I remember when my precious Georgia was in the final stages of battling lymphoma, how often I wondered if I would know when it was time for us to say goodbye. I struggled with this question almost daily, worried that I would hold on too long out of my own cowardice or selfishness and make her suffer unnecessarily, or that I would give up on her too soon and force her to leave me before she was ready. It was something that created an indescribable ache inside of me and cast a shadow on each of our final days together. People told me that “I would just know,” but I didn’t believe them. How could one ever know the right time to deliberately choose to end the life of someone that you loved with all of your heart and soul? How could one ever really feel ready to say goodbye? It seemed impossible.
In our case though, the friends who offered this advice were right. After two days of not being able to sleep or breath well, a final Hail Mary drug to kick the cancer back a couple of steps, and a rapid progression of jaundice, abdominal swelling and an inability to eat or stand made it clear to us that it was time. We had tried everything and our little girl was tired and the light in her eyes had gone. In the end, my desire to protect her from her obvious suffering became stronger than my intense desire to keep her with me for as long as possible. I could only protect her by helping her to transition from this life with the help of our veterinarian. It was a difficult realization, but one that I felt at peace with. I still do.
But what if the signs of suffering aren’t as obvious? What if your pet is dying from the natural aging process but is not in pain? What if you struggle with the concept of euthanasia in general or just don’t feel ready to make that choice yet? What do you do then? Here are some questions to ask yourself to help determine what is best for you and your beloved pet.
1. Is My Pet in Pain?
If the answer is yes, then can that pain be managed somehow? There are MANY pain management options available – everything from acupuncture, homeopathy and herbal medicine to conventional drugs that can be given orally, topically or via injection. It’s important to talk with your vet early about the warning signs of pain, which can often be overlooked in animals, who are inclined by nature to hide injury and illness. Knowing what to look for and how you can manage pain successfully is very important. If your pet is in significant pain and it cannot be adequately controlled with the help of your vet, then your pet is likely suffering and euthanasia should be considered.
One level of pain that is often overlooked is an inability to breathe. While shallow breathing can be a very normal part of the dying process, this is different than if your pet cannot breathe due to an obstruction or other complication associated with their condition.
2. Am I Able to Properly Care for My Pet as Their Condition Progresses?
Caring for a seriously ill animal can be very costly in terms of time, energy and money. It also generally requires the assistance and support of a veterinary team. Not all of us can go to the lengths we wish we could to provide the care that our animal needs when they are seriously ill or at an advanced age. They may need round the clock care, expensive medications or specialty treatments in order to ensure that they do not suffer and can remain safe and happy in their home environment. Providing this level of care may not always be possible for a wide variety of reasons. No matter what we want in our hearts, sometimes hard realities have to be faced. That’s okay. One of the most beautiful things about our pets is how they accept life exactly as it comes to them and they don’t expect or ask any more from us than what we give them. They love us for exactly who we are and have absolute faith that we always try our best for them.
As pet parents, we are not expected to be superheroes. Sometimes we have to accept that while it’s possible that our pet could continue their life for a while longer with the right supports, we just aren’t able to provide that for them at this time. In these cases, it is our obligation to recognize that harsh truth, and to make the choice to help them cross peacefully rather than provide them with inadequate care that may ultimately cause suffering or create new problems for them.
3. What Makes Up MY Pet’s Quality of Life?
There are several Quality of Life Scales which can be used to help you assess how close your pet may be to the end of their life, and they can be very valuable tools. One that I have found particularly useful over the years is the Quality of Life Scale designed by Dr. Alice Villalobos. While helpful, a Quality of Life Scale should not be used exclusively as a guide to your decision-making though as they can’t begin to quantify key aspects of your pet’s situation such as your ability to manage the symptoms associated with their condition, or most importantly, your pet’s will to live.
Think about people that you have loved who have been very sick or who have suffered a serious illness or reached an advanced age. They may have temporarily or permanently lost their ability to engage in activities that they used to enjoy. They may not have been able to eat and drink normally, or to move around on their own, or to control their bladder and bowels. They may have slept more than they did before or experienced some amount of physical discomfort, or even pain, all the time. They may have lost most of their physical abilities — but you may have found that they still retained that primal will to live. That they still seemed to enjoy spending time with those they love. To feel the sunlight on their face and the comforting touch of their family. That they had lost nearly everything physically, but still were not done living. Your pet may feel this way too. Just because they lose the ability to do some, or nearly all, of what they used to DOES NOT NECESSARILY MEAN THAT THEY ARE READY TO DIE.
You know your pet best, and you will see if that spark leaves their eyes. Use a Quality of Life Scale as a tool to guide you and provide some objectivity to the situation, but trust your instincts above all else and listen to your heart when it comes to judging when quality of life has suffered too much. No one else knows what this means for your pet.
4. What Will I Be Able to Live with Down the Road?
Too often I find that pet parents are encouraged to consider euthanasia before they are ready. And sometimes they are never ready and prefer to assist their pet in experiencing a natural death, which is often frowned upon by others and rarely supported by conventional veterinarians. This pressure to meet others’ expectations can result in tremendous feelings of guilt for the pet parent and can turn what should be a sacred part of their pet’s life into a nightmare that can last a very long time. Euthanasia is difficult even under the best of circumstances and it is human nature to feel as though you are somehow responsible for your pet’s death rather than the disease or simple aging process that prompted this choice. But for those who choose euthanasia when they are not ready, it is very hard to come to terms with this decision and to ever fully let go of the feeling that somehow they let their best friend down.
Despite what others might say, if your pet is not in unmanageable pain, they are being cared for well, you are working with a veterinary or hospice team to regularly assess their condition, and you believe that your pet still has a will to live despite their physical condition, then you have every right to wait and to continue to support your pet in their dying process. There is no rush to make a final decision. Aiming for a natural death, or postponing euthanasia for as long as possible is a perfectly reasonable decision. Don’t let anyone else talk you out of that if it’s what you feel is right in your heart.
On the flip side, if you are a pet parent who believes, “I would rather euthanize my pet one day too early than a minute too late” and worry about them having to suffer in any way, then you have the right to make the choice for euthanasia when you feel that your pet is about to take a turn for the worse. You may feel strongly that your pet would want to leave this earth with some of their physical abilities still intact. Or, you believe that you would not be able to forgive yourself if your pet did reach a point where they were genuinely suffering, and you felt that you could have prevented it. This too, is okay. I have always felt that we are lucky as pet parents to have the option of euthanasia at our disposal, to be able to give our pets a gentle passing when the time feels right and under circumstances that we can control.
Having the options of either euthanasia or a natural death gives us a full spectrum of choices so that we can honor our pets and help them to make their transition from this life in the way that we feel is best for them. In either case though, the choice has to be yours alone, and one that you and your family can feel comfortable with today and in the long run. No one else has the right to choose for you or to pressure you into a decision before you are ready.
When wrestling with end-of-life decisions for your pet, it’s important to recognize that there is never a perfect time to say goodbye to someone you love. No matter when it comes or how, it will always feel too soon. While we can’t control the grief that comes after the death of a beloved pet, we can control the amount of grief and anxiety that we put into the process of making a final decision about how or when they will make their transition. By asking yourself these four questions, being honest about your situation, and then listening to your heart, hopefully you will find the clarity that you need to make the decision that is right for you and your beloved animal companion.