When is it time?
Perhaps the most difficult question a pet parent will have to consider is “how will I know it is time to say goodbye?”
While there may be an obvious answer, most times the decision presents an incredible struggle. And, an owner may have to consider this question for a prolonged period of time — for example, when a pet has been diagnosed with a life-limiting disease such as cancer, yet continues to have a reasonably good quality of life. We don’t want to euthanize too soon, but we definitely don’t want to wait too long.
The absolute truth is that people do not want their beloved pet to suffer or be in pain, so for most owners, the right time to say goodbye is when suffering occurs and cannot be controlled. The challenge is that there is no “correct” answer as to when chronic uncontrollable suffering first occurs. How do we know when their quality of life is no longer acceptable?
Thankfully, there are several tools Dr. Sara and her team use when having this discussion with people.
Dr. Alice Villalobos, a veterinary oncologist, has been a leader in the pet hospice and palliative care movement. Her quality of life scale may help owners assess where their pet is at, in order to make an informed decision. Depending on the disease process, it may be valuable to visit this scale frequently to monitor their pet’s decline in quality of life.
Pain can be very difficult to read in our pets – they hide it extremely well. In fact, from an evolutionary standpoint, animals do not want others to know they are weak or hurt. We often hear people say they don’t think their pet is in pain because they aren’t crying or whimpering, however, animals don’t typically vocalize their discomfort unless their pain is incredible (e.g. a broken leg). They do give us clues, though, about their discomfort or pain — for example, body posture, ear position, restlessness or panting.
Sometimes a pet doesn’t appear to be in a lot of pain but also doesn’t appear to be happy. What then? Are they still enjoying life? An example is a geriatric dog with arthritis and mobility problems. He sleeps all day, is restless at night, isn’t excited to see his owners, sometimes eats, sometimes doesn’t. When is the right time to say goodbye? In cases like this, there may not be that distinct sign that a person hopes to see to make the decision easier.
One common suggestion is to consider 3 activities the pet used to love to do – when they cannot do 2 out of 3, maybe it is time to say goodbye. A geriatric dog will no longer be able to rip around a dog park, but maybe they have even stopped wanting to spend time outside watching the birds. Or they just raise their head when you walk in the door instead of being excited to see you home.
One thing we suggest to people ahead of time is to consider the “line in the sand” that a pet needs to cross for an owner to say goodbye. This will vary. For some it may be when the pet can’t get up, or doesn’t want to go for their favorite walk. Many people will say it is time when the pet stops eating. While this parameter may be appropriate for many pets, it is important to realize not every pet will stop eating (think beagles and labs).
Of course, quality of life issues not only involve the pet, but also the owners. Caregiver fatigue, as well as physical and mental demands all come into play. Most people we meet gladly accept these demands if it means keeping their beloved pet comfortable for a longer period of time. But still, it is difficult.
Our doctors can always provide guidance through a quality-of-life assessment. During the consultation, we review a pet’s history, perform an exam, help owners determine pain/discomfort levels in their pets, and provide resources to help gauge their pet’s quality of life. Sometimes we are able to make suggestions to improve the quality of life, and other times it becomes clear to the owner that it is time to say goodbye. Regardless of the outcome, we do our best to support the owners and their pets through this difficult and emotional time.
Rest assured that we are committed to making this process as peaceful as possible for our clients.