I have a twelve-year old Shetland sheepdog with transitional cell cancer of the bladder. Apparently the breed is predisposed to it. She started exhibiting symptoms last June, dx in August, been on Piroxicam and a pain med since and had been doing pretty well. I'm struggling with the expected question - when is it time. She's still fairly happy - she interacts with us, can get up and down stairs slowly, has her appetite and is staying hydrated. She is slowing down, sleeping a lot, and sleeping hard. She's been coughing a little and starting to vomit (a little, small amounts, not total voiding) a couple of times per day the last few days. She's still passing her water but it's become a trickle and today we're starting to see some blood. Wants to go outside constantly, incontinence in the house, lots of licking. Her breathing is not labored, but it's taking on some unusual sounds here and there. She's not herself, but nor does she seem to be in any great pain. Obviously, I don't want to wait until her flow is totally obstructed and her bladder ruptures. Discerning her quality of life is very difficult right now. Are there any vets or pet-lovers around with any experience with end stage TCC in the bladder? I'm wondering if the passing of blood would correlate with increased pain for her. Clearly, she's feeling a constant need to go and as an aging guy with an imperfect prostate, I know that's not at all comfortable. I feel like we're within days now, and I don't want her to suffer. But it's so hard when she's still of strong mind and still mostly "there."

This message has been edited. Last edited by: Aquilon,

I can't offer you anything but support. You are entering the hardest phase of pet ownership. I've been there and it's heart wrenching.

I would think your vet could answer these questions or help you with your decision making.

Would your vet consider a catheter? But that only prolongs the inevitable.

Take solace in knowing that what you're trying to do is the right by your pet.

Thanks. Our vet is out of the office today but will probably get back in touch with us later in the day.

We didn't want to put her through chemo/radiation (due to her age - twelve and change is a typical lifespan for the breed), and probably feel the same way about a catheter. The cancer is absolutely terminal, so we just wanted her to enjoy as much good time as she had before the inevitable.

Take her to a place she likes and be alone with her, look her in the eyes, and ask her.

She'll let you know.

It is always hard but when the time comes we used Lap of Love and they are fantastic. They will come to your house.

https://www.lapoflove.com/

quote:

Originally posted by whododat:
It is always hard but when the time comes we used Lap of Love and they are fantastic. They will come to your house.

Thank you for this suggestion. We've checked and they are not available in our area.

We've been there 5 times and it is always very hard and especially so when there is not an obvious answer.

We take our vets guidance along with our dogs guidance (listen to sigmonkey) into account.

Prayers said and sent for both you and your sheepdog and best of luck.

I wouldn’t presume to advise you on this stage of your dog’s life. Most of us have experienced the same thing that you are. Ultimately, I think you know what’s best, whether it’s now, or later. Sorry brother

Prayers for you. It the hardest part of having pets.

Love makes us wait a little too long.

quote:

Originally posted by Aquilon:
I feel like we're within days now, and I don't want her to suffer. But it's so hard when she's still of strong mind and still mostly "there."

I suspect it is time now.

quote:

Originally posted by sigmonkey:
Take her to a place she likes and be alone with her, look her in the eyes, and ask her.

She'll let you know.

This.

I've had a pup (six months old) get parvo. His eyes, even when he could barely lift his head, said he was willing to fight. He did.

My Madaline (14 year old) had tumors which eventually impeded her from breathing deeply and that caused her further stress. When I finally got her to relax that last day, she was able to relax in my lap.

And then Wolfie (12 years old), 130 lbs of pure loving Malamute/Shepard mix. He was my dog. Had the tumors, which large dogs all seem to have, rupture one night. He kept trying, trying like the strongest and most willing of any dog. The reality was, all his trying wasn't enough. In the end, I'd like to think he knew his pain and distress was going to go away.

My wife refuse to let me cry with Wolfie's head on my lap. She made me talk to him as the sweet loving boy he was. My wife knew best. Wolfie knew and passed in peace knowing I was safe.

quote:

Originally posted by sigmonkey:
Take her to a place she likes and be alone with her, look her in the eyes, and ask her.

