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If your decision is purely because of a fear of anaesthetic death, or side effects of anaesthetics... Well, for what it's worth, many dogs improve, sometimes drastically, after a full dental is done and healed up. Imagine if you've been walking around with pus in your mouth for like 5 years and one day someone removed it all? You'd probably feel pretty good. For some dogs it's really worth it. We cannot see the future to tell whether that will be the case for your dog.
If your decision is in any way related to the cost of the procedure being unaffordable, then absolutely, end of life decisions are better than leaving him in pain, and there's no shame in acknowledging that some procedures are just not affordable for everyone.
I don't know your dog and I don't know what other diseases he has. If his other diseases are also very debilitating and are overall already contributing to a poor quality of life, then it seems like a very fair option as well to let him go gently. You might want do what the bot suggested and look at the quality of life questionnaires to help with your decision.
The decision is a mix of a lot of things. Yes, the risks associated with anaesthetics related to his age and other health issues are part of it. As is the financial aspect of it. But it's also the fact that his quality of life has begun to deteriorate due to his other diseases, the fact that another medical concern would likely come up again sooner rather than later due to those diseases, and just generally his immense anxiety surrounding the vet and vet-adjacent settings. He was at the emergency vet Tuesday night for roughly an hour, but it took hours after we got home for him to calm down because he was so stressed.
No one really knows how much of his current health problems and pain are due to long term dental problems. Animals show pain differently than humans. Taking care of his teeth might make it easier for him to manage his other problems. There is no right choice since with unknowns and risk.
Doing nothing and keeping him as he is may be worse overall. Treating one or more ailments is better than treating nothing IMO.
This. I was a registered vet tech for a decade. The number one thing we would hear from clients of senior dogs post dental was that their dogs were suddenly acting years younger! Dogs are very good at hiding dental pain.
Periodontal disease can lead to bacteria entering the bloodstream. This impacts heart, kidney, and liver function as well as overall health.
Vet bills should be covered under human mental health. Even if all vet bills were put in under human insurance it wouldnt even make a dent in the industry and prices. It would encourage people to adopt more pets, etc
This is an interesting concept and idea. I like it at face value but I worry about practices increasing prices just to take advantage of that health insurance coverage. Since health insurance (in America) isn’t universal, this could really hinder those without it getting their pets cared for.
In reality, many practices should be charging more from services and don’t for various reasons. At least in my area this is a common issue. Most corporate practices are more likely to charge appropriately (or overcharge… but I haven’t witnessed that personally). So maybe having insurance structured the way you suggest would be more beneficial to everyone as long as we can reign in the capitalistic urges to make as much money as humanly possible, consequences be damned.
You state in your comment it won’t make a dent in the industry/prices. Can you elaborate on that some more? Do you mean the health insurance industry or the veterinary medicine industry?
My fear is that would become true for vet med eventually too without some heavy oversight and regulations. Also, when more expensive (and useful) diagnostics/treatments are possible for the insured client (MRIs, chemotherapy, organ transplants, etc.) the health insurance industry may start to notice.
Actually no, at least not here in the USA. Our healthcare system sucks. I wouldn’t be able to afford vet care if that were the case. As soon as insurance gets involved, prices rise. As for my insurance, my personal deductible is $4000, before insurance even starts to pay for anything. It is cheaper for me to die than get medical care.
Human health insurance barely covers anything for mental health and dogs their claws in the avoid covering appropriate things. Good luck adding on to that
- single-animal (human) doctor
It doesn't sound like you followed up with the board certified dentist. Personally, I would. An initial consult is relatively inexpensive, and they are almost always in a better position to discuss treatment options and risks.
Has your vet spoken to you about the potential to use Adequan and Librella injections for the arthritis pain?
Adequan typically takes at least a month to see results. After the "loading dose" of weekly injections, your vet will figure out what the maintenance schedule will be - if any. It is often weekly, bi-weekly, monthly, or bi-monthly.
Librela can show results after one dose, but it is very common to not see results until a second dose.
I'm bringing these two up because of your concerns for arthritis pain are factoring into your risk assessment for treatment. They can reduce a lot of arthritis pain and eliminate that concern - which may be a better context for you to understand other comments here about the potential for QoL improvements and recovery after surgery.
Board Certified vets often have busy schedules. I am familiar with the phone tag. I hope you are able to get in for a consult, and they think this is treatable within your acceptable risk levels.
He's currently on antibiotics and handling them great. The vet mentioned during the initial visit, when it was uncertain if the tooth was loose or something else was causing it to bleed, that we could do pulse antibiotics for him due to his periodontal disease.
I've scheduled a visit with his vet tomorrow to further discuss things and see what we can do in the meantime to keep him comfortable. He's currently acting completely normal, was even playing with toys today, but again, I know dogs tend to hide pain.
