I not only see pet owners contend with this period of canine and feline life, but have contended with it time and again as a pet owner myself. By the “grey area of life,” I am referring to the time when a dog or cat has reached a very advanced age, the body is breaking down, the pet is a shell of his/her former self; yet they eat, potty outside, enjoy being pet, and there is no definitive systemic disease that confirms that it is no longer humane to keep them alive.
These pets often have poor eyesight or be blind altogether. They may not hear well or are deaf altogether. Most have debilitating general arthritis and suffer from mild to severe cognitive dysfunction (dementia). For many owners of these pets, it is questionable at times whether the pet recognizes them.
Pet owners often share with me that they wrestle with the fact that they do not know it they are being inhumane by keeping them alive. They wonder if the pet is now existing more for their own inability to say goodbye, with no virtually no quality of life; or if the pet enjoys adequate quality with its age related deteriorated state. Pet owners seek guidance from me to help them make the correct determination.
The advice I will give you is the same advice I give my own clients…and the same guidelines that I live by for my own pets. The first step for these pets is to make certain there are no diseases that may indicate that quality is severely compromised, or if there is a reason beyond age related breakdown as to why they make exhibit certain deficiencies. Here are some examples:
– The patient has arthritis: Are there any metabolic diseases like hypothyroidism that may be exacerbating the effects of arthritis.
– The patient cannot hear: Are there infections or inflammatory polyps in the ear canals that may be contributing to loss of hearing”
– The patient has urinary incontinence: Does the patient have underlying diseases that may be causing that, such as diabetes, kidney failure, or urinary tract infections?
– …and so on.
It is important that we not just assume that a certain health problem is just the result of age related breakdown. Once we assess the patient’s overall health, only then can we see if any of these issues are treatable, if it truly is an age related problem, and really assess quality as objectively as we can. After this is determined, we can then look at the four essential functions that are necessary for any a pet to enjoy a reasonable quality of life.
1.) The ability to ambulate – Can the patient walk from point A to point B. Is the able to at least visit the litter box or go out in the yard to potty effectively?
2.) The ability to urinate and defecate effectively.
3.) The ability or willingness to eat and drink.
4.) The ability to breathe.
If the pet can perform all of these functions without serious debilitation or pain, then it is likely that quality of life is adequate. If there is severe pain or debilitation as the pet engages in these functions that are essential to enjoy a reasonably good quality of life and there are no medical modalities left to change that, then the pet owner must give serious consideration to humane euthanasia.
The biggest grey area I see is the case of cognitive dysfunction, far more common in dogs than it is a cats. The affected dog may be fine with 1-4 on the list of essential physiological function, but the cognitive dysfunction has caused confusion, anxiety, and sleeplessness for the dog. For dogs who live for the companionship and love of their beloved owners, the stress that comes from lack of recognition of those they are most profoundly bound to can be tormenting. Thus, even though they can function for all intents and purposes, quality of life may still be at an inhumane low. There are medications to help treat canine cognitive dysfunction, but the improvements are often short lived, weeks to months at best. As a result, a case can certainly be made subjectively that a dog that suffers the advanced form of this disease is most humanely treated by letting him go peacefully by humane euthanasia. The decision for humane euthanasia in these cases can be especially difficult for the owners who ultimately make it, many unable to shake the feeling of guilt of perhaps the decision is premature.
As a veterinarian who strives to preserve animal life, I am never in any hurry to euthanize an animal. However, to let them live on suffering without the possibility of relief, even in the absence of a smoking gun disease that makes the decision for euthanasia clear cut, is inhumane. Where that point is, is not often clear.
From the veterinarian’s end, we assess the health, offer any viable treatment options if any. Once the point arrives when all treatment options have been exhausted and yet the pet’s quality is in question; the decision for euthanasia must unfortunately come from the pet owner or family who have loved the pet and knows him/her better than anyone else in the world. From my perspective, when the pet is in this grey area of life, if that decision comes from the heart, it is never wrong.
Dr. Roger Welton is the President of Maybeck Animal Hospital in West Melbourne, FL, Chief Editor of the Veterinary Advice and Information Website, Web-DVM, and founder/CEO of Dr. Roger’s Holistic Veterinary Care.