I've added this section mainly for my own healing. Months ago I searched the Internet for info about knowing when it's time to euthanize and the options. There was not much info so I hope this will assist others going through the same thing.
 

Last Hopes
Monday, October 30, 2000 Amie had her first acupuncture treatment. The new vet disagreed with Claudia's diganosis that her swollen kidney was affecting the nerve in her spine. When he turned her foot under Amie corrected it, unlike when she saw Claudia. He thought the problem was advanced arthritis. He recommended a vet brand of MSM. At the same time she was not eating as much or with as much interest and her urinations (pH 6.6) decreased to 2 or 3 a day. This concerned me. Our goal with the acupuncture was to improve her walking. He said she could get a lot worse in the first 24 hours but we could see improvement in 48 hours or by the second treatment a week from now. We anxiously looked for signals that something magical had happened.

Tuesday morning she ate some food. MSM can upset the stomach so we stopped it. At noon she had a seizure. I was working at the computer and she was chair next to me. I heard a thump and noticed she had pushed her blanket to the floor. She was lying on her side with legs outstretched, breathing very hard. Her tongue was on the chair and a fluid had come out her mouth. I picked up her very limp body and held her and talked to her. She didn't seem to be breathing at all. I told her it was okay to go to Grinny (my dead mother and her first master). She had been limp for a few minutes, with eyes open. At one point she looked at me and I was startled to see that she wasn't dead. She urinated and defecated. I called Jeff's office to relay the message that it was time to put Amie to sleep. I called the vet who said she didn't have a stroke, it was a seizure. He had never heard of a seizure being associated with acupuncture. He said to watch her carefully in the next 24 hours. He didn't think we needed to rush to euthanize. This might be the "getting worse before she gets better". So I called Jeff and told him the emergency was cancelled.

I called Claudia who said a seizure can't be good, but she acknowledged that she doesn't know about acupuncture. I said that Amie's spirit still seemed OK. Claudia said that labradors are the worst - they can have their guts spilled out and they'll still want to play and to live. Sometimes you can't go by the spirit.

That evening she was very subdued, as the vet said she would be. We were able to do the moxibustion treatment. We burned a mugwort smudge stick about one inch above her skin over some acupressure points between her belly button and her anus. She drank some but didn't eat or urinate again.

On Wednesday she was increasingly growly. She had meat-breath. We never noticed that before. She ate pretty well and drank some. She urinated only once around 5 pm and then ate and drank some more around 7pm. We were encouraged, but decided not to use the smudge stick. She increasingly didn't want to be touched. She was in pain when we picked her up, but once up or seated she seemed like her usual self. This is confusing.

The new vet said the seizure might be a sign of something shifting but he was very cautious. He discussed some options - kidney function tests, more acupuncture. I would rather put her to death early than put her through her most hated activity - getting blood drawn. The test might have shown conclusively that her kidney was shutting down - or it might have shown that she just had a bad infection (with no fever?). We made another acupuncture appointment for the following Monday knowing that we wouldn't wait that long if we didn't see some improvement soon.  He suggested we consider quality of life and our expectations for her getting better. We decided to see how she was doing in the morning. We hoped for a turn-around but thought the end was near.

On Thursday she refused to be picked up - hurting. She bit both of us twice. She didn't urinate but she did eat and drink. While I was doing dishes I heard my dead mom say I had helped Amie much more than she would have. I looked into Amie's eyes and said "Does Amie feel good?". She gave me the low growl that said, "No". When she had a fever and a bad kidney infection she would look at us with creases between her eyes saying "help me". She didn't do that. She didn't have that pleading Help-Me look, but we knew.  Although there were several things we could have tried we just knew it was time to let her go.
 

The Decision
We always had a picture of how we would know the end was near. Tippy, our border collie, had kidney disease. She went to the basement and refused to eat. She didn't feel well and didn't want to be bothered. When her stool was bloody we took her to the vet and were surprised that nothing could be done. My dad died of kidney failure. He became very agitated and disoriented before going into a coma. The kidney info I have found said she would have massive clear colored urinations. Claudia said we should expect her to stop eating and urinating, fever.

We decided there were several "markers" for telling us when it is time.

When she can no longer stand up and therefore can't get to her food or her papers.
When she can't control her excretions (although I have thought about preemie diapers).
When she won't eat.
When she's not interested in us or anything anymore.
When she doesn't want to be touched.
When she has a high fever and we can't bring it down.
When she looks at us with pleading eyes.
When she's not happy.
When she's obviously in pain.

Claudia said to keep track of good days vs bad days and when there are more bad in a week than good, it's time.

Since Amie's urinations were a good yellow color and she had no fever, I didn't expect that she was in kidney failure. The hunching of her back that Claudia associated with kidney problems had disappeared. She wasn't very interested in food but struggled to get herself up when we were making lasagna. The biggest indicators were her diminishing frequency of urinations and inability to be handled.
 

