Thursday, March 4, 2010

When to Euthanize

This is a subject that is a part of every pet owner's life - how to handle a pet's last days.

My first dog I ever had to put to sleep was terminal with cancer. I asked my then Vet more than once, "How will I know when it's time?" and she always answered, "You'll just know". This was not at all helpful to me. When I did make the decision, I questioned myself right up to the emergency clinic.

I realize now that for me, this is normal. It is no small thing to end the life of a pet, even when you are doing it as a kindness to relieve suffering. Questioning my own judgment is not a bad thing.

Likewise, it is normal for me to look back and wonder if I made the decision at the right time. The only thing I refuse to dwell upon is "If I'd known then what I know now, the dog could have lived longer". I didn't know then what I know now just as I will (hopefully) know more in future. It's not fair to judge my past decisions on when to euthanize against a standard of knowledge I did not possess at the time. I won't beat myself up like that.

To get into some specifics, the dogs I've had to put to sleep have been Flatcoats. They have all been happy dogs who enjoy companionship but more than anything - food. I wish I could flatter myself by saying they valued my company more than life itself but that would be a lie. (Side note: I once took a nursing dam to the emergency Vet because she refused a meal. That's how much my Flatcoats have loved food. Turns out, she had mastitis.) So one factor that has been useful for me in deciding when to euthanize is whether the dog can be enticed to eat. When we reach the point that food is consistently refused, I know that dog is miserable.

I have never been of the mind to go for extensive treatment when a pet is terminal or simply old. Even if I won the lottery tomorrow, I don't think that would change. My pets are like most people's I would imagine - they don't like going to the Vet and definitely wouldn't like staying there for days. I can relate. I am a homebody and being at home gives me a sense of peacefulness and comfort. I think age increases the attachment to home and routines. I've been able to keep my pets at home until the final Vet visit was needed. I tend to think that would be their choice too, if they could be The Decider.

This is in no way meant to disparage owners who choose extraordinary measures and hospitalizations. Nor do I look down upon those who opt for a natural death, allowing the pet to starve himself or whatever the circumstances may be. We must each make the decision that is right for our situation and with our pet's best interests in mind. Aside from something extreme (e.g. a pet who has been badly mangled by a car and the Vet gives little hope for survival even if the owner opts for heroic measures), I don't think there are "wrong" end of life decisions for ailing pets. The best we can do is the best we can do.

One of the many things I've learned from my pets is to live in, and cherish, the moment. For me it's question=yes, regret=no.

What has been helpful to you in deciding when the time is right to euthanize a pet?


Anonymous said...

I know that for me I never felt comfortable with a discussion to euthanize. I will always second guess those decisions. I think part of that comes from my own feelings about medical issues. Most people today would say if they were paralyzed or in a vegetative state they would not wish to be kept alive. I, however, would wish all measures to be taken. I also would wish to live with a terminal disease rather than opting for suicide as some people would (easy to say now when I am somewhat young and healthy, of course). It is, in effect, the opposite of your own feelings. But where you perhaps feel comfortable assuming your pets would wish the same, I do not. I would take extraordinary measures to keep an animal alive if there is a reasonable possibility of a comfortable recovery or life (and my defination of comfortable recovery or life is probably quite different from your own). If I feel they are in intractable pain or recovery was unlikely, I will euthanize despite my own feelings that it is not what I would wish for myself. There is no way for me to explain or justify that conflict. My own measurement (and what I used to tell owners as a vet tech) is that when your pet is having more bad days then good, it might be time. Never "it is time"- just that you might wish to consider it. I believe as you do that there is no wrong decision to be made on this issue, since we can never know for sure what the pet would prefer.

That said, I have seen situations were an animal was kept alive past the threshold for what a reasonable person would consider abuse. The example that haunts me still is a dog with a basketball sized tumor in his lower jaw that had dislocated the joint of the jaw and rotted the bones. If they have removed the tumor when it was small the dog would have lost half his lower jaw but survived quite happily. Instead they opted to do nothing. It was quite simply horrifying, but Animal Control could do nothing since technically they were seeking veterinary care. So I think there are some rare situations were I am deeply uncomfortable with the choices of the pet owner.

redvelvetfemme said...

my daddy grew up on a farm and, to this day, knows more about animals and animal behavior than anyone i know. my english setter was 13 before she got sick, and it came very fast. one day, while she was sunning herself as she liked to do in a confined spot, she managed to get out and wander off. i came outside and she was gone and i freaked. i found her circling in a neighbor's yard down the street. i called my daddy and he told me she was going off and looking for a place to die because it was her time.

hearing him say that was the push i needed to see that it was time. she wasn't eating much at all, she couldn't go up or down stairs anymore, and she was so frail. it broke my heart, and it makes me weepy to write this. it's always a horrible choice, and no matter how long they live, you never have enough time with them. you're right, we just have to do the best we can do.

Dog Foster Mom said...

A few days ago I had to euthanize a previous foster dog. It was plain to see that she was suffering, and there was no cure or even treatment to make her more comfortable. She was unable to swallow food and if we did not euthanize her, she would have just starved to death. Due to a degenerative disease, there weren't any other options. She was so hungry and in obvious distress, that I believe it was the right thing for her. But it is never an easy decision.

Pai said...

My first two dogs both died of cancers (Osteosarcoma and Lymphoma). I really can't stand to go through such things again, to be honest I would rather euthanize than prolong the life of a dog. I've seen what 'holding on' for too long can do.

Barb said...

I think that I am more willing to euthanize my pets earlier nowadays than I used to be. Not that I'm ever in a rush to do it, nor is it ever anything other than a completely awful and heartbreaking thing. But looking back, I think that I waited too long with most of the pets that I've had to let go over the years. Not to the point of abuse, but to the point where they were probably constantly miserable.
I agree that we shouldn't beat ourselves up for decisions made in the past. I've always done what I truly thought best for my animals.
But as I get older myself, it may be that quality of life issues become more important. Life is always precious... but a life lived in pain is a terrible thing.
As to deciding "when", I watch 2 or 3 things that the pet has always enjoyed doing. Eating, going for a walk, going for a ride in the car, snuggling on the couch, barking at the neighbors - whatever. When those things have mostly disappeared then it is usually time. I no longer wait for them to all disappear completely - especially eating. A dog who has always had a great appetite has to be in dire distress before they quit eating.

Rob said...

With our last two, it was very obvious. The boy, Foley, had a nasal sarcoma that eventually started pressuring his brain. He lost his sight and then his sense of smell. When he started wandering aimlessly without settling, there was no relieving the pain he was obviously in.

With Hannah, after surgery, radiation, and chemo for the vaginal tumor, she was great for about two years afterwards. One night, we went on a walk, and as she often did, she would turn at a corner and point: "Wanna keep going."

"No, Hannah, we're going home."

We awoke the next morning to the rhythmic sound of her seizures in the guest bedroom, paws uncontrollably scraping the carpet. Her tumors were breaking up and entering her brain.

And that was all.

Rob said...

Also, I agree with Pai. It's not clear that extending their lives was doing them any favors, especially considering the focus of veterinary oncology. They are primarily about adding quality of life to the remaining time the dog will have as a consequence of treatment, which I like; but of course there are no guarantees that treatment will "work", for some definition of that word. I'm not saying I regret what we did, but I would think harder about proceeding, and the consequences thereof. (Carboplatin is a platinum-based drug, and priced accordingly.)