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Pet Caregiver Support Blog…

The Harmful Old Wives’ Tails, Part 1: When Pets Stop Eating

By Brad Bates, DVM

I have come across several things pet parents say to me working in the veterinary hospice field for the last 5 years.

These phrases were classic tales, or as I call them, Old Wives Tails, or related to ones I have heard. The overwhelming feelings I got from these pet owners were confusion and guilt. Mainly because their hearts and souls told them one thing, and something they either heard, were taught or came across over their years told them something different.

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Four Common Old Wives’ “Tails” About Dying Pets

So, I want to discuss the most common ones I hear and why I feel they cause confusion and why I feel strongly that these should not be considered in the decision-making process surrounding end of life care for an ailing pet (or at least without some additional understandings). To be concise, I will break this blog into a series. I will touch on 4 common old wives’ tales I hear every day.

  • This one is probably the most common and most harmful one I hear, so I will spend the most time on it. It has many variations but the gist of it is:

“When pets stop eating, they are “ready” for euthanasia.”

Often, I hear a pet parent say something like: “My pet is still eating, she can’t be ready for euthanasia, but she seems so unhappy and sick-I don’t want her to suffer.”

  • The next common one is something like this:

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

  • Another common one:

“I do not want to make the decision unless she is suffering, is she suffering yet?”

Often pet parents also say something about their pet’s pain, or what pain they perceive them to be in. I’ll touch on this later.

  • “My dog still wags her tail, she is not ready, right? Then why does she seem so sick.”

A variation: “My cat purrs, even when I’m not petting her. That means she is still ok, right?”

Often, pet parents have the thought in their minds that one thing they will look for to decide on euthanasia is the lack of tail wagging or purring.

So, this blog will focus on the first one:

“When Pets Stop Eating, This Means They are Ready for Euthanasia.”

This is a loaded statement, to say the least, and offers a lot of misconceptions. It is often confusing for at least a few reasons, and even misleading.

For one, it groups all pets their diseases into one generalization that such a statement cannot be applied to. I think we all know the same thinking cannot be true of all diseases and pet owners will often see this first-hand, making an already difficult decision that much more confusing and guilt-ridden.

I can write a small book on this old wives’ tale but to be brief, the six major reasons this statement cannot be applied across the border is as follows:

1. It does not consider what I call “positive” diseases.

I describe “positive” diseases as those that can induce activity and/or eating behavior despite causing a very poor quality of life and potential unpleasant death. These include:

  • Brain disorders (of which cognitive dysfunction and tumors are amongst the most common, and often cause pets to pace and circle despite being tired)
  • Diabetes Mellitus (which, until the very end of the disease course, often make pets have ravenous appetites despite ongoing weight loss and generalized dysfunction)
  • Hyperthyroidism (which we see mostly in cats, and can also cause ravenous appetite at the same time as debility, namely heart disease and potential congestive heart failure)
  • Malabsorption type diseases (mostly gastrointestinal and pancreatic diseases, which can limit absorption of nutrients and make pets eat more)
  • Even some cancers (which often require a ton of metabolic energy and can cause an increase in appetite especially for carbohydrates and treats, even towards the end of the disease process). Some diseases literally are bad when they make the pet eat MORE, not less.

2. It does not consider the loyal and appeasing nature of our pets.

Down below I will talk about defining “eating,” which is imperative to understanding the most helpful parts of this old wives’ tale.

Often pets, especially dogs, will continue to eat treats (partly because we hand them to their mouths), or will eat food by us offering directly. They may not eat from their bowl left on the floor, but they will from their parent’s hand. This is more of an appeasing nature of especially canines, not what I define as “eating” (especially for a pet that was always food motivated or previously eating better).It does not consider disease processes that affect

3. It does not consider disease processes that affect the quality of life.

Not all disease processes impact appetite until maybe the very end when suffering is substantial. These include isolated cancers that often can cause pain, debility, anxiety, and even nausea (I have seen many dogs with stomach and intestinal cancers eat and then vomit and continue to do this constantly, even eating their own vomitus).

