How to pick a time when no time is a good time?
April 5, 2022 12:28 PM Subscribe
My elderly (15 year old) terrier has multiple medical conditions, including both renal and congestive heart failure. It's clear that we're getting close to the end, but when is the right time?
Over the past 4 years she's had an increasing number of problems, including an IBD diagnosis, persistent acute pancreatitis, the development of separation anxiety (timed with staying at home because covid), renal failure, arthritis, and now, most recently congestive heart failure. The congestive heart failure is the most concerning: she's gone from nothing to a stage 6 heart murmur just a few months, and has been hospitalized twice in the past 2 months, running up over $15k in vet bills, for complications stemming from the heart failure.
All of that has lead to weight loss/infrequent eating, incontinence, and tons of bodily functions that include blood, but outside of that, she's confusingly fine. She loves exploring and cuddling and short walks. It's very clear that she can't do these things to the level she likes, to the point where she's very frustrated and bored or will cause herself pain trying to pursue them (and then hide the pain, because she wants to keep doing the thing).
Using tools like the HHHHHMM scale, she pretty consistently rates on the low end of fine. Comparing to others who have posted similar questions here, she doesn't seem in as obviously as bad a state. She's struggling, but she also has things she enjoys. So I don't feel like it's clear what to do.
My biggest fear right now is that she's going to die from another cardiac related event, and so she will die while in pain while struggling to breathe or on oxygen. I'm even more afraid of this because I have some travel coming up (necessary if I want to pay the vet bills), which probably increases the chances of this happening while she's alone, even though the place boarding her is hands on and aware of her health conditions.
I don't want to cut her life short when she still can find enjoyment, but given the pace at which she's been developing problems, I'm concerned that I'm letting things go too long. The specialists and techs at the vet have been all over the place. Probably the most clear answer I got from any of them is that the best she can hope for is another 6-12 months (and that was before the most recent cardiac emergency).
So - when is the right time for this active dog?
Over the past 4 years she's had an increasing number of problems, including an IBD diagnosis, persistent acute pancreatitis, the development of separation anxiety (timed with staying at home because covid), renal failure, arthritis, and now, most recently congestive heart failure. The congestive heart failure is the most concerning: she's gone from nothing to a stage 6 heart murmur just a few months, and has been hospitalized twice in the past 2 months, running up over $15k in vet bills, for complications stemming from the heart failure.
All of that has lead to weight loss/infrequent eating, incontinence, and tons of bodily functions that include blood, but outside of that, she's confusingly fine. She loves exploring and cuddling and short walks. It's very clear that she can't do these things to the level she likes, to the point where she's very frustrated and bored or will cause herself pain trying to pursue them (and then hide the pain, because she wants to keep doing the thing).
Using tools like the HHHHHMM scale, she pretty consistently rates on the low end of fine. Comparing to others who have posted similar questions here, she doesn't seem in as obviously as bad a state. She's struggling, but she also has things she enjoys. So I don't feel like it's clear what to do.
My biggest fear right now is that she's going to die from another cardiac related event, and so she will die while in pain while struggling to breathe or on oxygen. I'm even more afraid of this because I have some travel coming up (necessary if I want to pay the vet bills), which probably increases the chances of this happening while she's alone, even though the place boarding her is hands on and aware of her health conditions.
I don't want to cut her life short when she still can find enjoyment, but given the pace at which she's been developing problems, I'm concerned that I'm letting things go too long. The specialists and techs at the vet have been all over the place. Probably the most clear answer I got from any of them is that the best she can hope for is another 6-12 months (and that was before the most recent cardiac emergency).
So - when is the right time for this active dog?
I think you would be happier, and she would be more kindly served, if you decide to let her go now. That way you'll remember her better and she will suffer less.
I waited a month or two too long with my sweet dog; he was still enjoying some things, but had difficulty with others, and I should have let his end life with more dignity.
It's so hard, hugs.
posted by anadem at 12:36 PM on April 5, 2022 [13 favorites]
I waited a month or two too long with my sweet dog; he was still enjoying some things, but had difficulty with others, and I should have let his end life with more dignity.
