Question:
My wife and I adopted an 11-year-old "doxiepoo" (dachshund/poodle) named Andy. We understand that this breed lives between 11 and 15 years. Unfortunately, Andy probably won't make it to 15.
A trip to the vet revealed that Andy has Cushing's disease, which explains his constant thirst and need to urinate, and the loss of hair on his hips. The vet explained that the treatment of choice is weekly chemotherapy that is not without risk; will not extend his life but will control symptoms, such as frequent urination; and is very expensive, especially in the beginning when dosage is being determined. Even if cost were not an issue, we are reluctant to put him through the rigors and risk of chemo for essentially our convenience -- we can handle the urination. We are thinking that the best way to handle this condition is to let it run its course, and as long as Andy seems to be enjoying himself, he'll have a loving home with us. Perhaps this is an unwise choice.
We would appreciate your thoughts. Andy is affectionate and filled with energy, and he doesn't appear to be in any discomfort. He lets us know when he needs to go. The very occasional accident is usually on a towel we've placed near the back door.
A.P., Martinsburg, WVa Aug 15, 2011
Answer:
There are many endocrine diseases, other chronic degenerative diseases and various cancers that affect older animals whose quality of life is reasonably good. They are not in pain or apparent suffering and, like your dog, still enjoy life. But as the condition progresses, your caretaker role (as with our two old dogs) will increase significantly.
The costs and, most especially, the side effects of treatment must be weighed against how much longer the animal will probably live without treatment and might live following treatment, and whether there would be any significant improvement in quality of life. In many instances, there is no real way of knowing, and embracing the uncertainty principle is the best option. Longevity is too often overrated as a measure of treatment success, especially when repeated treatments and constant monitoring affect animals' well-being and that of loving caregivers.
In some communities, veterinarians are promoting and practicing hospice care for companion animals. They come into the home to monitor pets with chronic, terminal conditions, eliminating the stress of hospital visits and determining and discussing treatment options and euthanasia with the animals' caregivers.
I am fully aware of the advanced diagnostic and therapeutic procedures being marketed in both human and veterinary medicine. The above considerations can help put things in perspective, as well as the fact that his hyperactive adrenal disease may well develop into secondary diabetes, kidney disease, arthritis and poor wound healing.
Discuss with your veterinarian supplementing his diet with antioxidants, anti-inflammatory nutrients, vitamins C and B6, dehydroepiandrosterone (DHEA) and melatonin.
A useful reference text for veterinarians, "Integrating Complementary Medicine Into Veterinary Practice" (Wiley-Blackwell, 2008; edited by Dr. Robert S. Goldstein) offers many potentially beneficial treatments for this and many other conditions in dogs and cats beyond the conventional and often costly and risky treatments.
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