When to Say Goodbye

Will there come a time when you need to help your dog with dementia leave this world?

Book: Remember Me: Loving and Caring for a Dog with Canine Cognitive DysfunctionI can help with that. My book has a whole chapter on the difficult question of whether and when to euthanize a dog with dementia. Because dogs with cognitive decline are sometimes still physically healthy otherwise, this question, which is always difficult, can be even harder.

I let my little Cricket go on May 31, 2013. Here is an article on how I made the decision. I tell the story in full in my book, and two other people generously shared their stories of how they made the decisions for their own dogs.

 

Quality of Life Calculators

These quality of life calculators can help you assess your beloved dog’s whole life situation. Often these calculators bring up conditions we haven’t considered.

Book on Euthanasia

I highly recommend the following book. It was a real comfort to me as I assessed and reassessed little Cricket’s quality of life.

 

Facing Farewell: Making the Decision to Euthanize Your Pet, by Julie Reck, DVM

 

 

Facing Farewell is a comprehensive guide to making the hard decision, but in addition describes the euthanasia process in detail and helps you know ahead of time what to discuss with the veterinarian and what to expect.

Other Helpful Articles about Making the Decision

Grief

Finally, here is a piece by a physician on grieving for a dog. I think he makes some very wise points.

Lessons from Zachary: What a Physician Learns from the Death of his Dog.

An old black and white rat terrier is lying on a bed with her head on a pillow. She is staring off into the distance

                               My last photo of Cricket

403 Comments

  1. Julie Blasberg-King says:

    In January we had to say goodbye to our 12 year old dachshund Lucy who had dementia. To be honest, this was probably about one week too late. Her sister Edie (now 13 years old) started to show signs of dementia about 3 months ago, she just seemed a bit lost at times but not much more than that. A week ago I found her staring at the shower cubicle. She was just rooted to the spot and it took me a while to bring her round. She also became absolutely fixated on me, following me everywhere, obsessively licking my hands and always searching for me if I left the room, which is very, very out of character. On Wednesday, I came home from looking after my grandchildren (my partner stayed at home with the dogs) to find Edie very distressed. She is very lost, fearful, barely recognises me and just wants to sleep all the time. Although her symptoms vary from those Lucy had, it’s very obvious that she is very unhappy. Yes she still loves her food, but after eating it she just stares into space. Today we have made the decision. Her appointment is at 2pm. We will take her out to the harbour in an hour for an ice cream, then on to the vets. Our other dog Elza (2 years old) is going to be so confused. We have gone from 3 dogs to now one dog and knowing her as we do, she is going to need company. My heart is absolutely broken but I know we are doing the right thing. Actually this morning she is very weak in her back legs, so this just confirms it. I’m posting this not just to help myself, but to help and reassure others out there. I woke up this morning and there she was ready for her breakfast and my first thought was, ‘we’re making a mistake, it’s too early’, but after eating she stood at the back step staring out at nothing and I knew that this is the right decision. I don’t have any religion, I don’t believe in heaven, but I think her little essence will stay with me, just as Lucy does. Crying now so I’ll go.

    • Debra Leninger says:

      Julie. My heart is breaking for you. I said good-by to my dog with dementia June 1st 2018. I am still so sad.

    • Elizabeth Good says:

      I am so sorry to hear this about you’re beloved wee dog and you’re description of him is everything my wee dog is doing now and has been doing for a few months now still lives food as he was always a greedy wee thing, he has become totally blind as well and am finding it very difficult to try and make him happy he’s not even interested in walking anymore also but goes with his dog walker but I think she gives him lots of treats and that’s why he goes , how was youre dog diagnosed if you don’t mind me asking?

  2. Bobbi Donaldson says:

    I am trying to decide if it is time for my Mattie. She is about 14 yrs old, having a hard time with her back legs and is on pain medicine. She also has glaucoma in one eye and is losing her hearing. She can’t go up or down stairs by herself or get up on the couch. The other night she went down the hallway in the dark and sat down and began low barking. I had to go to her and tell her to come back to the living room. She is still eating, drinking and has not had any potty issues. How will I know???

    • Eileen Anderson says:

      Bobbi, it’s one of the hardest decisions to make. Did you check out the Quality of Life scales linked on this page? Sometimes they can help. I hope you still have some good times with your Mattie. Even though it’s agony to consider, it’s good that you are thinking about this.

