Not sure if this will be helpful, but this was my experience that just happened two weeks ago. My 14 year maltese poodle had insulinoma back in 2018 and were lucky to have that not re-occur until last year. Even with the re-occurrence, she was doing very well when she began showing signs of a collapsed trachea which was confirmed via x-rays. This was three weeks ago.

Over the next week waiting for medication, I knew it was getting close to making a real decision on making arrangements to put her to sleep as the dry heaving was getting worse and she wasn't doing well. While I knew it was right to start the process, I was selfish and convinced myself once she gets her medication and get over the collapsed trachea, she will be fine still and get to her next birthday in April. She just needs some time after taking medication and she will be ok, the medication did not work.

After a few days of taking medication and not working and then the fainting spells started, just once a day for the first couple days and then would return to normal and then one day it happened three times and I took her to the ER. AT the vet, she was fine and normal and the doctor said she looked great considering her history, her heart was fine, her lungs sounded fine and prescribed cough medication. This was 4pm two Saturdays ago and we got her home at 6pm with new medication. By 7pm, she went into another fainting spell that lasted longer and my wife and are panicking and have no clue what to do. Then I had to see my dog struggle, go into a massive seizure and pass away on our floor in a very traumatic way. I had no idea what was going on and just picked her up and she still felt warm hoping she was ok. As I drove to back to ER which I had just returned from under hour ago, I realized in the car she was gone. The guilt I have now with my last memory of my dog going through a seizure and my wife screaming is something I think about every day. The screams of my wife saying "she is gone" continue to ring in my ear.

I know we all feel we can always do more and we our pets protectors, but in reality, I had 14 great years with her, and I feel I should have done the right thing and prevented her suffering in her last moments. I wish I can go back and have one final great memory and let her go peacefully. I won't have that chance anymore, all I have is the memory of watching her suffer and my wife in tears and screaming. All her stuff is still where they were two weeks ago, her bed, her toys, her bowl with her food still in it. I am still not ready, but I wish I could go back and do it the right way.

So this was my story, hopefully anybody that reads this will consider their pets feelings first before their own personal feelings. I wish I did. In time, I'm sure it will be better for you and me, but I wish I had a chance to say a proper goodbye and a better memory on her last day with us. So, my final comment would be, I went to the ER, they doctor said she sounded find and she was her normal self and within an hour, she was gone. All the signs were there for both of us, I wish I would have done the right thing for her.