How Do You Know When It's Time?

[Kavik]

How do you know when it's time to say goodbye? Zoe is 14 with diagnosed kidney issues and suspected Lupus. She was going OK until recently, she is now starting to fall over when walking on the floor at times, sometimes cannot go up the steps, and this morning collapsed at the bottom of the steps, I had to pick her up to bring her inside She is still eating and looks bright when she sees I have food. Morning seems to be when she has the most trouble.

Edited February 20, 2014 by Kavik

[Rebanne]

when the bad outweighs the good, when your head says so, when you gut is tied up in knots trying to 2nd guess, when you think of how good a dog they have been and that they deserve to go as pain free as possible, with dignity.

hugs Kavik and Zoe

[Airedaler]

Not much help........but you just do! I found the following article a useful guide when I had to make the decision recently. Hope you do as well.

How to Know When It's Time to Euthanize Your Pet

By Dr. Andy Roark | vetstreet.com

Just last week, while I was performing euthanasia for a critically ill patient, the pet's owner looked at me and said, "I bet this is the hardest part of your job." That gave me pause.

For me, putting animals to sleep is not one of the hardest parts of being a veterinarian. That's because euthanasia is often a blessing and gift to a suffering animal. In my experience, the hardest part of being a veterinarian is telling owners that their beloved pet has a terminal illness and will soon be leaving this world. The emotions that pass across their faces, even if they have suspected the worst for some time, are heart-wrenching.

I still remember the first person I had to share this terrible news with. He was a nice, middle-aged man with two small children and an 8-year-old Rottweiler named Stone. Stone was a member of the family, and when he started to limp, his owner brought him straight in to be checked out. Stone was a wonderful dog at home, but he was not a fan of the veterinary clinic. My best dog treats did nothing to warm his heart, and when I manipulated his painful left shoulder, well… that ended our chances of being best friends.

Even though Stone was not an admirer of mine, I liked him, and I really liked his owner. That made it so much harder to discuss his diagnosis: osteosarcoma. Osteosarcoma is a painful bone tumor that responds poorly to treatment. In some cases, treatments involving limb amputation and/or radiation therapy can be beneficial. In Stone's case, these options were not feasible.

Together, Stone's owner and I decided to provide him with the best palliative care we could, and we promised each other that we would not let Stone suffer. When the time came, we would do the right - if tough - thing and put him to sleep rather than allow him to live in increasing pain.

Stone's owner was the first person I ever had an end-of-life discussion with, and he was also the first person to ask me a question I have heard hundreds of times since: "How will I know when it's time?"

The most recent person to ask me this question was my own mother. Her Miniature Schnauzer has battled long-term health problems and was recently diagnosed with diabetes. Unfortunately, she initially responded poorly to treatment. She lost her love of food, began soiling her bed and was generally acting pitiful.

How to Decide

Over the past few years, I've heard a lot of veterinarians give wonderful advice to people who are wondering when it is time to give their pets the gift of a peaceful passing. Here are four of the best pieces of advice I've heard, and they are the same ones I passed on to my own mother for her consideration.

Every pet, illness and situation is different. There is no single rule that can be followed for when it is time to help your best friend "cross the rainbow bridge." Getting input from your veterinarian on the specific medical conditions that your loved one may face is vital for doing what is best for your pet. You may also benefit from having a caring friend who is not as emotionally involved in the situation as you are to help you gain perspective and really "see" what is happening with your pet.

Remember that pets live in the moment. One of the most wonderful things about animals is how they embrace the present. Every time I walk into my house, my faithful Viszla throws a one-dog ticker tape parade. The fact that I have entered the house thousands of times before, or that I will leave again in a few hours, means nothing. All that matters to him is the joy that he feels right now.

When our pets are suffering, they don't reflect on all the great days they have had before, or ponder what the future will bring. All they know is how they feel today. By considering this perspective, we can see the world more clearly through their eyes. And their eyes are what matter.

Ask yourself important questions. Sometimes, articulating or writing down your thoughts can make the right path more apparent. Some questions that help pet owners struggling with this decision include:

• Why do I think it might be time to euthanize?

• What are my fears and concerns about euthanizing?

• Whose interests, besides those of my pet, am I taking into account?

• What are the concerns of the people around me?

• Am I making this decision because it is best for my pet, or because it is best for me because I'm not ready to let go?

Measure their quality of life. This is no more than trying to determine how good or bad our pet's life is at this moment. Trying to assess this can be difficult, but there are some ways you can try and evaluate it. Let's take a look at a few of my favorites in the next section.

Is Life a Joy or a Drag?

Our pets may not be able to talk to us and tell us how they are doing, but if we pay close attention, there are many clues that can help us answer that question.

The Rule of "Five Good Things": Pick the top five things that your pet loves to do. Write them down. When he or she can no longer do three or more of them, quality of life has been impacted to a level where many veterinarians would recommend euthanasia.

Good Days vs. Bad: When pets have "good days and bad days," it can be difficult to see how their condition is progressing over time. Actually tracking the days when your pet is feeling good as well as the days when he or she is not feeling well can be helpful. A check mark for good days and an X for bad days on your calendar can help you determine when a loved one is having more bad days than good.

HHHHHMM: Doctor Alice Villalobos is a well-known veterinary oncologist. Her "HHHHHMM" Quality of Life Scale is another useful tool. 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). Dr. Villalobos recommends grading each category on a scale of 1-10 (with 1 being poorest quality of life and 10 being best). If the majority of categories are ranked as 5 or above, continuing with supportive care is acceptable.

