"When is it the right time?"

posted on Tuesday, April 11, 2017 in From the Mailbox of Dr. M

“What do I do, doc? He won’t eat, and looks so sad.” The dismay on the owner’s face was heartbreaking, as we both stared down the inevitable path before us. Just a short time prior, I had diagnosed Reno with advanced lymphoma. It came as a blow to the owner and me, as this was his lifelong companion, and his sidekick to get him through the days since his wife had passed, and me, well, I tend to get attached to my patients and clients, more than my heart can handle sometimes. When Reno was first diagnosed, we discussed all the options moving forward. We knew curing him wasn’t going to be an option, but we did know that keeping him comfortable was. So we started what is known as a palliative care plan. This involved medication to keep pain and inflammation at bay, appetite stimulants and special foods to encourage eating on days when Reno just wasn’t feeling it, and above all else, living each day filled with plenty of truck rides, treats, and love. We had the discussion that “this day,” would come- the one where medically I was out of magic, but also that Reno would be ready to cross the Rainbow Bridge.

Losing an animal is never easy. Having to make the decision to let your companion go can be even tougher. The decision to euthanize does not come without its fair share of heartache and a heavy conscience for most people. This is true for dogs, cats, horses, or our farm stock that held a special place in our lives. However, as difficult as the decision is to make, I often tell people you are doing the most loving and unselfish thing you can for your pet. You are showing them the love and affection they have brought you by letting them pass away with their grace and dignity intact. All too often, I am presented with animals that are skin and bones, who haven’t eaten a meal on their own for three weeks, or haven’t moved off of a certain spot without prodding or being carried for days. These animals are past the point of being comfortable, happy, or even close to healthy. Yet, the pain and sadness in their owner’s eyes tells me that the inability to bring the animal in sooner isn’t due to lack of care or love- but the opposite. The thought of life without their companion, was tougher to swallow than the pain of watching the animal exist in a shell of what they once were.

So how do I respond when I am asked, “When is the right time to euthanize my pet?” I tell people that unfortunately I don’t have the clean cut, perfect answer. Every case is different, but together we can formulate a care plan. When the time comes, we can work through the decision making process of euthanasia together. I recently attended a veterinary seminar on end of life care for animals. It may come as a surprise to many, but hospice and palliative care for animals is becoming more and more a huge component of companion animal care in veterinary medicine. Throughout this session, different care plans and comfort options were presented that can be discussed with owners who are in this tough position with their companion pet. I strongly encourage all owners to have this talk with their veterinarian and find out what to expect as a disease progresses in terms of signs, symptoms and concerns. Also ask how the euthanasia is performed, what to expect should you ask to be present during the procedure, and what plans you have for the animal for burial/cremation. Four of the common things I instruct pet owners to look for as euthanasia becomes an issue that must be addressed are:

1.       Lack of appetite/inability to eat

a.       We consider this red flag when the animal refuses to eat for more than two days in a row, and refuses foods that normally would have them eating readily. Inability to eat could be failure to physically complete the eating motion, or as a side effect of nausea etc

2.       Inability to sit up, stand, or move on their own

3.       Loss of control of bathroom functions

4.       Change in behavior/vocalization/responsiveness

As owners, I tell people that ultimately you know your pet better than anyone else. You know what makes them happy, you know what daily habits and routines they look forward to, and therefore despite the hurt, you know when it is time to let them go. Sometimes it just takes a gentle reminder and encouragement from a veterinarian to let you know you are not wrong in making the decision to let your pet go. I adamantly tell owners I will never judge your decision when you feel the time has come.

Through my patients and their owner’s, I get the opportunity to live so many lives, and experience more in a 30 minute office call than many people get to their entire life. Through stories and pictures, I find myself transported back to when the animal was young, and first brought into a family’s life, new tricks learned, or mischief achieved. I travel the path of their life and love right along with them. This is one of many reason I am blessed to be a veterinarian. Truthfully, euthanasia was a topic that was hard for me to swallow while growing up. My love for animals, whether it be my cattle, dogs, cats, or the abundance of 4 legged critters that have made their home with me, was so large that I couldn’t think about purposefully letting one go. This of course changed the more I was involved in the veterinary industry, and as I better came to understand and grasp the raw truth that death and dying happens to all living creatures, but that there can still be peace and beauty in alleviating and animal’s suffering.

For veterinarians and veterinary technicians, performing euthanasia is not just a routine procedure. Whether it is on the small animal side, or large animal side, it is a procedure that demands of us thought and emotion. We took an oath to uphold animal welfare and act on the best interests of the animal. Sometimes upholding that oath involves euthanasia and ending pain and suffering. Personally there is a piece of myself that stays with each animal I euthanize, and whether I knew that animal for years or hours, I look to learn something from their time in my care.  Here at AMVC, we take the topic of euthanasia seriously, and ensure that all are carried out according to humane industry standards.

The day I helped Reno leave this world for the next was sad. It hurt, but it also was a gift. Reno’s owner knows there will never be another Reno in his life, but he already knew that day, that when the time was right, there would be another spot in his heart and truck seat for another dog that needed him, and him that dog. From Reno’s case, I was reminded of the fact that the meaning of love extends so much further than a spoken four letter word.

The picture included with this article is one of my brother-in- law with my sister’s dog, and speaks for itself the undeniable bond between humans and our 4 legged companions.