Chronic CRF - how do you know when it's "time"

[jindc]

OK, I know there have been extensive posts about CRF in dogs and I've read through more than I can count...  But I'm still struggling to figure out how to know when it's time to put my beloved 14 year old pup down.  She was diagnosed with Chronic Renal Failure last fall and it's been a roller coaster ever since.  Getting her to eat has been a struggle but after a lot of trial and error we seem to have found a diet that works - we are making the home made renal diet (our vet gave us a recipe).  We do sub-q fluids every 3 days.  She'll seem to be doing well for a while and then will have a day where she won't eat much (if at all) and occasionally will vomit.  On those days we look at her and think she looks like she's on deaths door...but then she'll rebound and be much better the next day.  On her good days she's alert and loving and will go for walks (although her hind legs are very weak).  She definitely sleeps a lot but overall she is still the dog we remember and love.  I keep reading here that you will know when it's time but I worry that I might never know.  I definitely don't want her to suffer but the thought of letting her go before it's her time is truly painful.  I ask myself if she has more bad days than good and I definitely think she has more good than bad but my family disagrees a bit about what constitutes a "good day".  I mean, her good days are definitely not the same as she was several years ago but she will eat well and is alert and will go for a walk, etc...  But then there are bad days.  Like yesterday she hardly at at all and was pretty lethargic and then this morning she vomited and we found her sitting in it, which is very odd.  But then tomorrow she could go back to eating relatively well and seemingly enjoying life.  

[LoveMyBostons]

I'm sorry you're going through this. It's so hard to know when it's time to let them go.

All I can offer is my experience. I had a dog with congestive heart failure. His meds caused kidney failure and he was on subQ fluids every 2 days. It was honestly so hard in the end. I had to wash his bedding every day. He couldn't go for walks. He would eat one thing one day and refuse it the next.

I finally just knew one day that I was making him go on for me, not for him. I was being selfish and knew I had to do the right thing for him. I probably waited too long because the freshest memories for me were of the bad days. All of our interactions seemed to be medical - related.

I'm not saying it's time for your dog. I'm just saying that it is true - when it's time you will know. Good luck to you both.

[tonyb286]

Hi

First, I'm sorry you are going through this with your best friend ... but you are not alone. We have a wonderful Chronic Kidney Failure in Dogs User Group here on MedHelp, whose members are those that have or have had dogs with kidney disease. I would urge you to become a member of this group, as you will find it a rich source of information, support and advice. We are a friendly bunch - and we all have one thing in common.

Secondly, you seem to have a really good insight into the condition, which I'm sure has come about due to trial and error, reading a lot and experiencing a lot. I very often mention the "good and bad days" with this disease - and yes, it's when the bad days outweigh the good ones that we have to consider the inevitable question about euthanasia.

Honestly, no one can tell you when the right time has arrived. It is a very personal thing. All you can really do is consult with your vet about how far the disease has progressed, and look into your dog's eyes to see what they are saying. When "that look" comes that says, "I've had enough!", then you'll know. It's the look none of us want to see, but eventually, we all see it.

On the plus side ... it strikes me from what you have said that maybe that time isn't here yet. The sub-qs and the diet you have devised is clearly having some success, even if it's not always consistent success. While she takes an interest in things, in people, and in going out on those good days, then she has a decent quality of life and wants to continue sharing it with you.

On the subject of diet ... I know you have read a lot, but maybe not my article on this subject. It may have a few ideas you haven't yet tried, so please have a read. The link is below:

http://www.infobarrel.com/How_Diet_Affects_Dogs_with_Chronic_Kidney_Disease

I hope to see you over on the User Group threads ... please start your own thread with the name of your dog, give a short history and ask any pertinent questions you may have.

Regards

Tony