Need Advice on 'End-of-Life' Issues

[bgdavis]

Yesterday was the day I've been dreading. When I went home at noon to feed my dogs lunch, Criss was unable to get up or stand on her own.

Crissy has had 'atypical Cushings' since 2002, diabetes since 2004, discoid lupus since 2003, has been hypothyroid since 2000, has bad arthritis and torn cruciate ligaments in both back legs, and of course, she is blind. She is still a big dog. At one time, she weighed 90 pounds, looked great at 75, and now weighs about 52 pounds. She started losing muscle and body mass two years ago and was tested for all types of tick-borne diseases. Her last CBC and exam showed no indication of kidney, lungs, heart, or other organ problems. She does have fairly high liver enyzmes and takes Sam-E and milk thistle.

She has had two troubling bouts of extremely elevated bg's and ketones over the last three months, lasting about 3 days. Both times she has taken a treatment of Baytril and recovered. She will stop eating and start drinking huge amounts of water and have urine 'accidents' in the house. She started to show these signs again on Sunday. I've given her two Baytril tablets since then.

She was reluctant to eat breakfast yesterday morning, but with lots of help from 'mom' got it done and had her insulin. Yesterday was also one of the days she takes Lysodren (for the Cushings') which always 'wipes her out', making her pant more, sleep more, and weaker in the back legs.

When I got home at noon, she had urinated on the kitchen floor and had been unable to get herself out of it. Crissy doesn't just make a little pee-pee puddle.... she can pass up to a quart of urine. She's been wearing her lift for months now so that I can help her to her feet. But yesterday and last night, she couldn't assist me at all, so I was really carrying her back half with the lift all the way. This morning she's a bit better and was placing some weight on her back legs. No change in her appetite. I doubled her pain meds, Tramadol, last night, which my vet said was OK.

I live by myself (and the 3 dogs) and work full time. How am I going to be able to deal with Crissy if she becomes immobile? I know I could buy doggie diapers for her, but that still would keep the urine against her fur. Criss also just can't be bathed every day. It takes up to 3 days just to get her dried! We have a ramp to the outside to assist in getting her in and out, but it is a struggle if she isn't helping.

Crissy takes the following meds: a total of 38U of Humulin N via 3 shots, 4 pancrenyzme tablets, 2 L-thyroxine .6 tablets, 2-4 tablets of Tramadol, a multi-vitamin, Sam-E 400mg, Metacam, SynoviG3 chewable each day. She takes 500mg of Lysodren on every 4th. day.

Does anybody have any suggestions on how I can help her and keep her going? I know some might say to leave her outside (she really does love cold weather), but I think being in the house reassures her. She hasn't shown any signs of 'withdrawing' from me. I know this probably doesn't make much sense to anybody, but I'm looking for hope to keep going.

Bonnie and Crissy

[k9diabetes]

The only way I can see keeping her out of the urine would be something like a rabbit hutch grated floor that would allow the urine to mostly pass through into the tray below, which you could line with pee pads to make it easier to clean out. This is the best solution I can think of as you could probably get something fairly large and it would airy and allow her to be indoors but contained.

Even pee pads alone might help as I presume they absorb the urine into a sublayer, leaving a top layer that's fairly dry. I have never used them so I'm not sure. But they would surely be drier than a large pool of urine on the floor.

Seems to me that her being outside won't solve the problem all that much if she's unable to move out of the urine pool so that wouldn't really fix things anyway.

If you go with doggie diapers, would she let you use pet wipes or just wipe down the surface of her fur? Then you wouldn't have to bath her - just wipe down what's been up against the urine and dry that with a towel.

Sending a big hug,

Natalie

[bgdavis]

Just a quick note. Criss is a bit better today. She was able to walk around the yard a minute or two on her own at noon. I think the antibiotic is kicking in, but we just can't figure out why these bouts are taking place. Last time, with full blood workup and urine tests, we found no infection.

Bonnie and Crissy

[k9diabetes]

Perhaps the antibiotic is treating something other than a UTI.

