Caregivers usually ask, “How will I know when the time comes?”
As you care for your pet, you will learn what makes your pet comfortable. You, the caregiver, will begin to set new and different parameters for what is an acceptable quality of life for your situation. You will ultimately become your pet’s advocate for defining its quality of life or the lack of it. Your pet will let you know when its “time” and there are tools to help.
User-friendly Quality-of-Life (QOL) assessment scales are available to help veterinarians and pet owners make proper assessments and decisions at the end of a life.
Dr. Alice Villalobos, director of Animal Oncology and Consultation Service, Woodland Hills, California and Pawspice, Hermosa Beach, California says “It is up to the veterinary professionals and to the pet’s individual caretaker to design an end-of-life program. The program needs to address each factor that deals with quality of life openly and honestly.” We can be very proactive in helping pets achieve an improved score on their evaluations.” To accomplish this, she has 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 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 tool, to be used as a starting place to explore your pet’s quality of life, and address your concerns with your veterinarian, is included in the appendix of this guide.
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. To aid in your decision making, Dr. Julie Reck, DVM, suggests asking some of the following questions in her book, Facing Farewell: Making the Decision to Euthanize Your Pet:
- 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?
Euthanasia is the Greek word for “good death.” It is emotionally very difficult to think about making plans for your pet, both before and after death, whether it is a natural death or by euthanasia. Because anticipatory grief (that grief one feels before a pet dies) is so painful, it often prevents some of us from making such plans. Many of us hope that natural death will come before we need to decide on euthanasia. Realistically, however, this does not always happen.
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, 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.”
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