QOL Question for Senior Dog

[Ample Prosecco]

So we are nowhere near yet but I was just wondering how you weigh up the emotional impact of physical versus mental decline in an older dog. Daisy is 11 now and physically still pretty good. She can't walk more than 2-3 miles but she loves her walks and is still very puppyish and playful. However it seems increasingly clear she has dementia. Possibly as a result of TIA. She has gone completely off her legs twice for a few minutes - fell over sideways and could not get up and was shaking. But by the time she saw the emergency vet she was back to normal and he said just wait and see. That has not happened again for motnhs after happening twice quite close together.

Anyway, she gets confused and anxious, yelps randomly, gets 'lost' in the house and is incontinent. But it's not every day (apart from the weeing) and even when it does happen it passes quite quickly and she is back to seeming contented and relaxed. But it's really hard to see her agitated and anxious and have no way of helping her. At what point does that become persistent and frequent enough to start thinking about quality of life?

Also are vets smpathetic to thise sorts of conversations for dogs who are physically fit and well. I've read some horror stories of vets treating owners like murderers. I'm furious with my mum's vet who has encouraged her to keep her old lab going WAY past what I think was ethical and persuading her into high risk surgery with lengthy recovery in a dog already physically very compromised.

 

[TPO]

Personally, I'd have called it a day already. When there was a fit later, after the initial two, I think that would have covered giving her time for me.

In my [limited] experience [of other people's dogs] dogs find incontinence stressful. Mum's got one who got nicked during her spay leaving her incontinent. She gets propalin (sp) and is absolutely fine on a low dose, but until diagnosis and treatment she was really distressed at having accidents.

So if my dog had untreatable incontinence I'd pts on qol grounds.

I'm aware that I'm very "agricultural"/ black and white on this topic.

My aunts vet "made" her keep going with her cavalier for years longer than was right. Every time my aunt took the sof to the vet she'd come home with even more drugs. It's was awful for dog and owners. Those vets got an absolute fortune out of my aunt with monthly prescriptions.

So I guess it depends what relationship you have with your vet determines how to tackle it. Do you want a conversation about possible treatments and tests or do you want to make your own decision ans have it followed? Maybe you could ask for a phone consult if you don't want to be having a difficult conversation at an appointment?

There's a new vet service started in my local area by a vet who specifically does pts at home. If it's up here I'm sure there's similar elsewhere. Maybe someone like thst would be more understanding and able to have a sensible conversation with you?

So sorry that you're in this position. Animals are such heartbreakers. Take care of yourself x

 

[Clodagh]

I’m with TPO.
Friends of mine kept their dog with dementia going. He was, like yours, falling over and incontinent.
One day he suddenly had a complete panic attack and soiled himself and was screaming with fear, they had to catch him and whizz him to the vets to be pts. It sounded appalling.
Brandy was a bit dementia like towards the end, in that she became even more obsessed with food than before, but when she went off her legs that was it.

 

[Ample Prosecco]

Thanks for comments. I feel a bit shocked but also validated that it's legitmiate to question QOL. I was a bit scared to even post the question. I am seeing the vet again nect week about the weeing as that was intermittent but is now pretty much every night. I might broach the issue then. But to clarify there were the 2 off-legs episodes which vet felt might have been TIAs and nothing like that since. She is still physically active. If you pick up the lead she is as happy and excited as ever. The idea of PTS just does not fit with that tail waggy happy dog! But then you see her anxious and think this is horrible for her.

 

[Pearlsacarolsinger]

I am with the others who say that I would have pts already tbh.
I have a friend whom I think is allowing her GR bitch to go on for too long. GR is used to sleeping on the bed at night, friend, who has osteo- arthritis is carrying her upstairs every night and walking downstairs in front of her every morning, in case the dog falls. I can see both of them landing in a big, injured heap at the bottom of the stairs, one day. Dog is also incontinent, seems unaware, lies in the mess and has to be cleaned up. GR also gets excited about setting off on a walk but walks slowly. She eats well.
Ime, you have to tell the vet when your dog, who you know better than the vet does, has had enough. I prefer my dogs, where possible, to still have some enjoyment of their life and go with dignity, rather than wait until pain and Confusion form the greater part of their life. Occasionally I have asked about pts and the vet has offered an 'effective' treatment, which I have accepted. Sometimes I have regretted doing that.

