Vet advice… AIBU about costs.

[MyFairLady22]

My Dog is 11yrs old. She’s a large breed and is therefore a good age. She’s been loved and cared for to within an inch of her life for every moment of those 11 years! She’s on YouMove Max, salmon oil capsules, and prescription anti inflammatory medication from our vet.

In the past few months, she’s been back and forth to the vet with trembling… shaking…wobbling and difficulty getting in the car/on the bed/sofa. I lift her! It’s worsened in the past few weeks. Suddenly, she jerks/mouth snaps/falls. She eats well. Swims. Plays. Gets groomed twice a day (she’s very woolly ☺️).

Now, the vet thinks she’s having myoclonic seizures. A form of late onset epilepsy/fitting but NOT losing consciousness. It is caused by tumours to which the breed is susceptible. I’ve put mats all over the house to prevent slipping; bought two ramps she will not use! Support her on off my bed at night (I’m divorced - she took over the vacant side of the bed pretty quickly!).

This morning, went to the vets for her blood test for the medicine she’s on. The vet last week tested her liver/kidney function and fasted blood sugar which all came back “like a five year old dog’s”She’s pretty healthy but for this degenerative disease process starting recently.

Today, it has been suggested to do a referral to a neurologist. Months ago, my own lovely vet, who knows I’m paying my own bill said “It depends how far you want to go and in reality, WHAT YOU DO with the results; she’s an old girl (for the breed); were she a puppy or aged 5, then that’d be very different”. This helped me enormously. The vet understood that I just don’t have endless funds available and we agreed that scans etc were NOT the way to go.

So, AIBU to feel frantic that now, the vet is suggesting initial diagnostic tests totalling £3,500 as a starting point? It’s like we never had the conversation about costs. My sister has offered to loan me the money but this payment is just the first consultation and scan.

Help please. Am I giving up on man’s best friend? AIBU to think the vet has done a total u-turn on appropriate treatment options?

@SayNo2Drama I think there could be meds/treatment plans but MRI/Spinal fluid exam = diagnosis. It’s so difficult. As I say, if she were younger and I had a bit of support with it (financially/emotionally) that’d be different. It’s just me and her.

Is there any way they could offer treatment without the scans? Most vets know, with a fair amount of certainty, what is going on without confirmation scans. There may be restrictions around their ability to medicate, though, until confirmation. I'm not sure. Might not hurt to ask. I am sorry you're going through this...it's hard to know when we're being fleeced, doing too much, not doing enough, being proactive, being selfish, sensible etc.

I know you're doing your best with everything available to you x

Bluntly, I'd put her to sleep. It seems likely there is a serious underlying cause (which you wouldn't want to treat due to operative risks, lack of clear benefit & costs) and the dog is having frequent collapses with risk of injury. If she's struggling to get on and off a sofa it sounds like now is the time to let go - before she starts getting injured or being incontinent for a start.

Don't panic about what the vet said, they are just offering you options.

I'd sit and have a think about a few things.

Quality of life for DDog now. And in a few months time.
Quality of life for you now. And in a few months time.

Is it likely the seizures will worsen and damage her brain? Have they said anything about that? Or about what to do in the event that a seizure doesn't stop?

Is she coping at present? Are the seizures leaving her distressed?

What level of risk is there with the anaesthetic for her in her current condition? Will she tolerate this?

If she's given a diagnosis, what is the prognosis? What is the treatment? Is the treatment one you can afford? Or one that you're prepared to put her through ie side effects of it?

We lost our beautiful dog to sudden liver failure a few years ago now and they wanted her to go up to a specialist vet several counties away for a liver biopsy. But even if they knew the cause of the failure it was vanishingly unlikely they could actually do anything about it. This was a dog they knew couldn't make 1/4mile in a car journey without vomiting - how could I put her through a 3+hr trip in a car before doing all that to her for no gain? We refused the biopsy, they gave her some steroids and we allowed her a couple of days of anything she wanted (McDonald's chicken nuggets for the win!) before she was put to sleep.

Sometimes, the dogs are telling us when they've had enough. My girl was telling me with every step she tried to take that she was exhausted and couldn't function any more.

I've got an older cocker spaniel who last year was diagnosed with mitral valve disease. I had briefly changed vets who wanted £1700 for testing etc but was so devastated, I thankfully went back to our original vets who had a good listen to his heart and all over check up. She told me he was 12, he had a grade 5 murmur, and whatever tests they did wasn't going to change that. So she did a simple scan at the surgery with some bloods, all under sedation rather than GA and the bill was under £500. He's now on a low dose medication and has got a great quality of life for now but I know that will change. At his last check up, she said to me he'll die with heart disease rather than because of it - his arthritis is more likely to see him off.

I wouldn't put a dog through all of that knowing they've had a good innings. I'd ask about medication that may help but nothing more.

