When to help your older dog cross the Rainbow Bridge

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By Laura Pakis, Certified Professional Dog Trainer and Blogger

As dogs age, taking care of them becomes more problematic. An older dog’s ability to learn, their awareness and their senses of sight and hearing can all deteriorate. Owners of aging dogs often struggle with their pets’ dementia and incontinence — as well as navigating through the maze of end-of-life care decisions.  Dogs that are dying exhibit symptoms such as impaired movement, reclusion, restlessness, sadness, lack of interest and incontinence.

Euthanasia:

There comes a time for many of us when euthanasia becomes the loving thing to do. This is because veterinary medicine, like human medicine, has succeeded in extending life beyond the point where quality of life is satisfactory.

No matter how long a pet lives with us, the time will never be enough and we will never realize the strength of our attachment to a pet until it is gone. Quality of life issues bring most clients to me for euthanasia. Usually they rely on me to reinforce and affirm their decision to put the pet to sleep. I have found that loving pet owners usually recognize when their pet is suffering seriously. If there is a sin, it is delaying this moment of decision beyond its proper time. Guilt often weighs heavily on the person who must make this decision and it is rare for there to be unanimity within the family. But do your Buddy this favor when you see in its eyes that the time has come.

 Is The Time Now?

When making the decision to euthanize consider these questions as well as the quality of life scale. First, what is the current quality of their pet’s life? Is the pet still happy and playful? Does it show joy and affection? Is it eating well and is it aware of its surroundings? Is the pet in pain? Have we exhausted nursing and veterinary care? How is the pet’s illness affecting the family? Can you or your family really afford the cost of care that will likely be unrewarding?

Once the decision has been made to put the pet to sleep you must decide if you want to be present while it is done. Veterinarians euthanize pets by administering an overdose of barbiturate anesthetics intravenously. The process is painless. You can cradle your pet while this is done or you can wait in the reception area until the process is complete. About seventy-five percent of dog owners decide to be present. Most dog owners elect to have their dog cremated although some of the more traditional owners still bury the pet in their back yards. You can also bury the ashes of your pet in a treasured spot. Alternatives include every option offered in human funerals and interment.

Permission to print the following scale has been generously granted by the author, Alice Villalobos, DVM.

QUALITY OF LIFE SCALE

Pet caregivers can use this Quality of Life Scale to determine the success of Pawspice care. Score patients using a scale of: 0 to 10 (10 being ideal).

Score Criterion
0-10 HURT – Adequate pain control & breathing ability is of top concern. Trouble breathing outweighs all concerns. Is the pet’s pain well managed? Can the pet breathe properly? Is oxygen supplementation necessary?
0-10 HUNGER – Is the pet eating enough? Does hand feeding help? Does the pet need a feeding tube?
0-10 HYDRATION – Is the pet dehydrated? For patients not drinking enough water, use subcutaneous fluids daily or twice daily to supplement fluid intake.
0-10 HYGIENE – The pet should be brushed and cleaned, particularly after eliminations. Avoid pressure sores with soft bedding and keep all wounds clean.
0-10 HAPPINESS – Does the pet express joy and interest? Is the pet responsive to family, toys, etc.? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be moved to be close to family activities?
0-10 MOBILITY – Can the pet get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, but an animal with limited mobility yet still alert, happy and responsive can have a good quality of life as long as caregivers are committed to helping their pet.)
0-10 MORE GOOD DAYS THAN BAD – When bad days outnumber good days, quality of life might be too compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware that the end is near. The decision for euthanasia needs to be made if the pet is suffering. If death comes peacefully and painlessly at home, that is okay.
*TOTAL *A total over 35 points represents acceptable life quality to continue with pet hospice (Pawspice).

Original concept, Oncology Outlook, by Dr. Alice Villalobos, Quality of Life Scale Helps Make Final Call, VPN, 09/2004; scale format created for author’s book, Canine and Feline Geriatric Oncology: Honoring the Human-Animal Bond, Blackwell Publishing, 2007. Revised for the International Veterinary Association of Pain Management (IVAPM) 2011 Palliative Care and Hospice Guidelines. Reprinted with permission from Dr. Alice Villalobos & Wiley-Blackwell.

Alice Villalobos, DVM, DPNAP, a renowned veterinary oncologist, introduced “Pawspice”, a quality of life program for terminally ill pets. Pawspice starts at diagnosis and includes symptom management, gentle standard care and transitions into hospice as the pet nears death. Dr. Villalobos developed this scoring system to help family members and veterinary teams assess a pet’s life quality.

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