Ls: How To Know When You Can Do No More...

[dbullwinkel]

Missy's LS is worsening. At 141/2 it s not unexpected. ...She is much more unstable, now often needing help to make it up her ramp as well. Walking is unsteady. Good appetite. Usually needs help getting up.

Pro-actively I have increased acupuncture to weekly and added amantadine (yesterday) to her meds (gabapentin, tramadol) depo shot one week ago.

I look at her struggling, and say to myself...why am I waiting to let her go?? She will not improve much.. I was planning on giving the amantadine a chance ( maybe a week ?) to see if it helps...I am so torn.

My vet will be away on a conference for a week beginning the 17th...so I feel like I need to have a decision by then....

Advice from those going through this would be appreciated.

[fliggie]

My boy does not have LS, but some significant arthritis and is on several meds. He is 13. I don't have any advice, I think it is a personal decision and I am guessing that you are very close to making the decision for your girl. I do understand, it is so difficult to watch them struggle. The cold weather is not helping. I wish you peace in your decision, whatever that is. Mary Ann

[dbullwinkel]

Thank you. I put my Ig down the day after Christmas.......

[Guest MnMDogs]

Give the amantadine more than a week. Will try to Pm later if I have time

[GeorgeofNE]

You don't know me, nor I you--but anyone who has ever loved an old pet knows what you're going through, and that includes me.

 

The very fact that you're asking yourself, "What am I waiting for?" tells me you know in your heart it's time.

 

If you can handle a page of "houndish," George wrote a blog entry about this very difficult subject, which was shared over 1,000 times (so I guess people found it helpful?):

 

http://wp.me/p3PIWm-27

 

I am of the "better a day too soon than a day too late" camp, but obviously only you can make the call.

 

Best wishes.

 

Susan (and George)

[Guest greybookends]

I am also in the camp that if you're asking then it is most likely time.

 

I do not like to wait until they have lost all their dignity and they have to beg you to release them. Better a day to soon then a day to late.

 

You will never feel good no matter what you do. You will wonder did I let them go to early, did I do the right thing, but I promise you the guilt of letting them go a day to late is much worse. I've been in both camps.

 

[GreyPoopon]

I'm in the "day too early" camp too, but I disagree that if you're asking, it's time. Some of us ask early and often, and don't always go forward. (ETA: I've been early and late too. Early hurts less.)

 

I was in a similar position with one of mine before Christmas. It felt like I was being pushed into it (pushing myself into it) because of the clinic's holiday schedule. She wasn't ready and neither was I. My vet advised that I not do it if I weren't ready. We tried another therapy and had success with it for a bit.

 

Re therapy: I don't know if it works for LS or not, but we've had some great success here with laser treatments. They kept a couple of mine going for quite a while.

 

I'm sorry about your IG.

Edited January 10, 2014 by GreyPoopon

[charbess]

Please, what is LS? Also, while we are at it, DH (I am thinking Dear Husband?) I need to make a glossary of the abbreviations!

[Guest MnMDogs]

I'm in the "day too early" camp too, but I disagree that if you're asking, it's time. Some of us ask early and often, and don't always go forward. (ETA: I've been early and late too. Early hurts less.)

 

I was in a similar position with one of mine before Christmas. It felt like I was being pushed into it (pushing myself into it) because of the clinic's holiday schedule. She wasn't ready and neither was I. My vet advised that I not do it if I weren't ready. We tried another therapy and had success with it for a bit.

 

Re therapy: I don't know if it works for LS or not, but we've had some great success here with laser treatments. They kept a couple of mine going for quite a while.

 

I'm sorry about your IG.

I also disagree... it's normal to have these times with our elderly hounds. If I euthanized Mork the first time I thought about it (when he fell in our bedroom, and could not get himself up almost 2 years ago) I would have lost a lot of very good time with a very happy boy, whose dignity remains in tact despite his age related issues.

 

The bottom line is, you're going to get a lot of input from people who do not know you, or your girl. This is a decision you need to make with yourself and your vet. We will all have our feelings on the subject, but we are not you.

 

Thinking of you, as I do know how difficult this is.

Edited January 10, 2014 by MnMDogs

[Burpdog]

Well, I'm not a fan of a day early. I believe in "the right day". Sometimes they tell you and sometimes they don't. Only you know your dog.

