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Dear Doggers,

11 year old June was diagnosed with lymphoma and we decided against chemo. Two weeks later she was dead. I regret her death but not our decision. Your experience will be different in its particulars and may enlighten all of us. http://www.nytimes.com/2012/04/06/us/new-treatments-to-save-a-pet-but-questions-about-the-costs.html?hp

 

Donald McCaig

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although i would not spend that kind of money on my dogs (don't think my finances would let me even if i wanted to!), i'm glad somebody is doing it. hopefully it will lead to new ideas, treatments,knowledge that will help all of us keep our friends a little longer and pain free. some kind of trickle down effect. very sorry about june. from your stories, i know she had a terrific journey.

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I haven't been faced with that decision yet, and I hope I never am. I just hope that if I am, I can face it putting the welfare of the dog ahead of my own desires, which I think is what you did. I also do not feel that I could put a great deal of money into implementing a treatment that did not have a very high likelihood of a positive outcome, and maybe not even then.

 

I remember a list I used to be on, reading what people (often young people) wrote about their problems with an ill animal, their credit cards all maxed out, and not being able to deal with paying for vet care - when they already could not afford the treatment in their situation. Sometimes, no matter how much we feel otherwise, we have to face reality, both with regards to the animal and potential treatment/outcome and with financial ability/inability to afford treatment.

 

June had a very good run with you.

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This is a hard question. I'm pretty sure I wouldn't put another beloved dog or cat through what we put Buzz through. It was very hard on him, and expensive.

 

A younger animal, with a better prognosis? Buzzie was 10, and the prognosis for bone cancer is about 50/50.

 

Don't know.

 

Again, I'm so sorry to hear about June.

 

Ruth and Agent Gibbs

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Quote from the article: Will treatment give it a good quality of life, or merely extend it?

Cancer treatment for geriatric dogs, including cytostatica, radiotherapy, and bone marrow transplants? Most likely the second with the added misery of the suffering due to the effects of the therapy itself.

 

For me the question is not very difficult. We had to put down a relatively young dog (6 years) due to cancer. She was a great character, we all loved her,but the best thing to do in her situation was to let her go.

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My condolences to you and yours, Mr. McCaig.

 

There are so many variables to consider when making a decision about our pets’ health care that it’s almost never a cut-and-dried, black-or-white situation. When Lewie was diagnosed with Evan’s Syndrome, had he been 14 years old rather than 4, I most like would have opted for euthanasia to spare him any more suffering. Even during his treatment, while he was so very sick and both the vet specialist and I thought we might lose him, I questioned whether I was doing what was best for my precious boy.

 

Happily, he is now in remission and back to his pre-Evan’s happy, clownish ways. I will most likely always be waiting for the other shoe to drop, however. If /when that day comes, I will have to weigh the facts to do what is best for him.

 

We each have to do what we feel is best for our pet, and ourselves, at the time. No one can make the decision for us. It’s part and parcel of being a responsible pet owner.

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Sometimes, letting go is the costliest and most loving decision of all.

 

Often, we pursue these alternatives because we can, and not because we should. I see many pet owners make decisions based on whether they can afford some exotic treatments before they decide on the healthiest alternative for their pets — so when they can't afford a bone marrow transplant or specially mixed pharmaceutical, they come away feeling as though they have failed their beloved dog or cat.

 

Suddenly, our investments in those relationships become a measure of our wallets rather than a measure of devotion, or even responsible care.

 

I came face to face with this conundrum when a beloved old cat fell victim to blood pressure and kidney problems that left her blind. I ordered the medicine, gave her a dose and realized, 24 hours later, that I was sentencing her to a horrible life because I was unwilling to give up. I realized then that promoting her welfare was about comforting me, and not about caring for her.

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As far as cancer goes, if it was a younger dog and there was a good chance that the dog would continue to have good quality of life because of the treatment, I'd consider a more invasive treatment though my financial limit would probably be around $5000. With an older dog the treatment would have to be minimally invasive and allow for good quality of life for me to consider it.

