet owners know
their pet better than anyone, even the vet!
Blog by:
Dr. Dani McVety
Lap of Love Veterinary Hospice
Dr. Dani helps families in the Tampa / St. Pete area. She also consults for veterinary clinics and industry on end-of-life care for our companion animals.
Posted by: Mary Gardner, DVM
Not really trying to be anonymous, but I don't have any of the indicated profiles--Howard C. Berkowitz on Facebook. One useful approach came from the palliative medicine people at Tufts: "what are the three things you pet most enjoys? When all or most can no longer be done, it's time." Of course, acute distress, emotional or pain, overrides quality of life.
ReplyDeleteThere's a very wide range. I did not euthanize my best friend cat, Mr. Clark, because it was clear to all that he had a strong will to live, and we provided palliative care that kept him comfortable. https://www.facebook.com/note.php?note_id=113577978716889
We did recently euthanize two dogs. Josie was discovered to have advanced cancer of the spine and, while not in severe pain, was exhausted and had lost interest in life. Wren, at age 15, had a managed cancer, but began to become increasingly anxious, moving with difficulty, and then began to convulse. Unfortunately, home euthanasia did not go smoothly, but I hope she was sufficiently sedated.
My mother died in 1975, of breast cancer metastatic to breast and brain, and the physicians would not honor my medical power of attorney. She received a full resuscitation twice. Being very familiar with pain medicine, I knew her agony was not controllable with the treatment of the time, and euthanasia would have been kind and ethical.
The decision to euthanize was a clear-cut one with some of my pets, but not with the last one. Max had cancer, but his decline was not linear. Just when I thought it was almost "time," he bounced back a little. I did the Quality of Life questionnaire to give me more objective guidance. Max was borderline. I was pretty worried about it since he and I were supposed to go away for Christmas. I decided we would take our trip anyhow because I knew of good vets at our destination. Max was a trooper and seemed to enjoy the trip, as much as he could for an old geezer. When we got home, his quality of life declined very rapidly. He hung on enough to give me one last Christmas and then he let me know when he was ready.
ReplyDeleteThank you so much for your comments. I appreciate your honest accounts of your own experiences, I know from personal experience how hard that can be. You are both absolutely correct, there is not one way to make the decision easily. This is why I don't lean heavily on the Quality of Life scales that are out there - they help some people immensely but they can be a bit too objective for my taste.
ReplyDeleteI'm so sorry for your losses. Wishing you both the very best.
Is It Time to Say Goodbye? A Guide for Considering a Difficult Decision for Your Pet by Timothy J. O’Brien, M.S. provides a step by step guide through the maze of all the difficult questions and considerations that go into a compassionate end of life decision for your pet. A unique feature of the book is the Quality of Life Assessment Graph (QOLAG) that allows a human companion to track the condition of their aging or terminally ill pet. This book is available as a FREE 80 Page PDF Download at http://petlossgriefguide.com/time
ReplyDeleteThere is a page specifically for Veterinarians and their staff, including an article on Compassion Fatigue for Veterinarians, so, if you have a pet, please share this with your Vet.
Please share this FREE e-book with your friends - with 62% of all American households having at least one pet, most of your friends will have to deal with this at some time.
But what do you do in a case of a pet with a chronic illness. My 2 year old cat has chronic diarrhea and won't clean herself. I spend so much time cleaning her, her living area, bedding etc. It is unsanitary and frustrating. My vet has tried everything and we have done all we can and this is as good as it gets. Now what? None of us can live like this.