      Hugs if you would like them,
      Eileen

  3. Eileen Morrison says:

    My dog has severe dementia, but is physically healthy. I give her CBD for extreme anxiety , trembling and pain which is very helpful. I am a nurse with experience with the elderly. Finally decided it was time to put her down. Went to the vet who said she wouldn’t euthanize a healthy dog. Offered to do $300 of tests and suggested her problems could be “managed”. This is the 3rd vet I have seen; moved recently to NC. I’ve been crying since I left the office

    • Eileen Anderson says:

      I’m so sorry, Eileen. If you are still struggling with this, drop me a line through the contact form on the Photo Gallery page. I have a dog training friend in NC and she knows a lot of vets there.

      Eileen

  4. christine says:

    My dog is 15+ years old. I rescued him 9 years ago to help me transition to widowhood. He went blind from SARDS a year and a half ago. Once he went blind we also discovered he is deaf. He pees in the house so I keep male diapers on him while inside. Our vet said she thought this was dementia but I didn’t believe it because he is a smart little guy. He sleeps much more than he used to but whenever awake he paces. He is crated when I leave home and is anxious. We recently added Trazadone but it seems to have little effect. He barks the entire time I am away so I am often hesitant to leave home.. It is hard for me to determine if his behavior is from impaired sight and hearing or if it is dementia. I have been struggling with the decision to euthanize him for many of the reasons stated throughout this website: he seems happy sometimes (especially upon waking in the morning), he eats as he always did, he walks less but is this dementia or blindness, and does it matter why? I’m just confused and often feel overburdened. I struggle with guilt over this decision.

    • Eileen Anderson says:

      Dear Christine,
      It’s super hard when they have sensory problems as well as dementia. I’m so sorry your dear dog is going through this. I don’t have an answer to your question, but please know there are others here who have had this same struggle. My heart goes out to you. –Eileen

  5. Norma says:

    In May 2019, I made the decision to put Dazee, my 17 yr old Llasa Apso, to sleep. She had been showing signs of dementia for about two years, the last year being much more difficult. With a hardwood floor it was easy to just let her potty in the house on pads and towels. The final decision was made when I slipped (but did not fall) on a puddle she made in the dining room. This made me realize my health was in danger if I fell, the injury would make it impossible to care for all three of my pets. Taking her to the vet to be euthanized seemed like the only choice and I did so with heavy heart. Her sweet and gentle nature left her many months before, but I could still remember how much she just loved life. A few months after Dazee left us, her “sister”, 14 yr old PennyLane began showing signs similar to Dazee’s. I was stunned to think she too would be embroiled in this dreadful disease. It was surprising to me how quickly her dementia progressed and I discussed this with my vet. He gave some suggestions and reassurances, but I can see with my eyes that she is slipping more quickly than Dazee. I am at this time suffering from sleep deprivation due to night pacing and barking. It is so difficult and so different from Dazee. I am not looking forward to the next step with Penny. She has been a sweetheart and very loving to everyone. It is hard to see her withdrawn from human interaction and losing this battle. Thank you for allowing me to share this very painful time.

  6. Sandra Fraser says:

    My 13 1/2 poodle, irish setter mix started with symptoms 6 months ago. He has episodes of being very needy but I didn’t think too much of it. A few days before our annual car trip to Florida (bags were packed), he started wandering into corners, barking, walking under short tables and then needing reassurance lasting a couple hours. Trip went fine. Got here and everything escalated. Barking, howling, panting severely and wandering progressing to nose bumping and knocking things over floor lamps, books on tables, tv tables, floor vases. Then he would push these things around the room. Went into the shower and knocked the shampoo around ..anything that was on a table. At first, the episodes were every couple days lasting about 4 hours….that is despite the new vet giving and increasing his medication to Prozac 40 mg., Trazadone 200 mg. three times a day, Xanas 4 times a day, acepromazine 3-4 times a day. Despite the increase in meds, his symptoms increased occurring more frequently, night and day and lasting longer with little rest in between. After an 8 hour episode, at 2:30 in the am, he was leaning his front paws on me as I lay down on the bed and panted, rapidly for about 1 1/2 hrs. I promised him I wouldn’t let him suffer any more. Despite the many symptoms of CCD, it seemed like more to me. I called my vet at home and he wondered if he had a brain lesion. I had wondered the same thing. Without seeing him, I wonder if anyone has seen symptoms this severe. Not that it changes anything and despite his age, I wish I knew what caused his symptoms.

