Good article on when to euthanize a pet
Not a cheery subject, but it is the difficult decision all of us come to at some point. As many of you know, I've had to have this talk with my vet many times about Bel the Shiba, though she always manages to pull herself back into a degree of health. Anyway, I came across this link, and was particularly interested in part of it that suggests paying attention to:
"HHHHHMM" Quality of Life Scale: The five H's and two M's are: Hurt, Hunger, Hydration, Happiness, Hygiene (the ability to keep the pet clean from bodily waste), Mobility and More (as in, more good days than bad).
Here's a link to the rest of the article: http://shine.yahoo.com/pets/know-time-euthanize-pet-162100593.html
Sometimes the decision is clearer than others--when my GSD was dying of bone cancer three years ago, it was pretty clear when it was time for him to go. But sometimes, it's not as clear. I'm still trying to figure out what one does with a dog that does not have a terminal illness, but has many other serious health problems that effect her quality of life and the life of other animals and people in the house. There is not easy answer, and for the moment, Bel's still here and stable, but this has given me something more to think about.
"HHHHHMM" Quality of Life Scale: The five H's and two M's are: Hurt, Hunger, Hydration, Happiness, Hygiene (the ability to keep the pet clean from bodily waste), Mobility and More (as in, more good days than bad).
Here's a link to the rest of the article: http://shine.yahoo.com/pets/know-time-euthanize-pet-162100593.html
Sometimes the decision is clearer than others--when my GSD was dying of bone cancer three years ago, it was pretty clear when it was time for him to go. But sometimes, it's not as clear. I'm still trying to figure out what one does with a dog that does not have a terminal illness, but has many other serious health problems that effect her quality of life and the life of other animals and people in the house. There is not easy answer, and for the moment, Bel's still here and stable, but this has given me something more to think about.
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We discuss our old cats' conditions on a lot of days...They are nearing 20 years old and are all bony and feeble now. Finn has thyroid and kidney disease and arthritis- all are under *some* control with diet and medication. he wasnt washing himself for a while, either. His coat is now quite nice, but I can tell his joints still hurt- even just to move from standing to sitting- he is slow to do that and his hocks bump. He has developed an ugly tumor on the side of his nose. But- he still jumps on the barstool to watch us cut meat for dinner, he spends his days curled up sleeping in a ball with Loki the other cat. They wash each other. He loves to eat, and will eat as much as he can- but more than a couple tablespoons and he throws up.
Loki was always a big fat bowling ball of a cat- now I can feel every rib, sometimes she sleeps through mealtime and I have to go wake her up and carry her down to the cat room. Her wrist ligaments are completely lax and she walks on her wrists, not her tiptoes. She quivers at the water bowl and flicks her paws, sometime she spaces out. Every evening she takes laps around the living room, visiting each of us on the couch and walking around the room like she cant decide what to do or remember where she was going. But she curls up with Finn, she can jump from the back of the couch to the counter (*over* the fruit basket, mind you) and we have to go rescue her from there so she doesnt jump off since her 'shock absorbers' (wrists) are shot.
She sits at the slider and watches (something?) outside. She sleeps in the sun. When I get my boots out to go outside she sits at my foot and plays with the laces. LAst night she was playing with a tennis ball... ? The cats are not in good shape, but they have some joys still. They arent missing the litter box, they arent immobile. They arent showing me its time to go. Is it too long to wait for the absence of *all* joy? Can I make that appointment when there is still a shoelace to pounce on, and a nap to take together? Can;t Finn tell me that honestly, his hips hurt *constantly* and he'll forego watching us cut up chicken for a few more months to be free of that? Or that Loki actually *IS* delirious and has cat alzheimers and really can't remember the shoelace game she was playing?
I fear there will be an accident with these fragile cats- one of us will step on them (they still get underfoot- I think "Underfoot" is a cat's middle name) or one of the dogs will hurt them. I dont want that on anyone;s conscience. I dont want them to die that way, and as I wait for them to just die naturally, I wonder what I am giving them anymore. Does the simple pleasure of sleeping together outweigh the pain? The delirium?
I dont think they can live w/o each other, so I imagine taking them to the vet for their final appointment together, they can be buried curled up together like they like to be. But I fear what the vet will say to us- that we should try a new treatment, that we should let them ride it out. I fear what my daughter will think. So I do nothing and wait and see. Wait for some sign that is SO OBVIOUS it cant be ignored. But I feel bad doing that too.
I remember having a conversation with my mom after we put Sevuk to sleep about what a blessing euthanasia is for pets. It lets them go peacefully, ending their suffering. I remember having to weigh all of these things last year, but it came down to the fact that Sevuk had been having a really good day that day: he'd met new people (we had taken him to a new vet's office that day), which he loved, and had eaten a good breakfast (eating was pretty much his 2nd favorite thing, going on walks being the 1st). But, he had been suffering since the day before (he looked very uncomfortable because of the fluid in his belly, and was having trouble walking because of it too.)
