End of life decisions

I will trust someone whose practice is mostly animals at the end of their lives to help me with this decision.

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Three years ago I wrote a blog post about “how to know when the time is right for euthanasia.” A the time, I had three friends and family members who were facing this decision. One dog, Beau, was euthanized not long after I wrote the post. Lena lasted another year before her owner decided that the dog was too disabled to go on. Chaco, the third dog is still living, the last I heard (I don’t hear from that friend very often anymore). But as I said in the post. I hoped it would be at least several years before I was mulling this topic again.

Well, here we are, almost exactly three years later. Guys, I’m having to think hard about this right now, with my nearly 15-year-old heart dog, Otto.

He had surgery on his liver about four years ago, and we keep an eye on that organ with annual abdominal ultrasounds, to make sure that the benign growth that was removed hasn’t grown back. He’s had a handful of teeth extracted for various reasons, including one broken and several cracked. And he’s been receiving an increasing amount and variety of medications for arthritis pain for a couple of years now.

But until recently, he honestly looked pretty darn good for his age. This last year, though, as the arthritis pain has ramped up, he’s moving less, and has lost a lot of muscle tone, especially in his rear legs. His weight is a few pounds less than his ideal “high school weight” and he’s a little on the ribby side – but I’m trying to keep him on the light side, to reduce the burden on his arthritic joints. His worst arthritis is in his elbows and front paws, and the pain seems to be altering his stance – which is probably causing more pain in his shoulders and back. In the past few weeks, all of a sudden (it seems), he just looks awful when he stands around, swaybacked and panting, and with his ears back and face tense.

We’re having a really hideous heat wave in California right now, so that’s not helping as I try to figure out how much of his panting is due to pain and how much is the heat. He’s always hated being hot. Now it’s even too hot for him to find relief, as he’s always done, by digging a hole in his dampened sandbox, in the shade of an umbrella under an oak tree. For the past few days, it’s been over 100 degrees in the shade! I’ve had to make him come in my office and stay with me and the other dogs where it’s cooler – but he hates this, too. He lays down for a few minutes, then gets up, pacing and panting. He scratches at the door, wanting out. I open the door and he gets only halfway through when the wall of heat makes him stop and remember why he’s not already out there. He turns around, stiffly, and stands for long minutes in the middle of my office, panting and with that awful, painful-looking posture, before laying down again. This just breaks my heart! I don’t want him to be in pain.

Is it the dementia that makes him forget it’s too hot to go outside? Absent-mindedness? Stubbornness? Why can’t he seem to get comfortable in my cool office? There are three beds, of varying heights and softness, and he gets first dibs on any of them. But he just doesn’t want to be in here, he wants the heat to go away and he wants to be in his sandbox. I know the heat is temporary, but his arthritis pain is not.

I don’t want him to suffer.

I use several different assessment tools, developed by various experts on hospice and end-of-life issues for dogs, in an attempt to find some objective data points to help me decide whether “it’s time.”

On one, the result translates to, “Quality of life is a definite concern. Changes will likely become more progressive and more severe in the near future. Veterinary guidance will help you better understand the end stages of your pet’s disease process in order to make a more informed decision of whether to continue hospice care or elect peaceful euthanasia.”

On another, the score indicates, “Everything is okay.”

On a third, the score suggests that Otto has “acceptable life quality to continue with pet hospice.”

I discuss Otto’s condition with close friends who know him. My trainer friend Sarah suggests a consultation with a veterinarian who has a housecall practice and specializes in hospice care for animal companions. Well, why and how the heck did I not think of that on my own? I called and made an appointment for next week. For now, a load has been taken off of my mind. I will trust someone whose practice is mostly animals at the end of their lives to help me with this decision.

dog swimming in lake
Much more comfortable in the lake. If only I had a lake in my backyard! But 5 or so miles is not too far to drive every day, if it keeps him happy. © Nancy Kerns | Whole Dog Journal

And in the meantime, of course, the goal is to give Otto the best possible daily experience I am capable of delivering to him. I’m trying to make up for his unhappiness with the heat and the unaccustomed confinement in my (cool) office by taking him and my other dogs to the lake every evening. There’s a place that has a sandy, gravelly (but not sharp) bottom and with water that gets only very, very gradually deeper. It’s where I like to bring small dogs, novice swimmers, and now, my old guy, too.

As shallow as it is close to shore, the water is refreshing but not cold. We can linger at dusk, when the other lake-visitors are all gone, and not get a chill. Woody asks me to throw his ball, and he bounds through the shallow water, happily fetching. Boone looks for opportunities to steal the ball from Woody and then play “catch me if you can!” Otto wades back and forth, back and forth – not like his nighttime dementia pacing, but like a happy water buffalo. Every so often he wades into the deeper water and swims a bit, and then comes back, tail wagging slowly on the surface of the water, looking extremely content. When he’s like this, the end feels far away from now, and I find a little bit of hope that it truly is.

101 COMMENTS

  1. Anyone else crying as they read this? I have faced this decision many times with many species. It is never easy. Sometimes the decision is made for us and sometimes we have to make the decision. So hard. Not much anyone can say except follow your heart.
    Please update on what the hospice vet says.
    Otto is lucky to have a pet parent like you.

    • Yes….I am crying also…..this brings back all of the terribly difficult decisions that have been made…..
      Nancy…thinking about you now at this painful time…..
      Signed….Fan of Otto

    • Yes, balling my eyes out. For Nancy and for my aging Yorkie and for ME having to make this decision.
      Everyone says, you will know. I truly believe that you WILL know Nancy.

      We all love you and Otto.

      • You absolute will know.

        My Ramses died two days before our last appointment at the vet, thus relieving me of having to follow through with that decision. A gentleman to the end. He gave me the gift of knowing when and then not having to act on it.