 

[meleeka]

Is she on any meds for the incontinence?

Are you sure her confusion/anxiety isn’t a sign of pain? My old JRT wouldn’t settle in the evenings. Plenty of people mentioned dementia to me, but it could have easily been due to joint pain. She didn’t show any other signs, but was always fine all day. She was PTS for something unrelated, so we never got to the bottom of it, but if yours isn’t on anything for joint pain, it might be worth a trial.

 

[AShetlandBitMeOnce]

I'm sorry AE, but I would be considering it now too. Incontinence can be very stressful on a dog, as can dementia and mental anguish is no different from physical pain.
I am another who sways towards the pragmatic side of the PTS view, and I would ask yourself, how much worse/could you be okay with seeing her worsen, before you let her go. If no, then that answers your question for you.
My mum keeps her animals going for much longer than she should, it's been a real source of conflict in our house at times, so I appreciate that when you see them every day and become used to their behaviours, it is easier to see past it.

 

[TheresaW]

Our vet didn’t question at all when we had Ellie pts. She was still in really good health generally at almost 14, but mentally not. She hated our dogs. She went to live with mum for the last 6 months. Happy as anything for a few of those, then the behaviour started again to Mums cat. She would have been happy in a pet free home I think. We thought about looking for one, but given her age, spending the first 12 years of her life in one home, we didn’t feel it would be fair to her.

 

[skinnydipper]

Thanks for comments. I feel a bit shocked but also validated that it's legitmiate to question QOL. I was a bit scared to even post the question. I am seeing the vet again nect week about the weeing as that was intermittent but is now pretty much every night. I might broach the issue then. But to clarify there were the 2 off-legs episodes which vet felt might have been TIAs and nothing like that since. She is still physically active. If you pick up the lead she is as happy and excited as ever. The idea of PTS just does not fit with that tail waggy happy dog! But then you see her anxious and think this is horrible for her.

As she is physically well I think it would be worth asking if either Anipryl or Vivitonin would be helpful for the congnitive dysfunction.

 

[Ample Prosecco]

Ok my OH and I feel she is way, way off that. I asked the question because I wanted to make sure I’m not underestimating her distress and for ideas of how to gauge when we do need to start thinking the unthinkable. Most of the time she presents as a healthy happy dog.

Your replies have made me worry that I have already been underestimating distress. Or maybe that my description paints a worse picture than the reality.

Is there anyone who manages these issues and feels confident this is ok?

I really do appreciate everyone’s comments but they have blindsided me!

 

[Jenko109]

I've only had two dogs PTS, however neither vet questioned my decision.

My collie came into the vets like a bull in a china shop that day. Having been allowed a game of fetch (which we had quit playing with her some years ago due to her aging bones) she was euphoric. Visually she looked just fine. On her walks, she again looked just fine. She was on an NSAID which had worked great for a few years. What they look like is not a clear representation though, is it. My dog had started pacing in the evenings over the last few days, struggling to settle and had not got up quite quick enough and wet herself. It didnt matter that she still enjoyed her walks or that she still scoffed her food down or that she would still try and coax you into a game of fetch. Nothing will negate the clear discomfort she had began to experience in those evenings, or the emotional toll it would have on her to continue to have accidents.

My vet simply asked me to tell her what had been going on. I told her. She didn't examine my dog or try and look at alternate options. She accepted my word that it was time.

That vet now works somewhere else dealing with specialist cases or something. Gutted that I now cant take all my animals to her because she was just fantastic.

 

[AmyMay]

Keep a daily diary @Ambers Echo xxx

 

[Jenko109]

To add, only you know your dog!

You don't have to listen to people on the internet who have never met you and have never met your dog.

We will not always have the right answer.

