Osteo- when did you know it was time?

[schultzlc]

I realize that this is a sad and sensitive topic, as so many of you have been through it.  

I had a thread on Nova’s limp and diagnosis of an obviously cancerous tumor on her right scapula a couple of weeks ago.  Due to her age and overall health, she’s receiving palliative care.  The pain meds are working well, and at this time, she’s living a relatively normal life.  The difficulty in that, especially as a person who tends towards intense optimism, is having to realistically remind myself that, while the meds are making her feel better, she’s not actually getting better.

For those of you who have been there before- was there a point when things started to decline and you knew it was time to let your hound go?  I have this constant internal battle of wanting to be so careful to not be selfish and keep her for too long, but at the same time, not wanting to prematurely end her time with me.  This is my first time dealing with osteo, and I’m doing the best that I can to know what to expect.  
 

 

[Remolacha]

The obvious answer is when the max dose of pain meds don’t control the pain. Don’t hesitate to ramp up the dose, BTW, if you see any signs of pain. That said, it isn’t always that clear. My two osteo dogs both broke their legs before I even knew there was anything wrong (and the screaming was the absolute worst thing I have ever heard), but I have had two other dogs with other types of cancer, and I could see they were in pain and tired of fighting and ready to go. I have also had pets, cats and one dog, that never gave me “the sign”, I just had to  make the call, best guess.

i guess what I am saying is, other than the obvious pain thing, you just have to go with your knowledge of your dog. Sometimes you have to be the grown up and make the hard decision, and that really sucks. 
edited to add, I have always believed in A day too soon is better than a day too late, and after 20+ pets over the years I have never had cause to not believe this.

Edited August 2, 2020 by Remolacha

[schultzlc]

52 minutes ago, Remolacha said:

The obvious answer is when the max dose of pain meds don’t control the pain. Don’t hesitate to ramp up the dose, BTW, if you see any signs of pain. That said, it isn’t always that clear. My two osteo dogs both broke their legs before I even knew there was anything wrong (and the screaming was the absolute worst thing I have ever heard), but I have had two other dogs with other types of cancer, and I could see they were in pain and tired of fighting and ready to go. I have also had pets, cats and one dog, that never gave me “the sign”, I just had to  make the call, best guess.

i guess what I am saying is, other than the obvious pain thing, you just have to go with your knowledge of your dog. Sometimes you have to be the grown up and make the hard decision, and that really sucks. 
edited to add, I have always believed in A day too soon is better than a day too late, and after 20+ pets over the years I have never had cause to not believe this.

Thank you for this.  The leg break is obviously what I would most like to avoid, not that it’s possible to predict or prevent.  I’ve done some things to mitigate risks though.  Tons of rugs around the house (it’s only one floor, but the floors are trendy poured concrete), short leash walks only, etc.  For right now, Nova’s pain seems managed, but that’s something I’ll be watching like a hawk too.  
 

 

[GreyPoopon]

 

1 hour ago, Remolacha said:

The obvious answer is when the max dose of pain meds don’t control the pain.

Basically, I agree with this. The sticking point, though, is the definition of control. 

The OS rate in my departed hounds has been close to 50%. Yes, really. I've found that that I'm sending them off earlier and earlier. If they start to limp badly when the meds are maxed out, I say goodbye. I know that we might miss a good day, but I also know that they can have an even worse day. 

[schultzlc]

13 hours ago, GreyPoopon said:

 

Basically, I agree with this. The sticking point, though, is the definition of control. 

The OS rate in my departed hounds has been close to 50%. Yes, really. I've found that that I'm sending them off earlier and earlier. If they start to limp badly when the meds are maxed out, I say goodbye. I know that we might miss a good day, but I also know that they can have an even worse day. 

Thank you.  I appreciate this perspective.

Right now I’m having major issues getting Nova’s gabapentin refilled because of TN’s laws regarding controlled substances.  We are going to run out tomorrow morning, and I’ve been working hard the past few days to try to figure out a solution.  Really worried about what happens if I can’t get her medication. 

[ShebasMom]

Maybe get the gabapentin from the vet while fighting for the refill? Or is the problem at the vet's?

