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Pet Caregiver Support Blog…

The Harmful Old Wives’ Tails, Part 2: Quality of Life for Dying Pets

By Brad Bates, DVM

In the first part of this blog series, I described the misleading notion that euthanasia is only appropriate for pets that are not eating. In this blog, I will touch on another very common and harmful old wives’ tale. (Or in this case, a tail.) This deals with the quality of life for dying pets.

This one goes something like this:

“My dog/cat greets me at the door when I come home. She/he can’t be ready for euthanasia, right? But all she/he ever does is sleep and she has such a difficult time getting up and laying down.”

Once again, I will outline why we cannot use this in our decision-making efforts without some further understanding and evaluation.

Nothing About Your Pet’s Care is Black & White—Including Euthanasia

For one, nothing about caring for a pet, especially end of life care and euthanasia, is black and white.

Everything is about the degree of severity, progression, response to therapies, and overall wishes of the family. So, in evaluating a pet, one would look for trends. It’s not about DOES a pet greet her/his pet parents at the door, but it’s more appropriate to consider this:

How OFTEN does the pet greet the pet family compared to its normal routine? How many times does the pet seem to want to do this and just can’t, versus it doesn’t want to at all?

We can take a rule of thumb, cautiously, and say if a pet always greets the family at the door, it is very alarming when it doesn’t happen and something should be done:

  • Assessment and treatment
  • Hospice care
  • Euthanasia, after evaluation by a veterinarian

At the very least, we need to be in monitoring mode to evaluate the trend and progression of this change in behavior. For a behavior that is so intrinsic to many pets, even one instance when it doesn’t happen may be significant. Sometimes we have time to evaluate for trends and sometimes things progress so quickly we may not have that time. But in many cases, an evaluation of the rest of the pet’s quality of life and even its stability of health needs to be assessed, often as soon as possible.

Quality of Life Measures Are Different for Pets

Mobility problems and quality of life aren’t necessarily connected. Many animal diseases bring mobility problems and affect a pet’s ability to continue to greet the family.

The two most common quality of life issues I see are upper and lower respiratory diseases and cognitive dysfunction and similar neurologic anxieties.

  • For respiratory diseases, consider the severity and how far the disease has progressed. Pets with respiratory difficulty often have trouble resting, especially sleeping at night. They often pace or continuously lay down and get up. And they will often continue to greet families, with an occasional absence.
  • Pacing is also a clinical sign for cognitive dysfunction. This is usually a more regular and constant pacing than with respiratory disease. Pacing is often to one direction. Pets in cognitive decline pace as if they do not even know they are doing it, but they are very much conscious. They often startle. Or their attention may be focused elsewhere, including the door.

Sick Pets Try Their Best to Act Normal

Pets, especially the most loyal pets, will use all their energy to continue being themselves as much as possible.

They want to protect us, they want to love us, and they want to receive love from us. They are habitual as well, and this drives their instinct to continue to do what they were always doing. It’s one major reason why it’s so difficult to know a clear time for humane euthanasia.

For example, pets will still desire to protect their families from a new person entering the home. Changes in this behavior can provide clues about how a disease is progressing. Most pets will use as much energy as as possible to follow their normal behaviors. (This is why we veterinarians tell our clients that changes in behavior are often significant signs of disease). So if a normally protective pet leaves a room when someone new comes around, or a friendly one becomes anxious when someone new shows up, take this as something to watch,

Similarly, pets that have great difficulty standing but are hypervigilant about not eliminating in the house will often force themselves up to get outside. And of course, they will eliminate in the house if they can’t get out fast enough or lack the energy to “hold it,” making them feel even worse for not being able to act normal.

Pets Don’t Stay in Bed When They’re Sick!

We might expect pets to “stay in bed,” as we would do when we’re ill, or at least remain in one place.

But we often forget that we cannot communicate to our pets to remain in bed to retain as much strength and prevent themselves from getting hurt. They may instinctively understand something is very wrong with their body, and even feel pain, anxiety, and nausea well beyond what we can notice. They do not contemplate death the way humans do and can.

So don’t expect a sick pet to just sit down and give up, especially when it’s so focused on being there for the family.

Remember to Evaluate the Pet’s Condition

As I discussed in the first blog of this series, we need to fully evaluate how we think about a pet’s condition. It’s rarely straightforward and certainly not black and white.

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Brad Bates, DVM, is a hospice care veterinarian with Lap of Love in Philadelphia. logo for Lap of Love

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