EUTHANASIA - GENTLE DEATH, PAINFUL
DECISION
Copyright 1993, 2006 Sarah
Hartwell
Adapted, with permission, from Cat
Recourse Archive and
edited by Dog Breed Info Center®.
This article was the original euthanasia article which was later
expanded into
Time
to Let Go. It
contains some information which was edited out of the Dog Protection
version of Time to Let Go. I have kept the original information, but
made one or two updates and additions.
The decision to end a life is hard and can feel like a betrayal of
trust. One may feel she had murdered her terminally ill dog.
Another, in a similar situation felt guilty at not making the decision
sooner.
It is easy to become emotionally caught up in keeping a pet alive
when common sense tells you there is no hope of it regaining its health.
Sometimes it seems that your own life can't go on when you have to make
the decision to euthanize a long-term K-9 companion. It is hard
enough to end the life of an old and frail dog; perhaps if you give it
another day, or another week, the dog might die naturally in its sleep
even if you know that it will linger uncomfortably until it succumbs to
dehydration, starvation or to the gradual poisoning of its blood by
liver or kidney failure. If the dog appears outwardly healthy, but has
an untreatable medical condition, the decision is made yet harder.
A good vet will help you to weigh up the pros and cons of further
treatment versus euthanasia, but ultimately it is your decision. It is
never easy, but it helps if you are prepared. The following are common
guidelines:-
- A dog is in incurable pain which cannot be alleviated by
drugs.
- A dog has severe injuries from which it will never recover or
which severely compromise its quality of life.
- A puppy is born with serious defects which cannot be
surgically corrected and cannot be endured by the dog; it may not
survive weaning or it may not reach maturity (e.g. progressively
worsening hydrocephalus)
- A dog has unresolvable behavior problems which mean you
cannot keep it and which mean that it is not re-homeable; the
problem behaviors have not responded to behavior modification
therapy or to drugs e.g. aggression towards humans which result in
people being physically injured (Note: some behaviors are due to
neurological conditions/brain damage and are incurable), soiling behavior
- A dog has an age-related condition which cannot be alleviated
and which causes misery e.g. advanced senility, incontinence.
- A dog is terminally ill and will deteriorate. Euthanasia may
not be an immediate concern, but will be later on. Euthanasia may
be chosen immediately to prevent suffering later on.
The first 5 points are fairly clear cut cases for euthanasia - no
caring owner lets a pet suffer. The final point causes the most
soul-searching and this article addresses some of the problems of
deciding when to have a terminally ill dog euthanized and whether
treatment to prolong life for a short while will benefit the dog.
Sometimes, a terminally ill or injured dog is given life-prolonging
treatment because the cannot yet come to terms with its condition. It is
hard to come to terms with mortality in general.
Cost of treatment may be the deciding factor at a very early
stage. Unless the dog is insured, the owner has savings or unsecured
loan facilities or the vet offers a pay-by-installments plan, any
available treatment may simply be too expensive.
FIND OUT ABOUT THE ILLNESS OR CONDITION
- How much do I know about my dog's illness or condition?
- Is it in pain, distress or mild discomfort? How feasible is it
to alleviate this pain and give the dog a reasonable quality of life
for a period of time?
- Are there any new treatments available for it?
- Are there any surgical advances for this condition?
- Would a second opinion be beneficial to the dog?
- Can I afford the treatment?
- Can I administer treatment at home e.g. daily tablets, daily
injections, prescription diet, manually expressing dog's bladder
and/or bowel?
- Will the dog physically resist treatment?
How fast will my dog deteriorate without treatment? How fast will
it deteriorate with treatment? How fast does the illness progress and
what are the signs of its progression?
Some vets view disease as a challenge and death as an insult to
their competence, regardless of the animal's condition. Others believe
that prolonging an animal's life through treatment is inhumane. Most
fall between these extremes and recommend that life be prolonged only
for as long as the dog has a reasonable quality of life. While a second
opinion may be helpful to you, don't prolong a dog's existence in the
hope that the fourteenth, or fifteenth, or twentieth vet consulted knows
of a treatment. Don't prolong its life purely in the hope that a
treatment will be available before the illness or condition reaches its
inevitable conclusion.