For an 11 year old large breed dog diagnosis isn’t very likely to change the outcome. It’s bound to make you feel guilty if you’re given an opinion and decide against it. The vet’s laying everything out for you to decide which is what they should do but not always what you need. A couple of years ago one of my horses fractured his shoulder and the vet initially said it could possibly be catastrophic but an option to try was complete rest and pain relief and revisit later in the week, spoke with someone else later that day and they said no at the horses age it couldn’t heal and they would come straight away to put him down. It was such a relief that the second person gave a strong opinion as although the initial vet did everything right I felt I would be denying my horse the chance of a few more years if we didn’t try and that would have been the wrong decision. It’s so difficult, especially when they are still continuing with some of their normal behaviours. I found it helpful to keep a record of good and bad days with our old dog, when you look at it in black and white it can help you judge how they are doing without leaning into emotions. I hope you and your dog have some lovely quality time together ❤️

Ridiculous , our late dog had high blood pressure on various medications and was diagnosed with a splenic tumour ( he was scanned to look at his adrenal glands primarily) , we declined surgery as the prognosis for the worst case tumour would have been only a few months even with surgery , at that point he was still insured so it wasn’t even a monetary decision . He lived for another 18 months until he had a catastrophic stroke ( which I also declined to treat ) . Sometimes , however much we love our animals you need to be realistic .

I’m sorry about your dog.

As a human with progressive myoclonic seizures (and progressing to. tonic clinic), I would definitely prefer to have a peaceful death without treatment. We can afford our pets that dignity and I think it’s a gift you would be giving her, and you should see it like that.

obviously im a human not a dog so probably not useful advice at all, but that’s how I would see it. You’d be being kind to your dog, it’s a positive for her (of course very upsetting for you and I don’t want to minimise that)

@CornishPorsche Oh god. Now my eyes are stinging. And nuggets… wonderful! Last year I walked my girl at the park. A couple sat on a picnic mat with a dog and I thought “how lovely”. As I got closer, I could see they were both terribly upset. I didn’t pry but could see it was an older dog, wrapped in a blanket. Treats were on the mat and a small bowl of water. It was so very sad and then I thought, what a very well loved dog. I had a feeling it was a little farewell park trip.

We love them. They love us. There is inevitable loss and grief but honestly, it feels like five minutes since she was a pup.

I asked my vet what to do now, notwithstanding the MRI/spinal fluid test. She said she was unable to say as it was not within her knowledge base. It’s specialist referral stuff. Years ago, pre-human style diagnostics, there wasn’t this dilemma, I guess.

11 is a good age for a large breed dog. As she has a tumour and seizures it’s time to say goodbye.

We decided not to investigate when our small wobbly dog started throwing up blood.

He'd had several vestibular attacks and bounced back but he was 17, he was blind, he was stiff and struggling with some positions, occasionally having accidents when a wee snuck up on him - he was still himself, still a stubborn old git, still determined after heaving up a stomach full of blood that he was having breakfast and going to find a toy to squeak incessantly... I didn't want to reach a point where he wasn't 'him'.

We decided, with our vet who has known him since he was 6, that any investigation that would give us answers would be too invasive for him, and the answers we were potentially getting would involve further invasive stuff or a 'nothing more we can do' here answer... So we let him go with a mouth full of chocolate biscuits.

Money really didn't come into it, I have a credit card with a 15K limit, theres a few K in the savings account, but I always keep in mind 'just because we CAN, doesn't mean we should'.

I am sorry you're going through this, its so hard when we know them so well, particularly if they're the determined 'TIS BUT A FLESH WOUND' types as my old boy was.

Many years ago, soon after I’d had a year of surgery, chemo and radiotherapy, one of my cats had kidney failure, aged 14-15. At the vets’ suggestion I gave him a raft of daily medication and spent around £1000 to buy him another three months of reasonable normality.

My teenagers were glad I’d “given him a chance” but I wish I hadn’t prolonged things, and wouldn’t do it again.

It’s really tough being responsible at the end of a treasured pet’s life.

@QueenOfHiccups Thank you. That’s so kind. I’m sorry to read of your condition.

@tinyspiny What’s the ridiculous part? The £3500 or the fact that I’d consider paying it? Genuine question.

Medication is not possible without diagnosis.

@SayNo2Drama Thank you. That is my horrible situation, laid bare. Try. Let it progress until quality of life declines so significantly that pts is a kindness. For now, she’s eating well, has short walks, lots of attention and cuddles. Shes “happy”. I’ve just ordered a harness with support handle to hook her up with a little more elegance and comfort when she goes down spread eagled.

Id hoped there was some kind of treatment for the tremor/falls. There isn’t.

Your vet said it was a specialist referral. We had one many years ago to a neurologist and although it was £250 just for the consultation they didn’t actually push for diagnostic tests like an MRI and said we should wait and see for a couple of days which was the right call.

I still would say no in your shoes if it was my dog BUT if you wanted to get a second opinion and felt strong enough to say no if you felt it wasn’t in their best interests it might be worth just having a consult so you know in your heart that you had considered everything and weighed up quality versus quantity of life.

