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Slower than a…

While Romeo didn’t have yesterday’s surprising amount of energy, he was nowhere near as low as he was the few days before that.

This afternoon he did have a nice time outside resting on his dog bed between the big events of drinking water and going potty.

After Romeo came back inside and settled back on a human bed, Trent noticed that Romeo had silvery trails over his hip.

Yes, a slug ran over my dog today.

Again with the spunk

Ok, maybe not spunk, but at least a bit more energy for our Romeo today.

Today I was actually making some alternate arrangements at work in case this was the week I needed a day off to say goodbye to Romeo.

Then I got home to a Great Dane who almost ran to come back inside to greet me when he heard me arrive. Romeo also made it onto the couch this evening which he hasn’t done in over a week. Even when laying around tonight, he has been hanging out with his head up a lot more than he has over the last few days.

He ate pretty well today and even got to chew on a pizza box, although he was much more into the peanut butter jar that he got to help lick clean. So it was a pretty good day in Romeo’s world.

Lights out except for our two laptops, here is what my computer's photobooth caught. His head is almost hanging off the couch and of course he is surrounded by feather pillows.

 

 

Rest Stop

During one of Romeo’s trips outside today, he again used the outside bed for a rest between drinking water and hopping to the grass to pee. Trent used this time to grab some pictures of our gray faced boy.

 

HHHHHMM

Hmm is kind of how Romeo feels today. With another day spent on the bed, he still has little energy but seems content to mellow.

After another throw rug was added to connect the path between the bed and the back door, Romeo was more willing to try hopping around and eventually made it up for lunch and an outing to the backyard for potty time. He wasn’t really interested in dinner though, but has eagerly taken the treats we have offered him.

Since he was diagnosed with osteosarcoma almost 7 months ago, we knew the day would come when we’d have to talk about euthanasia. Thankfully, even through amputation recovery and chemo, Romeo has had a good quality of life since diagnosis. But with his dramatic recent decline, thoughts about the end keep edging into our minds.

This spring The Latham Letter, an animal welfare magazine, featured and article about quality of life at the end of life. They discussed pet hospice and tips on the evaluation of whether it is was humane to continue hospice or if it was time to consider euthanasia.

In order to evaluate quality of life, they discussed the HHHHHMM scale. The initials each stand for one aspect to be considered: hurt, hunger, hydration, hygiene, happiness, mobility, and more good days than bad.

Working in a shelter where we offer request euthanasia services to pet owners whose pets are at the end of their lives, this was a helpful tool to share with owners who were struggling with the decision. It’s a tricky balance not wanting to say goodbye too early and not wanting to make a pet suffer unnecessarily, but ultimately it is an individual decision best made by those who know and love their pets.

The entire article (“Quality of Life to the End of Life” by Alice E Villalobos, DVM) is available on the Latham Foundation’s website in their article archive. More information about the HHHHHMM scale is available at Pawspice’s website. Here they go into more detail about each of the Hs and Ms.

I liked the descriptions on Pawspice’s website since they recognized that all these factors shouldn’t necessarily be weighed equally and similar issues in different dogs may also be weighed differently. Individual criteria could carry more weight depending on the impact to the pet’s life.

The example that stood out to me was under mobility. Severe mobility problems may be less of an issue for a small breed dog than more minor mobility issues are for large dogs. Since it is easier for people to help the small dogs get where they need to be they can compensate more easily than large dogs. Having helped a Great Dane learn to walk on three legs, I can relate to this. Had our little 5 pound Julio needed help learning how to walk after surgery, we would have carried him anywhere he needed to be while he learned how to work his body again. That’s not really an option with an uncoordinated 130 pound pooch.

It’s not a cheery subject, but it’s nice to have some guidelines to use when evaluating when pets are nearing the end of their lives.

Anyway, all is not gloomy in this house. We’re not ready to say goodbye to our big guy yet, but since thoughts of euthanasia are rising occasionally, it seemed like a good time to share this tidbit.

Tired, tired puppy

Over the last few weeks Romeo’s energy has been declining, but today seemed to be a big struggle for him.

Romeo has been camped out exclusively on our bed for the last few days, just getting up for mealtime and brief visits outside. With simple wishes, he doesn’t really have to move much anyway. He knows that when the other dogs get treats, I’ll bring him one. He also doesn’t bother to get off the bed when I get home, but when I come to visit he’s usually alert and waiting for me.

At lunch today he did get up but didn’t finish his kibble before deciding it was time for a break. At dinner time I ended up bringing Romeo his bowl of kibble so he could eat in bed since he was showing no interest in getting off the bed. And for the first time he didn’t immediately dive into his food bowl. I’m not sure if it was too much effort, a lack of appetite, or the novelty of eating in bed.