[BestBuddy]

Hi Bonnie,
I read you post this morning and couldn't work out what to say so didn't say anything. I was glad to read your update. I still have nothing constructive to say but I did want to let you know that I am thinking of you and Crissy and hope when the questions arise you will know the answers. Some days I feel like I will have to start making these plans for all my "elderly" dogs including Buddy but how can you plan for the end not knowing what each day will being. So I know I am no help at all but I certainly am with you in spirit.
Jenny & Buddy

[Dollydog]

Hi Bonnie,
I'm no help either with the physical situation but am definitely with you in spirit. We have our own issues here that may bring about the end before I think it should happen....money and physical safety being part of the problem. I try not to stress out about it and take each day as it comes and just hope there are some answers to give us more quality time together.
I've just read your post so if something comes to me later that might be of some practical help, I'll post back.
I'm glad to hear that she had a better day,
Jo-Ann & Lady :)

[Cara's Mom]

Hi Bonnie!
I cannot give any advice either, but still want to let you know that my thoughts are with you and Crissy. It was nice to hear that she had a little better day:).

Hugs, love and our best wishes!

[eyelostit]

I'm hoping all goes well on Friday, Crissy may just surprise you:)

[rhodesian46]

JUst checking to see how Crissy is today It is horrible when they get old. Am hoping that she gets up better today My thought are with you
Marianne

[Debbie & Apollo]

thinking about you guys.

Sorry I have no words of wisdom, just prayers.

[bgdavis]

Crissy spent some time with Dr. Mayfield this morning. He clipped the hair from her rear and back legs. I'll have to get a picture of her: she looks like to two separate dogs were glued together! She's down to just 49 pounds in weight. He agreed with me and a vet I 'talked' to on another internet list to stop giving her Lysodren. At this stage, even if the Cushings' kicked in, she will probably be gone before it could damage her internal organs.

One of the vets on the internet thought the source of her 'infections' could be her nose. The lupus has been wrecking havoc over the last few months. It's bery cracked, bloody, and literally, pieces fall off. Dr. Mayfield put her on another antibiotic this morning.

She's able to walk, but now that I can see the structure of her back legs, it looks like she's on toothpicks. There's nothing much there except the bones.

She was feeling pretty good yesterday. Barked a little, was alert, and sniffing the air checking out the cooking smells. She got a tad of the veal I had (no turkey). It was the 13th. Thanksgiving she's spent with me.

I know we're reaching the end of the road, but am hopeful she will hang on through Christmas and maybe even her 13th. birthday, Feb. 20, 2009.

Bonnie and Crissy

[Ricksma]

Bonnie, I can't offer any advice...I just want you to know that I have been where you are now, and my heart breaks for you...and Crissy. It is so hard when age and illness take them away from us a little at a time. We see it coming, and are still surprised when it happens. Crissy may yet have some very good days, so I am not giving up...and I know you aren't. I am sending prayers your way for Crissy's well-being...and also prayers for you because you are Crissy's voice.

Love and hugs, Teresa and Ricky

[Dollydog]

Hi Bonnie,
I'm glad you've seen the vet and that Chrissy had a good day yesterday. Hope you have many more good days with her. This part of the journey is so hard...
(((HUGS)))
Jo-Ann & Lady

[k9diabetes]

Any reason she can't just have her antibiotic every day from now on?

Sending a very gentle hug to Crissy and to you and wishing you a shared Christmas 2008.

Natalie

[rhodesian46]

Oh Bonnie,
I am sorry . It is really hard to watch them like this : the good days then the bad days. Enjoy every moment with her an every minute.You are a good fur mom. Wish our animals lived forever. Would love to have Pebbles back. My thoughts and prayers are with you.

[eyelostit]

Oh, I'd bet she'll be around for her birthday.:)
Take Care

[bgdavis]

Thought I'd tell you all that Criss had a wonderful day yesterday and seems to be very lively this morning. She's walked by herself around the front yard, yipped, and sent up a gale of howls when some fire engines went by. This morning she was 'singing' and ate her breakfast with such gusto that she finished before the boys!

She's on her 8th day of the new antibiotic. It's made a big difference. She also has had no Lysodren in almost 2 weeks.

