Liver failure - end of life

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Liver failure - end of life

This is a discussion on Liver failure - end of life within the Dog Health forums, part of the Keeping and Caring for Dogs category; Hello! I'm hoping you all could provide some guidance. I've spoken with my vet but wanted an impartial opinion. I have a 12.5 year old ...

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Old 09-07-2016, 09:56 AM
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Liver failure - end of life

Hello! I'm hoping you all could provide some guidance. I've spoken with my vet but wanted an impartial opinion.

I have a 12.5 year old maltese. About 4 years ago she had a vaccine reaction and since then her liver values have been very high. I moved three years ago and the vet here connected her high liver values to her symptoms: lethargy, weight loss, vomiting, diarrhea. She was treated with medication for a few months until her values came closer to normal and she was asymptomatic but has been on a liver diet ever since.

Three years ago with the diagnosis of liver issues she had a bile acid test, ultrasound, biopsy, and probably some other tests I can't remember but nothing was able to determine the cause. We're thinking it's the vaccine reaction since it started about that time.

She's been asymptomatic since she recovered. Her values were never "normal" again but were much closer to the range they were supposed to be. She had her check up again last week and the routine blood work shows that her values are incredibly high again, about double what they were at her highest. The month or so she has slowed down some and gotten pickier with food but no vomiting or diarrhea. I probably should have taken her into the vet earlier but was in a little bit of denial on what it all meant. She will eat if I feed her food she wants, like grilled chicken. She's back on the medication as well.

My question is more what I should look at for end of life stages and how do I know it's time? My vet gave me the clinical symptoms to look for and "does she seem happy?" But I'm concerned she's in pain and I just can't tell. I'd like to have her as long as possible but on the other side don't want to prolong her life if she's in pain just because I'm not ready to let go. Since I've been watching a little more closely I have noticed that she's gotten a little less friendly with the other dog and cat that we have. Not aggressive but if they jump in her face she snaps at them, where as before she wouldn't. She's not playing with the cat any more either, and she was always the one initiating a few months ago.

Thanks for any help or advice.
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Old 09-07-2016, 11:10 AM
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I'm with your vet on this one, although my vet would say, do the good days outweigh the bad days?

The good days would be different than a young dog, at 12 with a serious health problem you're looking for comfortable, content, sleepy, relaxed--not playing with the cat, and getting a bit grumpy I think would be par for the course (she's just maintaining space)--that still counts for good days.

As for not knowing if they're in pain...you've had her for 12 years;
While you won't know if she's in pain or not, it's not the physical presence of pain that you or she will worry about; what you need to know is, 'is she in distress' and after 12 years, have confidence that you will know that-- those would be the bad days.

Keep in touch with your vet for 'management', meds to make your dog feel better, and keep in mind some things are still fixable and some things are chronic but not immediate.

I thought my 16 year old cat was 'dying' 3 years ago...he has pancreatitis, and is getting older, and older, and slower, and more finicky, and so it goes...he loves to sleep in the sun--having a wonderful day in western window.
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Old 09-09-2016, 09:30 AM
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Thanks for your response! That helps a lot. I think I was concerned she was in pain and I didn't notice because of the behavioral changes but you're right that those changes are probably more in keeping with a dog her age and health, not necessarily just pain. She was so lively before it was a contrast to me. Thanks again!
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