Coming to the decision to euthanize a beloved ailing pet can be very difficult.  Pets are now considered by most as part of their family.  I have two cats and two dogs myself, and I would be heartbroken if I lost any of them to an illness.  They each represent a different personality, and each fit into “the pack” in their own way.  One day, the time will come when I will be faced with making the decision of whether or not and when to end their lives.

The only time it becomes easy to make this decision is when they are in a medical crisis.  Even those families who are planning on supporting their pet through a natural death must have a plan in place for euthanasia.  Those who are blessed enough to have a pet pass away quietly in their sleep are more fortunate.  Sadly, for most of our beloved companions, it doesn’t happen this way.  Witnessing death can be very distressing, as many will suffer until the end.  This can take seconds, minutes, or even several hours.  The longer it takes, the more suffering an animal endures.  Pets depend on us for their safety and well-being.  When we love our pets, we commit to protecting them from harm.  Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering.  Humane euthanasia is a way of giving your pet a peaceful, painless goodbye.  In-home euthanasia allows this to happen in a loving, familiar environment, surrounded by family members and friends.

A more complicated situation occurs when family members do not agree on when to euthanize their pet.  Feelings of resentment and guilt can arise and cause deep rifts between family members.  In some cases, family members who do not want to euthanize or want to wait to euthanize are in denial about their pet’s condition.  Communication between each family member and the veterinarian is very important.  I will usually try to talk to each member separately before addressing the family as a whole.  Educating the family about the pain and suffering their pet is or is about to endure is paramount to the decision-making process.

When determining whether or not it is time to euthanize a loved pet, there are several factors to consider, such as:  Is your pet ready for death? Has a terminal illness or age related change become so unbearable for your pet that death would be welcomed?  Is the family finding it difficult to provide supportive care? Has euthanasia become the kindest thing for everyone involved?

What causes suffering in animals?  Most pain causes some level of suffering.  Pain can be physical hurt as well as emotional suffering.  The Association for the Study of Pain (1979) defines human pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”.  Although animals may perceive some painful conditions differently, the internal pain pathways are very similar to human pathways, and thus, I feel it is likely that they experience pain and suffering as we do.  Examples of conditions that cause physical and emotional pain in domestic animals include musculoskeletal disorders, neuropathies, cancer, injury, inflammation or necrosis of internal organs, surgery, eye disorders, lithiasis, periodontal disease, and headaches from hypertension.

Most of us have felt the emotional and physical pain of nausea   It is not unusual for pets to become nauseas with any terminal disease.  Signs of nausea include inappetance, vomiting, drooling, and/or smelling, but turning away from food.  The inability to feed the gut and resultant dehydration from both decreased intake and loss from vomiting and/or diarrhea causes a degree of suffering.  Many pet owners use their pet’s appetite as a gauge to determine whether or not they are suffering.  The problem in some cases is, even though the pet is suffering in other ways that significantly affect the quality of life, they will eat until the very end.  Incontinence causes anxiety and emotional suffering, as well as respiratory distress and seizures.  Cognitive disorders cause emotional anguish in some pets.  Pets with cognitive disorders can’t sleep normally, they pace, they bark, they wander aimlessly, and become emotionally detached, which can sometimes weaken the human-animal bond.  Alone and confused and sometimes isolated to one area of the house away from everyone else, the pet suffers.  When we recognize that supportive medical and emotional care for the pet will not be provided and suffering is eminent, all veterinarians support the choice to euthanize.

How is suffering measured?  One way is to assess your pet’s quality of life in a quantitative way.  You can find canine and feline quality of life scales online.  The HHHHHMM scale represents a measurable way to determine whether or not your pet may be suffering.  Criterions including Hurt, Hunger, Hydration, Hygiine, Happiness, Mobility and More Good Days than Bad are considered.

As your pet’s caretaker, you are the one who will ultimately decide upon humane euthanasia for your companion.  It is our responsibility as veterinarians to help guide decision making, to educate, and to eliminate fear at such a critical time.  I urge you to ask your veterinarian if you have questions regarding your pet’s quality of life or if you want more information on euthanasia, anticipatory grief, and/or pet loss.