 

When I got Missy's hemangiosarcoma diagnosis, the decision was made for me. The primary tumor was on her spleen, but it had already metastasized. So I kept her on pain meds, adjusting them as needed, and spoiled her rotten. She only had a handful of bad days in those last 8 weeks. Her last afternoon was a bit groggy from the drugs and cancer but she was relaxed, wagging her tail and wanting attention.

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I agree that there are many variables to weigh. My Sophie was diagnosed with a mast cell tumor when she was nine. My options were to do nothing, remove the tumor only, remove the tumor and do chemotherapy, or remove the tumor and do radiation. Doing nothing or merely removing the tumor meant she would likely be gone within a year (the location of the tumor made getting clean 5mm margins impossible). Chemotherapy would likely give her a cancer-free life extension of three to five years, and radiation would likely give her a cancer-free life extension for five-plus years. I struggled a bit with the decision, but I decided to go with chemotherapy because MCTs are one of the very few cancers that respond well to chemotherapy. (Most dogs also tolerate chemotherapy pretty well--I would have stopped treatment if Sophie was one of the rare ones who didn't.) The cost was $3,000, which is expensive, but I was in a position to spend the money at that time. Sophie will be twelve next month, and her quality of life is exactly the same as it was before her chemo treatments. She does not act like an old dog--she has slowed down a bit with age, of course, but she is still very, very active. There have been no recurrences of the tumor so far. I keep my fingers crossed, and I do not regret my decision to treat her cancer.

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I lost my first two Border Collies to hemangiosarcoma. Duncan's tumor was in his heart. It was only caught during routine screening to see if he was healthy enough to undergo anesthesia to have a broken tooth removed. Chemo would have doubled how long he lived, but he was only given 7 to 14 days without treatment. That meant that with aggressive treatment I might have extended his life a week or two. He went into heart failure just days after being diagnosed. We managed that with meds for a week before admitting defeat and letting him go peacefully in my arms. Survival time, 10 days.

 

Flyboy's primary tumor was on his liver and had already spread to other organs in his abdomen by the time we figured out what was wrong. (He presented with vague symptoms of vomiting a few times.) In the space of a week his blood values went from totally normal to high elevations in his liver enzymes. The tumor had grown exponentially in size and was now easy to feel in his abdomen. Ten days after he first started to act sick the tumor bled and he collapsed. He also went to sleep peacefully in the arms of myself and my family.

 

I don't regret not treating either of them. I spent those last days feeding them tasty human food like steak, cheese and eggs. We lounged in the sunlight together. Duncan liked to watch the birds and insects fly past, occasionally snapping at a beetle that got too close. Flyboy spent his last hours by the fence watching the goats graze, his favorite activity in his retirement years.

 

Had the prognosis been better with treatment I might have attempted to buy them some time, depending on how hard the treatment would be on the dog and how much longer they would be expected to live. I don't think dogs understand getting to live 6 months longer, but they do understand being happy and pain free in the moment.

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I don't think dogs understand getting to live 6 months longer, but they do understand being happy and pain free in the moment.

I think this sums it up for me. Even when I was making a great salary, I don't think I would have bankrupted myself trying to provide the latest and greatest medical care for one of my pets. In hindsight, I've done more than I should have for some, definitely.

 

When Willow had a bad response to chemo for her mast cell cancer, I decided to go the route of palliative care (I had already put her through alternative med treatment, surgery, hig-dose pred, and rounds of two different chemo drugs), because as Liz points out, the dog doesn't really know that you're "buying it time;" it just experiences suffering or not. Where would it have ended? For me, that decision was made when Willow became quite ill and her liver enzyme values went through the roof. I was in effect killing her while trying to save her. I firmly believe that a shorter life, well and happily lived isn't a bad thing.

 

In Willow's case she actually went into remission for a while, so I got lucky. She'll be 15 in June, but a small mass has appeared at the same location as the original tumor, she's suffering with bouts of anemia, and of course her heart is causing problems as well, despite the treatment she gets for that. She's much quieter than she ever was, preferring to stick near me. I have discussed the latest issues with my vet and he concurs that palliative care is not a bad choice to make, especially given her age. And I will have to be observant enough to know when her quality of life has gotten to the point where it's no real quality.

