One of the harder questions I get asked as a veterinarian is how to tell “when it’s time.” It’s the day no one wants to face, but as dedicated pet owners, this is the last true act of kindness we can perform for our beloved pets.
Everyone hopes that as their pet reaches their final days, he will pass quietly in his sleep. Unfortunately, that rarely ever happens. The “lucky” ones develop a quickly progressive catastrophic illness that makes the decision as easy as such a decision can be, but the suddenness can be devastating when we have no time to be emotionally prepared.
Other pets develop chronic and slowly progressive problems, like hip dysplasia that causes greater and greater pain and is no longer responding well to medications, or intestinal problems that cause more and more weight loss with an appetite that just seems to wax and wane. There are senile pets that eat all their meals but lose their housebreaking routines and are up barking in the middle of the night.
How do we make that decision? How do we know when it is time?
For starters, I talk with my clients about their pet’s quality of life. Can they do the basics? Are they finishing their meals? Can they get outside to use the bathroom or are they soiling themselves? Are they pain-free? Do they feel good? These can sometimes be difficult for a pet owner to assess. Sometimes people see their dog’s struggle to get up or lie down as “just a part of aging,” and not as chronic pain from arthritis. They see their cat run to the food dish, but don’t realize she only took two bites before walking away and letting the other cat finish the food.
I also look at how a pet is interacting with the family. Are they still seeking attention? Do they still want to play and go for walks, or are they spending most of their time sleeping in a room away from the family? Changes in a pet’s normal social behavior can be a symptom of chronic discomfort and pain.
Finally, I look at how the pet’s illness is impacting the family. Caring for an incontinent, poorly mobile, ailing pet takes a toll on the caregivers. They often keep going fueled by guilt and by love. No one wants to feel like they let their pet down. In almost 20 years of practice, though, I have never had a client tell me they think they put their pet to sleep too soon. I have had a number of people tell me they think they waited too long.
I recently went through the decline and loss of my own dog. George, a 13-year-old pitbull mix that we jokingly called a “South Central Labrador,” (he hailed from the South Central Los Angeles pound). George was a shameless but harmless hooligan who did as he pleased, and we loved him dearly. But he had two knee surgeries that resulted in some arthritis, and anti-inflammatory medications weren’t cutting it anymore. We added additional medications, made up charts so that we could make sure he was getting his walks, and injections, and supplements, and I hoped that we would have at least one last good summer and maybe put him to sleep in the fall before the weather turned bitterly cold.
But then one warm, spring day, George was lying in the front yard. The sun had shifted to the back of the house, so I went to help him get up and move to the back porch to continue sunbathing. He could barely rise. I looked at his gums. They were pale. I checked his pulses. They were fast and thready. I gently felt his abdomen where I could feel the fluid accumulating there from what experience told me to be a splenic tumor that had started to bleed. There was nothing I could treat, and nothing I could fix. All I could do was end the pain.
I settled George down on the back porch and called my husband to come and sit with him while I went to the clinic to get the medication to end George’s life. My children sat in the sun, read George stories and said goodbye. Then we sent the kids inside, and together, my husband and I pet George one last time and I gave him the solution to make him sleep and stop his heart. He faded away, gently, and quietly, surrounded by love. My final duty as an owner and veterinarian was done.
Months later, writing this still makes me cry. Not like I did that day, or the ones immediately thereafter. Now, though, it’s easier to remember the happier days with George, where he hiked, ran and swam, playing and filled with joy. He was a member of our family, and we will always remember him. But our family wasn’t complete anymore. George left a void, and while there can never be another George, it was still a void that needed to be filled.
It was time for a new dog.
…to be continued…