“Her heart has stopped, and so has her pain”. This emotional statement was spoken by one of my clients after the death of his cat, Annie. It was said out of both sadness and relief, which so many people feel during pet euthanasia. Watching a beloved pet suffer with physical and/or mental decline is emotionally painful for clients, who often feel conflicted about what to do. Do they provide medical care or do they elect euthanasia to guarantee an end to suffering? To me as a veterinarian, the main question I must ask myself is not only whether the patient is suffering, but is the patient suffering badly enough that death is warranted. Let me explain.
Many animals suffer from different conditions: arthritis, organ disease, obesity, dental disease, and anxiety to name a few. Animal suffering is the conscious, negative experience of pain, distress, or discomfort. It occurs when an animal undergoes physical or mental hardship and is unable to easily adapt or escape the situation.(1) While a veterinarian’s mission is to prevent and alleviate animal suffering, the truth is, suffering remains commonplace across the world.
Many years ago I learned a definition of suffering that has stayed with me. Suffering is “anything that denies us our true self.” Pets suffer when they are unable to play the way they want, eat their preferred foods, be with loved ones, and more. In other words, suffering is all around us. When other veterinarians and I really start to worry is when physical and mental suffering is all the animal has; when daily pleasures are gone and nothing brings relief. This is when suffering warrants euthanasia. Just today, I watched an old obese dog struggling to walk behind his owner down a hot street in Colorado. This dog was suffering as he limped along in pain and tried to keep up with his well-intentioned owner. Gone were the days of his youth when, I imagine, he would pull his owner toward the park, ready to play. Yet, I still wouldn’t say he was ready for euthanasia.
Veterinarians and pet owners alike have their own tolerances to a pet’s suffering. An owner may euthanize their pet the same day that cancer is diagnosed, while another will wait until the pet stops eating. One veterinarian may suggest euthanasia for a pet patient with severe anxiety, while another may prefer to postpone until all the anxiety medications have been tried. After 20 years in end-of-life work, I’m still unsure what the right approach to such things is, but I do know that not all suffering is created equal, and that an animal’s will to live should be taken into account.
Many quality of life scales have been created to guide veterinarians and pet owners in discussions around euthanasia or continued life-sustaining treatments.(2) We all worry about what age and disease can bring – pain, nausea, insomnia, medication intolerance, fear, and a break in the human-animal bond. When seeing such things, our instinct may be to euthanize out of fear that conditions will worsen, or even out of the mere perception of decline. I was once called upon to euthanize a very thin dog with gastrointestinal disease, owned by a man with advancing dementia. The man’s daughter was afraid the neighbors would call animal control to take the dog from him. The dog was happy enough and enjoying life with the man, yet we all agreed that euthanasia sooner rather than later would prevent unwanted drama.
So what is suffering that warrants euthanasia, and who decides? Sometimes it’s clear: excruciating pain that cannot be controlled, gasping for air, or unrelenting seizures. More often than not, though, there is uncertainty, worry, and the desire to avoid regret at having euthanized too soon or for having waited too long. For now, this is the reality for veterinarians and pet owners hoping to make the decision for euthanasia at the right time and for the right reasons. My best advice is to proceed with caution, explore modern medicine to the fullest, and reach for euthanasia only when all alternatives have been considered. Depending on who you ask, including the pet, suffering may not yet be bad enough and life is still worth living.
References
- Pietrzykowski, T. and Smilowska, K., 2022. Kinds of harm: animal law language from a scientific perspective. Animals, 12(5), p.557.
- Cooney, K. 2022. Pet Quality-of-Life Scales in Euthanasia Decision Making. (https://caetainternational.com/pet-quality-of-life-scales-in-euthanasia-decision-making/
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