 

[tda]

It is entirely your decision, it depends how comfortable you are with it , on going. I have very similar 13 yr old terrier, we're taking it one day at a time. Daily diary is a good idea.
I'm with TPO, I will make the decision sooner rather than later

 

[quizzie]

Ok my OH and I feel she is way, way off that. I asked the question because I wanted to make sure I’m not underestimating her distress and for ideas of how to gauge when we do need to start thinking the unthinkable. Most of the time she presents as a healthy happy dog.

Your replies have made me worry that I have already been underestimating distress. Or maybe that my description paints a worse picture than the reality.

Is there anyone who manages these issues and feels confident this is ok?

I really do appreciate everyone’s comments but they have blindsided me!

Given that she is essentially healthy physically apart from the urinary incontinence, then discuss the use of Propalin ( or similar), it would make life more pleasant for you and her if it works ( It does in many cases).

The mental deterioration is again quite common, and sometimes likened to a a light bulb starting to flicker...and if she is suitable for a drug such as vivitonin, it can make a massive difference , as if the light bulb switches back on !.

QOL is incredibly important, but drugs such as the 2 above can make an enormous difference. It would be worth discussing them with your vet, and maybe trialling them for a few weeks if she is a suitable candidate.

 

[fankino04]

I'd agree with keeping a diary and make a decision that when the good days go below x% then that is when you make that call. Some people will say when the bad days out weigh the good others will day when the good days are 60% or less or whatever but I think you have to choose that number gor your dog so you can be comfortable with the decision. A diary will show you it in a non emotional black and white way.

 

[CorvusCorax]

Personally, if a dog is incontinent and off their legs, it's time, for my dogs.
Practically speaking, I have big dogs and live on my own. If my dog loses power either in the house or out on a walk, I'd find it very difficult to help them and for me that's a welfare issue.

The last dog I had PTS, I asked should I go away and think about it, and the (large animal) vet looked at me and the dog with a pained expression and asked 'why?'. I'd rather my dogs go when they're in good form/compos mentis.
Not all of our dogs get the right kind of end and I'd personally rather make the decision too early than too late, because some things never leave you.

 

[CanteringCarrot]

Ok my OH and I feel she is way, way off that. I asked the question because I wanted to make sure I’m not underestimating her distress and for ideas of how to gauge when we do need to start thinking the unthinkable. Most of the time she presents as a healthy happy dog.

Your replies have made me worry that I have already been underestimating distress. Or maybe that my description paints a worse picture than the reality.

Is there anyone who manages these issues and feels confident this is ok?

I really do appreciate everyone’s comments but they have blindsided me!

You do need to start thinking the unthinkable and not refer to it as the unthinkable though.

As you can see, a vast majority would not manage these issues and are not confident that this is ok.

I feel like I'm going to come across rather harsh, and I can understand why you feel blindsided.

The big thing for me is that humane euthanasia is not the worst thing to happen to a dog. Allowing conditions to worsen or waiting until the dog is really in distress, well, that's just not my personal preference. For me, I don't care if the dog is 3, 8, or 11 years old. When basic functions deteriorate, it's time.

Now, for incontinence complications due to a spay in a young dog that can be managed with medication, I'm not as offended about. Incontinence due to age, I'm a little more wary about, especially combined with other symptoms. I'm not going to wait for the dog to fully lose their marbles, so to speak, or when the dog is in a screaming blind panic one day because it has no idea where it is.

I feel like so many dogs would still wag their tail in less than ideal situations, it's not always a sign of happiness either. There are some dogs where you could probably chop off 3 out of 4 legs, grab their lead, and they'd still be wagging and trying to walk. That's dogs, to some extent.

Granted, you know your dog best, but at the same time, you do have to sort through the emotional aspect of it all. Sometimes I try to think, if this were someone else on HHO posting or someone else IRL telling me this, what advice would I give? Sometimes it sort of hits me that my judgment is being clouded.

I don't care if a vet gives me flak. Yeah, it may make things harder mentally, but my animal not suffering and their QoL comes first. Some vets will let animals kick on for far too long, I'm fine with putting my foot down or going to a different vet. At the end of the day, I'm my animals advocate. I have to be.

