Struggling with unanswered questions and guilt -Hemangiosarcoma

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Struggling with unanswered questions and guilt -Hemangiosarcoma

This is a discussion on Struggling with unanswered questions and guilt -Hemangiosarcoma within the Dog Health forums, part of the Keeping and Caring for Dogs category; This is my first post here, and I only wish I found this forum while my girl was still alive. Our 10 year old boxer ...

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Old 12-09-2016, 03:50 PM
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Struggling with unanswered questions and guilt -Hemangiosarcoma

This is my first post here, and I only wish I found this forum while my girl was still alive. Our 10 year old boxer Layla is our whole world. We do not have human children, so we treated her as our baby. The diagnosis of cardiomyopathy two years ago was devastating, but we controlled it with regular ultrasounds, holter monitors, and sotalol, then most recently mexiletine. Her first few months on the newer anti-arrhythmia meds were wonderful - she was more playful, more alert, energetic and so happy!! It was truly precious; she was like a puppy again.

When she started having symptoms again - coughing, fainting spells, lack of energy, not playing with her favorite toys - we called her cardiologist to get a recheck to make sure her meds were right and see if perhaps she was now suffering from congestive heart failure. He got us in Wednesday after this past Tuesday's very scary nighttime seizure, followed by a long coughing fit and rapid breathing. We had no reason to believe it was anything other than her heart, but on the day we were going to see him she coughed up a dime sized amount of blood, and she had a considerable amount of fluid in her abdomen. The cardiologist was very surprised to see this and after X-raying her found that she had a walnut sized tumor on her heart, and her lungs were full of smaller tumors, and this combined with the blood in her belly area provided him with the answer, which was our worse nightmare - Hemangiosarcoma. He was certain there were tumors elsewhere in her body as well. He gave no indication of suggested treatment because it had progressed so quickly, and it is such an aggressive cancer - he had seen her this past August and she was cancer-free (at least in her chest and lungs) at that time so was visibly shocked to give us the news, as were my husband and I. We have never been so sad and worried in our lives.

We went home hopeless and devastated, Layla none the wiser. The cardiologist's suggestion was to spoil her rotten because she likely had just weeks left with us. My first idea was to find anything we could to prolong her life - Chinese herbs to help the bleeding, B17 to fight the cancer, and to stay as close to her as we could at all times to help her through the inevitable seizures and coughing fits. Wednesday night she had two seizures at night and one collapse after getting up. She was looking blankly around the room and at one point was visibly frightened by what she saw, and startled by me when I tried comforting her. She was drinking so much water and losing her bladder on the couch and on her bed. She had no energy, but still alert and watched us cry all day long.

My husband and I decided to see our normal vet last night to see what would be the best option for her to be most comfortable. I was very tentative to not fight as hard as possible to keep her with us past the couple of weeks the cardiologist gave her to live. She was alert when we brought her to the vet last night and she still had her appetite - these were the two things (plus that wagging nub of a tail) that made me hopeful and want to see if she could fight this.

Our vet confirmed there was nothing we could do for her - we could wait it out with her at home with us, with her likely dying painfully at any time from a ruptured heart - so we made the decision I never thought I could. We held her and kissed her and told her we loved her. This was yesterday at 4:15pm. I still can't believe she is gone.

Besides just being somehow therapeutic to share Layla's story, I had wondered if our decision was too premature. The seizures were traumatic for us, but were they just as bad for her? How can I ever get over making this decision for her, while she looked alert and confused at me with her clear, very alive beautiful brown eyes? The guilt is getting the best of me, despite knowing the alternative would have been worse. Any feedback is appreciated - if nothing else I've told her story and it somehow gives me relief. Thank you??
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Old 12-09-2016, 04:28 PM
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Hi Rachel518

So sorry for the your loss of Layla.

Don't give yourself a hard time about this, you did the right thing. It's heartbreaking to make this decision, but you have to do the right thing for your dog, you can't let them suffer.

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Old 12-09-2016, 05:53 PM
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Rachel, you absolutely did the right thing.