She'll let you know.

I'll agree with this. I'd been telling my Lab for a year, "I know we both know it's about time. You let me know when it IS time."

Last week she had a different bark about her. We laid on the floor for a bit, and she put her weight against me. I fully believe that action, plus the odd bark, was her letting me know.

quote:

Originally posted by Spudgun:
Love makes us wait a little too long.

Can't deny.

quote:

Originally posted by Aquilon:

quote:

Originally posted by whododat:
It is always hard but when the time comes we used Lap of Love and they are fantastic. They will come to your house.

Thank you for this suggestion. We've checked and they are not available in our area.

When I called my Vet, they told us of a local Vet that did in-home euthanasia. Your Vet may know of one.
Be present for your pet in those last moments.

I agree with others in that we delay that decision a bit too long.

Sorry to hear this, it's the hardest part of having a pet as you probably know.

Better a day too early than a day too late.

We've had about seven dogs over the last thirty years so we've faced this a number of times. Most vets will just give your the clinical facts but won't say, now is the time. Once you've decided, they will agree it's the right thing to do, but there are too many pet owners that react in unpredictable ways from this stressful situation. Because of that they are understandably cautious about giving advice beyond explaining what's going on medically. They want be sure it's your decision, not theirs.
You know your dog isn't going to recover and is getting up there in years so the real question becomes, what's the benefit to your pet of delaying?
It's much easier for all of us to see from a logical point since we're not the ones facing this difficult decision right now but you'll understand better after the fact.
Again, sorry to hear this and it's never easy.

So sorry for your family; courage and love are key.

Sigmonkey is correct … they tell you.

Thank you all for your thoughts and kind suggestions. Did get in touch with the vet who suggests trying an antibiotic for a few days as long as she’s not getting worse. He says UTI is a common comorbidity with bladder cancer, so while this could be end stage TCC, there is also a chance she has a UTI and may come back around for a little more good time with antibiotic treatment. Will start the antibiotic this evening.

I'm so sorry for your situation, it isn't fair to you or her.

If your vet has an ultrasound or access to one, that could answer a number of questions you have without being invasive. Ultrasound will measure the size of the mass and the location relative to the ureters (though not specifically) and give you an approximation of what's going on in there without the use of a scalpel.

In general there will be a loss of "stretch" to the bladder wall as the disease progresses, so at the end stages a significant portion of the trigone area and surrounding bladder wall will not give at all when filling. Hence, the remaining normal bladder wall will feel stretched with a much lower volume. The blood could be coming from some of the border area of normal/cancerous cells being disrupted, and of course as the cancer progresses the vessels lining the lumen of the bladder become more prominent and likely to leak.

I do agree with your vet that this might be a UTI, especially since females are predisposed to UTI with their shorter and wider urethra, and the antibiotic is a good idea.

IF he/she has an ultrasound, you might inquire about getting them to look, might give you a better idea on where you're at. If they've been using u/s already, they might have charted thicknesses of bladder wall and tumor size, and that can be helpful to compare.

Hope this helps somewhat, and again I'm so sorry you're in this position. If I can help more, feel free to contact me.

I am so sorry you are having to go though this.

Having been there four times, my Dogs let me know when it was time.

I wish you all the strength in the world during this challenging time.

Pearl and I are sending our best.

Update, 1/30/22. Maggie had some good days left after the original post but declined rapidly this weekend. Our sweet old girl was ready. We took her in this afternoon and lay with her while she drifted off to rest. She grew up with my kids, she gave us twelve great years and just one really hard day; that's a good life.


Friends by Jim Harrison

Dogs, departed companions,
I told you that the sky would fall in
and it did. How will we see each other again
when we're without eyes? We'll figure it out
as we used to when you led me back
to the cabin in the forest in the dark.

This message has been edited. Last edited by: Aquilon,