This topic is quite fresh for me as I had to put my beautiful black 3 year 4 month old German Shepherd dog, "Luna" (Luna vom Burghard) to sleep very recently.  Perhaps I could offer some thoughts and insights that might help someone else as well as give me a chance to express my thoughts and feelings on this topic. 

First of all, Jerry is right that as difficult as it is, it is very important to think about and discuss end of life decisions, not only for our pets, but also for ourselves and our loved ones.  I hate this topic, but I had to face it with my grandmother, mother, and father, and now, just a little over a week ago, on Tuesday, September 16th, I had to face loss again and to make "the" decision to put my precious girl, Luna, to sleep.  This was the first time that I had had to make this decision as an "adult", a person who was responsible for the care and life, and yes, even death, in some cases, of my pet.  My family had had pets that had to be put to sleep, but my parents were the ones who had this tragic task.  In this case, I was the one who had to decide in the end what was best.  Although I had the input of my dear boyfriend, Dave, I, in the end, was the one, and the only one, who would give the nod of the head to "go ahead' and inject her.  I really didn't know how I would be able to do that if it came to that, I really didn't.  But, when the decision had to be made, I was able to do it because it was what was best for Luna.  I had to put her feelings ahead of my own, and rather than running out of the room sobbing and saying "don't do it", I'll take her home and see what happens and hope that she'll die peacefully there somehow, without my having to make a decision, I stayed and still cried, but held her furry, black paw and stroked her neck and said the special things to her that I needed to.  It was indeed one of the hardest things I have ever done in my life.

When Luna was diagnosed with hemangiosarcoma (primary bone, of the right hind leg, with amputation and hemipelvectomy), we were stunned.  She was only 2 and a half years old.  Thinking about end of life decisions for her was the last thing on our minds.  Suddenly, with so many dismal prognoses, it was one of the main things on our mind.  I made an appointment with my local vet to discuss end of life options.  Dr. John Dee of Lake Mary, Florida was so very kind in his 30 to 45 minute discussion of this so very hard to talk about topic.  He told me that I could do the euthanasia (I personally prefer the term "put to sleep") at his office or at home.  He explained the pros and cons of each way, including the fact that if done at home, the person might associate the room or place in which the pet was put to sleep with that "event" in the future and it would, in essence, "ruin" that room for them in the future, as all they would be able to envision was the death of their beloved dog or cat in that spot.  I told him that if we did this at home, that it would be ok, as the room that was Luna's room had been where my 92 year old father had just passed away a few months earlier, so it was already "associated" with death of a loved one, and in a strange way, would be more comforting to me in that way.  He added that if done at home, that he would bring an assistant who would help him with the IV needle (a thought that also bothered me, the fact that I thought the animal would "see it coming" and that the needle would be just one more "pain" to endure before the end.)  He explained that it would be very fast and peaceful and that they would be very sensitive to the situation and would handle her body with care and gentleness and take her back to the vet's office where it would be picked up soon after by a local person who cremates dogs, if that was what I wanted.  I wasn't sure what I wanted, but I knew that where I live, it is against the law to bury your dog in the back yard.  If I had a ranch or farm, I could have had her buried on my property, but where I live now that is not an option.  He told me about a local cemetery for pets, and gave me the web site which I checked out later.  I didn't want to have her buried at this pet cemetery though, because if I ever moved, she would be left behind, so to speak.  I ended up mentally deciding on cremation.  I didn't get far in our conversation before I started to cry.  He was very kind and understanding.  I asked him about how long he thought Luna had to live, and he said probably two weeks to two months.  After the 30 to 45 minute consultation (I didn't have Luna with me, I just wanted to talk to him about this topic and didn't want her to see me upset), my face was red and swollen.  As I went to the desk to pay my bill for the consult, they told me that there was "no charge".  I was truly touched by this vet's kindness in that gesture.  I thanked them and left. 

