Approaching End of Life- Fanconi/Seizures/GME?

[AllisonMosley]

Hi everyone, Mya is 14 years 8 months old. Diagnosed with Fanconi around age 6. She had 2 seizures 12/21/21 and 7 over a 12hr period on 1/10/22. The labs from 12/21/21 showed BUN/UREA 34 mg/dL, BUN/CREA 8, CREA 4.1 mg/dL.

We started her on .5(I think it was mL) of Keppra for the seizures after the episodes on 1/10 to see how she does. She is still eating and drinking, but in general has had some changes in the last year with increased urinary incontinence, seeing/hearing loss, major weight loss(22 to 18 to currently 16lbs). There is discussion of possible GME(has a lot of the symptoms) and VET thinks the seizures are brain tumor/GME related and not metabolic. ABD/CHEST scan showed no cancer. We are not having an MRI done because we would not seek treatment/surgery.

If your basenji was in a similar state...
-if they had GME... how "rapid" was the decline?
-Did you see results/or decrease in CREA etc when flushing the kidneys via fluid administration with a CREA of 4.1? If so... how long did those results last? Did it extend their life or improve quality of life?
-She gets 3 sodium bicarbonate tabs BID...but at 14 years old is getting a venous blood gas worth the effort in order to change dosage? (For reference... barriers exist for us. No local vets with iStat machine, human hospitals unable to help, local pet ERs so busy & require referral + admission=$$).
-Did your pet weigh this little? Were they able to gain some back or even maintain it? VET thinks it is a combination of renal failure/old age.

This is my first pet that I have needed to consider all the factors that lead towards the decision of euthanasia. I have read books and websites but I think I just need to hear from some basenji lovers. One moment I realize euthanasia is coming, the next I am wondering if maybe she has a few more months.

Our current game plan is to continue the Keppra and monitor for seizures, while assessing the side effects of it and how it changes her quality of life.

[eeeefarm]

My experience was with a 13 year old healthy Basenji who had a bad seizure out of the blue. Speculation was that a brain tumour might be the cause and we ended up using Prednisone on and off for the next three years until the seizures came back and we chose to euthanize at just short of 16. Towards the end there was some incontinence and also "doggie dementia" and I probably postponed the decision longer than I should. It comes down to quality of life, and in retrospect I waited too long. In your case, I think you have done amazingly well with a Fanconi situation. You are the best judge of whether your dog is getting any pleasure out of life. Appetite is a good indicator, and of course anything else she seems to enjoy. It's a tough place to be in, whatever you decide.

[AllisonMosley]

@eeeefarm Thank you for your reply. 16 years is amazing. How special that you got 3 more years. Doc had also mentioned steroids but that it wouldn't be good for her kidneys if I remember right. She is still enjoying the day to day for now.

[Kembe]

@allisonmosley
I feel for you. I just had to put my B down this past fall and she was 15 years 10 month - it was so sad and I’m still not over it. It really comes down to quality of life as @eeeefarm stated. My basenji had dementia, her hearing and eyesight were going, and she lost a lot of muscle mass - but she still was eager to eat until the very end. You’ll make the right decision on what’s best for you and your basenji. My thoughts are with you. ️

[tanza]

@kembe - Agree... you need to assess the quality of life... It is a hard decision.... but you have to believe that if you choose to end life, it is the release them from pain.... Watch them, they you tell you.. and when they do... let them go in peace.... remember you will always carry their soul in your heart....

[Zande]

We had one who had a massive seizure at 14 years. The night duty vet was a locum and he asked if he could try a steroid shot. If not successful he would come out next morning at no extra charge and send the boy on his way to the Rainbow Bridge. He helped me carry a large crate upstairs to a spare bedroom and we put the boy in and pulled the curtains. He had quietened by then anyway.

Next morning all hell broke loose. The crate was being rocked from side to side by a very angry Basenji ! What am I doing here ? I want OUT ! I want my breakfast - NOW. Let me OUT.

So I opened the crate and he raced downstairs. Marvin shrugged his shoulders but put down his feed bowl as usual and the meal disappeared in short order.

We had him for another full year, no more seizures, perfect normal - so I would not dismiss steroids. OK long term they may damage kidneys, but this was a single injection and I would guess quite a strong dose.

When the time came, he told me he was ready this time and asked for help. Basenjis almost always tell you when they are ready to leave and it is wise to listen. You show them how much you love them by letting them die with dignity and without suffering. I would always rather be a day early than late.

