petmd.com
There’s something about the holidays that always seems to help usher a high percentage of our older pets out of this world. It’s something many veterinarians I know comment on. As in, “Is it the humans who are suddenly ready for euthanasia or are our pets picking up on stressful holiday cues and ‘choosing’ to go the way of the rainbow bridge?”
I don’t know the answer. I just know the holidays brings me lots of patients like yesterday’s kitty: Nineteen years old, recumbent, non-responsive, breathing hard and readier than you can imagine for the long sleep that awaits us all.
Trouble was, her owners weren’t convinced they wanted to take the usual route. In fact, kitty’s visit yesterday was not to do with her primary condition. We’d been dealing with that detail for weeks now and her owners were resigned to the multi-organ failure she was suffering. The hard part now was gauging her degree of discomfort and intervening via euthanasia only if needed. Her owners preferred that she die at home on her own if at all possible.
So you know, this is a common point of view. “I want her to die peacefully at home,” is among the most popular death-related lines whenever the issue arises––usually with respect to extreme geriatrics or pets with terminal conditions. In cases where death planning is a morbid necessity, dying “at home in her sleep” is what everyone seems to want.
But pets don’t normally comply. Not without a significant period of uncertainty as to whether suffering is being felt or not. Given that uncertainty, it seems to me that erring on the side of caution––of preventing the suffering by letting euthanasia preempt it––is always the right way to go. So that’s how I counsel my clients.
Nevertheless, there’s always room for dissent in the exam room. My clients don’t have to agree with my approach to death. They’re always free to do as they want with their pets. It’s my job simply to point out suffering when it’s indisputably there or eminently imminent and to offer them options. And when I don’t believe suffering is happening, as in yesterday’s case, I think it’s perfectly acceptable for owners to take their pets home to die––that is, as long as they understand that conditions may change.
However, the converse is also true: There are times when it’s so very wrong to take a pet home to die on their own when you consider that the comfort of euthanasia is just seconds away (or can be brought home to your pet if you so choose). Here’s when it becomes clear that there’s a right way and a wrong way to let pets die at home. My rules? Very broadly speaking, here are my ABCs on the issue:
Awareness
Patients that are awake and fully aware are more apt to suffer pain and fear acutely. Those that are glassy-eyed and far away? Not so much. A reduced awareness level bodes better for at-home dying.
Breathing
Struggling to breathe? This is the scariest thing possible for an animal. When a terminal patient is awake and gasping for breath, “going home to die” is just about the cruelest thing I can imagine.
Comfort
If severe pain is present, going home is a no-go. In fact, if there’s no way to keep pets comfortable any longer on a variety of fronts it’s time to step in and euthanize. For example, if they’re soiling themselves and can’t be properly cleaned, if they’re getting bed sores, if they’re suffering moderate to severe anxiety, etc.
What if they’re not eating and drinking? Isn’t that uncomfortable? I get asked about this a lot but to my mind it’s not so important as long as pets don’t appear to be suffering thirst or hunger. As long as they have access to food and water and choose not to partake, I’m OK with it. Moreover it’s important to keep in mind that terminal patients of all species will often die slowly and humanely via malnutrition and dehydration. Feeding tubes and IV catheters do not necessarily make for a more humane and comfortable dying process.
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So that’s where we left things yesterday. Kitty was going home to die. I explained what they should expect to see (final, agonal gasping, sudden rigidity, seizures, etc. can look really scary, especially if no one’s told you to expect this). Two hours later I got the call that she had passed. Peacefully. One more holiday moment.
Though it’s not always possible or advisable to have your pet die at home on their own, sometimes it will happen beautifully. Kitty’s tale is proof again that when it comes to death and dying one size doesn’t always fit all.
