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I would never put down an elderly person's pet to make it easier on oneself, only if the pet is not enjoyable life anymore....And we owe it to our parents to love and care for those who have brought them comfort, maybe even when we could not be there....
I absolutely think that a puppy would be a very bad idea...a pet is a lifetime commitment and it would not be fair to your Mom or the puppy
Otherwise, if the pet is happy and doing fine, even with the tumors and hip dysphasia, the dog could enjoy another year or two, and your Mom could continue to enjoy her pet.
As long as dog is eating and "bodily functions" are working - other issues especially so long after diagnosis don't matter so much.
If dog goes, and if you can handle taking care of another - please consider adopting an older dog (rescues, and animal shelter have lots and lots)
A dog offers non-judgmental support and love. If you can help to take care of it, it may keep Mom happier. Not to mention helping to save the life of an "unwanted" dog.
If the dog seems to be in pain, definitely do investigate pain meds with the vet; there are several that are quite effective.
A pet that's ready to die goes through the same thing humans do - they stop eating, they sleep, they cry, they're lethargic; be attuned to those signs...but pain can do the same thing to an animal, so adequate pain control may help. Labored breathing is a sure sign that it's time; please be on the lookout for that because there's nothing worse than watching an animal have trouble with its breathing..
But just as some humans have trouble "letting go", so do animals. Sometimes, they need some help, and that's help that we can give them (unlike humans). Your vet can help guide you with the decision.
Be aware, too, that the dog may take the decision out of your hands by simply not waking up one morning. Be prepared for that, discuss that with your mom as well.
On a more personal note, I worked for a vet for years. There was nothing I hated more than when someone said "I'll just take him home to die, I want him to die in my arms" when the animal was clearly suffering. Putting an animal to sleep, in my mind, is the greatest final gift we can give to an animal that's suffering or is just "done" with life. And many, many of them show their gratitude for the "help".
I'm wondering if your mom would be able to go with you when the time comes? Just as with some children, I would imagine that it might be helpful for her to be with her beloved dog at the end. Obviously, that would have to be your call.
Something else that might help when the time comes - this is something I told all of our clients - is to take your mom outside that night and find a star...that can be an outward symbol to her that her dog is up at Rainbow Bridge, looking down on her and saying "it's okay, I'm okay, thank you for the life you gave me." That might be something that could help you both after the fact - gives her something tangible to point to, something that represents the love they shared. And it could give you something tangible to point to, when she questions the dog's absence.
And the idea of adopting an older dog is brilliant (if that's something you/she want to do, your hearts need to guide you). I'm not sure if it'd be a great idea to bring in a new dog now, it might stress out the current dog - again, your vet may be able to guide you with that - but if the current dog's basically happy, eating, acting well, you might try it. You could try asking the shelter if you could bring your dog to do a meet and greet with the potential new dog, see how they do; you could also ask if you could take the potential adoptee home to see how they do on the current dog's turf. They're territorial, to a degree, and introducing a new dog at this point may not work. On the other hand, animals are pretty darn intuitive, and the current dog may realize on some level that this new dog - while not a replacement - is meant to "take over" for her, when she's gone.
Good luck - this can be a terrible decision to have to make in the best of times, and when you add in the Alzheimers...it adds a whole new dimension.
I just recently had to put down my dog of 18 years and so I speak from a place of caregiving for two elderly parents 24/7 and having to walk this fine line between when to let go of the best companion I have ever had and when to seek outside support as you are now. There is a Yahoo group called caninecancer and it will be a great help. These groups ask you to fill out a questionaire. My group caninekidney did too. The moderators are very committed to every member. They are knowledgeable and so are the members in offering solutions to symptoms and diagnostic test results in addition to what you learn from your vet. Because I didn't have the time or the knowledge, I posted my BOYJOY'S test results and shared what the vet was doing. The level of supportive feedback was theraputic for me and my dog had a better quality of life. You can't go wrong. It is beneficial in every way. You post your concern about the health issues and people who really are walking in your shoes will out of devotion and a commitment to animals reach back to you with incredible direction and tailor it to your dogs specific medical tests results and condition. I went to my vet with many points to discuss. I got so many ways to extend his quality of life right up to the end. The best thing you can do is give yourself the opportunity to reach out for information about your mother's dog cancer history and current prognosis. Post the tests results such as blood tests etc and voice your concerns about the dogs symptoms as they progress. You will get the support you need and you will know you did go the extra mile for both the dog and your mom so that they can spend more time together. The group also is there to discuss concerns about how to know when it is time to let go.
