I frequently counsel pet owners on end-of-life care for their ailing companions. Most of us, faced with this difficult transition, will at some point agonize over whether our pet is suffering, which procedures are worthwhile for the sake of extending life, how much money it is reasonable to spend, and most importantly, when to make that most difficult decision to choose euthanasia. The “right” answers are unique to each pet and their family; I try my best to merely help guide these choices.
I made it remarkably far – at least a decade – into my veterinary career before having to face some of these decisions myself. With that experience came some unexpected lessons.
My geriatric cat, Spooky, had been diagnosed with intestinal cancer, and I knew she was approaching the end of her life. She had already had a major surgery, not that long ago, for a different medical issue. With a heavy heart, I contemplated all of this as I watched her enjoying her favorite spot on the back of the living room couch, purring and regarding me placidly. It was the exact same expression she had when I first encountered her, thirteen years prior, as an injured and homeless kitten recovering in B Ward at Tufts University’s small animal teaching hospital. She continued to gaze at me, so completely content and happy even as I sat there in tears, and I was suddenly struck with the rather obvious realization that Spooky neither knew nor cared that she was dying.
We humans cling so desperately to life that we often feel morally offended if a loved one is lost before we feel it is “their time.” We agonize and fret over our own mortality and wonder about our legacy once we are finally gone. This is the blessing and the curse of the thinking mind – we have the capacity to both anticipate life and dread our own demise. Animals, as far as we can know, are gifted with the ability to live completely in the present moment. Certainly they have the will to live, and will defend themselves in the face of an immediate threat, but that ability to fear the future is, most certainly, a uniquely human experience.
This quickly set off a second light bulb: all medical interventions which do not directly relieve or prevent suffering are not, therefore, for the sake of the pet, but for that of the family. I had a very brief crisis as my life’s work was suddenly turned on its head, but it did not take long to conclude that so long as we, the veterinary profession, are not facilitating unnecessary pain and suffering, extending the life of the pet so that the owner can enjoy their companionship is still a noble and worthy goal.
My epiphany not only helped me accept the impending death of my sweet Spooky, it helped me to be at peace with the necessary and important work of performing euthanasias, no matter how far along that particular pet may be on their final journey. Die now or die in six months, or six years, it is, in the moment, all the same to the dog. We can treat the illness, giving the family much needed time to reach their own state of acceptance, or we can have life end now, on our terms: peacefully, painlessly and free of distress and agony. Our most important duty is to provide respectful guidance when needed, and to above all protect the patient from undue suffering as they near the transition from this mortal world to whatever may lie beyond.
In my years of traditional clinical practice, I watched many family members clutch their dying pets, sobbing and telling them that they are so very sorry. I would stand by silently and unobtrusively, trying to respect their emotions and the intensity of this moment. Oddly, now that euthanasia is a frequent part of my everyday practice, I cannot recall a single time when this has happened. I don’t know what is different about their experience. Is it that people who seek out my services are already secure in their decision? Or am I communicating differently, following the same script but with more acceptance and conviction?
Whatever the reason, I always wanted to tell those families that they shouldn’t apologize, that we are the ones who cling to every last second, who refuse to let go, who fight to delay the inevitable. That I believe, in my heart of hearts, this is OK.
Really. It’s OK.