None of us like to think about the passing of our pets, but the fact is if you have a pet then eventually you will have to go through the process of caring for them during the final days of their lives and in most cases assisting them to pass peacefully. All pets will eventually succumb to an illness of some sort – cancer, renal failure and heart failure are the most common but other factors such as severe arthritis and progressive neuropathies can have significant effects on a pet’s quality of life.
It is important to remember that age in and of itself is not a disease. When a pet contracts a condition that leads to weight loss and a general deterioration in condition there is an underlying disease process that is responsible. It is true that the older a pet is, the more likelihood there is for such a process because there has been a lifetime of acquired exposures to environmental toxins and stresses on the body that can damage organs and lead to random mutations in the DNA that lead to cancer. It is also true that if we know what that disease process is we can often manage the condition in such a way that can lengthen a pet’s life or alleviate symptoms to provide a better quality of life. That being said, the best medicine in the world cannot make pets live forever. We will always eventually have to provide supportive care and management for the final stages of any disease process.
Palliative Care
Essentially, palliative care is any treatment that will allow the pet to function at a level that will maintain a good quality of life but ultimately will not cure the underlying disease. That means that eventually the treatment will fail as the disease progresses beyond a certain point where the symptoms can no longer be masked or controlled. When this leads to a loss in the quality of life for a pet, then euthanasia is a consideration.
Most people tend to associate palliative care with pain control, but the treatment of other symptoms such as nausea, fluid retention and dietary intolerances may be considered palliative as well. As veterinarians we are trained and experienced in recognizing what factors play a role in the well-being of a pet with numerous conditions as well as palliative care options that would be appropriate. In all cases, however, the pet owners make the final decision based on what they and their pet are comfortable with and able to do.
Quality of Life
When we talk about “quality of life” we are talking about both physical condition and attitude. The two are closely related, but often when we are having end of life discussions it is the pet’s attitude that becomes more important. We can help our pets both by alleviating or treating the causes if possible, or masking the effects with pain control or other supportive treatment. Your assessment of your pet’s attitude is personal and although others may have different opinions, it is your assessment that is most important. You know your pet better than anyone else, but it can be difficult during the end stages of a pet’s life to make a firm assessment because there are so many factors.
In general, if your pet still performs most of the actions he or she enjoys (e.g. eating, sniffing, play, affection) then quality of life would be considered acceptable. As there is a reduction in these activities there comes a point when quality of life is considered poor and euthanasia becomes a consideration if there is no way to alleviate the condition. When that point comes will be different for different people and that is normal.
For a family with a pet that can be difficult, but as long as everyone tries to empathize then the appropriate decision will be made. That works both ways: those who are ready to euthanize need acknowledge why one family member may not be ready and feels it is too soon, while those who are not ready need to acknowledge how stressful this can be on the other family members if they feel the pet is suffering.
Euthanasia
Euthanasia is often referred to as putting your pet to sleep or putting your pet down and is performed when an owner feels their pet with an incurable condition has deteriorated and has a poor quality of life. The purpose of euthanasia is to allow the pet to pass away peacefully without any pain or suffering.
We perform euthanasia by the administration of a drug (Pentobarbital Sodium) that first renders the patient unconscious, then brings the breathing and heart to a stop as the dose is increased. Pentobarbital Sodium must be administered intravenously, and is often done with an IV catheter in place to make the process easier for the patient. Once the drug has been administered, the veterinarian will assess consciousness, then breathing and heart contractions. Only when these vital signs are absent will the veterinarian consider the patient as passed. The process is usually quite peaceful and often takes less than 60 seconds from the time of administration of the drug to the time the patient has passed.
All veterinarians perform the procedure in a similar manner, but there will be minor variations depending on the veterinarian’s preference and the pet. It is up to the owner if they wish to be present at the time of passing. There is no right or wrong decision in this, either is perfectly acceptable. Our clinic has a bereavement room for this purpose and owners can spend as much time as needed with their pet before and after the euthanasia.
If you have any questions regarding the process, including the handling of remains after the euthanasia (e.g. cremation), you may discuss them with the veterinarian and clinic staff at any time.
By Dr. Thompson