 

If the dog wants to live, I will support them in any way I can to accomplish that, usually with chiropratic, acupuncture, laser, pred (or depo shots) and chondroitin (Fresh Factors). I am fortunate to have an acupuncture vet(s) who is honest. Sometimes add chinese herbs.

 

You get to a point where it doesn't help anymore and you have to send them off, whether or not they want to. Those are the hard ones. At the end, Heart was on 40mg of pred and day along with alternative treatments. I was ready long (months) before she was She still wasn't ready and at 14 3/4 I made the decision to send her off (she had developed a horrible vaginal infection, most likely from the pred and was getting worse in the mobility area).

 

I think about what would happen if I withdrew all the meds. I think about all the meds -- there is only so much you can do. It's not up to us <sigh>

 

I usually don't say everything I want to on here but I am going to say this, something I think about quite often during these discussions: those who are quick with the needle apparently haven't done it much. I don't care if they are ready or not, it is not easy, it does not get easier. Bottom line is you are killing your best friend, whether that is looked at as kind or not. Many people like to sugar coat the act with nice words. Euthanasia is hard, period. And in the end, your friend is gone, and you did it.

[MP_the4pack]

My 15.5 yr old lost the use of her bag legs during that horrible icy winter of 2011. As I look back I wonder why didn't I take her to a specialist? Why didn't I wait until the ice melted (it was the last ice of the year). I saw a little improvement before I left her with the vets for an overnight. Why didn't I give her more time when I came back?

I have no answers.

 

So make sure you are ready as well as her.

[FiveRoooooers]

This. I'm sorry you are at the point where you are asking, but talking about it can often shed light on what we see or don't see. Like many here, I have lost far too many dogs and had to make the decision with each one to let them go. With one, I know I waited too long and it still beats me up. But I want to tell you about Pal, who has been gone a year this past October. Pal's LS finally became unmanageable. He was 14.1 and lived a grand life. I sat with him on several occasions and asked him what *he* wanted to do and think it crazy or not, we decided together. He had a wonderful last day. He ate all his favorite things. He got to go for a (very short) walk in the rain and wear his favorite raincoat. He hadn't fallen and become infirmed, but I could see that this is where we were heading. He (we!) had a lovely day together. Our vet called to give a heads up about 20 minutes before she arrived. Pal and I continued to quietly snuggle on the couch where we had been for two hours after his dinner. As soon as I hung up the phone, he sat up and kissed my nose, *I believe* saying "It's ok momma, I'm ready." His passing was peaceful and I believe in my heart that he is watching over me, every day. Though you doubt yourself, i am sure, truly, that you *will* know when it's time. Because no decision ever made with love for your hound is wrong.

 

I'm in the "day too early" camp too, but I disagree that if you're asking, it's time. Some of us ask early and often, and don't always go forward. (ETA: I've been early and late too. Early hurts less.)

 

[DonnaBehr]

Buddy developed fecal incontinence toward the end and he was mortified. He NEVER made anything in the house from the day we adopted him but because of the severe LS, he couldn't feel that he had to go. The day came that he could NOT lay down. He would go into a regular dog sit and not be able to move. He was soooo unhappy and uncomfortable at that point and we knew it was time.

[Guest Heehoo]

I always ask myself are you waiting for when she's ready or are you waiting on when you're ready? At 14 1/2, unfortunately she's probably not going to improve enough to have quality of life.

[o_rooly]

Aston's LS recently took some major progression -- he suddenly started having bouts of near-hind-failure on New Year's Eve, and I had to really start considering whether everything I was doing was delaying the inevitable *for him*, or *for me*. I knew that if I posted here saying that I was wondering whether this was the time of "a day too early," I would likely receive a response of "if you are asking, you already know the answer." No -- I don't. My heart is ALWAYS on the side of wanting Aston to be happy, and pain-free. and Happy. My brain runs at 3000rpm regardless, always the "fixer." Of course, if I let him go now, he would be saved from any pain that would happen down the road, whether it's nerve pain, or a stubbed toe. BUT -- am I robbing him of a LOT of quality time??? This is my first foray into this realm with a canine friend. It's so unimaginably difficult when they can't speak plain English.