 

[FinnishLapphund]

Like in all professions, you might come across a veterinarian who you think is less good at their job, sometimes it's down to personal chemistry, sometimes they're actually not so good on at least at the death aspect of their work, and if you find yourself in either of those scenarios, you need to book an appointment with another vet.

I just want to mention that how they react to being incontinent is individual. I've had 1 bitch who did become mortified when she had some indoor accidents due to an urinary tract infection (which by the way also made her develop dementia like symptoms which disappeared with the UTI treatment). I've also had 1 bitch who lived very happily for many years with a bit of urine incontinence. We tried anti-urine incontinence drugs, but it didn't help her, so instead we just washed her when needed, and made sure she slept on materials that easily could be cleaned/washed.

However, I assume that your girl's problem isn't related to a UTI, without that she shows signs of real dementia, and for me it doesn't sound worth it for her to try to fix the incontinence problem, when there's nothing you can do about the dementia.

I can understand if it's a difficult decision, when she seems otherwise so her usual self, and playful, most of the time, and only have brief moments some days when her dementia shows. But you've given her body time to recover, and it isn't happening.
The dementia is only going to get worse, and in the worst case scenario, who knows what she'll do in one of those moments when she's lost, and anxious. Many years ago I heard about a dog with dementia who jumped/tried to jump straight through the glass in a closed window because they saw a family member on the other side of it, and presumably forgot how windows work.

{{{{{{Hugs}}}}}}

 

[blackcob]

Also are vets smpathetic to thise sorts of conversations for dogs who are physically fit and well.

The good ones are and if you feel you have a good working relationship with your vet, it would not be at all weird to ask for a consultation to discuss this sort of thing. Possibly without the dog, or by phone. Independent end of life specialist vets are also available (our local one is Dignipets, I don’t know if they’re perhaps a franchise and available elsewhere in the country) and again this is exactly what they are there to help with. They may utilise various quality of life scales to help you be objective about what the situation is and assess how it is changing.

FWIW my old lad had occasional fecal incontinence in the last months of his life and because we were able to manage it well I don’t feel it was a huge factor in his QoL scale - I worked from home and had someone to share night wakings with, so his dignity was never compromised. It would have been very different if I’d had to leave him during the day, for example.

However, off-legs episodes were my personal line in the sand and excepting brief, non-invasive investigation after the first, having ‘recovered’ quickly, he was PTS after the second.

 

[Pearlsacarolsinger]

I'm sorry but from the moment you decide to add a pup/dog to your life pts has to become thinkable. You are responsible for the health and welfare of your dog, because no-one else can be. Sadly I had to pts a young Lab, it was something of a surprise/shock but it had to be thinkable.
Have you discussed your dog recently with a vet? Has she got any medication? If not, I recommend making an appointment sooner rather than later and asking if there is anything that can improve her QOL atm.

 

[irishdraft]

Thanks for comments. I feel a bit shocked but also validated that it's legitmiate to question QOL. I was a bit scared to even post the question. I am seeing the vet again nect week about the weeing as that was intermittent but is now pretty much every night. I might broach the issue then. But to clarify there were the 2 off-legs episodes which vet felt might have been TIAs and nothing like that since. She is still physically active. If you pick up the lead she is as happy and excited as ever. The idea of PTS just does not fit with that tail waggy happy dog! But then you see her anxious and think this is horrible for her.

My collie bitch is 14 and has had incontinence issues for about 2 years but she is on propalin which sorts it completely. We dropped her dose down abit for about 4 months but the incontinence (wee) has just come back so put her dose up again & now she's fine . She also seems confused at times but has gone partly deaf so just doesn't hear properly. She's still very active & happy so I think the quality of life is still there. If your bitch is not on medication for the incontinence then I'm sure your vet would be able to prescribe.

 

[Ample Prosecco]

‘Think the unthinkable’ was just a turn of phrase meaning something difficult to face up to. Of course I know all responsible pet or horse owners have to be willing to make that call in the interests of their animals. And to make it at any age. I put Katie’s pony down when she was 6.

