put him down before it gets worse?
March 31, 2005 12:03 PM   Subscribe

Assuming my dog has a brain tumor, should I have him euthanized? (I found some good advice here, but it just wasn’t enough).

Maybe my dog has a brain tumor. Maybe he doesn't. He does, however, have seizures at regular intervals. The seizures occur approximately every three to four weeks. Usually it's just one, but occasionally (including this past weekend) they come in clusters. Now he will sometimes suffer tremors that knock him off balance or even cause him to fall. He falls down easily when walking (he has a scrape on his chin from a bad one the other day), and has a hard time getting up because of a bad hip. Sometimes he’s blind, and sometimes he’s not. He whimpers a lot at night now, and does not like to be alone. My wife and I don’t let him in the bedroom because he acts restless and won’t let us sleep. Sometimes, but not lately (that I’ve noticed), he tries to eat weird things like the stove handle or wooden tables.

I've taken him to the vet several times, and already decided that the expense for an MRI is just too great. That, and I don't want to put him through it. He's currently on 487.5 milligrams of Phenobarbital a day (he’s 100 pounds), which includes a recent increase of 48.75 milligrams per day since the last seizure.

What I don’t want to do is prolong his suffering, if indeed he is suffering. He still seems happy overall, but my fear is the seizures may eventually cause enough brain damage to wear away his personality or kill him outright. It just doesn’t seem worth it to keep him going through this every so often, but I don’t want to do it unnecessarily. This is obviously a tough decision, and I appreciate any advice or insight.
posted by malaprohibita to Pets & Animals (26 answers total) 1 user marked this as a favorite
It sounds to me from reading your post that you already think it is the best thing and that you are trying to solicit encouragment to build your confidence.

How old is your dog? To me, it definitely sounds like an end-of-life-ish situation. But no one else can tell you how to handle it.
posted by xmutex at 12:17 PM on March 31, 2005

If I were in this situation, I would err on the side of letting things be for awhile, hoping that either a seizure would do the work for me, or that suffering would become obvious and make the decision easy (if still painful). My natural instinct to procrastinate in the face of hard choices would be at work full-on in a case like this, and I don't think that's necessarily a bad thing. As long as you don't ignore blatant signs that your dog's happy time on earth are over, and you and your family aren't being unduly burdened with care duties, I think there's a lot to be gained for your own peace of mind by keeping him around for a while longer. It sounds like this isn't going to be a very long limbo period anyway.

I'm sorry for your dog's bad health.
posted by dness2 at 12:37 PM on March 31, 2005

Response by poster: He just turned 11 last month, so while he's a senior citizen (so my vet tells me), I just don't feel like he's all that old. Confidence is definitely an issue here.
posted by malaprohibita at 12:56 PM on March 31, 2005

This is one of the hardest decisions a person ever has to make.

But it sounds like he's ready to go. He's restless, he's sedated, he has a bad hip and he's having episodes that must confuse him and worry you. The whimpering makes it sound like he's hurting despite the barbituates or confused and scared a lot.

It's a personal decision. But if I were in your position, I'd put him down.

And I definitely feel for you. I've been there a few times and it's always awful.
posted by Mayor Curley at 12:58 PM on March 31, 2005

This might help. Sorry about your dog.
posted by Capn at 1:34 PM on March 31, 2005

I'd try to take a fair accounting of his overall quality of life and its impact on your overall quality of life. If making his time marginally pleasant is a huge detriment to your life I personally don't think it makes you an ogre to factor that in. There's a lot of ground between coping with some unpleasantness (unexpected pee in the house from age-caused incontinence) and upending your life (having to be home every possible moment to comfort an increasingly anxious and confused pet).

Or more succinctly, can you have time together that's pleasant for both of you?
posted by phearlez at 1:41 PM on March 31, 2005

We had to put down a tri-color collie, 14 years (old for that breed). The family loved him. Toward the end he'd lost total control of the lower half of his body. He was nearly blind from cataracts.

Like all here say, it's a very personal decision. Status epilepticus, an unremitting series of seizures, is damaging to your dog's brain. I'm no doctor, but loss of sight, behavior changes, tremors and seizures suggest nothing less than a brain tumor.

Is there a way you can finance the MRI with the vet? Most are very accommodating. This way you will know the prognosis. It may be expensive but it could help you know the realities.

