Making End of Life Decisions

The District Vet

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This January’s commentary is sad, but very worth having. As in all of life, there is death. It is part of the process and it is inevitable. Through life we find happiness, through death we find sadness, closure, and once again, happiness — or at least fond memories. Our pets lead much shorter lives than us –therefore their aging and their passing is inevitable. Finding the comfort to say goodbye to a friend when the time is appropriate for the pet is as important as welcoming the pet into the family on the very first day.

This is a first person discussion–journalism out the window. I want you to know that we veterinarians have many roles, but our duty is to be the advocate for your pet. This is part of our oath, to “do no harm.” Our opinions are honest and based upon what we see, medically and even a bit metaphysically. As vets, we have seen many of your now elder dog or cat since the joyous first days of puppyhood and kittenhood. We have watched them grow, learn and develop into a sentient being with feelings, emotions, and quirks. We have played on the floor with them. Tossed treats and snuggled at many visits. Together we have done all in our power to assure that they have a medically healthy life and to be certain that you have the tools to be the best pet parent possible. Through illness, health, old age, we are there. For me, it is not a doctor-patient relationship: you and your pets become friends and family.

And I lose a lot of friends.

And it makes me sad.

But herein lies the best part of our job: we know you, we know your friend, and we are here to help you through a very difficult time. As a friend. As an advocate.

As part of the care of your pet, we at some point will usually have the discussion as to when it is time for you and your pet to part ways. It is a very deeply emotional time, one where assessing the condition and quality of life can be difficult due to pet owner’s emotional attachment, feelings of love, sadness, and loss of companionship.

We first discuss the medical status of your pet. Is there a chronic disease present, or do we have an aggressive cancer? Medicine has come a long way in the past decade, but we cannot cure all. Some cancers are aggressive and we know that there is only a limited amount of time before they make the pet uncomfortable. Renal failure can be controlled for some time, but will lead to weight loss, poor appetite and decreased activity. Knowing the projected timeline of a disease can help you prepare for the next step.

Consider if the medical condition is causing discomfort or pain. Some tumors may be pressing on areas, leading to decreased appetite or loss of range of motion. Arthritis may become severe, limiting mobility, causing pain and a decreased quality of life. Many chronic illnesses will over time result in a progressive loss of appetite. If appetite stimulants are not helping, quality of life is certainly a topic to discuss.

Judging quality of life is difficult for anyone. I ask the pet owner: is your cat being a cat? Is she grooming, eating well, using the litter box, interacting with you, or appear to be old, but enjoying life? Is your dog able to rise on his own, has a decent appetite, seeking attention, acting like a dog? After reflection, most people find their comfort in answering the question: is my pet happy? If yes, we continue to do all we can to keep him or her happy. If not, is there anything within reason we can do, and if not, time has grown short. And we will honestly answer your questions and tell you our feelings.

We must remember that a dog is a dog and a cat is a cat. There are decisions that they cannot make for themselves. Yes, all pets will pass away on their own, but usually after much discomfort, and this is where we –you and me– come to a compassionate decision. An easy one? No, but listen to your pet and talk with his / her advocate: their veterinarian. We will help guide you through a difficult time. When you join our practice, you become family.

 

Dan Teich, DVM, is the Medical Director of the District Veterinary Hospitals at Eastern Market and Brookland.