    • Yes, things are looking blurry at the moment.
      Thinking of all of us with aging pups, and knowing the grief endured when losing beloved pets, I feel for you, Nancy.

      Another Fan of Otto, and of you, Nancy.

    • Yes & it’s during this time with my dogs that the word “excruciating” comes to mind. Lots of wonderful good days, as a friend once told me, for some excruciating ones at the end.

    • Absolutely crying… I have followed Nancy and Otto in the Whole Dog Journal for a long time; and, having lost my senior dog to bone cancer a few months ago, I totally understand the questions you have… when is it time? No one can answer that for you.. It is so sad… Just give them all the love you can while you can, and then help them cross with as little pain as possible. Nancy, we Love you and Otto. Our prayers and thoughts are with you.

    • I put down my best friend on September 1, 2022. Tica, in the last 14+ years had not spent more than 20 nights outside my bed. She was a rescue. I took her to Europe 8 times (Belgium, Germany, France, Holland); across Canada twice, and down into Florida. My wife was placed in a home earlier this year and I am helping to raise a granddaughter whose mother (my daughter) has ADHD and is a single parent. I am not coping well. But, as Will Rogers purportedly stated, ‘If there are no dogs in Heaven, I want to go where they go.’ Now, back to my tears knowing I have a family of friends (like you) who share my sorrow.

  2. My heart goes out to you. A vet once told me that it’s a fog, not a finish line. I consider myself pretty practical and knowledgeable and thought that was good advice. Even experts need experts – take care.

  3. My girl will be 15 on September 16. Many items in your letter connect with us. She is an Australian Shepherd. Thank you for sharing!

  4. I wonder if a plastic kids swimming pool with damp sand in your office would be a good compromise for him? Huge mess but hey, if the dog’s happy….

  5. Have you tried homeopathic arnica to help with pain and or some MSM coarse flakes from a company like Kala health. Soaking in an epsom salt bath helps people. Haven’t researched that for dogs but listed here since it came to me while typing. These things usually don’t interfere with meds you may already be giving. Sounds like your taking him to the lake did good for both of you. He enjoyed himself and you were able to see a bit of “the old himself” or at least felt like he was happy. Making these decisions has always seemed to me to be the hardest things I have ever done. I’ll keep you both in my thoughts and prayers and hope that you’ll find your right answers.

  6. I am so sorry that you are having to even think about this with your Otto.

    My husband and I both agree that we don’t want our pets to suffer as they age. Our schnauzer was 16 when we made the tough decision. His hearing was gone and his back legs were no longer able to hold him up for long. He did have some fatty lumps as well. Our vet came to our house so that our other two dogs and cat were there.

    There’s rarely ever an “easy” decision to make when it comes to end of life. When our Westie girl turned 14, she was perfectly healthy and active. Then she started walking in circles and other neurological issues. She finally had a horrible seizure and the ER vet said that she was no longer cognitive and recommended that we euthanize her. We were thankful to essentially have our girl make the decision for us.

  7. Oh Nancy , I so know your pain now, deliberating sometimes daily if he wants to call it quits.
    There eyes and face wil help you know. Good luck with the specialist .

  8. you are a good dog mom. I would think that the water therapy is good for him. I know you have heard what I am about to say before. But here goes. You will know when the right time comes. So as of today, it is not.

  9. We have all been there and know how difficult this is. It’s horrible but dogs are worth it. I used to think I would ask God – when I get to heaven – why do parrots and elephants and other animals live so much longer than dogs but now I realize there will be a lot more dogs in heaven because of their shorter lifespan. They are worth the pain when you lose them. Bless all of you who take such excellent care of your companions and make their time on earth full and happy. When you lose one to illness or old age, the best thing you can do is get another one.

  10. I went through this with my Buddy, and ended up having a mobile euthanasia service on Father’s Day. I’ve always heard that it is better to be a week early than a minute late. What finally made the decision for me was when he began falling and being unable to get up without help. He also wanted to go and lie in the sun, which he’d never done before because he would overheat so quickly. I did not want that to happen when I wasn’t home. The home euthanasia was such a great idea. Buddy had a disease which required regular, multi-hour blood tests to treat, and developed an extreme fear of going to the vet. When I made the decision, it was about 10 AM on Fathers Day Sunday, and I didn’t want him to suffer another day before I helped him. A vet and tech were here by 5 PM, and it was such a relaxed, easy passage, with no fear at all. I recommend it highly. All my other pets were euthanized at the vet’s office, which involved a lot of stress at a time when I wanted them to be relaxed and at peace.

  11. Breaks my heart to read about Otto but I knew it was coming. I am so sorry. The question that got me was “what are you waiting for?” Lap of Love is awesome and is helping me with the grieving process as well. I had to put my sweet Cooper down a few months ago and I’m devastated. She was a shepherd rot who lived to be 13 1/2. She had degenerative myelopathy. It was a very difficult year. Thank you for your journal. Ive been reading it since Cooper was a pup. I always look forward to it every month! Always awesome information. Thank you so much and I am so sorry about Otto.

  12. Nancy, I am so sorry that you are facing this difficult decision. Otto is indeed a very lucky boy to have someone who loves him and wants what is best for him. Have you tried Lubrisyn for his arthritis? I’ve used it for my horse who had severe arthritis and had great results! I’ve also given it to my dogs as they’ve gotten older and it has helped. My thoughts and prayers are with you and Otto.

  13. I just read your thoughts about Otto and making the ultimate final decision, one that is really final. I also have a 15 year old dog and I am always thinking and assessing each day and each activity how he feels and how the day is going. He is definitely not as mobile as he once was, but he goes for one good walk a day with my other two dogs and me and what I call his mini-walk every evening where we don’t go far, he has all my attention, and he can SNIFF to his heart’s content. We also do fitness work (having learned the exercises from a rehab vet) three days a week. There are days when he says NO to the first walk with the other two dogs, but so far he has never said no to the mini-walk. But, i find myself wondering if his standing around is beginning dementia or something else. Wondering if i should not do his fitness exercises, etc. I have never seen any of the assessment tools you put in the article, i am trying so hard to make sure his last months and maybe years are as pain free as possible, as enjoyable as possible, and as stimulating as he seems to tolerate. I think the assessment tools will help. I felt real connection to you reading your thoughts about Otto, so similar to mine about my boy, Pan. Thank you for both the assessment tools and writing such an important blog note.