ReplyDeleteWe have a 6 year old lab/hound mix with a torn meniscus that is having considerable mobility problems. She has short knobby legs and a long thick body (about 65 lbs) so I always suspected she would eventually have arthritis, knee, and back problems. We tried anti-inflammatories and limited movement but that didn't fix it. Plus our other, more athletic dog makes it near impossible to immobilize her long term. Surgery is not really an option financially and only strong doses of pain meds seem to make her feel better. It feels premature to consider this as her physical decline but we can't stand to see her not want to get up, and limp when she does. She's not been herself for about 4 months now and we don't know if "it's time". =(
ReplyDeleteDear Anonymous on July 29th... a 2 yr old kitty should not have chronic diarrhea without a cause. Respectfully to your regular veterinarian, I think a second opinion may be a good idea. A fresh pair of eyes on the situation may help. Or an internal medicine specialist. There are many very tricky parasites that do not show up on typical diagnostic tools - that is the first thing that comes to my mind. http://en.wikipedia.org/wiki/Tritrichomonas_foetus
ReplyDeleteDear Anonymous August 12 - I know personally how hard it is to see a pet suffer from Arthritis. My own dog has problem as well. First and foremost - make sure she is SKINNY! Weight loss is a huge benefit to many dogs with joint issues. And if she is not overweight and 'regular' weight now - make sure she is thin. :) Second - anti-inflammatories and pain meds will never cure her - but they will make her feel better and that is what is most important - so I would continue BOTH medications. There are also some other very useful medications out there that may help tremendously: http://lapoflove.blogspot.com/2011/09/dogs-with-arthritis-adequan-great.html
ReplyDeleteLastly - lots of massage is also good - helps circulate natural anti-inflammatories and gives you special time with her! :)
I know surgery can be expensive - if it may be an option in the future, definitely look into Care Credit which allows 6 months at no interest!
Hope this helps a little.
Dr. Mary
Yesterday is a day I will never forget. I had to put my best friend down. Twice a beloved friend owner this was not my first time. I feel guilty-I had a feeling I should have done it sooner but my vet made me feel there was hope. My best friend was diagnosed with pancreatitis, he bounced back & I sincerely thought the worst was over-then it was back to square one - I called my vet who advised me there is no cure-pancreatitis goes up & down. I really wanted my best friend to get better & stay better. When breathing seemed a chore I knew & he stopped eating. We took him to the hospital when the Dr could tell it was a struggle-Dear Lord-please forgive me for my intention was not to prolong the suffering, I should have done it sooner-my dear best friend I love you-always.
ReplyDelete@discodiva1979 - I am so sorry you lost a dear friend yesterday. I am also so very sorry you are feeling this guilt - you loved your furry friend and did the very best for him. It is ok to want him to bounce back - at least you knew when it was definitely time. Some people just wait for mother nature - and that is not always fair.
DeleteMy story may help you during this time: http://www.lapoflove.com/default.aspx?did=6 I also have guilt of waiting too long.
But just know he is 'ok' now - up in heaven completely healthy and watching over you with love!
Dr. Mary
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DeleteI lost my 14 year old chocolate lab last week. He had severe arthritis and although he needed help getting up he still ate well and walked around the block. Somehow his femur broke on the hip that was really bad. He had a habit of flopping down and he couldnt seem to control the position of his back legs. A friend of ours walked him on his last walk and said there were no problems. I found him panting and as usual at the other end of the room but this time he couldnt get up. He had a habit of trying to get up and scooting back. I felt alot of crepitus in his leg and found out the severity upon xray. He had a mass on his lower leg of the hip and we questioned cancer. He had tumors removed last year but knew i didnt want to put him through chemo. His discomfort seemed controlled with anti inflmm. and pain med. He did have significant muscle atrophy from the waist down. I feel bad that he was laying there w a broken leg. At first i thought it was just a muscle pull until i looked closer. I could have gotten surgery but his other hind leg was just as bad. I know he didnt want to leave me. What a tough decision. My fiance was out of town and I didnt want to do it alone. I wish I had known it was broken sooner. I just miss my dog and wish he hadnt of had to have pain. I chose to euthanize him out of love but its still tough.
ReplyDeleteI'm so sorry for your loss - I know it was a difficult time for you and to not have your fiance present must have been difficult. :( You did the right thing - although a difficult decision. Warm thoughts sent your way.
DeleteMary Gardner, DVM
I had 2 mongrels who I hand reared after we found them abandoned. Murphy was put to sleep last year at 14, after also fracturing the femur, following arthritis, and a long period of anti inflammatories. Today we are waiting for the vet to come and send Paddy on his last journey- whilst he still enjoys his food , he has deteriorated (also arthritis) and on Sunday we decided the time was right to end his pain. I am heartbroken about it, but know it is the humane thing to do, and don·t want him to suffer a fracture. I hope he meets up with Murphy somewhere.
