Thursday, January 17, 2013

Deciding When to Say Good Bye

Euthanasia is something that most pet owners will face at some point in their lives. For many pets, their passing will be decided upon by their human caretaker. The time and date will be chosen in advance, not decided by “nature” or some higher power.       

Euthanasia is typically thought of as a choice between suffering and death and it can offer relief from pain that doesn't end. The level of pain is often used to assess whether an animal should be euthanized. Fortunately for many pets, palliative treatment is often exercised prior to euthanasia. Untreated or undertreated pain is epidemic among companion animals. Kevin Stafford, an authority on veterinary ethics, estimates that 10 million dogs in the United States suffer from osteoarthritis but that only a small fraction get treatment. The only treatment many arthritic dogs receive is euthanasia.
     
Why, then, are so many animals in pain? The reasons are largely cultural. Some veterinarians, particularly older ones, have been taught that animals don’t feel pain. To be sure, animal pain can be tricky to recognize and treat. Cats are notorious for their so-called stoicism, but dogs may not display pain in ways we easily see. As with humans, responses to pain vary. Effective pain management often requires trial and error with various types of drugs, as well as the use of non-drug therapies like weight management, controlled exercise, physical therapy, massage, acupuncture and nutritional supplements.
      
Quality-of-life assessments have been used within human end-of-life care. But this does not routinely exist in the veterinary profession. As it should in every veterinary hospital, we insist on quality of life assessments which include a discussion about lifestyle, behavior, and a thorough physical examination. Some of the things assessed include hurt, hunger, hydration, hygiene, happiness, and mobility.
 
One of the most troublesome moral challenges involves money. We could say that money shouldn’t matter when an animal’s life is in the balance, but this is neither realistic nor fair to pet owners. Beyond necessary pet care, every pet owner has the right to decide what they can afford and what they cannot. And most pet owners do not have pets just for the sake of having them. They truly care about their pets, incorporating them closely into their lives and often treating them as members of the family.   
 
Unfortunately, the love we feel for our animals can prolong their suffering. We may wait for our animal to “tell us they are ready,” but our love can make it hard to hear their cries. We may focus on caregiving, feeling vindicated when our pet shows interest in typical things like special treats. There is nothing wrong with this.
 
As your partner in pet health care, your veterinarian can help you decide when the time is right. No one but you and your family can make this choice. But having a resource, even attending a pet loss support group to prepare for that day, is something that will help with what many say is the one of most difiicult decisions you will have to make.
 
 

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