<p>Wow, the things you discover! My dachshund has IMHA, and we are at our wits end. He was diagnosed in the summer after all kinds of tests, including a bone marrow biopsy (ouch), and had some darbopoetin shots and prenisone, which brought up his red blood cells to a low normal level. The specialist wanted him weaned off the prednisone, which we did over several months, but his blood tests were way back down. His regular vet admits that she doesn’t know much about this disease, and the specialist, I think, sees him as a “case” rather than a patient. He was muttering something about anti-cancer drugs. The dog went for a blood test today, back on a high dose of prednisone, and we will find out the results tomorrow. What is your experience, anybody, please.</p>
<p>"Of course it’s possible to regret letting a pet go too soon, but I think I’d rather live with that than with my sad memories of our girl’s last months, which now shade the memories of so many happy years. "</p>
<p>^^^I have to disagree with that advice. I think making a life or death decision for another being is a tremendous responsiblity, and I would always counsel anyone to err on the side of extreme, extreme caution, making sure you know that’s 100% what the animal want/would wants. This is not just a hypothetical for me - I have experience with illness and animals - I grew up with a dog that had cancer for a year before passing away. I think my parents made the absolute correct decision to treat and fight for him. And now, I have an animal with the undiagnosed condition that, on certain occasions, has turned life-threatening. I have been taking care of her for a year now, and it has changed my life and certainly been very challenging, but I don’t regret it for a second, and I can see the will to live in her every day.</p>
<p>I am NOT talking about you MommaJ - I am sure you did what was best for your dog, but in my experience being involved with animals, I think far too many people take euthanasia too lightly, doing it because of their own financial/emotional needs or just because it gets too hard and not because of what’s actually best for an animal. Not every animal that is sick wants to die - maybe it’s just my good luck, but I have encountered quite a few animals with a very strong spirit/will to live even in the face of medical issues. Also, I think sometimes people give up too soon - finding the right routines, medications, etc. can take a little time. Just because one medicine is not working or making the animal miserable doesn’t mean is the one and only option. Just like with people, sometimes it’s just trial and error and an adjustment period.</p>
<p>I don’t know OP’s situation, I am not there - just wanted to share my thoughts from the other point of view.</p>
<p>fafnir, our dog was diagnosed two years ago in early December. It happened over just a few days, although in retrospect she’d slowed down a bit over a longer period. But, over that few days, she stopped eating, stopped wanting to go outside, stopped going upstairs, stopped being a pest :); all things that indicated something dire was happening.</p>
<p>We took her to our vet who did a blood culture immediately and saw that her hematocrit was critically low. She sent us right to the specialist at the Emerg. Vet. Hospital, where our pup spent six days in their ICU. Initially, the specialist did a transfusion and started prednisone and azathioprine. She warned us that the majority of dogs in her condition did not survive and that if she was to survive, it would be a long haul, and an expensive one. She was right. We were fortunate enough to be in a position to afford the care but most people would not be.</p>
<p>She slowly improved over those six days and was released to come home to further recuperate. She had to return to our vet weekly for the blood test to check her numbers, then eventually every two weeks, then monthly. Her meds were stable for many months and they were reduced very, very slowly. She finally was off everything by this summer but then her numbers started to go down again so she’s back on prednisone and this time, cyclosporine instead of azathioprine. She’s also on a Pepcid twice a day as well as melatonin twice a day. </p>
<p>Our vet read about a vet somewhere in the U.S. who had tried melatonin as part of the drug mix for IMHA patients and had favorable results. It also worked for our dog so she’s still on that, with no side effects. We are back to taking her every two weeks for bloodwork. She’s a real trooper and has been poked and prodded so often for the past two years, with never a complaint. </p>
<p>The cyclosporine, which is very expensive, was rough on her digestive system at first but the vet prescribed something called fortiflora that has eased the stomach issues, although she still has very bad gas! She looks good, seems to feel like herself, lots of energy, but the prednisone makes them voraciously hungry and that’s no fun. Some dogs also drink and drink and drink while on it and then have problems making it through the night without urinating. Thankfully, our girl hasn’t experienced that. </p>
<p>fafnir, if you would be interested in your vet speaking to ours, send me an email and I’ll get her contact info to you. She’s been wonderful and she and we have learned a lot about this disease over the past two years.</p>
<p>I am glad your baby is doing well. I am going to wait to see the blood results and talk to the specialist. Now I have some medication names to throw at him. My dilemma is that my dog is almost 12, and I worry that the treatment will be as bad as the disease. I’ll certainly be in touch–Thank you.</p>
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@acollegestudent, I appreciate your sensitivity, but I don’t believe that pets “want” any particular treatment or lack of treatment. That’s the hard part, to me–dogs live 100% in the present and have zero understanding of why they are in pain or unable to run and play and no capacity to willingly tolerate either in hopes of a better future. But the upside of living in the present is that they have no fear of death and can pass on in complete peace and comfort, surrounded by their loved ones. (We humans should be so lucky!) </p>