No matter what you decide, go on a camping trip, or to a cottage in the country, or even dog parks for a few days. Enjoy being outside and playing together as much as possible. Take lots of pictures.

Dogs are unusual companions. They bond with people unforgettably. They have faith that we will protect them and do what is best for them. Treasure that faith and do what you think is best.
posted by nj_subgenius at 1:42 PM on March 31, 2005

I can relate to this immediately. Our (almost) 14 year old lab--who I consider to be the sweetest dog on earth--had a few seizures about 9 months ago. Her seizures came in clusters as well. She also has arthritis in her hips. I cried when the vet came by (our neighbor is a vet) and begged him to be straight with me. I absolutely do not want her to suffer and I don't want to keep her on because I can't decide what to do.

We discussed this openly. Her appetite is still very good (she is ravenous, in fact). She seems happy and is still playful. She does sleep more...old dogs do. She also dreams more vocally...lots of whimpers and restlessness and even a tail wag now and then. She still enjoys short walks and will even have (rare) episodes of playfulness.

We discussed trying to diagnose a brain tumor. And he brought up a really good point...if I knew she had one, would I want to put her through the treatment? My answer was very easy...no. We discussed the signs that the end would be nearing for her. Appetite failing, loss of any body systems, lack of enjoyment in daily activities, lack of responsiveness.

Otherwise, we give her painkillers for her arthritis, I massage her legs each night and morning, and we enjoy the time we have with her. We keep her comfortable and so far so good. She keeps getting up earlier and earlier now...this morning at 5 am. Actually, she reminds me of many folks at the end of life I cared for when I was a candy striper. Not always easy, but she is worth the trouble. She's always been very good to us.

At this point, having a plan for the end has helped us to rest a little easier about this decision when it comes around. Our vet will come to our house when we need him. In the meantime, I'm just loving her as best as I know how.
posted by jeanmari at 1:51 PM on March 31, 2005

It's not at all unusual for larger dogs to live shorter lives - my parents' (pretty healthy) Goldens live to 12-14, and when they had Dachsunds, the last one lived to 18 or so. I think subgenius' advice is excellent - spend your energy having a really great, special time with your dog. If things don't stabilize after a period of time, it's completely normal and acceptable to consider his quality of life and yours in deciding if it's the right time to put him down. My sympathies to both of you.
posted by deliriouscool at 1:57 PM on March 31, 2005

I've had to let go of two dogs, and neither was easy.

One I put down a year and a half ago. It was really hard because at 14, he was doing great physically. He had a little arthritis, but that was easily medicated. What we couldn't medicate away was his anxiety. We managed to hold it in check for a couple of years, but finally I couldn't leave him at home alone (I took him to work and left him in the back of my truck where I could come out and see him every couple of hours) and then one day he got confused at a park and ran away from me and into the street. He actually dropped to the ground just as a giant pickup rolled over him. How he didn't get hit, I'll never know, but he was okay. That was the moment I accepted what I had known for a few weeks. That his comfort in the world was overshadowed by his discomfort. We took him in a week later.

I wish I had had the emotional wherewithal to put the other one down before he died, but I just couldn't do it. He was an older German Shepherd (12 or 13, the vet was never completely sure) that I adopted from the street when he was seven. He survived a near-fatal heartworm infestation and the removal of a spleen consumed by cancer. A year after the cancer operation (the vet had given him three months), he suddenly started having trouble walking. Two days later he couldn't hold himself up, and I had to carry him outside and hold him up to pee. I dropped him off at the vet on my way to work, knowing that I would probably have to let him go that night, but he beat me to it. He passed shortly before I got back to the vet's after work.

My point is that there's never a good time, but there is the right time. Deciding on the right time is hard, but for me it comes down to how the dog is doing and how you want to remember him. Make sure that his last days don't consist of seizures and pain.
posted by mccreath at 2:01 PM on March 31, 2005

I think it's time to let go. There's a combination of things that make me worry about his quality of life. It sounds like he's pretty frail, and may be getting a little senile (door handle snacks and such). I wonder about the stress of the seizures, and wooziness from medicine. And, if he's whimpering at night, he's stressing, scared, or sad.

I think mccreath is right: his last days shouldn't consist of seizures and pain.