So, basically when we found out he was only going to go downhill, and the cancer spreading in his body was going to greatly deteriorate his quality of life to the point where he wouldn't enjoy his favorite things anymore, we realized the best thing would be to put him to sleep when he was still fairly positive and before the really painful suffering could begin.
I've often gone with the mobility issue: if they can't get up, I think it is time. Some people can care for their dogs through lack of rear leg mobility, but for me, that's too much, and as with my GSD, I saw such pain in his eyes when he couldn't get up on his own.
I would have liked him to go after a good day, like Sevuk did. It was kind of what we intended. He did make it to his 11th birthday, and we had a party for him, and he got a burger and seemed happy, and had some mobility. But a week later, Bel knocked him over in the yard (and a Shiba knocking over a GSD, well, you know he was fragile) and he cried and cried when he couldn't get up on his own, it seemed more out of frustration and fear than pain (he was on a lot of meds by then). I'd taken him to the vet the week before, and he'd seemed so much better that my vet said maybe he'd have more time than we expected, even though the xrays showed quite clearly the bone cancer in his rear legs and spine. But that next week, he got a fever. My vet wanted me to try to get it down, so even though I was dubious, we tried One the day before we euthanized him, his fever was so high that I had to wrap him in cold wet towels--even aspirin wouldn't bring it down. I took him in the next day, and when my vet saw him, he too, was in tears, and he apologized to me for making me wait, and said if he'd known how bad it was, he would have not made me wait two days for the appointment. (He did because he honestly thought it wasn't time, and that we could get the fever down). And when we took him in, and the vets asked him if he was ready to go, he wagged his tail for the first time in days.
So with him, it was pretty clear.
But what to do with a dog like Bel? She has touches of all the problems listed in that article. Right now, she's not always mobile; by the end of the day, I have to help her get up because the torn ligament is so much worse at the end of the day. She eats well when she's not sick, but every couple of weeks, whether from kidney disease or something else, she will only drink water, which she vomits up with bile. She'll do that til she goes into dehydration if I don't get the vomiting under control, which I do with meds from the vet (I have both pills and injectable meds for it). On those days, she doesn't eat at all, and she is restless and groans and pants, and is obviously in pain. On those days, I always begin to wonder if it is time. Then she comes out of it, and she's back to her normal.
Some days, especially if she's sick, she's incontinent. She doesn't even know she's peeing on herself.
And that's not even mentioning the seizures, her often inexplicable fears and anxieties. Some days she's afraid of the wind. She's always afraid of thunder and rain. Some days the most ordinary things seem to terrify her. Some days she hides in the closet, under the bed.
So I think the only thing I can say for sure is that we still, mostly, have more good days than bad. She's in the negative part of the month on at least everything else--I don't even think she's happy when she's so anxious and scared--but still, she bounces back, and then she runs in the yard and seems happy, and I don't know what to do but wait for the bad days to come back.
One thing I've come to, though, that probably sounds awful, is that I've decided not only not to do the surgery on the ACL (I can't afford it, and this dog's health is too precarious anyway), but I'm not even really making a huge attempt to limit her activity. One of the few pleasures I know she has left is running in the yard. She seems most happy, most herself, when she's tracking something out there, running. She's absolutely miserable when she's confined (the last ACL/LP surgery recovery was a nightmare), and she's sick enough of the time as it is. I don't think this little girl has a lot of time left with us (though who knows, I've thought that for years), and I think I'd rather have her enjoy it even if it hastens her demise.
So I don't have any answers yet. I hope I'll know what to do when it's time. Right now I'm trying to balance care for her too--what we can afford, but also what she needs so she does not suffer. We'll take care of her broken teeth--that's too painful and can fairly easily be fixed. We give her her meds, and I care for her when she's sick. But I won't take extraordinary measures to save her (if she goes into a downward spiral with dehydration from vomiting, I won't put her on an IV and let her spend days at the vet), and I'm not willing to go with something like the knee/ligament surgery, that will just be months of miserable convalescence.
http://www.veterinarypracticenews.com/vet-practice-news-columns/bond-beyond/quality-of-life-scale.aspx
and one more: http://www.naturescornermagazine.com/help_companions.html
I found that one particularly interesting, and unfortunately, when I ran through the numbers on that, Bel got an 11.
also, this article from slate on euthanasia was interesting: http://www.slate.com/articles/news_and_politics/heavy_petting/2003/10/when_should_you_put_your_dog_down.html
I'm getting closer and closer to having to make the decision with Bel. Well, I think I have--it's just my husband doesn't believe it's time. She's having fewer and fewer good days, and she's limping around groaning, or alternately pacing like crazy and acting crazy. And she's even unpredictable in her reactions to meds. Some days pain meds seem to help her. Some days she gets so hyped up and the pain med seems to add to it. Some days a tiny bit of Ace will help her settle; some days the same dose won't touch her agitation. I realized the other day that I spend a whole lot of time trying to figure out which med to give her that day--does she need an antiemetic? Does she need tramadol? Or ace? that's in addition to her now twice daily doses of phenobarb, thyrosyn and methocarbomal.
