Euthanizing a beloved pet is heartbreaking. The decision to euthanize a dog is the most important and difficult dog-related decision a person can make. I wrote recently about how emotionally difficult euthanasias are for me and for most vets. But I don’t fool myself: The sadness I feel during an euthanasia is nothing but a small fraction of that felt by the dog’s owner.
Of course, I also believe that euthanasia, when performed appropriately, is a good thing. In fact, ready access to euthanasia is one of the few definitive advantages that veterinary medicine has over its human counterpart. Many people suffer intensely, often for years, before they die. They may suffer loss of dignity and chronic pain, even if they are receiving comprehensive hospice care. Special nursing homes known colloquially as “vent farms” exist; each patient in these homes is on a ventilator (a breathing machine that is a form of life support) indefinitely. The cost, in human suffering and in dollars, is astronomical.
Euthanasia, when performed appropriately, prevents pets from suffering and spares their dignity. But that doesn’t make it easy for the people who love the dog being put to sleep.
Two questions about euthanasia are frequently asked. First, people wonder about when to perform euthanasia. How does one know when the time is right? People also wonder whether they should be present for the procedure.
Both of these questions are intensely personal in nature, and like all intensely personal issues, people who have no business in the matter often offer unsolicited strong opinions, often after the fact. They may say that you should have euthanized your dog sooner so that he would have suffered less. Or they may say that you should have tried harder to save your dog before resorting to euthanasia. They may say that you should have been with your dog when he was euthanized, or that you should not have.
Here is what I say you should do: Ignore the meddlers and follow your heart. Do what you honestly believe is best for your dog and do not allow anyone — including yourself — to make you feel guilty about your decisions. Other people can only say what would have been best for them. You can only do what is best for you.
Let me also say this: Remember that hindsight is 20/20. The decision to euthanize a dog must be made in the present. After the procedure you may feel guilty for having waited too long, or not having been present for the procedure. (Conversely, some people deeply regret the decision to be present for the procedure, and wish that they had been spared the memory of seeing their pet deceased.) Do not beat yourself up. Make the best decisions you can, and remember that you cannot know with certainty in the present what you would have wanted in the future.
Two conditions must be met for euthanasia to be appropriate. First and foremost, the dog must be ready. To be ready the dog will be suffering, or on the verge of suffering, with no reasonable alternative to eliminate the suffering. Second, the people who love the dog must be ready, or at least as ready as they can be. However, the second condition must be met within reason; it is not fair to a dog to allow her to suffer for weeks or months because the owners cannot bear to part with her.
Dogs have wonderful spirits, and it can be very hard to tell when a dog is suffering. I have seen dogs with terminal kidney failure smile and wag their tails at the sight of a friendly person. Their behavior can belie their suffering.
However, there are some general guidelines that can be used to determine whether the time is right. Appetite and behavior are the key things to monitor. Poor appetite is a sign that a dog does not feel well. It rarely means that she is simply “not hungry.” It more often means that she feels nauseated or too ill to eat.
Monitoring of behavior can require observation of more subtle changes. You and only you know your dog’s favorite activities; when your dog loses interest in those activities, something is wrong. For instance, on the dreaded day when my pal Buster has no desire to fetch a ball I will know that we are in trouble.
In the end, the only thing you can do is follow your heart, and try your hardest to do right by your dog. However, I will tell you that over my career I have had countless people tell me, with their 20/20 hindsight, that they felt they had waited too long to put their dog to sleep. Almost nobody has ever said they thought they did it too soon. Perhaps this signifies that people who rush to euthanize their pets aren’t prone to soul searching, but it definitely means that many people realize in hindsight that they were keeping their dog alive for their own sake rather than their dog’s sake. All I can tell such people to console them is the truth: that they made the best decision they could with the information they had at the time.
Many people struggle with deciding whether to be present for their pet’s euthanasia. I described what to expect during euthanasia in my previously mentioned earlier article. In the comments section of that article, many people voiced strong opinions that owners should always be present for euthanasias. I beg to differ.
Of course, any owner who wishes to be present should be. The reason why many people wish to be present is easy to understand: They want to be with their pet to comfort her during her final moments. But for some people being present is simply too difficult. For them the experience, or the thought of seeing their pet no longer alive, is unbearably painful.
The decision is phenomenally personal, and I have complete respect for either choice. In my experience a slight majority of owners wishes to be present; however, a very sizable minority does not.
When my pal Buster’s day comes, I imagine now that I will want to be with him at the end. But in the heat of the moment it is possible that I may not be able to bear the pain of watching him go (I already know that I will not be able to be the one to perform the procedure). I hope that either way I will cut myself some slack when hindsight kicks in.
Other stories by Dr. Eric Barchas:
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