ReplyDeleteI'm sorry you have lost two dear friends so recently. I know Murphy and Paddy are together watching over you! <3
DeleteMary Gardner, DVM
I went with my friend to put his dog (a beautiful, smart Australian shepherd mix that he saved when she was a homeless pup) down today. I was there for support because he said he couldn't do it by himself. The dog (probably 16 or 17, age unknown) lived a long active life, but in the past few years had problems with her hearing, her eyesight, and thyroid, in addition to taking medication for not being able to hold her urine and recent convulsions. She was a trooper and it was a hard decision because she was always happy to see him or me, and was constantly watching over us (despite her compromised hearing and sight). The vet did the pre-euthanasia physical and questioned my friend about the dog's health, giving reasons how they could be treated. She then left us in the room for about ten minutes to discuss what to do. After talking about the best way to handle the dog's deterioration (while still being the best dog) for months, I thought it was odd that she gave us this extra time, and then after we said it was the dog's time (through tears) we waited about 25 minutes for her to get everything ready. It was torturous. A horrible day. We were both with the dog until the end. I am so sad, but I know that she had a wonderful life. As I mentioned, she was a trooper and could have held on for another year or so but with what quality of life? I send compassion and love to all who will go and have gone through this transitional moment.
ReplyDeleteMy heart is broken wide open today. For the past month or so my 8.5 yr old Golden retriever had not been himself. He didn't seem interested in walks or playing and his appetite was slowly decreasing. He used to dance around every morning when I would get up and I would sing "you are my sunshine," to him. The last two weeks, he could barely walk over to me and was hard to get him moving. Last monday I had to drive 240 miles because my father was hospitilazed in renal and cardiac failure. My husband and son stood home with our dog and they called me monday to say that he was sick. He had lost his functions and vomitted several times. I came home the next day and he seemed happy to see me and better. We decided we would wait till wednesday to bring him in. On weds we took him to our vet who discovered a large mas on his spleen and a blood count that was off. She said that his gums were pale and she was concerned that this mass on his spleen may be a metastasis from another organ. She suggested maybe getting an US to see. Well we waited again because he started to act fairly normal for a few days. He took a long ride in the car with us to visit my dad and seemed fairly ok. Then the next day he didn't get up, wouldn't go outside, would not eat or drink and wasnt interested in us at all. The following day, I was home alone with him and he had a few vomitting episodes after which he drank a little water but still would not go outside. I left for about 30 mins to get my son at school and when we got back, he had vomitted about 8 times in the room he was in and he was just laying on his bed. I cleaned it all up, I held him close and told him we would help him. I called my husband at work and when he arrived we brought him to the ER. We were told that the mass was bleeding into his abdomen and that his blood count was low. The doctor said that could do surgery but in his experience with goldens the surgery hasn't had a lot of success in saving their lives, maybe giving them a few weeks, which of course would be spent recovering from the surgery. With a heavy heart we all decided to let him go. He died peacefully in my arms. I have such guilt that I didn't do enough or that I missed something and I hurt so much I want to die..I miss my buddy. he was such a good sweet dog and I only pray to God that I did all I could and that this was the best way to let him go. I just wanted to grab him and run and not look back but somehow we mustered up the courage to let him go. I couldn't sleep last night and all day have been anxious and sad..dont wish this on anyone.
ReplyDeleteI am so very sorry to hear what you went through. Splenic tumors are very common and usually do not have a good prognosis. I consider them a ticking time bomb because they could bleed out at any moment. But just know that you boy had a peaceful departure, in your arms and hearing your voice. That is a wonderful treasured gift - you were HIS sunshine and to have your face and voice with him as he left for his next adventure is wonderful. I hope he runs into my boy Neo up there. <3
DeleteDr Gardner,
ReplyDeleteThank you for your kind words. It is such a hard time and I dont know how I will get through this. His unconditional love was always there even through what I know was a painful time. I am sure that Sport and Neo are playing and having fun up there and we will see them again. I know you understand and I appreciate your website and this forum you allow for all of us to share our feelings. You are a remarkable soul. Much love to you, Marion from Chicago
Your very very welcome Marion. And it warms my heart knowing my Neo has such good friends to keep him busy till one day I get to be with him again.
DeleteLove from Oregon! :)
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ReplyDeleteDr. Gardner,
ReplyDeleteI have a sweet lab mix who is around 14 or 15 years old. Sally can't see well, nor can she hear as well as she used to. She has severe degenerative arthritis in her hips and back legs. She can no longer go down steps without falling, and she has a really hard time getting up or sitting down. I feel so sorry for her. She is on pain meds, but no longer taking the Rimadyl. Hate to even entertain the thought, but is it time to let her go? She is besties with a pit bull mix, who is much younger, and she is constantly knocking her down. Any advice?
