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  • Tiffany Downing, RVT

Quality of Life

They say that the loss of a pet can be even more painful than losing a human family member. What family member follows you to the bathroom every time you pee? Who leaves their hair all over your clothes and your car, lest you leave the house without them and forget them? Who sleeps on your feet so they’ll know if you leave the room? Dogs aren’t always the center of their family’s world, but that family is absolutely the center of the dog’s world and they’ll spend every waking moment with you if they had it their way.

Labrador Retriever receiving therapeutic laser therapy.

Our relationships with our dogs are truly unique. Being responsible for another life, right up to their last moments, is a momentous duty but also a momentous gift. We can alleviate their pain, even free them from their debilitated body. The decision to say goodbye to such a valued friend can be incredibly challenging and the thought of life without them can sometimes result in having made that decision much too late. At CROC, we often treat patients in their senior and geriatric stages of life to help them maintain mobility and relieve pain so they can stay with their families as long as possible. We do our very best to support our clients as they navigate the changes age or disease can bring to their best friend while also adhering to one of the most important promises Veterinary Professionals make – to be an outspoken advocate for the wellbeing of those who cannot speak for themselves.

Is Your Pet in Pain?

If your pet is in pain that cannot be reasonably controlled with medication(s) or other medical therapies, then the answer has already presented itself. Our greatest gift as pet owners is to prevent, treat, and end any pain our furry family members might experience. It doesn’t matter if your dog is still eating well or still wags their tail when you come home. Those behaviors are just minutes out of the day, during the remainder of which, they are stuck experiencing pain and discomfort that they can’t understand.

Labrador Retriever getting therapeutic massage

Pain can be hard to determine with some pets. We must remember that instinct tells our pets to hide their pain so that another animal doesn’t pick up on their weakness and attack them. Some obvious signs of pain include limping, inappetence, whining or crying, or even growling and biting at housemates or humans. Less obvious signs include panting, drooling, teeth grinding, reduced mobility, decreased interest in play time or other favorite activities, change in gait, difficulty sleeping, hiding, or having urinary or fecal accidents around the house, but every dog is different and some may have different signs of pain.

***Continuing to eat is NOT a significant determining factor for your dog’s Quality of Life. Even dogs in obvious and excruciating pain have been known to eat right up until their very last moments of life***

Medication can be a simple way to treat pain, but this isn’t always an option, especially for our older patients. As the body ages, organs stop working as well as they used to. Specifically, the liver and kidneys, which are responsible for metabolizing everything that goes into your dog’s body. Several common pain medications used for dogs can cause increased strain or even damage to the liver and kidneys. Other medications may make your dog too drowsy to participate in the activities that make their life worth living. And some, while effective for others, may not help your dog at all.

Cavalier King Charles Spaniel getting therapeutic massage

Physical Rehabilitation may be helpful for the painful pup. Therapies like Laser, Ultrasound, Stretching, Massage, Passive Range of Motion, and Acupuncture may help relieve pain in conjunction with prescribed exercises or Hydrotherapy to improve your dog’s mobility. However, there is a limit to what Rehab can help. If we feel that your dog is too weak or sick to safely work with, we may recommend that you take them home and focus on making their remaining time as comfortable and enjoyable as possible. We will provide you with information on how to manage your dog's pain and other symptoms, and we encourage you to spend as much time as possible with them.

CROC does not turn away patients due to age. Our assessment focuses on the safety of our patients. Can your dog participate in therapy without experiencing further pain or injury? Can your dog’s heart or lungs handle the strain of exercise? Can any of our therapy modalities provide meaningful pain relief for your dog? If the answer to any of those questions is “no”, we will not offer in-clinic therapy. If your dog’s medical condition is that fragile, we cannot in good conscience risk performing therapy and cutting your time with your dog short. As Veterinary Professionals, we take an oath to do no harm and that also means refusing treatment if it is not in the best interest of the animal.

