What Would You Do?
At some point in our careers as veterinary professionals we will be asked by a pet owner: what would you do if it was your pet? Often, we are asked this question when a client (or family member, or friend) is trying to wrap their head around the disease or injury that has inflicted their beloved dog or cat. It can be troubling to weigh the options of a life saving surgery or the overwhelming details of chronic disease management. As someone who has worked in veterinary medicine for 10 years I can tell you that the decision is not always clear cut, even for those of us in the field.
A large driving force behind the decisions we make regarding the care of our pets has to do with the relationship we have with that particular animal. As an owner of four cats, a dog and a horse, I can tell you that I have very different relationships with each of them. I share a stronger bond with some and would address certain health issues differently with each one. For example, one of my cats is a very nervous and skittish creature, she hides most of the day and only comes out to socialize at night. You can't reach down to pet her or pick her up without causing her distress. Because of this, I am not as closely bonded to Pearl as I am to my other pets. If Pearl is ever diagnosed with an illness that requires a lot of medical management and daily handling I do not know if we would be able to handle that level of care. She would be terrified as I tried to administer medications and treating her disease would put a huge strain on our delicate relationship. Now on the other hand if Pearl needed a life saving surgery (perhaps she gets a blockage in her intestine, for example) that procedure would likely be a one-time event. Once she was recovered from the surgery Pearl could return to her recluse ways and be happy in her solitude. In her case, I would likely opt for the one-time surgery than I would for something like Diabetes which could require twice daily injections and frequent veterinary visits.
I had an experience a few years ago where I chose not to pursue additional treatments and diagnostics for my cat Raspberry and instead opted for the hard choice of euthanasia. This was my first personal pet that I have had to make that final decision for. I adopted Raspberry when I was working as a veterinary assistant at an animal shelter. She came into the shelter with terrible skin disease that was proving hard to manage. After 3 months in the shelter and yet to be available to the public for adoption, I decided to foster her at my home. Long story short, she never went back to shelter and I officially adopted her some months later. Her skin allergies were always a problem (she wore T-shirts and little sweaters to keep her from scratching), and then down the road she also developed IBD (Inflammatory Bowel Disease).
For seven years I cared for Raspberry. She was the best darn cat, so sweet and easy-going, I loved her so much. She required many veterinary visits, medications, injections, x-rays, ultrasounds, special food but despite all that I believe she had a good quality of life with us. Her IBD was hard to control and it was a progressive disease, always getting a little worse. Towards the end Raspberry started to visibly look thinner and was vomiting more frequently, but she was still having more good days than bad. We continued to alter and adjust medications as necessary to keep her happy and comfortable. One night she was having some vomiting and I gave her some medication and separated her from the other cats so she could rest in peace (some times my other cats would bully poor Raspberry), I didn't get too worried about vomiting since this had been an on-going issue.
The next morning when I woke I went to check on Raspberry, she was surrounded by little vomit piles, dehydrated, hypothermic and too weak to even stand. I rushed her into a 24-hour emergency hospital. I gave the vet her medical history and said that I didn't want do any extensive diagnostics or imaging, just supportive care to see if we could get her through this episode. Despite warming up her body temperature, providing IV fluids, anti-vomiting medication, Raspberry was still very weak, she still had low blood pressure and started having an abnormal heart rhythm. At this point the veterinarian let me know that we needed to do some more diagnostics to help guide treatment, but at that point, after seven years of high maintenance care, I was done and I felt that Raspberry was done as well. I let the doctor know that I was instead opting for euthanasia.
I called my husband and he came down to the hospital, we were both there when Raspberry passed very peacefully in our arms. In the following weeks I struggled with regret, that I should have done more to try and save her. But once the acuity of her absence had worn off, I came to realize that I made the right choice for myself and Raspberry. In the months leading up to this event, she was declining. The vomiting was increasing in frequency despite medications and her energy and weight were trending downwards. I was emotionally drained even before she crashed and we don't know what would have happened afterwards even if we had been able to pull her through the crisis.
I am sure there are plenty of pet owners who would have continued medical care in this situation, and that's ok. I am sure there are plenty of owners who would have struggled to provide the long-term care that Raspberry needed, and that's ok too. The decision to pursue treatment or surgery is so circumstantial, it can differ between pets, it can change based on financial situations, or on the amount of time and effort an owner is able to dedicate to at-home-care. So, my dear clients and fellow animal lovers, when you ask me what I would do in your situation, I will always answer you honestly. But just know, that the decision you make is entirely yours. You know your pet, you know yourself and what you are realistically able to handle. It's never easy to make these medical decisions, but it's the burden we bear for the love our furry family members.
Katie, BS, AAS, LVT
Patient Care Technician