Hi Kim,
ReplyDeleteI am so sorry to hear about Sally - I think the main concern is her arthritis - seeing and hearing is nice but not life threatening. I have my own 14 yr old in the same situation. I would absolutely make sure she is on the correct dose of pain meds AND anti-inflammatorys. With pain meds - like Tramadol - you can give it more frequently than twice a day. So I would absolutely go back to your vet to make sure they know your concerns and to see if doseage can be increased. IT will not make Sally lethargic. It is also easier to keep pain 'away' than try to chase it.
I would also suggest using our "hospice journal" to track Sally's quality of life. www.pethospicejournal.com
The other dogs knocking her down is a problem (I have the same problem here) - I always make sure my girl is first out the door while I hold the others back - I hate seeing her get run over by everyone. :( Her spirit can run circles around them - but her legs cannot.
I hope this helps,
Warmly - Dr. Mary
My pit boxer Ava a few months back had some blood in her pee. It stopped after a few days. Then about 4 weeks ago she had blood with her pee and after she went she would squat try again and only pass blood. Took her to Vet said bladder infection. Batril given 10days. Still bloody urine and second and third attemts to go after peeing but pure blood. After 10days right back to vet another specimen. Showed very little bacteria. Xray for stones negative. SMZ given vet concerned said thought she had tumor. If bleeding got worse come right back but call in a few days because he feelt exploratory surgery should be done. Surgery was done he called us back said she had a very large mass in bladder and was only peeing thru a small space. Did not think she would respond to meds. Said we should consider not waking her from surgery and letting her go to sleep. Said little quantity but no quality of life. We did that and I on the other hand feel so guilty that I left her go like that. Questioning myself maybe should of brought her home. Is this common?? Do Vets only do this as a last resort?? Broken hearted...
ReplyDeletePatti - I am so sorry to hear about Ava. It sounds like she has a WONDERFUL life with a GREAT mom! Please keep those memories and thoughts in your mind and do not allow the grief you feel for losing your life co-pilot get you doubting your decision.
DeleteI can't tell you for sure about Ava's condition - but as a vet I can tell you that when urine is blocked, this is a life threatening and painful condition. One that will lead to a painful death quickly. And leading up to that point, it is very painful not being able to urinate properly. Ava would probably have NEVER complained about it - they rarely do - such troopers. But the discomfort and pain would still be there.
I know as a mom you would never want her to have pain or suffer - and what you did - by letting her go while she was peacefully sleeping - was allowed her to NOT feel pain in the future.
My own dog passed when I was not home and it was not peaceful. In hindsight - I wish I was as brave as you.
You did the right thing... albeit the difficult thing.
Much love and comfort sending your way!
Dr. Mary Gardner
Thank You for your kind words. I guess when we only see what we want to see as far as our pets it makes its hard. I looked at a pic of her at the Vet that day and her eyes werent bright and her panting was unusual. Make no mistake her Vet was very kind and comforting with us that day.. He took us to a room and showed a drawing of the tumor how nig it was. Said if we woke her she would have to deal with the surgery and we probably would be back in a short time. He said she wouldnt respond to the meds and her quality would be very poor. He I felt was saddened by the outcome. He brought her in gave her more pain meds woke her up a little so she could see us and then og so gently put her to sleep... Its just I read all these stories of people whose dogs lived 6mos with cancer and meds and I keep thinking maybe just maybe...The Vet said if he had a magic trick he would use it but... Thank You Doctor...
DeleteYour vet is very wise and very kind - you have a great one there! <3
DeleteYes, SOME cancers can be slowed down with medications or surgery... and others simply cannot. Do not every wonder 'what if'... just concentrate on 'what was!' <3
I don't know if anyone is looking at this thread but I am in desperate need of advice... in July 2012 I rescued a 4 weeks old pitbull puppy. He is now 18 months old and has been sick at least 50% of the time since we got him, seizures, skin infections, eye infection... he has not put on a pound since he was 10 months old... his appetite has always been on and off... and for the last 3 months he has been having 1 urinary track infection after another, his kidneys are swollen and damaged, there is blood in his urine and no vet can find out what is wrong with him so we give him antibiotics for the infections but as soon as we stop, he is ok for a week and boom, it comes back... now his urethra is irritated and swollen and he has a hard time passing urine... Some days he is acting like everything is fine, playing, wanting to go for a walk and some days he sleeps all day, pees himself in his sleep, doesn't want to go out... He is just a puppy but his has had almost no quality of life since day 1, We love him like our son and we don't want to give up on him, but i think is suffering... I have never had to euthanize a pet before so I don't know if I should let him go or keep fighting for him... I am afraid to give up and that maybe if I wait just a bit longer he will grow out of it or something... I wish someone could make the decision for me... If someone has any advice that would help me, please take a moment and let me know... I am desperate... thank you.
