Convenience Euthanasia

This week has been full of sensitive topics. In the game world, there are sexual assault victims coming forward about a well known player. It is a difficult topic to discuss, and everyone coming forward to share their experiences is incredibly brave. And I hope it prevents people from being hurt in the future, and I am heartsick that people had to go through those experiences in the first place.

I am lucky. I have never experienced a similar situation. My heart goes out to the brave people coming forward to prevent future cases.

In the vet world, I came across the following article. I can't appear to get a link working- so here it is: https://www.facebook.com/haoting.chow/posts/10158955082305572


I'm not sure how well that links, but below is a piece from a veterinarian on a sensitive topic- aggressive pet euthanasia and convenience euthanasia. I have never performed what I consider a convenience euthanasia, but I have euthanized animals for treatable conditions. In some cases,  even with  treatment they had a poor prognosis. In some cases, the condition was treatable but the treatment would be tough, or was expensive. It's a fact of being a veterinarian that you will euthanize something for a treatable condition due to finances. In my cases, that particular experience was a GDV, which can have a poor prognosis and a number of GVDs end up euthanized on the table when you see the extent of the damage to the stomach and intestines.

I have been asked to perform what I considered a convenience euthanasia as a vet once, and as an assistant to schedule one by a client once. That case was someone moving who did not think her adult cats would adjust to living with anyone else and did not want to surrender them. We did not schedule her. The case where I was the veterinarian was scheduled as dog with malformed legs, owner requests euthanasia. It sticks in my mind rather vividly, since it was my first time encountering this as a vet.

It was a mastiff, with normal conformation, who had really bad flea allergies. The owner was also complaining the dog wouldn't eat anything, but when we put canned food in front of him he gobbled it up. And she said "well of course he'll eat canned food" but she refused to try changing his food at home. She claimed he had lost 20 pounds due to lack of appetite- records we had showed a 3 lb weight difference. I refused to euthanize, and that was the first time I really felt supported at that job as my boss told me she would stand behind that decision. The owner refused to surrender (I worked at a shelter at the time and we would have taken him and treated), and agreed to try treatment. Came back 2 or 3 days later screaming about how I don't have to live with the dog peeing everywhere because of the steroid we put it on, and how they can't just let him stay outside because their neighbor will feed him even though one of their complaints was the dog wouldn't eat. She eventually left after we refused to euthanize a healthy dog with a treatable condition that we were willing to take on.

That is my line for euthanizing treatable conditions- am I willing to take this case on if the owner will surrender it and find it a home or keep it myself? If I can't conceivably treat the case, how can I expect the owner to?  I suppose the best example of this is diabetic pets: I discuss (more with dogs than cats, due to the nature of the condition in the different species) with all new diabetic pet owners euthanasia when the diagnosis is made. If you can't treat this, I tell people, consider euthanasia. Dying of diabetic ketoacidosis is not a kind way to go. I would rather euthanize before they get to that point than have an owner willfully not treat.

My other line for euthanizing is aggression. I have an aggressive German Shepherd myself. She is great with me, and will let me do anything to her, but she will try to bite strangers. I give her medication before company comes to my house. I put her up if I can, avoid the issue altogether. I muzzle her if she has to come to work with me. And in the past, my family worried that we would have to euthanize her.

I have never felt unsafe around my dog. She has never shown aggression towards me or my family. But if did, I would euthanize. I am not sure I could do it- I have not been a vet long enough to have to euthanize my own pets, but as they get older I know that day is coming and I still don't know what I will do.

But on the issue of aggression- I love animals, but human lives are just as valuable. If a dog is showing aggression towards people, and I refuse to euthanize, and it goes on to maim a child- I feel like that would be on me. That is the one case I will euthanize even a sweet, seemingly healthy animal. I will certainly ask some questions- what was the situation, do an exam to see if the pet is painful and the child hurt it. But I have euthanized a young, physically healthy dog while the owner sat there with bandages on her arms crying because she was unpredictably aggressive. I have euthanized a physically healthy pit bull in the shelter who just would not allow anyone to safely handle her even with slow, careful attempts and much time spent trying.

And I believe that while these dogs may be physically healthy, they are not mentally healthy well adjusted dogs. And these are some of the hardest euthanasias to do, and some of the hardest decisions their owners can make. It's easy to euthanize a physically sick dog, when you can see how bad of fit is.. It is so much harder to make that decision for a mentally sick dog who is physically healthy. But living in fear of your pet, and for a pet to live in potentially isolation if that's the only safe way to handle it, is no kind of life. I have worried about having to euthanize my own dog for this reason, and cried over it multiple times. I have not had to thank God, but I can understand where the decision comes from. And it is the one case where I will euthanize physically healthy patients.

Euthanasia is the toughest decision you cam make for your pet. There are all kinds of quality of life scales designed to help people come to that decision. And all kinds of clients who want me to tell them it is time. And that is something I cannot do. I will honestly tell people if I think their pet is suffering. But I also tell people we can throw money at diagnostics and potential treatments for a long time before getting there. And is a temporary suffering that the pet may recover from like an episode of CHF that is improving a reason to euthanize? Getting past that episode may be more than some people can afford to spend though, and that is understandable. Or a broken limb- that's certainly suffering, but a healable injury for sure. Anyone who comes to be after making the serious decision to euthanize I will evaluate. It is not an easy decision to come to.

But as I told the woman with the mastiff- I have to be able to live with my decision to euthanize. And as she yelled back at me, I don't have to live with the pet I refuse to euthanize. (though she didn't have to either- we offered to take him) But that is the question I ask for every treatable condition- can I live with this pet, if the owner can't? Thank goodness a lot of them have no idea we can treat their pet's issues and are willing to try when they find out we can.

But I cannot kill a perfectly healthy pet because the owner just doesn't want it anymore. A lot of  my cases stay with me. I sometimes forget their names- I very often forget the owners. But I can see the brown shih tzu developing heart failure and the older woman who can barely afford the exam fee to see me, much less the ~$100 /mo of medication alone her dog would need, not even talking about the blood work monitoring.  And the 13 year old dog with GDV who has been having issues for days. And the older lab with a hemoabdomen, We waited for their adult children who grew up her to get there before she was euthanized. All potentially treatable, but unlikely to have a good prognosis. 

I could go on and on. I don't remember every pet I euthanized- I don't even remember the number. Some stick with me more than others. My goal is always euthansaia- a good death. A peaceful passing for the pet and owner, the best final gift I can give my patients. And I dread the time for so many of my patients, and  thinking about this is making me treat up. Though I have been especially emotionally  unsteady lately- lack of sleep + bad diet = teary and / or easily angered Nala.

At one point I seriously considered a job in palliative care and home euthanasia. I am not sure I am cut out for such a position at this time in my life. But I still put a lot of effort into my euthanasias.

As I re-read what I wrote, I keep thinking of more and more cases- some heartrendingly sad, some sweet. This has dragged on way longer than I meant it to, but I wonder if I should write the stories down somewhere.