I'm trying to decide what to do with my 10 year old chocolate lab, Max. He is a blind diabetic. His diabetes is under control now with two insulin shots a day. A few months ago he a bad bout of pancreatitis which set off a horrible case of ketoacidosis. He was in intensive care for days. Thousands of dollars latter he is now better.

Though not related to Max's recent medical emergency, his voice started to go. He sounds hoarse and the poor soul can no longer howl at the sound of a siren. The vet suspected nerve damage in his throat from diabetes. Over the summer things progressed from bad to worse. Now he has severe retching when he wakes, day or night. He often spits up during these long gagging/retching episodes. His breathing is always loud but his oral colour stays a nice shade of pink. He has only choked once while eating.

I have not had a diagnosis of LP confirmed buy I very sure this is the problem. I'm not sure what to do. I'm on a pension and cannot afford another large hospital or surgery bill. I'm just getting over the last three thousand dollar (plus) bill from his diabetes episode mentioned above. I don't mean to sound whiny but the hundred dollar a month cost of insulin, syringes plus fairly often fructosamine testing is a little steep. Tie back surgery for LP is not an option for me. My budget can't handle it and I'm not sure if my dog is even a good candidate for surgery. (Diabetics have bad veins.)

I know I'll have to put this dog down but I don't know when.

That's the question. What do I do and when do I do it?

I live by myself. If Max stops breathing there is nothing I will be able to do. I can't lift him. He is a very large dog (106 lbs.). Because I have COPD, I won't be able to give him first aid and/or resuscitation. Heck, I can't breath for myself let alone anybody else. I know how terrifying it is not being able to breathe. I don't want my dog to suffer that.

Thoughts?