Heart Failure: When is it time to stop?

Hi,
I have not posted for a long time but know this site is always good for advice. I rescued Popsy about 3 years ago and she had a slight heart murmur then. It has got worse over time and she is on Vetmedin and Frusomide. The last few days she has got very bad and her breathing has become laboured. The vet gave her a boost of drugs and asked if I wanted her PTS but I just could not bear the thought so brought her home to see how she goes the next few days. She has a slight chest infection so that is not helping.
My question is will this improve or is this a slippery slope. The vet said she might pull through but I am not sure what to think.
Some honest advice would be appreciated.
Her stomach is slightly bloated so I know that means a fluid build up but have people seen this worsening in dogs and then them get better for a while?
Thanks in advance for any help. Am clutching at straws because she is my little princess and I can't bear to think this might be the end.

I am so sorry about Popsy I can't imagine how tough it is for you right now. I would read the forum post Karlin put about when do you know it's time. No one wants to go through this and I will pray for both you and Popsy. This forum has great people to offer you support. Thoughts of you

What is her quality of life? Does she walk around and wag her tail? Does she have a good appetite? Does she just lie on her stomach and breathe heavily? Can she go out and squat to urinate and defecate on her own? Does she still do anything that she always has enjoyed doing?

I think that at some point we have to get as objective as possible and ask ourselves if our dog is enjoying any part of her life. Ask ourselves if we just keeping our dog alive for ourselves.

I think Karlin has a thread elsewhere on this forum about this topic.

Quality of life

Thanks, I read the other posts that Karlin listed and they do help.
She has always been an old dog that walked slowly etc but is struggling a little more than usual. She was stood wagging her tail when I got in and is eating and drinking and going to the toilet ok. She is not managing the stairs at the moment without struggling for breath.
I just don't know whether this is going to get any better or if its just going to get worse. Can't find posts on dogs with heart failure and chest infection that have got better after a few days (I know that at some point the heart failure will get untreatable)
I am going to see how she is over the next day or so and then make a decision. The vet can come to the house so she would not have the distress of a visit to his surgery.

It's one of the hardest decisions so many of us have had to make over the years. With mine there has usually come a day when I just "knew" they didn't want to struggle any more. Things can sometimes deteriorate very quickly though, so I now feel it is much much kinder to give them their wings before there is any desperation about it, especially if you have faith in your vet and they can come to your home.

Will be thinking about you and holding you in our hearts.

I'm so sorry you're going through this. My thoughts are with you and it's true that you will "know" when it's time. Sending lots of support...:hug:

Extra diuretics can help sometimes but I think they will only buy a little time.

Spoil her while you can and let her go when you know in your heart it is time.

We are all here for you.

No words of advice, just wanted you to know I am so sorry you are in this situation now. I will be thinking of you and know that you will make the right decision, whatever that may be. Hang in there and know that there is a community of people behind you.

So sorry to hear this - a chest infection would make things worse, I presume she is on antibiotics for this? If so, maybe give it a few days for them to work [see what your vet says about that]


Fluid build up is managed with diuretics, there are various different ones and combinations that can be tried, also it is possible to drain the fluid in a special procedure, but it's not pleasant for the dog and something you would not really want to repeat.

Sadly it's a battle that your dog is not going to win which is something you need to prepare yourself for - as others have said, they usually let you know when they have had enough, but sometimes we just want to keep them with us and that is not fair to the dog - or to yourself as you will always carry a level of guilt afterwards.

I always feel it is better to let them go too early than too late.

Is Popsy under the care of a cardiologist? They really are the best people for managing heart conditions - a vet is the equivalent of our GPs - brilliant for many things, but you would really want a specialist to manage a heart condition for yourself.

Cardiologists are experts on all the drugs - it is worth asking your vet - also as I said before, whether the vet thinks that the current problems are due to the infection or whether this is part of the deterioration.

Please keep us posted, we are all here for you - and will help however we can.


If you scroll through this forum you will find stories of other dogs battleing MVD which might help

http://www.cavaliertalk.com/forums/forumdisplay.php?56-SM-and-MVD-cavaliers-forum



Perhaps you would also be kind enough to share your story for the Two Little Cavaliers blog who are doing a feature on MVD in Februrary?

http://twolittlecavaliers.blogspot.com/2010/12/syringomyelia-awareness-event-we-need.html

If it's any help, I am another who has a gut instinct when it is time for the last kindness. Unfortunately I am not one of the lucky ones whose dog has made the decision for them

I have had to help several across the bridge over the years.

The most definite indications have been a greedy Poodle who sat on her food bowl because she was too ill to realise she was supposed to eat the food and then there was Angus, a very macho Cavalier almost 17.

I knew he was really frail when a tiny little Yorkie pup came rushing up to play, collided with him and poor old Angus went down on his side and found it difficult to get up again. A few days later I was out with him when he wanted to do a pooh, but he could not squat to do it. The expression on his face was pitiful. I didn't even stop to ring the vet's to say we were on the way, just went and got it done.

