How Will I Know When It's Time?
Deciding to euthanize your companion animal can be one of the most difficult decisions you may ever make. As pet owners/parents, our strongest desire is to shield our faithful friends from unnecessary pain and suffering, but because our pet companions respond to pain and suffering differently than we humans do, it can be very distressing knowing when its time. No one wants to say our goodbyes too soon or too late.
So how do I know when my companion animal is really suffering? This is a question we often receive as veterinarians and can sometimes there is no straight forward answer. The answer involves factors such as your pet's age, disease condition, availability of hospice care, financial ability and caretaker considerations and our goal is to help you with making the best decision and help create the most peaceful experience for families facing end-of-life decisions for their companion animals. If you are unsure of this decision, even after reviewing some of the resources available here, please know that we are only a phone call away and will be happy to consult with you about your beloved cat, dog or other furry friend.
In attempts to help assist you with this incredibly difficult decision, below are some resources designed to help guide you towards an informed discussion with your family and your veterinarian.
Signs that Your Pet is No Longer Enjoying a Good Quality of Life:
- Your pet is having trouble breathing, experiencing weakness or extreme lethargy
- Your pet has nausea, frequent vomiting or diarrhea that cannot be resolved by treatment from a veterinarian and is resulting in weight loss and/or dehydration.
- You pet experiences chronic and intractable pain that doesn't go away even with medication (signs of pain in dogs or cats)
- Your pet finds it very difficult to walk or cannot get up
- Your pet is refusing to eat or drink
- Your pet is having trouble urinating or defecating
- Your pet has had a significant behavior change and has lost interest in surroundings, family activities or his/her favorite activities
Tools to Help in Making the Decision
(The Ohio State University Veterinary Medical Center)
- Enlist the help of your pet's veterinarian or a Peaceful Passing veterinarian. While your veterinarian cannot make the decision for you, it is helpful for him/her to know that you are considering the final gift euthanasia.
- Remember how your pet looked and behaved prior to the illness. Sometimes changes are gradual, and therefore hard to recognize. Look at photos or videos of your pet before the illness.
- Mark good and bad days on a calendar (may use something as simple as happy or sad face). If bad days outweigh the good or there appears to be only a few good moments in otherwise bad days, then it may be time to discuss euthanasia.
- Write a concrete list of 3-5 things that your pet likes(d) to do. Things can be as simple as expressing happiness when you come home, or excitement at barking at the mailman. When your pet is no longer interested or able to enjoy most of these things, it may be time to discuss euthanasia.
Assessing Quality of Life
Pet quality of life scales are used to determine a more objective measure of a pet's quality of life based on how your pet is feeling. A QOL quiz helps you address different variables in your pet's life to assess overall comfort and happiness. Variables such as mobility, appetite, presence of anxiety and breathing difficulties. QOL scales are typically used when a pet has a terminal illness or is at an end life stage. A terminal illness is one where the pet will not be cured or recover but perhaps can be managed so the pet is comfortable. Treatments at this point are focused on palliative care (or hospice) – helping with pain, nausea, dementia, nutrition, dehydration and mobility, but not curing the pet. A QOL scale may help you decide when it's time to give your pet the final gift of letting them go peacefully.
This Quality of Life Scale was adapted from the HHHHHMM Quality of Life Scale designed by Dr. Alice Villalobos.
One of the more common concerns and questions we receive are from pet owners who agonizingly question whether or not it's time to consider humane euthanasia. When its our beloved pet, we can sometimes be too emotionally involved and subjective to make a clear decision. The following Quality of Life Assessment questionnaire is a tool designed to help you make a more objective assessment of your pet's overall quality of life.
The Four Stages of Dying
The process of dying is different for every pet. Some deaths are sudden, while others are marked by a prolonged, steady decline in function and quality of life. You know your pet better than anyone. Recognizing the following stages and the symptoms that are often present can help you understand the progression that your pet may go through toward the end of life.
- During Stage One, your pet may eat less and lose weight as well as physical strength. He or she may spend less time grooming, exhibit a detached gaze, and experience constipation or incontinence. Your pet may also seem more restless or irritable, vocalize more, change his or her drinking habits, move less, and prefer solitude.
- During Stage Two you may notice sunken eyes, increased weight loss, decreased energy, a progression of intestinal changes, a further decrease in appetite, and changes in breathing patterns. Any behavioral changes that occurred in Stage One will become more pronounced, and your pet may lose all interest in playing, have difficulty relaxing, and start seeking out new places to sleep. His or her gaze may become less focused. This is also the stage when some pets experience a final rally, exhibiting a return to normal behavior for a period of time.
- In Stage Three, physical changes such as twitching, pale gums, cold extremities, discharge from mouth, eyes, or nose, weakness, incontinence (eventually no output), and breathing difficulties become increasingly noticeable. Your pet’s daily routine may stop, vocalizations may stop, and your pet may seem emotionally detached and no longer bothered by urination or defecation in his or her sleeping area.
- During Stage Four, the final stage, your pet’s eyes will be fixed and set, and your pet may be unresponsive. Body twitching is common, as is a weak pulse, panting or open-mouth breathing, irregular breathing, cold extremities, lack of reflexes, and the kicking of legs. When your pet reaches stage four, death is imminent.
We encourage you to speak with your veterinarian about your pet’s condition, and please contact us if you have any questions.