It's so hard, hugs.
posted by anadem at 12:36 PM on April 5, 2022 [13 favorites]
My experience is that I never feel like there's a right time. If I wait till I'm sure suffering outweighs life, then the animal has suffered unbearably already.
If I don't, then I wonder if it's too soon.
So knowing that, I accept that it's a no win situation with no real right answer.
It sounds like you are ready to let her go, and definitely sparing her the suffering and fear of what might happen, is a good reason to justify that decision.
Be with her at the end.
I'm sorry you are having to make this decision. It's never easy.
posted by Zumbador at 12:43 PM on April 5, 2022 [2 favorites]
If I don't, then I wonder if it's too soon.
So knowing that, I accept that it's a no win situation with no real right answer.
It sounds like you are ready to let her go, and definitely sparing her the suffering and fear of what might happen, is a good reason to justify that decision.
Be with her at the end.
I'm sorry you are having to make this decision. It's never easy.
posted by Zumbador at 12:43 PM on April 5, 2022 [2 favorites]
If a dog of her great age isn't eating, she's telling you she's done. She doesn't value the time you are fighting so hard to give her. I have provided palliative care for many dogs at the end of their lives and I can tell you with absolute certainty that you will never regret going early, while making the choice too late will absolutely haunt you.
I read your post and I see so much love and compassion. You say "she's struggling, but she also has things she enjoys" and you need to ask yourself: are you waiting for a time in her life when she has no enjoyment? Why, when you can give her a glorious day filled with love and cuddles and a park and a McDonald's cheeseburger and an at-home appointment with the vet for a compassionate ending.
posted by DarlingBri at 1:07 PM on April 5, 2022 [32 favorites]
I read your post and I see so much love and compassion. You say "she's struggling, but she also has things she enjoys" and you need to ask yourself: are you waiting for a time in her life when she has no enjoyment? Why, when you can give her a glorious day filled with love and cuddles and a park and a McDonald's cheeseburger and an at-home appointment with the vet for a compassionate ending.
posted by DarlingBri at 1:07 PM on April 5, 2022 [32 favorites]
All of that has lead to weight loss/infrequent eating, incontinence, and tons of bodily functions that include blood, but outside of that, she's confusingly fine.
They're always fine in the good moments outside the bad ones. If a pet is in pain and frustrated when they try to do the things they love, it's time.
posted by Jairus at 1:09 PM on April 5, 2022 [4 favorites]
They're always fine in the good moments outside the bad ones. If a pet is in pain and frustrated when they try to do the things they love, it's time.
posted by Jairus at 1:09 PM on April 5, 2022 [4 favorites]
I can’t answer for the specifics of your pet, but I’ve never heard anyone talk about feeling bad that they put a sick pet to sleep too early, while I’ve heard lots of people (including myself) talk about having left it for too long.
posted by LizardBreath at 1:10 PM on April 5, 2022 [10 favorites]
posted by LizardBreath at 1:10 PM on April 5, 2022 [10 favorites]
I think it’s better to wonder if you acted too soon than to know you did it too late. I bet it feels really bad to consider euthanasia timing based on travel timing, but I think it would be a kindness and a gift to her to do it beforehand, to ensure that she doesn’t struggle while you’re gone.
posted by maleficent at 1:13 PM on April 5, 2022 [10 favorites]
posted by maleficent at 1:13 PM on April 5, 2022 [10 favorites]
This is an awful wretched no win situation, and the grim benefit is when all your choices are bad you can ease up on yourself on which one is right.
Given what you're describing with her rapidly failing health, and your upcoming trip, and her separation anxiety, I'd suggest scheduling home euthanasia before the trip, and also moving from a healthcare to save her mindset to a palliative only healthcare mindset. That is, if she faces another health emergency between now and then, instead of fixing it you let her go. Because if I was you, I too would be worried about leaving a dog in fragile health behind; it's extra stress on her already stressed system. And if something goes south, you wouldn't be there for her, and that could be very difficult to go through for both of you.
