How do you know when “it’s time”?

Posted on September 7, 2014 by Lynn Henderson

I was asked recently by a client how she will know “when it is time” to consider euthanasia for her old dog. I hear this question often, and always feel my answer is a bit vague. So I have given it some thought, and upon reflecting stand by what I told her. 

If you google search Quality-of-life for pets, you will see multiple scales that can be used to objectively assess various physical parameters and assist you in decision-making. Each of these scales has its merits, and can likely add to the assessment of a geriatric animal – but which one is “THE one”? I have never really used any of these scales to the letter – I understand the types of parameters they employ, and some of these are important by my measurement (appetite, ambulation), but how do we personalize them for each pet, each family? Each scenario is individual, and should be considered as such. 

When speaking with the above client, she relayed a concern that their old dog (let’s call him Bear) is her husband’s baby. She loves the dog, but he has always been far more important to her husband and her kids. So when she is the one who has the vet come out to assess the old lab’s quality-of-life, she is afraid that any move or suggestion towards euthanasia will make her the ‘bad guy’. If she sits the family down for a heart-to-heart about their beloved pet’s health concerns, and a discussion about when they should consider euthanasia, she will be labelled as the one that ‘never really loved him’, and an already difficult and emotional family situation will be compounded by finger-pointing and polarization.

She discussed this possibility with tears in her eyes, both for the beautiful old dog laying on the bed staring at us, and because she is afraid of making a hard situation even harder. If her husband can come to a place of considering euthanasia on his own (and when warranted), he will be in a healthier place after the procedure is complete and his beautiful Bear is gone. He will not point fingers at anyone in particular, because in the end, he made the choice.

Ok. So what did I tell her to do? 

I suggested that all of the family members who are involved with Bear’s care get together and brainstorm about him. Anything that they feel represents his happiness should be written down and considered. This list will usually include many of the items listed in the standard Quality-of-Life scales (eating, drinking, playing), but may and SHOULD have items on it specific to this individual pet. If for example, this pet has spent the last fourteen years of his life racing to the door when his daddy gets home from work, some measure of this activity, and this joy, should be incorporated into his assessment. In another pet, this would not be applicable – but for Bear it has been a major source of happiness and purpose in his life all along. 

After the list has been completed and all family members have participated, create a chart using the various qualities to assess along the vertical axis. Along the top, label columns with dates that you will ALL assess pet for each of these items and give him a score for 1-5. For example, If throughout Bear’s life, running to meet daddy at the door was a major source of joy for him, then his ‘perfect’ score for this activity would be a ‘5’. As he ages, we can expect that the speed at which he runs to the door, or how quickly he hears and responds to the door opening might change – but the eagerness and joy it brings him is what we assess. So, for sake of clarity then, a score of ‘1’ for this parameter might be a pet that just lays in his bed and watches his owner enter after a day at work. No effort to get up, no tail wagging – Let’s say that on that particular day, Bear just doesn’t care. 

Each parameter along the side of the chart is assessed and a score given, 5 being the best you could expect, and 1 being the worst. Add the values up for each day at the bottom of the column, and continue this practice a couple of times weekly for a few weeks. It is never a drastic change in any one parameter that tips the scale, but a gradual decline in a pet’s total score

While any ‘quantitative’ means of assessing the ‘value’ in a life feels wrong and cold – An objective way to step back and look at your pet when you are drowning in love and emotion for the animal, lets you SEE what is happening. With Bear’s mom, this suggestion was incredibly well-received, as it allowed all family members to be heard and contribute to the making of the chart, the continued filling-out of the chart, but also in coming to the conclusion that Bear is getting older and failing. 

I ALWAYS believe that a pet’s family knows their pet best. No medical training can instill in me the ability to assess if Bear is still Bear deep down inside – that is for his family. I use their opinions and the history they give me to formulate my opinion about his health and happiness, and can assess standard medical parameters to add further evidence to the pot (weight loss, muscle wasting, dehydration).  Further, if I can give families the tools to come to end-of-life decisions on their own, they will heal from the loss of that pet better after he is gone. If I come in, assess the pet, and tell them ‘yep, it’s time, ” I risk that owner waking up the next day feeling like I made them do something they may or may not have been ready to do.  

I hope you found this helpful. Please pass it along!

Lynn

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