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Hospice Care and Euthanasia

Hospice Care and Euthanasia: How to Know It's Time
Dr. Elena McComas
Sept 10, 2018

Senior Cat

Pets are increasingly becoming an integral part of our families. We experience many milestones in life with them, such as births, graduations, weddings, and death. As our pets age, they become prone to developing certain diseases (liver disease, kidney disease, heart disease, etc.) and mobility problems. 

Caring for our pets that have become terminally ill or are geriatric can be challenging in many ways. Often special routines are implemented and frequent visits to the veterinarian are needed.  These visits can leave owners sad and worried that the time you have left is decreasing with every visit. 

Often the discussion arises between owners and vets about euthanasia versus a natural death, and can leave both parties with a multitude of emotions.  Unfortunately, pets will rarely pass at home in their sleep and the decision to say goodbye needs to be made. It is natural to experience anticipatory grief before that actual loss of the pet occurs. It is also natural to feel a full range of emotions including anxiety, fear, and sadness.  Some people feel that the loss of a pet can be worse than a family member due to the feelings of grief from making the decision to euthanize. It can also be natural to feel relief and happiness before and after the euthanasia occurs, knowing your pet is no longer in pain. 

Senior Dog

There are some decisions that you should consider in preparation for when the time comes to euthanize your pet. Who in the family does or does not want to be present? Do you have any questions concerning euthanasia and do you understand the process?  Having these questions answered and decisions made regarding your pet can help alleviate your anxiety and allow you to focus on providing your pet with the best and most compassionate care possible. 

There are various points that should be taken into consideration regarding quality of life (QOL) and euthanasia.

Pain and Anxiety

Pets don’t demonstrate pain in the same ways that people do and can often be overlooked.

Pets are often more affected by anxiety, which can stem secondarily from pain. Pets often demonstrate pain and anxiety by panting, pacing, and whining/crying. 

Waiting Too Long

Fear can be a paralyzing factor in making the decision to euthanize a pet.  Owners are fearful in doing it too soon or giving up too early. Owners often tell veterinarians that they have waited too long to euthanize previous pets and that they don’t want their current pet to suffer. After reflecting on previous experiences, feelings of guilt can creep up if owners have put a previous pet through multiple procedures and trips to the vet that didn’t improve their quality of life.   

It is never easy to say goodbye to a furry family member.  If the most important thing for you and your family is to wait until that last possible minute to say goodbye, then you may be faced with an emergency situation, which can be stressful on you and your pet.  If you choose a time to say goodbye, then it can be a loving, peaceful, and family-oriented time where you can say goodbye to your loved one.

If you are struggling with deciding if it is time to let go of your pet, use the below scale to determine your pet's quality of life. You can also use this scale when discussing your pet's quality of life with your veterinarian. 

- Elena McComas, BVMS

Quality of Life Scale

Below are some key factors in assessing the Quality of Life with your pet. Fill in the appropriate number for each category and then add the numbers together for that day.

Mobility: These issues are common in elderly pets. They are first evident at night when the pet begins pacing. It can progress to falling, unable to stand, unable to posture to urinate/defecate and panting. Pets can develop anxiety because they are unable to sit/stand/lay down easily and can feel helpless. 

2 Good Mobility- no problems getting around
1 Poor Mobility- difficulty getting up, hard time posturing to eliminate
0 Minimal Mobility- needs assistance and pain management doesn’t help.

Nutrition/Hydration: Pets can physiologically survive without food and water for many days. Appetite stimulants can be given, but a lack of appetite can be a sign that the body is shutting down.

2 Good Appetite/Thirst
1 Poor Appetite/Thirst- hand feeding, needs enticing (Sometimes increased in particular diseases)
0 No Appetite/Thirst

Interaction: Social interactions with family members as well as other pets can be a good gauge on the mental health (as well as physical) of your pet.

2 Normal Interaction
1 Some Interactions
0 None/Hides

Elimination: Animals are clean and do not like soiling themselves.  If they are having problems relieving themselves properly this can lead to anxiety. 

2 Normal
1 Reduced/Irregular  
0 None

Favorite Things: Most pets are easy to please and are keen to have their routine. Once your pet starts to become disinterested, their quality of life should be discussed.

2 Normal (activities, toys, etc.)
1 Decreased
0 No interest


Scoring: 

9-10: Everything is ok :-)
6-8: Requires intervention. Speak with a veterinarian to see if any medications can help your pet's quality of life.
5 or less: Consider euthanasia. 


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