Max is fading and I don't know how to handle it.

[maxs_mommy]

Mr Max turns 13 today, against all medical prognosis, but the last 6 months have been hard. As I type this he's pacing, it's almost 1 am, he won't pee outside (he pretty much doesn't give a flip about where he pees inside as long as it's not on the pee pad), his vision is much diminished to where sometimes only the highest contrast is visible, though sometimes it's better. He's decided his food is poison so we've been feeding whatever he'll eat as often as he wants, he puts himself to bed quite often, doesn't really care about his toys and his rear legs give out at first when he stands. He frequently falls off his dog beds and paces frequently, making a loop through the house.
Some of this is chemo brain I think. His mouth tumor is well controlled, almost flat and growing normal skin cells, I need to follow up about the treatment plan. I'm just worried about his quality of life. When I mention it to my vet she kinda waves me off. I've done the quality of life scale but it's hard because those questions also consider our ability to manage his issues, which we can and do. That doesn't mean it's great for him. I'm in uncharted territory here. He is in no pain and wants for nothing but I want to make the right decisions for him. Damn it, this isn't for sissies.

[SherriA]

Oh Ashley, my heart is breaking for you. It's so SO hard, especially when it's a gradual decline and you continue to adapt as things worsen. Quality of life is so subjective, and your quality of life while managing Max's needs is an important consideration too. Whatever and whenever you decide, I know it will be the right decision for all of you.

[MaisyPancakes]

I hear you, all the way. All the way into a well full of tears and infinite question marks. Like Sherri said, you keep making new normals, new ways to manage, finding new ways to replace the old go-to things that made him happy—and it's so frickin' "real time" that it can feel disorienting. I don't think you could make a wrong decision about Max, and I think your vet's reaction is a good gauge, too. Great news re: mouth tumor!!!! Sending best quality high efficacy time-release supervibes your way! xxxxx

[emmas_mom]

Ashley, I've traveled that road many times and it never seems to get any easier. As long as his pacing is not from pain, and as long as he seems more content than discontent with life (relaxed around you, sleeping fairly soundly when he sleeps, has his needs met) then he is probably doing fine for now, and you can trust yourself that you will know - or at least have a very strong indicator - when it is time. The nighttime meandering, food fussiness, and pee mishaps are all pretty normal for a very elderly dog and I expect exacerbated by chemo-brain. As long as you trust your vet to be straight with you, she will let you know if you are prolonging his life too long - a gentle hint that it 'might be time' is sometimes a vet's way of saying you're at the tipping point. If she is clearly saying he's not in pain and doesn't need help to pass just yet, then just enjoy every day you get to watch him sleeping on the floor with his head the only part that made it to the bed or didn't fall off the bed.

[BuddTX]

Ashley, I realize your dog has multiple medical issues, so I apologize in advance if my comments are redundant, or obvious.

Have you talked to your Vet about Max and this specific issue? My dog will be 18 in May, and in December, she stopped sleeping in my bed. I was not going to take this lying down (pun intended!). I did not just want to chalk this up to "she is old".

I talked to my Vet, she said it could be because of arthritis. She prescribed Movoflex and Galliprant, 20mg.

That seemed to make a world of difference for my Dog, she never will be that feisty 2 year old Jack Russel Terrier again, but I did notice her being more active during the day, and does jump on the bed every once in a while.

I am only giving her 10 mg of the Galliprant. I am also looking for a Glucosamine & Chondroitin supplement that she will eat, I have the Newman's own on order, it will be here Saturday.

Ashley, I hope and pray that you and Max will have many more happy years together.

[maxs_mommy]

Thanks, we are frequent flyers at our regular vet (the receptionist knows me by voice and the vet takes my calls off-hours) and we're on top of his issues medically. It's just that ultimately time wins and I know it's winning more and more lately. Max has a small grocery list of chronic conditions, including Cushing's, melanoma, deafness, low vision, a total cataract in one eye and reactivity to anything with 4 legs. All of these are well managed by his veterinary team (Onco, Dvm/Chiro and ophthalmologist) and he wants for nothing, it's just hard seeing the decline and wondering how far to take modern medicine's remedies before quality of life suffers.