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Hello Admin, I was wondering if you have a quality of life scale?
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Greater Western Washington area
Member Since:
25 August 2010
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6 February 2011 - 10:13 am
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I have looked at the scale on Fortis's blog, but I don't understand the points of it.  How many points is too many?

Did you have a scale for Jerry?

I need some help for my old girl, I don't know if I am doing her justice.  I have looked on-line but it is just shades of grey.

 

Elizabeth and Sammy

Diagnosed with osteosarcoma in the right front leg 8/23/10,

leg fractured 8/27/10,

leg amputated 8/30/10

http://sammyand.....pawds.com/

 

I couldn't begin to say how special Sammy is to us.  Living and laughing with and loving this wonderful boy is priceless.

Member Since:
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6 February 2011 - 10:51 am
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I think the Golden Girls posted this article some time ago, I have it saved as a document on my computer for just this occasion! It is not a "scale" per say, but gives you a LOT to consider when looking at quality of life. Hope this helps Elizabeth!!

Defining  "Quality of Life"
        by  Moira Anderson Allen, M.Ed.

When ever one considers the painful choice of euthanasia, one is always advised to take the pet's "quality of life" into account. But what is "quality of life"? How can you determine whether a pet is still experiencing a good quality of life — or whether its level of suffering is no longer acceptable? That decision is individual to every pet, and every owner. Following, however, are some factors to consider when attempting to assess a pet's quality of life:

Mobility:

An older pet often loses mobility. A dog may no longer be able to climb stairs or hop into a car; a cat may lose the ability to jump onto a bed or chair. At this stage, however, your pet may still be healthy and happy, and you can easily make accommodations for its reduced ability.

If, however, your pet can barely move, that's another matter. Can your pet get to its feet without assistance? Can it sit or lie down without collapsing? Can it walk? Can it handle basic functions, such as squatting on a litterbox? Does it whimper or growl if you attempt to move it? I've seen dogs so crippled with hip dysplasia that they literally had to drag their immobilized hindquarters across the floor; this hardly represents the "quality of life" I want for my pets.

Appetite/Eating Ability:

Is your pet able to eat? Can it consume enough food (or digest that food) to remain properly nourished? Does it regurgitate immediately after eating? Is it unable to chew, or does it have difficulty swallowing? Does it enjoy eating, or do you have to coax every bite past its lips? A pet that is unable to eat or gain sufficient nourishment from its food is on a slow road to starvation.

Breathing:

A number of illnesses, including cancer, can affect the lungs. When a condition causes the lungs to fill with fluid or foreign matter (such as cancer cells), a pet quickly loses its ability to breathe easily or comfortably. You'll notice that your pet may seem to be panting, or that it is laboring to breathe; often,you'll see its stomach or flanks "pumping" as it can no longer breathe with just the chest muscles. It may also experience wheezing attacks. If such symptoms occur, ask for a chest x-ray to determine the condition of the lungs. If the problem is due to an allergy, infection, or asthma, medication may help; if it is due to fluids that are the result of cancer or a heart condition, however, little can be done.

Discomfort:

It can be difficult to determine whether a pet is in pain, as animals instinctively mask discomfort as much as possible. You can pick up clues, however, by watching its posture and expression. Does your pet's face appear furrowed or "worried", rather than relaxed and happy? Does it sit hunched or "hunkered" and tense, rather than relaxing and lying down? Lack of mobility can also be a sign of pain.

Another indication of pain is "denning." An animal in pain will seek a safe place where it won't be disturbed by other animals. If your pet has forsaken its usual territories or sleeping places for the back of the closet or a spot under the bed, this may be a sign that it is pain or distress and feels vulnerable.

A more obvious indication of pain is a pet's reaction to touch. If your pet responds to touch by flinching away, hissing, snarling, or even snapping, this is a clear indication of pain. Sometimes this can indicate a localized pain; if the pet doesn't want to be touched at all, however, it may indicate a broader discomfort.

Incontinence:

Many pet owners feel terribly guilty over the natural annoyance they feel when a pet becomes incontinent. They feel they should be more loving, more patient. Incontinence, however, can also be stressful for the pet. As a basic survival mechanism, animals learn not to "mess where they sleep" (for the smell would draw attention to the location of one's den). When an animal can no longer control when or where it urinates or defecates, you can be sure it is not happy with the situation.

