Deciding when to euthanize a dog with arthritis can be difficult and devastating. To help provide clarity and comfort, integrative veterinarian Dr. Julie Buzby invited end-of-life-care veterinarian Dr. Dawnetta Woodruff to share some heartfelt advice from her years of supporting families and their beloved dogs through that final farewell.

When your beloved canine family member has received a diagnosis of arthritis, it can be a scary moment. You may wonder what will happen next, and how his or her life will be altered. How long can he or she live with the pain and decreased mobility that comes with arthritis? Will you know when to euthanize your dog with arthritis?

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The answer to those questions is multi-factorial and depends on the severity and progression of your dog’s arthritis.

An arthritis overview

Osteoarthritis in dogs is a progressive disease that affects the joints. It often starts because a dog was born with poor conformation. When the joints are not properly formed, as is the case with hip dysplasia in dogs or some instances of luxating patella in dogs, they wear down faster than they should.

Arthritis can also happen secondary to injuries such as a torn ACL in dogs or a broken bone (in or near the joint). Plus, age-related wear and tear on the joints, and/or increased strain on the joints from obesity can also contribute to the breakdown of the joints.

In a healthy joint, cartilage is present over top of the smooth bony surfaces. It functions to cushion and protect the bones. However, when cartilage becomes inflamed and irritated due to injury or poor conformation, it eventually wears out.

At this point, bone-on-bone contact occurs, which is quite painful. And as arthritis progresses, it actually begins changing the shape of the affected bones. The bone edges become rough, the joint’s normal fluid increases, and joint swelling becomes evident on X-rays. Sometimes that enlargement can even be visible when you look at your dog’s joints.

Symptoms of arthritis

At first, though, your arthritic dog will look very normal, as visible changes often progress gradually. Eventually, you may notice:

• Your dog’s walk will become less smooth, and he or she will appear stiff when moving—especially when he or she first gets up after a long rest.
• During walks, your dog may slow down or have a hard time walking the distances he or she used to run with ease.
• Going up and down the stairs may become more difficult for your dog, and he or she may not want to jump up on the couch or the bed anymore.

These, and other signs of arthritis in dogs, are all reasons to bring your dog to see your veterinarian. This allows your vet to create a plan to help your dog feel his or her best both now and long-term.

Arthritis management options

How your vet recommends managing your dog’s arthritis depends on how severe it is when it is diagnosed and how it progresses. Your veterinarian may recommend:

Joint supplements

Giving your dog joint supplements for dogs such as Dr. Buzby’s Encore Mobility™ hip and joint supplement can help give your dog the necessary building blocks to keep the joints lubricated and protected.

You could also consider adding Omega-3 fatty acids for dogs to your dog’s diet in the form of a fish oil supplement. Omega-3 fatty acids are fantastic for dogs with arthritis because they have natural anti-inflammatory properties and help support joint health.

Weight management

Keeping your dog at a healthy weight or helping your dog lose weight is an incredibly important part of arthritis management. Extra weight puts more stress on your dog’s joints and will speed up the progression of the disease. This increases pain and decreases life expectancy.

(Wondering if your dog is overweight? Start by finding your dog’s body condition score (BCS) or ask your vet if your dog could benefit by losing some weight.)

Alternative therapies

There are many therapies that can provide comfort, decrease inflammation, help keep your dog mobile, and offer great natural pain relief for dogs. They include:

• Physical therapy
• Underwater treadmill for dogs
• Laser therapy for dogs
• PRP for dogs
• PEMF for dogs
• Dog chiropractor
• Acupuncture for dogs

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Also, combining some of the above therapies with gentle exercise (when tolerated) can help your dog hold on to as much muscle strength as possible.

ToeGrips

With time, your canine friend will lose lean muscle mass, and you will see worsening weakness. As the weakness progresses, using mobility aids like Dr. Buzby’s ToeGrips® dog nail grips will be helpful to keep your dog moving comfortably about your home.

Pain medication

Your veterinarian will probably recommend beginning pain medication as part of the plan to relieve arthritis pain in dogs. He or she may start out with something simple like a non-steroidal anti-inflammatory (NSAID). These medications, such as carprofen or meloxicam, are similar to ibuprofen for humans but are safe for your canine companion.

Over time, the pain management program will evolve into a multi-modal approach. This means the vet will combine different types of medications (i.e. gabapentin for dogs, tramadol for dogs, or amantadine for dogs) to help decrease pain in different ways.

Managing discomfort from many different avenues gives a much greater result than using any one method on its own. This can help maximize the time your dog can live comfortably with arthritis.

How long can a dog live with arthritis?

Sometimes, dogs with arthritis go on to live full lives. Their arthritis is well-managed for many years until their life comes to an end for unrelated reasons. However, in other circumstances, arthritis progresses more quickly, to the point that it is keeping a dog from enjoying his or her life.

In this situation, it is natural to wonder, “How much longer can this go on?” and “Is it fair for him or her to live in pain?” You may also question, “Is it right for me to consider euthanasia? He is still healthy otherwise.” or think “She still seems so happy! But I know she is hurting. When do I need to let her go?”

How do you know when to euthanize a dog with arthritis?

This is a complicated and difficult decision. Our natural tendency is to look for the good, and focus on the joy our dogs have in their lives. Dogs are blessed with the ability to deal with physical pain without attaching human emotion to it. They don’t feel sorry for themselves—they just try to have the best day possible.

This is one of the things we love about them! But it also makes it difficult for us to truly know when it is time to set them free from their pain.

Watch for “red flags” that indicate your dog is declining

It is common for families to look for one “big red flag” as a sign that it is time to say goodbye. This “big red flag” might be the day their dog completely stops eating or the day he or she can’t stand up at all. These things can certainly let us know the time has come for humane euthanasia.