After going home, I studied the cemetery and the various urns and such that pet owners can get.  There is quite a variety.  I hated looking at that stuff.  But, by familiarizing myself with it, I knew what I liked, didn't like, or possibly could tolerate.

Even though I studied all these things on the Internet, it still didn't answer how I was going to handle the death of my dog, especially if it involved putting the dog to sleep.  I really, really didn't want to do that, but with 12 German Shepherds to my name, I knew the odds were that I would probably have to do that at some time.  This one, would be my first though, and although I knew it wouldn't make it any easier if I had to do it again, the first time would be "unique".

After Luna's diagnosis, I gave this topic a lot of thought.  I knew I didn't want her to suffer, and I knew as much as I hated this concept, that I could do it IF she was suffering enough.  Being uncomfortable, or a "hassle" to care for, would not suffice or warrant putting my dog to sleep.  It would have to be something "significant".  As a person of faith, I always ask God to give me a "sign" when I need a clear cut answer.  I did this with my own mother and father.  When would I continue trying to keep them alive, and when would I call hospice and have them make them as comfortable a possible and let them die, with the help of morphine, not enough to say that you are "putting them to sleep" but enough to facilitate the "process" and make it so that they are not "aware" of any type of medical  crisis that might happen between "dying" and "dead" and certainly no pain, mental or physical, of any kind.  I didn't want them to "see it coming".  And, that is how it was in both cases, thanks to the kind folks with hospice and the sedation that they gave them.  I felt that the experiences I had had with my parents helped prepare me somewhat for what I would need to go through with my dog, but it wouldn't make it any easier, only more familiar. 

Luna surprised everyone, and she didn't die after two weeks to two months.  She was lively and happy.  We were thrilled and hoped that she had beaten the disease, or perhaps her results had been mixed up with another dog's results (although I would never want to wish that diagnosis on another dog). So, six months after her diagnosis, she was doing great until one day she let us know that her right hind leg, which had had the femur bone removed where the cancer was, was now in horrible pain.  We immediately took her to a specialist. 

Getting out of the car, Luna accidentally bumped her leg and hip into the car seat, she suddenly screamed in pain, over and over and over.  It was horrible.  She had never screamed like that before, and it was loud and piercing.  She was basically a stoic dog, but at this moment, the pain was too much.  After what seemed like an eternity, she quieted down and we went into the vet's office, but while the screaming was going on, I felt like if I had had a gun, I would have shot her in the head, because each scream was like a knife in my heart, to think she was suffering so horribly.  I was ready at that instant, to "put her to sleep". 

We went into the office and the vet said that the cancer was growing back in her leg.  She added that she knew that she had not "gotten it all" during the initial surgery to remove part of the femur bone.  We could have done the amputation at the time of diagnosis, but everyone said she was only going to live a few weeks to two months, so we didn't want to put her through all of that just to die in the near future.  Something had to be done and done soon.  We decided to restage her and do a head to toe exam, chest x rays, abdominal ultrasound, CT scan, and bone scan.  Because of her extremely painful leg, she had to be given general anesthesia for all tests, and, with my voice cracking,  I told the vet, if the results are bad, while she is under general anesthesia, we can put her to sleep and she'll never know what happened.  The vet agreed with this plan if needed.

When the phone call came from the vet, she told me that all of Luna's results were "clean" and that there was only one small spot on her leg/hip area that glowed on the bone scan.  "She is still under general anesthesia, but I suppose you don't want to put her to sleep now, do you?" the vet said.  I told her that I just couldn't do that at this time.  She had gotten a really good report, in my opinion, and she was young, bright, and full of life.  Besides, Luna was only 2 and a half years old at the time.  There had to be another option, and so I told her that we would find other options.  I knew, by the tone of her voice, that the vet didn't agree with my choice, but it was the choice I had to make, knowing that down the road, I might regret not just letting her go that day, but she was in such good health otherwise, I just felt I couldn't do anything else.