Is Your Pet Enjoying Life?

white dog playing with lots of toys

Dogs are emotional creatures and their mental health can play a big role in their physical health too. They can experience anxiety and depression as their body changes and it becomes difficult to do the things they’ve done their whole life. For example, choose your dog’s top 5 favorite activities. It could be getting a special chew treat, playing fetch, wrestling with housemates, going for hikes, or just snuggling on the couch. When your dog stops doing any of those favorite things, or maybe isn’t as excited for them as they used to be, you have to consider that they just aren’t as happy as they used to be. They might be experiencing physical pain or other physical ailments like blindness or deafness that make their favorite activities difficult or even painful which can then lead to frustration. Remember that dogs don’t understand why their body is failing them, only that they want to do a thing they like and doing that thing is now harder or more painful than they remember.

Signs of stress or anxiety include whining, barking, pacing, drooling, panting, excessive licking, diarrhea, change in appetite, hiding, aggression, destructive behavior, and difficulty sleeping. Signs of depression include decreased energy level, decreased appetite or thirst, avoiding socializing, avoiding playtime, hiding, changes in grooming habits, and changes in vocalization like becoming quieter or less communicative. Keep in mind that dogs can also experience Canine Cognitive Dysfunction or “Doggie Dementia”, which can be difficult to cope with since there is little to no treatment for this condition. There is emerging evidence that certain diets or supplements could potentially help support cognitive function for senior

and geriatric dogs, but this is still very much in early stages of research.

Is Your Pet a Danger to Themselves or Others?

Some dogs experience an unfortunate combination of symptoms. For example, a dog that is going blind, has Osteoarthritis, Muscle Atrophy, and Canine Cognitive Dysfunction. This is actually a very common combination of conditions for our geriatric patients. These patients become a danger to themselves because they may not understand where they are, can’t see very well (if at all), are weak and uncoordinated, and their body hurts with every movement. They are at significant risk for falling or injuring themselves on furniture or walls they may bump into. They may even snap at their family members out of fear because they don’t remember who they are or can’t see the person coming before they’re suddenly being touched. This can get dangerous for owners, especially with large dogs, when they try to help their furry friend and end up with a serious bite wound.

Collie mix relaxing on bed

Sometimes, modifications to the home environment can help with some of these problems. Adding extra grip to the floor like yoga mats or well secured rugs can help your dog stay on their feet and provide some cushion in case your dog falls. Blocking off access to stairs or furniture may help prevent injury. Good lighting and sometimes even night lights can help dogs with diminished vision get around a bit more comfortably. Dogs that have gone completely blind often memorize the layout of their home, so any changes such as moving furniture or changing the texture of the floor may throw them off and leave them lost, confused, and scared. Care should be taken with housemates, as compromised seniors and geriatrics often get inadvertently beat up by the more enthusiastic young pup because they can’t see them coming or move out of the way fast enough.

Are Resources Being Used in a Sustainable Manner?

Yorkshire Terrier getting veterinary acupuncture

As our pets become more and more integral to our lives, us humans have begun to spend more and more resources on their care and most of the time, that’s perfectly wonderful. We encourage our clients to expend their resources in a healthy and sustainable way. Can you physically perform the tasks needed to help your dog without throwing out your back or otherwise getting injured? Do you have the time necessary for your dog’s care? What if that means waking up multiple times every night or coming home from work in the middle of the day? Are you willing to put off vacations because your dog requires intensive care throughout the day? Is caring for your pet taking away from your other responsibilities such as other pets, children, your job, or your own self care?

Finances can be the most heart-breaking aspect of decision making. Sometimes, there is more advanced medical care available to treat the pet’s condition but the owners just don’t have the funds to pursue it without putting themselves at risk of being unable to pay their rent or bills or even to buy groceries. It’s important to remember that you must continue to care for yourself even after your pet is gone. Hard as it may be, you may have to call it quits before your pet’s financial burden puts you in a risky position. Over the years, we have seen clients sell their car or go without power in an effort to save their pet. When their pet inevitably passes, they are then without the resources they need to keep their job or live with reasonable comfort.

