Making The Hardest Decision

Today I saw a new client who had made the difficult decision that it was time to euthanize her cat.  
It was made even more painful for her because this cat was the last living attachment to her deceased husband. 


This cat was a patient at another animal hospital but she came to us for convenience.  Sometimes this baffles me (in her case it was truly time/drive convenience) as I've seen euthanasia appointments when an animal has been treated for months to years elsewhere. I've found that sometimes, they don't feel comfortable going back to the veterinarian that diagnosed a diseased or suggested some treatment because they don't want to be made to feel bad or guilty. I think that's sad and I truly hope that it never happens to me (granted I may not ever "know" it has) because ultimately (unless it's case of "this cat doesn't match my furniture"), making a client feel bad about an already arduous choice is not something we should be doing.


In this case, they had (some time ago - unknown how long) diagnosed him with kidney disease and he was being managed with diet and some meds (though she said he didn't tolerate them well). I didn't have a lot of details and I didn't need them to help her.


Chronic renal insufficiency and subsequent failure are one of the top 3 things we see in older cats. Dogs can also be affected but to a lesser degree (and for sometimes other reasons).  This cat was now showing a decline in his quality of life. 


"Quality of life" is a term many of us vets use to bring up the end of life discussion or to assess how the patient is doing. This is very subjective and can be very difficult to assess for some. There are some people that absolutely will NOT see that the animal is suffering. Others don't want to see any problems arise and will request euthanasia immediately.  Then there are some that have to make that decision based on financial issues. And there a many variations of all those cases!  


There are some basic things to look at: attitude, eating, elimination habits/issues, pain (but remember they often do not show pain), etc.


Age is not a disease so some change - like arthritis affecting mobility - is to be expected in many patients. There are often things we can do to help them feel better. However, there does a come a time when medicine or surgery (no matter how much money one has) is simply not going to help.  


One thing I hear so frequently from clients is: "I wish he would just die at home" or "I am going to let her pass on own."   Unfortunately, this is usually NOT going to happen and even when it does, it's not always a nice peaceful event, where they simply go to sleep and never wake up.  


It is really important there be open, honest communication between you and your veterinarian on this.  I always believe in telling people if I feel the animal is suffering but it is NEVER my decision to make for them. Each case and situation is unique - as each person and pet is unique.