[eeeefarm]

@zande said in Approaching End of Life- Fanconi/Seizures/GME?:

We had one who had a massive seizure at 14 years. The night duty vet was a locum and he asked if he could try a steroid shot.

This sounds exactly like what happened with my girl. When she had her initial seizure it was bad. I knew my neighbour down the road had her vet visiting for routine work on her horses, so I phoned her, the vet came quickly, gave Lady a steroid shot, and we hoped for the best. I lay beside her all night. By morning she seemed almost normal. There was a new vet who had just come from University at my vet clinic, she suggested a possible brain tumour, and recommended Prednisone. We didn't use it non stop but on and off, and the strategy worked for almost three years.

[LifewithAva]

I walked almost the exact path with my last boy, who was also a Fanconi dog. He had a Grand Mal seizure at age 10 and the vet diagnosed a possible brain tumor and recommended a whole battery of tests, including an MRI. I went to another vet and the new vet recommended starting with a short round of steroids to see if he would respond. He did and had a healthy life until he was approaching 15.

The last year, his sight and hearing had been declining and he had become a picky eater, so his weight was down. Then one night, he had a series of seizures-- the first in almost five years. The meds and SubQs helped him keep going for another month, though he started eating less and was looking frail. Everybody said he would tell me when it was time-- and I wasn't totally sure I'd recognize it-- but that's exactly what he did. I felt like he wanted to keep going and I helped him do that for a month, then one night, he put his paw on my hand and gave me this look. I knew. You will, too.

[elbrant]

Everyone's memories are making me tear up. It's hard to deal with, but I am glad that we have such a strong support group. Thank you, everyone, for sharing. Please (always) feel free to share the good memories of your pups as well. (excuse me... I need a kleenex or two) to all

[LifewithAva]

It goes by fast. Seems like Ava was just a feisty puppy a short while ago... and now she's nine. Her face just started turning white. Puppies are fun, but these older dogs are a treasure.

[JENGOSMonkey]

@AllisonMosley I'm probably the wrong person to ask on this topic. I did everything possible to save Jengo. Everything I could think of. While I don't regret why I did it... it haunts me that I let him suffer longer than I should have. Why did I do that? Because I/we loved him very much. He was absolutely part of the family. We were shattered without him. Crushed. In retrospect... I should have let him go earlier. As some say... they'll tell us, but I wasn't listening to him. I was listening to us. I sorta regret that now.

We tried Phenobarbital, which worked great till it didn't. It finally hit his kidneys. Then we switched him to potassium bromide, I think. It settled his kidneys, but his anxiety went off the chart. I kept telling myself he'd get over it. That was mistake.

I don't envy the choice you're facing, but I'll also never judge you for the one you make. Clarity is something I didn't have going through it. My thoughts are with you.

I don't regret one second that we had Jengo... beginning to end. Our love for him is why we have 2 more (6 more temporarily till the puppies leave). We find ourselves comparing the pups to Jengo, other Basenjis to Jengo, etc. I wouldn't be showing a Basenji if not for Jengo.

My point is... as hard as this is stay strong and focused... for your dog. Stay focused on your dog and not emotions like I did. Do what your dog is telling you... as fricking hard as that is. One of the hardest things I've ever had to do.

I'm sorry if I'm veering off course from your initial treatment question.

[Zande]

@jengosmonkey It is so easy to forget what is best for the beloved dog and put off the inevitable. The instinct is for just one more day - and it is completely understandable.

We all love these sublime critturs to distraction though and somehow have to do the best for them in the end, however hard it may be for us.

No-one judges anyone else - we all do whatever we can.

[B5004EVER]

Longtime member, not active. Had a basenji with the same diagnosis back in 2004. He took a tremendous amount of bicarb each day, his Fanconi was being well managed, but he started having seizures at night. Our vet gave us something to stop the seizure that we'd administer rectally. We kept track of the number of seizures and they started becoming more frequent, to about twice a week, if I recall. The final seizure he had he went temporarily blind and howled and howled and we knew that was it was time. I just sat on the floor with him and cried. A couple months later we looked at photos we had taken of him right before and he looked very, very tired. Very much the hardest thing we had ever done was to let him go across the Bridge, but after looking at those photos, we had done the right thing. Our vet had told us that it was possible he would have a seizure and not come out of it, and we certainly didn't want that.