It IS hard to know when enough is enough. Their life in OUR hands after years of their unconditional love.

Years ago, my 12yr old cat had renal failure and was medicated for that. As he worsened over the months, his organs started to go. I’m ASHAMED to admit, that the vet offered to insert a pulmonary tap (his lungs were filling with fluid). I went twice a week to the vet thereafter to have the fluid drained off. One evening, this beloved cat came to lay on my chest. I just looked at his tired heavy head and thought “enough”. The next day, he was pts. My five year old was distraught. So was I. But I did say I’d NEVER do anything like that again.

We’re nowhere near that point with my dog but I think the rationale remains. Whilst she’s like this, we carry on. For now.

Shame on your vet for pressurising you. Ask yourself 'How is Ddog's quality of life today.' If it's acceptable then carry on. If not, then PTS.

Thank you. The vet isn’t pressuring me but is saying that they cannot treat without knowing what they’re treating. It makes sense. What also makes sense is the conversation I had with her some months ago which was “You don’t want to put her through a raft of tests (she’s had bloods so far, that’s all) which may be traumatic at her age as they’re invasive, only to find treatment is minimal and cannot change outcome.

Good god. My head is spinning!!

I have had friends who treated their dogs when I wouldn’t have but I supported them as they thought it was best for them.

What I said to them was what I am saying to you. You know your dog better than anyone including your vet. There is no right or wrong answer in a lot of dilemmas. Once you decide what to do even if that means nothing or PTS or treatment then it is the CORRECT decision as you made it at the time with the knowledge that you had.

Sorry @MyFairLady22 I meant it is ridiculous that a vet would suggest it to you . Your dog looks like a very well loved girl .

Can you phone the specialist vet for a discussion about what potential diagnosea could be even if it means paying for a phone appointment (if that's a thing)?

It does, though, sound like you're towards the end.

An anaesthetic / sedation brings it's own risks. The potential diagnoses bring additional problems such as the costs which may be prohibitive in any case.

So that being said, it doesn't sound as though an expensive search for a diagnosis is the way to go.

Which kind of leaves you with the daily assessment of both your and her quality of life. You're both allowed to say that things have become overwhelming and that it's time to say stop when that's the way of it.

@MyFairLady22 we were in a similar situation but with our cat. He had hyperthyroidism which had been managed with medication for several years, but the blood tests were getting ridiculous. Our cat was getting stressed by all the needles and he was a cat who would tolerate a lot. The vet refused to prescribe any more medication without doing yet another one, bearing in mind all his previous ones had come back fine and he was good in himself. We contacted another vet who just deals with cats and he was happy to prescribe the medication without more tests, and would only do them if he or we had concerns about his health.
On another note, recently our other cat was ill and the vets she's at wanted to do a range of blood tests which were going to start at £250 when all online prices said should be under £100, and it would have been a longer wait for the results as they were being done out of house. If we wanted in house and fast results it would be more. So we contacted yet another vet, different to previous, and the bloods were done in house, results in 20 mins and was about £60 all in.
I think it's good to contact other vets, especially when the bigger ones, which ours is currently is at, have these pressures from the owners to make certain amount of money each day/week. We are planning on moving to this other vet soon, if not with this cat at least with the puppy we are hoping to get this year.

I think if your vet is happy to treat the symptoms as they are without more tests to make your dog more comfortable then I would do that, but if they are saying they will only treat if your dog has all these tests then I would probably speak to another practise and see what they say

This is a decision there is no right answer for. I think it's wise to think about at what point you think it is wise to pts. She is 11 and I think spending ££££ is just unwise for anything save a complete cure

Listen OP. I've said this before on MN a few times in case it brings comfort.

We are all going to die. It's the nature of life. We as humans know this, animals have the luxury of knowing nothing about death. A loved pet is a lucky lucky animal! They have you (OP) to give them a good life and a good death. Your final and arguably most important duty. It's OK ♥️

And some of us with a sick elderly parent wish we could make those choices. We can give our pets a graceful loved gentle exit and should never be made to feel wrong in doing so.

@MyFairLady22 You need to always remember it's a dog life and not a human life, so sometimes you have to do what is kind.

Our previous dog (14 years ago now) had something similar where they kept collapsing, then would be OK. We had them put down as they were so confused when they came around it wasn't nice for them. They were 12. It was sad but we did what was best for the dog.

After that we got a rescue. Two months ago, at almost 11 years old, he just wasn't himself. Lethargic moments, struggling to jump up on the sofa etc... The vet found a liver tumour. We decided the stress of (risky) surgery wasn't fair on the dog, along with other potential complications, so had him put down. It was very sudden but for the best.

We still have our older dog, and again if she was ever in pain or suffering, we would make the same decision.

Sometimes you have to do what is kind for the dog even though it is not the decision you want to make.