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Six year old dog in Stage 4 Kidney failure, when to say goodbye...

My six year old rescue dog is in Stage 4 kidney failure according to our vet.  Bear has malformed kidneys from birth and it was diagnosed about 5 years ago when he nearly died.  The vet called him miracle boy.  His creatinine levels were 13.4 then.  After giving hospital IV's and lots of home IV's, getting him on Royal Canin Renal food, and some meds, Bear did fine for the past few years.  In fact so well, that I made the mistake of returning him to regular high quality dog food.  A few weeks ago my daughter stated Bear seemed sluggish to her.  I didn't even notice....he was a bit overweight and I had reduced his food intake.  Took him to vet on Saturday because he stopped eating and drinking, and was mostly sleeping.  They did blood tests and gave IV for dehydration, plus appetite stimulation meds.  He has been eating again, but still sleeping lots.  Just got blood tests back and his Creatinine level is now 17.6.  Vet said that is extremely high and stage 4 renal failure and said we could try more IV's, but in her opinion it would be costly and just extend his life, but not have quality life.  Time couldn't be worse, we are heading on a one month vacation overseas in less than a week.  The vet recommended putting Bear to sleep now.  How can I do this when he is still eating, drinking, wagging his tail, walking outside ok, he isn't loosing fur, his breath is terrible though, he's not shaking or trembling, and he looks pretty good, doesn't appear to be in pain - just sleeps alot and not interested in playing.  I'm feeling so guilty and just don't know what to do.  Bear is my baby and he's only 6.  Please help me with any advice.
Thank you all so much.  
1 Responses
675347 tn?1365460645
I am sorry about Bear. He has done so well over the years, and you have helped him live a good and full life.
It is never easy when we have to face them leaving us soon.

I don't suppose there is any possibility of postponing your vacation?

Bear obviously means so very much to you, and there is a chance he may not last another month. Of course, I hope he does, and with decent quality of life or as long as possible. But there is that chance. How would you feel if you left, and came back and he had passed?
Sometimes that can happen with a dog who isn't doing too badly, but is nearing the end of life. They pass when their family is away.

That can cause so much recrimination after they have gone, and make grieving harder.

It may also be important at this stage to keep a close eye on him day by day, as an illness can suddenly take a turn for the worse, and a clear decision might have to be made then.
I do feel all that would be easier and more "organic" if you were with him, rather than being forced into such a decison from a great distance over the phone for example.

And he needs you. His last days....weeks (hopefully) are very precious and it might  bring you some comfort after he has gone, that you watched over him as his life drew to a close.

Re: his quality of life.
Obviously he still has a decent quality of life, and is able to enjoy some things. There are those who would disagree with me, but where there is life, there is a right to live.

As I said, that could turn "on a dime" at any time.

One thing that will seriously lower his quality of life will be if nausea takes over. Now to some extent ant-nausea drugs can help, but if it gets to the stage that they don't....then there really are few options for extending his life with quality of life.

That's why he will need to be carefuly observed by someone whom he loves, and who loves him.

If you do postpone your vacation, don't think of it as putting a "dog" before your life, but as standing by a dear friend in his last days.
Please excuse all my typos in my answer!
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