By Suzanne Engelberg
Mali is my 11-year old ODH Final Refuge dog. She is a cute Chihuahua mix with a calm, regal air who isn’t afraid to snap at bigger dogs if they get in her space. She and her sister ChiCha (an 11-year old doxy-mix) have been with me since mid-November. Mali arrived relatively healthy except for some minor liver problems.
After Mali settled into my home, I noticed that something else was wrong. She walked stiffly, was obese with an erratic appetite, and frequently had a pained look in her eyes. Her tail was always down except when she was outside, and she spent most of her time sleeping. All her test results were normal though, except for the mild liver disease. I suspected arthritis. The vet wasn’t so sure because Mali’s range of motion and ease of movement weren’t bad, and the vet’s manipulations didn’t seem to cause pain. But since arthritis seemed the most reasonable explanation, she agreed to treat for it. And thus began our dramatic dilemma.
The most effective arthritis medication worsens liver disease. Should we start it anyway, try a different medication that probably wouldn’t work, or leave things the way they are? In other words, do we choose comfort now with an earlier death, or a longer, uncomfortable life?
ODH executive director Judith Piper and I both favored a higher quality, shorter life. The vet, a caring, skilled professional, disagreed. Or as she put it, “Liver failure isn’t comfortable either.” Not only that, but we weren’t certain arthritis was the problem. What if we gave Mali the liver-damaging medication and the cause was something else? What if we didn’t give it and Mali suffered longer?
Those of us who care for old, sick dogs often have to make such difficult decisions—current comfort over longer life, surgery that may or may not help, treatments that solve one problem but cause another. These are almost impossible choices to make, especially on behalf of someone else. But, since most people don’t speak Dog, and most dogs don’t speak English (or any other human language), it’s up to us to decide for them.
Our decisions are ultimately guided by our values. Is life so precious that nothing should be done to shorten it? Is quality of life so vital that we should sacrifice months or years to improve it? Or is the answer somewhere in between?
Fortunately, those of us with ODH Final Refuge dogs don’t have to make these decisions alone. Judith and others are always available with guidance and suggestions, as are our dogs’ veterinarians. It can also be a relief to know that the final decisions are up to ODH, although the foster parents’ input is given great weight.
Back to Mali. The drama isn’t over, but it’s closer to a resolution. We tried several medications that don’t stress the liver. None of them worked. I even tried different foods in case the problem was dental or digestive. My last desperate attempt was boiled chicken and white rice. To my surprise Mali wolfed it down like she hadn’t eaten in weeks. Since then her tail is up more, and she’s more active. I immediately emailed the vet, and am waiting to hear back. I still don’t know the cause of Mali’s discomfort, but I’m hopeful we’ll find a solution that preserves both the quality and quantity of her life.