Life is a continuum, and the evaluation of the quality of life for your pet also exists on a sliding scale. This time period is variable and can occur over days, weeks, or even months. During this period, it is important for the family to make whatever decision is best for all of them. Some people need time to process the decline of their pet while others want to prevent any suffering, even if it means coming to a decision quickly.
This decision is very dependent on the disease progression your pet is experiencing, your pet’s personality, your ability to act as a caretaker and ultimately, your personal and family beliefs. When evaluating quality of life, personalized patient and client information is needed to reach an educated, informed, and supported choice that fits not only the pet’s medical condition but also the family’s wishes. In short, quality of life applies not only to the pet; it also applies to the family.
Frequently Asked Questions
What questions should i ask?
These questions can help to evaluate your family’s time, emotional, and (when appropriate), financial budgets when facing end of life choices:
1. Have you ever been through the loss of a pet before? If so, what decisions or plans would you repeat or change?
2. What do you hope the life expectancy of your pet will be? What do you think it will be?
3. What is the ideal situation you wish for your pet’s end-of-life experience (at home, at the veterinarian, in her favorite place?)
4. What is the most important thing when considering my pet’s end-of-life treatment?
5. What are my thoughts about euthanasia?
6. Would I consider euthanasia if the following were true about my pet:
• Feeling pain?
• Can no longer urinate and/or defecate?
• Starts to experience seizures?
• Has become uncontrollably violent or is unsafe to others?
• Has stopped eating?
• Is no longer acting normally?
• Has a condition that will only worsen with time?
• Financial limitations prohibit treatment?
• Hospice care has been exhausted or is not an option?
• The veterinary team recommends euthanasia.
7. I am concerned about the following things:
• My pet’s suffering
• My desire to perform nursing care for my pet
• My ability to perform nursing care for my pet
• My pet dying alone
• Not knowing the right time to euthanize
• Concern for other animals in my household
• Concern for other members of the family (i.e., children).
What conditions in my pet should I consider when thinking about quality of life?
Pain /Anxiety
There are some common signs of pain that we see in both cats and dogs: This can include such things as pacing, excessive panting, hiding in strange areas, avoiding interaction with family, growling, snarling, snapping, immobility, whining, not eating, lameness or odd postures and flinching when touched. Many end-stage arthritis patients begin panting, pacing, whining, and/or crying, but many of these symptoms are due to anxiety, usually arising secondarily from pain. Anxiety may be just as debilitating as pain to dogs and cats.
Mobility
Degenerative joint disease (arthritis) and mobility declines are common as our pets age. Most commonly, these signs first become evident at night when the pet begins to pace around the house. It may progress to slipping, falling, inability to stand, inability to posture to urinate/defecate, and panting heavily. In later stages, you may find your pet very anxious. When anti-inflammatories and other medications cease to work to ease pain, quality of life should be a concern.
Cognitive Decline
Many senior pets show some cognitive decline. This can range from vision and hearing loss, to inability to remember commands, loss of housebreaking control, loss of ability to navigate safely in the house and outdoors, and to loss of sleep /wake cycles.
Incontinence
Pets may lose control over bodily functions either due to physical changes (i.e., arthritis) or those caused by organ failure or cognitive decline. Pets do not like to “soil their den” and may experience anxiety which can be seen as increased panting or appearing uncomfortable. If left unkempt, both fecal and urinary incontinence can lead to sores and even systemic infection. Many owners feel terribly guilty over the natural annoyance they feel when their pet becomes incontinent, and it can become a quality of life issue for both pets and owners.
Eating and Drinking
In many cases appetite or the lack thereof can be a good indication of the internal functions of the pet. Animals nearing the end of their life or facing long term illness may no longer want to eat or drink and may show weight loss or dehydration.
Happiness/Mental Health
You love and know your pet and, because of that, will be the best at determining when they no longer seem “happy.” They may no longer enjoy food, toys, or the environment around them. Most of all, they no longer enjoy or seek out contact with you and the rest of the family. After all, you mean everything to them, so when they no longer interact with you, it is time to consider euthanasia.
How do I know when it’s time?
To veterinarians, euthanasia is a gift, something that, when used appropriately, prevents further physical or mental suffering for the pet. We will help to guide you through this very difficult choice.
The following items may help you in making the decision to euthanize.
• Enlist the help of your veterinarian. While we cannot make the decision for you, it is helpful for us to know that you are considering euthanasia.
• Remember how your pet looked and behaved prior to the illness. Sometimes changes are gradual, and therefore hard to recognize. Look at photos or videos of your pet from before the illness.
• Mark good and bad days on a calendar or a quality of life scale. This could be as simple as a plus or minus sign on a calendar for a good or bad day or using a checklist or digital calendar. If the bad days start to outweigh the good, it is time to discuss euthanasia.
• Write a concrete list of three to five things your pet likes to do. When your pet is no longer able to enjoy these things, it may be time to discuss euthanasia.
What is a quality of life scale and how is it used?
Pet quality of life scales are used to try to objectively score how your pet is doing. Quality of life scales can be useful when a pet has a terminal illness or is at end of life and can help the family decide more objectively when it is time to consider euthanasia.
There are a variety of tools to help the entire family evaluate quality of life. One tool has been developed by Lap of Love and is a digital version of a quality of life scale.
Many people will use the scale daily or weekly to see how their pet is doing, and compare the results to see how well the pet has been doing over time. Family members can also complete the checklists and compare results. These discussions can be helpful in getting consensus on the next steps.
What if I do nothing? Wont my pet just quietly die?
Peaceful and painless death is rare. Although you many have personal reasons to avoid euthanasia, you need to know that natural death can take a long period of time and can cause great discomfort. Unfortunately, almost everyone who chooses this option later regrets doing it. There is no way to comfort a pet that is truly suffering. Making that decision should not be about ending suffering, but should be about preventing suffering from occurring in the first place. Above all, our pets do not deserve to hurt.
If the most important thing to you is waiting until the very last possible minute to say goodbye, you will most likely be facing an emergency, stress-filled, sufferable condition for your pet. It may not be peaceful or dignified and you may regret waiting too long. If a peaceful, calm, loving, end of life experience is what you wish for your pet, then you will probably need to make the decision sooner than you want.
The more times people experience the loss of a pet, the sooner they make the decision to euthanize the next time they have to make that choice. First-time owners may wait until the very end to make that difficult decision. They are worried of doing it too soon or may feel guilty for having “given up”. Later, however, most of these owners regret waiting. The next time they face the same situation with a different pet, they are much more likely to make the decision at the beginning of the decline instead of the end.