 

If I had all the money in the world, I wouldn't necessarily put a pet through all sorts of invasive or painful procedures. With humans, you can explain to them the necessity of what they're going through and the expected or hoped-for outcome. You can't do that with pets, and that fact for me is a big decision driver. I don't know how many cats in renal failure I have put through all the fluid therapy, etc., and that's not even expensive to do. But I've thought long and hard about that. It may not cost me much in the way of time or money, but does the cat understand or care why it's getting stuck with a needle and filled with fluids on a daily basis? Or the cold that comes from those fluids? Or the nausea that doesn't go away despite the fluids? Or the food it doesn't really like to eat? Is that a life the cat should be living?

 

Clearly, we all need to make our own choices, but over time I really have come to believe that quality of life and palliative care should play a large role in any decisionmaking process.

 

J.

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Liz P, on 06 April 2012 - 09:06 AM, said:

 

I don't think dogs understand getting to live 6 months longer, but they do understand being happy and pain free in the moment.

 

Julie writes:

 

I think this sums it up for me. Even when I was making a great salary, I don't think I would have bankrupted myself trying to provide the latest and greatest medical care for one of my pets. In hindsight, I've done more than I should have for some, definitely.

 

 

Ditto for me. It's such a hard decision to know when enough is enough. If we error in the name of to much I think they forgive us but for me quality not quanity is my main goal, I just wish it was easier to see the difference when I am so involved with my heart.

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.. because as Liz points out, the dog doesn't really know that you're "buying it time;" it just experiences suffering or not. .... I firmly believe that a shorter life, well and happily lived isn't a bad thing.

 

... I don't know how many cats in renal failure I have put through all the fluid therapy, etc., and that's not even expensive to do. But I've thought long and hard about that. It may not cost me much in the way of time or money, but does the cat understand or care why it's getting stuck with a needle and filled with fluids on a daily basis? Or the cold that comes from those fluids? Or the nausea that doesn't go away despite the fluids? Or the food it doesn't really like to eat? Is that a life the cat should be living?

 

... I really have come to believe that quality of life and palliative care should play a large role in any decisionmaking process.

 

J.

 

I agree that longer is not necessarily better for the pet - and the best interests of the pet should be put first.

 

Having said that, I have also had a cat in renal "failure", but my experience was that the cat had a very good quality of life until the last two months - and I regret not being brave enough to make the decision at that time. For over 2 years of his life (~17-19 years old), my cat loved the goat milk he got morning, noon and night. He ate a normal, high-quality cat food (I would not feed him that awful corn-based Rx food the vet wanted to sell me), he had no 'accidents' - although he peed buckets and litter usage tripled, he was normally mobile and slept up on our bed every night. (Actually, he spent more bed time with me during his lifetime than my husband, who travelled a lot.) Although the vet suggested daily fluids, I gave fluids every other day because I felt that if I needed to do more than that, I would have to seriously think about continuing to extend his life in this manner. I think he actually LIKED his fluids -- I would warm up the fluids in a bowl of hot water, he would settle in my lap and I could feel him relax as the warm fluids went in. The 200cc took only about 5 minutes, every other day. Then, as I said before, the last 2 months he took to staying in a closet where I provided a bed, food (he still ate) and a litter box (he still used it). I had to give him daily fluids, and he no longer came up to sleep in bed. He was obviously not happy. I finally realized that, and ended his suffering. Next time, I hope I will make the call earlier.

 

Jovi

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I don't think dogs understand getting to live 6 months longer, but they do understand being happy and pain free in the moment.

Well said, Liz. Thank you.

 

I have made the mistake too often of keeping on an animal that no longer had the quality of life they deserved because I could not bear to lose them, and that was the ultimate in selfishness.

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I've heard many an owner say that they regret waiting as long as they did to euthanize, but I've never had anyone tell me they regret euthanizing too soon.

 

When Briggs was at Canada West and they internist did the ultrasound (he had an acute attack of pancreatitis) he told me that in all his years of doing this, it was the single worst case he had ever seen, that there was absolutely no hope of recovery and that if I wanted him to, he would euthanize him on the table right then and there. I didn't really regret giving my dog a few more days at home before we let him go, but I was grateful for the information because it gave me a very realistic idea of Briggs' chances (zero).

