So very sorry your family and Molly are going through this difficult time. Unfortunately, over the years, I have had to make that decision more times then I like to think of as it is never an easy decision to make.
Sometimes, you need to step out of the emotions involved and look at this objectively. I know, as a nurse, you can understand.
Molly is 11 years old and likely in pain. Animals have a natural instinct to hide their pain. She is not going to get any better. She may have a few good days but how good are they really? She is not going to get any better, you understand that. Assuming your Vet is a compassionate one, the procedure can be a peaceful one and you can be with her. Some Vets will actually come to your home. Do you want to take a chance and wait until she is on so much pain that you are rushing her to the Vet? Have you discussed this with your Vet and asked for advice on her present condition? Actually, you know your dog best and will know when it is time.
Years ago, we had a Greyhound that developed Lymphoma, a fast moving Cancer. There were options for treatment but all carried side effects and, most likely, would just buy some time. I opted to do palliative care only with diet and supplements. He survived another 6 months. The lymph glands in his neck were getting very large. I was pretty sure it had spread to his lungs. When he did not want to take a walk, I knew it was time. My Vet arranged for us to come in at the end of the day and we were all together in a quiet room. His passing was peaceful and he was with the people that loved him.
None of us want to see our animals suffer and, for me, it comes down to a quality of life issue.
This is often the last act of love we can do for our pets.
Yes, many of us understand your heartache.
I am so sorry. My own dear dog had this. It is called "Hemangiosarcoma". In her case she lived (quite well) but only two weeks after diagnosis.
Unfortunately this cancer does not have a good prognosis, and treatment is not really an option. If the cancer has spread (which it almost always has by the time it is discovered) then spleen removal is more debilitating that useful to the dog, and won't give any extra time.
There have been some good results with alternative treatments but they are unproven....that is the nature of the disease itself can be very up and down, and sometimes a dog can live for weeks or months even, with this. So those who report great results may be not always getting the full picture of the disease progression.
Now with it, they get internal bleeds, yes. But sometimes the bleed is a very small one, and apart from a day or so of lethargy, they can recover. Of course, they are terminally-ill, but can have some good quality of life in between bleeding episodes. This will be a slowed-down version of their normal energy. But some can still enjoy their food, gentle walks, sleep well, enjoy family life etc.
Our own vet told me of cases he had known of dogs with Hemangiosarcoma who had lived very happily between shortlived minor internal bleeds, and had enjoyed their last weeks.
The problem with Hemangiosarcoma is it is literally a ticking time bomb. At any moment a huge hemorrhage could happen quite suddenly, and you really cannot take your eyes off your dog. It would mean 24 hour care and vigilance. For someone who cannot do that because of work or family commitments....it is better to set a date with the vet for a graceful and dignified ending, and will definitely protect the dog against a traumatic 'natural death' from internal bleeding when the owner is out at work. But for anyone who can give that 24 hour care -it does give the dog some more time.
Quality of life is the FIRST concern here. For a dog that usually means food, exercise (even reduced), love and affection, sleep, and no pain of course. If a dog is getting all that then it doesn't matter that they are terminally-ill. They are still living. Even if they spend more time on their bed....if there is a wag in that tail and a lick for loved ones, and a good appetite, that is a sign they are not necessarily ready to go.
Urinary or fecal incontinence can occur with many conditions and isn't always a feature of Hemangiosarcoma. Again -this issue depends on how the dog handles it. If the dog is okay about it, then it isn't losing any quality of life. But if it is mortified and upset every time an 'accident' happens, or skin problems start because of constant wetness, etc....then that is ruining their quality of life.
I am very sorry. I have been through this with my own sweet girl. I absolutely knew when it was 'time'. There was no question. She needed help and I provided it for her in the form of a pink injection to release her from her body which wasn't working any more.
And....she showed me some weeks later that her Soul lives on, still loves, and waits for me very happily. (The most amazing thing I have ever learned.)