I had a spinal injury a few years ago and the surgeon warned me of permanent nerve damage causing incontinence being a potential consequence if it got worse. It's called "cauda equina syndrome", I did a quick search and it looks like it occurs in dogs too. Essentially you lose all nerve feeling on your bowel, hence not knowing when you need to go. I'm not sure what the solution is (if any) but it could be a clue.
Quality of Life scale
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Not a particularly fun topic, but if you are in the unpleasant situation where you are trying to decide whether to help a very sick or elderly dog cross the Rainbow Bridge, a Quality of Life scale (HHHHHMM Scale) may be of some help, particularly if you are very conflicted about what to do. This is the one that our veterinary internist gave us. We're using it now with Nemo, and I would say it has at minimum helped foster the discussion of what is important to each member of the family.
http://virtuavet.wordpress.com/petqualityoflife/qualityoflifescale/
Clay
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Interesting scale,. Number one IMO should be whether or not the animal is interested in eating, so I would tend to put the "hunger" criteria at the top of the scale and give it more weight than for instance pain. This past year I went through a very difficult time with a horse, and I know she endured quite a bit of discomfort…..yeah, pain.....but she never lost her appetite, her eyes were bright, and she was interested in her surroundings, so I supported her as well as I could and she is currently pain free without meds. I didn't feel I should give up on her before she gave up, and in this case I have a good outcome. Some animals are more stoic than others, and will hang on through difficult times. Others give up, and I think they should be allowed a painless end if there is no way to revive their will to live. Age is obviously a factor, as is prognosis. Enduring a difficult time when you know there is light at the end of the tunnel is a lot different from eking out a few weeks or months when the outcome is certain. Knowing whether you are doing it for them or whether you are doing it for you can be difficult to determine.
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It just goes by total score. A score of 35 is considered decent quality of life. You could certainly weight or modify the different components as you mentioned.
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Thanks for posting Nemo. I have a 16 1/2 year old border collie mix and she is on the cusp of the criteria. Having something concrete to see really helps to sdetermone how she is faring. Thank you so much for posting this. I wish it were more concrete, but this certainly provides a guide to help see when it's time to help out old friends over the bridge.
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If you have a dog in pain, I highly recommend Tramadol. A vet will have to give you a prescription and you will need to make sure it does not cause a problem with other medication. It helped tremendously with my elderly BRAT foster Annie who had back problems. Sometimes if a dog is in pain, it will not want to eat.
Jennifer
