The beginning of the end?

[QueenOfFlippingEverything]

Poor old WoofDog has been at the vets again today as he has anal adenomas that have now ulcerated. He also has bad arthritis and the start of kidney problems

He's 13, a Lab/GSD/Newfie cross - DP got him as a teeny tiny puppy, DP was only 19 at the time and street homeless. WoofDog was his absolute saviour and best friend during some really grim times, he's never ever gone without even when DP couldn't even feed himself. DP reckons the fact he had a dog to look after saved his life when he was severely depressed in the past.

And now WoofDog is, lets face it, really rather old and decrepit. We have no wish to keep him going if he has no quality of life - we are not at that point yet (I don't think), though he is pretty much deaf and his vision is going, he does still come pootling along slowly if we go for a walk round the fields (we live on a farm so he has constant access to the outdoors) and he still comes to greet us when we come home if we've been out, and likes sunbathing, and shows great interest in cheese and the offerings our toddler makes from the highchair

But he is visibly aging and failing and, well, creaky now. He can't hear much, or see much, and can't get up the stairs or into the car unaided anymore. He won't go swimming any more either, something he has always really loved and was still loving last summer. He gets out of breath easily, he spends most of his time sleeping, he is having to wear a collar/cone thing to stop him chewing his arse to bits, and he is now on steroids, antibiotics, and tramadol.

The vet is reluctant to put him through surgery (with the risks of a GA plus the risks of damaging his sphincter muscle) if we can control his symptoms through medication for now, and tbh so are we. DP is very much against what he sees at stringing a dog out when it can no longer do any 'dog stuff' and I tend to agree with that. We want him to have the best quality of life, rather than keep him going for as long as possible by whatever means and at whatever cost.

So... how will we know when its right to end it? Are we sounding really ruthless by not wanting to 'do everything possible'? How do you balance the whole quality of life/treatment options thing? How do I support DP to make the inevitable decisions that are ahead, when WoofDog has been the constant in his life for so long and through so much?

No advice but he sounds like an amazing hound and I seem to have something in my eyes, sniff

No, you are not being ruthless. Sometimes great courage is shown when you make a decision not to do something as much as when you do, if you see what I mean.

One of the things you need to do is have an honest discussion with your vet - make it clear to them that you are ready to have that conversation about the end. Hopefully you should have a good enough relationship with vet to be able to do this. Sometimes this conversation can be upsetting and difficult. Try to see if you can be fitted in say at the end of surgery so you have time to discuss the important issues. You should be making sure for instance that pain relief/management is at the top of the agenda, maybe have a discussion with your vet about this and ensure this is reviewed regularly, and simple things like making sure you don't run out of any meds over the BH weekend. Also check and discuss with your vet what the holiday arrangements are, in case dog takes a turn for the worse over the Easter weekend. You should also think about and be prepared for decisions on when and where. For instance, DH and I have decided if at all possible, we will move heaven and earth for our dogs to be PTS at home, rather than in the vets surgery. Maybe it will help your DP to think about burial or cremation, and perhaps where this might take place? Your DP might also like to think, as a dad, how this might affect your DC, and how your DC can be involved in, say, having a little funeral service for dog or planting a tree in their memory, or something special.

There is a very useful scale developed by an American vet called the HMMM scale which is useful when assessing Quality of Life for terminally ill pets. See link here - this is very useful as it gives you a starting point and something to think about. You could talk about this with your DP and think about what specifically are the milestones that might trigger the final decision. You will also find that with cancers in dogs, actually a week can be a very long time. Quite major changes can happen very suddenly, so this is something not to delay. It is often said "Better a day too soon than a day too late" for PTS decisions and I would have to agree with that.

Having said that, though, there is a great deal of QOL that your dog could enjoy, albeit at a much reduced tempo. Even if he can't swim, can you set up a paddling pool for him? Make sure meals are tempting - would it help if you hand feed him, or make sure he's getting his special treats? Soft and comfy places to lie to avoid any pressure sores, gentle affection, and walks with plenty of sniffs are all things he can still enjoy.

I also have an unaccountable need to blow my nose and am going to go and hug an elderly greyhound.

Sending you all best wishes, and most important of all, just really appreciate and enjoy these final days with your special friend.

Scuttle has said it all, in her wonderful post. When its time you will just know, he will let you know. (((hugs))).

Lovely post Scuttle. How hard for you OP. Wish you the best and strength to make the right decision at the right time.

For me with the last dog, it was when I took him out one day and he didn't want to sniff anything...he did the toilet and stood there waiting to go home gain.

He was still happy to see people and eating and drinking - but the spark had gone. :(

Unfortunately I had to wait a few days as my DC were away and he had a crisis and had to be PTS without planning it (with my DS still away) - but I knew...

Having been though this with a boxer who had a tumor on her lungs and a GSD with CDRM, you just know when the time is right.
OUr boxer was ill for a few months and slowly worsened, one evening she just kept coming to sit with us and looking at us ( and I mean LOOKING), I rang the pet hospital in tears (like now writing about it) who said I should take her in to be checked. The vet said it was very advanced and nothing could be done. The point is, the dog knew it was time as well.
Our GSD had advanced CDRM and I nursed her for months, we cancelled her PTS appointment four times before we could go through with it.
Its a really hard decision to make.