Dealing with Death

Dear Dr. Eisenberg:

I have a 14-year-old Chihuahua mix that has been recently diagnosed with terminal cancer. I was given many choices by my veterinarian about treatment options and more tests available. I felt that my questions concerning euthanasia were quickly glossed over.

I am struggling with the possibility of having to "put my pet to sleep" but I am really wishing that she dies peacefully in her sleep. How do I know if she is suffering? What is the procedure for the euthanasia of a pet? Is this a cruel option?

Signed,

Dealing With the End

Dear Dealing With the End:

Your question is one that crosses the mind of most pet owners at some point in the Human-Companion Animal bond. As a veterinarian, I try to alleviate pain and suffering. This may be through the use of pain relief medications, sedatives, alternative therapies, and other forms of medical management. Ultimately, the pain or suffering may be so great that the pet needs to be euthanized or it is able to pass away on its own once the body has shut down. I try to use the patients' appetite as a gauge for pain and suffering. Granted, there are many causes for the loss of appetite, but I feel that most pets in pain or suffering will not eat. They often need to be force fed because they no longer are eating on their own. An animal that is eating on its own is trying to make it to another day. This quality is very useful in guiding a pet owner along the path of whether or not to continue caring for their pet or realizing that the pet may be trying to "let go" and prepare to die. Animals have an instinctive quality that they often recognize that death is soon and often try to be left alone or seek areas of privacy away from any activity. This is similar to an animal thinking of itself as prey and wanting to be hidden from any predators.

I also try to focus on the issue of "quality of life" for the pet. Sometimes a patient may be mentally alert but physically cannot walk or control basic functions such urination or defecation. Sometimes they are the opposite &emdash; able to physically get around but have limited mental capacity at the end. Both scenarios affect the quality of life for the pet and the caregiver. Knowing that a dog may lie in its own waste for many hours each day because it can no longer stand affects the dignity that this dog once had. Cleaning up for the dog numerous times each day may be too much to ask for many people. The important point is that I feel the caregiver knows in their heart when the quality of life for all involved has deteriorated to the point of bordering on pain and suffering. Some illnesses present with growths or tumors that have ulcerated to the point of needing constant nursing care. This may progress to having to confine the pet to a certain location in the home because discharge is being left everywhere the pet walks or lies down. This affects the quality of life for the caregiver and the pet that is now having its freedom restricted. As a veterinarian, I try to understand the entire situation that the patient and client are dealing with. I then use this information to guide the process along, even if it means having to euthanize the pet.

When a pet is euthanized, it is most commonly done by an injection of a barbiturate anesthetic overdose. The process should be swift and free of pain if done correctly. There are techniques a veterinarian may employ to ensure the procedure goes smoothly. This may include the use of a sedative first, or a gas anesthetic.

An intravenous catheter may be used to prevent leakage of the barbiturate outside the vein and causing a slower reaction in the body. The veterinarian will usually determine the most peaceful process based on the physical condition and temperament of the pet. It should be discussed beforehand whether you would like to be with your pet during the procedure. Also, discuss the options for the after-care. Most of the choices are between group or individual cremation, private burial, or any other arrangements you may have requested.

Your final question, "Is this a cruel option?" should be answered by the reasons for why you may be choosing euthanasia. If it is out of love, kindness, and compassion then it cannot ever be construed as cruel. If it is simply a decision of convenience, then the choice is the wrong one. This decision is a deeply personal one that deals with moral, ethical, religious and even legal issues.

There are several organizations available to help with pet loss and grieving. These include the Chicago Veterinary Medical Association and the Delta Society (206) 226-7357

Other useful references include:

• Pet Loss: A Thoughtful Guide for Adults and Children. Herbert A. Nieburg and Arlene Fisher, Harper and Row, 1982.
• Coping With Sorrow on the Loss of Your Pet. Moira K. Anderson, Peregrine Press, 1987.

Thanks for your letter!

Dr. Ken Eisenberg