Eventually this evening, it was time for him to go outside. Romeo has a giant bladder but hadn’t been out since midday and needed to before bedtime. We tried multiple times to entice him off the bed, but eventually I lifted/shoved him off the bed. Never a graceful dog, he had a lot of trouble getting coordinated and moving. He did manage to get to the back door with me coaxing/pushing him along but didn’t seem inclined to go any further.

We finally got out his harness from his amputation recovery days so we could help him walk more easily. Trent and Romeo walked out to the grass and Trent helped hold Romeo up while peed. Romeo did drink some water and halfheartedly bit at the hose while I filled the bowl. All of this was exhausting, so he took a rest on his outside rug.

Now he’s back on our bed and all is well with the world.

Earlier today we were just commenting the fact that Romeo hasn’t been doing much coughing over the last few days. Today he has coughed a bit more, but still not much overall. He is just very, very tired. I think this is his agenda for tomorrow:

The traveling bed

Enjoying the beautiful summer afternoon.

 

A bit more spunk

Romeo had a surprising amount of energy today. He did the happy dance when it was lunch time. He enjoyed hanging out outside on his bed.

He even decided to hop up and run when Dante took off barking to the far side of the backyard. Romeo only made it this far though before realizing that took a lot of energy.

Romeo even helped fill the water bowl.

 

Just a Thursday

Since Trent was still out of town, Romeo got to come to work with me on Thursday. He is a very mellow office assistant. Since my office does not have a couch or queen size bed, it is required that we travel with Romeo’s favorite bed.

This bed has seen better days but is the biggest one we have and actually fits Romeo. It is filled with egg-carton shaped foam which all our dogs really like. After several years of use, the foam was breaking down, so we stuffed a queen sized feather mattress topper in with the remaining foam and now this bed is extra comfy.

When Romeo isn’t sleeping on the couch at home, this bed has to be moved from room to room with him since sleeping on a normal dog bed isn’t Romeo’s idea of the appropriate level of comfort.

A quick note on the pillow – this pillow lives in my car since everyone should travel with a car pillow. Romeo appreciates it when he rides with me. This spring I got this pic after Romeo grabbed the pillow with his mouth to bring it closer so he could settle in with it. This dog loves to be comfortable.

Romeo’s Rug

Being a three-legged Great Dane is a lot of work. Being a three-legged Great Dane with growing lung tumors is even more work.

As the weeks go by, Romeo is getting tired more and more easily.

Romeo likes to hang out outside sometimes, but he doesn’t have the energy to meander around for long periods of time. But he doesn’t like to lie on the ground. The obvious solution was to put a rug outside for him.

On days when I hang out in the hammock, I’ll put Romeo’s favorite bed on the rug so we can both enjoy the nice summer weather.

Here he is after a big trip to the backyard for potty time yesterday.

Romeo’s Summer

Summer is flying by and I have been very behind with the Romeo updates, so here is an attempt to catch up.

In May Romeo finished his chemo at OSU. He even got a nifty certificate to celebrate the occasion.

Once his five rounds of chemo were done, his next check up was a month later for another chest xray to check for metastases in his lungs. At this appointment in late June, a small tumor was found in Romeo’s lung. Only the size of a pea in Great Dane sized lungs, Romeo wasn’t feeling the effects of the tumor yet, but this did mean that the first round of chemo didn’t succeed in stopping the cancer.

Here is an unconcerned Romeo frolicking just after his tumor was found.

Since his first round of chemo didn’t work, the doctors at OSU talked with us about other treatment options. Next we started a four week course of palladia – a cancer drug that inhibits growth of blood vessels to tumors, hopefully slowing tumor growth. The nice things about palladia is that is is given as a pill three days a week, so Romeo didn’t need trips into Corvallis for treatment. At the end of the four weeks Romeo would have another set of chest xrays to see how the tumor was doing.

The only drama Romeo had while taking palladia was some vomiting and diarrhea at the very end of the treatment. Eventually Romeo vomited up a six inch roundworm (how embarrassing!!), which probably had more to do with the stomach issues than the drugs did.

On July 25th, at his post-palladia check up, Romeo’s xrays showed that in the month since his last xray, his tumor had grown to the size of an apricot, which meant that palladia hadn’t worked either.

If the tumor keeps going at its current rate, Romeo has one to two months left before it won’t be possible to have a decent quality of life. There are a couple of other treatment options that may or may not actually help. Since it seemed like Romeo’s energy level had already begun to decline and he hadn’t responded to the other medications, we decided to stop treatments.

Over the last two weeks, our big puppy has slowed down and is even more mellow. He tires easily and his outings to the backyard are shorter and shorter. But he’s still happy and enjoys “helping” fill the water bowl with the hose and is currently begging quite persistently for dinner.

So for now we’re enjoying our time with our big puppy.