A: This is one of the most difficult questions that veterinarians face on a daily basis. The answer has a little bit to do with medical judgement, but much more to do with value judgements. When a pet is in uncontrollable pain, I believe veterinarians have the responsibility to speak up and advocate for euthanasia. However, most of the time we are not dealing with such a clear case. More often than not, we are having discussions about when to intervene for a gradually declining pet, how much diagnostics or treatments are fair to the patient, or how much her owners can afford to provide.
I like to tell people that there are three sets of clients out there. One set does not or can not provide the level of veterinary interventions that I provide for my pets. The absolute smallest set provides exactly the level of medical care that I provide for my pets. The other set does more for their pets than I ever would for mine. I genuinely hope that my clients never know which set they are in. My job is not to pass judgement on their situations, their values, or their relationships with their pets. My job is to provide information and expertise. In most ways, I have the easier side of the exam table.
When asked, I am happy to also provide some philosophical commentary based on my two decades of practice experience. These are particularly suited for situations when an aging or sick pet is experiencing a gradual reduction in quality of life.
The first observation is that euthanasia is hard on people, not on pets. In most modern practices, veterinarians use an anesthetic injection to heavily sedate pets before overdosing them on a powerful anesthetic. That means the euthanasia visit is very similar to a dental cleaning visit in the eyes of my patients. They have an injection and gradually drift off to sleep. Of course, instead of cleaning their teeth and waking them up, the final visit will not include the waking up phase. However, speaking from my patients’ point of view, it is a very peaceful process.
Secondly, I am convinced that pets do not understand time in the way that we do. A dog would never think, “I just want to hang in there until Christmas.” A cat would never say, “twelve-years-old is too young to die.” They do not understand if their life comes to an end on February 24th, or March 12th, or April 30th. What they do know is how much they are loved. They rely on us to make life and death decisions based on our love for them, not based on how much time they could have left.
Third, in my two decades of practice, I cannot think of a single individual who comes in a year later and says, “I wish I had not made the decision so soon. I wish I had just waited one more week.” However, I could give you a very long list of people who say, “why did I wait that extra week?” I understand how hard it is to make the decision to say goodbye to a very special friend. I have been on that side of the exam table with my own pets. Yet, all too frequently pet families end up regretting waiting until there was some terrible crisis that forced them to rush to an emergency clinic in the middle of the night because their pet was in excruciating pain or experiencing some severely distressing event. Afterwards, there is universal regret for waiting too long.
The list of reasons to hold on is long. “Well, he’s not in excruciating pain.” “She’s still eating.” “She still greets me when I come home.” When a pet is clearly on a down hill journey where there are no “ups,” I have to ask the tough questions. “Do you want him to be in excruciating pain?” “Do you want her to be so miserable that she will not eat or so confused that she does not even recognize her family?” Of course, the answer is always a negative. However, if we wait until these things happen, we are condemning our pets to experience them. Therefore, I counsel pet owners to define what an unacceptable quality of life looks like to them, and then make the difficult decision to say goodbye to their pets before that point.
If your pet is starting to experience a decline in quality of life, please make an appointment to discuss it with your family veterinarian. Do not wait until there is an obvious problem to have the discussion. With advance preparation and open communication with your veterinarian, you can help to ensure the most peaceful end possible for your beloved companion.