Knowing When It is Time to Say Goodbye

As I was leaving work last night, I got a call from a friend and client who needed to have a serious conversation about his dog’s current quality of life and what the right decision to make is.  My friend has had his goofy, wet kiss giving, fun loving chocolate lab since he adopted him at the age of 8 weeks in 1999, when my friend was 24 years old and single.  His dog is now nearly 15 years of age and my friend 38 years of age and married…the long history and life together through those years so filled with transition and change cannot be overstated, the bond between them so strong, words cannot describe it.   My friend’s wife who he met 10 years ago has also formed a deep bond with this Labrador, such that she felt she needed to be present at our discussion as well.  When he proposed to her years ago, he had done it by bringing her breakfast in bed, followed by having the dog bring the ring in its box over to her and drop it on the bed next to her, a testament to how strongly this dog is engrained in the fabric of their lives.

The frustrating part of my friend’s dog’s situation is that at nearly 15 years of age, a very advanced age for a 90 pound chocolate lab, is the dog’s spirit is still there: he wags his tail, eats and drinks with gusto, gets excited every time his beloved owners come home…but his rear limbs are failing him.  Stricken with a combination of degenerative spinal disease and degenerative joint disease in his hips and knees, walking to even go outside to eliminate is a struggle multiple times per day.  Simply getting up to walk to the door to go outside is hard enough, but posturing to urinate and defecate is even more difficult.   Anti-inflammatories and joint chews have helped alleviate his discomfort and sustained him for the past year, but their benefits are rapidly providing diminishing returns.

What compounds the problem, is that alternative treatment modalities like acupuncture, therapy laser, and glycosaminoglycan injections require regular visits and are thus off the table because of the toll that the trip to and from the clinic takes on the dog given his physical limitations; and stress levels such a trip creates at his advanced age.  Nutritional management and anti-inflammatory medication is therefore all we can offer the dog, and with only those modalities at our disposal, we are rapidly losing ground in battling the progression of his disease.   Seeing this is heartbreaking for his owners, yet they are torn to make the decision to humanely have him euthanized because his spirit, his mind, and his love for them remains so abundant.  He does not seem willing or ready to give up, but his body is far less able.

When the death of a pet has occurred because of disease or injury, so severe that medical treatment failed or disease or injury manifested too quickly for the pet to have gotten access to veterinary care on time, parting is not as devastating for owners, as such an event was not their choice.  The most heartbreaking side of pet ownership occurs when quality of life is compromising and deteriorating yet not fatal, and it becomes the responsibility of the pet owner to decide when it is time to humanely say goodbye.  While as veterinarians we are able to guide pet owners as to when the decision for humane euthanasia is justifiable and even perhaps in the best interests of the pet, we cannot make that decision for them in these subjective cases.   In light of my friend’s situation with his chocolate Labrador, the purpose of this post is to help pet owners decide when it is the appropriate and the most humane option to elect euthanasia.

In that regards, the first thing one must do in the case of an ailing geriatric pet is observe the 4 basic necessities to maintain reasonable quality of life, the ability to: 1.) breathe, 2.) eat and drink, 3.) urinate and defecate, and 4.) ambulate.  If the pet can do each of these things without severe debilitation or distress, then usually quality of life is adequate.   Let us apply this rule to my friend’s Labrador retriever.  In his case, he breathes fine, eats and drinks well, but he has pain and distress when attempting to ambulate and urinate/defecate, meaning that 2 out of the 4 basic criteria for reasonable quality of life are compromised.  Based on this, I advised my friend and his wife that this at the very least put their dog in the category where humane euthanasia is a justifiable decision, perhaps even the most humane option with increasingly less medical alternatives available to him.

Put in this perspective, the decision will be no easier for the good people that I write of today, but it gave them a more certain perspective to be confident that in the coming days or weeks, that they will make the right decision in the best interests of their beloved companion.  While there are difficult times ahead of them as they will likely inevitably have to make that heartbreaking decision to say goodbye to their dog, they will be poised to do so with more clarity than guilt.

There is rarely an easy path around these types of situations, and for those of us who love animals and will always have pets in our homes, we will all likely inevitably face with the same tough decisions.   I hope this post can give my readers more confidence and clarity if ever they are faced with similar quality of life decisions.

Dr. Roger Welton is the President of Maybeck Animal Hospital and CEO/Chief Editor of the veterinary information and blog online community, Web-DVM.