Author TB Thompson DVM has been a licensed, practicing veterinarian since 2000.
Deciding when to euthanize a dog with liver failure involves complex, emotional challenges. It’s often not a straightforward decision because these dogs have both good and bad days.Â
I’m a veterinarian and I wrote this article to help you assess your dog’s overall quality of life and manage the emotional journey. Remember to talk to your own veterinarian for advice tailored to your dog’s unique situation.
Making the Decision to Say Goodbye
For most people, it’s never easy to decide on euthanasia for their pet. I think it’s good to take this difficult situation very seriously. But you also need to have some practical, objective measures to evaluate how much your dog is suffering.
Below is a Quality of Life Scale inspired by Dr. Alice Villalobos’ work that looks at physical and mental factors. By scoring each item and looking at the total, you may be able to see your dog’s situation more objectively.Â
Quality of Life Scale for Dogs with Liver Failure
| Quality of Life Factor | Considerations for Dogs with Liver Failure |
|---|---|
| HURT 1-10 | Is your dog in pain, especially from liver-related discomfort? Can they breathe without difficulty? |
| HUNGER 1-10 | Is your dog eating enough? Do they require special feeding assistance or a feeding tube due to liver issues? |
| HYDRATION 1-10 | Is your dog dehydrated, a common issue in liver failure? Are subcutaneous fluids needed to maintain hydration? |
| HYGIENE 1-10 | Can you maintain your dog’s cleanliness, especially if liver failure causes incontinence or vomiting? |
| HAPPINESS 1-10 | Does your dog still show interest and joy, or are they mostly lethargic and unresponsive due to their condition? |
| MOBILITY 1-10 | Is your dog able to move without assistance, or are they immobilized due to weakness from liver failure? |
| MORE GOOD DAYS THAN BAD 1-10 | Consider if your dog has more bad days than good. Are the symptoms of liver failure leading to more discomfort and less enjoyment of life? |
How to Use This Scale:
Each factor in the first column is scored from 1 to 10, with 10 indicating the BEST possible condition. A total score over 35 points suggests an acceptable quality of life. Low scores, particularly in areas like pain, happiness, and mobility, may indicate that it’s time to consider euthanasia.
Do your best to evaluate these aspects objectively, perhaps with input from a family member or friend, to make the best decision for your dog. Consider the average for each factor over the last week or two.
In my experience as a veterinarian, many pet owners later say they waited too long to seek euthanasia. Very few felt they let their dog go too soon.
Good Days and Bad Days
Dogs with liver failure often experience fluctuations, having good days interspersed with bad ones. This inconsistency can make assessing their overall quality of life challenging.
To get a more accurate picture, consider the average of their condition over the last 10-14 days, rather than focusing on a single day.
More from NPHQ Veterinarian
Understanding Liver Failure and Symptoms
Many dogs are affected by liver disease in one form or another. But complete failure of the organ is less common.
Liver failure is a severe condition caused when over 75% of the liver is damaged. (Guilford, et al.) The liver is a major organ that is responsible for essential functions like producing proteins for blood clotting, generating bile for digestion, metabolizing nutrients, and eliminating toxins.
When this vital organ fails, whether due to acute causes like toxins and infections or chronic issues such as copper accumulation or immune diseases, the effects are profound.
Symptoms can range from loss of appetite and vomiting to more severe signs like neurological problems, jaundice, and drastic changes in thirst and urination. Remember, different dogs show varying symptoms, and understanding these can guide you in making informed decisions about their care and quality of life.
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Stages of Liver Disease in Dogs
Liver disease occurs across a spectrum of severity, sometimes turning into liver failure. The disease typically develops in stages:
- Early-Stage: In early liver disease, symptoms may be mild, such as increased fatigue or changes in appetite. This stage can often be managed with medication and diet changes.
- Middle-Stage: As the disease progresses, symptoms become more pronounced. Dogs may experience jaundice, noticeable weight loss, and increased lethargy.
- End-Stage: In end-stage liver failure, symptoms are severe. Dogs often show significant discomfort, reduced mobility and may have trouble eating or drinking.
Recognizing these stages helps in making informed decisions about care and quality of life as the disease advances.
Prognosis for Dogs with Liver Failure
The prognosis for dogs with liver failure is generally poor. Most dogs only survive a few days to weeks, especially if they have elevated bilirubin, blood clotting issues, or hepatic encephalopathy. Over 80% with acute liver failure do not survive despite treatment. (Lester, et al.)
Emotional Challenges Before and After Pet Loss
Dealing with a pet’s liver failure involves significant emotional challenges, both before and after pet loss. Before the loss, owners often face anticipatory grief and the stress of decision-making, knowing their dog depends on them to alleviate suffering in the best manner possible.
Afterward, intense feelings of sadness, loneliness, or guilt are common. These emotions are a normal part of the grieving process. Seeking support from friends, family, or professional counselors can help navigate this emotional journey.
It’s important to remember that healing takes time. Mourning the loss of your dear companion is a natural and necessary step.
Resources
I want to share several resources that will help you through your difficult time. The following list includes providers who specialize in pet-related grief and will understand what you’re going through.
Editor’s Note: NaturalPetsHQ.com is supported by readers and may earn for purchases made through links in this post.
- Pet Loss Resource Center: a non-profit group offering support resources for the times before and after saying goodbye to your pet.
- Pet Loss Support Hotline: based at Cornell University College of Veterinary Medicine. You can call (anonymously, if you wish) and get support at 607-218-7457.
- Goodbye, Friend: Healing Wisdom for Anyone Who Has Ever Lost a Pet: a book by Gary Kowalski. (click title for Amazon.com link)
- The Pet Loss Companion: a book written by family therapists Ken Dolan-Del Vecchio and Nancy Saxton-Lopez. (click title for Amazon.com link)
Conclusion
Deciding when to euthanize a dog with liver failure is profoundly difficult, but understanding the disease’s progression and evaluating your dog’s quality of life can guide this decision.
Remember, this act of compassion is ultimately about alleviating your dog’s pain and suffering, making sure their final days are peaceful.
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