Excerpt from the book:
Peaceful Passing for Pets: “A Caregiver’s Guide to Pet Hospice Care” Chapter 6
As a chaplain and priest, a lover of pets and co-founder of a pet loss support program in Montana, Reverend Mary Piper has walked closely with many individuals going through the grief of the loss of a beloved pet. She has heard the anguish of pet owners asking:
Do I have the right as a pet owner to end the life of a fellow being?
Do I have the responsibility to choose when my pet should be euthanized and how, exactly, do I do that?
The following is one example. Clearly distressed, tears in her eyes, Jennifer said, “I still wonder if there was something else I could have done.” “Could a different treatment have been tried?” or “Would a different pain medication have given a few more days by providing greater comfort?” Jennifer’s feelings and questions are typical for a grieving human who has just euthanized a companion animal. Such questions raise the possibility that the decision to euthanize was made too soon.
On the other hand John said, “I regret that I waited too long to accept euthanasia. Now, as I look back I recognize that my pet was suffering. If I had it to do again I would not wait as long but, in the moment when my heart was hurting, the decision was too hard for me to make.”
Caregivers usually ask, “How will I know when the time comes?” Some will say, “Your pet will tell you.” Not in words, of course, but they do “tell” us a lot in their own ways. As you care for your pet, you will learn more and more about what continues to make your pet happy and comfortable, so in this sense, your pet does tell you. You, the caregiver, will begin to set new and different parameters for what is an acceptable quality of life for your particular situation. You will ultimately become your pet’s advocate for defining its quality of life or the lack of it.
Dr. Michael Henson, Associate Professor at the University of Minnesota and the Section Chief, Oncology states, “Almost every day, pet parents tell me they want to say goodbye before there is significant suffering. Almost all are interested in palliative care, some interested in hospice, but yet they want to euthanize when it is the right time. Almost all pet parents do not want medications that change alertness and attitude. They would rather say goodbye than have sufficient pain medications such that the patient is somnolent. It depends on the disease, but natural death without significant opioids is often not without suffering, so euthanasia is the greatest gift.”
No matter how stressful it is to decide a time for euthanasia, you may ultimately find that to end your pet’s suffering is indeed a gift and an act of love and compassion.
User-friendly QOL assessment scales are available to help veterinarians and pet owners make proper assessments and decisions at the end of a life. It is generally agreed that the pet’s owner is best qualified to evaluate QOL but a team approach is important to provide empathetic support when end-of-life decisions are made.
Dr. Alice Villalobos, director of Animal Oncology and Consultation Service, Woodland Hills, California and Pawspice, Hermosa Beach, California states, “created a Quality of Life Scale “to provide an easy guideline for assessment of the pet so that family members can maintain a rewarding relationship and nurture the human animal-bond. This Quality of Life scale offers some objectivity while remaining sensitive to the caregiver’s wishes. It will relieve guilt feelings and engender the support of the veterinary team to actively help in the care and decision- making for end of life care.”*
JOURNEYS: A Quality of Life Scale for Pets has been developed by by Katie Hilst, DVM after hundreds of conversations over the years with pet owners and their families making the decision to euthanize their pet. Dr. Hilst states, “Sometimes, after the discussion, people realize that their pet is enjoying life, and they still have time left with their pet. Other times, people realize their pets are suffering more than they were aware, so they choose the final act of caring. In either case, the JOURNEYS scale is meant to get pet owners thinking and considering the factors that affect your pet’s happiness and sense of well-being. This is a tool to be used as a starting place to explore your pet’s quality of life, and address your concerns with your veterinarian.”*
This may sound a bit too abstract, so learning how other pet owners have made their decisions may be helpful. You will notice a wide range of circumstances that cause people to decide “when the time came.” In his book, DOG YEARS, Mark Doty describes one morning finding his old dog, Arden, crying out in the kitchen as he lay in a pool of urine and feces. Over the past few years, he and his partner had used acupuncture, herbs, special diets, and various pain drugs to keep him comfortable, but on that morning they cleaned Arden and called their veterinarian to end Arden’s suffering.
In the book, A DOG YEAR, Jon Katz watched his dog, Julius, “lose steam.” He lagged behind in walks; he lost interest in sniffing the wonders of outdoors, and he became more and more lifeless. With the diagnosis of colon cancer and no possibility of further treatment, Katz finally chose a day to visit his veterinarian. Jon held Julius and stroked him lovingly as the drugs of euthanasia took over.
My golden retriever, Ben, had lymphoma and lost his sense of fun very rapidly. One night he could not get up on our bed as usual, so my husband picked him up and laid him on the bed. Ben cried out in pain as he was moved. The next morning Ben went out in the yard as usual. When he came in the house, he could not stop shivering and shaking. He sat down beside me, gave me a very quick glance and then looked forward into space. He did not come for a scratch as usual and I read his glance as, “Please help me” We made our appointment with our veterinarian that afternoon.
The singer, Fiona Apple, canceled a South America concert tour in 2012 to be with her dying dog. For canine or feline family members, it is vital to stay with them during their last days so you can assure yourself that natural death or euthanasia prevents any undue suffering. In other words, Fiona Apple wanted to be the one to decide when her pet’s quality of life crossed from acceptable to unacceptable using her criteria. She exemplifies the need for the owner who knows the pet best to be there to make such an important decision. When it is time for you to make this difficult decision, try not to back away emotionally as the end comes. Sometimes the fear of a painful or distressing death becomes overwhelming and distorts our ability to see a situation clearly. In this case, we may unconsciously ignore important symptoms.
Throughout the years that you and your pet have lived together, you have learned the meaning of many non-verbal communications between the two of you. Now is the time to become especially sensitive to changes in your animal, both
behavioral and physical.
Dr. Julie Reck suggests asking some of the following questions in her book, Facing Farewell:
• Can your pet get up and down without assistance?
• Does your pet have frequent urine or bowel accidents in the house?
• Does your pet still enjoy toys?
• Does your pet still enjoy going outdoors?
• Has your pet lost vision and/or hearing?
• Does your pet spend more time alone, hiding, or in seclusion?
• How is your pet’s appetite?
• Does your pet have more bad days than good days?
Keeping a daily record of the answers to these questions will help you to answer, “Am I maintaining my pet’s quality of life or am I prolonging his suffering?” It is often very hard to let go because of your own emotional pain, usually in the form of “anticipatory grief” which may include dread, anger, anxiety, and even physical symptoms. However, when your pet can no longer live with dignity and be pain-free, it is probably time to make your decision. When it seems close to the end, it is usually best to proceed a day too early as opposed to a day too late because terminal changes proceed quite rapidly.
This is the time you will need to call on your support group. Hospice provides support with the availability of chaplains and social workers tending to emotional, social and spiritual needs you are facing. Be kind to yourself. Spend a quiet time with your pet, telling him how much he has meant to your life and that he will never be forgotten. Speak to your pet, communicating as a 2- way team – listen and talk. Use a soothing voice so that your anxiety is not communicated. Like all grief, your experience will differ from others so do not compare your reactions to those of others.
Copyright © 2016 Peaceful Passing for Pets®
PEACEFUL PASSING FOR PETS: A CAREGIVER’S GUIDE TO PET HOSPICE CARE
Available Now A Caregiver’s Guide to Pet Hospice Care is a resource guide designed with the caregiver in mind to help pet owners and family provide comfort care to pets that have a terminal diagnosis. The focus is on preventing suffering of the pet and empowering the pet owner as they provide care… More about the Book >
