Thank you so much for the extra information.
Based on the sounds of where your dog is accumulating fluid, it sounds like she has something called cranial vena cava syndrome, where there is something in the chest that is pressing on one of the large veins that drains the head, causing back-up of blood in her head and neck, and this leads to the swelling. Often, in our older dogs, this is caused by a tumor in their chest pushing on that vein before it enters the heart. It sometimes does not show up on x-rays and needs a CT scan to diagnose. This can be a very tough condition to treat, as you are unfortunately finding out first hand. There has been some success with an experimental procedure where a metal stent is placed in the vein to hold it open and allow the blood back to the heart. However, this is something that only a few veterinarians in the country can do. If you are near New York City, there are doctors at the Animal Medical Center that do this procedure, and if you are near Michigan, a veterinarian at Michigan State also does this procedure, should you wish to talk to them.
The fact that you are asking the question about whether or not to continue treating her tells me that you are doing the best possible thing an owner can do; thinking only of your dog and her quality of life. That is the best mindset to have in this situation, and very refreshing to hear an owner thinking only of their beloved dog.
When I counsel owners in this position, and when I was in this position with my own dog, here are some of the questions I ask (many of which it sounds like you answered for me above):
- does she do the things she loves still (play with the kids, go for walks, beg at the table)?
- is she still able to eat and drink (and does she still want to)?
- can she get around the house well enough withou her feeling frustrated?
- do you feel like she is still happy and herself?
- do you think she is in any pain?
Based on your answers, it seems like she is doing remarkably well given everything that is going on, especially since she will still play with the kids and keeps up her home patrol duty. And it is understandable that she has some trouble eating when the swelling gets bad.
I feel like you are in a situation where there are not right and wrong answers, just right and wrong choices for you and your dog. And by thinking exactly the way you are right now, meaning her quality of life is your biggest concern, regardless of which choice you go with, I feel confident that you will make the best decisions for her. As long as you feel she is happy, able to eat, tolerating her medications, is not in any pain, and is able to get around, I think it is completely reasonable to continue treating her. And if that means leaving her on cephalexin, that is ok. But, if you feel she can't eat (even canned food
or ground beef and rice), is painful, is having any trouble breathing, or just isn't herself, then it is absolutely fair to consider putting her to sleep. As owners, it is one of the worst decisions we have to make and live with, but for our pets, sometimes it is the best one.
I hope this information helps you with a very difficult decision. Please do not hesitate to let me know if there is more I can do to help you.