Mental Capacity:

Older pets occasionally develop signs of diminished mental capacity. They may seem to "forget" things, such as where a toy is located or what a command means. Such a pet may become confused by its surroundings, and this confusion can develop into fear. (In some cases, this "confusion" may be the result of hearing or vision loss, to which both you AND your pet can often adapt.)

Happiness:

Determining whether your pet is "enjoying" life is certainly a subjective decision. However, if you have been a keen observer of your pet's behavior and attitude during its lifetime, you are likely to be able to determine when it no longer seems "happy." You'll know when it no longer seems to take any pleasure from its food, its toys, its surroundings — and most of all, from contact with you and the rest of its family. Most pets are tremendously easy to please; when it no longer becomes possibly to raise a purr or a tail-wag, you can be fairly certain that your pet is receiving little joy from life.

 Response to Treatment:

When a pet becomes ill, our natural response is to provide whatever treatment we can. This may mean tests, medications, even surgery. But drugs have side effects, repeated trips to the vet cause emotional distress, and more invasive treatments take a physical toll. Eventually, we may conclude that our efforts to treat a pet's illness are more stressful to the pet than the condition itself — and that our efforts to save a pet's life are actually diminishing, rather than enhancing, the quality of that life.

Making a Decision:

Assessing a pet's quality of life is an ongoing process, not a one-time decision. Initially, we're likely to attempt to compensate for the problems we see. Pain medication may relieve a pet's discomfort and improve its mobility. A change in diet may improve a pet's appetite or provide better nutrition. We may resolve that we're willing to clean up after a pet and carry it wherever it needs to go, for as long as necessary. But eventually such measures will cease to be effective. The process of assessing "quality of life" is really a question of determining (and deciding) when that point has been reached — and what you intend to do next.

It is often tempting, at this point, to postpone a decision still longer by deciding to "let nature take its course." Before choosing that course of action (or inaction), however, it's important to understand that, as a pet owner, you have been thwarting the "course of nature" from the beginning. By ensuring that your pet has food and shelter and is protected from predators, you have already guaranteed that nature will not take its course. By providing medical treatment, you have prolonged the life of your pet far beyond

what it could have expected if left to "nature." In nature, an animal that becomes too ill to obtain food or protect itself will perish quickly,

though not necessarily comfortably.

Nor does nature necessarily offer an "easy" death even if you choose to let it "take its course" in the comfort of your home. An animal that cannot breathe easily, cannot eat or digest food properly, cannot control its bodily functions, and can scarcely move or enjoy human contact because of pain, is hardly dying "comfortably."

This is really what the "quality of life" issue is all about. By usurping nature's role throughout the life of our pets, we must sometimes also accept its role in determining (and bringing about) the death of a pet. To accept this, we may also have to accept that, in some cases, the quality of life we're really trying to protect is our own: That we're allowing our pet to suffer out of a desire to avoid the anguish

we know that we will experience when it dies. And that, ultimately, is the most unselfish act of love we can offer: To end a pet's suffering, we must choose to accept our own.

 

-Chloe's mom

P.S. I fixed the weird formatting when I copied and pasted it initially.

Chloe became a rear amp tripawd on 7-29-10. Another tumor was removed on front leg 2-20-14. Found 3rd tumor on neck 2-2015, but she's still kicking cancer's butt at age 14. Chloe's blog

On The Road


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6 February 2011 - 12:11 pm
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We didn't have a "scale" per se. We made a promise to Jerry early on that we would never let him loose his dignity. When that time came, as difficult as it was, we kept our promise.

Another helpful quality of life measurement we heard of is the two jars method:

  • Put two jars in plain sight. Label them good days and bad.
  • When you feel Sammy is having a good day, put a marble (stone, penny, whatever) in the Good Day jar.
  • If times seem tough for the old girl, one goes in the other jar.
  • Continue this for a set period of time you determine.
  • When that time comes, count your marbles – and your blessings – and compare the jars.
  • When bad days outnumber the good, you have determined a poor quality of life.

Hope this helps. What helped us most was to envision how we always wanted to remember the last days we had together.

Thanks for asking. Peace.

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

krun15
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6 February 2011 - 3:23 pm
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Hi Elizabeth,

I wanted to clarify- your not talking about Sammy- right?  But one of your other older pups.