I relayed my concerns to my vet (with whom I text often with updates on Aston) -- we are pulling out the big guns to max out his quality time. She is not in it for the money -- she often writes off expenses for us, without us asking. We have put him back on prednisone, despite its ill effects, so that he is free of arthritis pain everywhere (a lower dose than previously, and his body will be monitored as usual). Luckily, his pred side effects are not ones that mitigate the bouncy, 'roid-fueled sparkle in his eye. Increased frequency of acupuncture visits, a ton of supplements -- none of which hurt his tummy, he is well-cushioned by pepcid -- and now Adequan are in the mix. He has not had another bout of major weakness since the Adequan started, and they had greatly lessened with the acupuncture and pred. There are still options... and yes, my brain and heart both see the list of 7 medications and 9 supplements that Aston's on -- so I stay grounded and realize that I have "an old, sick dog" as my friends comment when they see what I put into Aston's food -- but you would not know it by looking at him, except for the silver face.
He greeted me with zoomies in the condo when I got home last night, and bounces onto and off of the couch without a problem. Eats with gusto as always; drinks, pees, poops normally.

I have a giant scale in my head, too -- meds and their benefits on one side, possible side effects on the other side. I reiterate and reiterate with my vet that I DON'T want Aston to feel negative effects from the medication that would make him feel crappy. If we are pulling out all the stops at the expense of Aston FEELING well (regardless of how "well" it may make him LOOK) -- well, that is not acceptable either. I am in agreement that a day too early is better than a second too late -- but I think that right now, it's "too TOO early."

Ugh, look at the book I wrote. From others' experiences, and from my own thus far, it's an ugly monster either way. My heart goes out to you. We are here for you. Any decision you make for Missy is made out of love.


Edit to add: Aston has retained fecal continence, though cleanup for me wouldn't be an issue -- but if it looked like incontinence struck and it distressed HIM, that would be another matter.

ugh. it's hard to write about this situation.

Edited January 10, 2014 by o_rooly

[Guest Heehoo]

Jan your post is beautiful.

[Guest grey_dreams]

I agree with Dianne (Burpdog). Jan, your description of Pal's last day brought tears. I am not in the "day-too-early" camp. Just look in your girl's eyes and she will tell you if she is ready and wants to go or not. As long as there is still a desire to keep going, then that is what I would do. I kind of wouldn't schedule it based on your vet's vacation days. Maybe look around for other alternatives if they should become necessary when your regular vet is gone (like ER vets or another practicing vet). It's never easy

[Guest Yankeegreyhound]

Well, I'm not a fan of a day early. I believe in "the right day". Sometimes they tell you and sometimes they don't. Only you know your dog.

 

If the dog wants to live, I will support them in any way I can to accomplish that, usually with chiropratic, acupuncture, laser, pred (or depo shots) and chondroitin (Fresh Factors). I am fortunate to have an acupuncture vet(s) who is honest. Sometimes add chinese herbs.

 

You get to a point where it doesn't help anymore and you have to send them off, whether or not they want to. Those are the hard ones. At the end, Heart was on 40mg of pred and day along with alternative treatments. I was ready long (months) before she was She still wasn't ready and at 14 3/4 I made the decision to send her off (she had developed a horrible vaginal infection, most likely from the pred and was getting worse in the mobility area).

 

I think about what would happen if I withdrew all the meds. I think about all the meds -- there is only so much you can do. It's not up to us <sigh>

 

I usually don't say everything I want to on here but I am going to say this, something I think about quite often during these discussions: those who are quick with the needle apparently haven't done it much. I don't care if they are ready or not, it is not easy, it does not get easier. Bottom line is you are killing your best friend, whether that is looked at as kind or not. Many people like to sugar coat the act with nice words. Euthanasia is hard, period. And in the end, your friend is gone, and you did it.

 

I agree with most of this. Sara was a 12 1/2 year old tripod when she was diagnosed with LS. I made a list of signs to let her go. The main one was her not eating or not taking treats. If she got to that point, no more interest in something she loved, I would let her go. LS is hard. It's not like osteo. The dog isn't in pain with LS. I was told it's more of a nuisance to them. Sara knew I couldn't make the decision no matter how many lists I made so she made it for me. Your decision will not be an easy one but whatever you decide, it will be the right one.

[Batmom]

I'm a "better a day too early" person. Been on both sides of that.

 

I much prefer that a dog is not only comfortable but is also getting a reasonable degree of pleasure out of life. If either of those conditions isn't met and if there's no possibility that they will consistently be met, then for me it is time.

[Guest k9soul]

It's such a personal situation, and while I don't think there is one right or wrong answer when it comes to the day early or day late situation, I think there can be a right and wrong answer that can vary for each person. I too have a struggling senior and go through an emotional gauntlet more and more frequently. Yesterday when she was having a bad day I had the thoughts of "am I waiting too long? What is best for her versus what I can live with?" and so on. Today she's having a good day, and I'm so relieved and grateful to have her still with me for now.