I'm sorry you are faced with this decision.
posted by Specklet at 2:28 PM on March 31, 2005

my fear is the seizures may eventually cause enough brain damage to wear away his personality or kill him outright

Why do you want to put him to sleep now, rather than when/if either of these eventualities takes place? (serious question, no tone involved, I suspect that the answer to this question is the answer to your question)

As I've said before, it is always better to let them go a bit too soon than a bit too late. The ones you keep around longer than you should are the ones that haunt you. If his condition is distressing you, and it sounds like it is, I think you know that it's probably time. Having a dog go through seizure after seizure is extremely upsetting.

I agree with xmutex that it sounds as if you've already made your mind up and just want someone to tell you you're right. The truth is, if you feel that it's time, then it's time, and that's really all there is to it. I do not believe you do a pet some huge disservice by putting them to sleep when their prognosis is poor, regardless of how many good days they may have left in them. They do not understand and anticipate death the way people do, they do not think about their "last car ride" or "last meal". I think the actual time you choose to have him put down is far less important than your being with him to hold him and stroke him and tell him how much you love him and thank him for being your friend when he goes (and this is as much for your sake as his).

I have spent a fortune on my pets over the years, and even I would never in a million years try to finance an MRI for an 11 year old large-breed dog who is very likely on his way out (and probably not even if I could easily afford it outright). 11 is well within the expected lifespan for most large-breed dogs, what will an MRI tell you? Either he's got a brain tumour and has a few months to live, or he doesn't have a brain tumour and he has in all likelihood at the outside a year or two, if that.

It's never easy to do this, but sometimes it's all we can do to do right by our pets. I feel for you.
posted by biscotti at 3:05 PM on March 31, 2005

I 've been raising dogs my whole life, and a couple of them have had to be put down for very similar reasons. I didn't like it, but I don't regret it now. Give the boy a couple of weeks, feed him some steaks or whatever his favorite treat is. And if you really get one to one with him, he'll let you know anyway. He understands.

Oh, I just remembered! Usually when my dogs get all worn out and sick, I get a puppy. My last old man, "Shep", totally forgot about his blindness and inability to walk when our baby rotti started biting his tail and barking at him. He was twelve then and he gave us two more good years before he had to be put down.
posted by snsranch at 3:19 PM on March 31, 2005

I tried to post this earlier, but the server wouldn't accept it.

Domestic dogs are one of the few other species besides man that commonly suffers from epilepsy. My own hunch as to why is that dogs were extensively bred to be trainable, and that this property of their brains, that they share with us human folks, is what gets them into trouble in this department.

That's so much chin music to you, who is wondering what to do. After many decades trying to figure it out, it's still not clear whether a short, self-initiated and self-ending seizure causes brain damage, in humans or animals. If it does, it is a small amount, not a massive thing. Many of my patients have seizures far more frequently than you report your dog having them, and still manage to lead fairly functional lives, with some limitations.

Seizures in themselves don't hurt, which is nice to know. In fact, awareness is lost during the convulsion itself; people (and animals) are a bit confused for a while afterwards, but this usually wears off in a few minutes or tens of minutes. So enabling your dog to continue living with 3 or 4 seizures a month, while definitely a burden, doesn't seem to me to be cruel or unusual.

If other things are going on: the dog seems to be impaired, or in pain, separate from the seizures; then, that's something else to consider.

In general, keep doggy away from water and places where a sudden fall or loss of consciousness could result in injury. And whatever you decide, I'm sure it'll be the right decision, tempered by your obvious compassion and love for your friend.
posted by ikkyu2 at 4:12 PM on March 31, 2005

Response by poster: Thank you all very much. I really appreciate the kind thoughts and great advice: it's just what I was hoping for.
posted by malaprohibita at 4:47 PM on March 31, 2005

I want to add my voice of support as well. I'm sorry for your pain. We had a dog we put down back in 2001. She was 13, and had had recurring tumors in her mammary glands. She had been operated on three times over the years. We knew there was no way we could do it a fourth time. And chemo at that age was out of the question. Putting her down broke my heart (and my wife's) a million times over.

I know it's going to sound hokey, or like I'm avoiding giving you the answer, but only can decide when it's time. There's not much you can do to ease the pain (other than time) but do remember the good times, and the good life you gave your dog.
posted by O9scar at 10:18 PM on March 31, 2005

May I jump in, rather than start a new thread? Because I'm wondering about this too.

