This is a unique and painful moment in many peoples' lives, having to decide to euthanize a beloved companion and for many a family member. For many owners this maybe their first experience with both the decision making process and dealing with the grief of loss. There are feelings of whether or not we have the moral right to intervene in addition to decisions of how and when. We end up in much more of a decision making role, more so than in losing a human when the medical and funeral establishments play a greater role.
A decision to euthanize a pet is a personal one. It is based on ones' own sense of what they feel is right for them and their animal. As owner's we take on the responsibility of being our pets stewards in life.
At Saiki Veterinary Mobile House Calls we are dedicated to trying to give you as much information to help in your decision making. The following articles will hopefully help.
Quality of Life
In deciding when to euthanize a cat or dog, the paramount issue revolves around the issue of their quality of live.
From an animal welfare perspective there are five "Freedoms of Animal Welfare"
2. What is the medical prognosis? Are viable treatment options available and are you able to afford them?
3. Do you have all the information you need to make a decision.
4. Interspecies empathy refers to the ability for humans to feel and empathize with their pets (and how they are feeling) across species lines. As owners, we are in the best position to feel and empathize most closely with our pets. That is why owners are the best suited to make decisions about quality of life.
5. Is hospice care for your pet an appropriate alternative?
A More Specific Guide: The HHHHHHMM Quality of Life (QoL) Scale
This scale provides a more object and specific assessment which is used in consultation with a Veterinarian. It helps pet owners with the most difficult decision: When is the right time to euthanize my pet. It is used for patients where owners have embraced palliative care, where no further diagnostic or therapeutic measures are being taken. The owners have placed their pets in Pet hospice care (Pawspice). In addition, this scale might guide highly bonded pet owners, those who might be in denial to consider issues that are difficult to face or help the caregivers improve upon their pets' home care. A score of 35+ is acceptable quality of life in hospice care.
Caregivers should reassess and compare the pets HHHHHMM QoL score monthly, weekly, daily or even hourly when making decisions about pet euthanasia for the terminally ill patient.
1. There is no quality of life if the pet is experiencing the distress and pain of respiratory distress. This means that the pet is having difficulty breathing and is detected by watching how well they are about to breath in and out. In respiratory distress there is no quality of life. One might note an inability to sleep restfully at night. Hospice care is not warranted and humane pet euthanasia is indicated.
• Diseases which cause difficulty breathing include those involving the heart, lungs, chest cavity, trachea and larynx.
• Ask your Veterinary Pawspice care team if you pet may have a disease which will cause respiratory distress.
2. Control of pain is first and foremost the QOL scale. You and your veterinarian need to work together to determine the type and source of your pets pain and treat appropriately. There are many oral, transdermal and injectable medications which can be used to relieve pain. Pain control especially in cats must be given preemptively or early in the course of care, for cats do not communicate their pain clearly. Many cats suffer needlessly because of this.
3. If your pet has cancer, their pain is often more severe at night. Cancer can simulate the tissue pain receptors as it enlarges in size, causes tissue damage or is a source of inflammation.
1. Monitoring food intake and weight is important. Nutrition is essential to keeping the immune system of the patient functioning properly and therefore fighting off secondary infections. If 10% of body weight is lost in 3-5 days, a feeding tube should be placed.
2. For cats it is important to offer a variety of flavorful foods and may take patience and persistence coaxing them to eat. Heating the food is important for most cats need to smell their food in order to eat.
3. A variety of appetite stimulants are available for both dogs and cats. They seem to work especially well in the cat.
4. Cancer has been shown to alter the body’s metabolism of protein, fat and carbohydrates. Cancer uses simple carbohydrates preferentially as an energy source so the optimal diet is one that is lower in simple carbohydrates and higher in proteins and fats. Consult you oncologist for their recommendations.
Hill’s n/d (neoplasia diet)
Merrick (Before Grain) and Wysong
1. Adequate fluid intake is 22ml/kg/day.
2. Some patients benefit significantly from supplementation via subcutaneous fluids. This is the administration of a balance sterile electrolyte fluid just under the skin. Many owners are able to learn how to administer these fluids themselves in an effort to support the hydration needs of their pets.
1. Proper hygiene is important for the well-being of the patient. Cats in particular are usually fastidious groomers and do much better if they feel clean and well kept.
2. Excrement not cleaned off can result in areas of moist dermatitis.
3. Antibiotics may be needed if cancerous masses become infected open wounds.
1. What is the level of happiness of your pet? Is your pet depressed, anxious, bored, afraid and interactive with the family?
2. Create events of enjoyment for your pet. Pet them, talk to them and play with them.
1. Move them closer to where the family interacts not keep them isolated.
2. Does your cat purr and enjoy being on your lap? Do they play or bat at a toy? Watch a laser light? Perk up with catnip?
3. Take your pets outside to sit on the grass and enjoy the sun.
1. For larger dogs mobility can be a challenge. Patients should be helped to stand, moved and rotated every 2 hours. If left immobile, they are prone to secondary recumbent pneumonia and decubital ulcers or bed sores.
2. Sadly, for larger breed dogs, the inability to be mobile because of various musculoskeletal problems is a common reason for humane pet euthanasia.
3. Provide your pet with soft bedding.
4. Is your pet able to move around the house for meals, elimination or to be closer to the rest of the family? For cats, you can make it easier to get to the litter box by using low rimmed boxes or small steps to get up and down from their beds.
More Good Days than Bad Days
1. If a patient in hospice care has more than 3-5 bad days in a row, their quality of life is compromised and hospice should not continue.
2. Bad days maybe those filled with undesirable experiences such as vomiting, nausea, diarrhea, frustration or falling down. Or when they are not experiencing events of happiness.
Suffering to death: Some individuals feel that they want their pets to have a natural death. However some dying pets suffer at the end with terrible respiratory distress, thrash about and become agonal before death. This is not a natural death. In the wild, sick and ill animals will naturally become pray and do not survive long enough to endure suffering to death. Although euthanasia (Greek: good death) is not “natural”, but it is humane.
A mobile veterinary house call makes it convenient and less stressful for the pet hospice patient. Many pets hate the experience of getting into the car, traveling to the animal clinic, waiting to be seen creating great anxiety. A vet home visit also allows the Dr. Saiki the ability to evaluate and make suggestions about the home environment which can improve the quality of life for your pet.
One Last Important Thing to Remember
After we have agonized over your decision and your best friend is gone, for many guilt comes. This then leads us to doubt. They are both very common feelings in this situation. Together they rob us of our confidence and turn our precious memories into a source of pain. We being by wondering...Did I do the right thing?... Should I have waited longer?....Should I have tried something else?
Remember that the decision you agonized over came out of love and caring and where not made easily.
..."it was very unfortunate that she had to come and euthanize my beloved doggie who was to sick to carry on. She was very kind and sensitive to the environment that would make my dog most comfortable, and it made me feel much better. I will definitely use this service for any pets I have in the future."
Dr. Saiki provides pet hospice care consultations as well as quality of life evaluations as part of her mobile vet practice. Her "at home veterinary service" is in a unique position to offer care in a relaxed and safe environment for your pet. An at home appointment allows her to not only fully evaluate your pet, but also make recommendations on their surrounds.
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