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Euthanasia can be an holistic option

Dr. Sara

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Dec 30, 2018
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331
This week, I had one of the most distressing experiences in over 30 years of veterinary practice.
A Shih Tzu came for a detailed consult for holistic treatment for chronic disease conditions. I reviewed the records prior to the appointment. The dog was last seen in August of 2018, and she had multiple serious problems at that time - glaucoma, atopy, weight loss, adrenal and splenic tumours. There had been no vet visits since then.

I was aghast when I saw the condition of this poor creature. She was emaciated. At 17 lbs she was described as underweight; she was now barely above 10 pounds. She could not rise, let alone walk. She was completely hairless, with pressure sores on her limbs which her caretaker had wrapped. She wore a diaper at all times. Her eyes had been removed because of the glaucoma, so she had no vision. Her skin was taut over the contours of her skull, and all of her bones were visible. When I touched her she screamed and snapped; emaciated animals are often painful. Her abdomen was grossly distended.

As a vet, it is important to have deep compassion for both animals and people, but this sight strained my ability to maintain unconditional positive regard toward the little dog's caretaker. I had to pause, breathe deeply, and remember that people can have difficulty seeing the condition of their beloved animal clearly. There was no doubt in my mind that this young woman deeply loved this dog. While I was staring at her pet in disbelief, she was telling me all the things she was doing for the little dog.

I nodded in understanding, and when she paused, I asked, "What does your little girl enjoy doing?" The young woman said "She still eats. And today, she rocked back and forth. She never did that much." I gently explained that her beloved dog was essentially living in a box, with no ability to do anything or move, and that her body was consuming itself because she wasn't able to take in enough food. I asked her if she would want to live like this. She quickly answered no, but that she had hoped that I could help since the dog was still eating. I explained that I might have been able to do something six or eight months ago, but not now. Any attempt at treatment at this point would be abusive, as the dog's condition was so grave.

After more calm and kind discussion, this woman finally understood the severity of her dog's condition, and agreed to allow us to euthanise her dog. This was the first time in my life that I have told someone that euthanasia was essential, and I hope it is the last time I need to say it. The euthanasia procedure was smooth and painless, and I felt immense relief for the little dog. The caretaker was still in denial, and we talked more afterwards, about how hard it is to recognize when a loved one is severely and terminally ill.

The vision of that poor suffering creature is seared on my mind. Every vet has seen abuse cases, and this was an abuse case where the caretaker had loving intentions, and inability to see the needs of the living being in front of her.

My intention in posting this is to show that euthanasia can be part of holism. Often, with holistic medicine, my clients have been able to support their animals in a comfortable state until the animals died on their own. That is not always the case, and I discuss when euthanasia is the holistic choice with all of my pet parents. In this case, euthanasia was obviously left too late; when is it appropriate?

Everyone has their own thoughts regarding the timing of euthanasia. I have a few guidelines that I discuss with people, based on what I feel is respectful of the life and soul of the animal.
* Is the patient interested in eating? [Not just tiny tidbits, but enough to maintain near normal body weight.]
* Is the patient able to stay reasonably clean? [Cats, especially hate to be dirty, but most dogs are not keen on 24/7 diapering.]
* Is the patient able to do the things he / she likes to do? [Even a short walk, or using stroller part of the time, is still a stimulating walk!]
* Is the patient reasonably comfortable? [Pain makes no sense to animals.]
* Is the patient able to have fun? [A dog or cat that doesn't have pleasures is not having a good life.]
* Are the good days more numerous than the bad days? [All elderly or ill animals will have the occasional bad day.]

My clients are deeply caring people, and they understand that we may have to make that final difficult choice for our loved ones. I encourage people whose animals are nearing the end to discuss the situation with their animal and let them know that they, the caretaker, are ready to let their beloved friend go, if the animal is ready to leave their physical body. I have seen a number of animals "let go" when they realise their person was going to be OK without them. I encourage all clients to give themselves periodic reality checks of the situation by reviewing the questions above, and any criteria that are more specific to their beloved friend.