 

A few days later when he soiled himself in my bedroom and turned yellow from jaundice and I brought him to my own vet, he was also firm in his conviction that it was time to put him to sleep. I was grateful to him as well, because I've had friends with very determined vets who pushed further treatment to no avail. I was out of money anyway, but I would have been fairly vulnerable to any glimmer of hope, I think, as pragmatic as I am. So I am still very thankful that both the veterinarians I dealt with were honest, practical and had the fortitude to tell me this.

 

If I were to do it over again, I might have brought Briggs home for 24 hours and spoiled him like mad, and euthanized him right at his high point - he rallied a little bit for a day or so, started eating and wanting to go for walks. In some ways, in hindsight, I wish he'd gone out on a high note. Still, those extra few days were time enough to process that the end was coming, and I know he'll forgive me for waiting a couple more days. He was a good dog and he had a lot of faith in me to do right by him, and I hope I did.

 

I love my dogs, but I think that in the future, my plan for anything terminal will be to manage pain and discomfort until it's no longer possible, and let them go when they are still feeling okay-ish. It's easier said that done, maybe, but I hope I will be able to do that. I don't get my pets' remains back because I prefer to remember them as whole and healthy beasts, not a pile of bone and ash in a jar on my windowsill. So I want to be able to apply that philosophy to their health and well being too.

 

Except Tweed. Tweed has to live forever or I will be very, very upset with him!

 

RDM

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Thank you, Sheena, you always put things in perspective very well.

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Dear Fellow Mourners,

 

I thank all who have contributed so honestly. I hope our discussion may help others to face an extraordinarily painful decision. I can think of two beloved dogs we kept alive a couple days longer than we should so they could die a "natural death". I believe I was mistaken.

 

In her wonderful, healing essay "Oyez a Baumont" (Animal Happiness) Vicki Hearne wrote: "All dogs are Immortal until they die."

 

Donald McCaig

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What a wonderful thread. One more thing. The experiences I've had with euthanizing beloved animals piggyback onto one another. If I'd not had that experience with Buzz, I might had tried to do more and created more suffering for Samantha and Shoshone. Thankfully, even with a breaking heart, I knew clearly what was the best thing for my wonderful girls.

 

And, we have to fit this into our whole world. Buzz was diagnosed 6 weeks after my father died. I remember thinking, "I can't lose him right now, I just can't."

 

It's never easy, I always think my heart is simply going to stop beating from the loss. It doesn't, and I go on.

 

Thanks for all the wisdom, shared so well.

 

Ruth

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Sorry for your loss but thank so much for bringing this up.

 

I done alot of thinking on this. Last year a friends 10yr. old aussie came down with cancer..she went the route of chemo. Yes dogs handle chemo better then people..but there was still weekly trips to the vet, shots. blood work etc...Dog went into remission only to have cancer return..dog died 7 months after the cancer was first found.

 

As the owner of a 13yr old dog and soon to be 14 yr old dog..I've made the decision that as much as it will hurt I will not put them though any kind of medical treatments. Other then meds to keep them comfortable. I do not wish to fill their last days with tests, shots, trips back and forth to vets, etc.

 

My friend with the aussie thinks "I owe it to them" to do all I can for them, like she did for her dog.

 

To each their own and there is no right or wrong decision. I will not comment on others decisions.

 

 

But thank you Donald for coming forward..I know my decision for my dogs is the right one. But nice to know others feel the same way.

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Yes dogs handle chemo better then people..but there was still weekly trips to the vet, shots. blood work etc...Dog went into remission only to have cancer return..dog died 7 months after the cancer was first found.

 

Just wanted to say that was not the experience I had with my dog. We didn't have to do weekly trips to the vet. Her prognosis was quite good. Each case is different.