  14. Oh Nancy, my heart goes out to you. The roller coaster of emotions that come with this time of their lives. I am so glad you have the assistance of the coming vet appointment.
    The image of Otto wading contentedly in the water, tail wagging slowly, is a treasure.

  15. I’ve had several old pooches with arthritis pain, and as an arthritis sufferer myself I can tell you that your cool office (air conditioning) is a source of pain in itself. It’s a conundrum for sure. I’ve found that a cool pad helps in the heat (not in your office) and have even put them on top of orthopedic beds.

    I’m so sorry that you and Otto are going through this. Hugs to you both.

  16. I remember when you adopted Otto, and the adjustment time he needed…Time flies and we loose our best friends too quick. I’ve rescued a good number throughout the years (close to 50 at last count) and I remember each life, and each farewell. Now my Red, the sweetest pitbull ever, is 13 and nearing her own end, but she still wags her tail, slowly but surely, so it won’t be today.

  17. Sounds to me, you are doing everything right for Otto. Please let us know what the vet has to say next week. Otto, and you will be added to my prayer chain🙏🏻

  18. Thank you for writing about this. Having lost my heart dog this summer, it made me cry, and I’m sure many other readers as well. Otto is “our” dog 🐕 too.
    Otto and Nancy,
    We love you, we’re with you, we understand.

  19. This next week is supposed to be cooler and you should be able to get a better idea of what part of his discomfort is heat-related.
    I always listen, read the info and go with my gut feeling. To me, the worst case scenario is making them live with pain. How is it that letting them go a little sooner, be pain-free sooner, always what we as a society worry about?
    Just my opinion.
    Fake email address in case of hate mail.

  20. So gut wrenching to make this decision. I have had to make it 3 times in the past five years and I currently have two (medium sized dogs) that are 15 years old and a GR/GSD/Chow mix that is 13. My lab/corgi mix is struggling with Sundowners and arthritis and, like Otto, had several teeth removed for various reasons. I just lost my Shih Tzu May 31st. He had been struggling with an ear infection for over a year despite several cultures, vet visits and treatments. After spending a weekend in Emergency Care I knew it was time six days before his 15th birthday. Hard to believe he succumbed to an ear infection but after being kept comfortable until I could get him to our vet I couldn’t let him suffer any longer. He was the last of my pups I could still pick up and cuddle.

    Thank you for your article and addressing this important decision, for providing some tools to help with making it.

    God Bless Otto and his days at the lake. May you find comfort and eventually peace when his time comes.

  21. I remember when you got Otto, Nancy. How time flies. I know you are doing your very best, I know it is heartbreaking. Sending our warm thoughts and hugs and dog licks as you and Otto navigate your way through this bittersweet time.

  22. Hi Nancy. My stomach literally dropped while reading your article on Otto as my husband and I are facing possible end of life decisions for my very, very special boy Tucker. We’ve been through the loss of many dogs, all but one Cocker Spaniels, and it hurts more each time. But losing Tucker sucks the air out of me. He has Cushings along with several other health concerns diagnosed over the past year or two. He’s 12. He’s on the upswing right now, and we just appreciate those times and thank God for them. God bless you and Otto.

  23. Have you considering a little CBD oil? I have a 16 year old Havanese who is my heart dog and am having the same thoughts that you are having. The CBD oil has helped as I have tried to keep her on a minimum dose of Carprofin (sp) which does help with the arthritis pain but also leads to kidney failure with long time use. My little dog also suffers from dememtia and that is a rollercoaster ride at best. She is totally deaf and has wobbly knees from luxating patellas which never caused her any pain when she was younger.
    It is truly a day to day watch to know when is the “right” time. My Frankie still loves cuddling with me and sleeps right up against me. I will so miss her but know too that a decision will be needed sooner rather than later.
    Lap of Love has been wonderful in the past and I will use them again. Your dog will pass in his own home with his human and dog friends surrounding him.

  24. This one is hitting close to home, as we had to make this heart-wrenching decision just a few months ago with our sweet Sheldon. My heart goes out to you and Otto, Nancy. I know you will do whatever is in Otto’s best interest. Much love from the other side of the country.

  25. I am truly sorry to read this. I have lost around 20 dogs already and it is always tough, some tougher than others. Currently I have a 14 1/2 y.o. Border Collie mix, a 13 y.o. Tervuren and an almost 11 y.o. Malinois. I am most worried about the Malinois. 6 months ago she was diagnosed with osteosarcoma. Her leg hurts despite being on 3 pain meds. I know with this horrible cancer it will be the pain that takes her. She is still too young and active and loving life to think of the time that is drawing nearer every day. I am keeping you and Otto in my sincerest thoughts.

  26. Oh I sooooo feel you! I have a 12 and 13 year old and this is constantly on my mind. One just got diagnosed with a soft tissue sarcoma which we had removed and are now recovering from side effects from radiation. The other is still healthy except for joint pain. Like your Otto, she hates the heat and pants like crazy on our walks but still insists on going. I noticed recently her rear end started drooping when she’s standing. We started doing ozone therapy and the holistic vet had us start a new supplement – Myos Fortitropin – which is supposed to help build muscle. I do believe I’m seeing a little bit of improvement but it hasn’t been very long since we started. Fingers crossed that will relieve some of her joint pain. Maybe try one or both for Otto? Why can’t they live as long as we do? It’s so heartbreaking. Sending you and Otto lots of love and healing thoughts.