Thank you for listening and reading. This is one of the most difficult topics for everyone who loves animals.
 

lizkunz

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Aug 29, 2017
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Thank you for posting this. I don't know what to say. This is one of the hardest decisions a pet parent has to face. I appreciate you giving us your perspective on the subject. Thank you Dr. Sara, Dr. Christina, and Dr. Jeff for your care of all of our pets. I know it must be very challenging at times.
 

Dr. Jeff

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Feb 23, 2017
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5,311
You're welcome Liz.

Dr. Sara, thanks so much for sharing this story and your quality of life checklist.

It is so unfortunate when we encounter pet parents who are unintentionally neglectful of their companions.

In this case, it sounds like the time for your clients Holistic Actions! were long past.

Do you know why she did not seek any help in 8 months?

Was she actively pursuing other options?

Thanks again for posting this poor pup's story.
 

Dr. Sara

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Dec 30, 2018
Messages
331
She had seen a remote consult with a holistic vet in May before the diagnosis (no follow up), and was on some supplements. I think she was simply in denial about her dog's condition. Possibly she knew, subliminally, that what she was doing was not the best thing for the dog, so she avoided anyone actually seeing the dog.

Since she never took the dog out of the house, no one was aware of its condition. This was a case that could well have been reported for animal cruelty, though the owner had the best intentions in the world.
 

Dr. Jeff

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I wonder whether ACO (animal control officer) @jumstead1023 has any other thoughts about this kind of abuse/neglect.

Judy is the wonderful officer who had Archie (then Rusty) removed from his neglectful owner (who was definitely not a guardian).

Thanks again for sharing Dr. Sara.
 

tsharlo1

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Aug 14, 2017
Messages
68
This week, I had one of the most distressing experiences in over 30 years of veterinary practice.
A Shih Tzu came for a detailed consult for holistic treatment for chronic disease conditions. I reviewed the records prior to the appointment. The dog was last seen in August of 2018, and she had multiple serious problems at that time - glaucoma, atopy, weight loss, adrenal and splenic tumours. There had been no vet visits since then.

I was aghast when I saw the condition of this poor creature. She was emaciated. At 17 lbs she was described as underweight; she was now barely above 10 pounds. She could not rise, let alone walk. She was completely hairless, with pressure sores on her limbs which her caretaker had wrapped. She wore a diaper at all times. Her eyes had been removed because of the glaucoma, so she had no vision. Her skin was taut over the contours of her skull, and all of her bones were visible. When I touched her she screamed and snapped; emaciated animals are often painful. Her abdomen was grossly distended.

As a vet, it is important to have deep compassion for both animals and people, but this sight strained my ability to maintain unconditional positive regard toward the little dog's caretaker. I had to pause, breathe deeply, and remember that people can have difficulty seeing the condition of their beloved animal clearly. There was no doubt in my mind that this young woman deeply loved this dog. While I was staring at her pet in disbelief, she was telling me all the things she was doing for the little dog.

I nodded in understanding, and when she paused, I asked, "What does your little girl enjoy doing?" The young woman said "She still eats. And today, she rocked back and forth. She never did that much." I gently explained that her beloved dog was essentially living in a box, with no ability to do anything or move, and that her body was consuming itself because she wasn't able to take in enough food. I asked her if she would want to live like this. She quickly answered no, but that she had hoped that I could help since the dog was still eating. I explained that I might have been able to do something six or eight months ago, but not now. Any attempt at treatment at this point would be abusive, as the dog's condition was so grave.

After more calm and kind discussion, this woman finally understood the severity of her dog's condition, and agreed to allow us to euthanise her dog. This was the first time in my life that I have told someone that euthanasia was essential, and I hope it is the last time I need to say it. The euthanasia procedure was smooth and painless, and I felt immense relief for the little dog. The caretaker was still in denial, and we talked more afterwards, about how hard it is to recognize when a loved one is severely and terminally ill.