  7. Joseph Levinson says:

    Brain – Dementia Update

    About a year ago, my dog Brain (15.5yo Boston Terrier, mostly blind, mostly deaf) was diagnosed with canine dementia. For some time now, he’s been showing all the known symptoms of the condition. Caring for him has become increasingly more difficult. The more challenging traits he displays are aggressive behavior, and extreme restlessness during night time hours. Meds have helped some, but the condition is permanent, and his behaviors have been getting more worrisome over the last few months. He already takes Gabapentin, Denamarin and Trazodon.
    I’m not sure there is anything else I can do for him, and I am in a desperate position. I am very sleep deprived (very!), and don’t know what to do. My health (and that of my family) is taking a toll. I feel like I’ve been taken hostage by my own dog, and it is quite obviously not his fault. I love him so much and want to take care of him and do right by him.
    I don’t know if Brain is happy in general. He seems mostly miserable, except for when he eats, sleeps, walks outside in good weather (which isn’t often), and only very occasionally when he allows limited petting… those moments give me hope that he at least he is still capable of enjoying life to some degree. But then the barking, howling, whimpering, heavy panting, pacing, all night long, suggests he is not having a good time. Mental anguish is not as straight forward as physical pain, so it’s hard to know where the lines are drawn. There’s an inner life inside that little head, and I shudder to think that I must decide at one point when that light should go off.

    This whole situation is really not sustainable, and I don’t know what to do.

    Any advice is welcome and appreciated.

    MORE DETAILS:

    AT THE BEGINNING
    Brain was never an easy dog. I understood that to be the case from the get-go when I adopted him as an already adult 9yo dog set in his ways. I accepted the challenge, even though I never had a dog before and had not experienced caring for one. I don’t think I was entirely aware of how much a pain in the ass he could be, but we were right for each other nevertheless, and I have loved him like I never imagine I could. He came with all sorts of issues, and I certainly didn’t know any better, so I gladly dived in. Brain was anxious and prone to barking fits from which it was never easy to snap him out. He was very demanding and not the kind of dog who favored snuggling or kissing. He was growly and spunky, though never malicious or threatening—he never once bit me back then. Growling was his way of expressing every single emotion in his arsenal. It was a really funny and charming aspect of his personality.
    Brain had not been properly socialized, I assume, so he didn’t get along with other dogs. But he did love humans! And he loved attention, which for him meant an expectation of extreme play time. If one petted him even for a second, he immediately took that as an open invitation for him to rush and grab a toy and not give up until you played fetch and tug-o-war straight until he tired, something that could take quite a while. Even at 9, 10, 11, 12 years old, he had enviable amounts of energy. That was a challenge, but it was manageable, and I loved how into playing he was.
    Even with all his quirks, complicated patterns of behavior, and medical conditions (of which he had a few), I loved looking after him and could manage it without much problem. When I traveled, which I often did for work, I had designated dogsitters who knew of all his quirks and how to handle him.

    DEMENTIA CREPT IN
    But of course, handling him has become an entirely different thing. He lost most of his hearing and then most of his eyesight, surely an extremely confusing thing for any dog. But then his mind has been going as well, and that has truly complicated matters much more, as anyone dealing with canine dementia will surely attest. His behavior began to show symptoms of aggression and confusion, toppled with nighttime restlessness and at times, extreme separation anxiety.

    Pretty much every symptom associated with canine dementia, he has shown to varying degrees. All of them concerning in their own right, but it’s the aggressive behavior that became the most worrying. It became tough to handle him. Putting on his harness or dressing up for the cold turned into potentially unsafe situations for myself. It got so bad that at one point last year I believed the end had arrived. He bit me pretty bad. He had that evil dog look in his eye.
    He was prescribed Gabapentin, and that helped a lot in calming him down. Though of course, aggressive tendencies popped up from time to time.
    He was also put on Denamarin when it was confirmed he in fact was suffering from dementia. (Selegelin was prescribed before but it only made him more restless and aggressive)

    Things got substantially better, though of course, a dog with dementia is a dog with dementia and I’ve had to resign myself to the idea that the disease progresses no matter what. As of the last few months, he has become very barky, confused, extremely restless at night, and sometimes a little aggressive and snappy.

