A Vizsla, an Osteosarcoma and an Emergency Vet all walk into a bar…

Don’t worry….it’s thankfully not Hank’s “time” just yet (however, there have been some recent changes, but we have still been busy loving life on three legs…hence the tardiness of this post…more to come soon), but as a veterinarian, I am asked this question by clients on a daily basis when their beloved pet is nearing that moment.  And, I have always had a good answer.  But will I be able to practice what I preach? I hope so. So here I sit, at work, with Hank next to me in my office…..and I write….and I cry….

If there is anything I have learned from being in emergency veterinary medicine and dealing with illness, sickness, death and dying all the time, it is that being able to make the decision to end the suffering of those pets that are so very important to us is not only a blessing, but a curse. When I first started practicing, being able to provide humane euthanasia was probably one of my favorite parts of my job. Not to sound morbid or anything, but there is something very satisfying about ending suffering and being able to provide a terminally ill/injured/old/sad dog or cat a feeling of euphoria and painlessness while being surrounded by those that love them in the last few minutes of their lives. How cool. The majority of people dont even get that opportunity when they are terminally ill. However, something it took me a while to learn was the effect that having that power to make the decision to end a life (human or not) has on people. The guilt, the shame, the sadness….it goes home with everyone (including myself) no matter how prepared you think you are to make this decision. So, then, how do we know? How do we know when it’s the right time? The right time to minimize suffering and maximize quality of life? The right time to be able to be strong and say good-bye? How do we know if its too early? Or too late? I have realized that this type of thinking will send most down a rabbit hole they don’t want anything to do with. But, really, it is very, very simple…..

Whack-a-Mole at its finest…he literally had his head in this hole for a solid 3 minutes…

My first experience with euthanizing a pet was my childhood dog, Roscoe. He was a 90-lb pitty from the “pound” that belonged to our neighbors and good family friends during my adolescence. They had three dogs (including Roscoe), and they had a swimming pool. Two things I definitely did not have, so as you could imagine, I was at their house constantly as a kid. Well, it became evident very quickly that Roscoe took a liking to me and I to him. But my mother had asthma and I grew up with the understanding that dogs and cats were not going to ever cohabitate with us in our house unless we wanted our mother to suffocate to death on pet hair and end up sounding like one of those people on the anti-smoking commercials that have to talk and breathe through a hole in their neck. But…it got to the point that when I would leave from a visit, Roscoe would literally lay by the front door of my neighbors house, with his nose pressed to the gap between the bottom of the door and the floor until I returned. He wouldn’t eat, he wouldn’t drink, or even move for that matter. So, the neighbors begged us to take him when I was ten for fear he would starve to death during my upcoming horse-show season when we would be traveling a lot and my visits to Roscoe would be few and far between for a few months.  Thankfully, my mom was a sucker for my pouty face and agreed to give it a try….and then I had a dog.

Roscoe was with me for thirteen awesome years and my mother even shipped him out to Colorado to be with me when I went to college. He was my companion, my protector, my first dog. He came with me just about everywhere and, since I lived in the worst ghetto of my college town (it was bad…drug dealing, questionable characters on every corner, random toddlers walking down my street in nothing but a diaper with no adults anywhere to be found, but hey, the rent was super cheap!), he was a great reminder to all the creeps in my neighborhood to never mess with me. He was always healthy, but his last year I watched a slow decline. His mobility was terrible thanks to typical big-dog arthritis as he aged, he developed several tumors on his rectum and near the end, he would have accidents in his sleep on his bed which mortified him. But, he was still happy as ever. This was before veterinary school, so I remember expecting him to just die in his sleep one night, as many people with geriatric pets do. And then, “the day” came. I still remember that day not only because of the profound impact it had on me at the time, but also for the unknown impact it would have on my entire veterinary career.

It was an early summer Saturday in Western Colorado between my Sophomore and Junior year of college, which for me at the time, meant I would get up at 4am to head to the barn to ride the 5-6 horses I needed to train for the day before it got scorching, Western Colorado hot. Then I would get home around 1 or 2pm and nap for the rest of the day in my air conditioned apartment. Roscoe and I had a routine in which I would let him out and feed him quickly before I left in the early morning, then I would take him on a much longer walk in the evening once it cooled down. But this morning was different. I couldn’t get him out of bed for breakfast which was VERY abnormal for him. This is a dog that never missed a meal in his entire life and ate an entire one pound box of chocolate covered coffee beans the Christmas prior that was wrapped and under my Christmas tree- he even ate the packaging, so he was pooping wrapping paper and bows for a week.