I have not been fortunate with many of my dogs to have to make the end decision because of age.  But I would think that this is applicable to any reason that you are faced with the end of life decision.

What I did with Mag was define in my mind what her quality of life was.  I had to factor in a lot of things.  I was not able to use appetite as a gauge, because of kidney failure she hadn't eaten much on her own in 3 months.  For Maggie it became a pain issue.  Her second cancer was a melanoma tumor in her mouth.  I knew that once the tumor started causing  pain we would be at the end.  Why?  Because she did not tolerate opiate or narcotic pain meds, they made her anxious and unable to sleep, and that is no way to live.  We couldn't do NSAIDs because of the kidney failure.  And besides, medicating the pain was a temporary fix- might have bought us a week or a couple of weeks. Another point that my vet brought up- at some point the treatment is worse than the disease.  I had to administer sub-Q fluids several times a week, and because she wouldn't eat solid food I had to stuff her meds down her throat.  So many of our interactions were becoming very unpleasant for her.

I guess what I am suggesting as a gauge is this: Define what is quality for your girl, write it down.  Write down anything you have to do to her that she does not like (meds, helping her up, whatever).  Is your pup enjoying some, or any of the things she used to?

I feel like I am rambling a bit.  Hope this at least gives you something new to think about.

Karen

Greater Western Washington area
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25 August 2010
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6 February 2011 - 3:38 pm
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These are all really good, very helpful.

My only girl is named Shy.  She is a 13 1/2 year old sheppard mix.  In the last 6 months have been a pretty drastic decline in her, as far as mobility and her comfort level.  She falls hard on her face often, at least once a day.  She just wants to lay around and sleep now, but does seem to find joy in time with me.  Her hind end is very weak and she walks like an octopus on land.

Her eating habits are sporatic, and her bathroom area was about an acre away but has become right outside the sliding glass door.  I took her to Dr. Pam this morning with Sammy and the doctor thinks she still has some good times ahead.   So I am getting her on NSAIDs and she is already on a combo oil and glucosimine substance.

I feel comforted knowing that there is stuff we can still do for her, that she still wants to be around.  I am going to keep these ideas in mind for a later date.  It just hurts watching my bright pretty girl starting to fade away.

thanks for the posts,

Elizabeth, Sammy, Shy, and Titan

Diagnosed with osteosarcoma in the right front leg 8/23/10,

leg fractured 8/27/10,

leg amputated 8/30/10

http://sammyand.....pawds.com/

 

I couldn't begin to say how special Sammy is to us.  Living and laughing with and loving this wonderful boy is priceless.

My heart lives at Rainbow Bridge
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28 November 2008
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6 February 2011 - 4:13 pm
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Elizabeth, I know we could really tell a difference when we started Trouble on the Rimady.  We started out slowly, just when she needed it, then about every other day, then daily, now twice a day.  I can tell if (God forbid) I miss a dose. The cold and wet we've had this winter has been hard on her.  I added Dasuquin to her supplements about 10 days ago.  I'm not seeing the dramatic results some folks see, but am pretty sure it is helping some.  She's no longer afraid to jump off the bed, and she seems more willing to get up and move.  It is so hard when they beat (or appear to beat) cancer only to have old age pop them on the butt.

Hope you see lots of improvement in Shy with her new meds.

Shanna & Spirit Trouble ~ Trouble gained her wings 3/16/2011, a 27 1/2 month cancer survivor, tail wagging. RIP sweetheart, you are my heart and soul.  Run free at Rainbow Bridge.
The November Five - Spirits Max, Cherry, Tika, Trouble & Nova. 11/2008 - 3/2013 An era ends as Queen Nova crossed the Bridge.

Greater Western Washington area
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25 August 2010
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6 February 2011 - 6:30 pm
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thanks Shanna,

I hope so too!  She fell out of the car when I was trying to get Sammy down and I feel awful that she seems bruised and sore after going on an outting.  I gave her the pain meds a little early tonight and she is now starting to snooze.

Here is hoping for a happy puppy tomorrow. 

Elizabeth

Diagnosed with osteosarcoma in the right front leg 8/23/10,

leg fractured 8/27/10,

leg amputated 8/30/10

http://sammyand.....pawds.com/

 

I couldn't begin to say how special Sammy is to us.  Living and laughing with and loving this wonderful boy is priceless.

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