However, it is rare that advanced disease such as arthritis only affects one area of life. More commonly, we see many “small red flags” that all add up to a bigger problem, rather than the one “huge red flag” we’ve been watching for.

These smaller red flags can be things like:

• Decreased (but not absent) appetite
• Increased thirst secondary to constant panting
• Restless sleep because your dog is in pain and unable to find a comfortable sleeping position
• Accidents in the house—When dogs can’t get up easily to go outside, they may wait until the last minute. And then the need is so urgent that they can’t make it outdoors. Or they may have accidents because they go outside and try to squat but can’t hold the position long enough to fully empty the bladder or pass stool.
• Your dog, who loved affection, may become nervous (tensing the muscles or trembling, even walking away) when you approach to give him or her attention in the form of touch.

Individually, these smaller red flags may not seem like a huge problem. But as more and more concerns arise, the “small” things add up, and they can severely decrease the quality of life.

Conduct a quality-of-life assessment

Looking for these “red flags” is one helpful way to know when the time to euthanize your dog is approaching. However, there are many other tools available to help evaluate the quality of life (QOL) as well. No one tool or method tells the full story.

Another approach I like is to use a quality-of-life scale for dogs. There are a variety of assessments available that take into account a dog’s health, appetite, mobility, hydration, sleep habits, hygiene, and more. You can pick one you like and use it on a regular basis or try out a few different ones.

It is best to perform the quality of life assessment at different times of the day. Otherwise, for example, if mornings are the best, and that is the only time you do your assessments, you could be missing the big picture.

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Having different people in your family evaluate your sweet pup’s quality of life is also helpful. That way you can talk about your observations and concerns together. Or if you are the only one caring for your dog, talk to a trusted friend or fellow dog owner.

It can also be helpful to ask your veterinarian for his or her input. These additional or outside observers can help you see things clearly, and from a more objective point of view.

What should you do if you think your dog’s quality of life is declining due to arthritis?

You may find that your dog’s quality of life stays steady for a long time and then slowly declines. However, in other situations, the quality of life can decline rapidly. This is especially true when there is a loss of mobility or an inability to control pain.

If your dog’s mobility is getting worse, if he or she won’t take pills well, or if he or she is dealing with concurrent health issues (like liver disease in dogs or kidney failure in dogs), you may wish to seek help from a veterinarian who offers dog hospice care. These caring individuals can help ensure that your dog’s last days are as comfortable and dignified as possible.

Or, you may wish to have a discussion with your dog’s care team regarding end-of-life arrangements. This may involve preparing for your dog’s euthanasia at the vet clinic or scheduling an in-home dog euthanasia. You may also want to start looking at dog memorial ideas that can help honor your dear departed dog.

Know that there isn’t one “right time” to euthanize your dog with arthritis

Deciding when that final farewell will occur isn’t clear-cut. There often isn’t only one precise moment in time when euthanasia is the best choice. Instead, especially when it comes to dogs with arthritis or other chronic conditions, there is a window of time in which euthanasia may be the right (albeit difficult) choice.

Some dogs may take their medications well and allow you to help them up. This may allow them to truly enjoy their life a bit longer. For other dogs, lifting them up and helping them outside is stressful, and taking medications is a battle. Since their days are full of difficulty, it may be kindest to set them free earlier in that window of time. Every dog and situation is different.

Understand that euthanasia is a loving gift

As a dog’s family, it is common to wish you could do more. But at the end of a long and difficult road (such as managing osteoarthritis), sometimes the kindest thing you can do is know when to give your dog an escape from the struggle. Choosing euthanasia is not a failure. It is a way of allowing your dog to skip over the very hardest days that are still ahead of him or her. And that is a merciful and kind decision, made with love.

While you might not be ready for your dog’s life to be over, there often comes a point where watching your dog struggle is just as heartbreaking as the thought of setting him or her free. That is when you know that you are probably as ready as you will ever be.

Be kind to yourself on this journey

Even so, the weight of these decisions can still be overwhelming and burdensome—as can anticipating the grief that will come when your cherished dog passes on. Plus, caretaker fatigue is very real but sadly not talked about nearly enough.

It is a given that you love your dog. And you are willing to do whatever it takes to keep him or her comfortable and mobile for as long as possible. But it can be exhausting to keep up with medications, therapies, and the constant worry of how well your dog is going to be able to get up or move around. Sometimes it may feel like taking care of your arthritic dog is a full-time job. And the day-to-day ups and downs can become emotionally taxing for you and your sweet pup.

There may be times when these burdens may feel like too much to carry. You know you and your dog can’t keep going with the way things are. But how can you bear to make the decision to say goodbye to your beloved companion? The weight of that decision is immense, but you don’t have to carry it alone.

Sometimes, as pet owners, we need to seek help from friends, family members, veterinary professionals, and/or therapists who focus on pet loss and grief. This kind of help, and access to pet loss and grief resources, are certainly vital after a loss. But they are needed just as much before the loss as we grapple with the decision of when to set our dog free from his or her struggles. There is no shame in reaching out for help.

Take comfort from your dog

Finally, you already know this, but dogs are excellent at sensing how much we love them. And if they could talk, they would probably want us to know that it is ok to let them go on a good day. It is ok to say goodbye before every bit of joy is gone and only pain and sadness remain. They know you are doing your best to care for them, they trust you, and they love you unconditionally.

The decision of when to euthanize your dog with arthritis isn’t an easy one, but you can, and will, get through it. And you don’t have to do it alone.

If your dog had arthritis, how did you know when it was time to say goodbye?

Please share your story below.

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