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.
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.
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.
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.
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….
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.
Thank you for the encouragement and insight. Otto has certainly had a very good life with you!
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.
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.
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.
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.