Please help me think this through

lostinrates

The decision is mine, I know that, but I am trying to make it clearly.


One of our dogs (big dog) actually belongs to my parents who separated and lives with us because we lived in their home with our dogs and she bonded with them and we decided it was kinder to keep the dogs together Nd easier for my parents, who are not young, too old really to handle a big dog.


Big Dog is nearing the upper end of her life expectancy and has a bad back for which she takes pain killers and sometimes a muscle relaxant, but otherwise has been fit healthy and bouncy. The back can be very pain ful and is degenerative and we have paid for treatment ourselves as its just pain killers, our decision was to save insurers co for a big deal. (Parents pay the insurance)

But a lump came up and having had it checked it is an aggressive cancer.

Insurers are now being difficult because the names policy holder is not the same address given for the dog. When I called tonight to ask if they would cover an op they wouldn't deal with me but did call my vet. My vet said all they were interested in was who they dealt with, I had already explained that the vets dealt with me. (Incidentally all our pets for some reason are registered with the vet only in my husband's name, its never been a problem, but we self insure our own pets mainly).


Now, presuming we have to cover this and insurers don't step in I don't know what decision to make.


Pro going in is obvious to any one on this board I would hope. She is Big Dog, we love her. anti, is that she has existing other problems that made us believe this was her last Christmas, we might be throwing money at something that might have spread already and even if it is contained for the lump we are probably buying a few months. Big Dog had a lot of operations as a you g dog, hates vets and doesn't cope with pain well, she is not stoic, and I cannot bear the idea of her having a busy vet ending to her life, (unlike the middle one, who would trot to the vets every week happily for the attention thank you very much). If it were a one of lump removal attempt ok......but a lump to find a spread to put her down in a short period of time .....is that fair to THIS person of a dog?

We have lost two other beloved animals this year, and I am worried I am in turn being either fatalistic unnecessarily prematurely or otherwise that I am desperately trying to keep her going impacted by those deaths (also old age/forced by health decisions, one timed, one emergency).


If the insurance cover it, I think I would have the lump removed and a look see and her put down in the table if it has spread :(. so am minded to do the same with our own money. Does that seem in her best interests, or mine? I cannot tell this evening. .

rising_from_the_ashes

So sorry to hear about big dog ....

The only advice I can really offer is to set the money issue aside and try to look at it in terms of her quality of life

If she already has other conditions and life can have its ups / downs, is it in her best interests to put her through an op for maybe a few more months?

On the other hand ....

If she still lives life to the full, the good days outweigh the bad and she has a good quality of life then it is def worth thinking about putting her through the op - obviously after taking into account what your vet things are her long term outcomes

(((hugs))) hope that helps a bit

lostinrates

Thank you rising from the ashes


I don't think its fair on her to buy a few months. She doesn't like vets, she'd dislike being a regular attendee.
A one off and return for stitch removal......yes, that would be fair I think.

The good days outweigh the bad on medication. We knew the end was coming. My parent who owns her is Distraught and wants to come and see her (of course , its a given!). and then had a yell when I asked them to buck up before seeing her as I don't think its fair to big dog to have distraught behaviour around her. .


Edit...have left a message for the vet to ask if we'd be likely to see secondaries etc. been there before where none showed up on screening and ended up nursing a sick dog for too long.......this dogs sister.

Better_Days

Very sorry to hear about Big Dog LIR It's so hard to know what decision to make and when, especially when the animal is coming near to the end of their natural lifespan.

I agree that it is important to focus on quality of life. I would consider having a chat with the vet to see how well he thinks any post op, and her other pain can be managed to keep her comfortable.

If the pain can be well managed (with max doses if needed) then I would probably go for an op to remove the lump, if possible, and ascertain if the growth has spread. If it has spread I'm not sure I would have her PTS on the table. For a dog that hates vets I would consider having her PTS at home where she feels safe and relaxed.

If you do decide to go down the route of an op could your vet prescribe something to 'chill her out' before you take her in so that the experience is not so stressful for her?

Her best interests are to be as pain free as possible, to enjoy her food, her walks and lots of love and cuddles. While she still has these then you are doing the right thing in continuing with veterinary care. The change from this to when it is time to consider having her PTS tends to be a process rather than a discrete event, and really only you can decide taking into account all elements of her life.

Your other option would be to decide against invasive surgery and focus on keeping her as comfortable as possible for as long as you can. In the circumstances you have described, I would seriously consider this too. Is your vet approachable? You could do with discussing the pros and cons of the different courses of action and how the consequences can be best managed.

At the moment it seems that her pain is well controlled and she is happy. I think the very fact that you are agonising over this indicates that you are doing your level best to make the decision in her best interests rather than yours.

lostinrates

My vets are great, I like the head vet a lot, we are on the same wave length, but he is a specialist ina. Different area, and this is not it.

The other vets are quite surgery driven I think, BUT they are all excellent and IMO the standard of care there is fabulous. I drive some distance to go there because I trust them a LOT. Sadly however this means PTS at home is not likely to be possible, though I could ask head vet if as a favour he or his partner might consider going the extra few miles......I think the time of year might make that a bit harder if it becomes pressing.


The other concern I have is that PTS at home, while nicer for big dog and easier for the others to understand poses certain practical difficulties.

