How do you know when it’s time?

Saying goodbye to a beloved member of our families is always incredibly difficult. Then add the fact that we, as pet parents, often have to be the ones to actually make the decision, and it can be excruciatingly challenging. 

Those who have been through it many times or who perhaps grew up on a farm, having had a lot more experience with life and death, often find it easier. 

Individuals who felt they waited too long in the past are also quicker to let a failing pet pass sooner than later, stating that “a week too soon is better than a day too late.” I agree. 

In most cases pets are so well cared for in our modern homes and with modern medicine, that they live well past when they would have in the wild. So, as long as a pet owner has, to the best of their ability and within reason for the wellbeing of the pet, exhausted any treatment options, we have an obligation to provide comfort, palliative care, and dignity to our aging or terminally ill pets. 

Sometimes the decision is a clear one. When a pet has terminal cancer and is obviously in extreme pain or refuses to eat or can no longer get up at all and is too big to be carried then most of my clients (pet parents) see that as a terribly painful but, obvious decision. For the sake of their beloved family member they must elect euthanasia. It is very rare anymore that a pet will pass in their sleep the way we all hope they will. 

Other times the decision is not so clear and for those patients I have a set of questions I will guide owners through. Here they are:

1. Can they breathe? 

Conditions like unmanageable congestive heart failure or lung cancer that dramatically reduce a pet’s ability to breath easily are a terrible way to die and I believe a painless euthanasia to be much more humane than allowing a dog or cat to struggle to breath. 

2. Can they eat? 

This one is harder. It’s very common for dogs and especially cats to refuse to eat when they are ill but, then go back to eating. Perhaps you have been through this many time with your pet? How is one to know that this is the time they will never eat again? I will give them one week. If they show no signs of improvement and you are not able to force feed them or feed them through a feeding tube (when appropriate) then one week is the maximum. 

3. Can they walk?

Osteoarthritis and degenerative neurologic diseases are very common problems for older pets. These can result in partial or complete loss of ambulatory abilities. Sometimes this can be the only major issue the pet is having. In cases that a wheelchair is appropriate or feasible, I recommend considering it. Especially for small dogs it can work. For larger and older dogs it is best to maintain a level of dignity. By this I mean that I do not believe it is humane to allow a pet top lay in its own excrement. 

4. Are they in pain?

This is the question pet parents ask me most often. “Are they in pain?” and it is often quite difficult to say for sure. Some pets (often chihuahuas) make it very clear when they are in pain. Others, especially cats, are stoic and do not complain. Many Labradors would let you step right on their tail and not even flinch. This shows us they are not going to tell us if they are suffering that way. Other clinical signs you might see are panting, restlessness, trembling, limping, licking or chewing, reduced activity, and increased aggression toward other pets or even sometimes people. 

We all have pain from time to time and that is no reason to end life in and of itself. Post-operative pain, for example, has an expected reasonable end point. However, when pain can-not be controlled with medications and/or other treatments such as acupuncture then it might be time to say goodbye. None of us want our pets to suffer. 

5. Do they know who they are anymore?

Dogs and to a lesser degree cats do develop dementia. It is common for older pets to become blind and deaf. Some adjust incredibly well to these changes and for others these changes can reduce their ability to navigate their environment and cause anxiety. I always ask pet parents to evaluate quality of life from this perspective. Ask yourself if they enjoy being pet or around the people, they love the most. Do they greet you at the door or enjoy any of their old favorite activities like playing with a ball or cat napping in the sun? Do they know if they have urinated or defecated on themselves? If not, I believe we owe them the dignity of letting them go. Perhaps I feel this way because that is what I would want for myself, or my mother, or any beloved family member? 

No-one comes to this decision without much deliberation. It is never easy. I (or your family vet) am here to help. While we cannot and would never make the decision for you, we can guide you. I will be honest when I feel strongly that a pet is suffering.  I took an oath to protect my patients and therefore I am obligated to tell you in the case that nothing can be done other than euthanasia.

Although not always possible, it is helpful to have a diagnosis and use that knowledge along with this list of questions to guide our decisions. Rarely are these so cut and dry as to yes they can or no they can’t. When it is, the decision-making process is easier. Most often, however, it is a combination of reduced quality in several of the five areas. 

We always say that quality is more important than quantity. I believe dogs and cats especially deserve this quality life. They are little fur covered angels here giving us unconditional love day in and day out. If the day has come that you must consider euthanasia please consider them and not yourself. We owe them that much. 

Grieving will be expected for the family. There is a list of resources here on this site under Pet Loss. 

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