I think that you will know when your dog’s quality of life is bad enough to warrant your putting him down. It sounds like you love your dog and you know him, so you will know. Trust your instincts and you will know.

If you can’t afford tieback surgery, maybe you can afford an alternate procedure, sometimes debark buys the dog some time and allows freer breathing for at least a while (not sure about the time frame). I know diabetics have special issues so you should probably have a frank discussion with your vet. There is a Yahoo Group called LPAlternatives that you can join and folks there have had this alternative procedure done on their dogs and they can help you. To my understanding it’s less than $200-300 to have that done, versus $2000 for the tieback. Again, I have NO personal experience with this but I know of others who have so it might be worth discussing with them.

When the time comes for your dog to be put down, ask the vet for a sedative for him first. The vet might say he doesn’t need it but it’s a very peaceful way for them to go. The sedative is injected and your dog falls to sleep (real sleep), then when he’s relaxed and sleeping, they give the “overdose” shot that ends their life.

Good luck to you, both with your own health issues and Max’s. Remember that whatever decision you make for your dog will be the right one, when made out of love for him.