The Dreaded Choice: Euthanizing My Dog With Dementia

Cricket was my familiar, my baby, my little soulmate. We chose each other and stuck together like glue.

Adopting a Middle-Aged Dog

When I got Cricket from rat terrier rescue, she was already about six to eight years old. I thought I was in for heartbreak by adopting a middle-aged dog. Well, I was, but not because we got only a couple of years. We got ten years, and I’m so grateful for that. But I was still in for heartbreak because of how much we loved each other and because ten years, or twenty, or thirty would never have been enough.

Cricket as I remember her best: confident and direct. The other dogs disliked her direct gaze.

Cricket was a robust little thing. Only 12 pounds, but sturdy, intense, brave, and frankly, bitchy to other dogs. Even with limited interactions between the two of them, Cricket managed to intimidate my very pushy puppy Clara, who quickly grew to be more than three times Cricket’s size but never even thought of messing with her.

Cricket never had many health problems. The worst thing that happened was that she would repeatedly scratch her cornea when rolling in the grass and had to wear a cone on her head for long periods during the summer. And as she aged, she developed neurological weakness in her hind legs. But that was it, man. Otherwise, she was healthy as a tiny, sturdy horse.

Cognitive Dysfunction Syndrome

So as bad luck would have it, this strong little dog who was aging so well and was so physically strong started to lose her mind instead.

I had some experience with dementia since my mother had Alzheimer’s, but I had no idea dogs could get it until then. I tell the story of Cricket’s diagnosis and how I learned about dementia in my book. But that’s not my focus today. Most of the people who come to this website are already struggling with the thought of euthanizing their dogs. So I am going to skip ahead, over our wonderful years together, and go to the end.

There’s that look again

I have to be honest. I could talk about the tragedy of canine cognitive dysfunction and the pathos of watching a dog’s mind deteriorate. Those things are real and commonly experienced by owners. But in my case, once I learned what was going on, I rolled with it. Goofy and mixed up, she was still my little Cricket. She was still essentially herself. I do realize now that, while I had to deal with some pretty difficult symptoms (like her pooping on the rug and walking around in it almost every day), we had it easier than a lot of others. She actually slept at night. She got quieter instead of barkier, to the great relief of my other dogs.

But this is the hardest thing to explain: I wasn’t really that sad about her dementia. Of course, I wished she had all her marbles. She had been such a sharp little dog. But I could and did accommodate her decline. She lived for two years after her diagnosis. I couldn’t be sad all the time. I loved her fiercely. She was still 100% my little girl.

Starting to Consider the Euthanasia Decision

I started agonizing over the decision of when/whether to euthanize her pretty early in the game. She scratched her cornea again when she was 15 or 16, and since by then she couldn’t cope with the plastic cone, I thought I was going to lose her. Over a scratch in her eye! But I found another kind of device she could wear that prevented her from bothering her eye, and she healed up and was fine. Whew. Thank goodness for the inflatable doughnut.

But from then on, I was always assessing. Was she happy? Were her days mostly positive? Was I being selfish by keeping her with me? Was she miserable because of her declining mental capacities? I checked with trusted friends regularly to make sure I wasn’t unduly biased.

Through observation, I determined that she wasn’t bothered by her decline. She didn’t know about it. This is true of many humans with Alzheimer’s as well. Not all, but many. There is even a name for the syndrome of not knowing you have something wrong with you: anosognosia. It is actually a typical symptom of dementia. And to all appearances, Cricket had the doggie equivalent of that.

What’s Are the Problems With Common Attitudes To Euthanasia?

I feel confident in reporting about typical attitudes in the U.S., and these may be prevalent in most other English speaking countries as well. People who can afford to give their pets good medical care usually decide to euthanize their pets when they won’t eat and start to waste away. If we feel like we can control the pain of whatever condition they might have, we take “not eating” or sometimes “unable to walk” as the main turning point. But I have come to observe that many pets are already living with pain and a poor quality of life before they refuse food or become too weak to walk.