There is also the possibility of futile medicine. This is when the pet’s condition cannot be reversed or reasonably treated, but medical care is continued anyway because a client is willing to pay for it. As Veterinary Medical Professionals, we have all seen patients continue to be poked, prodded, and hospitalized for days or weeks on end (which is often quite expensive) when we know that these attempts to save the patient are futile and a waste of client money as well as time with their pet. We would much rather see that patient spend some quality time with their family, comfortably at home, before a prompt but peaceful euthanasia.

Are You Enjoying Life With Your Pet?

Dedication to your pet’s care is an amazing thing and we certainly don’t wish to discourage that. We do however, encourage a healthy balance of dedication and self-care. As your dog’s needs continue to become more demanding, it can be exhausting trying to keep up. You might be carrying your dog everywhere, constantly cleaning up after their accidents, or losing sleep when they’re up all night. Many owners feel guilty when they reach this stage. They continue to overwork themselves because they feel that if they don’t, it means they’ve given up on their pet or otherwise let them down. That couldn’t be farther from the truth! If you are not at your best, you are not providing your dog with the best care either and this situation can quickly spiral into feelings of bitterness and resentment.

It’s okay to be tired. It’s okay to say that enough is enough. Our goal is for you to be comfortable identifying the situation before the relationship with your dog is damaged. We want you and your dog to enjoy your time together for as long as possible and as soon as that starts to be affected, it’s time to start thinking about euthanasia.

Natural Death vs Euthanasia

Everyone wants their loved one to die peacefully in their sleep, cozy in their bed. The unfortunate reality is that this is highly unlikely to be the way your pet will go. Natural death in animals can take an extremely long time to occur, during which your pet is likely to be scared and in pain. Not to mention, it can be heart wrenching for an owner to watch their pet go through the process. Many animals retreat from their family and hide. It’s not uncommon for them to cry and whine, spasm and twitch, and go back and forth through many different levels of mental acuity. We have seen many owners decline euthanasia in favor of natural death only to later rush in as their pet is going through the agonizing dying process, begging the veterinarian to end this suffering. During the process of dying, your pet will feel their body giving out, become weaker and sicker. Conditions that affect the heart and lungs mean that those patients slowly suffocate to death. In addition, their pain may be so significant that there are no longer any medications you can give at home to soothe their suffering.

The definition of Euthanasia is “Good Death” and that’s exactly why we’d recommend it over allowing your pet to pass naturally. With euthanasia, you get to choose how your pet goes. You can choose to let them go on a high note, before the worst bouts of suffering have taken hold. You can make sure that your dog’s last moments are full of joy and love, instead of fear and pain. In Orange County, there are many different Veterinarians who will come to your home to perform the euthanasia in the place that your pet is most comfortable, which is a great option for pets that get stressed going to the Veterinary Hospital.

The Euthanasia Process & What To Expect

During the Euthanasia procedure, an IV catheter may or may not be placed depending on your pet’s condition and the veterinarian’s assessment. When you are ready to begin, the veterinarian will first give a short acting injection to soothe your pet’s pain and help them relax until they fall asleep. Once your pet is adequately sedated, they will administer the euthanasia solution, Pentobarbital. This drug is a strong anesthetic that slows brain activity which will cause the heart and lungs to slow and eventually stop. Because your pet is unconscious while this drug takes effect, they do not feel any pain or fear. The time from injection to death is usually just minutes or even seconds. Your veterinarian will use a stethoscope to listen and confirm that there is no longer any heartbeat or breathing.