So, we took Luna home and started a frantic search for other options.  Those other options turned out to be amputation and a hemipelvectomy for Luna at the University of Florida in Gainesville, about a 2 and a half hour drive from our home near Orlando.  We added six treatments of chemo (Adriamycin).  These options gave Luna another six quality months and we got to know her even better and love her even more.  But after the chemo stopped, and the metronomics started, they found several mets in her lungs.  We were devastated at that news and still hoped that the metronomics would work.  The time wasn't right for putting her to sleep.  She still seemed healthy and alive, bright eyes and playful.  It broke our hearts to think that after all of this, that she was fighting mets.  The next month showed that there were two more mets in her lungs, but they were small, and that there might be something in her abdomen.  We just couldn't understand why this was turning out this way.  I didn't think that I would have to make a decision about putting her to sleep for many years to come, now, that awful decision was looming in the distance. 

On September 12th, 2008, something strange happened with Luna.  She had been doing just fine, but that Friday, she seemed to be unsteady. She had also thrown up that morning, but we just thought it was just one of those things.  Perhaps due to the metronomics meds she was on, or something like that.

But the unsteady gait continued that morning.  Sure she had only three legs, but that never stopped her.  She was agile and fast on those three legs, so when she started to sway and stumble, I didn't understand what was going on.  When I took her out in the morning, she was staggering, scraping against furniture and me.  She'd take a few good steps and then start swaying again.  She also refused to eat.  I offered her every favorite food that I could think of.  But she didn't want it.  And, she didn't want any water either.  Then, she threw up again.  This was not good and I was worried.  I called the local vet, Dr. Dee and got her in right away.  He examined her in the back on an "emergency" basis and his assistant reported that Luna seemed to be doing all right, they would do some blood work and then get back with me.  Later that afternoon, they reported that the blood work was actually rather good, just a tad low on the potassium, but that was it.  But, I was still worried, something was very wrong, and I thought that she might have swallowed an foreign object or something like that, so I insisted that an x ray be done of her stomach and while they were at it, I asked for another chest x ray, even though it had only been two weeks since her last chest x ray at UF.  When the results came back, they didn't think that she had swallowed anything, but they said that the seven mets in her lungs had doubled.  We were devastated.  Doubled in two weeks.  They sent us home with some potassium gel to give her and said to come back in the morning, on a Saturday, to repeat the abdominal x ray to make sure that nothing was in the stomach.  That night, Luna seemed to improve, a bit brighter, but still not eating.  The next morning, though, she had improved 200%, her walking wasn't perfect, but it had improved so much that I was so relieved.  She still wasn't hungry, but I wasn't as worried about that as I was the staggering.  When I took her back to the vet, Dr. Dee's associate who was there on Saturdays saw Luna.  I proudly told everyone how much better she was, how much better she was walking, and that this was good news indeed. 

The stomach x ray was repeated, and appeared to be normal, nothing in the stomach.  She was sent home.  I had hope again, even with the news about the lung mets.  I just didnt' want to have to make that decision anytime soon.  I knew that Jerry had had lung mets for a long time, so I hoped she could last a long time, too, with lung mets, but Luna's lung mets were different than Jerry's, they were smaller and more numerous, and now, seemed to be growing much faster, too. 

Saturday night, September 13th, Luna seemed to get worse again.  She was staggering again, but she did eat a little bit of food, even though I had to beg her and hand feed her.  I was encouraged by the food consumption, but still very worried about the walking.  She was almost falling down at this point, and here we were right in the middle of a weekend.  By Sunday morning, she was continuing in the same condition and I knew that something had to be done.  We called our vet at UF and told him what was going on.  We all decided to bring her up there Sunday night and admit her to the hospital, where she would get an IV for fluids and they would run their own tests. 