I started listening to wise people like Blanche Axton and Sue Matthews, who both wrote beautiful pieces about their attitudes towards euthanasia and were kind enough to let me reprint them in my book, Remember Me. I think the chapter where the three of us tell our stories gives more comfort to people than any other.

They—and I—don’t want to squeeze out every last day our pets can handle. We want to help them leave this life before the final decline. The saying, “Better a week too early than a day too late” has become my mantra. I imagine this is shocking to some people. We all need to make our own decisions about this. But I bet also that to some people who are struggling with guilt over a dog with dementia it can be a great comfort.

The Last Months

In 2013, Cricket could no longer go on a real walk (she circled instead). She got trapped behind stuff and paced or circled much of the day. But she still went to work with me most days. She had a good—a great—appetite. And she still knew me. This was pivotal for me, and I don’t think I was being self-centered. She had gone through periods of anxiety early in the onset of dementia but seemed to have passed through them. The medication she was on, selegiline, probably helped. But I feared the day she would forget me. Maybe the anosognosia would help there, too. Maybe she could keep sailing through life just fine without me. But I didn’t want to risk it. So that was one benchmark I was conscious of. I wanted to let her pass out of this world before she forgot me, lest she would become anxious again.

A friend remarked how she always stayed close to me. When I was present, she would toddle up (remember the rear end weakness) until she could sniff my leg to make sure it was me. Then she would stick around with me. She would stay with her head right next to my leg, her nose often touching. This was such a comfort to both of us. And a signal to me of what was important to her.

In the spring of 2013, I observed that she enjoyed our time together outside less. She had lost most intention. She still peed when I took her out, bless her heart. But after that, she would simply walk downhill, wherever that took her. She had little volition. And she was less interested in smells. In late March she forgot how to drink water. She still had an appetite and ate healthily, but she had forgotten how to drink water. I made all of her meals into soup with milk or unsalted broth, or just water in a pinch. She continued to eat with gusto and I kept her hydrated that way. But I knew her quality of life was teetering.

rat terrier with dementia with her head on a pillow

Cricket near the end of her life

She grew frailer. She had no metabolic or internal problems that I knew of, but her rear end weakness was making it harder to walk. Her balance was poor and when she did walk she had no idea where she was going. I knew the time was coming, and I obsessed about when. I was proud that she was still at her lifetime normal weight of 12 pounds. She was still eating great. When might that change? What else might change before that?

Owning My Decision

People often say that the dog will “tell you when it’s time to go.” My opinion may not be a popular one, but I believe that when we wait for dogs to tell us, we have often waited too long. So many dogs are stoic. The day they lose one more pound and look more emaciated, can’t get up to stand, or look at us pleadingly may well come after they have already suffered. We can’t eliminate all suffering, but we don’t have to force them to go down this road, either because we want their companionship or we feel guilty taking our beloved dog’s life.

So I didn’t wait for a signal from Cricket. She was cognitively impaired, after all. I can be sentimental and romantic, but I won’t do it at my dog’s expense. It’s a romantic thought that the dog will know when it’s time to go and somehow convey that to you. I decided not to count on that.

The day Cricket had a major seizure, I decided to euthanize her. That, to me, was the turning point that indicated we were looking at a downhill slope in her quality of life.

It was one of the hardest things I’ve ever done, but I decided to euthanize her immediately. I didn’t try for a sweet last day or night. The weekend was coming up and I didn’t want her to have more seizures. And I had already been trying to make all of her days sweet.

It Wasn’t Her Decision

These are some of the hardest words I’ll ever write, but Cricket didn’t go easily. The vet had to use six times the normal dose of the drugs to euthanize her. There was a point during the process where, if I could have, I might have changed my mind. But I was afraid she would be left with permanent damage if I tried to reverse the process. In the end, I still think my decision was the right one. But when she sat in my lap, alertly looking around, after the first dose—double what should have euthanized her—it was agony.