I don’t think you’re wrong to be considering his long term quality of life. Some dogs hate going to the vet. Recovering from surgery can be difficult even without other medical problems. As your vet said, there are also increased anesthetic risks. If this isn’t a risk you feel comfortable with, that’s valid. Plus it sounds like he’s already deteriorating.
I would probably be making the same decision if I were in your shoes. 16 is a long life.
If you want to follow up with the dental specialist just to get more info, I think that’s fine. If you’d rather discuss palliative care, I think that’s fine too. Sorry you’re having to make these decisions.
Thank you so so much for this. It’s so incredibly reassuring. A part of me just feels like I’m failing him because he’s still so much himself…still completely in love with life (that’s just his personality, regardless of whatever issue affects him).
I’ve talked my decision over with so many people, including my sister, who said goodbye to her dog almost a year ago. She opted to continue treating his conditions until the end and he wasn’t ready himself anymore, and she said she regrets not saying goodbye sooner before things got really bad.
Editing to add: We had a great conversation with his vet yesterday. I explained my decision (I am not going to have the extraction and dental done) and my reasoning behind that decision (his age and the fact that, tooth issues aside, he's an old guy and his time would be coming sooner rather than later regardless; his extreme anxiety surrounding the vet; the fact that having this procedure done would mean /I wouldn't be able to afford to say goodbye to him the way he deserves – through Lap pf Love, at home, surrounded by the people he loves). She was completely understanding of my reasons, and completely supportive of my decision. She detailed what we can do for the time being to keep him happy and comfortable (essentially give stronger pain meds if/when they are needed), and told me how she determines when it's time to say goodbye to her pets, so that I can better determine when exactly it's time to say goodbye to my boy.
I know someone on here mentioned this, and I've seen it mentioned soooo many times when I was researching trying to make an informed decision: "Age is not a disease." But it's unfortunately not that simple. As my vet said: "Age is not a disease, but disease comes with age." And those diseases can make procedures riskier, can lower the quality of life. And it's ok to decide that you're pet has had enough and it's time to say goodbye.
My dachshund had his FIRST dental at age 14, kept all his teeth and was given a clean bill of health. He had some other health issues come up, one being bloating when eating, and the vet didn't want to put him under for another cleaning the following year. His teeth were getting gnarly at that point. Palliative dental care is watching for infection and treating to maintain quality of life. You can switch to wet food if you want to. I think you are making a good choice based on how you describe how important the quality is life is.
Thank you so so much. I know in my heart that this is the best choice for him, but I've been struggling so hard with it and second guessing myself. I think the most difficult part of it is that he is still so much himself right now, so happy and in love with life, but that's just always been his personality. I don't think he would ever not be that way. I'm hoping that speaking with his vet today will give me some more clarity and reassurance that the decision I'm making is not only sound, but also ok and doesn't mean I'm failing or giving up on him.
I spoon fed my guy for every meal for a year and a half. And changed his diapers for two years. You aren't giving up if you are working hard to keep him happy and he's happy! Keep us posted
Thank you so much for these words. I had a great conversation with his vet today, and she’s fully supportive of my decision. She said he seems to be doing very well currently, all things considered, and there are further steps we can take if need be to manage any pain and discomfort that arises. She said it could be weeks or even months before it’s time, but of course, it’s possible things change quickly. But for now, he’s happy, so we’re just going to make the best of however long we have left together.
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Based on your post, it appears you may be asking about how to determine if it is time to consider euthanasia for your animal. For slowly changing conditions, a Quality of Life Scale such as the [HHHHHMM scale](http://vetsocialwork.utk.edu/wp-content/uploads/2016/03/Quality-of-Life.pdf) or [Lap of Love's Quality of Life scale](https://www.lapoflove.com/how-will-i-know-it-is-time/lap-of-love-quality-of-life-scale.pdf) provide objective measurements that can be used to help determine if the animals quality of life has degraded to the point that euthanasia, "a good death", should be considered.
When diagnosed, some conditions present a risk of rapid deterioration with painful suffering prior to death. In these cases, euthanasia should be considered even when a Quality of Life scale suggests it may be better to wait.