On Monday, September 15th, the vet at UF said that Luna was looking much better and that he had walked her himself outside the animal hospital and she did quite well.  His opinion counted for a lot because it was he who did the amputation and hemipelvectomy on her.  I was encouraged again and asked if she could come back to the hotel with Dave and me that night, but he advised us not to do that yet, to keep her in the hospital where she could get fluids.  Her blood work was also good, potassium back in the normal range.   Then, the vet said that he felt an MRI of the head would be a good idea.  I immediately knew what he was thinking as the awful thought had already passed through my mind.  "You're looking for a brain tumor, aren't you?" I asked.  Yes was his reply.  At this point, my voice cracked again and I proposed the same plan as I had six months before to the vet near my home.  While under general anesthesia, if something bad was found, we could keep her unconscious and she'd never see it coming.  We'd just let her go at that point.  The UF vet agreed that this plan was a good one.  He was very kind and said she'd have the MRI in the morning at 11:30am.

On Tuesday, September 16th, the vet called us to say that Luna was doing well that morning and was a "happy girl".  That was very encouraging and Dave and I both agreed that the likelihood of her having a brain tumor was very low, because she had improved with her walking the day before when the vet walked her and she was a happy girl now.  Yet, in the back of my mind, I had to wrestle with that decision, and what I might do if the results were not what we wanted.  The vet told us he would call us in about 45 to 60 minutes, and let us know the results of the MRI.  It was a surprise when our cell phone rang 10 minutes later.  "I have bad news", the vet's voice said.  "Luna just had a seizure on the way over to the MRI center".  At this point, I had pain in my chest.  It was not what I wanted to hear.  I then asked him what the seizure was like, I wanted details, a description, so I could visualize it in my mind.  I needed to know, because that would be part of the data that would help me make the decision that I dreaded so much.  He told me that he had only seen the very end of the seizure, but they had called him immediately when it happened.  By the time he got there, it was almost over, but he said that she had been foaming at the mouth and trying to bite herself.  This vision in my mind of her in this state was what I felt was the "clear sign" from God that I had been hoping for if needed.  I felt that this was a sign that the MRI was not going to hold good news, and that if that were the case, this seizure was the clincher that would help me to do the impossible.  I asked the vet what we were going to do at this point, and he recommended that we continue with the MRI and see what was really going on.  We both agreed if they found out that the news was not good, that we would keep her under general anesthesia and Dave and I would come over there to say good bye.

About 45 minutes later, the vet called.  "I'm so sorry" were his first words.  "Luna has multiple brain tumors".  It was a crushing blow, dashing our last bit of hope that she could continue on in a comfortable manner at home.  "I think it is time to implement the plan that we discussed previously" the vet said.  "Yes", I sobbed, "we'll be right over".

Fortunately, Dave and I were on the same page with this decision.  It all had happened rather quickly, actually.  She had been fine just a few days ago, but things got worse rapidly.  We rushed over to the hospital and when we walked through the door, they immediately called the vet without our saying a word to anyone.  It was as if everyone on staff there knew what was going on.  He came out and gave us a hug and again said how sorry he was.  I believe it is very important when considering this topic, to have a vet or vets in mind who might do it, and where it would be done.  You want to make sure that you have someone who is compassionate at a time like this.  That is for sure.

My feelings at this point were that I had no choice, but I dreaded it with every cell in my body.  Seeing her in the little room called the "Quiet Room" lying on a gurney, asleep, with a little pink blanket on her, was heartbreaking.  Dave and I said our goodbyes and then he left the room.  He said that he just couldn't handle being there when she was put to sleep.  I told him that I understood completely and to go ahead and leave.  I think it is important to say here that some people can be there and some can't, and there is no right or wrong, but simply what that person can do.  I also think it is important that someone not be "forced" to witness this if they are not able to do so and should not be made to feel that they weren't there for the pet or anyone else who might have chosen to be there.  Witnessing a beloved pet, or family member, can be a traumatic and deeply disturbing experience for many people, and each person must handle it as best they can, in my opinion. 