I am posting a file from one of my groups written by a veterinarian that was available in the hope it will encourage you to reach out to the Yahoo caninecancer group. It is a very active group and restricted so you have to request to join and you will have to answer a questionaire about your mom's dog. I recommend it with all my heart.
Quality of Life Scale Helps Make Final Call
By Alice Villalobos, DVM
For Veterinary Practice News
There is a real need for assessing various levels of quality of life for aging, ailing and terminally ill pets.
Most geriatric animals have one or more abnormal conditions that appear in their senior years and these conditions generally worsen with time. One third of senior pets are obese. Additionally, half of our nation’s companion animals over the age of 10 become burdened with cancer and its related treatment issues.
Veterinarians are frequently asked, “When is the right time to euthanize my beloved pet? How will I know?”
A quality of life scale may help everyone, especially those in denial, to look at difficult-to-face issues. Caretakers can use this itemized scale to ask themselves if they are able to provide enough help to maintain an ailing pet in a humane way.
Every animal has certain needs that should be recognized and respected.
If we can meet these basic needs at a satisfactory level for our ailing companion animals, then we are justified in preserving the life of the ill pet during its decline.
The goal in setting up the Quality of Life Scale is to provide a guideline so that pet owners can maintain a rewarding relationship that nurtures the human-animal bond.
This scale alleviates owners’ feelings of guilt and engenders the support of the veterinary team to actively help in the care and decision making for end-of-life, or “pawspice,” patients.
It is up to the veterinary profession and to the pet’s caretaker to design an end-of-life pet hospice program that encounters each factor and deals with it openly and honestly. We canuse a quality of life scale from one to 10. Ten is the best.
This list, called “HHHHHMM,” stands for: hurt, hunger, hydration, hygiene, happiness, mobility and more good days than bad days. A score above five on most of these issues is acceptable in maintaining an end-of-life program. Each pet’s situation needs an individual, kind and supportive approach.
The HHHHHMM Scale
Hurt: 1-10
Adequate pain control is first and foremost on the scale. This includes the pet’s ability to breathe properly. Most people do not realize that not being able to breathe is ranked at the top of the pain scale.
Some families are willing to provide oxygen therapy at home for their ailing pets and the veterinarian can prescribe it through a medical supply house. Pain control may include oral, transdermal and injectable medications.
Hunger: 1-10
If a pet is not receiving adequate nutrition willingly, by hand or force feeding, then consider placing a feeding tube especially for cats.
Malnutrition develops quickly in sick animals when the caretaker is not educated. Instruct owners to use blended or liquid diets to help their best friend maintain proper nutritional and caloric intake.
Hydration: 1-10
Subcutaneous fluids are a wonderful way to supplement the fluid intake of ailing pets. It may take a few sessions for a pet owner to get the hang of this helpful procedure.
Hygiene: 1-10
Can the pet be kept brushed and cleaned? Is the coat matted? Is the pet situated properly so that it won’t have to lie in its own waste after eliminations? Pets, especially cats with oral cancer, can’t keep themselves clean, so they get demoralized quickly.
The odor associated with necrotic oral tumors can be offensive and cause social rejection by family members. Antibiotics help reduce foul-smelling infections and using a sponge dampened with a very dilute solution of lemon juice and hydrogen peroxide (to mimic the gentle stroking action of a “mother tongue” on the face, paws and legs) helps soothe and clean cats’ fur. Dogs enjoy this, too.