<p>I can’t think of one person I know (and pretty much everyone I know has a dog) who takes euthanasia lightly and who wouldn’t take all reasonable steps to prolong a pet’s life. The question is what is reasonable in light of prognosis, cost (yes, that matters), and the amount of misery the animal will suffer as one more treatment after another is attempted. My dog was past the point of any help, still eating, mostly incontinent, just lying in one spot all day, clearly miserable. Keeping her alive for however many days or weeks she could have persisted in that condition would have been an act of selfishness on our part, more cruel than kind. Instead, she drifted off peacefully with my son’s arms around her (our vet made a housecall, so she didn’t have to move an inch off her bed). It was a good ending.</p>
<p>We have a 7-year-old schnoodle who is dying of cancer - lymphoma. It has been over a year since initial diagnosis - we had a 10 month remission with chemo - which was well tolerated. Now remission has ended and we have decided against more chemo. We know it is just a matter of weeks until we have to make that decision to put our dog down. Our vet oncologist has guided us to evaluate if the dog is eating, pooping, playing somewhat, ready to go for a walk, greeting us with barking and wagging, etc. When those normal dog behaviors stop - it is time. Having this type of checklist makes it easier - although still awful. Today - I can still say yes to all of those behaviors. When most/all of those behaviors stop - I know it is time.</p>
<p>Igloo- I’m sorry about your dog.</p>
<p>We’re having a little crisis here ourselves and I don’t know what to do. Our dog is 12, had hip dysplasia surgery as a pup. She’s a healthy weight. She has torn an acl and her arthritis is really flaring up over the past few weeks and every day seems worse than the day before. She is taking rimadyl, toradol and a dog version of cosequin. She’s limping really badly and it’s heartbreaking to see. She groans getting up and down and is just laying around now. We went today and bought her an orthopedic bed to lie in and she literally hasn’t moved all day from it. Hubby carried her into the family room to give her meds and to see her - she just hobbled back to her new bed.</p>
<p>Anyone know if there is anything we can be doing?</p>
<p>Rockville, I’m so sorry about your dog. I regret that I allowed my cat’s life to go on too long; if I had to do it over, I would have chosen to put her down earlier. This checklist idea of your vet’s sounds humane.</p>
<p>eyemamom - try hydro therapy. We took our dog to a specialty vet hospital for chemo and they treat all sorts of serious pet ailments. They had treadmills in water tanks - warm water - dogs with arthritis, hip and back issues would be in a harness, walking on treadmill, in warm water up to their bodies. They also had what looked like a walk in hot tub for dogs that just needed to soak in warm water and the vet tech would do simple stretching and range of motion exercises with the dog. Do you have a facility like that near you? Would you try just giving the dog a soak in a warm tub?</p>
<p>Cardinal Fang - thank you. The checklist does make me feel better. It is as if my dog will actually be making the decision in a sense by signaling to me when he no longer has any pleasure in life. I will have to carry it out - but I feel he will communicate to me when it is time.</p>
<p>Just wanted to point out that there are a number of versions of the checklist online. Here’s one: [Quality</a> of Life Checklist](<a href=“http://www.allpetsmacomb.com/qualityoflife.html]Quality”>http://www.allpetsmacomb.com/qualityoflife.html)
They don’t provide an easy answer, but they do force you to think clearly about your pet’s quality of life, and in some cases may make the decision more obvious than you imagined.</p>
<p>To everyone with an aging or infirm pet, wishing good health if possible and an easy passing if not.</p>
<p>Thanks for posting list - have not seen that before. I will refer back to it in the coming weeks.</p>
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<p>I am usually a skeptic about these kinds of things, but will share an experience I observed. My massage therapist has a boxer who must be pushing 13-14 years old. Last spring I would have sworn this dog was on his way to the rainbow bridge, and in fact, I had a conversation with a mutual friend where we both couldn’t believe she was keeping this dog alive. They had to basically carry him everywhere and/or use a harness to get him outside to potty. He looked miserable - it was all arthritis/old age-related stuff. She wasn’t getting any better with the recommended meds from the vet. My massage therapist is a firm believer in supplements/essential oils, and eventually read that aloe vera pills make a big difference in the kinds of symptoms her dog was having, so she started this dog on aloe vera pills. I kid you not, this dog that I thought should have been put down, has been, for several months now, almost back to her own self. Gets up and down on her own, greets me at the door like she used to, follows us around as we head back to the massage room, wags her tail, etc. I cannot believe the difference that the aloe vera has made; it’s the only thing that was changed in her treatment. I still show up to the house, expecting to see this dog laying around, uninterested in my presence, like she did for many, many weeks (months, likely), but she’s proven me wrong. My massage therapist insists that the aloe vera is the only thing she’s giving her now.</p>
<p>MommaJ, I want to bow out of this thread, because I strongly disagree with the sentiment (not directed at anyone specifically). I think our society is way too accepting of animal euthanasia as a treatment for illness and pain than can be managed through other options or even the animal equivalent of hospice/palliative care. But I know I won’t convince anyone, so I just wanted to share some final thoughts. </p>
