The difficult goodbye: Deciding when it’s time to have a pet euthanased

The single most challenging part of being a vet that is euthanasia, or to use the commonly used phrase, “putting down animals”. This is one of the most common tasks that vets are asked to carry out – I might be called to do this several times on one day.

I know that I only ever carry out euthanasia when it is the best interests of the animal itself, so it is always an act of kindness.

One of the big challenges for owners of sick or older pets is to decide the right time to let a pet go. It’s rare for pets to die quietly and peacefully on their own, so euthanasia is nearly always needed.

People sometimes ask me why it’s OK for humans to die at home, but not pets. The reason for this is that humans can communicate with their carers: if a human patient feels pain, they can say so, and pain relief can be given.

Animals can only go quiet, or groan, or look unhappy, and it can be difficult for owners to understand what they are feeling. So if a pet is allowed to die “naturally”, there is a serious risk that they will suffer significant pain and distress.
Euthanasia (from the Greek for “good death”) is nearly always the kindest approach. Pets don’t know that their life is about to end – they don’t have the conscious knowledge that we have – and all they are aware of is that they are feeling sleepier and sleepier, then they drift into unconsciousness. This is how we would all like to die: why would it be any different for animals?

How does an owner decide that it is time?

The four common reasons why euthanasia is considered:

  • A pet has a long-term incurable illness that is causing increasing pain or discomfort
  • Due to old age, a pet is developing signs of pain, discomfort, or is just losing interest in life
  • A pet has an illness that is too expensive to treat and the pet will suffer without treatment
  • A pet has severe behavioural problems that cannot be resolved

How do you assess quality of life?

In many pets, especially older animals, treatment may be possible to prolong life, but a full recovery may not be likely. It’s up to an owner to make the judgement about the timing of euthanasia.

The general idea is to ask whether your pet is still enjoying life enough to carry on. This can be difficult to do, so a scoring system has been devised to help family members and veterinary teams assess a pet’s life quality.

The HHHHHMM Quality of Life Scale.

The five H’s stand for: Hurt, Hunger, Hydration, Hygiene and Happiness.
The two M’s stand for: Mobility and More good days than bad.

Patients are graded in each section using a scale of 0 to 10 (with 10 being ideal)

  • Hurt
    Adequate pain control & breathing ability is of top concern. Trouble breathing outweighs all concerns. Is the pet’s pain well managed? Can the pet breathe properly? Is oxygen supplementation necessary?
  • Hunger
    Is the pet eating enough? Does hand-feeding help? Does the pet need a feeding tube?
  • Hydration
    Is the pet dehydrated?
  • Hygiene
    The pet should be brushed and cleaned, particularly after going to the toilet. Pressure sores need to be prevented with soft bedding and all wounds need to be kept clean.
  • Happiness
    Does the pet express joy and interest? Is the pet responsive to family, toys, etc. Is the pet depressed, lonely, anxious, bored or afraid?
  • Mobility
    Can the pet get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling?
  • More good days than bad
    When bad days outnumber good days, quality of life is likely to be too poor to carry on.

TOTAL

A total over 35 points represents acceptable life quality to continue

Full details are available at www.pawspice.com

Another simple way of analysing a pet’s quality of life is to write down two columns on a piece of paper. In the left column, write a list of all the things a pet used to enjoy doing. In the right column, write a list of the things he or she still enjoys doing. When the list on the right is very short, it’s obvious that life is not much fun any more for your pet, and it may be time to go.

If your pet is still interested in food, happy to see you, generally comfortable and not constantly depressed and unhappy, then it may be OK to carry on. If an animal has lost interest in life as a result of their health issues or old age, and if pain management and other treatments have been tried, then euthanasia may be the best option.

Support and advice

Making the decision to have your pet put to sleep is not easy, even when you know it is the right action to take. It’s normal to be upset or even devastated, and many people find themselves questioning their decision. Grief is normal, but the level of grief varies dramatically between individuals. It can be hard to find someone to talk to about the situation. People often worry that that their grief is deeper “than it ought to be”, or that other people will not understand why they are so upset about losing “just an animal.”

For some pet owners, the grief can even lead to deep seated feelings of depression, and there are now pet bereavement counselors to help people come to terms with their sadness at the loss of a pet. Most vet clinics are aware of such help in their own localities, if you ever feel that such help may be needed. Indeed, sometimes the staff at the vet clinic can be helpful even just to share a few words. Often theymay have known you and your pet very well, and they are likely to understand some of your emotions and worries.

We are lucky that we are able to euthanase animals – we are able to give pets calm, painless, controlled exits from their lives. But it will always be a difficult, challenging process. There is no easy way.

5 tips on coping with loss of pet

  1. Make sure everyone is involved in the decision
  2. Discuss the process in detail with the vet beforehand
  3. Talk about the animal afterwards
  4. It’s normal to be sad, so don’t suppress it
  5. If you can’t cope, do seek professional help

Finally, if a grieving pet owner wants to talk to someone professionally about grief, visit www.solacepetlossireland.com/

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Please note that I am unable to answer veterinary questions in comments. If you have questions or concerns about your pet's health it is always better to contact your vet.

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