So this week's post- one of the tough ones. Rarely do people come out and say Doc, how do I know when it's time? But in a myriad of little ways- I don't want my pet to suffer doc. I don't want to pursue needless testing. I don't want to put them through painful treatments. I don't want to wait too long. I don't want to give up too soon.
I am an eternal optimist- and it's a flaw. I try to be realistic, but one of the truths of the world is there are very few absolutes. So when people ask me- is there any chance? I say yeah, a slim one. But I've heard the cases, the one-in-a-million's that live past the expectations. Of course, I've also heard the apparently benign turned out to be terrible and died young, but they don't stick out as often as the other. So sometimes I feel like I give people more hope than their situation warrants.
This has been something I've been pondering a lot lately, because the last week the thought of my own dog's euthanasia has been heavy on my mind. Lina, the last dog I had to euthanize, still weighs heavy on my mind. I didn't know as much, I didn't know what else I could do- and I feel I failed her.
Bella, who has been with me since undergrad. VA Tech and NC state (I did not subject her to Grenada- the plane rides would not have been fun for her), my first job, my current job, all 3 boyfriends- is getting old. And it is showing. She has an arrhythmia and arthritis. She has some pretty bad muscle wasting in her hind limbs, and is starting to have trouble getting around. She is currently on 2 arthritis medications, 1 heart medications, a joint supplement and prescription joint food. And I do acupuncture on her, perhaps not often enough. I've tried other medications, and I am considering swapping hers up a bit more, but I also realize that no amount of medication is going to make her run up the stairs again.
There are a variety of resources out there to help people decide. Lap of Love, an in-home hospice and euthanasia service, had an app, Grey Muzzle. The Ohio State University has it's own thing. And I'm sure there are others.
A lot of my information I provide to clients I repeat so often it sounds like a rehearsed speech. Vaccine reactions, heartworm prevention, my pre-euthanasia "this is what is will look like" talk. I don'r have one for this. How do I know when it's time? It's different for every pet and owner, and truth is sometimes euthanasia is a viable option that I discuss with clients, for treatable conditions. And those are the toughest- because yes is is the right decision for this pet and this client, but that doesn't mean it isn't hard or I don't wonder "if only we did this" or had tried that.
But back to the question- how do I know when it's time? Some pets make it really easy, and come down with something that will kill them. It sounds harsh, but that's how I recently phrased something to a client: you will have to decide when it is time for your pet because what she has now will not kill her but it will make her really painful and affect her quality of life. The ones where it's deadly and I can give you an estimated life expectancy are in some ways easier- then you have a goal. This will kill my pet, so when I start to see bad days, it's time.
The others are harder- the this won't kill my pet but it will make them miserable, and painful, and require a lot of supportive care to keep them in a reasonably comfortable state. And that's where Bella is at.
So where is my line for her going to be? I still have 2 or 3 medications I can try. I can increase acupuncture frequency. I can send her to physical therapy. I still have some options.
But when those run out? She's a lab, she'd wag her tail and eat something for me until the end. Is my line going to be she can't walk on the slick floors? She can't stand up unassisted? She can't make it the 2 inch step outside to go to the bathroom? Or is it going to be subtler- she's panting and grimacing in pain occasionally now. If I can't get that expression off her face, is that my sign?
It's the hardest choice you can make as a pet owner, and sometimes the kindest thing you can do for your pet. And it's rarely easy, and always heartbreaking. And my job as a vet is to guide people to these decisions, but I can never pull the trigger. I get asked all the time, what would you do doc? If this was your pet? And I answer as honestly as I can, but I do tell people I'm in a different situation. That's sometimes the hardest question to answer- what would you do if this was your pet?
And writing this, I hope I know it when I see it. Another vet, somewhere on the internet, once said she's heard a lot of clients say they waited too long, and not as many say they gave up too soon. Once I do make the decision for Bella, I'll have to decide- am I going to be the vet for my dog's euthanasia, or the client?
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