  27. I know this is a heart-wrenching time as I am going through it myself. My 14 year old Lab, Ebony, has geriatric onset laryngeal paralysis with polyneuropathy in its late stage, and my thoughts are consumed with questions about the quality of her life. She is incontinent but mobile. Sometimes I look at her and she seems so life tired. Other times she plays and moves like a puppy although I have her sedated to avoid sudden respiratory distress. She, too, is my heart dog and taught me what true joy is. I can’t imagine life without her. I can’t stand the thought of her suffering. How many of us are going through this right now? It’s an awful choice to have to make. They say a dog will tell you when he is ready to go. I don’t know if that is the case, but I feel for you. I have really loved your stories about Otto and in that sense, many of us readers will miss him. I wish you the absolute best and I know you’ll make the best decision for him. They say a dog will tell you when he is ready to go-in his eyes.

  28. My 11-year-old has had hip issues since a pup due to previous owner physical abuse. I know I am going to have to address the current issue in the next few years. With previous pets, I worried if I was too early. I read great advice somewhere…It is better to be a moment to early, than a moment too late.

  29. Thanks Nancy, My Mini Schnauzer Eddie is nearing 15 years old. He has a bit of arthritis , but not bad..His kidney numbers have gone up according to his July bloodwork. His Vet said to get him on Epakitin , a powdered supplement to help lower this kidney numbers..Other than that and then loss of muscle mass he is still doing ok. I really appreciate your articles on this subject as it certainly pertains to my boy and me ask he ages…Thank You.

  30. Not fun! My ‘recipe’ through the years has been that if there is anything he/she still obviously enjoys (including meals), and there is no pain, I’ll manage the less-fun parts.

  31. Such a difficult place to be and we all have been there with our dogs. The visual image of your last paragraph made me smile. Otto still has joy! Not quite time yet.

  32. Hello, I have a 13 yo Weimaraner and we have had to face several health issues ( I adopted him just before his 4th birthday). There are two companies whose products I use on him all the time: Silver Lining Herbs and Natures Farmacy. The herbs have helped him so much. I did start to notice some weakness in his rear legs so I put him on PhytoFlex from Natures Farmacy. This seems to be helping his legs. These are just suggestions. It seems Otto has had a great life at 15 yrs and I know you want to keep him going as long as possible and as long as he is feeling well. I wish you all the best.
    Elaine

  33. Hello, Nancy. My dog Chance has liver cancer and had 2 liver surgeries with benign results. The last surgery 2 years ago indicated liver cancer. He is 14, we live in New Orleans Louisiana, where it is hot and extremely humid. He has some of the same behaviors as Otto but is doing well. I am assuming you have him on TCM or Western Herbs for his liver. Chance is on TCM medications and doing well. I massage him every night and use Frankincense essential oil. He stays inside most of the day and we walk early morning and at night. I mist him with water before we walk, and we are facing at least another month or more of this weather. Chance also suffers from arthritis, mostly in his back hips and legs, has muscle atrophy and not as stable as he once was in his youth. Thank you for article. I am hoping we both get to keep our boys going with some quality of life for as many days as possible.

  34. The most difficult part of sharing our lives with our fur babies. We only borrower our pets, they are given to our keeping only for a few precious years.
    Honestly, I kept a pool in my office (inside another slightly larger pool for spillage) just to keep my “Jazz” happy during heat waves. It is only a sample of how far we will go to keep them happy. Otto is so blessed to have you.

  35. Nancy — hang in there! Not yet time, as you can see he has many good moments and all. I have a 14 year old and that thought is always there as we deal with his medical issues. One is arthritis and have truly found helpful Acupunture. Vet also prescribed couple supplements (Ligaplex and Super Eff) and essential oils (Valor, Copabia, PanAway). The oils have made a huge difference on his being hot—it took awhile. Also have but haven’t needed since the oils is a blanket that is specific to throw in freezer (microwave if need too).

  36. My vet prescribed gabapentin for my Cali. She has osteoarthritis, arthritis and lumbosacral instability. The gabapentin would work for a few days, seriously less than a week, every time I would try them again. I did a lot of research and decided to try cbd oil. For her I am an advocate. She gets Charlotte’s Web twice daily and yes somedays she is slightly slow in picking her back end up but that is usually after running around the yard at top speed with a smile on her face. When she has those days I give her an additional 5mg mid day. I tried other brands but Charlotte’s was the best for her. I wish you the best with your beloved fur baby.
    Thank you for this article.
    Sincerely, Carla

  37. This might be a really dumb question, but seeing as he’s enjoying his evening wading so much, is there any way you could make him a mini indoor sandbox version in your cool office? Maybe in a kids’ wading pool or something, and lay it out on a large sheet of plastic? Just thinking.

    • I was thinking the same thing. You could wet it down like the sandbox outside. What about a wading pool outside in the shade?

      I have an 8 year old Pom. Sometimes she overheats. One thing I learned throughout my 40 years of dogs owning me, is to get a bowl of tepid water; cold would be too much of a shock. Slosh each paw through the water, getting it wet up into the pad. Do a gentle “squeeze out” and let air dry. I also dab water on her belly making sure it coats the skin, doesn’t need to be drippy. This works so well to cool off any dog I’ve used it on.

      Other things you might try are Trazadone, Tramadol, Gabapentin, and NSAIDS. I’ve used Acepromazine on horses to calm them for hoof trimming. I don’t remember what you’ve mentioned in the past. Also, chiropractic, laser, and acupuncture services that come to your house are good. I’ve used all 3 together. Acupuncture in particular left my dogs in a sleepy calm state. I find that the sound of rain or calm orchestral music from YouTube soothes as well. A gentle breeze from a fan might be helpful for his peace of mind. Someone taught me that trick when I was afraid to fly. The air is distracting for our brains. I have a fan blowing on me every night.

