Palliative care for 9 year old boy

Darling

Post   » Tue Jul 18, 2017 4:00 pm


My pig's name is Santino and he's 9 years old. He's on 6 medications for arthritis and an enlarged heart, plus laser treatments twice a week (down from 3). He has no use of his back legs and one of his front legs is starting to give out so he doesn't really move anymore. Sometimes he'll drag himself few inches, but spends most of his time lying on his side, with his upper body upright (both front feet on the ground).

I soak him in warm water twice a day (after his dose of tramadol) and every few days I shampoo him. I feed him 20 cc of critical care three times a day. I set him upright several times a day (only when he's awake) to prevent him from getting sores. Both front feet have bumblefoot, which is also being treated by the laser.

With all of this going on, he still purrs when I pet him, looks up when someone walks by his cage, and loves eating. He's never been able to "wheek", so I taught him how to ring a bell instead, but he can no longer reach it, so he's silent. He's a wonderful boy and has a great vet team looking after him. His vet is treating Santino as his own and doesn't think we should euthanize him since he's still eating and enjoying affection.

I'm trying to do good things for him to make sure he's happy, but I can't help questioning myself. It's very hard for me to see him like this and I ask myself if it's harder for me to watch him like this or is it harder for him to exist like this?

We use Care Credit for his treatment, so that's not the problem. I don't at all mind giving him his baths and moving him around as he needs it. I see it as though he's a person in a nursing home. Mentally he's fine, it's his body that's failing.

I don't really know what I'm expecting here, but I was hoping to get some opinions on the situation. What are some other things I should be doing for him? Any ideas on increasing his comfort? If you've been at this place before, how did you know when to euthanize?

I'm relying on his vet to answer that last question, but I'd still like your thoughts on it.

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Lynx
RESIST

Post   » Tue Jul 18, 2017 9:28 pm


This is a difficult decision. It sounds like you love your guinea pig a great deal. I am so sorry he is so ill. I don't know if you have read this page but it might help:
http://www.guinealynx.info/euthanasia.html

Talishan
You can quote me

Post   » Tue Jul 18, 2017 9:31 pm


"With all of this going on, he still purrs when I pet him, looks up when someone walks by his cage, and loves eating."

Not time yet.

You're doing a beautiful job caring for him.

At our house -- if they are in severe, unremitting, untreatable pain, or if they are listless, uninterested in food, their surroundings, their cagemate(s, if any) or us -- if they've essentially withdrawn and lost their personalities, their selves -- it's time.

Trust your gut. If or when the time comes, you will know.

I look at it this way: guinea pigs don't think, or worry about, or fear, what's coming. If they have bad days, they feel awful. If followed by a good day, they're fine. If they wake up, breathe clean air, have good food and water, they are alive, they are here and that's good.

They don't see themselves disabled. You do. They don't think about it, you do. They only know they are alive, and that's all that matters. They want to live, until they don't.

Look at it more like he does, and you will know if or when that time comes.

Thank you and bless you for caring for him so well. Walk with him, one day at the time.

guineapiggirl05

Post   » Tue Jul 18, 2017 10:15 pm


If it were me, I'd put him down. You're doing all you can for him, but he doesn't have the best quality of life. I know it's hard to let go, but sometimes it's just their time. I am not trying to put you down or make you feel bad, but there is always another side to things. Whenever you think he's ready, then do it. He seems like a beautiful boy who doesn't deserve to leave you. Just think about it.

With sympathy,
Gia xoxo

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daveandtiff

Post   » Tue Jul 18, 2017 10:39 pm


Your description reminds me of our eldest boy as he later developed a bit of dysplasia. I alternated floor time and pillow time (he was less mobile as yours so sleeping on a bed pillow in his cage covered partially with light baby blanket gave him the most comfortable and full sleep. I would roll towels and place around pillow as a safety net). For another, had used a chenille bath rug (the kind with thicker finger like protrusions) covered by blanket over bottom of cage which was another way to alleviate pressure spots. Both might be nice for Santino given the bumblefoot and side resting. Massage is also a nice way to bring oxygen and nutrients to muscles and tissue, and touch is very comforting. Ours would fall asleep quickly into dreams during massage. Even with the discomfort of regular tooth filings and dysplasia, he showed interest in his brothers and us. He enjoyed snuggles, outdoors grass time. He also had become quiet, and possibly had lost some hearing, but I think that's part of getting older. Just focus on the now, hopefully the bumblefoot will heal soon. He doesn't sound ready by the way you describe.