When is a second opinion useful? Vets in small-animal practices
may have more up-to-date information than those who mainly treat farm
livestock. In these cases the vet himself will most likely refer you to
another vet. A good vet is aware of his own limitations. There is a
tendency to look up information on the Internet (that's possibly why you
are reading this). There is some excellent information available about
up-to-the-minute treatments. There are also articles and individuals who
will give you false hopes and some of those ground-breaking treatments
may not mention the failure rate or whether they are still experimental.
Find out about your dog's illness or condition. Ask the vet to
explain it to you in terms that YOU can understand. Ask sensible
questions. He may recommend reading informational leaflets produced by
animal welfare societies. Write down any questions ready for your next
visit to the vet. If you have obtained information from other sources -
journals or the Internet - ask your vet to discuss it with you.
Treatments offered in one country or locality are not available, or
feasible due to lack of expertise, or perhaps not affordable, in other
localities.
Your vet may know of specialists offering experimental treatments.
They may be situated some distance away which means a lot of traveling or leaving your
dog with them for a while. The word 'experiment' does
not mean vivisection and your dog will not be made to suffer
unnecessarily. Whether the treatment is successful or not, your dog will
not be made to suffer unnecessarily and lessons learnt from treating it
will be useful in helping other dogs in the future.
If you have any misgivings about allowing your dog to receive
experimental treatment/surgery then discuss these. If the veterinary
hospital offering the treatment is some distance away, you may decide
that travel and separation will distress your dog. As the owner, you
know your dog better than anyone else and a good vet will respect your
decision if you decide against further treatment. Choose what you
believe will cause your dog least distress.
When faced with the difficult choice of whether or not to attempt
life-prolonging treatment with no guarantee of success, I sometimes have
to say, "She's had a good life, I don't want to prolong it just
because I can't bear the thought of losing her."
LIFE EXPECTANCY AND LIFE QUALITY
- What sort of life expectancy does my dog have with/without
treatment?
- Will treatment prolong life or merely prolong suffering?
- Will the treatment or side-effects cause distress for either of
us?
- Do my other dogs risk being infected or can they be inoculated?
Having learnt that a pet is incurably ill or showing signs of
advanced age, an owner usually asks 'how long has he got?' Some
illnesses progress very slowly even if untreatable. Other conditions are
more aggressive and progress rapidly after symptoms first appear. Dogs
are good at hiding early signs of illness and, even if the owner is
vigilant, some are reach an advanced stage of their illness before
exhibiting symptoms. Dogs also differ in the way they react to diseases
and to treatments so your vet probably won't be able to give you a hard
and fast forecast about life expectancy. He can give you guidelines and
he can tell you about the signs of deterioration. Knowing whether the
dog has a few weeks or a few years of relative health will affect your
decision.
Most vets will give estimates of life expectancy varying from days
to months depending on the normal rate of progression of the illness,
the stage of illness the dog is at, the dog's age and general condition.
They will normally advise as to what sort of quality of life the dog can
expect and for how long. Knowing whether a dog can expect a few weeks or
a few years of relative health or of discomfort greatly affects the
decision.
Some diseases are infectious though the dog may stay relatively
healthy for a while. Dogs with certain diseases can remain healthy for some time.
Your other dog may be vaccinated, but what about your neighbors' dogs?
Are you able to keep your dog indoors or segregated from other dogs all
the time?
Assessing the side-effects of treatment (ranging from a
prescription diet for first-stage kidney disease to daily injections for
diabetes or even to weekly dialysis sessions under general anesthetic)
is also a major factor as is the possibility that a dog can survive
comfortably for a short period without a potentially distressing course
treatment.
When an 11 year old pet showed the first signs of heart failure
(collapse and loss of consciousness) The owner opted to try the available
treatment. Some animals had lived for 18+ months using daily medication.
However, after 4 days the pet began to deteriorate, refused to eat and
showed signs of distress at enforced inactivity. She was depressed,
suffering and the vet confirmed that she was not responding to
treatment. For a previously active, happy pet there was no alternative
but euthanasia, however much it hurt the owner to make that decision.
What matters to the animal is quality of life not length of life. A
dog doesn't make plans for next year's vacation. Dogs live for the
moment - and for their next meal. Some treatments offer a good quality
of life for many years. Sometimes, however, a 'short life and a gay one'
is better than a long, miserable existence.