      As long as my dogs are not seizing, mobile, not incontinent, eating, and find joy in something during their day, I don’t let them go. I am a strong believer in euthanasia. I won’t let my dogs go without my help. Athough with 3 dogs, it was out of my hands and I still cry about it years later.

      My Pom sometimes has great difficulty walking, due to neurological issues. Other days, she’s slow, but prancey. She has trouble lifting her head. It’s a day-to-day consideration, depending on how happy she is. If she wasn’t getting around and not eating, I’d let her go.

      There have been times in my life where my own suffering became a factor too. We need to take that into consideration as well. Good memories are important to preserve. My Sheltie, Tyler, was in a wheel chair for 3 years and couldn’t empty his own bladder so I had to do it about 6 times a day. But, he started seizing and I knew immediately, it was time to let him go.

      My heart goes out to you, Nancy. Like many here, I remember when you adopted Otto. I and my dogs have benefitted immensely from your wisdom and willingness to seek answers for the best dog ownership possible. You helped Tyler and I through puppy class all the way to an AKC CGC title. I thank you from the bottom of my heart and, of course, Otto, too.

  38. Poor baby. I just hate this part but would and have done anything for my heart dogs. How about a wading pool that he can lay in? It would be cooler and lift some of that weight off the old joints.

  39. Thanks, Nancy, for this beautiful presentation of what is such a difficult time as a dog parent. We have had canine children for over fifty years, most of our married lives. Aside from our human children, our pups have been a huge part of our family, as you know. I can’t imagine never having had them.

    We currently are living with eleven year old Luka, who is of a Siberian Husky background. Up until about five months ago, he was the typical energetic, busy and healthy pup. He’s had some stomach problems, now resolved, but he, too, is slowing down at home and spends most of the day, after morning exercise walking, sleeping. He moves a little slower, when getting up to go across the room, but runs when he smells food! We’re watching him, but realize, as you do, that we have to pay close attention to make sure we’re taking care of him, as we would, to know what’s happening. Thanks for the thoughts about seeing someone who can evaluate, unemotionally, what is best for our beloved canine child.

    Our best to you and your family… all canines included!

  40. If you’re looking for opinions, I’d say keep the vet appt, but go with your own heart and observations. That he’s able to enjoy the swims, you, that speaks volumes.
    I have put off going to our vet of current record who is at a distance. Our former vet suggested her and she seems okay but we have no long term relationship and I don’t think she knows me well enough to understand the deep bond even though her practice pr claims to so respect the bond. I nearly died 2 years back, and last year mom’s dementia took a turn; she developed incontinence, I live with her (she’s 100 Tuesday) and Dad who is 105 and a bigger challenge in spite of not having dementia…but he is deaf and demanding.
    The goal was to enjoy what we could each day, and get through to the peace of getting in bed each night and snuggling.
    Mom is now in hospice and I’m so distracted and held hostage by daily visits that it’s hard to plan much as well. So my loves nails have gone untrimmed though I have resorted to filing as able, She has a few sores she’s made from biting. Her hair has not completely returned from the scratching and biting of a bout of fleas last year. She has not had her usual titer testing.

    IF not for her, I would go insane. I was distressed when she showed hesitancy and/or refusal to suddenly not do the steps. It began oh back in April…She turned and snapped on my hand drawing blood when I tried the towel under belly lift to assist…vet no longer practicing who I loved, suggested Cosamin…tried her on that at the suggested loading dose of 2 tablets a day….and then diarrhea developed. Stopped it. Still having some poo issues even now consistency wise, though it is showing some signs of improvement. I did try to find a more local vet and have been refused…or I won’t deal with them due to the bad signs. One is what would be very helpful…mobile. She has more patients than she can handle/not taking on new ones even though she was informed of our circumstance (perhaps my mistake?) and lives no more than 10 minutes away…that lack of empathy/compassion makes me not want to deal with her going forward. Another vet demanded a rabies vaccine. They worked that into an outrageous estimate that could be even MORE if she was uncooperative and had to be sedated for xrays which were X per view and interpretation….Vax was no wiggle room. I conveyed it was no exceptions for ME either. She has been regularly titer tested until the past year or so due to my own illness issues. Good results. I’ll be damned after all these years of my efforts that I will subject her to the vaccine. There is a painful reality here…some vets are looking out for themselves and their interests and pocketbooks. They want to exploit ours and our pups but doing massive workups and charging with little regard to what they put us or our pups through. Another practice had an ability via their website to send a message. It’s been at least 2 months without a word. ANd lastly our beloved vet who stopped practicing when she had a baby (who is going to Dartmouth this fall!!) had a vet friend we saw for a long while, and SHE stopped practicing…I asked who she was going to (we keep in touch) and she herself has not found a practice she feels good about. But there is no way, accidents or not that I will consider the E word. We are managing and will do our best to continue to do so. We offer love and comfort to each other and that makes it all Okay. And worthwhile. and btw, she does the tiled steps from the family room to living room often all on her own. But there is something about 6 steps to the bedrooms…that are carpeted, but open, that she is hesitant on, so I give her an assist…no towel trick…and she’s ok. Hugs to your little ones and one for you too Nancy…

  41. Everyone seeing this will feel your pain. It’s been five years since I made that same decision, for my heart dog, and the pain remains. I believe in my case I waited too long, and was being selfish when on her third day she refused all food. It wasn’t of course just refusing all her favorites but a long litany of health issues and multiple medications.
    Your columns are always insightful and informative, you will come to the right decision, it’s just painful doing so.

  42. My eyes are filled with tears. As I finished reading this hearing how special your sweet Otto is and how much love you’ve shared. The hardest part of the blessing of having them in our life. I am in this right now with my Lily.
    I hear you describe what your mind knows and what your heart feels……and what your eyes see. I needed to read this today…..thank you for sharing.