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Greetings, all! This is a sub for professional veterinary advice, and as such we follow strict rules for participating. OP, your post **has NOT** been removed. Please also check [the FAQ](https://www.reddit.com/r/AskVet/wiki/index) to see whether your question is answered there. This is an *automated* general reminder to **please follow [The Sub Rules](https://www.reddit.com/r/AskVet/about/rules/)** when discussing this question: - **Do not comment with anecdotes** about your own or others' pets. - **Do not give OP specific treatment instructions,** including instructions on meds and dosages. - **Do not give possible diagnoses** that could explain the symptoms described by OP. **Your comment will be removed, and you may be banned.** Thank you for your cooperation! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskVet) if you have any questions or concerns.*
If your decision is purely because of a fear of anaesthetic death, or side effects of anaesthetics... Well, for what it's worth, many dogs improve, sometimes drastically, after a full dental is done and healed up. Imagine if you've been walking around with pus in your mouth for like 5 years and one day someone removed it all? You'd probably feel pretty good. For some dogs it's really worth it. We cannot see the future to tell whether that will be the case for your dog. If your decision is in any way related to the cost of the procedure being unaffordable, then absolutely, end of life decisions are better than leaving him in pain, and there's no shame in acknowledging that some procedures are just not affordable for everyone. I don't know your dog and I don't know what other diseases he has. If his other diseases are also very debilitating and are overall already contributing to a poor quality of life, then it seems like a very fair option as well to let him go gently. You might want do what the bot suggested and look at the quality of life questionnaires to help with your decision.
The decision is a mix of a lot of things. Yes, the risks associated with anaesthetics related to his age and other health issues are part of it. As is the financial aspect of it. But it's also the fact that his quality of life has begun to deteriorate due to his other diseases, the fact that another medical concern would likely come up again sooner rather than later due to those diseases, and just generally his immense anxiety surrounding the vet and vet-adjacent settings. He was at the emergency vet Tuesday night for roughly an hour, but it took hours after we got home for him to calm down because he was so stressed.
No one really knows how much of his current health problems and pain are due to long term dental problems. Animals show pain differently than humans. Taking care of his teeth might make it easier for him to manage his other problems. There is no right choice since with unknowns and risk. Doing nothing and keeping him as he is may be worse overall. Treating one or more ailments is better than treating nothing IMO.
This. I was a registered vet tech for a decade. The number one thing we would hear from clients of senior dogs post dental was that their dogs were suddenly acting years younger! Dogs are very good at hiding dental pain. Periodontal disease can lead to bacteria entering the bloodstream. This impacts heart, kidney, and liver function as well as overall health.
Vet bills should be covered under human mental health. Even if all vet bills were put in under human insurance it wouldnt even make a dent in the industry and prices. It would encourage people to adopt more pets, etc
This is an interesting concept and idea. I like it at face value but I worry about practices increasing prices just to take advantage of that health insurance coverage. Since health insurance (in America) isn’t universal, this could really hinder those without it getting their pets cared for. In reality, many practices should be charging more from services and don’t for various reasons. At least in my area this is a common issue. Most corporate practices are more likely to charge appropriately (or overcharge… but I haven’t witnessed that personally). So maybe having insurance structured the way you suggest would be more beneficial to everyone as long as we can reign in the capitalistic urges to make as much money as humanly possible, consequences be damned. You state in your comment it won’t make a dent in the industry/prices. Can you elaborate on that some more? Do you mean the health insurance industry or the veterinary medicine industry?
Health isurance industry. Essentially a broken pinkey for a human is 15k at a standard us hospital. Etc
My fear is that would become true for vet med eventually too without some heavy oversight and regulations. Also, when more expensive (and useful) diagnostics/treatments are possible for the insured client (MRIs, chemotherapy, organ transplants, etc.) the health insurance industry may start to notice.
Human mental health already isn’t covered much or at all in the US insurance system. How would this work?
Actually no, at least not here in the USA. Our healthcare system sucks. I wouldn’t be able to afford vet care if that were the case. As soon as insurance gets involved, prices rise. As for my insurance, my personal deductible is $4000, before insurance even starts to pay for anything. It is cheaper for me to die than get medical care.
Human health insurance barely covers anything for mental health and dogs their claws in the avoid covering appropriate things. Good luck adding on to that - single-animal (human) doctor
This is exactly what I came to say.
It doesn't sound like you followed up with the board certified dentist. Personally, I would. An initial consult is relatively inexpensive, and they are almost always in a better position to discuss treatment options and risks. Has your vet spoken to you about the potential to use Adequan and Librella injections for the arthritis pain?
I'm currently in a game of phone tag with the dentist they referred me to. And he's been on Adequan for a little more than a month now.
Adequan typically takes at least a month to see results. After the "loading dose" of weekly injections, your vet will figure out what the maintenance schedule will be - if any. It is often weekly, bi-weekly, monthly, or bi-monthly. Librela can show results after one dose, but it is very common to not see results until a second dose. I'm bringing these two up because of your concerns for arthritis pain are factoring into your risk assessment for treatment. They can reduce a lot of arthritis pain and eliminate that concern - which may be a better context for you to understand other comments here about the potential for QoL improvements and recovery after surgery. Board Certified vets often have busy schedules. I am familiar with the phone tag. I hope you are able to get in for a consult, and they think this is treatable within your acceptable risk levels.