Scheduling at-home euthanasia can be a great blessing when you pull it off--it's less stressful for them and you. And you can focus on making sure all your time between now and then is quality.
posted by foxfirefey at 1:15 PM on April 5, 2022 [8 favorites]
Given what you're describing with her rapidly failing health, and your upcoming trip, and her separation anxiety, I'd suggest scheduling home euthanasia before the trip, and also moving from a healthcare to save her mindset to a palliative only healthcare mindset. That is, if she faces another health emergency between now and then, instead of fixing it you let her go. Because if I was you, I too would be worried about leaving a dog in fragile health behind; it's extra stress on her already stressed system. And if something goes south, you wouldn't be there for her, and that could be very difficult to go through for both of you.
Scheduling at-home euthanasia can be a great blessing when you pull it off--it's less stressful for them and you. And you can focus on making sure all your time between now and then is quality.
posted by foxfirefey at 1:15 PM on April 5, 2022 [8 favorites]
This is such a difficult question, but I join the consensus here that it is probably time. We waited too long with one of our cats and it was a friend who hadn’t been over in a while who took my wife aside to tell her it was time. Our friend was shocked at how bad our cat had gotten and because we’d been there through the process we didn’t see it. Not saying that’s where you’re at, but you don’t want to let it get that far either. It was a rough day when we put him down but it was the right call.
posted by dellsolace at 1:15 PM on April 5, 2022 [3 favorites]
posted by dellsolace at 1:15 PM on April 5, 2022 [3 favorites]
Oh I'm so sorry. It is true there is never a right time to do this, but I think earlier is better than waiting too long.
My dog, who was younger and it sounds like otherwise healthier than yours, died of congestive heart failure about a year and a half ago. In my case, my dog's health turned quickly (I was unsuspecting enough that I ordered another month's supply of his VERY expensive medications less than 24 hours before he died) and I couldn't find a vet who was immediately available on a weekend in the worst of the pandemic to put him down. He ended up dying on his own after 8 hours of struggle he did not deserve. I would have FAR preferred to have put him down earlier and given him (and honestly, also me) the opportunity to do it on our own terms. Especially with the way congestive heart failure can go, I would probably consider sooner rather than later.
posted by mjcon at 1:20 PM on April 5, 2022 [6 favorites]
My dog, who was younger and it sounds like otherwise healthier than yours, died of congestive heart failure about a year and a half ago. In my case, my dog's health turned quickly (I was unsuspecting enough that I ordered another month's supply of his VERY expensive medications less than 24 hours before he died) and I couldn't find a vet who was immediately available on a weekend in the worst of the pandemic to put him down. He ended up dying on his own after 8 hours of struggle he did not deserve. I would have FAR preferred to have put him down earlier and given him (and honestly, also me) the opportunity to do it on our own terms. Especially with the way congestive heart failure can go, I would probably consider sooner rather than later.
posted by mjcon at 1:20 PM on April 5, 2022 [6 favorites]
Do it before your work travel. She can spend her last days with you at home rather than any of it in a boarding situation. I'm so sorry that you are dealing with this, you sound like a wonderful dog parent.
posted by cakelite at 1:30 PM on April 5, 2022 [5 favorites]
posted by cakelite at 1:30 PM on April 5, 2022 [5 favorites]
I agree with so much of what has been said above, but the thing that makes me say do it soon is your impending travel. It would be so, so sad if she passed while you were gone. It sounds like she's had a great life with you, and letting her go before she has to suffer any longer would be a great kindness.
posted by Serene Empress Dork at 1:32 PM on April 5, 2022 [3 favorites]
posted by Serene Empress Dork at 1:32 PM on April 5, 2022 [3 favorites]
I had a dog pass away while I was on a trip and I really don't recommend it. It's always hard but I was beating myself up for months and months.
In my experience most dogs are very good at hiding how miserable they are. They don't want us to worry. If you rate her at being borderline fine then I am betting she is less than fine. You have the gift of an opportunity to schedule a quiet, peaceful passing for her at home, after spoiling her rotten for as long as you have.
posted by muddgirl at 1:45 PM on April 5, 2022 [6 favorites]
In my experience most dogs are very good at hiding how miserable they are. They don't want us to worry. If you rate her at being borderline fine then I am betting she is less than fine. You have the gift of an opportunity to schedule a quiet, peaceful passing for her at home, after spoiling her rotten for as long as you have.