  43. Dear Nancy,
    Your article touched home and our heats about your dear Otto.
    We are on our way to our Holistic Vet now with our 14 1/2 year old beloved boy Fluffy.
    He suffers like your Otto but has recently been diagnosed with pelvic cancer. Didn’t see that coming.
    He can’t move his bowels any longer. Walking is difficult.
    To look at him, he looks like he still wants to live.
    He’s so good. How can we let him go?
    Its so hard to decide but we can’t let him be in pain. Oh how we love him.
    We hope Otto can fine comfort from the heat and relief from his arthritis.
    In Las Vegas here, we understand those high temperatures. Awful!
    Best of luck and prayers for Otto and you.!

  44. Nancy, I am so sorry….I have been following Otto and enjoying your stories of him since he was a young whippersnapper! It seems like they age way too quickly.

    I know you will make the right decision for him. It is just so hard to know “when”, but I think if we look into their eyes they tell us when they’ve had enough.

  45. I could have written this myself. I feel your pain so deeply. I am too, in the end stages of life with my 17 year old dog. Its not time yet, but it will be soon. Thinking of you…..

  46. Wait! stop thinking about the end of his life and focus on what is – now. He has been a simply wonderful friend to you and he deserves every day he has with you. He may tell you eventually but for now keep the faith!

  47. Nancy, I can truly sympathize. I have a 15 year old dog who IS in good shape, but she’s 15. It’s only a matter of time. Have you thought about an animal communicator? There are certainly charlatans out there, but there are some truly talented animal communicators. I’ve used one several times with my dogs for various problems and she has really helped my dogs out. I’ll admit I was very skeptical in the beginning, but the results after her sessions have been truly impressive (so much so that I am trying to learn how to do this myself). An animal communicator could “talk” with Otto and tell you exactly what he is thinking and feeling. It’s not a route everyone might take, but I think you’d be surprised by what Otto has to say. Hope that helps.

  48. Hugs to you and Otto! He has been a GOOD dog! The daily lake visits are a gift. I’m glad you are having the house call vet consult next week. It is concerning when he can’t get comfortable indoors because he wants to be out but the heat ruins that. Would something mildly sedating help him get the rest he needs in that moment, instead of enduring the discomfort of standing when he doesn’t know what else to do?

  49. I know where you are coming from. My 13-year-old Standard Schnauzer, Dolce, had really bad arthritis, spinal problems, nose bleeds and various internal nodules. She has had two bouts of vomiting, not eating, etc., but has come out of both of them. We are calling her “Lazarus.” I wish I knew of such a specialized vet I could call. Every day is a challenge but now she is eating everything in sight and taking her short little walks twice a day. One day at a time . . .

  50. Nancy, thank you for sharing Otto’s journey with us. My heart goes out to you facing the worst decision we make as pet parents. I’m not there yet with my 10-1/2 year old lab/hound, Clancy, but I know the day is coming. Otto looks so happy standing in the lake, I hope and pray you get more time with him. And thanks for sharing the Assessment tools, they really can help us make that decision, as difficult as it is.

  51. My senior lab mix at 13yr of age also suffered from arthritis and dementia. He was absolutely happiest when I would take him to the bay for some wading and swimming in the low surf. I think the buoyancy made him feel better. Love the photo in the lake!

  52. I’m so very sorry, Nancy. This is the time all of us dread – the knowing our good buddy is unhappy – for whatever reason – the heat, pain or just some confusion.
    Its been two years since I had to make the decision to put Suzy to sleep – she had made it through Lyme Disease, but I believe her immune system had been compromised – the Doxycyclene did its job & her back end issues improved, but then it was a battle with skin issues – my vet tried many different “fixes” but none really worked.
    I hope your vet’s house call and hospice eases your mind & Otto’s feelings.
    So enjoy reading about your dogs and your fostering. Hang in there.

  53. Years ago, a dear vet commented on end of life decisions for pets. She said, “In the wild, when canines are ready to die, they walk away from the pack, lie down and expire naturally. We don’t let them do that. If you think your dog is wanting or trying to “walk away”, it is probably time to say goodbye.” I’ve always thought that was good advice. We dog lovers cherish our dogs and try to defer that final goodbye. To all, try your best to be there at the end so that your voice is the last your dog hears and your hands the last touch felt. Sending you warm wishes as you approach Otto’s sad departure, Nancy.

  54. I cant tell you what a huge relief it has been to have access to hospice care for my pets. We’ve been lucky enough to have access to a good provider here for a long time, so I’ve used it for the last 5 dogs and 1 cat I’ve had to usher out in the last 10 years. Good luck and God bless old man Otto.

  55. Oh my heart is with you and Otto! I just made this decision for Roxy–she was only 14 but had been diagnosed with a brain tumor last December. I felt daily radiation would be too much for her so opted for just steroids to reduce the brain swelling (surgery was never an option). I used all the tools and struggled and struggled but finally she could no longer walk or stand . I think the three days between the decision and the vet appointment were just about the worst. The only thing that she could still do that she enjoyed was eat so I fed her chicken and cheese almost continuously. I know everyone says “you will know” or “the dog will tell you” but I did not know and I did not feel she told me. Did not help that I had just had cancer surgery and felt I had not been able to truly be there for her. Life just seems so empty without a dog.

  56. Poor Otto! I have followed you during your whole life with Nancy. I have a 14.5 YO Gordon Setter who is doing the same panting and pacing, more and more at 3 a.m. Many vets say, “You’ll know,” when the time is right to say goodbye. With Scout, I’m not so sure. He’s been stubborn from day 1! His bodily functions are doing what they’ve supposed to do, but he sure doesn’t look happy. I will follow with interest what the euthanasia vet has to say.

