Last week, I was 100% sure I would be having Otto euthanized at today’s appointment with a veterinarian who provides hospice and home-euthanasia services. I won’t beat around the bush; he’s still with us.
There was one important difference between last week and this: The “heat dome” that has kept California roasting for over a week finally broke, and temperatures dropped all the way down into the 80s, a welcome relief from a week with daily highs over 110°F. As dawn broke this morning, we even got a little spotty rain – bizarre for this area and this time of year, but welcome just the same.
As I said in my last post, Otto has never liked heat, and as an old guy, set in his ways, he was super grumpy about not being able to lay in his damp, shady sandbox outside. He didn’t want to be kept indoors (protected from the heat); he wanted to be outside, but outside was just awful! So he was extra miserable.
The veterinarian who came to my home today was impressed by Otto’s insistence at joining the scrum of dogs to greet her at my home-office door, even as young Boone and middle-aged Woody were knocking into him in their effusive greetings. She also was impressed by his intense interest in the treats I gave her to introduce herself to him. He’s also completely continent, in contrast to many of her other patients. Apparently, a lot of the dogs she sees in this type of practice are much closer to the end before their owners call her in, to the point where they won’t get up to greet someone, aren’t eating much, and are in diapers.
That made me feel a little bad; was I being over-anxious, pulling the trigger too soon? Maybe it’s the fact that I’ve been at the deathbed of loved ones – humans – who were in hospice care as well as those who were unable to receive hospice care for some reason; I just don’t want anyone I love to suffer before death. I’ve seen deathbed suffering; it’s ugly and unnecessary.
The doctor put some of my fears at ease. We discussed Otto’s panting, which I have interpreted as a symptom of pain and anxiety. She agreed that pain and anxiety could be a factor in his almost non-stop panting, but said something I’ve never heard before, that a lot of old dogs have enlarged livers (as I have been told Otto also has) and that as the liver enlarges, it pushes up against the diaphragm, and requires a little more forceful breathing.
She agreed that his front paws and elbows appear to be paining him quite a bit, and she could see how he has altered his posture to compensate, but thought that the amount of difficulty he shows in getting up from laying down is not too bad. As skinny as his thighs feel to me now, she thought his muscle tone was decent, given his age.
She also made me feel a bit better about the panic I was in last week. She said that a lot of old dogs have good days and bad days, and even good weeks and bad weeks, but that she often sees old dogs who look like they are death’s door bounce back when minor issues are addressed – and that the heat of last week was just pushing him past his ability to tolerate his chronic arthritic discomfort.
We reviewed his medications; he’s currently on omeprazole (for acid reflux), Galliprant (a non-steroidal anti-inflammatory), and Tramadol (a synthetic opioid). She suggested I add gabapentin back into the mix. I have had him on gabapentin before, for many months while he was also being given the Galliprant, but I could not say I ever saw any difference in either his discomfort or sleeping patterns when he was on it. But she thought the third medication might complement the Galliprant and Tramadol together, so I’ll give that a try again.
All in all, even though he seemed so much better today than he did last week, I’m so glad I brought this vet in for this examination and consultation. Given Otto’s lifelong aversion to slippery floors and most dogs’ apprehension to going to a vet’s office, it’s understandable that when I take him to see one of his regular vets, he always looks worse than he does as home, wide-eyed, trembling, and shaky. A month ago, I brought him to see his internal medicine doctor, and she seemed more dubious about his ability to go on than even I was last week. This morning, on his home turf, Otto seemed, for the most part, like a creaky, limpy, lumpy version of his usual unfailingly well-mannered and friendly self – if a little more unselfconscious about begging for treats than he ever used to be. Now this veterinarian will have an idea about his current baseline – where he is now, and what “too much” might look like. And I got some reassurance that I’m not doing to wrong thing by trying to keep him around at least a little longer.
A final note: Thank you all for your comments with support and advice. I read and appreciate every single one. I feel truly honored to be able to share my magnificent Otto with you, and I am grateful for your care and feeling for him more than I can possibly say.
Your blog last week about Otto hit me hard. I went through similar stressors during the heat with my old Aussie. Our air conditioning went out on Monday night and we spent the hottest week of the year worrying about our 13 year old Aussie, who despite our watchful care came close to heat stroke. I returned from a run to the store with a hubby in panic mode. I quickly misted my boy down, put him in front of a fan under a wet towel and fed him ice chips. I also groomed a huge amount of undercoat out of him. His temp and panting came down and he rallied but it kept me awake despite the heat. We had been sleeping on the deck, not the most comfortable of places. All this made me realize that I am totally unprepared for losing my Bear. I have since put in call to my vet and will probably be making the switch to a truck based dog vet. Each trip sends Bear into a panic mode though he appears comfortable with our regular vet when we are there. I wonder at how accurate tests are due to his anxiety. I know for certain I do not want his final journey made in that state of mind. So now, on to finding help to make his life and mine, just a bit more peaceful. Thanks for bringing this to the forefront of my mind.
