***

Endtime: When to Euthanizing Your Dog If It Has Cancer, Specifically Lymphosarcoma

My dog, Ruby von Bremerhaven was a wonderful German Shepherd. She was four years old. Ruby was full of pride and dignity. She was well trained and obedient to my command. I had owned her since a puppy of eight weeks. And I had always taken her to the same vet who I trusted and thought was reliable.

One day I noticed Ruby's lymph glands were swollen and took her to my regular vet whom I had known for over ten years. But he was busy or not in so another replacement vet examined Ruby. I was told Ruby probably had lymphosarcoma, a type of cancer of the lymph system. Within a week she would die...but I was not told this...only that it might be cancer.

I did not find out about Ruby in time to treat her. In fact she died while the replacement vet was on the way over to begin to treat her with chemotherapy. My regular vet left town while my dog was dying. Two weeks after my Ruby died my regular vet told me that chemotherapy probably would not have done any good since it was not discovered in time. Yet he removed a tonsil and did a biopsy of it, which did not arrive in time to help Ruby. The surgery was added stress and resulted in Ruby having difficulty breathing during her final days, fluid sloshing in her windpipe because during a tonsillectomy a tube is incerted in the windpipe and this can injure tissue and takes time to heal.

Of course my regular vet did not explain any of this when asking if he could remove Ruby's tonsil. Nor did he give me any indication of how long Ruby might live or if the surgery would add to her pain and suffering during her final days. The only thing I know for sure is it added to Ruby's final vet bill.

Ruby went from being a normal, active dog one week, to being dead the next. I could not get my regular vet to help tell me when the time was right to euthanize. In fact he left town! I could not believe this. It made the whole experience much more painful for the entire family. We all suffered along with my dog as she slowly died for four days. But I tried to comfort her and was with her the whole time.

It was very hard watching Ruby die. I attribute her suffering and the suffering of my family to the vet not telling me how to make the decision to euthanize Ruby. But now I know. I found the answer after Ruby died in a book entitled SO THAT OTHERS MAY LIVE: Caroline Hebard & Her Search-And-Rescue Dogs.

The time to euthanize is when a dog loses its dignity, can not walk and go outside to urinate. A well trained dog, like my Ruby, will try for hours to hold her urine, suffering the whole time, trying to do what a good dog does and not disappoint her master. But when she can't walk and get up and go out but wants to still be a good dog and you know you can help her keep her dignity by putting her quickly and painlessly to sleep, that is the time say your goodbyes and euthanize.

I also searched the bookstores and found a copy of The Complete Book of Dog Care. It explains the method of euthanasia on page 436. This is in the chapter "When the End Comes." This book is by Leon F. Whitney, DVM. I would highly recommend it to all dog owners. Don't wait to learn about euthanizing your dog until a crisis occurs. Make it one of the first things you learn as a responsible dog or pet owner.

I hope this helps anyone who is faced with a similar problem know when to make this very hard decision. But I would also like to share this thought, even though I was thinking about putting Ruby out of her misery, hoping against hope that her biopsy would come back and show it was not cancer, that the cancer could go away if chemotherapy was begun, after the biopsy results were known and I did tell the subsitute vet to come on over and begin chemotherapy and then Ruby died, I had the thought that I had chosen life instead of death, that I had somehow benefited from every moment of Ruby's life.

So I tell you this so you can know, there is no right or wrong answer, there is no easy way to say goodbye to your dog. But my regular vet should have given me all the facts and he did not. And he left town and turned it over to a subsitution vet I had not known and trusted for many years. So I had to deal with the problem myself and after Ruby died the first thing I did was go out and find the answer to this very question of when is the right time to euthanize a dog with a terminal illness like lymphosarcoma?

The way Caroline Hebard puts it in her book, (page 70-71) is, "German Shepherds are dignified." With this in mind I would support euthanizing your dog once you know it has a terminal illness and can not walk and urinate on its on outside where it was trained to go to please you. That is causing you and your family and your dog to suffer less. You don't want to end up like I did feeling abandoned by the vet you trusted for years, hoping against hope, you and your family having to suffer day after day as your dog slowly bleeds to death inside, hemorrhaging, bleeding from its nose, and can not go outside to urinate.

