Peaceful Home Euthanasia
How Do I Know When "It's The Right Time?
When a pet has become ill, physically challenged, and is no longer enjoying a significant amount of their daily living , then, as pet owners, we are faced with the emotionally very challenging decision of when to “put our pet to sleep” (technically “euthanasia” meaning” painless death”). We may worry, “Is it too soon? Have I waited too long? Is it the “right” thing to do?A veterinarian "Quality of Life" exam is exceptionally helpful at this stage in life, as explained below.
If you are struggling to know if this is the time to help your pet to “pass on”, it may be helpful to consider the following questions when you can calmly think about or discuss each of the following with those who want to be involved and considered:
We all wish that our pet would pass on naturally “in their sleep”. However, like with us, it is very rare, and usually not without a long drawn out illness, nausea, struggle, or sense of helplessness .
Euthanasia is a way to ease or prevent a pets suffering at their “end of life” stage. While it feels un-natural, it is a very kind, compassionate, and loving option to consider at this stage, when a pets quality of life now and in the near future is not going to improve, or, they are at risk for getting into a more painful or stressful state (eg: when large dogs suddenly can’t get up, or a heart condition pet is going to end up with a breathing crisis, etc).
Comfort and happiness considerations for your pet:
Is your pet still enjoying life? Is s/he still interested and able to do a reasonable amount of the activities that they normally do or enjoy when they were better (eg: a senior dog still enjoys a putter around the yard and a bit beyond)? Is your pet more uncomfortable, listless, or anxious, (panting dogs, hunched up or hiding cats) than “comfy and content”?
Does your pet still have a good appetite? (hand feeding or force feeding implies nausea and a pet is often eating more to please you rather than enjoying eating, many "hyperthyroid cats" hide their illness/nausea under a compulsion to eat).
Can your pet comfortably maintain bladder and bowel functions easily? Can you help them out on a comfortable and regular schedule (every 4 hours) if they need assistance? Pets feel extremely uncomfortable, helpless, and distressed if they can’t get up readily, have accidents in the house, or get soiled.
Is your pet’s pain, chronic discomfort, such as mouth pain or nausea, (expressed often as lethargy, decreased appetite), or bowel/urinating/mobility problems, from an underlying condition that cannot be improved? (eg: chronic end stage kidney, liver or intestinal diseases, cancers, general weakness/very old pets)
Is your pet struggling with a condition that will only worsen? (cancers, kidney condition, worsening mobility despite trial of meds and other support).
Is your pet at risk for worsening or taking a sudden turn for the worst? (heart , respiratory conditions , internal cancer, seizures, large old dogs with back or chronic lameness problems who often suddenly can’t get up, cats with hyperthyroid, kidney or high blood pressure prone to painful blood clots).
Do you feel your pet’s current conditions makes them feel increasingly more helpless than dignified? Is your pet becoming more socially isolated/lonely from their normal family interactions/favorite places, due to bathroom accidents, immobility, stairs, or other conditions/factors?
Are you able to continue giving your pet the increasing care that s/he needs? Physical/nursing care? Quality time and daily monitoring? Ample and regular (vs minimum or sporadic) bathroom breaks/access? Medications and financial aspects of pet care?Ample padding and rugs that prevent falls/slipping Ie: to keep your pet comfy and content, socially engaged, and so s/he can still enjoy their routines and most of the day?
Many dogs look “happy” when their owners arrive home, but consider how comfy, content and comforted, is your pet, during large parts of the day, when they are on their own, or overnight? Are you at home enough or are you on a busy work schedule? Are the family members who are hesitating with this decision the ones that see your pet less frequently? or maybe the one most attached is finding this an understandably more difficult a decision for them.
The size of larger dogs is another very limiting factor to their mobility, comfort, dignity, and helping them.
While cats may seem to 'sleep a lot", this can also become a way of hiding their lethargy, pain or nausea (nausea is very common in sick cats ) from an underlying disease, especially if they "weave" their way to their litter box or sit staring at their food. Making it to the litter box is not really a sufficient sign of comfort, as even very sick cats have an exceptionally strong drive to 'make it" to their box, and to drink (especially with kidney failure) above all else. They drink more because they cant stay hydrated, losing excessive fluid through extra urination from kidney disease and other diseases. Hyperthryoid cats will have an unnatural "compulsion" to eat, which can make a very sick cat (eg with concurrent cancer or kidney failure) look or act better than they feel.
New "hiding" behavior is a significant sign, as is being "clingy" of pain, quiet distress, or helplessness in cats or dogs.
Cancers can cause a lot of pain that pets feel they just have to live with. Pets rarely vocalize pain, except for a sudden pain, like a newly fractured leg, pinched toe, or trauma - after which they will do their best to be quiet about pain. Cancers create additional nerve and pain sensations that pets wont tell us about, except for some subtle changes in play, becoming "clingy" or distant, hiding, increased lethargy, and sometimes house soiling. Otherwise, they will generally do their best to look and act as normal as possible. Head cancers, bone cancer, pancreatic cancers are definately very painful cancers. Many pains and discomforts (especially cancers and arthritis) are worse at night, causing panting, restlessness, and intermittent fever.
