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.
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.
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.
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…
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!
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.
Very helpful, thank you!
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.
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
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).
Oh Nancy – I feel your struggle. You are doing it all as best as you can and finding the best ways to help Otto.
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.