We be so emotional about our pets when they are old and sick. That emotion can be closer to the surface for pets than for the people in our lives.
In an opinion piece in yesterday’s New York Times, “Deciding When a Pet Has Suffered Enough,” Jessica Pierce wrote about the challenges she faced when the health of her 14-1/2 year old dog Ody deteriorated badly. She covers issues of euthanasia, palliative care, costs, and quality of life for pets.
Consider these selected paragraphs, for people as well as for pets:
People ask me how I knew it was time. There was no watershed, but a slow accumulation of miseries. Ody had been in serious decline for six months. Partial paralysis of his laryngeal muscles made it hard for him to breathe, and he would begin to pant at the slightest exertion. His once deep tenor bark had transformed into a raspy Darth Vader croak. The signals from his addled brain often failed to reach his body, so when I walked him he left a Hansel and Gretel trail of pee and poop behind him. His muscles atrophied, and his walk was crab-like and unsteady. He grew increasingly uninterested in food and people, his two great passions. Worst of all, he began falling more and more frequently and was unable to get up by himself.
Toward the end, I would wake in the night to scuffling sounds. I’d search the house and find Ody trapped behind the piano or tangled up in the exercise equipment. It was on the fourth such night that my husband said: “It’s time. We can’t do this to Ody anymore.”
Euthanasia is typically thought of as a choice between suffering and death — and, indeed, it can offer relief from unyielding pain. But death is too often prescribed as a de facto treatment for suffering when much less aggressive possibilities exist. We can ease our animals into the valley of death, rather than abruptly shoving them off the cliff.
Pain is the barometer most often used to assess whether an animal should be euthanized, and one of the most important improvements we can make in caring for our pets is to provide them with better palliative care. Untreated or undertreated pain is epidemic among companion animals.
Quality-of-life assessments have long been used within human end-of-life care, and similar tools for assessing our animals are increasingly available, well-refined and imminently useful. One nice example is the veterinarian Alice Villalobos’s “Pawspice” program, which directs pet owners to assess their pet on a 1-to-10 scale on seven measures — hurt, hunger, hydration, hygiene, happiness, mobility and “more good days than bad” — with the lowest number being the worst. During Ody’s final decline, I would force myself to think through this assessment. It was hard to be honest. Ody’s score just kept getting lower. But the exercise at least offered a measure of objectivity.
Those who have companion animals know how wrenching it feels when our pet is sick, in pain, or mentally deteriorating to the point that there is no quality of life. How do we feel when the people in our lives go through the same process?
Do we insist on “doing everything possible” to keep that person alive? Do we recognize the quality of life aspect when insisting the doctors keep him or her alive? And when or how does one say “enough” to suffering at the end of a long lifetime?
Just some questions to ponder. Anyone want to weigh in on the topic?