This is Part II of a four part series on end-of-life care. See Part I to learn how you can promote quality of life and set the stage for a smoother transition into the senior years, no matter how old your pet is now. Here we discuss what you can do when your pet receives a terminal diagnosis. Parts III and IV will cover the end-of-life phase itself, and how to help yourself before and after a beloved pet dies.
When you learn of a terminal diagnosis
You knew the day had to come sooner or later. Still, it is never easy to hear that a beloved pet has a serious illness. Making important decisions that will have a strong emotional and possibly financial impact on the whole family is stressful. Here’s how you can help yourself and your loved ones as you sort it all out.
Ask the doctor what you can expect. What is the natural course of the illness, with or without treatment? What symptoms might you notice, which ones can be treated, and which ones should prompt you to call or schedule a recheck? How likely is it that a particular treatment will help prolong life or improve its quality?
Keep in mind that your vet may not have concrete answers to all of these questions. We must often make an educated guess, based on a combination of limited scientific studies and personal experience. I’ve known many great veterinarians who are not afraid to say “I don’t know,” do some research, and get back to the client if they’re unsure about the answer to a question.
Learn about all of your options. Some illnesses have multiple treatment options, which vary in effectiveness and cost. You have the right to know the pros and cons of each. Veterinarians are trained in school to offer the “gold standard” of care, which is the most likely to work, and sometimes the most expensive. We must learn through experience how to help families develop a Plan B (or even C or D) if the gold standard isn’t possible for whatever reason.
Complicating your choices even more, medicine is often more of an “art” than a science, meaning we cannot always predict the outcome of a given treatment. The unique experiences and expertise of different doctors may lead to somewhat different recommendations. This isn’t a bad thing! It can, however, be confusing for you. Don’t be afraid to ask questions. Most doctors love knowing that you want to make an informed decision, and are happy to help you understand.
“What am I going to do with this information?” Ask yourself this when considering expensive and/or invasive tests. Will it help you decide on a treatment or predict the outcome? Or do you simply need to know what is wrong? All of these are perfectly valid reasons for further testing, but it’s ultimately your decision to make. If more information won’t help you feel better, influence your decisions, or change the outcome, it’s perfectly OK to decline diagnostics.
In the face of a terminal illness, comfort care to treat the symptoms, but not necessarily extend life, is one very reasonable option for caregivers who do not want or can’t afford more definitive treatment and/or further testing.
Educate yourself. When I don’t know an answer to one of their many questions, my children instruct me to ask my phone. Today the internet is overflowing with information, readily available to us 24/7 with a quick search. The fly in the ointment is that a large proportion of those information sources are biased or inaccurate. A librarian friend of mine (librarians, if you haven’t noticed yet, are evolving with the times into supercool technology gurus) introduced me to the CRAAP test for vetting out information on the web. Keep these points in mind while you are reading:
- How current the information is – when was this published, and has it been revised since it was written?
- The qualifications of the author – was it written by a veterinarian or someone else with expertise in this field?
- Where they obtained their information -what’s the “proof” offered, if any, to support the claim?
- Whether there may be a hidden agenda or conflict of interest – is the author selling the product or offers the treatment that is being recommended?
We like to joke about consulting Dr. Google (hey, I do it too), but you will earn a few points’ worth of respect from your vet if you seek their honest feedback and listen to their thoughts with an open mind. Information on the internet is often one-sided or incomplete. Your vet has years of schooling, additional training, and experience. They also know your pet and how the knowledge does or doesn’t apply to your situation, giving them the insight to fill in the gaps and offer a valuable perspective.
Here are just a couple sites I like to send clients to for information that is written by veterinarians, in plain english, with pet owners in mind:
The above will hopefully empower you to partner with your veterinarian to make decisions which make sense for both you and your pet. In Part III, we will talk about preparing for the final stages of a terminal illness and finding ways to ease the transition from this life to what lies beyond.
Did you see the other parts in this series?
Part I – Steps you can take at any life stage to prepare for end-of-life
This Page– What to do when a terminal diagnosis has been made
Part III – End-of-life planning and decision-making
Part IV – Addressing your own emotional needs
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