posted by muddgirl at 1:45 PM on April 5, 2022 [6 favorites]
Chiming in to say that this is the worst part of having a companion animal. We had a very bright and wonderful cat who developed kidney failure at a relatively young age. We had another three years with her until the weekly injections and renal diet and tablets that she hated taking just couldn't combat the issue - she HATED the trips to the vets and when she crashed again, and the vet said Julia could have an inpatient stay with fluids to see if she pulled round, it was time. I still miss that cat, part of me still wishes we'd gone for the fluids option - but it would have been for our benefit, not hers, and it would have been selfish of us because even though she was still capable of walking and interacting and arguing with her sister, she was very sick.
So sorry for the situation you are in, it's horrible and heartbreaking.
posted by Martha My Dear Prudence at 1:53 PM on April 5, 2022 [2 favorites]
So sorry for the situation you are in, it's horrible and heartbreaking.
posted by Martha My Dear Prudence at 1:53 PM on April 5, 2022 [2 favorites]
I will just add that the renal failure alone would be enough. It's an extremely uncomfortable condition when your blood is no longer being cleaned.
posted by bleep at 1:56 PM on April 5, 2022
posted by bleep at 1:56 PM on April 5, 2022
I'm sorry to hear your news. Here's something I wrote a while back in response to a similar question:
IMO, the key thing to remember is that your beloved pet doesnt really have any conception of "tomorrow" and wanting to stretch things out to get more time. What he has is "right now." So it's your job, to whatever extent possible, to make sure he doesn't have any truly bad days. It's far better to pull the trigger early rather than late, because he would never blame you for missing a few future walks in the park. This is a highly personal decision, so I can't tell you when will be the right time -- except that I wouod encourage you not to take it down to the last possible moment. If you get a bad report from the vet and the vet tells you your dog is already feeling pretty poorly, it wouldn't even be inappropriate to do it then. If you make a different decision, understand that the rest is borrowed time and make peace with the fact that every day could be "the day." This thinking, for me at least, has made a lot easier for me to make the best decisions for my pets at the end of their lives. It's the last great responsibility of pet ownership and the best gift you could ever give him.posted by slkinsey at 1:59 PM on April 5, 2022 [10 favorites]
My elderly dog is in a similar position though with liver cancer. I have found this checklist helpful.
My vets advice was to fill it in 3 times over 3 different days to get an "average". It helps me think more clearly about each area and I feel it gives me a a slightly more "clinical" POV on the situation when what I really want to do is hug him close and cry at how hard the decision is.
As someone that has had to put down 3 old and sick dogs over the years, the decision is never easy and you will second guess yourself whenever you choose to do it and you have all my sympathy. I'm sorry you are going through this
posted by wwax at 2:35 PM on April 5, 2022 [2 favorites]
My vets advice was to fill it in 3 times over 3 different days to get an "average". It helps me think more clearly about each area and I feel it gives me a a slightly more "clinical" POV on the situation when what I really want to do is hug him close and cry at how hard the decision is.
As someone that has had to put down 3 old and sick dogs over the years, the decision is never easy and you will second guess yourself whenever you choose to do it and you have all my sympathy. I'm sorry you are going through this
posted by wwax at 2:35 PM on April 5, 2022 [2 favorites]
As I'm sure many have said, there's no "right" time. My adult daughter watched her dog die in the middle of a seizure 2 months ago—just a day after making the decision to have the vet come to her home to end his suffering. She's still experiencing trauma as a result. He was 15, also, had congestive heart failure, plus many other symptoms you describe. Letting our love outweigh our need for our animal companions can help in decision making. Wishing for a peaceful transition for your dog.
posted by Scout405 at 8:03 PM on April 5, 2022 [1 favorite]
posted by Scout405 at 8:03 PM on April 5, 2022 [1 favorite]
Earlier is better than later. In my case I set a date, before an extended trip. Having her in a boarding kennel and having something happen will make you feel guilty, and of course, it's infinitely better to go surrounded with your people.
My pup and I had one last great week, walks, an entire pizza to herself and then it was time. I left on my trip two days later.