Heart failure needs special and earlier consideration to either improve with medications, if still possible, or prevent suffering from worsening ability to oxygenate at the end stage. Worsening signs are: Increased coughing, swallowing phlegm after coughing/wretching, increased respiratory rate (while sleeping), increased effort to push in with abdomen while breathing out, decreased exercise ability, increased panting, decreased appetite, cant lay down for as long/restless- all of these are serious signs to discuss with a veterinarian during an exam if you want to evaluate and update your pets medications or prognosis.
I hope these questions help you to review many of the "Quality of Life" factors making up your pet’s health and happiness level. These factors include: your pet's daily comfort, having adequate company and support, the increasing effort, time and abilities required to help them daily, and your pet’s overall condition and prognosis. Suffering includes not only hidden or (rarely) overt pain signs, but increasing lethargy from weakness,chronic discomfort, dehydration despite increased drinking, helplessness and nausea. Pets rarely “vocalize” with chronic pains, instinctively hiding their weakness so as to not draw attention to their debilitated state. A veterinarian "Quality of Life" exam is exceptionally helpful at this stage in life, as explained below.
Philosophical Considerations:
Pet owners want their pet to pass on peacefully, “in their sleep”, and prevent “suffering”. To do this, the pet owner needs to look ahead, and plan for a peaceful passing, by arranging a peaceful home euthanasia (or clinic appt) , ideally before they “have to“ and before their pet “takes a turn.” Sometimes one member of the family needs to lead the family or decide for the family on the better time for their pet, if an ideal "conscensus" cannot be reached at the right time for the pet.
The decision to help your pet through euthanasia can feel very unnatural, and can bring feelings of guilt, despite being a great kindness. Perhaps it will help to consider that your dear pet is a domestic animal, not a wild animal or a human, and is depending on you to prevent it's suffering when possible. We couldnt "plate" fractured legs in the past, nor do "caesarians" with difficult pregnancies - these are also very artificial and newer aspects of western medicine, and yet these newer advances alleviate great suffering. When you know that your pet will not get better, and faces increasing illness, debilitation, or pain, consider the view that you are not taking a 'good" life from your pet, more that you are saving your pet from a suffering end. This is important to discuss with the children in the family - including the adult children, who have had their pet for many years.
"Euthanasia" means "painless death." In our society, this is possible through euthanasia by a veterinarian, using medications designed for that purpose. Additional sedation and analgesic medication used varies according to each veterinarian's preference or clinic protocol, and can greatly add to a pet's relaxation and comfort.
When discussing and deciding what is kindest for your pet, consider the daily quality of your pet's life, regarding their dignity, comfort, and happiness, at this point or in the near future. Pets appear to live more in the moment than we do, they are not looking ahead planning the future or recalling their happy past - their happiness depends on how they feel moment by moment, day by day.
If you or any involved person(s) are unsure, after going through these questions, as to whether to plan a peaceful home euthanasia, or, to go back a step and improve your pet's life (through treatments, tests or adjustments at home), then I highly advise a veterinarian consultation. This can be done either at a clinic or at home. A "Quality of Life" veterinarian consultation will help you to better evaluate and possibly improve your pet’s comfort and enjoyment of life.
Sometimes tests can help clarify your pet's conditions and prognosis (blood test and/or xrays usually, possibly ultrasound). You can discuss candidly with the veterinarian how much you want to do in terms of investigations or treatment.
Should an improvement not prove to be possible, likely, or sufficient, then a veterinarian "Quality of Life" consultation can also better prepare you and your pet's family, for planning to help your pet to pass on peacefully, via sedation and euthanasia, and surrounded by yolur love, at the best time for your pet, at this stage in their life.
When to Consider a "Quality of Life" Consultation
If you or any one member of the family is unsure if it is the right time for making a Peaceful Home Euthanasia appointment, then it is our protocol to not proceed at this time. Instead, we advise having a “Quality of Life” consultation as a separate appointment. This is a unhurried, neutral, thorough review of your pet’s situation, based on:
1) previous diagnostics and treatments that your pet may have already received;
2) a review of your pet’s environment;
3)an updated physical exam, and
4) your care options, given your pet’s temperament, conditions, and your abilities/resources.
5) We can also discuss further tests or treatments if feasible or helpful at this time. Sometimes a blood test at home can help clarify the general underlying health and prognosis of your pet.
The goal of a “Quality of Life” consultation is to provide you with information to assist you in making the best decision for your pet, to either to plan a peaceful home euthanasia, or to improve on how to care for your pet further at home at this time, and then see if things improve or not. This appointment can also provide “peace of mind” for you if it has been a while since your pet has had a veterinary exam. You can also discuss candidly your concerns and priorities.
After a quality of life consultation, or when you decide to arrange a Peaceful Home Euthanasia, our protocol is to ask owners to “sleep on it”, at least overnight. Otherwise, it has been our experience, otherwise, that many pet owners will falsely “second guess” themselves later, even if a peaceful euthanasia is the obvious and best kindness. Our goals are to prevent suffering of your pet, to provide a peaceful home euthanasia when the time is kindest and wisest, and to provide peace of mind for you, and for all involved in helping your pet, at this stage of life.
For the costs involved for a housecall and a "Quality of Life" consultation at home, please see the "Quality of Life" page under the "Peaceful Home Euthanasia" section.