When should I make THAT decision?

Hi Dr. Cheng,

Hope you can provide me with some guidance.

Darwin is a 14-year-old Husky/Shep/Rough-Collie mix with a back problem. We've taken him to see his vet. Two of his vertebrae, near his hips are fused. Besides the pain, he has IBS and his liver enzymes are only slightly elevated; otheriwse he's in good health.

Every day, he slumps his rear when standing/walking, and often leans on something to support his balance. On bad days (maybe two or three a week), we have to physically support him during a bowel movement, and about half the time, we carry him both up and down the stairs to the outside. We don't let him take any stairs in the house at all.

We have tried a number of pain relievers; one seems to work, but it makes him sleepy. We've also taken him to a holistic vet practitioner, where he received a chiropractic adjustment and some additional pain (herbal) medication. This treatment only worked for about two days. We give me massages with a heating pad daily.

In short, he is always in some pain, but some days he seems to manage the pain well. Other days, it's very sad -- and on those days, I suspect the pain affects his appetite.

My partner takes Darwin's health very personally and will try to keep him alive for another few years. I am not as idealistic and am really torn between the ethics (quality of life) and whether I'm overeacting (he's ok). Can you give me some idea of when we should be considering euthanasia?

I'm really torn, and our vet doesn't offer any guidance in that way.

[Aleda M Cheng, D.V.M., C.V.A]

You must ask yourself how far you would like to go financially.  I know that sounds blunt but it us an unfortunate reality.  That is because there are some treatments that will improve his quality of life but they may be costly!

Acupuncture is very helpful especially with adjunct therapies including physical therapy, chiropractic, cold laser therapy, and of course the correct herbal formulas.  But acupuncture treatments take a while.  Sometimes 6 to 12 treatments before there is a response, especially in an older dog with a chronic problem, and than he may need “touch up” acupuncture treatments long term.  You must be patient., and a bit committed.

Another extremely helpful therapy is Stem Cell therapy.  THIS IS NOT EMBRYONIC STEM CELL THERAPY!   All animal species have their own stem cells; this is why our bodies can repair wounds, knit broken bones, even repair nerves.  The stem cell procedure involves collecting fat from your dog in a procedure that is like doggie liposuction, than the fat is prepared in a lab to harvest the stem cells.  The cells are then injected back into the donor’s damaged joints.  Studies have shown that this procedure is extremely efficacious  for arthritis and the results have lasted upwards of a year.  I would suggest that you have a consultation with  a veterinarian that is board certified in this procedure, since the consult is risk free and not costly.  The stem cell procedure itself costs anywhere from approximately $1500 to $3000.  You can find out more information and check for a stem cell vet in your area at: http://www.vet-stem.com/ .

Lastly,  you  mentioned that you  had tried herbal formula’s for your dog.  There are literally 1000’s of herbal remedies.  Just because the ones that you have tried have not be efficacious doesn’t mean there isn’t one or more formula’s that will work for your dog.  A good veterinary acupuncturist with herbal training should be able to help.  And, combined therapies would also help:  Nsaids, with glucosamine/chondroitin supplements, with the right Chinese and other herbal preparations, etc.

When all therapies and procedures are exhausted, and your dog’s quality of life is really gone than you can think about euthanasia.