Happiness: 1-10
Is the pet able to experience any joy or mental stimulation? It is easy to see that our pets communicate with their eyes. They know what is going on.
Is the ailing pet willing to interact with the family and be responsive to things going on around him? Is the aging cat able to purr and enjoy being on the bed or in one’s lap? Is there a response to a bit of catnip? Can the cat bat at toys or look at and follow a laser light?
Can the ailing pet enjoy the upbeat greetings and petting of loving family members? Can the pet’s bed be moved close to the family’s activities and not left in an isolated or neglected area? Is the pet depressed, lonely, anxious, bored or afraid?
Mobility: 1-10
Ask if the pet is able to move around on its own or with help in order to satisfy its desires. Does the pet feel like going out for a walk? Is the pet showing central nervous system problems, seizures or stumbling?
Can the pet be taken outdoors or helped into the litter box to eliminate with assistance? Will a harness, sling or a cart be helpful? Is medication helping?
The answer to the mobility question has variable scenarios. I have met some utilitarian pet owners who are too rigid in the mobility area.
For instance, they regretfully but willingly sacrifice their pet’s life rather than elect amputation of a limb. Some pet owners have the honest yet teleological feeling that amputation is mutilation and not fair to the pet. Instead, they allow the pet to bear a painful limb for months before euthanasia.
Then there are cases like Krash, a 12-year-old, male, 90-pound, golden retriever, in Orange County, Calif.
Krash’s mobility was already borderline when he entered our pawspice program with osteosarcoma of his left distal radius. His history precluded amputation because of severe degenerative joint disease, degenerative myelitis, (some dogs have had previous bilateral knee surgery) and hip dysplasia. Krash wears a splint to offset a pathological fracture.
The mobility scale can be variable from 1 to 10. The need for mobility seems dependent on the species and breed. Cats and small lap dogs can and do enjoy life with much less mobility than large and giant-breed dogs.
If the pet is compromised and is only able to lie in bed, is there a schedule to change the position of the pet and rotate the body as often as every two hours?
Atelectasis and decubital ulcers must be avoided. The nursing care of large immobile dogs is very demanding.
Is the bedding material soft enough? Can an egg crate mattress be used and set up properly to avoid decubital ulcers? Is there a role for a pet mobility cart or an Evans standing cart?
These items really make a difference in the quality of life for the pet that has limited mobility yet is alert and responsive.
More Good Days Than Bad: 1-10
When there are too many bad days in a row or if the pet seems to be “turned off” to life, quality of life is compromised.
Bad days are filled with undesirable experiences such as vomiting, nausea, diarrhea, frustration, seizures, etc. Bad days could be from profound weakness caused by anemia or from the discomfort caused by an obstruction or a large, inoperable tumor in the abdomen.
This was the situation with my own dear Australian shepherd, Alfie, who had a huge undifferentiated mass rapidly overtake his liver.
If the two-way exchange needed to communicate and maintain a healthy human-animal bond is just not there, the pet owner must be gently told that the end may be near.
It is very difficult for families to make the final decision to end a beloved pet’s life with euthanasia. This is usually avoided when euthanasia is against the pet owner’s religious beliefs.
A decision to euthanize can be made more clear to clients if the standard scale for quality of life is set ahead of time and re-evaluated every couple of weeks or every few days as required.
If the pet is slowly passing on with a peaceful tranquility, it may be a satisfactory situation. People often want their pet to pass on naturally at home in their arms or in their own bed. That is OK as long as the pet is just weakening steadily and not suffering to death.
Home euthanasia with a kindly house call veterinarian may be elected.
Hopefully, the concept of a scale for quality of life and our professional guidance can help relieve the angst and regret about a beloved pet’s death.
Alice Villalobos, DVM, owns Animal Oncology Consultation Service in Woodland Hills, Calif. She received the 1999 Bustad Companion Animal Veterinarian Award and is associated with VCA Clarmar and Coast animal hospitals in Torrance and Hermosa Beach, Calif.
This article first appeared in the September 2004 issue of Veterinary Practice News.
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