That morning I even had to carry him down the stairs of my apartment building to get him to go to the bathroom and when I set him down in the grass, he couldn’t stand for long. I remember bringing him back upstairs, placing him on his bed and expecting he would be better once I got home from working. I wasn’t too worried until I pulled into my driveway that afternoon and for the first time ever, I didn’t see his goofy face staring down at me out of my second- story living room window. He knew the sound of my car and when he would hear me pull into the drive way, he would usually jump onto the sofa by the window (if he wasn’t sleeping there already) so he could watch me get out of my car and come upstairs. I even remember sitting in my car for several minutes and waiting to see if he was just moving a little slower that day….his face never came to the window. I finally made my way upstairs and he did not greet me when I came in the door. My heart dropped. I walked around the corner and into my bedroom where he was still laying on his bed- in the exact same position in which I had left him. I stood in my doorway for a while already trying to think which vet would be open for me to take him to that day….and then, without even raising his head, he looked right at me. And for a dog I had owned for 13 years, I had never seen these eyes before. Something was gone from them….something was missing. And before I could even begin to analyze what this look meant, he let out a big sigh and instantaneously, his eyes literally said to me…… “Mom….I’m done.” I ran to him and collapsed at his bed side, cried and tried to tell myself that this hadn’t just happened, that I was making it up in my head, but I absolutely knew in my gut that he had told me he was ready to go. He told me he was in pain, and tired, but that it was ok. A good friend of mine (who happened to be a veterinarian) came to my apartment the next morning and put him down as I sat with him on the floor in my bedroom, cradling his head in my hands as the wind blew through my curtains and the sun shone in on us. It was an absolutely beautiful experience that I will never forget. And I feel like every pet owner deserves a chance to have this type of end-of-life experience with their pet.

The combination of this experience and several years of practicing emergency veterinary medicine has taught me a lot about knowing the “right time.” And again, it really is quite simple. So in typical LP fashion, I have put my pearls of wisdom about this into a list:

1. Dogs and cats are very, very good at letting their people know when they are truly “done,” exactly as Roscoe did for me; especially when dealing with old age or chronic illness. But each pet is different in how they will “tell” you and the kicker is you have to be open enough to see it and not fall into a pit of denial. Whether its a look (or lack thereof), no longer wanting to eat, go for a walk, etc., they will tell you. I had one client tell me she knew it was time for her cat because for the first time ever, her kitty didn’t bite the dog that morning when he came in from outside as she had every single morning for 16 years.  I have learned that this a common reason why people will often show up at my clinic at all hours of the night/morning to euthanize their dogs/cats that have been sick for several days/weeks/months.  This used to bother me (really? your dog has been vomiting ALL day and hasn’t eaten for a week but NOW its time at 3am?), but I have learned that that just happened to be the moment when that pet told their owner they were ready, whether the owner knew it or not. And now I am glad when those people come in because that shows they were open enough to not be in denial about the life stage of their pet and didn’t make them wait any longer or suffer.  This is the meaning of true love and selflessness when the decision to end a life is in your hands.
2. People seem to never regret letting their pet go “too soon” when they are sick/elderly/have poor quality of life, but they almost always regret waiting too long. And that is the worst. The guilt that people feel when they all of a sudden realize that their pet may have been suffering and they were in denial about it is crippling and something I warn many about when they are contemplating the right time for their pet.
3.  It is all about quality of life. ALWAYS. Our pets love us unconditionally and bring us so much joy in life. The least we can do in return is to not expect them to suffer the human condition of wanting to live as long as possible, even if completely miserable. A dog should always be able to do the things that dogs do- walk and/or play, eat, chase things, enjoy being around their people. Cats should be able to jump, snuggle, eat, play, groom themselves…and most importantly, they should all be able to do these things and not be in an unreasonable amount of pain. If your dog/cat no longer has quality of life….it is time.
4.  If you wait until your pet dies at home without intervention, you’ve waited too long. In general, it is very, very rare that dogs and cats die peacefully in their sleep as most people expect them to do.  The diseases and problems that cause death in animals are not pleasant ones….and I guarantee are not ways in which you would want your pet to pass. And then you’ll never know for sure if they were in pain, if they were scared, if they suffered. However, when a pet comes to me for euthanasia, I can be 100% sure they were not in pain (thanks to the cabinet full of narcotics I have at my disposal and use without restraint in these cases), I can be mostly certain they were not scared (thanks to the shelf of Valium, sedatives and other good drugs I also have at my disposal) and that their last memory was most likely of you…their favorite thing in the world. What on earth could be a better way to cross over? I cant think of a single one…
   

   Recent fall day at the park

In remembering all these things, I can only hope and pray that I will do right by Hank in knowing when its his time. I have already promised him. And that is the least I can do after all he has done for me. I can make 100% sure he wont be in pain anymore, he wont be scared, and that I will be right by his side.

Until next time (sooner, I promise!)

LP