And she pees on herself at night several times a week.
and I have a 14 year old daughter who knows its coming but the reality of it will be hard for her. Im sure she will think the cats are not that different now than they were six months ago, but why now? I dont know that I can justify euthanasia, right now, today, to her convincingly, and maybe thats impossible. Its hard enough for us adults to agree, let alone get the child on board.
Thinking of Bel and peace for her and both of you.
I will also get his face tatted on my back to celebrate our life together. That's already planned. He's my soulmate.
This is something we're constantly struggling with Fate. I'm hoping he'll be ok enough to hit his 3rd birthday in September, but we're prepared for the fact that it might come sooner than that.
With Fate it's especially hard as as best as we can tell, he's not in physical pain. But, he can't do even 3/4ths of the things regular dogs can do.
I was speaking about him with Wraith & Aggro's breeder the other day, & she told me a good rule of thumb is when he can no longer do the thing he enjoys doing the most. We haven't quite hit that point yet, thankfully. We'll see.
~
I know how hard it is to deal with dog with illness. Junior wasn't too bad emotionally, but Pearly with hear seizures she got to point where she acted like she didn't knew me.
She was great off leash stayed in yard and followed on walks and never chased deers or ran off, but when she started having seizures she ran so she was kept on leash.
She once slipped the leash and when I went to put it back on she attempted to bite me like she was afraid of me.
Euthanasia is not fun to think about.
I figure it's better in the end when the dog is suffering due to leukemia(junior), seizures(pearly), Dink lived the longest to age 16, but we put her to sleep as she was in pain and the joint supplements and pain meds no longer worked. She got to point she couldn't walk to go drink, eat or potty so she declined despite being fed and taken outside to potty.
I'm so sorry to hear about Fate. I'm glad he isn't at that point where he has too many bad days.
And yeah, Saya, that's what we have with Bel. She doesn't recognize people after a seizure. We're able to mostly keep the seizures under control, but with everything else, it's just hard, and some days I have to fight to medicate her.
and @Tara....this is why we're not doing much with Bel's torn MCL. There are too many other issues, and I can't see doing the surgery on her. Especially since right now the vet doesn't even think she's in good enough shape to do go under general anesthesia, though we do have an appt to pull her broken teeth in June. I keep go
@Chrys, I'm sorry about your cats, too. It's just really hard to know when the right time is, and it's harder when there are other people involved.
@shibamistress - Yeah, I guess for me it's like...if he can AT LEAST make it to his 3rd birthday...it'll feel like I Got more time with him? I don't know. I'm sure it's irrational but it's kind of hard to stay rational in these situations huh?
That said, when Fate lets us know he's ready to go, I won't make him stay here until his birthday "just because." Its just a "hope" that he can make it that long.
I'm sorry about Bel. Fate had a few grand mal seizures and they were horrible. I know what you're going through
@WrylyBrindle - I'm sorry.
I was told there were two other cases in Japan with shikoku & both didn't make it to the age of 4
It just makes me really sad, though, to come back and see that beloved animals we were talking about here: Bel, Fate, and Chrys' cats, are all gone now.
But I hope this thread will be useful for others going through this agonizing decision--it's something we all must face at some point.
I had a dream a couple weeks ago that I heard a sound at the door, and looked out to see Loki - very large- wanting to come in, but at my feet was Finn- very small- wanting to go out. I think it fits them, though- Finn was done. Loki would stay if she could, but her body was not holding up.
I've had a couple of Bel dreams, and she was fighting in my dreams--and looked happy about it. Which she probably would have been in real life.
I do have to say that as hard it was to let her go, our whole household changed dramatically. All the other dogs are more relaxed, and while I was getting Toby and Leo used to each before she was gone, Toby really relaxed after that. He and Oskar still don't get along, but he's friends with Leo now and he's even relaxed around the puppy. He just seems so much happier, and Oskar seems a bit more easy too. I think Leo had the hardest time, and he clearly mourned her. We all did. But when I see Toby interacting with other dogs, and being relaxed and happy--something I never thought I'd see again--I realize that it was for us a blessing, and given how ill she was, and how her body was failing her and her mind had already failed, I think it was a blessing for her too.
I have to say, though, a couple of times I've sworn I heard her in the house--her little prancing steps up the stairs or upstairs, when all dogs were actually accounted for. I think if any dog was likely to become a ghost, it would be my little crazy girl! *lol*