[dante2zoe]

I have had 3 OS dogs and the first sign in 2 of them was a broken leg.  I wouldn't wish that scenario on my worst enemy.  I only say that because it has certainly influenced my thought process in dealing with this.  Our 3rd OS dog was Sherman and it was found due to a limp.  In his case, as soon as I had to up his pain meds, I called it.  I could not let him be in pain.  However, as with most things, the best laid plans, yadda yadda.  We scheduled it with our favorite vet and she would come to the house.  Of course, his pain increased dramatically overnight and she was off for the next 3 days.  So, we had to take him in and with a vet we never met before.  But, to stick with your question, in my personal experience, when the pain began to increase, it kept increasing and didn't level off like it did when meds were first introduced.  We had about two weeks from diagnosis to when we let him cross.  In order to keep him from panting, the meds basically knocked him out and that's not living.  

I am so very sorry and wish you peace.  What is Nova telling you?  I literally sat down with Sherman and talked out loud about what he had and asked how he felt.  I sat with him for hours and rubbed his head and we just were.  He slept best that way and I just knew.  

Gah.  I so loath this disease.  

  

[schultzlc]

35 minutes ago, ShebasMom said:

Maybe get the gabapentin from the vet while fighting for the refill? Or is the problem at the vet's?

The problem is that the vet wrote the script for 30 pills, one per day, but then told me I could give two if I felt more comfortable.  Nova is doing well on one in the morning and one in the evening, and I truly believe there’s no reason to be conservative on her medications.  But now that pharmacy won’t refill until 30 days because of how the prescription was written, and the vet can’t seem to rewrite a new prescription because of TN’s controlled substance laws.  I’ve been on the phone with everyone this morning, trying to figure out what we can do.  This is so frustrating.  

[schultzlc]

44 minutes ago, dante2zoe said:

I have had 3 OS dogs and the first sign in 2 of them was a broken leg.  I wouldn't wish that scenario on my worst enemy.  I only say that because it has certainly influenced my thought process in dealing with this.  Our 3rd OS dog was Sherman and it was found due to a limp.  In his case, as soon as I had to up his pain meds, I called it.  I could not let him be in pain.  However, as with most things, the best laid plans, yadda yadda.  We scheduled it with our favorite vet and she would come to the house.  Of course, his pain increased dramatically overnight and she was off for the next 3 days.  So, we had to take him in and with a vet we never met before.  But, to stick with your question, in my personal experience, when the pain began to increase, it kept increasing and didn't level off like it did when meds were first introduced.  We had about two weeks from diagnosis to when we let him cross.  In order to keep him from panting, the meds basically knocked him out and that's not living.  

I am so very sorry and wish you peace.  What is Nova telling you?  I literally sat down with Sherman and talked out loud about what he had and asked how he felt.  I sat with him for hours and rubbed his head and we just were.  He slept best that way and I just knew.  

Gah.  I so loath this disease.  

  

Thank you for telling me about your experiences.  For now, Nova is still her perky, goofy self, which is making this difficult.  Also, I am so sorry you had to go through this 3 times.  

Edited August 3, 2020 by schultzlc

[ramonaghan]

moved to PM

Edited August 3, 2020 by ramonaghan
rules

[schultzlc]

21 minutes ago, ramonaghan said:

Laura, I have an almost full 84 count container of 100mg Gabapentin. It's yours if you need it!

Rachel, thank you, I’ll respond to your PM.

[zimsmom]

For me its just a look in their eyes that says "I am done" 

[GreyPoopon]

I hope you're able to get more Gabapentin.

[schultzlc]

12 hours ago, GreyPoopon said:

I hope you're able to get more Gabapentin.

I was, thank you!  It took a few hours on the phone yesterday morning, but we are now back in business, and have access to the meds to keep Nova comfortable.  
 

It’s an unusually chilly morning here in TN, so we are currently lounging on our back patio, just smelling the wind and watching the birds.  ❤️

[smt]

2 hours ago, schultzlc said:

 

It’s an unusually chilly morning here in TN, so we are currently lounging on our back patio, just smelling the wind and watching the birds.  ❤️

From a fellow Tennessean, my heart is with you.  So glad you and your girl have been able to enjoy this amazing wether together the past few days.  

[schultzlc]

33 minutes ago, smt said:

From a fellow Tennessean, my heart is with you.  So glad you and your girl have been able to enjoy this amazing wether together the past few days.  

I appreciate your kinds words.  And yes, this has been a wonderful reprieve from the heat we had in July!