<p>I think animals are a lot more sophisticated than people like to believe. Yes, they do live in the present, but they also do approach illness and death in different ways. There are animals that will lay down and die when they are sick. And there are ones that will keep going and do everything they can to try to keep going. Just like people, they are very different, and they do have wants, although they do express things differently. </p>
<p>Finally, no I will never agree that costs should matter. I simply think it’s unfair to the animal. Pain, animal’s desire to live, risk vs. payoff are all very legitimate, but not money. An animal’s life or death should not hang on someone’s wallet. And quite honestly, I feel that if a person is not prepared to do whatever the animal needs financially (as in making medical decisions based on only what’s best for the animal), it’s selfish to get that animal in the first place. I know that I have it better than most - I have a good job, but I am also just starting out in life, so having a completely unanticipated emergency and having a huge percentage of my income for the year go to vet bills is a financial burden that has impacted my life in a big way. So, I know what it’s like. Still, that’s MY problem, not my pet’s, and knowing what I know now, I will plan better for any future pets, but as of right now that’s irrelevant. My only job is to give her the treatment she needs.</p>
<p>We let our dog go too long. He did nothing his last few years of life but sleep and bite people. Our vet had told us he wasn’t in any pain, and that he would tell us when he was-- and he did, and then we put him down, but I think we waited too long. He may not have been in pain but he was miserable and either didn’t remember us or didn’t care about us anymore. He eventually started having seizures out of nowhere and we think he had a stroke, and that was it, but had that not happened he probably would have went on for years more… doing nothing but sleeping and biting anyone that dared to touch him or stand too close. It was a difficult decision… whenever we were ready to pull the plug he would have a better day and convince us to wait.</p>
<p>We have euthanized a horse, too. There was a surgery that might have been able to save him but it cost a fortune and the odds of him surviving were slim to none, and if he did survive it would be a horrific recovery and we didn’t want to put him through that at his advanced age. So we didn’t. That was the humane thing to do. We wouldn’t have done it even if the surgery were free.</p>
<p>It’s never an easy or cut and dry decision. I like the checklist. When the time is right, you will know. There were times well before my dog’s real downturn where he seemed like he was on deaths door and turned right around, it does happen. Keep trying everything you can think of, and if nothing works you will know your answer. I’m sorry you’re going through this. It is so hard to take care of a sick little thing that can’t tell you what it wants or needs.</p>
<p>I had not seen that list before and it is very helpful. </p>
<p>I have an old dog, who has been blind for half his life. In the past year he’s gone downhill substantially (losing weight, very creaky, sleeping 23.5 hours per day) and I am going to have to make a decision at some point in 2014. Right now I am only scoring him at 19 on their scale – and I am surprised it came out that high, because I thought it would be closer to 30 before I started.</p>
<p>Our dog scored “yes” in only ONE category, but it was a clear choice. He would not have recovered from another $8K spinal surgery, which miraculously bought him almost 3 years of happy life prior to the return of IVDD. At the advanced age of 13, there was no way for him to “get better” or “live a happy life in hospice” (neither of us would quit our jobs to care after an immobile 100-lb dog 24/7). I personally think that, compared to humans, pets are lucky that they can be taken out of a miserable existence painlessly and quickly.</p>
<p>Igloo, lots of hugs.</p>
<p>I had a 120 lb. Alaskan Malamute who was 11 and had been having pain from what we thought was arthritis for a couple years. She suddenly developed a really bad limp one day, but it seemed to get better the next day. I balanced the trauma of getting her into the car to see the vet over waiting a few days to see what happened. It seemed like it got a lot better and she was barely limping at all. Then one morning, she couldn’t pull herself to standing. My son and I together had to help her stand so she could go outside and do her business. I thought she’d injured her knee somehow and we put her on a blanket stretcher and FOUR of us carried her to the back of my SUV to get her to the vet. I was seriously trying to figure out how we could care for her if she had a serious leg injury. The vet did some poking and prodding and noted that the pain was not coming from the joint, but from the main shaft of the bone. She did x-rays and determined she had bone cancer in both front legs. She also had severe arthritis in both back hips. The treatment alternatives were: 1) keep on her pain pills to alleviate her pain but eventually her legs would break from the cancer, 2) Amputate the worst leg and follow plan 1 for the other leg or 3) euthanize her. She was so tough to have been during this pain without giving us any clue at all until it was that advanced. But a dog’s life is about mobility. It was time to let her go. Tough, tough day, but I have never questioned that decision. The vet agreed it was the right thing to do.</p>
<p>How is your dog doing today, Iglooo? I agree with those who have said the largest worry right now is dehydration. With my dogs, if I look at their gums, and they are very red, I definitely suspect dehydration. When they inject the dog with fluids under the skin, that is really helpful, and can make a world of difference in how they feel. Have you been able to see a vet yet, since the first visit? My best wishes for your doggie, they are like children to us, we love them so much.</p>
<p>It is over. I am tired.</p>
<p>I really, really hope I’m reading way too much into the previous post.</p>