I had to say goodbye to my 13 1/2 year old girl in September and I know how hard it is, but take comfort in the fact that you gave Layla an incredible life and made the best decisions for her at the end. There's a saying that brings me a lot of comfort: better a day too soon than a moment too late.
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Old 12-09-2016, 06:42 PM
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You did the right and loving thing. Our dogs rely on us to make these decisions for them, out of love. I waited too long once with a dog and it's one of my biggest regrets in life

I'm so sorry for your loss
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Old 12-09-2016, 09:32 PM
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I've had two dogs with probable hemangiosarcoma- my 13 year old APBT and my Dad's 11 year old Cocker. My APBT, like Layla, also had heart disease, and had had issues with ascites (fluid in the abdomen) accumulating due to CHF. We were trying to manage that with various meds, and also removing the fluid as needed to keep her comfortable. She had had chest rads and an echo by a cardiologist a month or so before she died, and they hadn't seen anything amiss other than the heart disease. She occasionally had episodes of fainting/syncopy if she overexerted herself due to the CHF. She was losing weight as well, but I assumed it was due to her sometimes picky appetite. I got home from work one evening and she was "fine", rolling around on the floor with me while I was watching TV, but within a few hours, she had started to develop ascites, and seemed to be having a harder time breathing. We took her to the vets (I work there as well), and an abdominal tap revealed only blood. She had previously had slightly bloody fluid in her abdomen, so I was concerned, but not as much as I should have been. The vet who was seeing her (not her normal vet) suggested hemangiosarcoma when I asked what could cause the blood in the abdomen (my naive, logical mind cried, "but her rads and ultrasound were fine!"). I ended up taking her home, with the intention of trying to get an ultrasound appointment for her in the AM. She started wobbling/stumbled on the way out, and I carried her to the car and into the house, sitting on the floor beside her while I called the local ER, realizing at that point that I couldn't wait til morning if I wanted any chance to "save" her. She deteriorated rapidly once we got home, and died within 10 minutes of our arrival, plans for the ER dumped once I realized that it was too late- even if we had left from my work, she would have died on the way. She didn't seem painful, but I can't imagine it felt good. Part of me was glad she died at home, because she always hated the vets due to being kenneled there long term after an injury before we owned her, and she was fear aggressive- her last moments would have been muzzled and afraid, despite my best efforts to make her feel otherwise. Knowing what I know now though, I hope that I would have the sense and fortitude to choose to euthanize if faced with a similar "surprise" diagnosis in the future.

My Dad's dog was diagnosed with a spleenic- and likely liver as well- tumor (probably hemangiosarcoma) after I noticed one side of her protruded slightly more than the other. I was standing there when the rads went up on the viewer, and knew by the Dr's crestfallen expression that it wasn't good news. She was still eating, getting around ok, and asymptomatic other than the protruding abdomen, and she offered surgery to try to remove it, but cautioned that it was likely malignant due to the location and the fact that it involved more than one organ, and that prognosis long term even with surgery would be poor. My Dad decided not to do surgery (I would have too), and we euthanized her a month or so later when she started having a hard time getting around, eating less, etc.

Someone in the pet therapy group I volunteer with had a hemangiosarcoma removed from their Golden, and she lived another 2 or 3 months following surgery, I think. She seemed to feel good during that time, and recovered from surgery pretty quickly.

Regarding seizures, my old lady dog, Annie, died at the end of september, with a multitude of issues, seizures (probably a brain lesion due to increasing frequency and symptoms), mild heart disease, dementia, pulmonary edema, and kidney disease. The edema/breathing issues were a fairly recent development but were fairly well controlled by meds, and her neuro symptoms had worsened in the 2 weeks or so before she died, she had had a couple seizures over that span as well as some other abnormal things. Her appetite was picky, good one day/meal, and non-existent the next, though we could usually find something to tempt her. Several times over the 6 month span or so before she died, I was planning to have her put down because one issue or other seemed insumountable, and she rallied and changed my mind. She had done poorly (only eating select items, and usually not the same thing twice, 1 episode of disorientation plus other neurological symptoms) over the weekend, and I had decided that I would take her to be put down on my day off (tuesday) if she didn't have a dramatic change either way before then. She ate spam eagerly Monday morning, and even some dog food with spam mixed in, was wandering around like normal when I left for work, then died uneventfully in my Mom's arms that afternoon.

