what to advise

[twodoggies2001]

A friend 'phoned me earlier today distressed and asking me how do you know when it's the right time to let your dog go.  The family pet was diagnosed with a tumor in the throat about 10 days ago and the vet told the family that it is terminal.  Apart from finding this morning that he had been bleeding and has very bad smelling breath, he has been eating and acting  normal under the circumstances.  She feels confused and guilty if she makes the decision to let him go now but at the same time is afraid that he may choke on his blood while she is not there to help him f needed.  

The vet thought it was better to let him go now, rather than wait until things get worse.  I tend to agree with this decision, but he is not my dog, even though he stays with our family very often and to me he feels and is much loved like my own.  

It's a delicate situation.

 

 

Edited April 20, 2017 by twodoggies2001
mispelling

[stellnme]

So very hard and we all make our own decisions regarding when to let them go based on knowing our own dogs.  To me, when the quality of life has gone, or the dog is suffering, are pretty good signs that you need to consider.  A terminal diagnosis with a dog who is able to eat ,drink and toilet as usual would be something I would just watch carefully and take vet advice on when the dog had reached the next stage.  What worries me about your friend's dog is the bleeding,  I too, would be very worried about what may happen.  Maybe it is time for this little one.

[Airedaler]

I found this article very helpful when I was in a similar situation. Hope it helps your friend.

So often the decision we make to keep the dog going because they "seem happy" is made for ourselves and no tin the best interest of the dog.

 

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. 

Edited April 20, 2017 by Airedaler

[Papillon Kisses]

There are quality of life scales that can help:

http://vet.osu.edu/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf

 

http://www.aplb.org/resources/quality-of-life_scale.php

 

I would for starters advise her to think ahead and write down the names, locations and operating hours of vets that can PTS in the event that her regular vet is closed. Or see if the regular vet has an emergency number and can PTS outside usual hours.

 

PS you may want to move this thread to Palliative Care. 

[Scottsmum]

Urgh.  Um. 

 

I am unfortunately a very firm believer in simply knowing when the time is right. Was just there this weekend. 

 

Still a bit too raw but my thread is here:

 

I think the biggest thing I was reminded of is that it really is your (that being the owners/families) decision and  no one else in the entire world can really help beyond being a sounding board. 

 

best of luck to your friend

[twodoggies2001]

 

thank you all for responding to my post.  I had a call about an hour ago and was told that an appointment had been made for tonight at 6.30.  The vet had indicated earlier his month that it was only a matter of time, 4 weeks probably and 2 have now passed.  My friend thought that under the circumstances, she would in the long run feel better in this situation if her companion went earlier rather than later to alleviate any suffering that could overtake this beautiful dog.   I told her if she wanted, and her family was unavailable, I was  to be by her side and that of my beautiful boy and friend but left this decision up to her.  If I'm not there he and his family will all be in my heart and thoughts.

[Dogsfevr]

Your friend has made the right choice for all the right reasons

[Kazm]

Tough decision, probably the right one. Just been there myself barely 2 weeks ago. Your friend will need your support. Tough times. So sorry.

[twodoggies2001]

Well, the boy is gone.  I went to see him before his final journey to the vet and I was shocked at the condition he was in.  As sick as he was, his tail wagged when he saw me and for that I was grateful.  Poor boy, he was coughing and fairly weak and needed to lie down often while I spent an hour or so there.

My friend messaged me after and told me that after he had passed, the vet showed her the tumour and agreed that what she had decision.   S
he knows that I am there for her whenever she wants and hopefully, in the future, when she is ready, there will be another beautiful dog to fill the family's life with love and laughter.

I came home after the visit and hugged my two willing them to stay forever.

[harley]

Hugs to all of you, never an easy time