When considering euthanasia as a welfare option for your pet, and if you are in dilemma, try to define for yourself AND for your veterinary team what your definition of quality of life is for your own pet. Bear in mind that this definition may vary from pet to pet, and that decisions you may have made in the past, for previous pets, may/not be appropriate for your current one. Quality of life refers to a state of mind, and is a conscious, subjective, mental experience. It is not measurable or quantifiable. Feelings are either pleasant or unpleasant, and quality of life could be represented by the summation of pleasant and unpleasant feelings over a life. Anything that does not impact on feelings is not relevant to quality of life. For example, a human with an amputated limb might feel a reduced quality of life because they ‘felt’ incomplete, or maimed. A dog with this injury that was otherwise active and pain free, would not have a decreased quality of life because it does not psychologically ‘feel’ the loss of that limb.
In addition to the existence of unpleasant feelings in our companion animals, we have to consider their magnitude. Things such as fluid in the lungs when the heart is failing can cause low blood oxygen, which will lead to extreme and prolonged discomfort and distress, whereas a broken limb will lead to temporary discomfort until the morphine kicks in! Social relationships or the loss of them has been shown to affect human quality of life, and given that our pets have the ability to bond, we believe that the loss or change of social relationships can affect their quality of life too. Stress and mental stimulation also play a role. Individual pet personalities or breed idiosyncrasies also affect quality of life. It is well recognised that some breeds are more stoic, or accepting of pain and distress than others. This must also be taken into consideration in your decision-making.
Unfortunately vets and vet nurses deal every day with owners who have unrealistic expectations on what quality of life a therapy/procedure might achieve. If you know what you hope for, and you discuss this with your vet, they can advise objectively if they think you are hoping for too much. Try to realise that pain and suffering are two different things. Pain can be controlled by medication in many cases. A pets emotional distress because a they mess in the house, can’t go on their walks any more, or are unable to simply follow you about in the garden, may not be.
Draw a line in the sand
Talk to your vet honestly (expect tears). Discuss the chances of your pets’ survival as well as the quality of life for them that you might expect. Allow yourself time (where possible) to make a decision. Request additional resources, information, or referral for a second opinion if these things would help your decision-making processes. Examine your heart for what your feelings/worries/concerns are as far as making a decision goes. Seek validation for your feelings, and the difficulty you are having with such decisions. Request information, support and advice, but in the end make the decision yourself.
If and when your emphasis has shifted away from trying to save your pets life (at all costs), you will start to seek ways of making their death have quality, dignity and peace. Consider your thoughts on what a ‘quality’ passage from life would be like for your pet, and advise your vet on how they can help you achieve that. Consider what will be important about your pets passing when you look back on it in the future, and examine what your fears of ‘the worst’ are too. If your vet knows your personal fears, they will be able to help minimise the chance of the fear being realised.
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