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daisymay
Supporter 2016-2017

Post   » Wed Jul 19, 2017 6:34 am


I would continue as you are. Sounds like to me just old age. If he's still interested in food(like most men)and in you then I would keep going. When our Jessie and Jasmine had arthritis we would massage, maybe this will help Santino with pressure sores and any aches and pains. Nine years is amazing life for a piggy. You will know when it's time when you look into his eyes and find him gone. But as yet it's not time. Sending big hugs to you both!

Try giving him cuddles when watching the TV, wrapped in a towel. Ours use to and still do the ones we have love/d it.

Darling

Post   » Wed Jul 19, 2017 10:32 am


Thank you all for giving me your thoughts and advice.

The trending thought is that I'll know when it's time, but I doubt myself sometimes. I'll try to keep my own thoughts out of it and rely on how he's feeling day by day and keep in mind that's how he lives, one day at a time.

I keep layers of fleece under him to prevent soreness and massage him sometimes, but will now make that a part of his daily routine. He had laser treatment on Monday and they showed me how to move and gently stretch his legs. I think adding massage is a great idea. He goes again tomorrow for another treatment.

Thank you again, everyone. If it's okay, I'll try to update this with his progress over time. I'm sure reading your suggestions would be useful for someone else in similar situation!

GrannyJu1
Armcavy

Post   » Wed Jul 19, 2017 3:12 pm


We'd love updates. He sounds like an amazing pig.

Talishan
You can quote me

Post   » Wed Jul 19, 2017 9:34 pm


You'll know in your heart if/when the time comes. I've been in that situation. You don't completely trust your observations and instincts; after all, they can't talk, and you're not a vet, right?

Wrong. You'll know. Keep your mind and heart clear; walk with him, one day at the time. He will either leave you at home, in comfortable, familiar surroundings, or you will know. Trust your gut.

My very best to him and to you. Do keep us posted.

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Rome_Italy

Post   » Sat Jul 22, 2017 6:38 am


I would go on! he is not suffering at all and also my grand-grand mother lived (and wanted to live) sit on a chair, just eating and doing nothing else.
Of course, my opinion might change if you had written that your quality of life is going down because of all these cares and money spent... that would be another subject...

Darling

Post   » Tue Jul 25, 2017 6:06 pm


He had his 10th laser treatment this morning. He has gained 40 grams since they saw him last week. They wanted me to feed him critical care (20 cc 3x/day) but when I try he acts like I'm insulting his ancestors, so I used my coffee grinder to grind up his Oxbow pellets instead. I sneak a bit of critical care in that mixture and he loves it. Gobbles it up. Like a pig :P

Good things for him. He still loves carrots and discovered he's a fan of mango. He's eating less hay and drinking less water, though. I think it might be okay since I'm syringe feeding him and I make the mixture with Pedialyte and water. He's eating 35cc per feeding (sometimes a bit more).

He sleeps most of the time. He has 2 more laser treatments left and then we're done. I told them that I don't think we're going to do another 12 since he no longer walks. They're fine with that, so we'll just continue maintaining his comfort.

Thank you all again for offering your thoughts. I appreciate it.

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Lynx
RESIST

Post   » Tue Jul 25, 2017 9:41 pm


Wishing you both some good days! I'm glad you found some food he likes.

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daisymay
Supporter 2016-2017

Post   » Wed Jul 26, 2017 3:54 am


So glad things are still going well! Hoping there are many good days for you both ahead! Thanks for the update!

Talishan
You can quote me

Post   » Wed Jul 26, 2017 8:08 am


Excellent plan, and news. Thanks for the update.

You're doing everything right. Just keep going.

My continued very best to him and to you.

Darling

Post   » Fri Jul 28, 2017 11:39 am


Santino had his laser treatment this morning. Yesterday was a bad day for him. He didn't want to eat, not even his carrots. Last night, though, he lifted his head before I went to bed for a pet.

He hasn't purred in days and makes grunting noises any time I handle him. He's never been able to wheek, so he doesn't do that. Sometimes he chatters his teeth at me when I touch him. His back feet are very cold and pale. I told his tech about it today and she said it was because he doesn't move. I keep him covered up with a blanket.

My husband thinks it's time to euthanize him. I'm not so sure. His eyes are dull and rarely sparkle anymore. His front legs no longer work and he can barely lift his head. He doesn't eat hay or pellets. He's essentially a furry log that chews and is sometimes interested in his surroundings.

I made squishy little pillows, square ones and bolster shaped, to keep under him. They lift his head so he can still eat carrots and fruits if he wants. He seems to enjoy them.

He has a proper vet appointment scheduled for next Tuesday rather than a laser appointment.

He had trouble moving, but could still walk, prior to laser treatments. He declined very, very quickly, within days of starting laser, that my husband is wondering what he'll be like without the treatments. I think he's hoping the laser somehow made him unable to move and once it's discontinued, he'll gain his strength back. I haven't found any evidence online that laser causes progression of immobility, but rather the opposite. That's his only hesitation about euthanizing Santino. I'm curious to know what everyone's thoughts are on that. I read in the arthritis forum that laser has been successful.

