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.
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.
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.
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.
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.
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.
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.
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.
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.
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
Forgot, look into mushrooms too Nancy, and call Dogs Naturally Mart, That is the correct name.
Omega 3.