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Dr. Jo
Dr. Jo, Veterinarian
Category: Vet
Satisfied Customers: 2800
Experience:  DVM from Iowa State University in 1994; actively engaged in private regular and emergency practice since that time.
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Unfortunately I had to have my 13 year old Labrador

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Hello, unfortunately I had to have my 13 year old Labrador cross breed put to sleep on Wednesday on the advice of my vet, ever since I have felt guilty and wonder if I really needed to do that, I know the symptoms of her problem but there were no tests done and I wasn't given a diagnosis, could you help me try to understand why it was necessary if I give you more details please?
Submitted: 1 year ago.
Category: Vet
Expert:  Dr. Jo replied 1 year ago.
Hello,
I'm Dr. Jo and I'm here to help you with your question about Sophie. I'm so sorry you're going through this really difficult time. I'll do my best to give you a professional assessment of what happened to her if you describe the symptoms.
Please type in what you want to say then click REPLY.
Expert:  Dr. Jo replied 1 year ago.
In the meantime, please rest assured that these feelings and questions you're having are a really normal part of the grieving process. That doesn't make them any less painful, of course, but looking for the answers will help you process your feelings and eventually heal.
I've been a veterinarian for more than twenty years, and during that time I've been privileged to be at the side of many people as they've experienced loss and the accompanying grief. While everyone's experience is unique, there are some fundamental aspects of grief that are universal.
I'd encourage you to learn more about this difficult process you are navigating on these website:
http://grief.com/the-five-stages-of-grief/
And I also want to encourage you to reach out to the many pet loss support groups that are out there. You are not alone. Here is one, but there are many more. You may even have a local group you can meet with in person.
http://www.petloss.com/
Customer: replied 1 year ago.
Expert:  Dr. Jo replied 1 year ago.
I will be in and out of appointments starting in a few minutes, but I will look for your reply between appointments and answer as quickly as I can. Please take your time typing in what you want to say, then click REPLY.
Customer: replied 1 year ago.
I have replied but you don't seem to have received it?
Expert:  Dr. Jo replied 1 year ago.
Yes. I received a reply notification from you but it is completely blank on my screen. Just an empty chat square. Can you please copy/paste and resend. I apologize for the technical difficulty.
Customer: replied 1 year ago.
It won't let me copy and paste so I'll have to type it all again, sorry it may take me a while again
Expert:  Dr. Jo replied 1 year ago.
It's okay. I'm very patient. Again, I'm sorry for the trouble.
Customer: replied 1 year ago.
Sophie only had one hind leg, she lost the other as a pup, other than that she was fit and well with no problems.
Last week, Sophie seemed a little tired but otherwise ok, still eating etc until Friday when she seemed to be in pain on standing up. She could still walk fine once standing at that point.
On Saturday morning her condition was the same and I took her to the vet who prescribed anti inflammatories after testing her reflexes, she said her heart was good too. She said we'd notice a difference in 48 hours.
That night, Sophie was finding it harder to walk, same the next day and by now she'd started to pant and breathe heavily. I thought it could've been due to the pain or anxiety of a back problem and waited for the anti inflammatories to work. By Monday, Sophie had lost strength and use of her back leg and her paw began to drag. I knew that was a bad sign, the panting and breathing was even heavier too and at times Sophie was very distressed.
Tuesday morning we took her back to her vet, she saw Sophie's paw bent backwards and said her condition was neurological and it would be kinder to put Sophie to sleep. She said she thought there was something else going on too because of the breathing and panting difficulty. We brought Sophie home to say goodbye and the vet came to put her to sleep, Sophie's panting and breathing got worse and worse and her breath had a strange odour too, her tongue would also have an abnormal colour, sometimes deeper pink, sometimes an almost orange colour. No blood tests, x rays or MRI scans were done and now I just wonder what it was the vet saw that made her determine Sophie's fate so quickly. Thank you
Expert:  Dr. Jo replied 1 year ago.
Thank you for writing that all in again for me. I'm sure it's not easy to relive it all.
While from the bottom of my heart I want to be able to offer you words of peace and reassurance, I'm afraid I cannot honestly do so. The best I can do in that regard is to explain that there are no simple problems with easy solutions that would have caused this combination of symptoms. Most neurologic problems in a dog Sophie's age are difficult to treat at best, ***** ***** are untreatable period. Getting a diagnosis is not easy, and her prognosis was definitely guarded as she was deteriorating so quickly. Perhaps this is what your veterinarian was considering.