 

[splashgirl45]

I had a long time to think about the end for my collie cross, she was getting slower, was almost deaf and was losing her sight, but she seemed happy, always ate her food and still enjoyed short walks on level ground, so although old was still pottering around . I questioned myself all of the time about her QOL but the decision was made for me as she suddenly lost the use of her back legs and unfortunately had to take her to the emergency vet for PTS . I knew it was time earlier in the evening and had contacted my vet to come home in the morning, I had intended to spend the night on the floor with her and was hoping with a nights sleep she might be better, however she seemed very disorientated and by 9pm I knew I couldn’t leave it…. My regret is that I didn’t get my vet to come to me that evening as I was still hoping for a bit longer with her….she was almost 15

 

[misst]

My old JRT became demented. She would get "lost" on a walk - ie. She would sit in a bush until i popped a lead on her - but not every day. She definitely "forgot" why she went into a room and would stare into space for a minute before recovering and continuing. She also started snarling at nothing, just staring and snarling. We would reassure her and she would shake herself and return to normal. She ate well, drank well and was generally happy for about 6 months. Then one day she just seemed to switch off and become more vacant. Her final week she was incontinent of urine each morning, even going into the garden then coming in and doing a wee on the doormat. She seemed unaware of what she had done.

I spoke to our vet a few weeks prior to PTS and had the conversation about when is it time and how do I know. My vet said I would know but also recommended QOL questionaires to keep an eye on any deterioration - do it weekly. People on here recommended the same thing. We arranged PTS the week she switched off completely and on the morning of the vet coming to do it at our house my husband carried her downstairs and she wee'd all down him - again she was unaware but this was another big step down. She went quietly and quickly on my lap on our sofa.
My vet said he wished more people would call it sooner and said dogs are lucky, his grandmother was in a similar state in a nursing home and no one could do the same for her.

Tilly was physically "old but fine" but mentally she was not my Tilly that last week. The only reason it took a few days was because I wanted it done at home and we had to wait for an appointment for this. If she had been distressed we would have just taken her in at once.

 

[KEK]

IMO, vets saying owners will "know" when the time is right is pretty unhelpful. I have QOL indicators I discuss with clients and they are:
Animal needs to be able to eat and drink by themselves
Needs to be able to go to the toilet by themselves
Move around the house comfortably
Needs to be able to interact with his/her owners in a meaningful manner.

There are definitely drugs for urinary incontinence, however we would generally do some work up 1st to check for organ disease etc first.

 

[Boulty]

There are things you might be able to try drug wise if you wanted to both for the urinary incontinence and the confusion / dementia like episodes. They may or may not work but might be worth a try to see if you can improve things a little for her / get her in a place where you’re more comfortable carrying on with her. This is a basic QOL checker. Someone I used to work with came up with a better one but I don’t have easy access to it

Does my pet still have a good quality of life?

All pet owners want their companion to have a good life. As your pet gets older, or if they’re diagnosed with a serious illness, you may worry that they’re suffering and have more bad days than good.

www.pdsa.org.uk

 

[Identityincrisis]

With regards to the incontinence the vet can prescribe propalyn which is a very good drug for this issue. My dog ‘leaks’ but isn’t upset by it but would be if he fully emptied his bladder.

With regards to the chat with the vet when the time comes, sometimes you have to be firm. My dog went to the OOH vet as her tooth wouldn’t stop bleeding and it was distressing her, i asked him to PTS which sounds extreme for bleeding teeth but she also had several other issues and i had already been considering it. He started to discuss medication options which infuriated me as she was clearly old, distressed and unhappy, i said I know my dog, she has X/Y/Z wrong and I’m not prepared to let her go through more distress, he agreed

 

[Xmasha]

I’m sorry you are going through this AE. It’s an incredibly difficult time.
Our old boy still appeared very happy, wagged his tail and loved his food . But he had started to struggle getting up. The day he looked scared was the day we knew it was time .

 

[Ample Prosecco]

Thanks all. We are keeping a diary now and saw vet again yesterday who is running a few tests just to make sure we’re not missing anything physical. But he doesn’t think so. Bright, bouncy, enjoying walks, eating well. She doesn’t present like a poorly dog does.