While your veterinarian will always do their very best to make this process as peaceful as possible, every animal reacts to drugs differently. They will choose drugs and dosages based on how most pets respond to them, but sometimes a patient needs more drugs than the average or a different drug entirely. Even when things go perfectly, it’s important to know ahead of time that the body’s reflexes can cause some unsettling reactions. This is because for a short time following cardiopulmonary arrest, neurons in the brain or central nervous system can intermittently fire. These last random neurological reflexes can look like gasping for breath, vocalizing, blinking, or even moving a leg or tail but these are not voluntary movements and the patient is very much deceased. These events can be compared to when you turn off an old Television and an image is still partially visible on the screen for a few seconds, but the TV is definitely off and the image disappears.

Preparing for Euthanasia

Once you know that it’s time, you’ll want to figure out all the details ahead of time because the day of is likely to be an emotional rollercoaster. If your pet is suffering, euthanasia cannot wait and should be pursued as soon as possible. If your dog is currently stable and comfortable but you know that they are on track to continue declining, you can schedule the appointment out a bit.

Whippet hoping for a cupcake

Some people like to use the time before the appointment to take their dog to their favorite places and activities, take some extra special photographs, visit with family and friends. Some like to treat their dog to cheeseburgers or chocolate cake which is fun but must be done with care. Fatty or toxic foods will still cause serious discomfort and illness for your pet, so if this is something you’d like to do, you’ll want to do it in the minutes before the euthanasia drugs are given. Otherwise, your dog will spend its last days or moments feeling sick, possibly experiencing diarrhea, vomiting, or even organ failure.

You’ll also want to make plans for your pet’s aftercare, or what happens to your pet’s body once they have passed on. In Orange County and most urban areas of California, it is illegal to bury a euthanized pet. This is because the euthanasia drugs are still present in the body after death and those drugs can leach into the ground or be ingested by other animals. For this reason, the most common aftercare in utilized in Orange County is Cremation. Other options include Aquamation or burial at a Pet Cemetery. Most Veterinarians will have some sort of partnership set up with a local Cremation facility and can arrange transport for your pet’s once the euthanasia procedure is over, but you should confirm that when scheduling the appointment. Many facilities will give you options like if you wanted your pet’s ashes returned to you, if you would like their paw print in clay or ink, even save some of their fur. Everyone processes their pet’s passing differently and there is never judgement for how you choose to have your pet’s remains handled.

Last, but certainly not least – Make sure you have what you need. Especially if your appointment is taking place at another location, we always recommend having a friend or family member there to support you and get you safely home. We have seen owners leave the Veterinary Hospital in severe emotional distress just to get into a car accident leaving the parking lot. Stock your home with your favorite foods, movies, books – whatever will bring you some comfort while you emotionally process. More and more research is being done into the human experience of losing a beloved pet and in many instances, us humans are not getting the support we need to properly grieve. This likely because historically, losing a pet wasn’t considered to be as traumatic as losing a person so the mental health aspect of pet loss was largely ignored. Now that we are discovering that to be false, time away from work and professional counseling is more widely accepted and advised.

Lean On Your Veterinary Team

large dog giving kisses during therapy

We know - This decision is immensely difficult. We have assisted with thousands of euthanasia procedures over our Veterinary Medical careers and felt the emotional weight of every single one. We’ve also watched countless animals suffer through their last moments, wishing that we could have relieved their pain. We’ve had to make this decision for our own animals, walking the line between concerned pet parent and cognizant Veterinary Professional simultaneously. We want you to know that we would never recommend evaluating Quality of Life or pursuing Euthanasia lightly. We bring it up because it is our purpose as Veterinary Professionals to speak up for your pet’s needs, to advocate for their treatment. We never want to take priceless time away from you and your pet, because we know how it feels when that time is gone.

Whether you’re at the beginning of this process or you’ve already made the decision, your Veterinary Team (CROC included) is there to support you and your dog. Whether you need questions answered or just a confirmation that you’re making the right decision, we’re available to you if you need it.

Additional Resources

Quality of Life Assessments

Home Euthanasia in Orange County

Aftercare Services in Orange County

Pet Loss & Grief

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