My 13-year-old 81-lb mutt has been diagnosed as diabetic. She doesn't mind the insulin shots, but she is having a really hard time managing the stairs (we live on the second floor), and there's no way I can move right now. My vet can't tell me that she'll get better, and I hate the thought that I'm forcing her as much as I hate the thought of letting her go. Has anyone here had a diabetic dog?
posted by goofyfoot at 1:51 AM on April 1, 2005

If you're not willing to even pay to find out what's wrong with your dog, then I doubt you really needed ask whether or not you should put him down. No offense, but the only thing I read in your post was you complaining about the effect of your dog's seizures on *you*.

It sounds like your dog is nearing the end of his life, and of course I believe that putting him to sleep if he's suffering is the kindest thing to do, but I can't help being annoyed by people who look for excuses to put their pet to sleep the second they get a bit harder, or more expensive, to look after.

If an animal spends its life being a loyal friend to you, then I believe they deserve to be taken care of and not just immediately killed, even when they need the kind of care that is more than you would like.

Pets aren't disposable, you can't just throw them away when you don't want to deal with them anymore - and it seems like this question is just you trying to get other people to agree with you so you don't have to feel guilty about what you're going to do.

I'm sorry if I sound horribly judgemental, and I want to repeat that if your dog is suffering, or is likely to suffer soon, then I absolutely think you should put him to sleep. But the fact that you don't even know for sure what's wrong with him and that you don't want to "waste" the money finding out just really, really irks me.
posted by eatcherry at 2:38 AM on April 1, 2005

Holy crap, eatcherry you are being horribly judgmental. It's not that I disagree with most of your points, but I think you're way off base going into attack mode in this case.

The dog is 11 years old and a large breed, as I said earlier, 11 is already getting up there even for a healthy large-breed dog. Finding out what's wrong with him is unlikely to help either way and an MRI is ridiculously expensive, especially for a dog who is in all likelihood nearing the end of its natural lifespan anyway. If the dog has a brain tumour there's nothing that can be done, and if he doesn't, he's still having regular seizures even on a pretty hefty dose of anticonvulsants and the MRI has told you nothing useful. There's simply no good reason to spend that kind of money in this case. I am always an advocate of people not getting pets in the first place if they're not prepared to pay for proper medical care, but not spending an arm and a leg on this dog is in no way doing the dog a disservice. The dog is already old, an MRI won't tell you anything useful (either he's got a brain tumour and is doomed, or he doesn't and his seizures are still not controlled with the medication he's on). This isn't a case of the owner not wanting to "waste" the money, it's a case of throwing money away for no good reason and very likely no benefit to the dog.

If this were my dog, I'd probably wait and see (and I'd be crating it next to my bed rather than shutting it out of the bedroom), but I see nothing at all wrong with considering euthanizing it when its quality of life is deteriorating and its seizures are not being adequately controlled with medication. Dogs do not benefit from having their lives dragged out to the last possible second, they are not aware of being put to sleep, but they sure as hell are aware of a stressed-out owner. Even if the seizures aren't that upsetting to the dog, as ikkyu2 states (although my own experiences imply otherwise), they are upsetting to the owner, and whether you like it or not, this is a consideration. Quality of life, not quantity, should always be the priority, and I always find it bizarre when people who seem to want to have the animal's best interests at heart can't see that.

It's really harsh to accuse malaprohibita of treating this dog as disposable when we're talking about an elderly dog who's already had quite a lot of money spent on it trying to treat this problem. It's ridiculous to expect someone to spend the kind of money we're talking about for an MRI on a dog of this age and in this condition, and rebuking someone for not doing so is extremely low.
posted by biscotti at 5:12 AM on April 1, 2005

goofyfoot: I had a diabetic dog; we didn't know she was diabetic until the end. In retrospect, her urine had always been "sticky", the only diagnostic clue we ever had and I missed it. I think she'd been spilling sugar all those years. The vet said she could be maintained on insulin, but she was obviously suffering, and I had to let her go. She'd been good to us, she raised my kids, and it was time to be good to her. (The vet said diabetes can be managed, and I'm sure it can if it's something only recently developed.)

I have seen several dogs develop seizures, and I've never seen it end well. It probably doesn't matter why, because it's probably not something you can reverse. Many of us have jobs we would lose if we tried to arrange around anything that needed intensive care, whether it's a relative or a pet, and that does no one any good. When the time comes that the dog needs more care and reassurance than you can provide, you'll know it. Take the time you have together to enjoy it, and try to get your head to a place where you can do it when the time comes.

