Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your fellow is struggling with several issues including fecal incontinence, chronic lung disease which leads to a cough, and arthritis.
I'll address his most recent health issue first.
I suspect his fecal incontinence may be related to spinal arthritis which can cause inflammation of the spinal nerves that control urine and stool continence. These dogs have obvious spinal arthritis on radiographs and are painful upon examination. They may respond to anti-inflammatories (steroids or nonsteroidals like Deramaxx or Rimadyl), pain medications like Tramadol as well as omega 3's and glucosamine/chondroitin supplements like Dasuquin or Cosequin DS. I know he is already taking medication for arthritis but you might discuss trying a different anti-inflammatory with your veterinarian to see if it is more helpful.
The second condition that could cause incontinence would be a degenerative myelopathy. This is a degenerative condition affecting the nerves of the spinal cord, it starts in the back legs and ascends eventually affecting nerves to the bladder and rectum which leads to loss of continence. These dogs aren't painful. They are uncoordinated in the rear because they have lost the ability to feel where their rear legs are and place them properly. They become incontinent because they can not feel the stool building up and because their anal sphincter becomes loose. Unfortunately we do not have any good therapies for this condition. Radiographs look normal and diagnosis is by a blood test to look for genetic markers of the disease.
The other disease process would be lumbosacral stenosis and instability. This is an instability between the sacrum (pelvis) and the lumbar spine. It leads to inflammation and scar tissue and places pressure on the spinal cord leading to loss of function in his rear legs and stool and urine incontinence. These dogs are painful and should respond at least somewhat to steroids or anti-inflammatories. Diagnosis is by an MRI of the area. Treatment is surgery but once fecal and urine incontinence occur we cannot always reverse the damage done to nerves. Definitely worth trying though.
Unusual causes can also be a spinal cord tumor or a mass of the vertebrae or supporting tissues.
Dogs with fecal incontinence that cannot be controlled are difficult to manage. Unlike urinary incontinence, where we can at least keep things relatively clean with diapers, sanitary concerns often lead to owners choosing euthanasia. These pups become a health issue for themselves and their owners due to fecal bacteria and parasites.
In the meantime while you are making a decision about how to proceed it may help to increase the amount of fiber in his food to help him feel and be more aware of his stools. You can add 2 to 3 tablespoons of canned pumpkin or Metamucil to his meals to increase fiber. Make sure to get him outdoors frequently to pass stools as well so his colon is less likely to overfill causing stools to just drop out.
If he isn't already taking one it may also help to add a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). These work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them added. They are available over the counter.
Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.htm
Other alternative therapies such as cold laser, acupuncture or chiropractic may be of help as well is his problem is arthritis related.
I understand that you are struggling with whether it is appropriate to consider letting him go via humane euthanasia now because of his health issues. Your veterinarian will not judge your decision based upon the number and type of struggles your fellow has. We as veterinarians are here to help lead pets lead happy, good quality lives, not to prolong living when it is no longer enjoyable.
I try and guide clients on this very difficult decision by asking them if they believe they would want to live the way their beloved pet is.
I ask if their pet is still able to do the things that they have always enjoyed (albeit for a shorter period of time).
I also ask if they believe that their pet is comfortable most of the time and is living with dignity.
You also need to consider honestly whether it is reasonably possible that his quality of life is going to improve, and whether his problems are making you resent him and be less affectionate with him. Positive interactions are especially important for older pets.
If you honestly answer these questions I believe you will come to the best decision for your fellow.
I believe humane euthanasia is a gift we can give our pets when their quality of life is poor.
Euthanasia is not painful.
It is simply an overdose of anesthesia. All your pup will feel is the placement of an intravenous catheter or the pinprick of a needle.
They get very sleepy, become mentally unaware and then their heart stops, which leads to low oxygen and brain death.
I do think his quality of life is starting to suffer, but not living with him or knowing him well it is hard to say. You know whether he is happy and comfortable. Be honest in your assessment and I think you will make the right decision.
I have had to make this decision too. It is heartrending. But I was able to let go when I put myself in my dog's shoes. I didn't want her to be uncomfortable any more, and I knew I couldn't do any more to make her life better.
I can give you some tips that may make things easier for his at the appointment. If you feel it would be stressful for him you can ask for a tranquilizer before the procedure.
And if you wish staying with him while he passes can be very helpful for you and him, IF you can be gentle and reassuring for him. I find that dogs with owners who can be relatively calm and loving let go much more peacefully.
But if the owners are upset then they tend to fight the effects of the overdose of anesthesia and it is rougher for them, and then of course for you.
If you feel you cannot be calm and reassuring for him don't worry that he won't be well loved and taken care of. We are gentle and hug and speak softly to them as they pass. They do not pass alone and afraid.
If you can, you should make his appointment for the first or last appointment of the day so there are no distractions and the clinic is quiet.
Please let me know if you have any further questions.