# Help me decide...11yo arthritis/incontinence



## gstrub (Feb 15, 2006)

It's been a while since I've been on this website, but I've always valued the info I have found here.


Dante is nearly 11. His hips have slowly gotten worse over the years, from about age 5 he started walking funny, but over the last year his back legs have become weaker. He cannot run anymore. When he tries to turn he stumbles. On our walks, he occasionally sits and needs coaxing or physical help to right himself. I tried rimadyl (stopped because it bumped his creatinine), chiropractic adjustment (marginal improvement), and now he is on prednisone (this helped tremendously, but the effect has worn off completely after 4 weeks).


The mobility issues I was dealing with, but he started having accidents in the house, and quickly eating them to hide the evidence. It was clear he wasn't doing it intentionally, he would poop sometimes in his sleep, or when he was just lying there. He has had increased difficulty maintaining his position to poop outside. This got better when I started prednisone (vet thinks it's neurologic from his spine). But last weekend he had a bout of diarrhea, and it was a total disaster in my house. He felt so guilty it was heartbreaking.


His labs have been abnormal, his creatinine and LFTs are all elevated, he is on a prescription diet for this, but I imagine it is a chronic issue that will not get any better.


The problem, as many of you have written about, is that he is still full of life. He seems happy and wants to eat, play, and is very engaging. There are moments I look at him and I think how could I possibly put this dog down, and there are others when I feel like I have to because today is likely the best day of the days to come.


He hasn't "told me it's time" is what I am driving at, at least not overall. But when he was having diarrhea everywhere I finally made an appointment for this Sunday for his last visit to the vet, and have been watching him until then to decide whether to take him in, or cancel it and give him some more time.


I don't think he is going to get any better from a mobility standpoint. I can't keep him on high doses of steroids. And I don't want to drag out the end of his life. As a physician who treats humans I often see terrible end of life conditions, and I don't want him to be in pain at the end of his days, but when he looks at me, most of the time, he is still the same puppy I raised from 8 weeks old. I think I am ready, I have known the day was coming...2 years ago he had bloat and needed emergency surgery and survived, I promised to treat every day after that as a gift and I have done my best. I guess I'm just not wanting to say goodbye to my boy.


I've been hoping sometimes to come home and find him unable to walk, or that he would stop eating, or at the very least just lay there and look at me with a miserable face that will tell me what to do. But that day has not come, and I can't decide if I should wait for that day or take him now while he still has some dignity.


Sunday is fast approaching and I still am unsure, help me decide if I'm being selfish and cruel or if I should still give him some time to be with me


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## Lorrie (Jun 13, 2016)

Your post brought me to tears. We recently had to make this decision with our 7 year old, GSD, Barkley. Very similar situation, except that Barkley was suffering from Degenerative Myelopathy. 

I wish it was possible for me to tell you if the time is right. I will say that I did know in my heart that it was time for him, although, it still didn't feel right for me. 

It sounds like you have filled Dante's life with love and joy! 

Thinking of you both!


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## selzer (May 7, 2005)

Has the vet offered any solutions for the incontinence?


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## Dunkirk (May 7, 2015)

I went through this with Katie, my bearded collie. While no one else can make this decision for you, we can share our experiences. 

We tried penning Katie to limit the area she could mess. The first morning we came downstairs and there were dents in her muzzle where she was trying to push through the pen to get away from the mess. 

The decision that was right for us was, we'd rather put her down early, rather than have her suffer by putting her down later. One thing I'm happy with, we had the vet come to our home to put her to sleep, it saved her the trauma of a vet surgery visit. If you have other pets, we didn't, you wouldn't want them around if you go this route.

Do a google search on how to make the decision to put your dog down.

You have my deepest sympathy, and empathy.


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## Magwart (Jul 8, 2012)

I don't have advice on the fecal incontinence, but I wouldn't put a dog down for that. 

As for the hip arthritis, you have a lot of options to try to help him. I really believe that the #1 most important thing to try for arthritis is Adequan injections. They've been written about here on the forum many, many times -- PLEASE do a search for "Adequan" in the search box! It's a near-miracle for many dogs.

"Old school" vets don't recommend Adequan nearly enough, in my experience -- I literally fired the last older vet who thought that putting a dog on an NSAID (like Rimadyl) was a sufficient approach to arthritis. It's at most a temporary treatment while longer-term treatments kick in. I was happy I found a younger vet who had used Adequan with great success in many dogs. Adequan helped my dog transition from barely able to amble behind me to jogging again, and it eventually allowed him to want to trot again -- and got him off NSAIDs, once it kicked in.

Adequan is NOT a pain killer, but a joint lubricant (meaning it helps _heal_ the joint rather than just masking pain). It's expensive, but you can cut the cost by having the vet show you how to do the injections. You start with a loading dose, that's usually 2 shots per week for 4 weeks, then a maintenance dose (for my dog, it was every other week...for life). When it works, the difference is amazing.

There are also several great threads about supplements that help a lot of dogs--and those supplements work great together with the Adequan, there's a synergistic effect that seems to cause them to work better together. My guy responded extremely well to Natural Eggshell Membrane, Type II Collagen/Hyaluronic Acid, and a big dose of fish oil (a natural anti-inflammatory). There's a lot more about all these in the supplement threads.

Exercise is also part of the solution to hip arthritis -- slow walking and swimming were recommended to me, as much as the dog wanted to do. Acupuncture helped my dog too -- it's one modality I wish we had started sooner.

My old guy got over a year of very high quality of life when we found the resources go after the arthritis in a serious way. He was still going strong when cancer got him. 

Please don't give up yet. I want to convey that there's hope that you can make him comfortable, since he still is happy enough to enjoy life.


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## llombardo (Dec 11, 2011)

Magwart said:


> I don't have advice on the fecal incontinence, but I wouldn't put a dog down for that.
> 
> As for the hip arthritis, you have a lot of options to try to help him. I really believe that the #1 most important thing to try for arthritis is Adequan injections. They've been written about here on the forum many, many times -- PLEASE do a search for "Adequan" in the search box! It's a near-miracle for many dogs.
> 
> ...


I agree. Sometimes it's not just one thing that works but takes a combination. I just got the treatment plan for my girl;she is recovering from surgery from hip Dysplasia) and for example one week is the underwater treadmill, laser therapy and chiropractic. They are also going to teach me how to do therapeutic exercise and massages. They recommended fish oil(which she gets fresh sardins snd getting-that counts). Keep him moving so he doesn't get stiff. I like the dea of putting him in one area to contain any messes.


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## gstrub (Feb 15, 2006)

Thanks everyone. The more I read, and the more I watch him today, the more I am inclined to wait.

He is still eating, drinking, walking (albeit with weakness) peeing and pooping outside (with the occasional #2 inside), and wants to play ball in the house. Overall he just looks at me and says he's not done yet.

I think him being a bit sick over last weekend with diarrhea took a lot out of both of us.

I will ask my vet about adequan, my mother used that on her labs with good results. I want to wean him from prednisone, he is on 20mg every other day. I'm willing to give it a try.


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## Jenny720 (Nov 21, 2014)

I have many things about adequan. Prednisone makes the dogs urinate but does make them comfortable. You can always try other things. Keeping your dog confined in a clean area will limit everybody frustration -,was a great idea. When my dog does not eat or drink and let's me know they are in immense pain then I know it is time. It sucks getting old.


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