Lifting big dog for disposal is not going to be an easy task at all. I know what car my head vets have and she won't fit in that so I'd have to drive her to the surgery, then take her in and there would need to be my DH and another strong person to carry her. ( he can manage her alone alive, but from experience a dead big dog and a live one are different things altogether.


I'm sorry its all so graphic and horrid , but its the facts really.

elsien

I think I'd be talking it through with the vets a bit more as well - mine has always been pretty up front about saying what they think is best for the dog, and looking at the different scenarios.
I do tend to the better a day too early than a day too late school of thought. Your plan to have the lump investigated then taking it from there seems reasonable on the face of it, I think maybe you could talk through what happens if its bad news options a bit more though, rather than pts. Purely to see what quality of life and for how long, given Big Dogs particular issues. My sympathies, either way, its hard for all of you.
Edit - would it be possible for the animal cremation people to pick her up from yours, instead of the vets having to take her away. Presuming that's a route you want to go down.

phill99

My lovely 6 yr old border collie was diagnosed with an aggressive cancer in October. Cancer in dogs isn't curable.

Chemotherapy is available but has to be done weekly (in my dogs case) and at the most can defer the inevitable, maybe by a few weeks maybe by a few months. It is very distressing for the dog to undergo chemo and very debilitating. Apart from that, it's very expensive. Not sure if insurance covers chemo given that it can't cure them.

He ended up going on steroids for a few weeks, but these have their own side affects. I got another month out of him and he became very poorly over a weekend and I made the decision to de the kindest thing and he was PTS just over a month ago.

The thing you must focus on is the welfare of the dog. It's what is right for the animal, not what you want. It's an awful decision to make. My dog wasn't insured as I self insure, but the money was there to treat him. If he could have been saved, I would have saved him. The money was irrelevant. But he couldn't, so the financial side was academic in the end.

Just make sure you do what is right for the dog.

Better_Days

Just to add that in circumstances like this I don't think there is necessarily a 'right' or 'wrong' decision. All there is is the best you can decide given the information you have at the time.

A good vet at a time like this is invaluable. Have a chat with the head vet especially as you are on the same wavelength. This may not be his area of speciality but he will be very experienced in judgement calls of this kind and as he knows you he will also be able to take into account your approach to caring for your pets.

Sorry that the practicalities of PTS at home are so difficult for you. I don't want to upset you when things are still so uncertain but some pet crematoria do collect for you.

lostinrates

Insurance or not I have already decided chemo would not be right for big dog.

Her personality beyond all would rule it out as beneficial.

peachyprice

I would definitely consider agreeing with the vet to PTS on the table if the cancer has spread. Having her stitched back up, woken, taken home and then PTS is unnecessary and more for the benefit of the human than the dog, if he's anaesthetised it makes sense to do the easiest thing possible for HER.

As long as I could be there in the building when she went to theatre and, if it came to the worst, had a chance to be there at the end to say goodbye this would be the kindest thing I think I could do.

Gold_Dust_2

Dear Lostinrates,

I'm sorry to hear that you have to go through this. I recently had to make the same decision. Whilst caring for one critically ill cat, another one presented with a lump, and after having a fine needle aspirate done it turned out to be an extremely aggressive cancer. Like Big Dog, he was old, and like Big Dog, he had preexisting conditions (chronic kidney failure and FIV). He wasn't insured, but we would have afforded the treatment.

We decided not to have a biopsy done and to let him live out the rest of his days in peace instead of putting him through the vet stress, the physical stress of an operation and all of this without the guarantee of him surviving or being cured for the sake of a few more uncomfortable months, only to end up back in the same position.

The vet ended up prescribing steroids in order to shrink the lump and make him feel a bit better in the long run, and they also increased his appetite (and made him thirsty as hell). His cancer was so aggressive that he lasted about 3 and a half weeks after diagnosis, and he was PTS on Saturday morning.

Whilst the sentimental part of me regrets choosing not to treat him, the practical part knows that we did the right thing as it would have been grasping at straws and like pouring water into a leaky bucket. He's not suffering anymore, and I am glad for that.

.....

Now back to the other cat. He is also quite old but much healthier than the other one mentioned above, so when he spontaneously presented with a drastic illness, we chose to treat him. He is also uninsured, and has had many operations in the past three months. It was very expensive, but he was responding to the treatment and improving...until recently. We now face having to make the same decision for our beloved boy after fighting for all that we were worth and spending thousands of pounds. I'm talking round the clock care, medications galore and at least 4 special diets, and 3 normal ones.


So we fought for one cat, and didn't fight for the other. And after three months of doing this, I can't really say that it was worth it, as it is stressful as hell and the cat doesn't have much quality of life (but until he stops fighting, we won't either). It would have been easier on everyone had we had him PTS a while back, but I don't regret having tried to treat him. If I was faced with this decision again and the animal was younger then yes, I would treat without hesitation. If the animal was old, then probably not.

I hope you get something beneficial out of all of that rambling. I guess I just want to say that sometimes putting them to sleep and not treating is the kinder option. I think that your decision to go for a biopsy and take it from there is a wise and balanced one in that it gives you the best of both worlds - a chance to treat and to make an informed decision, and whatever you choose to do from there will be the best thing for Big Dog.

I wish you all the best, and if you have any questions please don't hesitate to PM me. Please do keep us updated.