Some personal thoughts on End of Life care for our dogs.

I recently went thru a modified shortened version of chemo with one of my dogs.  I wanted to share a few observations.   This is not a feel sad blog.  This is intended to be a continuation of the question we all have on when to let go. 

I was dealing with a fast growing t-cell lymphoma in his intestines.   The prognosis was bad and fast, weeks to a few months..   He was 14 years old.   Previously he was doing quite well for 14.  This story start to finish was approx 5 weeks.

The oncologist and vets in the process were all very nice and kind and offered a few treatment options including doing nothing.   While we were diagnosing the type of cancer they had me put him on prednisone which I learned is a type of chemo.   It worked wonders.   Within 24 hours his symptoms were reduced remarkably and he was cheerful and bouncy.    This had a great influence on my decision to move forward with a more aggressive treatment.   One option was full on chemo which takes a number of months and costs about $1500-2000 per month.    The next option was a condensed version of three treatments over nine weeks with monitoring in between.    The third was to simply keep him on prednisone but this treatment has some uncomfortable side effects, excessive drinking and night restlessness to name two.    Once I agreed to the 3 treatments over 9 weeks I felt good.   It was affordable and seemed to be in keeping with the amount of time he had left.   The goal was to get him off prednisone and treat the original symptoms which were no appetite, lethargy, and diarrhea.   After the first week he seemed to be stable.   At the three week mark I started to feel that I was holding on too long.   His symptoms were gone but I felt his breathing was different and he vibrated weirdly sometimes.   He was still taking his morning walks and appetite good.   One day Yanni said he was down at the shop and appeared disoriented.   I went to my three week appt for his 2nd does of chemo ready to tell the oncologist it is time to throw in the towel.   They wanted to do their exam and blood test first before I made that decisions.   They came back and said he is doing great.    In all honesty he was doing better than my original reason for bringing him to the vet before diagnosis but in general he was not doing as well as the day after the first prednisone.  She said the entire treatment plan is important to go thru.  He was doing really well based on their exam.  I was worried that I had 6  more weeks for a dog that had possibly only weeks to live.  It did not feel 100% right but I opted for the next does of chemo.   

A week later I went to my vet for a follow up blood test.  I got there with full intent to do the blood test and come home but my dog was not well to me.   I had a sad feeling over the last couple days even tho symptoms were all good.   So I got to the vet and they took me back and I said I am here for a blood test but I think I need to let my boy go.  I was starting to get teary eyed.   I talked to the vet who wanted to look at the history first.   He called the oncologist.     They wanted me to do a blood test before I decided.    They were telling me it may be an infection which can be treated.   I said, of course it can with more drugs.  The vet nodded.    I told them I live with this dog you all do not.    The vet nodded again.   Look at him now, I said.  He may not be dying at this moment but he wants to go.   They finally agreed and understood.   

Let me say I never got the impression the chemo was hurting him.   He always rallied a bit after the drugs.   I believe the poor guy just had cancer and it was a tough cancer and he was 14 years old.       

Every time I said this is too much they would tell me it is going as expected and let's do one more and we will make these changes.   So I would.  There were some great days and some bad days and all in between. The part that really bothers me is that two times I felt that I needed to let my boy go and two times I felt pressure from the vets to continue. I did not have the strength to say no.  I wanted to believe.  Once I was convinced to continue and the second time I held firm.    I am not going to say what is right and what is wrong for each person and each case but I do want to say a few things.

You are the one advocating for your dog.  You are the one living with your dog.  Waiting even one day too long is torture to your dog.   Don't let the vets pressure you.  I am sure they only want you to have all the facts but when you are at your weakest those facts may give you false hope.  My opinion is this, anyone starting a round of expensive chemo loves their dog so if they show up saying it is time, believe them.   There is so much to quality of life.  It is not simple as I had once thought, each dog has different quality of life issues.   With each decision to let a dog go I learn more about what that means.  One week too soon is far better then one day too late.   Watch your oldies carefully.   What do they love to do and can they do that which they love?  They have to go eventually, they need our help to go well.   Our pets are so lucky to have us to help ensure their last days are not miserable,  that is a gift to them.   Be selfless, do not think of yourself, think of your pet.   

It is a sad thing to practice, but I am getting better at this and it is getting easier.