What happens if a large tumor bursts open, and either gets infected or has the potential to be infected, even potentially leading to a state of sepsis? What if that tumor is bleeding so much it cannot be stopped?

If there are no good options for removal, for any number of reasons, how can we deny a peaceful passing just because the pet is likely still eating?

This also goes for diseases that cause complete or substantial immobility, especially with subsequent incontinence and skin/urinary infections (especially infections no longer responding to therapy due to severity or resistance) from this incontinence.

4. It does not define what “when pets stop eating” means.

This is very important. We need to define “eating” as eating to sustain life and willingness to eat (which often means from their bowl at the normal location). There is no one exact way to describe this specifically but we all can probably figure we eat a bit more than we need to, and some of our pets do as well. So, maybe our bodies, our

There is no one exact way to describe this specifically but we all can probably figure we eat a bit more than we need to, and some of our pets do as well. So, maybe our bodies, our health and weight, will be sustained if we eat 70 or 80% of our normal calories. Well, then this should be an estimate of what our pets should be eating if we are to help sustain life. Eating cannot mean munching here and there, or eating a third of a can of food a day, or eating treats, or eating some table scraps. We need to ensure a close-to appropriate intake of calories and nutrients (maybe not 80% of normal calories, but certainly not 50% or lower). Especially if we are actively inducing therapies to prolong life/time. This also must consider pets with feeding tubes. Administration of calories is NOT eating.

Eating cannot mean munching here and there, or eating a third of a can of food a day, or eating treats, or eating some table scraps. We need to ensure a close-to appropriate intake of calories and nutrients (maybe not 80% of normal calories, but certainly not 50% or lower). Especially if we are actively inducing therapies to prolong life/time. This also must consider pets with feeding tubes. Administration of calories is NOT eating.

Well, then this should be an estimate of what our pets should be eating if we are to help sustain life. Eating cannot mean munching here and there, or eating a third of a can of food a day, or eating treats, or eating some table scraps. We need to ensure a

We need to ensure a close-to appropriate intake of calories and nutrients (maybe not 80% of normal calories, but certainly not 50% or lower). Especially if we are actively inducing therapies to prolong life/time. This also must consider pets with feeding tubes. Administration of calories is NOT eating.

5. This does not consider what therapy you can offer and the likelihood for recovery.

One of the biggest things we must decide as caretakers (both pet parents and veterinary professionals) are:

  • What therapies are possible?
  • Which of these are possible for the family/pet?
  • Which of these possibilities is appropriate for the pet and pet family?
  • Most importantly a subjective approximation of what the likelihood of success? (including defining what “success” for that therapy means.)

Some pets have appetite changes that are manageable, even treatable. Some do not. We cannot group these pets under one umbrella statement.

6. It is often correctly read one way, but not the other.

A pet with a chronic or end-stage disease that was eating well prior, but no longer eating well is likely in a very progressed state of that disease.

If therapy was already instituted to prevent or treat appetite changes with no continued benefit or lack of response, the timing for euthanasia may be more urgent.

But, if a pet is eating or eating enough calories, we must look at the other quality of life indicators and make a complete assessment of the pet’s overall quality of life. (In a later blog, I will discuss how sleep habits and breathing ability are more important for assessing not only quality of life, but even life and stability of a pet’s health.)

Don’t Make Pet Euthanasia Decisions Based on Eating Alone

So, this old wives’ tale, in the least is a loaded statement, and we need to be very careful navigating around it since it is so common and potentially detrimental. Detrimental both to the pet and pet family’s peace of mind. The problems described above are the exact reason a pet parent should try to have a dedicated, thoughtful veterinary professional helping them assess their pet’s needs and helping them reach a decision for care and potentially humane

The problems described above are the exact reason a pet parent should try to have a dedicated, thoughtful veterinary professional helping them assess their pet’s needs and helping them reach a decision for care and potentially humane euthanasia, if elected.

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

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