Addison's disease with end stage CHF, when to say goodbye

[Lil Lynn]

I have a Standard Poodle who has been managed for Addison's disease for four years. Early Feb this year, I noticed he was coughing and took him to my vet. Snickers was diagnosed with a grade 3 heart murmur on both sides of his heart. He had been seen the previous October, with no sign of heart problems. Within a month, he had deteriorated and has CHF. He is on Zycortal and Prednisolone for the Addison's, Flusapex. Vetmedin, and Fortekor for the heart. We have reduced the Prednisolone as we have to watch the potassium and sodium levels now he is on fluid tablets. The medication timetable is pretty strict, and the day circles around best care for my boy. He has good days and bad days, depending how much he is coughing and gagging. His breathing is forced with his stomach working hard. He sleeps most of the time, doesn't want to go for a walk, but has a good appetite. Sometimes, when you are up half the night with him, you think, this cruel. Then in the morning, he bobs up, eats his breakfast and barks at the cyclist through the front fence. His head is up, the tail is curled, he is the man. By the afternoon, he is trying to find a comfortable position, so he can sleep with a very extended belly and fluid around his lungs. He isn't even 8 yet and he has end stage CHF. I am not sure whether to have him put to sleep before he gets any worst, because it becomes horrible as it progresses. or spend the most time I can on his good days. I have never had a problem making the decision before, this one is pulling at my heart strings.   

[Mairead]

The thing to ask is, am I keeping him alive for his benefit or for my benefit?

Since having a dog in her teens with spinal arthritis put down, seeing how tension-free her face was after death, and realising I had left the decision too long, I have preferred to send them off early rather than late. 

You could try the poem The Last Battle. This poem was published in a commemorative dog show catalogue many years ago and I kept it because I thought I might need it one day.

 

[tdierikx]

Of all the decisions we have to make in our dogs' lives, this one is the hardest by far...

 

The balance between quality and quantity of life is sometimes very hard to judge when we are so emotionally tied to our best mate - especially one that is high need and becomes a daily focus to keep them comfortable. If the process is stressful for you as his best mate and primary carer, it will most likely be similarly stressful for him, if not moreso.

 

My personal stance on this situation with my own dogs is that it's better to release them early than even one day too late, but not being in your actual position, I cannot judge you or your decisions at this stage of Snickers' health battles. What I would suggest is to look deep into his eyes and he will "tell" you when he wants to sleep the long sleep, OK? And be honest with yourself when you look for his signs to you... he deserves that, yes?

 

T.

[Lil Lynn]

Thank you for your thoughtful advice, I appreciate it. I deal with palliative care in people everyday, so I am familiar with the changes and what they mean. I appreciate your honesty, I will say goodbye sooner rather than later. We saw our vet on Tuesday, and he has made a slight change to his meds. I don't believe that make any difference, but I will give it a few more days. Will let you know when he has crossed the bridge to play with his old mate Stanley.