Also another sign will be white gums which lose all their red color and look like white clams (the subsitution vet told me this can be due to internal bleeding, to blood going to vital organs, that it is not alway a symptom of shock. In Ruby's case she still seemed alert when her gums were white. She did not seem in pain. Her breathing was rapid and her heart rate was higher than normal. Also, there was a bright purple discoloration in areas on her belly which gradually spread over much of her underbody.) In the case of lymphosarcoma, the white gums and not being able to walk and urinate outside should mean you can painlessly end your dogs suffering.

If a dog is hemorrahaing inside or bleeding from its nose like Ruby was, a transfusion might help, but really this would just prolong the suffering and loss of dignity. Also trying to hoist the dog in a sling and walk it around is not realistic or practical with a large, heavy dog. Although I was able to make a board with ropes looped through both ends and drag Ruby outside to relieve herself, this really only prolonged her suffering, time and again having to hold her urine until she finally went on sheets and would look at me like she knew it was wrong as I'd say, "It's okay, Ruby, it's okay...really, girl, I don't care about that anymore...it's okay" ...and pet and try to sooth her with a gentle voice.

If your dog has lymphoma and you read this, I hope you still have time to make the decision to euthanize your dog. You may share this information with others who may benefit. After all, our fur babies are not here to add to our suffering and they depend upon us to help them leave this earth without suffering themselves.

I would not hesitate to instruct my vet to euthanize Ruby now had I known how she was going to die; and I will be sure to euthanize any dog I may have in the future should a terminal illness like lymphoma occur to disable the dog. Of course it is always harder to do than say. That is why your vet should help you.

Read the books I've suggested, then say goodbye...hug, pet and say "I love you" to your dog. And then let him sleep painlessly and with dignity. It will be easier on everyone that way. Then if you want plant a tree on your dogs grave. Somehow that makes a difference.

With this in mind, let me think a moment about Ruby and talk to her as if she were alive. "See Ruby, you did not suffer in vain. Now others will know when the time comes, and they will be able to kiss their dogs goodbye and save them from the pain. What a brave dog you were...to have died in this way to help teach so many that the end time IS WHEN YOU CAN'T LIVE WITH DIGNITY AND PRIDE AND PLEASURE IN ALWAYS BEING A GOOD DOG."

I had to pull Ruby outside on a board so that she could urinate. There was four days of this. The regular vet who had left town told me he had to "Do the Lord's work," participating in a planned church camp. He knew Ruby was dying. He had given her only 12-24 hours. He wanted to turn Ruby's care over to a "recent graduate," an inturn. I told him I wanted the most experienced member of his staff to care for Ruby. Earlier I had asked him about euthanizing Ruby he said, "I just think we can let nature take its course." So me, my family and Ruby suffered four days of dying, hoping against hope... only to be told afterwards by this same vet there was no reason to have hoped in the first place, that chemotherapy would not have worked in such an advanced stage of lymphosarcoma. (Then why the tonsillecomy and why was chemotherapy made an option if in this particular case it only meant prolonging the pain and suffering?)

So I share this information with all dog lovers and tell you to ask your vet ahead of time if he will stand by you should your dog ever become terminally ill. Find out ahead of time if your vet will euthanize your dog should it become disabled to the point it can not functions properly and is caused to suffer and slowly die. Find a vet with the courage and convictions to help your dog or other pet die with dignity.

"Ruby, I love you...yes I do!"

UPDATE #1: Methods of Euthanasia

When Ruby was dying one of the problems I faced was not being able to obtain complete information with respect to euthanasia. All I was able to get out of my vet is that it involved an injection and then the dog would go to sleep. But not knowing when or how to make the decision to euthanize; not knowing the procedure and having my vet of many years around to help me know when to make that decision added to the pain and suffering that not only my dog experienced, but the pain and suffering me and my family experienced.

I also discovered that I could not just go to a different vet and get help for my dying dog. This was because some vets do not like to take a dying dog just for the purpose of euthanizing the dog. As Ruby was dying, feeling abandoned by my regular vet of many years who had left town, I visited another vet clinic. It was one listed as an emergency medical clinic. But when I explained Ruby's situation I was told that they would not accept taking Ruby just to euthanize her; that an entire evaluation would be required; that her records would have to be transferred; that only then after this process could they help.

