Right decision?

[NikkiDeland]

I haven’t contributed to this forum for awhile, but here I am looking for advise and opinions…I think Sorry, but this is long (lots of explanation)….

Alex (8 years) has something wrong with his left knee. He started limping a few weeks ago, so I took him to the vet and had his knee x-rayed. The x-rays were sent to a radiologist and the findings are he has arthritis with a lot of fluid build up. Enough fluid that his vet said she wouldn’t be able to tell if there is a drawer or not. We are not sure what the cause of the arthritis or fluid is. Alex’s vet recommended we take him to an orthopedic specialist, who would like to scope his knee to see what’s going on.

Now my dilemma. Alex also gets seizures, has a severely arthritic shoulder (had surgery), and has DJD of the spine which caused him to be nearly paralyzed in his back legs a couple of years ago. We were able to manage his spinal problems with acupuncture and the occasional dose of prednisone, but he’s been having more flare-ups with his back in the last six months and has muscle atrophy in his rear legs, neck, and along his spine. Did I happen to mention Alex is fear aggressive? Due to all of this my DH and I have decided not to have knee surgery for Alex. I just can’t see putting this dog through any more pain.

We have tried to treat his knee problem with anti-inflammatories for the past couple of weeks (Deramax and then Piroxicam) which made him lethargic and anorexic and didn’t help his leg at all. I finally got a vet to agree to let me try prednisone since nothing else has seemed to work and his leg is full of fluid.

Now of course I’m feeling heartbroken because I feel I’m running out of options to treat this conservatively, and I’m beginning second guess our decision to not have any more surgery. My brain tells me that I know what's best for my dog and surgery is not a good option for Alex, but the rest of me is kicking my butt.

I don't know what else I can do. Opinions? Advise?

[C Ross]

Are you asking if it's time to help Alex go to the Bridge? Only you can answer that. There are many posts about making that decision...

I would tend to agree with you on the surgery. An older dog with multiple health issues, poor quality of life, fearful - I would probably treat the pain/fluid as you have done and when that no longer gave relief I would say good-bye.

Christine

[alexav]

I would tend to agree with you on the surgery. An older dog with multiple health issues, poor quality of life, fearful - I would probably treat the pain/fluid as you have done and when that no longer gave relief I would say good-bye.

I second that. Sometimes there is a blurry line between what's truly best for them and what's best for us. I believe it is always good to err on the side of the dog's best interest, no matter how bad it hurts us.

Edit to add; If the pain meds he is on aren't agreeing with him, ask your vet for other options.

[JeanT]

It sounds to me as if your heart is telling you "no" to surgery. Listen again.

[SonnyRott]

Can you at least muzzle him and have the knee scoped? You may not opt for surgery but he could have a patellar luxation causing him pain and inflamation. Usually it can be manipulated back into place.

Having a serious knee problem myself, I know how badly a knee hurts when it is filled with fluid. I am not a vet....these are just my thoughts. Sorry your boy is going through this.

[NikkiDeland]

Thanks to everyone who replied. I know many of you have more experience with making these decisions and I value your opinions. My mother is staying with us (recovering from surgery) and she was kind of making me feel that I should do everything humanly possible for Alex. I just didn't want to put him through any more pain/recovery (he's already had enough) not knowing how much longer he'd be with us. He's already limited on what he can do with his spine; I don't want to take anything else away from him.

I was led to believe from the radiologist that she didn't feel that it was a patellar luxation, but perhaps I misunderstood. Would they be able to get some idea if it was or not from his x-rays?

On the bright side, the pred. and warm compresses seem to be helping. The fluid has absorbed some, he seems much happier, and hungrier (I know could be a side effect) and getting around better. Which is good because it breaks my heart to see him in pain.

By the way, is there a spell check on this thing? I get so embarrassed if I spell something wrong.

[Judi W]

There is no need to scope to check the patellar, it can be felt with manipulation

[SonnyRott]

It sounds like you've decided on some things through this discussion. Sometimes it helps just putting it out there.

I would not let an old dog suffer with chronic pain, and I don't think you will either. I will be keeping you in my thoughts.

And don't worry.....we ALL make spelling errors!

[marianne]

Good morning Nikki. I am so sorry to read of your handsome Alex's problems. You've worked so hard with the problems over the years. Is the new med still helping? Please keep us posted. I sending lots of good wishes your way.
I hope this is not the end of the road for Alex......But ONLY you can make that final decision. Quality of life is the most important thing.
So sorry Nikki

[NikkiDeland]

He's still showing improvement with the pred. and hot packs. I would like to see him continue to get better before we lower his dose of pred. He also has an acupuncture appointment next week, maybe that will help. We're going to give him a few days to see if there's continued improvement. Obviously we won't have him continue to suffer if this doesn't continue to get better, but we want to give him the opportunity to heal if it's possible. I'm going to ask the vet if he could take some other pain meds with the pred. like Tramodol or something.
Thanks to everyone for their thoughts and advise.