I am adding you and Otto to my prayers along with Mocha, my cousins Lab, whose scenario is just like yours. Her vet came to the house today and told her, after Mocha’s complete examination, to enjoy him during the fall and with the next call from her, he will help Mocha transition before winter. My heart is so heavy for her, Mocha, you and Otto. We just love our 4 legged “kids” so much.
I’m forwarding your article to her. I know it will give her the hope that she is not alone in making that decision. Thank you again for sharing with us about Otto and your love for him.
Happy for all of us that love him too! We get nervous and antsy towards the end in light of such a heavy decision. Wonderful that you have a great partner in the doctor to guide and accompany you.
So happy Otto is hanging in there & ya’ll have more time. my prayers are with you both🙏 He’s blessed 2 have a caring Mom🐾🐾💙 I hope the additional med. helps with a little extra relief!
Nancy, we are in the same spot with our 14.75 year old golden. Some days he seems puppy-ish (ISH), and others, I’m wondering if he’s actively leaving us. As a retired oncology nurse I have a clear-eyed approach to aging and death, and firm beliefs about what’s most important (comfort, quality of life). But unlike my human patients, our dogs can’t verbally give us their take, and at times, the honor of walking my best, years-long companion along this journey feels like an aching burden to shoulder.
We’ve had really good success with gabapentin for arthritic hips and spine, as well as Dasuquin Advanced (the kind that is not OTC). I’m all for comfort, so like you, I won’t hesitate to add more meds as needed. Side effects are weighed appropriately against benefit. I care less about long-term risk of liver problems from meds, for instance, than I do his comfort today.
Thinking of you with solidarity and fondness, and empathizing about the heat. I grew up in Chico, and gaaaawd. Summers are brutal.
Lucky Otto, to have found his best friend in you.
Dear Nancy, Oh my how your Otto posts grip my heart. We have had two “old” dogs in our home, both over the Rainbow Bridge now, but I do so relate to where you are at. I commend you for your diligent care of your heart dog and the obvious great love you have for Otto. At some point, would you please elaborate on how you found a Hospice vet…or more to the point, how I could find one. Our current boys are 7 and 5, so God willing, we have a lot of time before we need one but what a wonderful idea. When our first corgi girl was put to sleep, our veterinarian came to our home…it was so much more pleasant for Katie…she did not like slippery floors and cold tables. The same was true with our old man Owen. It would be wonderful to have ongoing support from a vet dedicated to animal hospice. I am a subscriber so if you write about how to find a hospice vet, I will know. Or feel free to email me. Praying for you and for dear Otto…cherish the time and the boy, I know you are.
I had a personal reference, but try the International Association for Animal Hospice and Palliative Care: https://inhomeeuthanasiadirectory.com/
Best to you and your dogs. I know that this pain is the price of the love we have shared with our dogs — and it’s worth it — but it doesn’t make the price any easier to bear.
I introduced a hospice vet practice with a traveling hospice vet tech into my black Lab, True’s, life before there was even a hint of her slowing down. She was 14 at the time, but continued with all of her normal daily activities plus scent work. I wanted him to be able to see, when the time came, whatever drastic differences there would be. Just before she turned 15, she began having fainting spells. They became progressively more numerous. She had some tests done and they diagnosed pulmonary hypertension. The vet tech led me through a series of “lines in the sand” for True. What things would jump at me that would mean she was getting ready. Appetite for sure was one, but there were others. As I struggled in her waning days to make a decision he asked me, “What would True miss?” At first that confused me because she was missing so much already. I then went OH! She wouldn’t miss walks because I was afraid to take her, plus she was becoming ataxic. She wouldn’t miss swimming because she couldn’t do that anymore. She wouldn’t miss eating because she was already refusing food (a LABRADOR that won’t eat is a BIG red flag. As she began having numerous syncope episodes in a day, I knew I had to make the decision. I was so fortunate that the veterinarian and the vet tech came to my home on a SUNDAY morning and treated us all with dignity and respect. One of my Maine Coons lay beside True until she was gone.
Thank you so very much for sharing your and Otto’s journey with us.
My heart goes out to you and your beloved Otto. I’m going through the same thing with my 13 year old Aussie. She was diagnosed with liver cancer a few months ago. Your comment about the panting cleared up the question I’ve had about her excessive panting–now I know why. I’m just waiting for her to let me know when it’s “time”. I also will employ the services of a vet who comes to the home. She’s so anxious when going to the vet. I don’t want to put her through that again. She’s on gabapentin and that seems to help. Also I give her rimadyl at night for extra support. Thank you so much for sharing your story. It really helps.
This is great news! Thank you for updating us. Every day is truly a gift.