Palliative care for dog

[Anonymous]

We have a 10 year old large (80lb) dog with back problems and cancer. We discovered this in early December and decided to opt for palliative care over trying to treat. With a large tumor on his liver, in addition to other organs, it seemed cruel to try to put her through surgery and chemo at her age. We wouldn't be able to afford the treatment, either.

She has had some bad periods mixed with longer good, energetic periods since diagnosis. I think we've reached a point where she's not going to bounce back anymore. I contacted the vet to see if we could add any additional pain meds to her Tramadol just to make her as comfortable as possible at this point. They won't do it without another visit and the same round of $600+ tests. I don't see the point in more testing to tell me my dog is dying.

Has anyone had luck with adding to Tramadol to manage pain?

I am fairly certain the next time we see a vet, it will be for euthanizing her. Does anyone have a recommendation for vets that will do this at our home in Fairfax county? I'd rather not put her through the trauma of a vet visit.

Any advice is welcome. Thanks!

[Anonymous]

So sorry about your dog. No help on the pain meds, but a few notes about the second question. I don;t have specific recommendations for a vet, although I remember that there was a big article in the Washington post a couple of years ago about vets that do this in your home, so I would try a search on their website. Even if none of those vets are in Fairfax, they should be able to put you in contact with someone who is, although I would imagine they do a fair amount of travel within the area.

Just as a note, I totally agree about the last traumatic visit to the vet being avoided, I had a dog pass away of natural causes in my home and that may be somewhat traumatic for you for the next few months. I think I would still have someone come to me (would rather have myself with trauma than the last few moments of my dog's life be traumatic for her), but just be prepared to have that be a very hard place to be in your home for a while.

Also, I might find a new vet for next dog, forcing you and the dog to do those extra tests, when you have decided (understandably) not to treat, seems cruel to both you and the dog.

[Anonymous]

Who is your vet? Maybe talk to another vet? We had a similar situation and it was what made us find a new vet. It may be the final visit for this pet (I'm so sorry) but a kinder way.

[Anonymous]

I have gone through this twice in the last 4 years. The vets will continue to suggest testing and treatment, but you know when your dog has had enough. (And I did treat one dog for cancer with radiation, but the cancer came back. The vet was trying to get me to do another round of radiation. There just comes a point where enough is enough).

Having said that, on one dog, I did increase the tramadol. I knew we were in the last stretch. And it helped tremendously. The vet had prescribed the tramadol as needed for pain. So I increased the amount and kind of took it day by day as far as determining when he (the dog) had had enough and was ready to go.

With the second dog, we increased pain meds and had him on chemo drugs (which really weren't helping). But we reached a point where he had trouble breathing and no amount of pain medication was going to help.

Just flat out tell your vet that you have accepted that he is dying and you just want him to be comfortable until it is time. I have found that being direct helps. Otherwise, the vet operates on the belief that you are still hoping to cure the dog or resolve the problem. If you let him/her know that you've accepted the situation and refuse to do further testing, then usually the vet will cooperate and help figure out pain management.

If the vet does not, go to a different vet. Bring all of the paper work (tests) and say, we've done the tests, we just want to manage the pain.

[Anonymous]

10:06 here again. I will add that one of my dogs had back pain, and the only thing that helped was prednisone.

Prednisone for prolonged periods takes a toll. But if you're dog doesn't really have much time left and you're at the point where you're just managing pain, it might be a good option.

I don't know how willing a vet will be to prescribe it. But really, for back pain, that's the best. I'm not sure if it can be mixed with tramadol. But prednisone on its own might be enough to make him comfortable. It will hasten liver/kidney issues, though. But it's a trade-off.

so sorry you have to go through this. It's gut-wrenching. I hope you're able to find something to make your dog comfortable.

[Anonymous]

sorry i kept calling her a him...

[Anonymous]

If you really think your dog is not going to bounce back this time, I would go ahead with the euthanasia.

Here is one service (note I am not affiliated with this vet nor have I ever used them, I just googled for you): http://www.novamobilevet.com/ They have a home euth service and say that the choice is yours and the doctors will respect that, so I'd imagine you won't get any pushback from them.

[Anonymous]

PP here -- here is another guy and he looks even better:

http://ww2.fairfaxtimes.com/cms/story.php?id=1465

[Anonymous]

Anonymous wrote:PP here -- here is another guy and he looks even better:

http://ww2.fairfaxtimes.com/cms/story.php?id=1465

Thanks for that, PP.

I appreciate all the comments. It's difficult to decide when to euthanize a pet.