On the other hand, I had long known that this was the way she would go out of the world. She was tough—terribly, terribly tough—and full of life. She wasn’t going to make it easy for me. That’s who she was.

Canine Cognitive Dysfunction Is an Illness

It is very, very hard to euthanize a dog who can still walk, will still eat, and has it in her to growl at the vet. I can’t count how many times people have come to this site with a dog who is in very late stage dementia but the person is convinced that they are being selfish for considering euthanasia. These people don’t strike me as selfish. Not at all. I think in some cases, euthanasia is the most unselfish things we can do for our dogs.

Dogs with metastatic cancer or end-stage kidney disease are obviously ill. We can see their suffering. But sometimes, when dogs with advanced dementia still have fairly healthy bodies, we can’t see it. But canine cognitive dysfunction is a progressive, debilitating illness, as serious and impairing as many others.

You folks who come to this website are almost all suffering. You don’t usually get a lot of praise or affirmation from the world for all you are doing. But you are heroes to me because of the amount of thoughtful, endless care you provide for your sweet, ancient, confused dogs. I wish for peace and comfort for all of you and for your dogs.

 

See more resources regarding euthanasia here

Copyright 2017 Eileen Anderson

Loving Enrichment for a Dog with Dementia

Jennifer and Yoda

Jennifer Fearing and Yoda

Enrichment is a win/win situation. Studies say that we **may** be able to slow the onset and progress of canine cognitive dysfunction by enriching our dogs’ lives. But even if we don’t, we certainly are helping them in the moment.

I have gotten to know Jennifer Fearing and her lovely dog Yoda through my book and this page. She read my book and prompted the Sacramento Bee to mention it in a feature article about aging pets. I’ve linked the article below.

What I want to highlight from the article is the movie Sue Morrow of the Sacramento Bee created of Jennifer and Yoda. It is a beautiful example of caring for a dog with cognitive dysfunction and keeping him active and engaged. It shows the power of enrichment.

Our pets are living longer than ever before–Sue Morrow, The Sacramento Bee

Jennifer has loved and cared for Yoda since he was an abandoned pup, four weeks old. Even with the slight standoffishness that has accompanied his dementia, you can see how strong the bond is between them. The movie gives me goosebumps. Jennifer speaks so frankly of their relationship, the ways she helps him. Jennifer is working with board certified veterinary behaviorists at U.C. Davis to give Yoda the best life possible for his remaining time, and speaks about the importance of recordkeeping to track his condition and quality of life.

Jennifer told me that Yoda has had no small part in shaping the person she has become., and that she feels it is her privilege to care for Yoda. We should all be so lucky as he.

Related Articles

Keeping a Wandering Dog Safe and Happy at Night

Beetle, a brown and white Jack Russell Terrier

Beetle


 

My friend Jane Jackson has graciously agreed to share her story about her wandering senior dog Beetle and how she kept him safe at night. These are her words.

“I have a Jack Russell Terrier who will be 16 the day after Christmas.  In the last year, he had started to pace and wander at night and eliminate in the house. I had never crate trained him beyond the early puppy stage although I had tried a couple times. He hated confinement (this was before I had trained at the Karen Pryor Academy, so I didn’t know how to help him feel better about it). My husband was really tired of cleaning up the house or the alternative when he got up in the morning (he got up long before I did) though, so something had to be done. I put a wire crate in my bedroom, right next to my bed, put Beetle’s favorite blankets in it and when I went to bed, I put him in it with a treat or two and then dangled my hand through the wire in an effort to help him feel comfortable as I tried to go to sleep. Before long, I could feel and hear him start to shake, pant, and then whine, and so I opened the crate door. He walked a couple steps and pooped on the floor. That obviously wasn’t going to work. 