What this meant is that I was stuck with Ruby dying and my regular vet out of town. On several occasions my regular vet did call me on his cell phone. But he was so far away that there was a bad connection; there was static on the line and it sounded like he was talking from the end of a long, noisy tunnel. This in it self was distressing. I did not know how much of what I was saying was getting through. And the vet did not act in a professional manner, go to a regular line phone, call me back on a good connection, and talk to me. This all occurred as Ruby was laying helpless dying in my home, waiting for biopsy results which would come too late to do any good. All in all I had been given a false sense of hope... when my regular vet knew and said that he was ninety-nine percent sure she had lymphosarcoma; then later after Ruby's death told me chemotherapy would not have helped saying, "I'm surprised in all your research that you haven't learned that it would have taken at least two weeks for chemotherapy to have taken effect," reducing lymph node size and causing a regression of the cancer.

So here my vet was, seemingly to me trying to cover himself, telling me things after Ruby died that I should have been told before ever asked to authorize surgery to remove a tonsil for biopsy. Had I been given all this information before asked to authorize surgery, had I know my regular vet was leaving town for a week on planned church activities and would not be here to help Ruby and the family through recovery, I may have not authorized

surgery. The surgery preformed just a week before Ruby died seems only to have added to her suffering by making breathing difficult. Since her lymph system was not working properly, given the swollen nature of her glands and legs, tissue bruised or injured during a tonsillectomy may have not been able to heal properly or as quickly as should be; as a result Ruby had a breathing problem during the entire last weak of her life. Sitting by her side listening to the whizzing, slurry sound of fluid in Ruby's windpipe as she breathed rapidly, watching blood drip from her nose; all these factors contributed to my distress.

After the fact it is easier to see and think more rationally about these things, but during the process of Ruby dying I did not know what to do. Because my regular vet was far away at a church camp doing, "The Lord's work," I had no one I could trust to help me make a sound decision about when to euthanize Ruby. Although the substitution vet helped me by giving me information over the telephone to try to make Ruby as comfortable as possible, my regular vet's counsel was missed.

In all fairness to my regular vet, I would not have wanted him to be the one to euthanize Ruby. This was because I had known this person for more than ten years. I would have wanted this to be done by an associate or recommended vet upon referral. I had even told this to my regular vet. But I never indicated to him that I did not want his counsel with respect to selecting the right time to euthanize Ruby.

After Ruby died I began to research the subject of euthanizing large breed dogs. The recommendations given by Leon F. Whitney, D.V.M. in THE COMPLETE BOOK OF DOG CARE are quite informative. Dr. Whitney says that, "There is no pain to euthanasia if properly administered." The process involves the injection of a small amount of anesthetic. Then the dog just lays down its head, closes his eyes, "sighs as he feels release from pain," and goes to sleep. Because the dog never wakes up, death is painless.

Dr. Whitney also points out that: 1. An animal does not miss tomorrow; 2. The death of a pet is not his loss so much as it is ours; 3. All dogs are going to die someday and that it is better to stop the suffering of a terminally ill dog than to let it linger in pain; 4. That if dogs or other pets could think they would probably tell their masters that they don't want to go, but please give me comfort from misery; please end my life with the least pain and suffering to everyone as possible.

This is advice well taken. It is the type of advice my veterinarian of many years did not have the courage, foresight, care or concern to provide me with. Because I was not given complete information about euthanasia, me and my family suffered for four days and forever have the memory of the pain and suffering that Ruby endured during her last few days. It is that memory, watching Ruby slowly die, bewildered, not knowing what to do, which compelled me to find the answer after Ruby's death. In a way I view this as Ruby's great contribution. She has helped me see the light; learn what it is to die with your dignity taken away. That is not how any pet should have to go. And so I shall relate to you the solution, as told by Dr. Whitney.

The method of euthanasia is a simple one. It involves giving a lethal injection of sodium pentobarbital. According to Dr. Whitney,

"The lethal dose of sodium pentobarbital is usually considered to be one and a half times the amount required for anesthesia. In nearly every case an injection of this amount is adequate, but we have known cases in which it produced only a prolonged deep sleep and a second injection was necessary. To eliminate even the possibility of such occurrences, we administer three grains for each five pounds of the animal's weight.. A dose of this size is completely and immediately effective."