I think loss of dignity is important here. You will know when it's time.

Fiddichs wrote: 'She is not managing the stairs at the moment without struggling for breath.'

Whatever you eventually decide, please don't let her even try stairs - just relieve her of anything that puts more stress on the heart, and carry her up and down - even out into the garden if necessary, especially if there is a step to go up and down.

Having had two Cavaliers die of heart failure, I found with both of them that there is a certain look when they know they have reached the end of the line. It's trying to do something simple, like walking even one or two steps without wobbling and having to sit down, or lowering their head even slightly to drink, and not being able to do it because their chest is so constricted. They look up and say with their eyes 'Mum, I can't do this - help me!' There are lots of ways you can help them before that stage is reached (like carrying them to prevent unnecessary strain on the heart), but when it is something as simple as walking or drinking and they can't do it for themselves and it distresses them, that for me is the moment when you help them on their way.

I'm in tears as I write this, because I can remember so clearly Meg (who had been in heart failure for 6 months but still enjoyed life) trying to drink, not being able to manage it, and looking at me so puzzled and so trustingly for help; and Rowley (who had only had a heart problem for about 2 months and collapsed out walking the day before) trying over and over again to go out into his beloved garden and never getting more than a couple of steps outside the back door without collapsing. The good side of it is that it becomes very clear what you have to do, so you don't feel guilty for doing it. It's your last act of love.

Kate, Oliver and Aled (who both have murmurs)

When is it time

I am so sorry to hear about your dog with MVD. I lost my dog 18 months ago to MVD. It is the hardest think to watch your dog go through this. We had our dog Sam for 12 years and he had a great life with us up until the last eight months of his life. He just went down hill very quickly. You have to be kind to your dog even though it is extremely hard to do because they are a part of your family for so long. When they get to a point where quality isn't good that's the time to say goodbye. I have tears streaming down my face writing this. It is heart breaking but it's the right thing to do for your dog. You will never forget them and you will always have great memories of her. Please don't let her suffer too long. My heart goes out to you.

Deb

Kate H said:

...The good side of it is that it becomes very clear what you have to do, so you don't feel guilty for doing it. It's your last act of love.

Click to expand...

I think that sums it up.

How are you Fiddichs? We're all still thinking of you and Popsy and are here for you when you need us.

Popsy

Hi everyone,

thank you so much for all the replies. This week has certainly been a rollercoaster but at the moment Popsy is still with us. She has improved and I think maybe the antibiotics have helped so after arranging to take her to the vets when the surgery was closed so that she would not get too stressed when we took her. I think she heard the discussion and decided to fight a little. She is still not back to where she was 2 weeks ago but is a lot better. I have noticed her appetite is not great, even chicken is left on the plate but she is eating a little. She can walk around (we carry her up and down the stairs, don't even let her try), goes outside etc.
We have decided to see how she is over the weekend. She is sleeping a lot better and seems happier.
I know the time will come soon but at the moment I think she is still having some quality of life.
Its so hard. We rescued her in a terrible state and I thought that we would get more than 3 years of her enjoying life and being pampered.
I will keep you all updated. Just so happy that tonight I can lay on the sofa with her and cuddle.

Thanks so much for this update. Glad that Popsy is a little better and we'll keep you both in our hearts over the weekend

Our last goodbye

Unfortunately Popsy took a turn for the worse and we made the decision yesterday to help her on her way. It was such a difficult decision and even when I got to the vets i wanted to run away however when I held her in my arms and she drifted to sleep I knew it was the right thing. Her heart was pounding in her chest for the last few days and you could feel it beating so hard. when she finally rested she was so at peace.
I just wish we had got more time with her. She was such a special little dog and was in such a state when we rescued her that she deserved to have a life of pampering and I feel it was not long enough for all the suffering she had.
Thank you for all your support and kind words.
Hopefully one day we will be able to enjoy another dog just as much.

I'm so sorry about Popsy:hug: we had a similar experience last year. I always hoped Sonny would just pass away in his sleep. Sadly this was not to be. I had always maintained to my hubby that I would never be brave enough to make the decision to take that last trip to the vets but his last night was so awful . At one point in the morning he looked at me as if to say "Mum help me" and I just knew. My vet had warned me that a time would come and decisions would have to be made that were in his best interests. It dosen't stop the pain.
For now remember the happy times and cherish the fact you put your baby before your own feelings. I joined this forum a couple of months after losing Sonny and they are such a bunch of lovely caring people so please don't feel alone, there's always people here willing to listen and help.

Carolxx

Three years of such kindness and care, and to die with someone you love holding you. It is so sad, but you gave her some last wonderful years and a good death.

Bless you for all you did for her.

My very best wishes,

:hug:So sorry to hear that you had to give Popsy her wings. Remember she will have a place in your heart always.