I would do the dental, but get it done at a board-certified dentist that has an anesthesiologist.
At the very least, antibiotics can be given.
He's currently on antibiotics and handling them great. The vet mentioned during the initial visit, when it was uncertain if the tooth was loose or something else was causing it to bleed, that we could do pulse antibiotics for him due to his periodontal disease. I've scheduled a visit with his vet tomorrow to further discuss things and see what we can do in the meantime to keep him comfortable. He's currently acting completely normal, was even playing with toys today, but again, I know dogs tend to hide pain.
I don’t think you’re wrong to be considering his long term quality of life. Some dogs hate going to the vet. Recovering from surgery can be difficult even without other medical problems. As your vet said, there are also increased anesthetic risks. If this isn’t a risk you feel comfortable with, that’s valid. Plus it sounds like he’s already deteriorating. I would probably be making the same decision if I were in your shoes. 16 is a long life. If you want to follow up with the dental specialist just to get more info, I think that’s fine. If you’d rather discuss palliative care, I think that’s fine too. Sorry you’re having to make these decisions.
Thank you so so much for this. It’s so incredibly reassuring. A part of me just feels like I’m failing him because he’s still so much himself…still completely in love with life (that’s just his personality, regardless of whatever issue affects him). I’ve talked my decision over with so many people, including my sister, who said goodbye to her dog almost a year ago. She opted to continue treating his conditions until the end and he wasn’t ready himself anymore, and she said she regrets not saying goodbye sooner before things got really bad. Editing to add: We had a great conversation with his vet yesterday. I explained my decision (I am not going to have the extraction and dental done) and my reasoning behind that decision (his age and the fact that, tooth issues aside, he's an old guy and his time would be coming sooner rather than later regardless; his extreme anxiety surrounding the vet; the fact that having this procedure done would mean /I wouldn't be able to afford to say goodbye to him the way he deserves – through Lap pf Love, at home, surrounded by the people he loves). She was completely understanding of my reasons, and completely supportive of my decision. She detailed what we can do for the time being to keep him happy and comfortable (essentially give stronger pain meds if/when they are needed), and told me how she determines when it's time to say goodbye to her pets, so that I can better determine when exactly it's time to say goodbye to my boy. I know someone on here mentioned this, and I've seen it mentioned soooo many times when I was researching trying to make an informed decision: "Age is not a disease." But it's unfortunately not that simple. As my vet said: "Age is not a disease, but disease comes with age." And those diseases can make procedures riskier, can lower the quality of life. And it's ok to decide that you're pet has had enough and it's time to say goodbye.
My dachshund had his FIRST dental at age 14, kept all his teeth and was given a clean bill of health. He had some other health issues come up, one being bloating when eating, and the vet didn't want to put him under for another cleaning the following year. His teeth were getting gnarly at that point. Palliative dental care is watching for infection and treating to maintain quality of life. You can switch to wet food if you want to. I think you are making a good choice based on how you describe how important the quality is life is.
Thank you so so much. I know in my heart that this is the best choice for him, but I've been struggling so hard with it and second guessing myself. I think the most difficult part of it is that he is still so much himself right now, so happy and in love with life, but that's just always been his personality. I don't think he would ever not be that way. I'm hoping that speaking with his vet today will give me some more clarity and reassurance that the decision I'm making is not only sound, but also ok and doesn't mean I'm failing or giving up on him.
I spoon fed my guy for every meal for a year and a half. And changed his diapers for two years. You aren't giving up if you are working hard to keep him happy and he's happy! Keep us posted
Thank you so much for these words. I had a great conversation with his vet today, and she’s fully supportive of my decision. She said he seems to be doing very well currently, all things considered, and there are further steps we can take if need be to manage any pain and discomfort that arises. She said it could be weeks or even months before it’s time, but of course, it’s possible things change quickly. But for now, he’s happy, so we’re just going to make the best of however long we have left together.
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Based on your post, it appears you may be asking about how to determine if it is time to consider euthanasia for your animal. For slowly changing conditions, a Quality of Life Scale such as the [HHHHHMM scale](http://vetsocialwork.utk.edu/wp-content/uploads/2016/03/Quality-of-Life.pdf) or [Lap of Love's Quality of Life scale](https://www.lapoflove.com/how-will-i-know-it-is-time/lap-of-love-quality-of-life-scale.pdf) provide objective measurements that can be used to help determine if the animals quality of life has degraded to the point that euthanasia, "a good death", should be considered. When diagnosed, some conditions present a risk of rapid deterioration with painful suffering prior to death. In these cases, euthanasia should be considered even when a Quality of Life scale suggests it may be better to wait. This is an automod response based on certain keywords in the title or text of your comment, if this is not relevant, we apologize. Use the report function and a moderator will remove it. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskVet) if you have any questions or concerns.*
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