There are other drugs which may be used by your veterinarian, but sodium pentobarbital is recommended by Dr. Whitney because, "when injected into the vein or directly into the heart, its effects are almost instantaneous." Dr. Whitney explains that sodium pentobarbital results in a sudden sleep which overcomes the animal and in a matter of seconds the animal is completely unconscious; that the heartbeat and breathing cease with the end coming quietly and quickly.

In contrast Ruby's death took all of four days. She lost the ability to walk without extreme and great effort; she could not go outside to urinate as she had been trained; her legs became swollen despite having been given steroids; her breathing and heart rate were accelerated; there was slow bleeding from her nose; her gums turned white and remained white for four days; and at the end she apparently had a hemorrhage, gasping for breath numerous times, blood flowing from her nose, urine being expelled and finally after she lay motionless, her heart slowly beat with a weaker and weaker pulse, until there was no more sound of a heart beat as I listened with a stethoscope.

Having a stethoscope handy helped me know when Ruby was dead. It also helped me monitor her as she was dying. I came to realize that she was breathing more rapidly due to the stress of having to hold in her urine. During those last days as I pulled her outside on a board to urinate, she would always relax and breath at a more normal rate after urinating. That is how I came to learn how much she was suffering, trying to be a good dog, trying to retain her dignity.

Now that Ruby has departed, I say to myself, "Ruby, you were so strong, so courageous, such an amazing dog! I just wish I knew, that someone had told me ahead of time what you would have to go through. But it's okay now. Other doggie masters will know and you and us together will have helped rescue them from the pain and suffering that they and their master might otherwise have to endured. I always knew you were a great dog, with a great purpose in life. Ruby, I love you. Thanks for being so brave, so strong and helping to give me this knowledge. Thanks for letting the whole world know that there is a better way to die with dignity, even if you are just a dog."

Of course Ruby was not, "just a dog." She was a loved member of my family, a companion which had occupied every moment of my life for the four years that I had Ruby with me. That is why Ruby's death was such a profound loss. It is the same deep hurt, deep pain and suffering which any dog or pet owner feels when they experience the death of a most loved animal. Yet our fur babies are not here to add to our suffering. I believe that is one reason some dogs wander off to die in solitude. They don't want their masters to suffer watching them die. I think it is some sort of instinct dogs have. One of Ruby's last efforts was to muster all her strength to walk over to the door and plop down. It was like she knew the time was near and she just wanted to get outside. And at that last moment I thought this meant she was getting better. I could not see it was Ruby's way of trying to keep me from having to watch her die.

I came over to Ruby, helped move her back into the middle of the room. I held and petted her and talked to her. I thought maybe she would make it after all. But then she just suddenly jerked her head forward gasping, like she was choking. I thought she was choking on her tongue the way she was working her mouth and stretching out her tongue. It was over in a few minutes. Ruby died in my arms, my not knowing what to do to make her suffering less; my not knowing what to do to end the pain.

Ruby should have been put to sleep some four days earlier. My veterinarian should not have even operated to remove one of Ruby's tonsils for biopsy. That surgery only added to Ruby's pain and suffering and to the pain and suffering of my family. My veterinarian should have given me complete information about euthanizing Ruby upon the first indication that Ruby had lymphosarcoma and upon my first inquiry about the possibility she may need to be euthanized. Instead all I really got was a false sense of hope, a bigger vet bill and a whole week of watching Ruby go from a health dog to one that slowly died in my arms.

I have taken some time to tell this story so that others may benefit from what happened to Ruby. It is a sad and painful story, but it is true in every respect. I have purposefully not mentioned the names of any of the veterinarians involved. I do not wish to hurt them. Rather I only wish all animal lovers, veterinarians includes, learn form Ruby's story. Then the next time a dog has a terminal illness be honest, frank and understanding; be informative and make every effort to prevent the pain and suffering of a long drawn out dying process. Give dogs and other pets the dignity of dying without the pain and suffering that comes from lack of courage, lack of understanding, lack of power to end a life, no matter how loved, once it is clear that there is no more dignity.