A brown and white terrier sleeps in his bed inside an exercise pen that prevents wandering

Beetle, cozy in his bed in his ex-pen, with night light nearby

Next I thought I’d try an ex-pen setup as I had seen another trainer do for her elderly beagles. I was afraid he’d howl and panic being confined but I gave it a try hoping he wouldn’t soil his bed. I put the ex-pen around his favorite bed in his favorite corner and made it about the size of two crates, putting pee pads on the bare floor. I waited until he was asleep and then closed it up. I turned a night light on right next to it, crossed my fingers and went to bed. Lo and behold, he was sleeping peacefully in the morning and the pee pads were clean and dry. The same thing happened the next night, and the next and so on. In the approximately nine months since we’ve been doing this, I’d say he has peed on the pads maybe once a month. I’ve never heard a peep from him (our bedroom is close enough I would) and my husband says Beetle is sound asleep when he gets up in the morning. He opens the pen so that when Beetle does wake up, he can get out on his own.

It is astonishing to me that this works and I can justify it in various human ways but I just wanted to share it in case someone else has a dog who can’t tolerate a crate and assumes that an ex pen won’t work. 

I got this particular ex-pen because it is plastic and I didn’t want a wire one scratching up our wooden floors. The thing I dislike about it is that it is REALLY loud when you move the panels. They don’t slide open and closed, but POP, POP, POP. I find it annoying but it scares the bananas out of Beetle. I open it all up during the day (as seen in the photo below) so I have to remind myself to get it set up for nighttime before he drifts off. I do always sit with him (the dining room table is right next to this) until he goes to sleep. I don’t know if it’s necessary but I prefer it to feeling like I’m locking him up and leaving. 

A brown and white terrier is in his bed inside an open exercise pen

The open pen during the day

My human best guess is that being confined reassured him rather than panicked him because it limited his options. Rather than wandering around the dark house looking for me or a way out, getting more and more anxious, he just went back to sleep. I didn’t use a webcam so I don’t know how much he paced in there but nothing was disturbed and as I said, I never heard a peep even though he was always one to squeak or howl if he got locked somewhere behind a closed door by accident.”

This is Eileen writing again. What works for individual dogs really varies. But Jane and I wanted to share this method because it’s worth a try for others who are dealing with night wandering and incontinence issues in their dogs. Beetle doesn’t normally like being confined, but he felt safe and comfortable in the ex-pen setup. Some of the rest of you may be so lucky with your dogs as well!

Jane Jackson is certified by the Karen Pryor Academy for Animal Training & Behavior (KPA CTP), is a Certified Level 2 TAGteacher, and a member of Alexandra Kurland’s coaching guild.

You can contact her and read more of her work at The Dog Chapter

Webinar: Canine Cognitive Dysfunction

Is your old dog starting to act a little…different? Or do you have a mentally healthy senior dog and you hope to keep him or her that way?

Join me in my webinar on canine cognitive dysfunction and dog dementia through the Pet Professional Guild on Monday, December 14, at 1:00 PM U.S. Eastern Standard Time.

Small black and white terrier stands in a corner with her head in a corner close to the wallI’ll be covering the definition and prevalence of the disease (much more prevalent than most of us knew!), common symptoms (including on unpublished videos), the treatments that show promise, and questions to ask your vet. I’ll also discuss the commonalities with human Alzheimer’s, and most important, how to keep a dog with dementia safe and enriched. I’ll include the subjects of euthanasia and quality of life. Euthanasia seems to be an even more difficult decision for owners of dogs with dementia than with a dog with most other infirmities.

Even though the behavioral symptoms that arise with cognitive dysfunction mostly can’t be modified with training, I’ll talk about how trainers can help their clients with dogs afflicted with this condition.

There will be resources galore for further information including links to videos, product descriptions, and assessment and decision-making tools. There will also be time allotted for questions.

The webinar will be recorded and all participants will receive the URL for access. This is a great option if you can’t come at the scheduled time.

Cricket with advanced cognitive dysfunction late in her life

Cricket with advanced cognitive dysfunction late in her life

Hope to see you there!

Canine Cognitive Dysfunction: What Dog Trainers and Owners Need to Know