The Goodbye
I made the appointment for 10:40 that morning. I sat with her on the couch with my hand on her back, feeling her breaths. I willed her to quit breathing but she kept on. Jeff came home around 10 and we gave her 4 mg of Valium that we had waiting for this moment. I got a special plate and put 4 blobs of Valium coated with peanut butter, brie, tuna, and broccoli - her favorites. She ate them all with relish and savored the treats by licking her lips. Before some medical tests a while ago I had given her about 1/4 of a 2 mg tablet of Valium. In a very short time she became drowsy so we thought that by the time we left she would already be asleep. She was feisty enough to draw blood when Jeff picked her up to go but once in my arms, wrapped in her baby blankie, she seemed fine - a little woozy but like our poodle.

When we turned into the vet's driveway Amie stiffened. She knew where she was. As we got out of the car I could hear the barking of the boarded dogs. It was upsetting to me, and I knew Amie hated to come here. Claudia had moved her practice to join with my least favorite vet. As one last indicator of the reason I wouldn't recommend this vet office is they had her breed wrong on the bill, which we, of course and gratefully, handled first.

We requested that we do the treatment outside. Amie was still woozy but a little distracted by the outside. I looked at her almost hairless, useless legs and felt so sorry for her lifelong struggles, and grateful for her wonderful spirit. She was still active enough to try to get away from the thing they put on the arm to raise the vein. Claudia inserted the needle, asked if it was time. We held her and told her she was a good doggie and within seconds, if not immediately, she was thoroughly limp. I wasn't sure she was dead yet. Claudia looked in her open eyes and listened to her heart and it was over. We gave her to Claudia.

Jeff had started sobbing by the time we went into the office and continued in the car afterwards until we could drive away. I did very well, comforting myself with a cheerful fantasy of Amie running through the tunnel of light, being surprised she felt so good and surprised she could run again, running into Grinny's arms. I was so relieved that I felt we had done the right thing.

We had had the foresight in the moments before we left to go to the vet's to throw all her bedding downstairs to the laundry room, we removed her wee-wee papers and the runner we had put in the kitchen to give her traction on the wood floor. We threw out her dog food and removed the barriers we had put up to prevent her from urinating on the rugs. So when we returned, the place looked fresh and different.

We blubbered for about 2 hours and reminisced about the lively dog we fell in love with and got onto letting her go. We've decided to let her be an inspiration. We remembered that one minute she'd snap at us, growl, try to bite a finger and the next minute she would be kissing and rubbing her head into our chests - irritation with each other don't mean nothin'. Even tho she couldn't stand very well she'd try to wag her dislocated tail - no matter the circumstances, you can always be happy. When she was her most uncomfortable she always was interested and wanted to play. Words of wisdom.

Amie will be cremated and we'll have a little ceremony when we spread her ashes at our favorite private picnic spot.

Needless to say I am still grieving with periodic bouts of unrestrained tears, but it wasn't as bad as I thought it would be. So here it is a day after and I'm sick to my stomach and can't think of anything else. I'm really lousy with grief - I don't go to funerals. I can easily see how people decide to never get close to anyone or any thing. I can't imagine having another dog. I'm giving myself one more day of semi-grief while I update her webpage for the very last time.
 

What I've Learned
When you read the section What Others Said in Amie's Forum you will see that so many of the dogs with problems are small - schnauzers, Shih Tzus, terriers, lhasas, toy poodles, bichons. If I ever have another dog it will be a medium-sized mixed breed and I would choose carefully.

I would be willing to travel if I had to find a vet that listens and works in partnership to find solutions.

I've said enough about taking control of a dog's treatment and working with vets. I have gained a tremendous amount of assertiveness and the peace of mind and confidence that occurs from taking responsibility instead of blindly following a vet. I'd get right on the Internet to learn as much as I can about any problems and then run any new info by the vet.

From the beginning I would find the best homemade recipe and animal supplements and work with that rather than feed any commercial dog food. There is something new called BNA - BioNutritional Analysis, a diagnostic tool to identify overall health and earlly stages of disease. It costs $250 which I think I would do right away.

I would never give another dog Pred. Once on the Pred treadmill, there is no other option. The info I have seen about acupuncture shows that it might be a better way to treat allergies. I'd try that before medications.

I might try the Animal Advocate again or other sources to see any breed-specific diet considerations.

Although I have repeated what others have said - that the U/D diet will prevent stones from forming, several people have emailed me to the contrary.

I am certain now that allergies and kidney problems are related.

At the first sign of stones I would see if the dog was a good candidate for lithotripsy.

There is a lab that will test a dog's blood for food allergies.  Can't find the source. I think its in Colorado.

Would also try rotating 4 menus over 4 days for allergies - worked for my own rash.

Unless I was head-over-heels in love with the dog I'd never go through this again.
 

Amie's Page
One of the reasons I haven't updated her page more often is that there is so much information that even I can't find my way around the site very well. It was my intention with the webpage to teach myself how to make one using Amie's information. After all this work, and there is a TON of info, I'm thinking of how to package it so it is easier to access - probably in booklet form. If you are interested, contact me via the Amie's Forum page.

Thanks to all who contributed.
 

Bye-Bye
Amie loves Kakker and Jeff. Kakker and Jeff love Amie. Ummmm.
 
 

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