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Oh my, all these responses are so meaningful, considerate and straight from the heart. Such good points brought up and to consider. Twice, I have been at the crossroads of this type of situation, and both times, wished I had not gone for the extended treatments and just brought Dixie (my first dog I got at 12 years old, a brittany spaniel bird dog) and my Ol' Sally hound dog (that I had for 16 years) them home and allowed them to die with me at home and not at the vet's office. I did not expect them to die there, it was in the hopes that they could be helped, you know, just stay overnight for observation. Please, Dear Lord, help me next time to stand by that decision and bring them home, especially if they are older. Did I have their best interest at heart? Sure, I did. Was it also partly cause I wasn't ready to let them go yet. Sure, it was. Life's a funny thing and we all just try to work it through the best we can at that point in time.

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I believe the euthanasia survey results showed that 95% of owners feel they waited too long, 5% said they chose the right time and no one felt they had done it too soon.

 

Some types of cancer have an absolutely dismal prognosis, others can be managed or even cured. I had a patient with lymphoma of the nasal passages that lived for 18 months. I know of a dog with cutaneous lymphoma who lived 4 years after a single round of chemo. Even though osteosarcoma (bone cancer) has a terrible prognosis, I know of a dog who lived 10 YEARS after an amputation and chemo (he was 2 yrs old at the time of diagnosis). Eventually he relapsed at 12 years old, at which point his owner elected to let him go.

 

Unfortunately, far more animals did what the text books said and lived only days to months after diagnosis. For their owners, humane euthanasia was a release that saved their pets from suffering a drawn out, painful death.

 

Aside from a childhood cat that was hit by a car, I have put all my animals to sleep. I've seen too many die a natural death in the course of my profession to want that end for my pets. With both Duncan and Flyboy I do wish I had let them go a few days earlier. In Duncan's case his heart was failing and the drugs couldn't keep him comfortable any longer. It would have been better to let him go at the first sign of failure. In Flyboy's case I was hoping for a few weeks to say goodbye, but the tumor bled. I am grateful I had time for my family to arrive so everyone could be there when I put him to sleep.

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With Maddie we had to stop, due to cost and her quickly deteriorating health, before even getting a clear diagnosis. We did everything that we could reasonably afford to do - bloodwork to check her organs, a stomach x-ray, various medications. By the time more in depth diagnosis was being considered, she was starting to starve herself to death. I don't believe, at that point, that there was anything that we could have afforded to do for her, even if we had gotten a diagnosis, and I honestly don't believe that anything could have been done at that point.

 

I also believe she had cancer. I don't know that for sure, but it makes sense in a lot of ways.

 

In the end, it didn't matter. I simply could not let her starve herself to death, so when it was clear that she was suffering, and afraid, and that she was just not going to get better, I made that hardest of decisions. I don't regret it because at that point there was no reasonable hope and I didn't want her to go through starving. I'm sorry that I had to - I wish she could still be here. But given the circumstances, I know it was the right thing to do.

 

And even though I wish I hadn't had to make the decision, I am very, very glad that Maddie didn't die alone. She was laying on her mat, with her head on my legs, just like we always hung out before we went into the ring to run Agility. I don't know if that gave her any measure of comfort, but I know she wasn't alone, and that helps me to some degree.

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I have twice opted to delay a dog's passing - in both cases more for my interests or the interests of loved ones than for the dog, I believe. I have tried to make myself a firm promise not to do this again, and hope I can stand by my decision when the difficult time comes.

 

I wish, too, that we could set up a culture that allowed me to make a similar decision about my own life.

 

Mary

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I have made the decision both ways - it depends on the circumstances.

 

Even though Sara was 14, she was in great health and not symptomatic. Her hepaticelluar carcinoma (liver cancer) was discovered on palpation during a routine exam. It was believed that surgery could possibly buy her another 18 months or so and I opted to have 40% of her liver removed. She lived almost another 3 yrs with a very good quality of life and I don't regret the decision to treat her at all. She then developed hemangiosarcoma and was gone in less than 10 days.

 

Katie, on the other hand, had advanced lymphosarcoma by the time she showed any symptoms and was diagnosed. My vet did not feel treatment would buy her more than a few weeks, and I opted to keep her comfortable and euth'd as soon as she showed signs that pallative care wasn't enough.

 

For both dogs, I think I made the right decision for that particular dog but I can't say either was an easy decision to make.

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