Bonnie and Crissy

[k9diabetes]

I am SO happy for you both!!!!! :)

[Dollydog]

That's great news Bonnie....your heart must be singing!!
Jo-Ann & Lady :)

[BestBuddy]

Great news Bonnie. Something is obviously working whether it is the lack of Lysodren or even the antibiotics. Doesn't matter which because it's working.
Jenny & Buddy

[Ricksma]

So, so happy to hear that your sweetie is feeling better....this is why we are so stubborn and never give up...because they don't. Ricky sends kisses...

Love and hugs, Teresa and Ricky

[eyelostit]

Glad she's feeling better today, she's a fighter:)

[bgdavis]

Thought I'd try to show you all Criss's skinny back legs now that the hair has been shaved off them. Notice how her back feet go out at 90 degree angles from her legs. That's why she has such a hard time getting around. That's her lift belt around her middle.

http://i29.photobucket.com/albums/c283/davisbg/Crissslegs.jpg

She's been a happy camper all weekend. Just very alert. Eating great. Took a stroll around the big yard (1 acre) all on her own.

However, she took her last antibiotic yesterday. We'll just have to see how she does without it.

Bonnie and Crissy

[rhodesian46]

Chrissy has sexy legs!!! :D:DGlad she is doing better

[eyelostit]

Glad she is doing ok.:)

Chiefs legs were spreading out like that too.

poor crissy, but she seems to be doing ok if she did all the walking thats a good sign.:)

Take care
Dolly

[Ricksma]

Sounds like she really is feeling better, for whatever reason. We'll take it!! She's beautiful....

Love and hugs, Teresa and Ricky

[k9diabetes]

Crissy has sexy legs!!!

LOL!! She does indeed!

I like the NASCAR bins too!

Any chance the doc will let her stay on the antibiotic long-term?

Natalie

[bgdavis]

Natalie,

I doubt that Dr. Mayfield will let her stay on the antibiotic for long term. He says that we need to withhold antibiotic use so she doesn't develop resistance to them (not that I think Criss could build up a resistance at this point).

I might be able to talk him into another round of it because her nose is still pretty bad.

Bonnie

[BestBuddy]

Hi Bonnie,
What is the antibiotic Crissy was on? Buddy has been on amoxycillin close to two years now. It was first given for a UTI and every time we stopped it the UTI would return so the vet decided that it would be better to keep using the antibiotic even if he developed a resistance because at his age it was better for him to stay well and there are always other antibiotics to try if that one stops working.
Jenny & Buddy

[BestBuddy]

I may be way off base here but have you check out Diabetic Neuropathy (sp). I wondered if that was a problem for Buddy so I did some basic searches and decided to try the B12. I'm not even sure if it's helping but it certainly isn't hurting so I am continuing to give him 1/2 250mcg B12 morning and night. I couldn't get the methylcobalamine tablets so I am using the cyanocobalamin although they may not be as effective.

http://www.delano.com/Articles/Methyl-B12-diabetic-pets.html

Jenny & Buddy

[bgdavis]

Jenny,

She just finished up 10 days of metronidazole. This is one that is used most frequently for bacteria type problems and can harm the liver over time. If I sense she is going down hill again, I will not hesitate to ask for more of it.

Thanks,
Bonnie and Crissy

[k9diabetes]

Has the antibiotic always been Metronidazole? Because that's Flagyl, which is used with intestinal problems. I didn't think it was normally used for UTIs.

That would explain why it makes her feel better even though there's no sign of a UTI.

[eyelostit]

I wash thinking about the B12 also, I've been reading here and there since last week, i have some of little ones you dissolve in mouth, i could give niki 1/4 of it, she is getting a little slower now.

[bgdavis]

Natalie,

She had been taking Baytril during the 'bouts' in Sept. and Oct. He gave her the metronidazole on Nov. 28th. because we suspected she had bacteria in the lesions on her nose.

Criss hasn't shown any signs of an UTI. All of her blood work and urine tests haven't shown any infection.... that's what's been so strange.

Bonnie and Crissy