The vision of that poor suffering creature is seared on my mind. Every vet has seen abuse cases, and this was an abuse case where the caretaker had loving intentions, and inability to see the needs of the living being in front of her.

My intention in posting this is to show that euthanasia can be part of holism. Often, with holistic medicine, my clients have been able to support their animals in a comfortable state until the animals died on their own. That is not always the case, and I discuss when euthanasia is the holistic choice with all of my pet parents. In this case, euthanasia was obviously left too late; when is it appropriate?

Everyone has their own thoughts regarding the timing of euthanasia. I have a few guidelines that I discuss with people, based on what I feel is respectful of the life and soul of the animal.
* Is the patient interested in eating? [Not just tiny tidbits, but enough to maintain near normal body weight.]
* Is the patient able to stay reasonably clean? [Cats, especially hate to be dirty, but most dogs are not keen on 24/7 diapering.]
* Is the patient able to do the things he / she likes to do? [Even a short walk, or using stroller part of the time, is still a stimulating walk!]
* Is the patient reasonably comfortable? [Pain makes no sense to animals.]
* Is the patient able to have fun? [A dog or cat that doesn't have pleasures is not having a good life.]
* Are the good days more numerous than the bad days? [All elderly or ill animals will have the occasional bad day.]

My clients are deeply caring people, and they understand that we may have to make that final difficult choice for our loved ones. I encourage people whose animals are nearing the end to discuss the situation with their animal and let them know that they, the caretaker, are ready to let their beloved friend go, if the animal is ready to leave their physical body. I have seen a number of animals "let go" when they realise their person was going to be OK without them. I encourage all clients to give themselves periodic reality checks of the situation by reviewing the questions above, and any criteria that are more specific to their beloved friend.

Thank you for listening and reading. This is one of the most difficult topics for everyone who loves animals.

Thank you for sharing the story and your suggested guidelines. Reality checks can be difficult but are important.
Debbie
 

jumstead1023

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Aug 3, 2017
Messages
340
Thank you for sharing the story and your suggested guidelines. Reality checks can be difficult but are important.
Debbie
Unfortunately as an ACO I have seen cases like this all to often. It usually takes a caring family member or neighbor to speak up for the sake of the pet. Too many people don’t want to get involved though and many times it’s too late. I am fortunate that the vets in my area will call me with a concern and I will do a welfare check. There are others who release an animal without letting anyone know. In my opinion sadly euthanasia sometimes is a blessing for the poor animal. Also people like this woman will get another dog. Thank you for caring about this little dog.
 
C

carolhulse

Dr. Sara, thank you for sharing your experience. I wonder if the fear of death was one of the main reasons that the caregiver in this situation did not seek help sooner. I think that this fear affects our lives on many levels, often unconsciously. One of the goals of BrightHaven’s education program is to help people become more comfortable with the death of their animal loved one. We share what we’ve learned from providing animal hospice care to animals for nearly 30 years and from being present at over 600 animal deaths, with the vast majority of the animals dying naturally. A few of these important lessons include: Death is a natural part of life, just like birth, and is nothing to fear; death is not a failed medical event, and death doesn’t cause pain, disease causes pain.

I’d like to share the Quality of Dying Checklist. Based on the acronym “PEACEFUL,” this helpful tool was developed by a consortium called GRACE (Gratitude and Respect for Animals and their Care at the End of life) consisting of Dr. Ella Bittel of Spirits in Transation, Dr. Kathryn Marocchino of The Nikki Hospice Foundation for Pets and Gail Pope, Founder of BrightHaven and a Holistic Actions! faculty member. The QOD Checklist is designed to help people better understand and work through the dying process of their animal loved one. It is a checklist–not a scale–and is focused on healing rather than cure.

In our upcoming Holistic Actions! course about holistic animal hospice care, we endeavor to help people better understand what death is and what it is not. We’ve found that knowledge reduces fear and may even lead to a deeper acceptance of death, which can possibly help us humans to live more fully!

--Carol Hulse, BrightHaven Education Program Specialist
 

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