That being said, I know that if I were Sophie's veterinarian, I would not have been able to make a recommendation for euthanasia without more information. I know that can't be easy to hear and I'm sorry for only making you more inclined to second guess what happens. If she were my patients I would have wanted the following...
-basic blood tests
-urinalysis
-chest and abdominal x-rays
And if those showed nothing, I would have referred you to an internal medicine specialist and/or neurologist.
Again, my heart goes out to you. A loss like this is devastating, and it's even worse when you don't have answers and are second guessing the situation.
I understand you'd like to know if her symptoms add up to some specific syndrome. They do not. Unfortunately, without the additional information that basic blood tests and urinalysis would have provided, this could have been almost anything...
-degenerative diseases (where parts of the body wear out)
-metabolic diseases (like liver disease, kidney disease, adrenal disease, etc.)
-infectious diseases (bacterial, viral, protozoal, fungal, and parasitic)
-auto-immune diseases and blood disorders
-neoplastic diseases (cancer)
-toxins/poisons
-trauma or injury
I'm sorry I can't be more specific without diagnostic tests.
I'd encourage you to discuss your concerns with the vet who provided Sophie's care. Be direct and ask for an explanation as to why euthanasia was recommended. Perhaps he'll have some reassuring answers for you that will help you heal.
Expert:  Dr. Jo replied 1 year ago.
Does what I've said so far make sense?
Expert:  Dr. Jo replied 1 year ago.
I cannot help but acknowledge that while your original question falls into the category of the first stage of grief (DENIAL AND QUESTIONING), I would find it easy under these circumstances to quickly transition to the ANGER stage.
In the conscientious practice of veterinarian medicine, it is not considered appropriate to make any treatment recommendations without a diagnosis, and the basic diagnostic tests are supposed to be offered to EVERY patient. Yes, the pet owners can decline testing for any reason (financial constraints or otherwise), but the veterinarian is expected to recommend basic diagnostic steps and perform them if consent is given. "By the book", a very thorough diagnostic workup was indicated for a dog presenting with Sophie's symptoms and if your vet did not do this, you could have a case against him for failing to meet the standard of care.
That's what makes it easy for me to feel angry about this. I'm worried he may have let you down.
It's quite possible none of that would have made any difference if Sophie's problem was incurable, but it would have been nice to know that.
Again, a dialog with this veterinarian is in order.
Customer: replied 1 year ago.
Thank you, ***** ***** replying but my answers aren't getting to you. I think it's because you reply to me again, I'll copy in future before I send
Expert:  Dr. Jo replied 1 year ago.
I apologize for the technical difficulties. I have received only these responses...
1. (blank)
2. "I have replied but you don't seem to have received it?"
3. " It won't let me copy and paste so I'll have to type it all again, sorry it may take me a while again."
4. "Sophie only had one hind leg, she lost the other as a pup, other than that she was fit and well with no problems.
Last week, Sophie seemed a little tired but otherwise ok, still eating etc until Friday when she seemed to be in pain on standing up. She could still walk fine once standing at that point.
On Saturday morning her condition was the same and I took her to the vet who prescribed anti inflammatories after testing her reflexes, she said her heart was good too. She said we'd notice a difference in 48 hours.
That night, Sophie was finding it harder to walk, same the next day and by now she'd started to pant and breathe heavily. I thought it could've been due to the pain or anxiety of a back problem and waited for the anti inflammatories to work. By Monday, Sophie had lost strength and use of her back leg and her paw began to drag. I knew that was a bad sign, the panting and breathing was even heavier too and at times Sophie was very distressed.
Tuesday morning we took her back to her vet, she saw Sophie's paw bent backwards and said her condition was neurological and it would be kinder to put Sophie to sleep. She said she thought there was something else going on too because of the breathing and panting difficulty. We brought Sophie home to say goodbye and the vet came to put her to sleep, Sophie's panting and breathing got worse and worse and her breath had a strange odour too, her tongue would also have an abnormal colour, sometimes deeper pink, sometimes an almost orange colour. No blood tests, x rays or MRI scans were done and now I just wonder what it was the vet saw that made her determine Sophie's fate so quickly. Thank you "
5. "Thank you, ***** ***** replying but my answers aren't getting to you. I think it's because you reply to me again, I'll copy in future before I send."