[LBass]

My beloved MoMo Meany Pants was with me for nearly 6 month after osteo was diagnosed in her left rear foot.  Knowing when to make the dreaded call is so hard.  For me, the deciding factor was how much help she needed from me in getting up and down and in managing stairs to the back yard.  Mo hated to be assisted in any way.  I still laugh at the memory of her reaction when I tried to put a towel under her tummy to help steady her down the stairs--she whipped her head around to glare at me, turned smartly around, and stalked back into the house.  How dare I!   She tolerated a support harness well but when that was not enough and she was clearly having a harder time getting up and maintaining her dignity, I made an appointment with my vet, who was kind enough to come to the house.  Mo and I spent a lovely afternoon cuddling in the sunshine in the backyard--sunbathing was her favorite thing.  Weirdly enough, throughout the process, I asked her to let me know when she was ready and I think that she did.

 

I'll share one of the deeply precious and weird experiences of my life, since it involves the decision about when to let a dog go, though not because of osteo.  Piper the Perfect had GME, a debilitating but sometimes manageable neurological disease.  There were 3 meds to try.  If one worked the vet said the recovery was almost "miraculous".  Med #1 did not help.  Piper was struggling to get up and needed me to lift and steady him always.  Did I try meds #2 and #3 or let him go?  He was my heart and I agonized over this decision.  I decided to try med #2.  Then I "heard" the words "Through. Through. Through." in my head.  I firmly believe that was Piper letting me know he was ready, even when I was not.  "Through" was not a word I ever thought of using in this situation.  It felt distinctly like something from outside being communicated to me.  I'm not a particularly fanciful person, but this experience with Piper is why I always ask my animals to tell me when they are ready to go and try my best to be open to either answer.

Sending you warmest good wishes for wisdom and comfort.  

[GreyPoopon]

12 hours ago, schultzlc said:

It’s an unusually chilly morning here in TN, so we are currently lounging on our back patio, just smelling the wind and watching the birds.  ❤️

Wonderful.   

[GreytMom]

I feel your pain and discomfort with this decision. My osteo girl has been generally doing well, but today not so much, and no more than an hour ago I asked her if she was telling me it was time. But she wagged her tail. I don’t think it is yet, I think she was just wanting some extra love. 🥰 Which, of course, she got! But I too am in the waiting and watching process. My last grey with osteo, if he had spoken English it wouldn’t have been more clear. He looked me in the eye one morning and told me it was time, he was done. I let him go that afternoon. 😢 It sounds like your girl is still living a relatively happy life... and I hope she continues to for many months. Best to you and your girl. Cancer sucks. 

[schultzlc]

On 8/4/2020 at 8:38 PM, GreytMom said:

I feel your pain and discomfort with this decision. My osteo girl has been generally doing well, but today not so much, and no more than an hour ago I asked her if she was telling me it was time. But she wagged her tail. I don’t think it is yet, I think she was just wanting some extra love. 🥰 Which, of course, she got! But I too am in the waiting and watching process. My last grey with osteo, if he had spoken English it wouldn’t have been more clear. He looked me in the eye one morning and told me it was time, he was done. I let him go that afternoon. 😢 It sounds like your girl is still living a relatively happy life... and I hope she continues to for many months. Best to you and your girl. Cancer sucks. 

I hate that you are going through this as well.  It’s heart-wrenching, but we do the best that we can and take everything day by day.  I hope that you get many more good days with your girl.  

[schultzlc]

Today I got my own answer.  The site around Nova’s scapular tumor is starting to swell and she looks tired this morning.  I talked with her about it, and she licked my face.  Nova is not a licker, and this was the first kiss I’ve gotten from her ever.  I promised her that I would let her go in grace.  The mobile vet who helped Luna pass a couple of months ago is able to come tomorrow at noon.  I’m grateful that we’ll be able to do this peacefully at home again.  I’ll be holding her extra close until it’s her time 💔

[ShebasMom]

I'm so very sorry that it has come to this decision, but it's the right one. Having the vet come to the house is going to make it a bit easier on both you and Nova. My heart goes out to both of you.

[dante2zoe]

Thinking of you both today while you travel this road.  My heart breaks for you both.  When my bonded boys passed within months of each other, it gave me comfort to think that Goose needed Maverick more than I did.  I imagine that Luna needs Nova, too.  Wishing you a peaceful transition.  

[ramonaghan]

Wishing you strength and peace.  

[Remolacha]

I am sorry you didn’t have more time