Pet Hospice Journal: Keeping a journal of your pet's condition, behavior, appetite, etc., can be

extremely valuable in evaluating quality of life over time.

A Tale of Two "Endings"

Thankfully, my mother's Schnauzer, Zoe, eventually responded to her therapy. As a perpetual optimist, I like to think that she may be with us for some time to come. Still, the reality of having older pets is that we must be vigilant in their care and aware that every day is a gift.

In the case of my long-ago patient, Stone, with whom I first walked this path, I am glad to say that he did not suffer unnecessarily with osteosarcoma. His owner made a good decision, and Stone crossed the rainbow bridge while in the loving arms of his people. He was remembered by them as a strong, loving protector of the children in his family, and I will always remember his owner for having the strength and wisdom I hope we'll all have when the time comes to say that final goodbye.

Dr. Andy Roark is a practicing veterinarian at Cleveland Park Animal Hospital in Greenville, S.C., where he lives out his dream of caring for animals and educating their owners on optimal pet health. Dr. Roark is also the founder and managing director of a veterinary consulting firm, Tall Oaks Enterprises, LLC, as well as a member of the VetPartners consulting group. While in veterinary school at the University of Florida, Dr. Roark served as one of the first national presidents of the Veterinary Business Management Association (VBMA). He currently serves on the NAVC Program Committee, the Veterinary Team Brief Advisory Board and the National VBMA Advisory Board.

A nationally recognized veterinary writer, speaker and thought leader, Dr. Roark pens regular columns for DVM Newsmagazine and Veterinary Team Brief.

Dr. Roark is also a dedicated concierge, chauffeur, storyteller, dress-up fashion consultant and diaper changer for two young daughters.

[persephone]

My rule of thumb is that if my dog is no longer independent in feeding/walking/toileting comfortably , the she/he is not really enjoying life , and deserves peace.

Thinking of you and your gorgeous Zoe .

[Dame Aussie]

Yes, I think that when the bad outweighs the good and when they can't live their life independently, as perse said.

One of our dogs got to 17, was half blind and deaf but still running around, playing and loving life.

All of a sudden she just started standing in rooms staring at the wall and getting lost around the house, even though she could still get around she was confused and wasn't loving life, no wagging tail, that was when it was time.

, it isn't easy when they get old.

Edited February 20, 2014 by Aussie3

[JulesP]

When you ask this question then the time is often near. It might not be right now but it will be soon.

Hugs Kavik. You will know the right time. I've always stressed that I wouldn't know and googled like crazy about right times to PTS a pet but in the end I did know the day that I had to do it.

[Rascalmyshadow]

I am sorry you are at this stage it is so hard to make the decision no matter how old or young they are.

I made the choice when my girl started to not recognise people, was having falls due to eyesight, was slipping on the floor just trying to eat, started to wake up in a pool of urine and basically was unable to enjoy the things she loved.

We could have gone on for possibly another year or so with more medication but I didn't think it was fair to put her through it for my sake.

I have watched a few friends and family hang on to their dogs until they were walking skeletons and it hurt so much to see, not fair to such a devoted companion.

[sas]

People told us we would know when the time was right.....that didn't happen.

There was no moment that made us go "Now is the time", no defining moment at all, just an ongoing and slow progression of her condition. We simply made a decision to end it before we saw those defining signs...some may say we waited too long.

[Sandra777]

There is no right time, but always go for a day too early rather than a day too late.

When their enjoyment of life is gone then it's time for me, and that is a very personal decision and varies a lot from dog to dog.

Edited February 20, 2014 by Sandra777

[Sankari]

I knew when it was time. My girl had suffered from Lupus for many months. The cortisone caused her organs to start shutting down, i knew she did not have long left, she was given 6 months to live, she lived 13 months before things went downhill. Then there was the night before I had scheduled her euthanasia, she could not get up and there she was laying down on her bed with pleading eyes, she was ready to go with dignity. It was the right time, i'll never forget the look in her eyes as her vet gave her the euthanasia, the look as if she was saying thank you.

[Nic.B]

It is such an individual thing for our dogs. Sometimes they may have a bad day and then perk up and move along happily. When the good days outway the bad, they get closer and closer together, quality of life is lost its time to make difficult decisions.

For me, I look at the dog I adore and think to myself, If I were you and you were me, I would want you to set me free.

You will make the right decision, you are a wonderful person and dog lover. Hugs to you both

[Dogsfevr]

I often think the better question is am i being selfish keeping my cherished pet alive .

I believe most people in there heart now there time has come its then making the decision that becomes hard.

Whilst they may have good days i still evaluate what a good day has become & often that is still a struggle.

Our oldies are very cherished here but i guess after having to make the choice many times now each time it becomes easier because we take great comfort in knowing what we are doing is the right thing & i can take comfort in that decision plus like all people we have hang on to a dog one time to many & that is harder to accept even many years later ,we do have regrets with a few that we let them go longer than we should have & it stays in your mind

I had to pick her up to bring her inside

For me this line would hold alot of value in my decision & has done so for one of my dogs & the reason why.

It was summer,if we went out & this happened we weighed up the worse case scenario & for us it wasn't pretty & not a way i wanted to see my dog .I had seen her struggle to get up on one two many occasions & the fear in her eyes at being completely incapable of getting up was heartbreaking .

But as others have said its personal & only you can live with the time you select

[Rebanne]

There is now a thread in the Rainbow Bridge forum