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Thread: CHF. How do you know when it's time to let go?

  1. #1
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    Default CHF. How do you know when it's time to let go?

    So elizabeth has been getting on fantastically on her vetmedin and fresuimide. Shes been like a different dog. Untill this morning.....
    Shes now panting, restless, short and sharp heavy breathing - ive even had to have a day off work because i dont want her on her own!
    She doesnt seem too bad right now, i've called the vets whom have suggested applying fortekur and prilactone back into the mix to recover her..... That is ALOT of meds for a dog who was fine yesterday!
    Im in two minds to take her down to the vets (shes currently sleeping)
    its just got me thinking, what if I take her to the vets and they suggest having her pts- i realky dont know if id feel this is neccessary at this stage- she is still eating/drinking and wants fuss. But when IS the right time, what will it take for me to know when the time is right, her to collapse, go off food?! I just dont know
    Ellie & Little Elizabeth

  2. #2
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    It's difficult to explain how this happens, but you will know without doubt when it's time to say goodbye to Elizabeth. Every dog has a different way of showing that they have had enough, with one of mine it was when a voracious eater sat on her dinner, with another it was when he was just too old to use his legs to grip the ground to toilet and yet another could not walk more than two steps without doing belly flops. The light goes out of their eyes when it's too much sometimes too.

    I am sure that by now you have decided whether or not to give the cocktail of drugs that the vet has recommended. It is probably the right thing to do, because what you were seeing was likely to be an isolated attack, which the meds are designed to clear. As I am sure your vet will tell you, the time to worry about changing the treatment is when the existing regime stops working for an extended length of time.

    Try not to worry and see what tomorrow brings.
    Warmest wishes
    Flo & the ByFloSin Cavaliers
    Rebel, Winston Alexander,Little Joe & Holly Poppet
    Birmingham, UK

  3. #3
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    Cavaliers have a huge capacity to come back from bad spells and enjoy even a limited life. But having lost two with CHF, as Flo says, it does become clear when they have had enough - there's a look that says 'Mum (or Dad), I've had enough and can't go on, please help'. I think you will know when the time comes; meanwhile take every means to keep Elizabeth comfortable and joining in life as long as she wants to.

    Kate, Oliver and Aled

  4. #4
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    Ive just read this and Im hoping Elizabeth has picked up.....thinking of you, let us know.

    Mel
    Mel
    Momma to Leonardo (Leo to his friends)

  5. #5
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    So sorry to hear you are going through this. I went through CHF with my own Cavalier last year. She was up and down for 9 months before I made the decision to let her go. It is very difficult because they seem to be doing poor one day and the next can seem like their old selves. So many times I struggled with the question "is it time?" Then with a med adjustment she was back again. I was fortunate to have a very caring vet who kept me realistic about the situation but also hopeful when things looked bad. In the end I did know when it was time and the vet confirmed it right away when we went in to see her. There just gets a point when it does take more to get them back to normal and you just know. It's hard to imagine that when you are in it but when the time comes you will do what needs to be done. When I finally did make the decision and she drifted away in my arms I felt only peace. I pray you will have that same feeling when the time comes. In the meantime try to enjoy whatever time you have. Cavaliers seem to have such a love of life.

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  7. #6
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    Hi -- I'm sorry this has happened, but the vet is right to suggest introducing some of the meds back in. With CHF, the dogs do tend to go through many ups and downs like this. It is sadly, part of the difficulty of this changeable, progressive condition (and why we've made campaigning for better health in the breed, and more responsible breeding using appropriate tests and protocols, a major part of Cavalier Talk). Too many cavaliers get heart problems, and most of them get them far too young, compared to other breeds.

    Most of the time the gradual addition, as needed, of further meds adds weeks to months -- even sometimes years -- of life for a cavalier, just as they do for people. Most of these meds will be used shorter term (as these are late-stage additions, generally, not given for years and years) and there's not a high risk of any debilitating side effects. The treatment approach for CHF is very well established and understood.

    It's important to do just as you have done -- at any sign of new or increased distress or difficulty, contact your vet or (ideally) vet cardiologist, as meds likely need adjustment or even just a little boost for a few days or weeks.

    I don't think people always know when it is time -- this can be very hard to judge and I think sometimes people wait too long, looking for some major sign of pain, which can leave a dog to struggle at a very poor quality of life for very long. I've posted an article elsewhere on the site about trying to understand when it is time -- but I've debated this in my head, for every dog or cat I've had to let go.

    Sometimes it is clear an animal is just listless, sad and so poorly that one can sense that keeping him or her going would be more for one's own comfort rather than for the loved pet.

    I think we all need to be watchful and honest with ourselves to try and prevent a dog dying in distress at home from heart disease when it could have been released gently with the help of a vet. The more experienced one becomes, the easier it is to read signs that it's 'time', but the support of a vet whose judgement you trust is hugely beneficial. I always ask mine for their honest view.

    I do think when the time comes when we are talking about days or weeks left, it is better to be a little early and give that gift of a gentle death, in the owner's trusted arms, to a companion, rather than leave him or her to suffer in distress because the 'time' was left too late.

    If a vet is advising a dog be let go when you remain unsure you can always get a second opinion, as well. But I think some of the closest ties to our vets are formed by going through these decisions, in an informed way, together.

    I would not give up hope yet, though. From your description this may just be a temporary setback needing a temporary boost in meds, or might be a point where she just needs more support from more meds but still has quite some time left. Talking to your vet should help you understand the process better.

    I'd also ask what timeframe they feel is left, as this can seem hard to know, but I think is useful to know for ourselves, and can help us to gauge what to be looking for, and when.

    Keep in mind all dogs manage differently on heart meds and progress in their own way so what stands for one may not be the case for another. Personally, I found adding prilactone made a huge difference when my Lucy began collapsing from heart episodes -- stopped them entirely for several months during which she had quite a good quality of life, before she passed on.
    Karlin
    Cavaliers: Jaspar Lily Tansy Libby Mindy
    In memory: Lucy Leo
    Cavalier SM Information site:www.smcavaliers.com

  8. #7
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    I am on this road with my Pippin, but he is doing well on meds, yet another added last week but already it is helping him. He is on three different meds for his heart now (vetmedin, cardalis and frusemide) along with his meds for epilepsy, but he is doing well and in good form, he has dips where he goes down a bit, starts coughing, not able to go for a short walk without being totally breathless and has the odd day where he seems down, but just when I start to panic, he bounces back and is demanding his dinner or mine and stealing the toilet roll!

    I totally trust my vet, who absolutely adores him, and she is always honest with me. We were very worried about him last Sept after a scan revealed he had gotten worse, but 6 months later, last week at a follow up scan we were pleasantly surprised that things had stabilised after we added in a new medication and we added yet another one for a new symptom, coughing and a bit of fluid build up that we caught early and is now not an issue. I know all this could change at any time.

    I hope your little one is feeling better by now. I panicked last Sept after that scan but now, think for me the time to worry that I have come to the end of the road is when we have tried medication and it is just not working any more, when my vet advises and/or I feel it is time, but I hope I will be able to realise when Pippin thinks it is time.

    I wish you well and future happy times with Elizabeth.
    Last edited by pippa; 20th March 2014 at 12:57 AM.
    Gus(blenhiem) Pippin(tri) DJ(ruby)

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