The Animal Doctor

DEAR DR. FOX: I have a 17-year-old Chihuahua that has CCD (Canine Cognitive Dysfunction), congestive heart failure, liver disease and kidney disease. His congestive heart failure is managed with with Vetmedin, Lasix and Benazepril. The primary concern is his CCD.

It is unclear, per our vet, if his heart problem is causing less oxygen to reach the brain or not. But he’s either pacing and circling or sleeping. He does not interact with others, and I suspect it’s for a variety of reasons: deafness, near-blindness and cognitive dysfunction. However, he does know when he’s alone in a room, as he will seek out signs of anyone being in the house. If he thinks he’s alone, he makes this “mooing” sound. He doesn’t understand what it means to go on a walk anymore, and will go in all directions. He is weak and wobbly; what he does most is walk a few feet, stop and stare as if his brain has been interrupted, look as if he is about to fall, then will continue walking. He does the staring and circling quite often throughout the day. He will also go to the side of my chair where I’m sitting and will begin to whimper. He gets lost in the house and trapped under barstools.

He doesn’t ask to get in bed with us like he used to (by reaching up with his paws), but he will come to the side where I’m at, then circle and leave. I retrieve him and put him in the bed, but he either settles down quickly or becomes very agitated and fights to get down. The other positive thing he does is he still eats and drinks water.

He doesn’t greet me at the door, and when I go to him and pet him, he doesn’t respond like he knows me. So basically his days now are spent either pacing or sleeping.

It’s becoming almost impossible to watch him 24/7, which he needs. I’ve had conversations about “quality of life,” and that it should determine whether to intervene or to let nature take its course. But I am so close to him that I just can’t say with full conviction that I think it’s time to intervene. How do I know what the best choice is for him? Everyone, including my husband, is telling me to let him go. I just keep thinking if I intervene, am I robbing him of days he needs to keep living? If I do nothing, will he be suffering?

I am reaching out to you because you seem to really understand animal behavior on a deep level, and not just what the books say. I made a commitment to take the best possible care of my pets, and I love them like my own children. At the age of 17 years and four months, he’s given me some of the best years of my life. He’s been the spark in my day. I don’t know if I’m holding on to the past or what. I really want what’s best for him, and don’t know if he’s trying to hang on to keep living or if he’s saying his body is spent.

I sincerely welcome your perspective. -- K.D. (address withheld)

DEAR K.D.: Your letter is important to other readers facing this kind of situation where an old animal can be kept alive with the best of care.

But what is the emotional and physical cost to the caregiver? That is an essential part of the equation in assessing animals’ quality of life, as detailed in the peer-reviewed article on my website, Your competence and devotion are quite evident in your letter.

For the dog’s sake and yours, it is time to sever the tenuous thread that is keeping this old spirit in a decaying body. Discard any feeling of guilt or failure in accepting this. The inevitable is merely being postponed, and in the interim, the poor dog is being subjected to a situation where, cognitive dysfunction notwithstanding, there are probably episodes of feeling the terror of total disorientation and abandonment. One temporary solution would be to carry the little dog next to you in a sling or comfortable bag most of the time, until you can reconcile yourself to the reality of your dog’s deteriorated condition and incredible will to live.

As a culture, we have difficulty accepting death, especially of our loved ones, whether human or nonhuman. But euthanasia is a humane and ethical decision, and one which I would consider now for your dog. I would secure the services of a veterinarian to do in-home euthanasia for the comfort of all.


At least 17 veterinarians, veterinary technicians and practice managers, along with four pet owners, say the Dr. Steve Abrams Memorial Foundation -- Petsavers Inc. -- has failed to live up to promises to pay for treatments and surgeries. The charity is run by Alan Abrams, who has been convicted of practicing veterinary medicine without a license and has been sued multiple times for actions he took as a veterinary practice consultant. -- Veterinary Information Network, Nov. 2

(Send all mail to or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.

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