As a Veterinary Technician, I witnessed life and death struggles every day. In veterinary practice, there were always those patients that surprised you – the ones you thought were never going to make it who ended up pulling through, while others died from relatively minor traumas or obscure complications during routine anesthesia.
Perhaps the most difficult struggles to watch were the clients agonizing over making end-of-life decisions for their pets. I can’t tell you how many times I was asked the questions – Am I giving up too soon? How do I know for sure? What would you do if it was your dog/your cat?
As a Technician, over time you develop a kind of sixth sense, an ability to quickly assess a patient and identify a gut feeling for what you think is going to happen – whether that patient will pull through or lose the battle.
But when it’s your own pet? Now that’s a whole other animal entirely.
An Unthinkable Prospect
What exactly is it that we dread most about euthanasia? Why is it so devastating to lose a pet?
The companionship of a pet is unlike any other relationship we have. Every emotion a pet has – joy, fear, anger, sorrow, impatience, or contentment – is pure. It’s experienced in that one unique moment, and then it’s let go to make way for the next one. What you see is what you get. There are no grudges, no passive-aggressive paybacks, no waiting for the perfect moment to throw something back in your face. It’s uncomplicated – our pets feel things in the moment and move on. They won’t take the keys to your car and lie about it afterwards, blame something they did on an unsuspecting sibling, or throw a temper tantrum and plot how to make your life miserable if they don’t get their way.
When they grow up, they won’t stay away for years and never visit. They are loyal companions in the truest sense of the word, for life. They don’t care if we’ve been sick and haven’t showered in days, won’t hold a grudge when we lose our temper. They don’t judge us for gaining a few pounds, for not getting that promotion at work, for making a bad decision that leads to losing half our stock portfolio. They think we are the greatest thing in the world, every day, without fail. They accept us for exactly who we are, and that love and acceptance is unlike anything else on the planet.
So when it’s time to face the prospect of losing that relationship, it’s no wonder our perspective becomes clouded.
Knowing When It’s Time
Terminally ill people know when it’s time to let go. Our pets do, too.
But what makes it so hard is that every pet, and every situation, is different. Some animals are fighters, while others give up more quickly. There’s a common saying that “Your pet will tell you when it’s time.” However, I’m not sure I entirely agree with that philosophy. It’s our responsibility to know our pets well enough to read the signs and make the decision that is kindest and most humane for them. And our ability to read those signs, to make one of the hardest decisions we will ever have to make, will always be clouded by our own emotions, interpretations, denial, and most importantly, our love for them.
I’ve struggled mightily with this in my own life. As a Veterinary Technician, I could easily see what seemed obvious with my patients, but as a pet parent, I had to learn about letting go the hard way.
Emily was a beautiful, long-haired marmalade senior kitty that I adopted when her owner, one of our veterinary clients, had to move into a nursing home. I had only shared life with Emily for a little over a year when she was diagnosed with a brain tumor.
I naively thought I had time to come to terms with losing her. But this tumor had other ideas. It was nasty and aggressive, almost doubling in size in the space of a week. It was a Friday, and all I wanted to do was take Emily home for the weekend to say goodbye. I just wanted a little more time with her before she was gone.
We placed a catheter in her front leg, and I took her home. It was early fall in Ohio, and the weather was warm. We spent hours outside in the yard, Emily laying in the grass in the warm sun while I mostly watched her and cried. She continued to eat, licking baby food off my fingers, but mostly she just slept. I took several pictures of her, the last ones I knew I would ever take.
On Sunday, my boss, a wonderful, caring veterinarian, came to the house and together we let Emily go. It was months before I could bring myself to look at the pictures I had taken. But when I finally did, I was cut to the heart by how much pain she appeared to be in in those photos. I just hadn’t seen it. I’d convinced myself that a little more time was going to be good for both of us, but the truth was, it was me who needed the time, not her. To this day I believe she ate that baby food off my fingers, and held on for those last few days, only because I asked her to.
It was a mistake I vowed I would never make again. Years later, when my beautiful Cavalier King Charles Spaniel, Spencer, developed heart disease, I knew what to do. The cardiologist had prepared me for the fact that, although we were managing his condition well with medication, eventually Spencer would develop irreversible pulmonary edema. He warned me that when this finally happened, I had to act quickly or his lungs would fill with fluid and he would no longer be able to breathe.
I monitored Spencer constantly, carefully listening to his heart and lung sounds with my stethoscope. I knew exactly what to listen for, the crackling sound of air moving across fluid trapped in lungs. Then one day, I heard it, and I knew it was time. Within 24-48 hours, I knew his heart and lungs would fail.
When my husband and I took him on his final ride to the vet, Spencer was still happy and comfortable, and he left this world peacefully, with us holding him and telling him how much we loved him. As devastating as that experience was, I was thankful that we had done right by this wonderful dog and had not waited too long, and that we’d been able to give him a loving, dignified release from his illness before the illness had a chance to claim him.
The Kindest Goodbye
The word euthanasia comes from the Greek words “eu”, meaning good or well, and “thanatos”, meaning death. When I first started working in veterinary practice, I loathed euthanasia and considered it the most difficult part of my job. Then one day, one of our veterinarians, who had been a human nurse before going to vet school, shared something with me that changed my entire outlook. She said that after years of watching the suffering of dying people, she viewed euthanasia in veterinary medicine as a sacred privilege – the last gift we can give the pets we love so much, a painless, dignified departure from this world when their bodies fail due to age or disease. I’ve never looked at euthanasia the same way since.
There are many resources available to help us with determining when “it’s time.” A recent article from Dr. Andy Roark discussed “The Rule of 5 Good Things”, where you pick the top 5 things your pet loves to do and you write them down. When your pet can no longer do 3 or more of them, it indicates that quality of life has been impacted to the point where it’s time to start considering euthanasia.
Quality of Life Scales, such as the one developed by The Ohio State University, can also help assess the quality of life of an ill or aging pet (you can view the scale here.) Tracking your pet’s good days and bad days are helpful as well. These tools can assist with answering one of the hardest questions we will ever have to face: is our pet still actually living, or just existing?
As anyone who has lost a pet knows, after the decision has been made and we’ve said our final goodbye, the time immediately following is always the hardest. The things that bring us comfort are different for every person. My biggest comfort after saying goodbye to Spencer came in the form of a small, clay medallion with his paw print in the center and a tuft of his hair right above his name – an unexpected gift courtesy of the caring Technicians at the veterinary hospital who helped take care of him. Many years later, I still cherish that small token and consider it one of the most meaningful things I have.
Fortunately, there are also many excellent support programs for dealing with the grief surrounding the loss of a pet. The ASPCA Pet Loss Program offers not only grief support services, but also assistance with making the decision to euthanize, helping children and elderly pet parents who are facing the loss of a pet, and helping the surviving pets in the household to cope.
A Time For Everything
There is a time for everything in life – a time to fight the good fight, and a time to realize when the battle is over. Personally, I’m of the opinion that it’s almost impossible for us to know when the perfect time is to let go, but I feel it’s better to be a little too soon than a little too late. All we can do is the best we can.
And euthanasia is not a battle lost; quite the contrary. When you consider it gives us the opportunity to hold our pets in our arms as they take their last breath, feeling safe and cared for and knowing how much they are loved?
We should all be so fortunate.
What do you think? How do you know when it’s the right time to make an end-of-life decision for your pet? Please share your thoughts with us in the comments below.