    CONSEQUENCES
    At night, he really doesn’t let me sleep for very long before he barks, whines, howls, scratches at walls. He wants to pee probably 7-8 times a night, and I have to let him out. (It would be great if he’d just do his business on wee-wee pads, or even straight up on the floor, but he demands to go outside). He wants attention, or rather he wants something. He is confused and restless and agitated. He paces back and forth, panting heavily, and no matter how many times I let him out to pee, or try to comfort him somehow, he keeps at it.

    I have been very sleep deprived the last year or so, but especially more the last few months. I have a 7 month old baby, and I am blessed that he is a good sleeper and doesn’t wake up with the barking (it’s a miracle, really), but my wife and I are truly suffering with all this. I constantly end up sleeping on the couch in the living room, with Brain leashed to the end of the couch so he doesn’t ambulate freely all night long creating havoc. If he barks or howls I will pull on the leash a little, see if that works. Or I may get up and let him outside.
    He was prescribed Trazodon as a sleeping aid, but that will only knock him out for an hour or two, after which he will wake up, drugged, confused, and equally barky and howly.

    I am the only one that can handle him when he’s at his worst. I know all the subtleties and nuances. I know when he will snap and when to quickly move my hand away before he chomps on it. A 20lb, 15.5yo Boston with missing teeth can still bite down hard and break skin if he catches you unguarded.

    Another concern of mine is that my son is fascinated by Brain. He doesn’t even flinch when Brain has a barking fit. He is 7mo and is now showing signs he’ll start crawling any time soon. Before we know it, he will be walking/running as well. That gives me pause. Brain will not attack unprovoked, but and uninvited hand could surely be taken by him as provocation. We will always keep them apart, but walking infants and old dogs are both unpredictable and occasionally sneaky.

    SOLUTIONS?
    Brain sleeps most of the day, so at night he is definitely energized. I’ve tried to keep him up during the day, but work schedule doesn’t allow me to constantly monitor him. It’s also not easy to keep him up during the day, though. He is lethargic and mostly uninterested in doing anything. He is not very keen on going for walks unless it’s warm outside. But even if I did manage to keep him mostly awake and active during the day, he will still be agitated and disruptive all night.

    I am looking forward to warmer weather soon so I can at least have him exercise a little more. Maybe that will help with his cognition, and hopefully it will tire him enough to maybe sleep better at night.

    I don’t know if there are other drugs he can take, but it seems like we have tried everything his body can take (he has other health issues, so not every drug is on the table).

    THE END?
    I know his journey is coming to an end in the not so distant future. It’s a disarming thought. Mostly because dementia is not clear cut, and the decision of when to draw the line will fall on me. How do I know if he is suffering more than he is enjoying life? Mental anguish is not as straight forward as physical pain. At some point, this will not be sustainable. I don’t know when that is, though. When one can confidently draw that line. All I know at this moment is that he is not doing great, but it is also probably not his time just yet. I think that’s the case. I hope that’s the case. I can’t tell and I’m getting desperate not only for him, but for myself and my family too. I can’t stress enough how sleep deprived I am and how much it has affected my own health and well-being, and that of my wife, who maybe doesn’t deal with Brain at night, but does wake up often with the barking and the howling.

    I am not going to send him away to a shelter or anything like that. I doubt he would be any happier in an unknown place, living in a crate. (I for one can’t bear the thought) And he’s most likely not the type of dog that could be rehabilitated with training at this point. Too late for that.

    Sadly, I am thinking that I will wait for the weather to get warmer, maybe that will help some, and in the meantime suck it up with the limited sleep and constant stresses. Best case scenario, he will have a good spring summer and be active during the day and sleep at night. Worst case, he will enjoy some days and continue to be miserable at nights.

    At the very least, I want him to enjoy a few more months of walking out in good weather (whenever that happens), smelling whichever tree and fire hydrant he desires. He genuinely does seem happy then. That makes me happy.

    Please, if you have some suggestions, I would love to hear them. I am pretty bummed out about it all and anything is appreciated.

    • Eileen Anderson says:

      Dear Joseph,
      It’s hard for me to imagine doing more than you are doing now. I wish I could make this easier. The only suggestion I might have would be if your vet would be open to a consult with a vet behaviorist. Several of them do phone consults and they are the absolute experts in meds, although it sounds like your vet is doing a good job. A VB may be able to help find something that can settle Brain down more at night. I’m so sorry you are sleep deprived. That is so hard. I hope maybe some others reading may have some suggestions as well. Take care. You are doing such a great job taking care of Brain.
      Eileen

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