ReplyDeleteI'm so sorry to hear about your baby. Have you seen an Internist yet? Someone who specializes in Internal Medicine? I would take all medical records there first and then see what they say. Could be lepto? Was he tested for that? He is too young for cancer (altho cancer doesn't always follow the rules). But I would first recommend seeing a specialist before giving up. You are a great family for trying so much! :)
DeleteI am not sure what is the best thing to do for my cat. He is a 12 or 13 year old male (rescue kitty, so his age is only a guess) who has had urinary blockages (two total and two partial) since he adopted me when he was 5. He is a big boy but has with this most recent bout lost some weight. His coat does not look good and his eyes look so sad. But he does not complain. He never complains. He never bites, growls, or hisses, not even at the vet during uncomfortable procedures--and he has had more than his share of those.
ReplyDeleteJack was hospitalized for a week during which time I felt sure he would never come home again. I thought it was just a matter of time before I got a call from the vet saying it was unlikely he would recover sufficiently for quality of life. But that did not happen. Instead, I got a call saying he was doing better and should go home and see how things go. That was a week ago. By yesterday he was doing reasonably well considering how sick he had been.
But tonight he is looking sad again. He sleeps a lot more than usual and he is not passing enough urine for the amount of water that he drinks. His bladder seems OK now but his kidneys may have suffered enough damage over the years that they may not be functioning very well now.
I know the end is near for Jack but I do not know if it is actually here yet. He is not squatting trying to pee so he is not blocked again but he has not peed in over 14 hours and even then it was not a very large clump. He walks slowly through the house meowing at times but mostly he sleeps. When he is awake, though, he is alert, is eating, and loves to cuddle on my lap. Still, I know he is not well and I cannot really know if he is hurting because--as I said before--he is not a complainer.
Yesterday I had hope, but today with this mild relapse I know that Jack will not fully recover. What I do not know is how long should I allow him to hang on just eating and sleeping...and nothing else? The numerous trips to and from the vet, most resulting in several nights' stay, took a toll on this sweet boy. He is such a gentle soul, and he does not understand why this is happening and why I am constantly leaving him. I am beginning to think that euthanizing him sooner rather than later is the way to go just to relieve his anxiety. For me right now, it is not a question of what to do, it is a question of when to do it.
We have a 14 year old mini schnauzer. A week ago, he started out the door and ran into a chair hard in the left shoulder area. He seemed ok after a few minutes, but by Tuesday afternoon he was barely able to stand and breathing terribly hard. We went to our vet, who diagnosed CHF, and an X-Ray showed a large tumor, probably on his spleen. She put him on tramadol and gabentin (sp?) for the pain, and lasix. He has bounced back some and yesterday we started vetmedin and enalapril as well. I am curious to know how long we should give to see if the combo of heart meds is working well enough for us to continue treating him. He is eating very well, has never stopped, but getting up and down is clearly painful. He holds his head down and his back sort of arched until he gets going; he is glad to see us, but definitely not himself. Tonight, he woke up from a sound sleep and urinated on the bed, which I realize may be a side effect from the diuretic. I just don't know what to do. Part of me feels like it is time, and part of me feels like I am not giving the meds time to work. Appetite is great, but he won't play and doesn't seem terribly interested in his normal activities. Thanks for listening, this is just so hard.
ReplyDeleteHi Betsy - I am so sorry to hear about your baby. I know this is difficult. Heart disease is very tricky because there will come a point where he needs help FAST and we do risk an emergency situation when we 'wait' too long with heart disease. But I would give him some time on his meds first to see how he does. It all depends on the severity of his disease and how he responds to the meds. I am confident that the urinating in bed was just a side effect of the lasix and that isn't such a bad side effect. :) It will happen. Appetite is important with his disease because when they start to fail - they want to do nothing but breath. HIs activity level will decrease for sure - the old man just can't keep up - but as long as he is happy in his retirement - that is ok. :)
ReplyDeleteHere is a link to information on heart disease: http://www.lapoflove.com/diseases/HeartDisease.pdf
And you may want to start using our Quality of Life Scale and Diary: http://www.pethospicejournal.com/ even if you do it once a week - you will have a baseline as things progress.
