Rhea, I am so sorry you also had to make the decision to euthanize Sneaks. I am also a nurse and went through the same self doubt as you are now. My Gigi had severe osteoarthritis with spinal stenosis. She was also dealing with recurring mast cell tumors as well as a heart murmur.
Although Gigi had always slept on the bed right up next to me, she made the decision to sleep on the floor on a very soft pallet. Looking back, I think it was because if I changed positions during the night, it hurt her to move. We have three other dogs in the house who she used to romp and play. But towards the end, she stayed away from them and retreated once again to her pallet on the floor. I had hoped we found an appropriate medicine, but when I took her for a follow up to our trusted vet, he said - "Alicia, look at her face and her eyes. Look at how she carries herself with her head down. She is still in pain. We can't operate because she wouldn't make it due to her comorbidities. If it was my wife in your place and I had to help her make the decision, I am so sorry, but I would have to tell her it was time." Rhea, those words still haunt me today. Was I selfish and kept her too long? Did this really need to happen now? Are there clinical trials working on her specific situation? My list was agonizingly endless until I finally had to stop questioning myself and specifically the advice of our trusted vet and realize that there was nothing more that could make her comfortable. It's been almost three months now and I've reconciled that the right decision was made. Like you, I was concerned about her dignity, her quality of life and I didn't want her to be in pain. I miss everything about her horribly but I do believe that she is not really gone, she's waiting for us to play again. Rhea, it's clear you have an amazing heart - you provided and received love from a precious dog whose life would have been receiving care in a shelter and who also had special needs. You gave Sneakers a wonderful and extended life because of your kindness and caring. Be kind to yourself Rhea - I promise you Sneakers will always remember you just as you will always carry Sneakers in your heart.
My warmest regards, Carmen's and Gigi's mom - alicia