Those are hard words to say, especially after having stuck it out with Ruby until the very end. But I believe it is what Ruby would say, were she able to speak. In fact I can almost hear her saying, "Let me die with dignity. Let me go without pain. Let me go without hurting you and the family. Just let me go to sleep, painlessly to sleep, because I love you too!"

Those would have been Ruby's last words had she been a person. But dogs can not speak except with their eyes. And that is what I saw Ruby trying to say to me in her final moment..."let me go to sleep, painlessly to sleep, because I love you too!"

Ruby's chance for a painless death with dignity was taken away by a veterinarian who left town while Ruby was dying. Ruby's chance for a painless death, to keep her master and family from the pain and suffering of having to watch Ruby die, was taken away by a veterinarian who said, "I have to do the Lord's work," as if caring for Ruby in her final moments was not part of that most divine of endeavors. Ruby's chance for a death with dignity was taken away because of my own ignorance about euthanasia. That is not acceptable. Every dog lover and veterinarian has a responsibility to be fully informed with respect to when and how to euthanize a most loved pet. To not provide the complete information about euthanasia and to not act so as to reduce the pain and suffering of both the dog or pet and family members is to act with neglect, abandonment and irresponsibly.

It is in effort to prevent such neglect in the future that I've told Ruby's story. Responsible dog owners and their veterinarians should act to prevent pain and suffering. I hope Ruby's story will serve as constructive criticism for veterinarians and will help dog and pet owners avoid much pain and suffering in the future. In a way it is like Ruby's death has taught me what death with dignity means. For those who have strong religious or moral beliefs, who oppose euthanizing animals, you might be comforted by thought that Ruby's story is God's way of telling pet owners what to do. Ruby died so that others might not suffer the same type of death. She is truly a dog worthy of sitting by God's side... and maybe that is why he took her.

For those whom believe in Rainbow Bridge, that place where most loved pets wait to guide their masters into heaven, it might be comforting to realize that our pets have a way of teaching us much about love and happiness. Ruby never went to church, she never heard any sermons. She never read the Bible. But I believe dogs can feel and that one of the strongest emotions dog's can feel is love. That is why dog's are such wonderful companions, they love their masters and don't want their masters to hurt. If this is true why should we humans let our most loved dogs and pets suffer because of religious or moral teachings prohibiting euthanasia. After Ruby's death I do not believe it is humane or moral to permit a dog to die without dignity and to hurt its master or family by allowing a dog to die without dignity. It is not what God or what a dog would want.

My regular veterinarian and his substitute were wrong to have allowed Ruby to die without dignity. They were wrong to cause me and my family to suffer this experience. But we all came through it and one day will have another dog. What I guarantee you is that that dog will not die with out dignity... thanks to Ruby.

If others read Ruby's story, you are welcome to write to me. My e-mail address is projectk9@aol.com

Letters of condolence are appreciated as is learning about your own dog. If you had to euthanize your dog and want to tell me about it, I do not mind. I regard it as my responsibility to learn all I can about euthanasia. Such information may be used to update this file in the future. I am also working to help people find quality breeders. I've started a referral service called Project K9 in Ruby's memory. Presently I'm working only with German Shepherds. Anyone who wants to help can send information about breeders to the above address. Donations of any amount are appreciated. Thanks in advance.

Ruby, I Love You! TAL/22 Aug. 1996

© Copyright 1996-2000 by Terry Lynch. All Rights Reserved. This document/file may be freely copied and maintained upon any electronic bulletin board service, the Internet or other service such as CompuServe, Prodigy, Delphi or America Online. This document may be freely shared with anyone so long as it is not changed or altered in any way and is presented in its entirety. Any publication or reprint for profit requires the author's written permission. If you want to help improve the breeding of German Shepherds, and other breeds of dogs the author has established Project K9 in memory of Ruby von Bremerhaven. Project K9 maintains a list of responsible breeders of German Shepherds.

If you like this site you are invited to support Project K9. Project K9 endeavors to maintain an on line education and information resource for dog fanciers. It is hoped that this will contribute to the breeding of healthy German Shepherds and other dog breeds which are free from genetic diseases and hip dysplasia.

Project K9 | PK9 | Ruby's Story | Famous Dogs Club | Fetch It Banner Exchange | Jade's Homepage | Alabama GSD Club | Guard Dog On Duty | Support | Ad rates | About the author | Contact