Chronic health issues

Hi vets! Sorry for the long post, but back story is required. I am looking for some insight and perspective here. (Please, no judgement!) I have a 7 year old, male, neutered, merle mini cocker spaniel. In short, he has severe and non-healing eye issues, pancreatitis, and severe separation anxiety. I just need another set of eyes and ears and some possible solutions. Cappy is the most energetic, playful, and food-motivated dog I have ever had. We don’t have children, so I consider him my child. He is so happy and so docile; he’s never met someone who isn’t a friend. Unfortunately, he’s very sick. He has had health problems since we brought him home at 8 weeks old. He was on a round of antibiotics as a puppy when he first came home for worms and a small infection on his tail. He has regular shots, check ups, etc. He has never had solid stool, but the vet didn’t seem to think it was a problem until around year 4. He was prescribed hydrolyzed dog food with the suspicion he had severe food allergies. At times, he has had explosive diarrhea. This helped him overall, but didn’t solve the loose stool issues. (His stool has been almost mustard yellow since he was a pup..)  He has never been given scraps or any people food. His food is used as treats when training. We just swapped his food and have seen great improvements. He has severe separation anxiety, suspected OCD, and has been medicated with various different meds and none have worked. (Meds have been used in conjunction with extensive separation anxiety training. Our trainer ultimately recommended behavioral euthanasia, which we do not want; we felt this was an extreme reaction!) I know his anxiety is probably multi-faceted—factors of him not feeling well. Fast forward to current— We have two vets and an eye specialist. Our dog has gotten progressively worse over the last 3 years. We have moved and his allergies have gotten terrible. His most recent vet states that she suspects he has pancreatitis and has had for some time, it’s just gone without being caught I currently cannot work due to his barking/anxiety while being overseas and the dog rules in the country where we reside. It’s taxing for our family, but we make it work because we love him. He has undergone extensive food and environmental allergy testing. For food allergies – he is highly allergic to beef and mildly allergic to lamb, deer, oats, and milk. Environmental allergies include severe reactions to dust mites. He was prescribed atopica, but it did nothing. We just switched to cytopoint injections and we’re not sure if it’s working.. he has severely itchy eyes. He enjoys licking his paws and scratching his face almost obsessively. His hair on his back is thinning, which isn’t something we’ve ever seen before. Poor pup has been in an e-collar off and on since April due to his eye issues. His vet agrees this is no way for him to live. We’ve tried socks with no luck. He now has corneal ulcers which won’t heal on both eyes due to scratching and his eyelids being open while he sleeps. He’s had two eye surgeries already for a tumor and a mole. Our eye specialist says his eyes are too big for his head and his lids don’t close all the way, coupled with the allergies and swelling, it doesn’t help healing. He explained a surgery to fix the ulcers, but that it would only be temporary and that he felt there was nothing else we could do except let him live with them.. He also will require removal of secondary eyelashes in his other eyelids every 3-6 months under sedation   Prescriptions: He is now on gastrointestinal low-fat Royal Canon food for the pancreatitis, he takes an omeprazole for indigestion daily, a small dose of trazedone daily, and a probiotic on his food for dinner.   The food/allergy issue. The vets disagree on the food, whether or should be wet or dry, since dry food has mites and should be avoided to improve his allergies.   We spend almost $650/month on treatment for him alone. It’s financially difficult, but we are doing what we can to make it work. He gets the best care possible, but we need to know a long term plan based on his current issues and past history. Is pancreatitis a death sentence? Does he have a poor prognosis? Coupled with all other health issues, what should we do?

Hello!  - and gosh, aren't you trying to balance a lot of conflicting conditions in one patient.  That's pancreatitis, allergies (for which he sounds to have undergone tests and the cause been identified), and what sounds like eyelids that don't close leading to secondary dry-eye and ulcers as well as eyelashes that point the wrong way (some of these disorders are treatable with specialist surgery, although you give the impression that you have consulted on this). Is pancreatitis a death sentence?  No, not in every dog.  Changes to diet and sometimes lifestyle (including weight-loss, often) can make a great improvement in some patients. Is pancreatitis enough to tip the balance in a dog with ongoing dry-eye problems with pre-existing allergies, who is already on a cocktail of drugs to keep things in order?  Is this the branch that breaks the camel's back? I guess it depends on the dog and the owners.  If the current measures are restoring life to a decent quality for him (and for you as dedicated carers here) then there is no reason to think otherwise.  If the reality is that he is miserable / not really coping and / or that you are miserable / not really coping, this demands a rethink. I can't tell you what to do.  I bet that your vet can give you a prognosis if you ask for one, but it may be complex eg.  Reasonable for any one condition but increasingly difficult for every additional condition. Questions you could ask include:. Do you think this is too much for us (that is all of you, him included?). I can't decide from reading your post whether you want me to give you permission to let a fed-up dog go, or encouragement that a balance may be achieved - and the truth is that without second guessing from the unintentional emotional loading you're giving in your description, I can't tell you. The best person to tell you where things sit on that spectrum is your vet.  An honest conversation with them about how you feel is absolutely ok - they will be used to such Frank conversations.  Questions like:. What would you do if this were your dog?  Can be asked of multiple different members of your veterinary team and you may get multiple different opinions, because we are all different.  One answer perhaps might resonate with you more than the others. There is sometimes no 'right' answer, just a choice of different answers. Best of luck.  

More questions for the vet:  What sort of outcome / quality of life can I realistically expect if treatment goes really well from here?  - I think this is the biggy.    I would also ask about how much this would cost, because like it or not healthcare does have a cost and I do appreciate your considering it (realistically, cost is a huge factor with chronic conditions).   I hope that helps.