So, in the end, even though the vet, a technician, a nurse, a medical student, and I were in the room with Luna, the attention was eventually on me, with no pressure from anyone, to finally give that nod of the head, and to mutter, through tears, to "go ahead".  As promised, the passing was quick and peaceful.  No struggling or suffering, no pain, and no fear.  For me, that was the most important thing, to protect Luna, to keep her from having to suffer any more than she had to.  She had already been through so much, so many tests, x rays, ultrasounds, needles, visits to the vet, syringes, loss of appetite, pain, nasty tasting medications, pills being shoved down her throat because she wouldn't eat them with food, and IV's for chemo.  It was "enough".  She was fortunate to have six quality months, but now that had changed.  Between the seizure and the knowledge that she had, what I would learn later, was ten brain tumors, the decision was clear and distinct.  So, I would advise anyone to make sure that you have the medical facts about the situation if possible before putting your pet to sleep.  It might be a "false alarm" and something that you could deal with.  But, if you have conclusive evidence, as I did, that your pet is not going to get better, and would probably get much worse before passing away, then it is important to be ready to give the command to let your pet be released from its earthly body and go to the Rainbow Bridge. 

The vet pointed out to me that Luna would only have gotten worse, had we brought her back to consciousness and taken her home, that the seizures would have continued, gotten worse, or even happened in the car on the way home.  He added that the staggering would have gotten worse, too, until she could walk no more, and then she would also be having seizures at the same time.  This information was important too because it told me that I had made the right decision.  Dave knows that we made the right decision, too, and has been very upset about losing our Luna.

I don't know how I did it, because I really didn't think that I could.  But I did, and I think that the reason I could was because I knew that there was no other humane choice.  I absolutely could not stand to see Luna suffer in any way.  The vet at UF told us that we had always put Luna first, above what we emotionally might have wanted to do.  He said that we had shown that to be true when we let Luna go.  We really appreciated his saying that to us. 

I know I have gone into a lot of detail, but I did it to help others see the nuiances of some of the situations and how they can affect your thinking and decision making.  I had to make that choice twice.  The first time, after the bone scan, I said no, even when I felt that vet didn't agree with my decision, but I know I made the right decision.  Luna gained another six quality months of life by deciding not to put her to sleep at that time.  The second, after the seizure and the MRI which revealed multiple brain tumors, I again made the decision, this time to let her go and to put her to sleep.  I feel that I made the right decision in both cases, and if I had it to do again, I would make those same decisions.

Find a compassionate vet or vets (have a back up if possible), check out what you might want to do (burial on a farm, pet cemetery, cremation), think of possible scenarios that you might face and how you would handle them and under what circumstances you might feel it was the right time to put your pet to sleep.  Pretend in your mind that you are putting your pet to sleep; know that your pet loves you and would understand that you are doing this out of love for your pet, the ultimate sacrifice, losing your pet so that you can save your pet from any further suffering.  If you know your pet is suffering, either through common sense, and/or medical tests, and your pet is miserable, like Luna was, staggering around, not eating, not drinking, and then having a seizure, which surely would have been repeated, then it may be time to make that decision.  I think that decision has a lot of connection with "guilt" and that is another thing that needs to be addressed. You have to realize that you are not committing a crime, you are not "killing" your pet, but gently helping your pet to pass from one dimension into another, a much better place with no pain or suffering.  Believe me, I know, I felt guilt afterwards, even with the choice being so obvious.  This, evidently, is quite normal, but once the intense emotions subside just a bit, you see that there is nothing to feel guilty about, in fact, you should be very proud of yourself, your courage to do something so incredibly difficult and unselfish.  I talked to the grief counselor at UF and it was very helpful.  There are support groups in many communities that have pet grief support groups now.  And, of course, there is this wonderful place where we are posting right now, that allows us to express these very personal and sensitive topics to other people who will understand us, cry with us, and nod their collective heads in understanding and sympathy. 

To Jerry and his family, I say a heart felt thank you for all you have done for so many, especially, my Luna.

Love,

Sandra Thomas, Burghard Shepherds      

your story sent tears down my cheeks. but you also helped answer the very questions I've been having regarding my own dear Uschi-dog's experience with cancer. thank you.