the quality of life conversation with our vet about our almost 13 year old golden retriever wally that i spent nine months avoiding and that turned out to be nothing like the conversation i had been dreading, the specific one page tool she handed us that broke my brain because it was so simple, what i actually meant when i said "i want to know when it is time" and what she heard i was asking, and the honest report from six weeks of tracking that has somehow made the last six months of him better instead of shorter

Wally turns 13 next month, red golden retriever, 71 pounds now down from a lifetime 78 that we managed on purpose starting at age 9 because our vet said the best senior intervention is a lean adult, which turned out to be the first true sentence anyone said to me about senior dogs and i wish it had come at year 3 not year 9. we are ten months into what our vet politely calls the "senior decline phase," which for wally has meant a chronic left rear soft tissue lameness that we manage with adequan injections and gabapentin at night, a diagnosis of stage 2 kidney disease from bloodwork in november, some cognitive changes that show up mostly as him standing in doorways at 2am looking mildly confused, and a stubborn ridge of hearing loss that means i now touch his shoulder before i speak or he startles. this is not a "wally is dying" post, wally has probably six to eighteen months in him depending on which of his diagnoses moves first, and this is a post about the conversation my wife and i finally had with our vet in may that i had been avoiding for nine months and that turned out to be worth every dread minute of the drive over.

the reason i had been avoiding it. i thought a "quality of life conversation" was a conversation about when to euthanize. every time i thought about booking the appointment i felt like i was scheduling wallys death, and i would not do it, and my wife would gently mention it every couple of weeks and i would say "hes not there yet" and change the subject. i finally booked it in the last week of april because my wife straight up said "please do this, im carrying it alone right now," which was a fair sentence and true. we went in on a wednesday afternoon, we had asked for a longer appointment slot, our vet is dr amara who has been wallys vet for four years and who is genuinely one of the best humans i have ever met in any professional context. she sat down with us in an exam room with no exam happening, wally on the floor between us with his adequan-injection routine treat, and she started the conversation with "before we talk about anything else, tell me what youre actually asking me. because i think you are asking me one question and my answer will be different depending on which question it is."

and i did not have an answer. i had been thinking of it as one question, when do we know it is time, and dr amara gently unpacked that into three questions i had been running at the same time in my head without realizing it. one, how do we know wally is having more good days than bad, right now, in this month. two, how do we know when the good days start to be outnumbered, in a way that is measurable and not just vibes. three, if we ever get to the point where the good days are outnumbered, what does that decision look like and who is involved. she said "i can answer all three, but they have different answers, and running them together is why you have been avoiding this appointment for nine months." and she was completely right, i had been avoiding a conversation about three separate things by treating them as one dark cloud, and just naming the three questions took about 60 percent of the weight off. we spent the rest of the appointment on question one and two, and we scheduled a separate follow up in july for question three which she said we did not need to have yet and she would tell us when we did. she was right about that too.

the tool she handed us and the six weeks of tracking. she pulled out a one page sheet and slid it across the table, it was a modified version of the standard HHHHHMM scale (hurt, hunger, hydration, hygiene, happiness, mobility, more good days than bad) with a few things she had added specifically for large breed dogs with mobility concerns. seven categories, score 0 to 10 each morning, takes about 90 seconds, do it before you look at your dog on purpose, do not skip days, no interpretation just numbers. she said "in six weeks come back and we will look at the numbers together, not the story you have been telling yourself about them, the actual numbers." i thought this was going to be depressing homework and it turned out to be the exact opposite. six weeks of numbers gave me a real chart of wallys life instead of the anxiety spiral chart that was in my head, and the real chart said wally is scoring 44 to 52 out of 70 most days, with the low days clustering in a specific pattern that turned out to be tied to his adequan cycle wearing off around day 26 of a 28 day interval. we bumped him to a 25 day cycle, his low days pretty much stopped, and my anxiety about "is he suffering" dropped from a 7 to about a 2 because now i have a spreadsheet that says he isnt, most days. the six weeks of tracking, which i had assumed would be a countdown, ended up being the thing that gave us the last six months as a real period of wallys life instead of a dark hallway we were walking through. i wanted to write this down because i spent nine months avoiding a conversation that ended up being the most useful thing we have done since he turned 10, and if anyone else is sitting on this appointment for the same reason i was, please just book it, ask the vet to help you separate your questions, and start the tracking. the tool is not the answer, the tool is what lets you see the answer when it comes.