You are in my thoughts!
Mary Gardner, DVM
I have a 12 y/o Anatolian Shepherd, Great Pyrenees mix. She weighs about 125 Lbs and is in great health even after almost dying at 3 from severe heartworm. She has arthritis in her hips. She has been on Rimadyl and Tramadol for a while now. After reading your article two things stood out to me. "These animals begin panting, pacing, whining, and crying, especially at night time." and "Anti-anxiety medications can sometimes work for a time but for pets that are at this stage, then end is certainly near.". She has better days and worse days, but good days seem to be a blue moon occurrence lately. On better days she's stiff and sore and limps a bit but has very little activity. On worse days I have to carry her back end up and down the five stairs that lead to any entry to my home. She falls on the stairs frequently and often can't stand up on her own after laying down, even on carpet. I have been discussing options with my family, though being my dog the decision is ultimately mine. I have read practically everything out there on the topic. I've seen the option of a corticosteroid, but feel that this may just be for my own selfish desires to prolong my dogs life. I just need a voice of reason in this. My vet is amazing, but he knows how much I love my dogs and tries to leave it up to me to throw out option we all try to avoid no matter how futile it might be. Your advice and wisdom would be greatly appreciated. Thank you so much!
ReplyDeleteCarrie
Hi Carrie - I know this is difficult for you. :( Since your girl is already on Rimadyl, you should not do corticosteroids. She is on a 'non-steroidal inflammatory' drug and you can not mix the two. But Rimadyl is great and what my own dog is on for arthritis. Maybe talk to your vet about the dose of Tramadol to see if it can be increased and/or given more frequently. Sometimes that is dosed on the low end. You could also try some massage and acupuncture - but eventually Carrie, the is nothing more you can do medically and you need to make the difficult choice. You have to suffer so she does not. :( Try using our Pet Hospice Journal which may help you a bit. http://www.pethospicejournal.com/
ReplyDeleteWarmly,
Mary
I'm not sure if this thread is still being monitored. But I am struggling horribly with the decision of whether to let me dear, sweet, closest buddy in the whole wide world, go. He is a 14 yr old Weim that is the most lovable dogs you'll ever meet. He he had so many issues in his life and always bounces back. Mostly has dealt with mast cell tumors for 6 or 7 years. He's had several surgeries and been on chemo pills. We got it down to a science over the years and have managed it quite well. Recently he had a tumor in his mouth that was removed that I was told was one that would definitely come back and eventually and that was a fatally type of cancer. It did come back and we had it removed a couple of months ago. All that said, he is happy and has "puppy" in his face. But he also has had nerve issues in his back legs from a couple of ruptured discs for several years. He gets around ok, but definitely hunched over. Now he has recently been losing control of his bowls. What's strange though, none of the above seems to faze him. He is sooo happy...seemingly. Then there is the issue of my husband. It distresses him to see our baby like this...so like it or not, that stress in our house is an issue as well. How does one call the vet to come out and end this precious life to prevent the future and certain pain while their baby is smiling and wagging their tail?? HELP!
ReplyDeleteI'm so sorry you are struggling with this decision! We have some information on our website that may be helpful: http://www.lapoflove.com/Quality-of-Life/How-Will-I-Know-It-Is-Time
DeleteBut it is difficult. Happiness is very important in quality of life - and it sounds like he is still happy. I do worry however about the hind end. That may eventually leave him unable to move well and that may be a reason to say goodbye. Those are difficult appointments because they are still 'happy' and 'themselves' but cannot move. So the quality of life is not what it should be.
I would make sure he is on good pain medication, anti-inflammatory, etc. I'm not sure where you live, but if you go to our website www.lapoflove.com and key in your zip code, if we have a vet that lives near you, they will appear.
If we do not have a vet in your area, you can reach out to your vet to see if they do housecalls. Some do and some do not.
Lastly - there is a directory of vets that perform in home end of life care - here is the link: http://inhomepeteuthanasia.com/
My thoughts are with you during this time!
Dr. Mary