  57. When I hear people talking putting their beloved pet down for any number of reasons, I always compare that to an elderly human. Would that person want someone to put them down or is it worth the discomfort and pain to wake up the next morning and see and be with their human family. Humans have pain meds to keep them relatively comfortable and there should be meds capable to handle pets pain within reason. I have a Golden that just turned 12 and thank goodness he is still comfortable and healthy despite his slowing down. It’s heartbreaking to see him going through his days without being that high flying younger guy that I admired. I love my Gunny more than life itself and would be very cautious about arranging that trip across the Rainbow bridge for age related discomfort. I would however be much more open to sending him over that bridge if it was a disease or life threating issue and considering his age. Quality of life should only be considered for that life threating decease….. Only my opinion of course. I also have a German Shephard, east German bloodline, that I hope I don’t have to deal with anytime soon. Both of my kids are my life and give me reason and purpose to get out of bed every morning and at my age, without them the purpose would end without them in my life….

  58. I feel your pain. I have always felt deciding to euthanize our beloved pets humanely is not a hard decision. It’s WHEN to do it that is difficult. In our family, we had three elderly dogs. My two adult children each had a senior dog, and we had a 13-year-old male Doberman. All of us have discussed ‘when the time comes.’ My dog was the healthiest although he was old for his size and breed. I felt each day with him was a gift but frankly, thought his time was still pretty far into the future, compared to the other two dogs.

    My kids came to our house for a casual pool party/cookout over Memorial Day weekend. It was a perfect day and at the time I even noted I will never forget this day. Our kids left and we sat on the back patio just relaxing and enjoying the quiet. Our two dogs were wandering around in the backyard as they typically do at sunset. I went into the house for a few minutes and suddenly heard my husband yell. Our beloved Marco had collapsed on the patio. As soon as I saw him, I knew Marco was gone but still tried to administer CPR and Mouth to Nose resuscitation to no avail.

    We never expected our dog to be the first to go. And this was the first time one of our dogs passed naturally. While I hated losing our dog so suddenly, it was so much easier than putting him to sleep. Sadly, my daughter’s dog had to be put down a few months later. Now my son’s dog is the only one left of the three.

  59. Beautiful beautiful article, thank you so much for this. My 16 yr old Zenzi girl and I are on a similar path as you and your Otto, including being overwhelmed by the current California heat wave. We find GREAT comfort in hearing your story and hope you keep us informed of the ups (hopefully LOTS of them!) and the challenges.

  60. Oh how I hate “that” decision! It sounds like he still has very happy moments, and is doing “ok” Nancy. I firmly believe they will let you know when they are ready. I have made that decision in a matter of days or weeks, or in a matter of a couple hours. Fortunately I have a very long-standing Vet, who knows me well enough to always make room when I call. For now enjoy your evenings with Otto, and trust that he will tell you.

  61. We just let our 14 y/o lab mix go. Unbeknownst to us she had advanced cancer…. Probably better we didn‘t know. Although somewhat expected we still we not prepared… her ashes came home the other day…sadness again. But up until recently she was still swimming in „her“ pool… so life was good until the last day…even then she wanted to get out of the vet‘s office. Unfortunately due to breathing difficulties we could not honor her wish.
    Unbelievable sadness! My hurt goes out to you!

  62. Your love for Otto and all your fur babies shines through when you write about them..I hope that you find peace when the time comes to make the heart breaking decision to say goodbye to Otto…he has had a great life and knows you love him…

  63. Very hard decision the hardest ever he will let you know we went through this 9/18/20 she let me know my bernese almost 13 years old couldnt get up any more crucial ligament also went bad she was so tired but I pray your decision will come from your heart

  64. Thank you for writing this, Nancy. I cried when I read it. So heartbreaking to contemplate losing your heart dog (I lost mine in June).
    The assessment tools you mention would be very helpful for this time in a dog’s life.
    There is some comfort in knowing we are not alone in our sorrow. But it still hurts.
    Blessings to you and to Otto.

  65. I have just pts my heart dog. Devastated.
    The best recommendation if I can call it that , it’s better to go a day early than a day to late.
    I did that, my heart said no but my brain said yes let the most loyal, loving old friend go.
    Broke my heart.

  66. I’m so sorry that you are going through this. But of Al course it is some that all of us who love and live with companion animals experience. It is difficult and I hope that your visit with the vet next week helps.

    Love and scritches to Otto. We so love him and you also.

  67. What everyone else is saying. I have never met Otto, but I love him. If you don’t mind a chuckle, I don’t think it is dementia that makes him forget it is hot outside. Dogs are just ever hopeful! I had one who didn’t want to go out the back door when it was pouring down rain, so he’d run to the front door, only to be disappointed that it was raining there, too!

    Glad Otto can still enjoy the lake. It must be a relief to see him happy at least for a while.

  68. Tears in my eyes. It’s such a gift to have our pups live to a ripe old age, but it’s also so difficult to see their health fade. I have had dogs whose illnesses made it clearer (not easier) to determine when it “was time.” In April of 2020, I had to make the agonizing decision for my 17 year old rescued pittie. The prior year was filled with “is now the time?” Days where I knew she was in arthritic pain and confused from dementia. My entire lower floor with wee wee pads for the accidents she wasn’t even aware she was having at times. When I thought I had come to a decision, she’d rally and have that happy pittie smile, stretch out on the chaise lounge in the sun, and wolf down her meals and snacks. When I finally “knew” it was time, we were 2 weeks into full lock down for Covid. My vet, who previously came to my home to help my other dog pass, was unable to come to my home, but assured me that even though clients weren’t allowed into the vet office, I would be allowed to come in and be with my pup as she passed. She passed on her own in my car as I was driving her to the vet’s. It made me question if I had waited too long, but I was glad I was with her, my hand on her side the whole time I was driving, when she passed. My heart goes out to you, Nancy. I’ve followed Otto’s story since you first got him.

  69. Those of us who love WDJ feel as if you and Otto, and now Woody and Boone, are family members. Your beautiful and moving descriptions touch us all deeply. I know that Otto is in the best of hands with you, and that you carry him in your heart, now and always.