Today Santino is better, though. He ate lettuce this morning, which he hasn't done in a few days. So far, he's finished 2 baby carrots. He didn't have interest in syringe feeding, but I think it's because he properly ate this morning.

I wish he could speak to me and let me know how he's feeling. I know we all wish that for our pets, even when they're not sick, just to be sure they're happy.

bpatters
And got the T-shirt

Post   » Fri Jul 28, 2017 12:00 pm


I know this is hard for you, but I'm with your husband. He's not going to have any significant improvement at that age. Santino doesn't understand time, or death. Having a few more pain-filled days is probably not something he'd choose for himself if he understood the situation. You seem to be keeping him alive for you, not for him. But he'll die soon anyway, and without any significant quality of life in the days he has left.

I approach things like this by way of what I'd want for myself. Death isn't the worst thing in the world, but living in pain, largely immobile, unable to enjoy any of the things life has to offer -- that's far worse, IMO.

Darling

Post   » Fri Jul 28, 2017 12:17 pm


Honestly, a large part of me is with my husband, too. I know we're not supposed to put our human emotions on an animal (though I think we don't give them enough credit when it comes to consciousness and emotions), but if I were in his state, I would choose to move to Oregon so I could take advantage of die with dignity/assisted suicide. Santino's vet, though, has been optimistic since he's still eating. I thought it was harder for me to see him like this than it is for him to exist, but now that he can't move at all, I'm doubting that thought.

I appreciate your opinion, bpatters. I've seen your other posts, along with everyone else that had posted on this thread, and you all always offer sound advice.

I did think I was keeping him alive for only me, but was told otherwise. Now, though, I'm certain it's merely for myself and not what he would want. So much can change in a few days, I'm finding. My fear of making a mistake is preventing him from peace, I worry.

There was another thread in this forum where someone had to euthanize their pig even though the pig was still enjoying food. It made the decision painful, and I totally understand why. I can't find the thread right now. I told my husband last night that I think this is what will happen with Santino. Yes, he's eating and loves his carrots and especially mango now, but otherwise it would be misery to be him. I would feel trapped.

I would still like to wait until Tuesday for his vet appointment. The vet has treated Santino as his own and has done what he would do for his own pig. I would like to know what he would do at this point.

I do worry -- what if the vet wants to continue treatment?! I trust his judgement and don't want to question his knowledge, so I haven't. I've left everything in his hands, with the exception of doing another round of laser treatment. I went to the Journey's euthanasia scale because I read that's used by vets, and Santino's score was 22 out of 80. 8 is suffering, 80 is fine. I don't want to force him to 8.

For a couple of weeks there's been part of me that has wanted to euthanize him while he's not suffering because I don't want to force him to that place. It's so confusing to know what's right.

Sorry for all the rambling, everyone. I suppose I'm thinking out loud.

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daisymay
Supporter 2016-2017

Post   » Fri Jul 28, 2017 2:03 pm


Follow your heart! NO-ONE can tell you what to do or what is right for your piggy! Your with Santino 24/7, only you know him best! Does he still enjoy his cuddles? If he is still eating I would keep going for now. You will know when it is time!
but if I were in his state, I would choose to move to Oregon so I could take advantage of die with dignity/assisted suicide.
I don't want to bring religion into it, but life is God's precious gift and to take it away even to ease pain in a person to me is Murder and just isn't right. There is NO way I would do suicide not even if I was in a vegetable state. To me it is so wrong in a person! I would make a will saying that I wanted to live NO matter how bad things got. That is my opinion and I have to be 100% sure before I take my pets in to let them sleep forever. Even today I wonder whether I did the right thing!

So you're right wanting to be 100% sure. Talk it over with your vet Tuesday, then you have all the facts and can make a wise well informed decision. Sending hugs and healing vibes your way! Maybe he will fall asleep on his own at home close to you and your husband, with people he knows and loves and in familiar circumstances. Enjoy every moment you have with him!

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Lynx
RESIST

Post   » Fri Jul 28, 2017 2:06 pm


It is a difficult decision to make. It sounds like at some point you will need to choose euthanasia. Know that that decision comes from your heart and that will be your last gift to him.

Darling

Post   » Fri Jul 28, 2017 2:27 pm


Thank you for sharing your thoughts, Daisymay. I respect your opinion and know many people share your beliefs. Thank you for sending well wishes.

Thank you, Lynx. I think so, too. The more he deteriorates the less I think it will be a peaceful death on his own, though that's what I had hoped for.

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