Wishing you all the love and strength in this situation.
posted by socky_puppy at 1:30 AM on April 6, 2022 [1 favorite]
My pup and I had one last great week, walks, an entire pizza to herself and then it was time. I left on my trip two days later.
Wishing you all the love and strength in this situation.
posted by socky_puppy at 1:30 AM on April 6, 2022 [1 favorite]
Oh, my sympathies. I think the travel seals it. You should be with her, both for her sake and for yours.
She sounds just like my most recent dog, also a terrier, similar health issues and similar age. On the day that I finally let her go, the vet said, "Not a bad way to go: after a long life, in the arms of your favorite person."
posted by BibiRose at 4:34 AM on April 6, 2022 [1 favorite]
She sounds just like my most recent dog, also a terrier, similar health issues and similar age. On the day that I finally let her go, the vet said, "Not a bad way to go: after a long life, in the arms of your favorite person."
posted by BibiRose at 4:34 AM on April 6, 2022 [1 favorite]
Please accept my sympathy. Our pets are more than animals; they each carve out their unique place in our lives. Though you can always "get" another one, you can't replace the one passed.
My list includes:
Three fine mares, Buffy, Cricket, and Mecca.
One twisty gelding, Nacho the superhorse.
Two machos, Jasper and Teddy.
One mula, Jenny The Sweet.
Buddy, the most talented hinny ever.
Three good dogs and a worthless mutt.
(The above were members of the First Battalion of the Whoop & Boogie Brigade)
Some cats.
They all gave me joy and kept me humble. They instructed me on how to live in the moment and schooled me in the existential parameters that bind us all.
Some equines and two cats passed with their heads on my lap. The deed was mine to do, so I was there when they passed, either by my hand or assisted by a wonderful veterinarian, who left us alone after she pushed the plunger on the syringe. I saw pain fade into sleep; then, sleep left the body along with a bit of my soul.
They all left empty spaces in my heart. I regretted mostly those times I waited too long because I was afraid to face the pain.
Tell me your Terrier's name, and I will think of her with you.
posted by mule98J at 9:05 AM on April 6, 2022 [3 favorites]
My list includes:
Three fine mares, Buffy, Cricket, and Mecca.
One twisty gelding, Nacho the superhorse.
Two machos, Jasper and Teddy.
One mula, Jenny The Sweet.
Buddy, the most talented hinny ever.
Three good dogs and a worthless mutt.
(The above were members of the First Battalion of the Whoop & Boogie Brigade)
Some cats.
They all gave me joy and kept me humble. They instructed me on how to live in the moment and schooled me in the existential parameters that bind us all.
Some equines and two cats passed with their heads on my lap. The deed was mine to do, so I was there when they passed, either by my hand or assisted by a wonderful veterinarian, who left us alone after she pushed the plunger on the syringe. I saw pain fade into sleep; then, sleep left the body along with a bit of my soul.
They all left empty spaces in my heart. I regretted mostly those times I waited too long because I was afraid to face the pain.
Tell me your Terrier's name, and I will think of her with you.
posted by mule98J at 9:05 AM on April 6, 2022 [3 favorites]
I agree with those who think you should do it before your travel. I had to put down a dog that I was dog sitting- fortunately I cared deeply for this dog and almost considered her mine, so she was able to go with someone who cared for her- but it was really hard on her owner, who had had her since she was a puppy.
posted by rockindata at 3:08 PM on April 6, 2022
posted by rockindata at 3:08 PM on April 6, 2022
This thread is closed to new comments.
My grandparents grew up on a farm, and they would shoot farm animals with broken legs or bad illnesses that didn't clear up. It was sad, but what had to be done.
My parents inherited some of that, but would know it was time when the vet bill was above 2x the cost of the puppy, unless it was a one-time issue and not ongoing. (Fish hook in gut? Fine. Heart problems? Not fine).
When I'm making this decision for my current, first dog, I know it will be hard. But, the time to make the call is typically when you have to choose to invest another large amount of resources into another intervention, vs doing anything randomly/out of the blue.
And, well, it sounds like 6-12 months is the best she can hope for. My recommendation would be to save resources on the next problem (>$500) and let her donate those resources to caring for the next pet.
posted by bbqturtle at 12:35 PM on April 5, 2022 [2 favorites]