And that's all. This is the first time I've ever had a customer with an issue like this, so the best recommendation I can make if there are technical difficulties with the site is to contact customer service.
You are already going through a really difficult time. The last thing you need are technical difficulties, so I want to be sure you get the help you need.
Customer: replied 1 year ago.
Sophie couldn't walk into the surgery herself, she was extremely distressed, panting heavily, breathing very fast. Each day she had deteriorated.
The vet did the positioning of her paw test, to see if it sprang back into place. It didn't. The vet said she could tell by looking at it, it would be difficult to get use of it back.
Could she tell that by looking at her? By that test?
Could she have made her decision due to Sophie only having 3 legs?
Sophie continued to become more distressed and it was very distressing to see, her breathing and panting were worse and she was really miserable, completely opposite to the dog she'd been so we wanted to do the best for Sophie. It's too late now but I can't stop thinking how did the vet know for sure that the leg would remain useless? Can you tell from that positioning test? Thank you
Expert:  Dr. Jo replied 1 year ago.
This process of checking the foot to see if it is knuckling is over is a test of proprioception. That is the body's ability to tell where it is in space.
This video does a great job of explaining it...
https://www.youtube.com/watch?v=IXpGX6xhJdM
And this video shows a dog who had proprioceptive deficits like Sophie...
https://www.youtube.com/watch?v=MwNHo7Eqqvs
The nerves that control proprioception run along the outermost layers of the spinal cord. That means that if something is putting pressure on the spinal cord like a slipped disc or tumor the very first symptom is a loss of proprioception.
When a spinal cord problem is severe, the symptoms will usually progress in order through the following...
1. Ataxia, or walking like a drunken sailor.
2. Loss of proprioception
3. Paresis, or generalized weakness of the legs
4. Paralysis of the legs, or "being down" in the rear
5. Loss of central recognition of pain, where the dog can no longer feel pain in the legs.
In general, it is not considered "too late" for intervention for a dog with back problems until Step 5 is reached.
In Sophie's case, your vet may have thought her missing leg would have complicated any potential recovery from a back issue.
Additionally, the other symptoms you described are not a typical part of most spinal cord diseases. That may have made your vet suspicious something even more serious was going on.
I'll attach some information on intervertebral disc disease for you. That is the most common thing to cause rear limb paralysis with proprioceptive loss in a dog.
http://www.veterinarypartner.com/Content.plx?A=3223
Customer: replied 1 year ago.
Thank you for all your help and information, you have been a great help.
I have needed to know the answers but I also need to remain focused on the fact that, whatever I learn, nothing can bring Sophie back to me. I also need to make sure I don't let the negativity, worry, guilt, anger etc to further damage my mental state. I know I gave Sophie a good life and I know she was happy. I think in time I will be glad she didn't suffer for long and it's me that's left distressed rather than her. I think I will email the vet to try to get her to further explain her decision to me. I just focused on what she said, trusted her expertise and accepted it as it was the way of putting an end to Sophie's distress. As I said Sophie was a happy, healthy, outgoing dog who enjoyed every day with us. She wouldn't have coped well with being dependent on us for everything. Thank you once again.
Expert:  Dr. Jo replied 1 year ago.
I'm glad I could be of assistance.
Your comments moved me. You are focusing on all the right things and your attitude is exceptional. Good for you!
You also hit the nail on the head when you said you *trusted* the vet. That's really what this comes down to and it's what I know I - as a pet owner - would need from my vet in a situation like this. That ability to trust is a wonderful thing and it can allow for a streamlined approach to managing a difficult situation. It's that trust that allows us to believe that the recommendation for euthanasia was made primarily out of concern for Sophie's well-being.
A decision for euthanasia is never easy, but in the end it is a generous, compassionate, and unselfish gift.
I wish you peace and healing.
Customer: replied 1 year ago.
Thank you Jo, that means a lot to me.
Expert:  Dr. Jo replied 1 year ago.
{{{hugs}}}
I'll be thinking about you and how lucky you and Sophie both were to share some time together, even though we're always left wanting more.
Please remember you can always return to this thread later on and post more, even after you've left the chat and entered a rating. I'll be notified via email and will do my best to help.
You won't be alone to deal with this.
Thank YOU for loving Sophie enough to let her go.
Dr. Jo, Veterinarian
Category: Vet
Satisfied Customers: 2800
Experience: DVM from Iowa State University in 1994; actively engaged in private regular and emergency practice since that time.
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