Thanks, biscotti, I didn't have the balls to say that, but I agree.
posted by unrepentanthippie at 5:15 AM on April 1, 2005

Uh-huh, so your dog is pissing sticky urine, you don't notice (?!), your vet tells you it can be managed and you still put it to sleep (since you apparently know better than a vet).

Yeah, try getting a hamster dude. They won't inconvenience you.
posted by eatcherry at 9:48 AM on April 1, 2005

My wife and I have a cat that is in a similar situation: he's on Phenobarbital and has had lots of seizures. We talked about it and decided to handle it this way: as long as he still has some quality of life, he's sticking around.

By this, I mean that once we have to give him a large enough dose of Phenobarbital that he can't do the basic things, then it is time to let him go. At the moment, he is really dopey and spends a lot of his time staring into his water bowl, but he's still aware and uses the litter tray (most of the time), enjoys his food and likes to snooze in the window. As his condition worsens, though, he will reach a point where he'll be so doped up that he won't be able to do that, and that's when we let him go.

The choice is yours, but I don't think there is anything to be gained by keeping your dog around for longer than he/she enjoys life.

I've not had a dog that had seizures, but I know how much pain my cat was in from the seizures: when he had one, he would miaowl for hours afterwards, wandering around the house looking totally out of it. Seeing a large Maine Coon twitching, frothing at the mouth and peeing everywhere isn't much fun for us either.

My advice: enjoy the time you have with your dog, make sure that they are comfortable and enjoying life, but prepare yourself for that time when they aren't, and decide at what point you think enough is enough.
posted by baggers at 10:02 AM on April 1, 2005

Response by poster: Thank you, biscotti. You summed up my situation perfectly.
posted by malaprohibita at 12:08 PM on April 1, 2005

I never noticed a thing until my girl was dognapped last week (totally my fault; I tied her up outside a store as I always did in San Francisco, but this is Los Angeles, and she was taken by someone and walked for two miles. She's just too old to be walked two miles).

When I got her back she was gulping water, which I thought par for the course, but then she didn't stop, and she pissed inside for the first time in twelve years. Suddenly she was not dealing with the stairs well. I kinda freaked and got her to the vet, who said it was just a bladder infection - huge relief - but then it turns out to be diabetes.

I don't understand how this didn't manifest itself before. What the hell is sticky urine? My girl was fine - old and slow and lumpy, but fine - until this motherfucker stole her and walked her around for nine hours. It's as if she was aged years in that time. I don't know if I'm being selfish here - she doesn't mind the insulin shots, and she still loves and reacts to me and our friends.

I'm babbling, sorry. It's just so scary.
posted by goofyfoot at 12:13 PM on April 1, 2005

goofyfoot, diabetes is often very controllable in dogs. I would wait and see how things go once she's stabilized and has been stabilized for a while. She didn't get diabetes from being dognapped, it's more likely that the stress simply made her symptoms more apparent. Calm down, give your dog the care she needs, get her glucose levels under control and then see where you are. It's premature to be thinking of putting her to sleep at this point, in my opinion, and I think this is more likely related to your stress over her disappearance and subsequent illness than anything else.
posted by biscotti at 2:56 PM on April 1, 2005

I don't know how to describe sticky urine. Usually pet urine just dries relatively clean and wipes up easily. When we picked this up with wet paper towels, it felt sticky against the floor and seemed to require a lot of water and more scrubbing than you'd expect, and I think had a more crystalline appearance than you'd expect. I apologize for not being more specific, I lost the dog 30 years ago.

We adopted the dog while we were in an apartment, during the Vietnam war. (No pets apartment, we had to hide her.) She was paper-trained for a couple of months until we got out of the military and took her home where she had a yard. She never went in the house again, and I had never had a dog before. We didn't know it was wrong until something like 12 or 14 years later when the vet said she was diabetic. She was old enough to die of old age by then, and I took her to the vet when she started to have problems we could see. He had never seen her before, and initially thought she had only recently developed symptoms because she was up in age, as seems to often happen with people. He agreed that she likely had had this all her life and that she probably had serious damage to her internal organs that was probably causing her pain olnce he knew all the facts. I mentioned that he said it could be treated because it would have been true if the disease were of recent onset, and I understand this can become a problem in older dogs. There's no reason to let anyone else whose dog has this think it's hopeless, this was simply a completely different set of circumstances.
posted by unrepentanthippie at 6:17 PM on April 1, 2005

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