 

I think for me when the days begin to become too constant of asking myself those questions, I will have to face an agonizing decision. Meanwhile, I know she is not going to ever be restored to her former self. I know her youthful carefree days are over and that she is going to have bad days. But she does still have good days too. She's excited to eat. She runs a bit outside. She enjoys snuggling next to me at night. She gets excited to go somewhere. As long as she is still having some enjoyment, I want to treasure that with her, and not cut it too short. I know this is the right answer for me but may not be for someone else. It won't be easy, no matter how and when it happens.

 

Sending hugs to you.. I so know the emotional pain you are dealing with (and so do most people here, I suspect).

Edited January 10, 2014 by k9soul

[Acadianarose]

This is a really tough one. I also believe “better a day early than a day late”. Keeping our dogs with us is for our benefit – not theirs. In the last year, my lab has really starting going downhill. He has a lot of trouble getting up and walking is obviously painful for him. His legs have started giving out and he falls over. He will have a couple of bad days and then the next day he seems much better. DH has said several times that it will be time to let him go soon. I don’t think he is ready to go just yet. I truly believe I will be will able to make the decision when it is time.

 

I really recommend reading George’s blog entry as suggested by Susan. It really is one of the most moving things I have ever read.

 

Hugs to you and Missy.

 

Edited to Add: Don't make this decision based on your vet's schedule.

Edited January 10, 2014 by Acadianarose

[Guest MorganKonaAlex]

When Morgan started getting fecal incontinence, I decided it was time. Even though someone was home, we'd find a poop near the door. It seemed like he didn't realize the need in time to let us know. At the time, he still got around pretty good but I made the decision. In a lot of cases, it's a list of issues, not just one. He was a 13 1/2 year old tripod (one of the few that beat osteo). It had been a struggle to keep weight on him. etc...

[fliggie]

I'm so sorry about your Ig.

[dbullwinkel]

Thank you ALL for your input, advice and experiences. Missy clearly has a will to live. This morning she was more stable and took a short walk. Ate actively and continues to beg for treats any chance she gets! The acupuncturists worked on her longer, treating many areas.she will cone next Thursday again...hopefully. The front left limp is still there. She has painful spot under her left front leg..soft and movable. Acupuncturist felt it and treated the area. I rubbed arnicare gel on the area today and put a heating pad. I will let my vet know about it tomorrow, as that wasn't noticible when she was in on December 31st for depo shot and corn removal. Today was her second dose of amantadine. I know I need to give it time to work.

She is getting six fresh factors a day, as well as joint health powder. For those who use fresh factors: is that enough, or should /can I give more? I realized I ran out of vitamin E a while ago..will get some tomorrow since it helps with inflammation. I had stopped salmon oil when she a bout with diarrhea .have restarted that ( slowly) again.

I know losing my Ig has affected me greatly...and I am sure it has affected Missy as well..she has nobody to steal food from anymore. But also no one to watch over. When he had vestibular last year..she sat with him and watched over him while he slept. She is a good old girl. I just want to o the right thing by her..

Again, thank everyone for your help. I will keep you posted.

Donna

[dbullwinkel]

Yesterday was day 10 of the amantadine.

Originally she was favoring her left front, now she is holding up her right front leg down, not really putting much weight on it. She was having difficulty bending her head down to pick up her toy. That is less now. Could this be Muscle stiffness? Doesn't seem like acupuncture is helping much at this point.

She is having great difficulty walking. Very unsteady, slow, but "makes" herself do it..I am usually at her side. She is still able to go out to relieve herself. Usually restless at night..panting. Will settle down if I lay with her. She seems to want to be near me all the time..

This is where I struggle: she is still "Missy"..begging, looking for ear rubs, bringing her toy outside to lay in the yard with. But I fear she is in pain or stressed..as moving is so hard for her.
I am thinking this is the end for her..unless there is some other med that will help her. I hate to see her like this. She can no longer take NSAIDS (last two times metacam was restarted, after being stopped for depo shot) she developed bloody diarrhea...real BAD.

 

I am wondering about a muscle relaxer. would oral steroids cause same side effects as NSAIDs...

 

I sent my vet an email this morning..basically the same info I put here. There are other vets in the practice..all grey saavy .

 

If it is her time. I will take her in today....I am so so sad for her.