This Just In…..

I have been in practice for over 25 years and one of the most frequent and heartbreaking questions I am asked is, “When will I know it is time, Doc?” This is a tough and serious question because once the act of compassionate euthanasia is carried out, there is no turning back. This question can result in a permanent answer.

There are 7 main points I think warrant your consideration.

1. Take your pet in for an examination/testing by your veterinarian.

Benefits of an exam:

a. You may discover your pet is healthier than you think

b. Additional testing will provide more information for both you and your veterinairan to help make this life or death decision.

c. There may be medications that can improve the quality of life, if not the quantity of life for your pet.

d. You can feel more confident about whatever decision you make.

2. Consider your lifestyle.

Nursing care can be emotionally and time consuming.

a. Do you have a consistent daily schedule? How much do you travel?

b. Are you comfortable administering medications?

c. Do you have help if you have physical limitations yourself?

3. How much will this cost?

Consider all the costs.

a. Some medications are inexpensive, while others are more costly. Ask about generic medications or using a “human” pharmacy to help with costs.

b. Some diseases require regulation once medication has been started. Ask about recheck visits, follow-up tests and potential problems that can arise, either from medication expense or progression of the disease.

4. Consider the quality of life for the pet.

There are 4 basic behaviors a pet performs that signify enjoyment in life.

a. Does your pet have a reasonably good appetite and enjoy eating?

b. Is there a normal amount of water being consumed?

c. Is your pet able to make it out side or to the litter box to eliminate normally?

d. Can your pet rest comfortably?

5. Have a family meeting.

a. make sure all concerned individuals are present. Use conference calls, skype or special meeting to make sure all voices that want to be heard are heard.

b. decide what suffering “looks like” to your family. Sometimes disagreements occur between family members regarding how much their family, and/or their pet is suffering. Talking this through is helpful. (See #4 above for suggestions)

c. Schedule a consultation with your vet if consensus can be made.

6. Ask about options/details regarding the actual euthanasia procedure.

a. Don’t be present: Some people do not wish to be present during the process as they would prefer a living memory as their final memory of their pet. This is totally understandable. We all have different experiences with death.

b. Be present: Some of us want to be present and hold or comfort our pets to say goodbye and if this is at all possible, your vet should help facilitate this for you.

c. Not present, but return to say goodbye: Some of us don’t want to be present for the actual procedure, but would like to come in once our pets have passed and are at peace, to say goodbye. Closure is important.

d. Come into the clinic: some folks want to bring their pets in the clinic so that they don’t have the memory of saying good bye in their home.

e. Home euthanasia: some pet owners want the vet to come into the home to decrease possible stress or because there are physical limitations in getting the pet to the clinic.

Talk to your veterinarian about your feelings, so this final step can go as smoothly as possible for all concerned.

7. Its ok to change your mind.

a. If you have scheduled an appointment, never hesitate to cancel it.

b. Monitor good days vs bad days on your calendar.

Sometimes subjective evaluation regarding how your pet feels can blur over time. I recommend marking the good days on the calendar with a star or the bad days with an “x”. This takes the responsibility away from our memories and creates a more objective evaluation.

c. Your vet may tell you “today is not the day”.

Sometimes your judgment can get clouded with fear or anxiety and you may misinterpret what is happening. This is fine. Do not feel badly. It gives you extra time with your pet that you may not have thought you had.

One of the worst things that could happen would be to euthanize your pet when you aren’t ready. It will leave you with guilt and remorse that no one can fix. Take your time and talk to your vet as you work your way toward acceptance of having to say goodbye. I promise you, if you follow the above steps, while the decision to euthanize your pet will never be easy, it will be easier. This video clip from a news interview highlights that you don’t have to grieve alone either.

http://www.wowt.com/home/headlines/Grieving-The-Loss-Of-A-Pet-353245291.html

After reading this, please remember, just as you are an individual with a history and set of experiences that shape your opinions, I am no different. These are my opinions and may or may not ring true for you.

To help illustrate the recommendations, I will detail them in the story of Miss Daisy.

Daisy was a 12 year old Springer Spaniel that was adopted by a lovely family. Debbie, Perry and their son, Eric, provided Daisy with wonderful health care and much love. However, one day Daisy came into the clinic with a small tumor on her rear leg. By aspirating the tumor and looking at the cells under a microscope, I discovered she had a malignant tumor called a mast cell tumor. These tumors can occur anywhere in the body and can be easily removed OR invade tissues within the body and be fatal. Unfortunately, Daisy had the latter condition.

Daisy was lucky to have pet parents that had the financial means to investigate her disease thoroughly. I examined Daisy, obtained biopsies, ran blood work and performed an ultrasound. The costs for diagnosis, while expensive, revealed an inoperable malignant cancer.
However, the blood work told me that Daisy’s body could handle medications to help her maintain a good quality of life and possibly slow the progression of her disease.

One of the medications Daisy took made her drink more water and urinate more. Perry worked from home and could let Daisy outside to urinate frequently to avoid accidents in the home.

As Daisy continued to decline, a date was set for me to go to the home to put Daisy to sleep, but upon arrival, it was soon discovered that not everyone was ready to say goodbye. As this is a difficult decision, my technician and I sat with the family and listened.

Eric, the son, wasn’t home as much, so what he saw upon coming home from work was a happy, energetic Daisy, that greeted him at the door, wagging her tail and begging for a treat.

What Debbie saw was an old friend who paced and panted almost all night and would only stop to lick her belly where one of the tumors was growing. Debbie tried having Daisy wear a special collar to prevent licking, but then Daisy would spend the night fighting to get the collar off. Debbie was becoming exhausted.

Perry saw a dog that slept fitfully throughout the day, but that drank water and had to go outside to the bathroom continually. It was becoming more and more difficult for Perry to work from home.

Their perspectives were all very real images of Daisy, but each person needed to explain what they were seeing and how they felt to arrive at a family decision.

What I was able to do for this family was to show Eric the tumor that Daisy was licking, talk to him about how quickly it was growing, clarify his mom’s concerns regarding Daisy’s discomfort at night and explain that his parents no longer saw Daisy purely enjoying life. They could see how her disease was affecting her, and their lives as well.

For Daisy, it was decided that truly, her quality of life was deteriorating. Because we knew the type of tumor Daisy had, I could offer this insight: Daisy’s tumor could result in a very painful end, I advised Debbie, Perry and Eric to let Daisy end on a “high note”, meaning that while Daisy doesn’t feel great, she isn’t suffering either. Daisy’s tumors, once they ruptured, would cause her excruciating pain. I knew this would break this family’s hearts and their ultimate goal was to prevent her from suffering. This was one of those times when I felt it was better for all concerned to say goodbye sooner than later. Joining them all in their home, I helped Daisy to pass away surrounded by her family loving, petting and soothing her.