Our 14 year old male maltese has congestive heart failure. I came to this forum to see how others have dealt with the same issue. I've come to the right place. Our maltese is showing the same symptoms I have read here in this forum, coughing, hacking, sleeping allot, not as active. Sometimes he stands there as if in a daze, staring into nowhere. We call his name and it takes several calls before he turns his head in our direction. He is also showing symptoms of tremors, where his lower jaw shivers as if he were too cold, yet the temperature is a warm 75º (not sure how that relates). I want to know how you can tell he is in pain or is suffering. Right now I don't believe he is, there are times he will act like his old self and barks and jumps for joy when giving him a treat. Yes we are guilty of spoiling him with lots of love and over attention especially now when we know he is having some bad days. The medication helps but the vet told us that the medication will not be able to keep up with the disease...and eventually....well he left nothing to the imagination. How do you know when is the correct time to consider euthanizing...to do the humane thing, to not let your family member for 14 years suffer? When is the quality of life not worth living anymore? We have the opportunity to prepare ourselves for the eventuality, but are we going to be truly ready? I don't think so. When my wife made the decision to buy our maltese from a breeder when he was only 3 months old I try to warn her in a subtle way that there will come a time...since a dogs life is much shorter than our own. I then never thought about it since. We enjoyed (enjoy) having him around every day!