QUANTITATIVE MEASURES OF DETERIORATION
Ultimately, the dog's condition will deteriorate as the illness
takes its toll. The emotive decision of whether to euthanize a dog becomes imminent. An owner who has opted for prolonged treatment may
have built up such an emotional attachment to the dog that the decision
is harder now than it was when the condition was first diagnosed. Blood
and urine samples, tissue biopsies and X-rays or scans can be used to
quantitatively measure the progression of the illness and can be used as
an indication as to the dog's quality of life (since dogs are capable of
hiding discomfort sometimes until they reach the point of collapse).
The measurement of Urea and Creatinine in the blood gives an
accurate measure of kidney function. The higher the levels, the worse
the problem. A special diet can compensate for impaired kidneys for a
while or even slow down deterioration. Once the Urea levels reach a
certain threshold, death is inevitable, uncomfortable and often
protracted. At this point, most vets recommend euthanasia although many
owners opt for euthanasia well before this point based on cost of
treatment, life expectancy and life quality (this being very
subjective).
GIVING TREATMENT
- Will other commitments (job, family, holidays) prevent me from
giving medication or from taking the dog to the vet regularly?
- Is there someone to continue the treatment when I go away on
vacation or am I willing to giving up vacations? What if I must
travel because of my work?
- How often must my dog visit the vet - can we both cope with the
traveling? Does the vet do house calls or must I take my dog for
check-ups at the surgery because check-ups require specialist
facilities/equipment?
- Can I afford long-term treatment for the dog? Does my pet
insurance (if I have a policy) cover this sort of treatment?
- Will the dog allow me to give it tablets, injections etc? Will
it become distressed when I try to medicate and how will the stress
affect the dog's condition any my relationship with my dog?
Once, diabetes was a death sentence. Nowadays dogs can receive
daily insulin injections and live an active life. Fifteen years ago, a
dog was most likely put to sleep because it had epilepsy. Many
epileptic dogs now have their condition controlled by tablets.
Life-prolonging treatment may mean daily medication and nursing.
Not all owners can cope with giving daily treatment. With an
extremely uncooperative dog, even giving tablets can be impossible. Some
vets will give the daily treatment for you - if you can afford this. A
determined dog may resist all attempts to nurse it until it is too weak
to resist, by which time treatment may be ineffective. It may be healthy
enough to enjoy a shorter life expectancy without medication, but check
this with your vet.
You will also need to know what side-effects to expect and whether
you can cope with them. You may decide that the side-effects outweigh
the benefits of treatment. Sometimes, the economics of the situation
will be a major factor.
| |
|
Don't feel guilty just because you couldn't afford a particular
treatment. You have no guarantee that the treatment would have
worked in the case of your dog. The important thing, from your dog's
point of view, is that you have provided it with a good home and
good care during its lifetime and that you are not going to let it
suffer or allow it to lose its quality of life. |
DETERIORATION
- Is my dog going downhill?
- Am I witnessing deterioration or just a hiccup?
- Is further treatment possible, or humane, at this stage?
Eventually an old or terminally ill dog's condition deteriorates.
Gradual deterioration may go unnoticed unless you keep notes, weigh your
dog regularly or physically examine it regularly. Discuss the normal
course of your dog's illness with your vet and ask what symptoms to look
for. Certain symptoms may mean the dog has reached the final stages of
its illness and has nothing but suffering ahead.
It is important to recognize when the dog is deteriorating and
decide whether treatment is possible at this stage and if so, whether it
is humane or would be purely to benefit the owner's desire to put off an
unpleasant decision.
FACING THE INEVITABLE
Finally, you can put the decision off no longer. Modern drugs are
extremely fast-acting and the end is very peaceful. The final stages of
a terminal illness, however, can mean a painful, prolonged end. If,
during its life, your dog has been well-cared-for, you owe it this last
duty - a gentle death and not a slow one. Further information on how to
make the decision, how euthanasia is performed, death from natural or
accidental causes and how to cope with bereavement are available in
Time
to Let Go, a dog care
article which evolved from this one.
In making the decision it is helpful for owners to understand how
euthanasia is performed. Euthanasia in small animal practice is by anesthetic
overdose, usually by injection into a vein or kidney,
sometimes by gas if the animal is distressed by handling. The knowledge
that euthanasia lives up to its literal translation of 'easy death' and
is painless and fast while a 'natural death' may involve convulsions, hemorrhaging, starvation/dehydration and, in the terminal stages of
many illnesses, pain, may be that crucial deciding factor.
