“How will I know when it’s time to put my pet to sleep?” This is a question every veterinary practitioner hears frequently, as veterinarians are truly the only health care professionals who see their patients from “cradle” to “grave” anymore.
Making the Decision
One of my clients made her decision to put her dog to sleep in the best words I have ever heard. She told me, tearfully, her dog had “lost his happy.”
Putting a pet to sleep is one of the most difficult decisions a pet owner will ever have to make. Unfortunately, it’s also a decision many owners want the veterinarian to make for them. While I can give my opinion on the animal’s quality of life and possible treatment options which may make it more comfortable, ultimately, this decision is one the owner must make.
From a professional standpoint, I can look for signs such as:
- Does the dog (cat, bird, hamster, etc.) still have a good appetite?
- Does it continue to recognize and interact with family members?
- Is it in pain?
- Does it has bowel and bladder control?
- Is it still ambulatory?
- Does it have a particular ongoing disorder, such as congestive heart failure or diabetes?
If the dog has a chronic condition, is it controllable, or is it a non-treatable illness? Is the owner just wanting to prolong the pet’s life? If, so, for whose sake—the owner’s or the dog’s?
A righteous man cares about his animal’s health, but even the merciful acts of the wicked are cruel. Proverbs 12:10
Sometimes, there really are no major quality of life issues and the owner tells me the dog is just old. To them I reply, “Old age is not a disease.” There is an excellent chart available for helping owners determine their pet’s quality of life at www.veterinarypartner.com. Finally, the financial cost of prolonging a pet’s life must be considered. It may be impractical to spend a lot of money on heroic measures when the prognosis is poor.
I often tell my clients, “You know your dog better than anyone. You are the one who lives with your dog every day. You are the best judge of when the time to let it go has come. You also have to be at peace with your decision in your own heart.”
One of my clients made her decision to put her dog to sleep in the best words I have ever heard. She told me, tearfully, her dog had “lost his happy.” This is probably the saddest thing to happen to a cherished pet—to lose its “happy.” When a pet’s quality of life is no longer “happy,” a humanely performed euthanasia is an owner’s last act of love he or she can give for a beloved pet.
Euthanasia
Whether an owner wants to be with his or her pet during euthanasia is a personal choice. Some people prefer for the veterinarian to come to their home, where the pet is more comfortable, rather than stressing the animal by taking it to the veterinarian’s office. A home euthanasia can be a special time of saying goodbye. The actual process is generally quick and painless. Some owners prefer not to be present, and that is okay, too. Something what works for many people who don’t want to be present for the actual euthanasia is to stay with the pet until it is sedated, and then leave before the euthanasia solution is injected into the vein.
Passing at Home
I am sometimes asked about letting the dog pass naturally at home. Unfortunately, it is pretty uncommon for dogs to pass peacefully at home without some sort of intervention. Usually if a dog is sick enough to die at home, it is suffering, and the dying process is seldom a short, easy one for either pet or owner. The last thing most owners want is for their pet to suffer. Watching an animal struggle to breathe with end-stage congestive heart failure or waste away with untreatable cancer is distressing, to say the least.
Hospice for Pets
There are veterinarians who specialize in hospice care, similar to the care provided for terminal human patients in the comfort of their own homes. According to the IAAHPC (International Association for Animal Hospice and Palliative Care), this program addresses the physical, emotional, and social needs of animals in the advanced stages of a progressive, life-limiting illness or disability. It is provided to the patient at the time of terminal diagnosis through the death of the animal, inclusive of death by euthanasia or by hospice-assisted or supported natural death. It addresses human mental health—the psychological, emotional, social, and spiritual needs of the human caregivers in preparation for the death of the animal and subsequent grief. It is provided by a multi-disciplinary healthcare team under the supervision of a licensed veterinarian. (1)
Life with a terminal illness can still be meaningful. Hospice can prolong the pet’s life while ensuring certain needs are met, such as hydration, nutrition, mobility, and alleviating pain. Owners can learn to administer subcutaneous fluids (fluids given under the skin) at home. Proper hydration is imperative for the body to function optimally, and decreases further deterioration due to poor transport of nutrients and elimination of waste toxins. It also helps the pet to feel better by decreasing lethargy, constipation, and headaches, and improving appetite.
Nutrition for Sick Pets
Nutrition is essential to maintain adequate cell metabolism. There are a number of prescription appetite stimulants available, such as Entyce, mirtazapine, cyproheptadine, and diazepam. Sometimes simply heating up the food or placing a small amount in the pet’s mouth will jump-start the appetite. Baby food meats, such as strained chicken, turkey, or beef are often palatable to sick animals. Extra calories can be added with supplements such as Nutrical or veterinary liquid diet supplements. Nausea can be a common cause in inappetence in sick animals, whether or not they are actually vomiting. Providing anti-nausea medication and stomach protectants is often helpful to counteract a poor appetite. Feeding tubes may also be placed surgically to allow owners to feed a liquid diet at home.
Mobility for Aging Pets
Mobility often declines in older pets. Problems with mobility can cause secondary problems such as house-soiling, snapping at people due to pain, or hiding. Providing warm, soft bedding, ramps or steps for getting onto furniture, toe grips, and pain control can help tremendously for pets who have trouble getting up and down, jumping, or even walking. Fortunately, today we have more pain relieving options than ever. Pharmaceuticals, such as non-steroidal anti-inflammatory drugs, joint supplements, opioids, anti-anxiety medications, and muscle relaxants are readily available from your veterinarian. Other alternative treatments for pain include acupuncture and laser therapy.
Cremation and Burial
Once that time has come, whether by euthanasia or natural death, the next question is what to do with the pet’s body. Body care is also a personal choice. Most veterinarians and humane societies offer cremation services. Cremation can be done communally (several bodies together) or privately, in which the ashes of the pet are returned to the owner in a decorative urn. If choosing to bury a pet at home, check city and county ordinances. In many places it is illegal. There are also some areas which have pet cemeteries.
For many people, losing a pet is as painful as losing a person, yet some owners feel as if they are being irrational or silly to grieve for an animal. Be assured your feelings are valid and you are not alone. There are a number of pet loss support websites, such as www.petloss.com and www.rainbowbridge.com.
The Heartache is Real
Putting a pet to sleep is never easy, but the reality is, for most of us, we will outlive our pets and have to face this decision at some point. The heartache is real, but the years of unconditional love and joy our pets bring us make the difficult goodbyes less painful.
IAAHPC – 2016 AAHA/IAAHPC End-of-Life Care Guidelines* Gail Bishop, BS, Kathleen Cooney, DVM, Shea Cox, DVM, Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CCRP, Kathy Mitchener, DVM, Amir Shanan, DVM, Nancy Soares, VMD, Brenda Stevens, DVM, DABVP (canine/feline)§, Tammy Wynn, MHA, LISW, RVT