  70. Have your tried cbd oil Nancy? I love Otto too, as do we all. What about mussel oil from Pets Naturally? That Omega helps hips etc? Call that company first before you make final decision, He is still worth having around I think.

  71. I have followed OTTO and you thru all his trials and tribulations and successes..

    Blessings and Bright Lights to Guide and Comfort each of you during this Time of Transition

  72. The outpouring of compassion and advice here warms my heart. Dog lovers are a truly wonderful part of life.

    Nancy, we’ve all been there and hope you know we are big fans of Otto! I trust that you will read through these posts, talk to your care team, and continue to do all that you can for Otto (and your other dogs). My thoughts are with you.

  73. We have all been there and it’s a terrible time, more so, after the fact. You loved him madly, he loved you madly. That’s life right there! My warmest regards.

  74. We are trying acupuncture for our 15.5-year Belgian tervuren and so far, it has helped her relax, and her panting has stopped. We live in Phonex and deal with the heat most of the year, so i get the not knowing if it’s the temps when its different for you. If you AC is on, and the other pups are comfortable, likely it is pain. If your boy is up to it try a session.

  75. It sounds like the lake is the solution. More lake time.

    If you don’t have one, I would also look into a cooling mat for Otto to lay on that is also cushiony for his arthritis.

    Up the pain meds if it’s safe to do so. It is so hard to access pain with dogs as they hide it so well by the time you notice it’s usually pretty bad. I had Ramses on opiods near the end but he had cancer. You have to be careful with them but I know you are.

    But it sounds like the lake is the answer for now. Not only does it cool him down but it can take the strain off his legs, joints, etc.

    I’m using the water myself for the arthritis in my back. On these hot days I do water walking in the gym recreation pool. The water buoyancy reduces the impact of gravity on my discs and I can walk for two hours in the pool when I can’t last for 20 min. on land. And the exercise helps me too. About the only way I can exercise for any length of time that doesn’t impact my back.

    Otto’s losing muscle because he isn’t moving because it hurts and he’s not eating because he’s in pain. Not really much you can do about that. He isn’t going to get that muscle back.

    You could try Omeprazole. My Vet had me giving Ramses the same dose I take for acid reflux. She said as animals get older they can have the same digestive problems we do as seniors and it wouldn’t hurt him any. Check with you vet for dosing (as I know you will.) I was also giving him some cannabis for both pain and to stimulate apatite. My vet could not legally recommend it but could answer any questions I had. Basically it couldn’t hurt and might help. I started him very low and gradually increased to just before he got loopy. My local MedMen had a special product just for dogs. I can’t say whether either helped with the apatite but I will tell you he has happy to eat portions of a chuck roast I cooked just for him. I figured at this point, let him eat anything he wanted and forget about nutrition. He also had steak and pork roast and even roast chicken, although he was allergic to it.

    This time with Otto is precious as it will be shorter and shorter. Indulge him and try to give him as much comfort in any possible form that he may want. I know you will. Spoil him.

  76. I know in my heart what you are going through, Nancy. When the furkid is our own, our love for the pet and emotions confuse us and get in the way of making the right decision at the right time. I so wish our furkids could talk and let us know exactly how they are feeling. We lost our beloved Ebony in May. Lap of Love, whose veterinarians are so knowledgeable about what our pets are—and will be experiencing—made our decision much easier. I asked Lap of Love if they refuse to euthanize if they believe the pet is not at that point and still has a good amount of good time left. Their answer was yes, of course. The vet also told us that they have had clients who keep delaying the procedure, and then the pet goes into crisis mode, and the client calls Lap of Love in a panic because the pet is suffering. As hard as it was to let her go, we could not bear that and did not want Ebony to get to that point. She trembled whenever she went to the veterinarian’s office, but her end happened at home where she was happy and comfortable. It was quiet, calm, and peaceful and she “fell asleep” laying on my husband’s lap while eating as many of her favorite treats as she wanted. I was very glad we enlisted help from Lap of Love in making the hard decision and getting their reassurance that we were doing what was best for Ebony—and out of our deep love for her. It was still heartbreaking for us to let her go, and I still cry at times because I miss her so much; but I know Ebony did not suffer in the end, and that gives me comfort.

  77. Thank you for sharing this. My heart hurts for you. You will make the right decisions for Otto, in this part of his journey. Trust yourself. Hugs.

  78. Grief is the price of love–sending you love & support as you navigate this terrible stage of pet ownership. You will make the best decision for you both, albeit one of the most difficult of your life. This is what my wise vet told me: 1. Are there enough good hours to make up for the bad? 2. Does enough of your dog remain to validate the deficits he is suffering through? These two criteria helped guide us to a decision that, in hindsight, we waited too long on. But we loved him so and held on a bit too long. I hope he understood.

  79. I doubt there is a dry eye amongst us. like all of us, I too have had to make these decisions, the last one just 7 months ago. So like everyone else, my heart aches for you and all your family, and Otto. Otto is family to most of us, as are you and Woody and all those wonderful fosters. I’m already greiving over that handsome gentleman.

  80. When the time came to make the same decision with my previous dog ‘Xena’, I had some valuable advice from the lady who was helping ease her quite chronic arthritic pains in her back legs. She had been applying some Bowen therapy, which certainly did provide some help. On the last visit, she gently mentioned that she noticed the dog’s aura had noticeably diminished over the past week. She also said that had the dog been in the wild, she would have found herself a place to let nature take it’s course. We were grateful for those observations which certainly helped us let our fur baby of 12 years go.
    We let ‘Xena’ just 24 hours later. The vet came to our house and ‘Xena’ greeted her with strong wag of her tail, and slipped away in our lounge. 2 months later, another rescue ‘Tessa’ (a foxy x/ black lab) joined our family.

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