I had asked her vet about "quality of life" after a seizure over the summer (the worst she ever had, she actually stopped breathing and turned blue, then started breathing again on her own), and he said that dogs are essentially unconscious/unaware during a seizure, so if she seemed to have no lasting post-seizure issues, and the seizures were manageable/not too frequent (we tried a low dose of phenobarbital which may have helped some, and they occurred about once monthly), that alone was probably not a reason to euthanize her. She would seem to have more significant vision issues (she was 18 and already had poor vision) following a seizure, and I had a diabetic dog previously who occasionally had seizures from hypoglycemia, and would be blind for a period after, I think that is a fairly common post-ictal symptom, and could explain why Layla would seem disoriented/startle when touched.

For Annie, since she seemed content and comfortable, most of the time, and there was no imminent "painful demise" at hand that we knew of, I had pretty much decided to put her down if/when she declined to the point where she was no longer doing her normal "old dog" things, eating, wandering/following my mom around the house, sitting with someone and getting petted/scratched. In a case where a natural death is more likely to be traumatic/uncomfortable, I think it is kinder to act sooner, rather than later, if there is any doubt. I have also heard from some people, but have a hard time drawing this line for myself, that once it becomes clear that the dog is not going to get "better" (ie: terminal diagnosis), it is better to have them put down sooner rather than to let them deteriorate, since they have no concept of the time that they "miss out on".

I don't really know that there's a "wrong answer", as long as it's made with the dog's best interests in mind. Given the care that your dog received and the love that you obviously had and still have for her, I have no doubt that you made the right choice for her. They should all be so lucky!
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Old 12-10-2016, 05:49 AM
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Thank you so much for your input, everyone. I needed the reassurance that you have kindly provided me and one day will be able to offer the same to someone else now that I've experienced this. It troubles me quite a bit still that her appetite and mobility and alertness were all there and I think that's why I reached out to the forum.

busannie thank you for your thoughtful and informative reply, since I didn't know they are blind for a period afterward and that explains some things. Since Layla is my first (we had several dogs as a child but she is my first in my adult years) it's my first time going through the issues of aging and caring for a dog with illness. So honestly I'm not even sure of specific differences between a seizure and syncope, but I believe after looking into it further a lot of her episodes were syncope related. She did have a lot of muscle tension during those times and I read that's common with syncope. Either way, my assumption is that since they were happening much more often and closer together than before, the end of her life was coming fairly quickly - not to mention the hopeless prognosis from both of the vets that saw her - and that does bring a little comfort that we provided her a peaceful end of life rather than a potentially painful and violent one.

I never thought I could have chosen this way of letting her go. I always felt strongly that I would not do the same to a human loved one (and it's not even an option anyway) so how could I with our beloved dog? And we miss her so very much - it's so quiet and empty here. I wake up thinking I hear her and I can smell her and I am seeing her hair everywhere but she is not here. Your responses have helped immensely however and I appreciate your kind reassurance. Better a day too soon than a moment too late is truly comforting, Bolt - thank you. I guess life will have to go on, just unfortunately without our sweet girl.
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Old 12-10-2016, 11:28 AM
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You made the only decision you possibly could have, to be as humane as possible. Now you should focus on how your love for Layla enriched her life. We fortunately are not at a point with our girl, to have to make that terrible decision, but I know watching her suffer would tear me to shreds. I like you would be forced to make the same decision you did, and I know like you, I would post decision, question myself over and over again, but the fact is there is simply no choice.
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Old 12-19-2016, 12:08 PM
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A wise man told me this weekend "we have to love them enough to let them go". And you did just that.
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