I cannot even understand why anyone would want their pet to suffer at home to die.  We see this all the time at my office where a cat or a dog is going down hill and the owners just let the animal lay around in it's own feces for weeks before it finally passes at home.  It makes me sick.  I understand that euthanasia may also be a hard thing to go through but I would much rather my pet go peacefully through euthanasia than suffer needlessly for weeks.  What is even sicker is that this summer we had a man who when his 15 year old pug started to go downhill, instead of euthanasia, he fed it antifreeze.  (shudders)  It's just plain sad, especially that money wasn't the issue with the man, he just thought he could do a better job. 

DNS83 December 11th, 2009 09:50:24 AM

I had no idea this was a real phenomenon! Two of my friends have endured the loss of three cats (total, not three cats each) in the past three weeks. Both humans elected euthanasia, though. They loved their furkids too much to let them suffer.

Loki's mom December 11th, 2009 10:10:47 AM

Glad kitty's last moments were peaceful and not painful as expected, but I think they got lucky.  My first husky died on his own of fortunately quick, but unexpected, heart failure.  My vet said he didn't suffer, but I still feel bad that I wasn't there

And despite all the careful planning and monitoring my vet and I did when my Tundra got cancer, he went downhill so unexpectedly fast that I had no choice but to rush him into the vet's office for euthansia rather than doing so at home, as we had wanted.  But I was holding him and he went in peace, which was what mattered.

However, I cannot imagine just waiting for him to die at home "on his own".  That is so unnecessarily cruel.  Helping our friends pass peacefully is the last kindness we can do for them and IMO, it is our OBLIGATION.

Di December 11th, 2009 10:36:57 AM

I had a little rescued Persian that lived only a year after I took her in.  Her poor little life was a struggle, with one illness after another.  However, her determination far outweighed her diminutive size (only 4 lbs).  She had spent so much time going back and forth to the vet that when she died it was peacefully - and mercifully- at home.

My little leukemia girl, though, was rushed to the emergency clinic early one Sunday morning.  It was obvious she was dying and was terribly frightened by what was happening.  I couldn't let my desire to have her die peacefully in the only home she ever knew outweigh the obvious kindness of euthanasia.  The emergency clinic was very kind (not always the case unfortunately).

Despite 2 very different endings, I truly believe that each instance ended in the way that it should.  I agree that a good ending to a life is as important as a good beginning.

Carol December 11th, 2009 11:17:23 AM

I guess I must have adopted some of the criteria in the post with respect to one of my old cats.  She was terminal, and I decided to let her pass in the comfort of her home without a stressful trip to the vet ... with the caveat that it had to be without suffering.  One morning, however, I realized that she was in pain and probably hadn't slept all night, so I took her in for euthanasia.

I never got around to thinking about how to handle the passing of my other granny cat because things happened so quickly.  She had some chronic health problems but was not yet in a condition that would have got me thinking about what to do when her time came.  Nine months after my first granny cat passed, I found her unresponsive.  I took her to the vet, but nothing could be done for her.  Given her unresponsive condition, the criteria set out in the post for taking her home to pass would have been met, but I didn't even consider it, even though I had considered it for the other one.  I guess I was more focused on what would be the least stressful option for her (and for me).  Taking her home would have been one more car ride (which she never liked), followed by a wait of unknown length.  And who knows what kinds of ups and downs she might have had to go through before the end came?  Euthanasia was a no-brainer decision for me.

welso December 11th, 2009 11:56:56 AM

Yesterday my vet came to the house and helped me give my 15 1/2 year old rottie/GSD boy a good death.  I had been giving him tramadol and injections of depo-medrol which pretty much eased his joint pain.  Because of that we had about six good weeks we would not have had otherwise.  But during the past week or so his mental state deteriorated -- he showed strong anxiety during the night and would sometimes get lost if he went outside to pee.  Physical suffering, no.  But I couldn't let this nighttime fear continue. 

He died by daylight on his own bed, by the heat stove, with me holding him.  I am content that it was the right thing at the right time.

Catherine December 11th, 2009 12:07:53 PM

Great post Patti.

I've noticed an increase in the number of owners who want their pets to die at home and it's a challenge for us vets. You just need to encounter one owner witnessing a traumatic, out-of-control death at home to realise the value of a calm, peaceful exit. That said, there are other instances where pets had had "ideal" deaths at home, slipping away peacefully in their own beds.

I really like your ABC on this issue and I'll be quoting you many times in the future. I think that as long as we outline our concerns to owners, and stress the risks, as well as giving an objective way of helping to reach the right decision, that's as much as we can do.

Pete

www.petethevet.com

Pete Wedderburn December 11th, 2009 12:10:49 PM

Yup.  Agonizing decisions, these.  We all dream of having our pets "die peacefully at home" and we all dream of this for ourselves, for that matter.  But I'm with you on wanting to pre-empt things should there be any quesiton of suffering.

As much as I've wished for that "peaceful passing" for my pets, there is not one single animal I have lost to death that I haven't euthanized.  I agonized and struggled and waffled and told myself I was "weak" and doing it for "me" but in the end, I just couldn't bear to think they either WERE suffering, or WOULD be suffering on the road to death in a way I could not control.

I've never euthanized over quality of life and doubt I ever will. 

I have euthanized over quality of death, though, each time, and suspect I always will.

Either way, prepare for friends and others to judge you.  In this most personal of decisions, everyone seems to feel entitled to sit in judgement.

I once had a woman on a support gorup list for feline CRF tell me that by euthanizing my end-stage-renal-failure kitty, LaPlume, I was depriving her of "cleansing her soul" through suffering at the end, suffering that would help her work off bad karma for her sins. By sparing her this suffereing, I was likely causing LaPlume to be reincarnated as an insect, she told me, rather than some exhaulted life form like humans.

This was her warped version of "bhuddism" talking.

The other thing is people who say that years ago before advancement in veterinary medicine, their pets would simply die peacefully of "old age" and this was better. 

That's kind of like "consumption" -- a catch all term which means we don't really know whats wrong.

What looks like dying of "old age" I'm betting is more often some kind of organ failure, or disease, and once you ** know ** what it is and know you can treat it and prolong life, hopefully with acceptable quality, the long slide begins.  It's really only when we don't know whats wrong that we ascribe it to "old age."  In humans or pets.  People don't die of "old age".  They die of age-related diseases.  Pets too.   The abiltiy to treat creates lots of difficult questions, but it creates the opportunity to have more life.  Increasingly cherished, precious life.

Stefani December 11th, 2009 12:22:13 PM

Nope! Never again will i do that. Both my springers (17 and 18 years old they died). I "wanted them to die peacefully at home" thats just not how it happened. And at 3 am on both occasions i was rushing poor dieing dog to the er for final EUTH. That was me, then, being selfish.Thinking death will happen peacefully is not a normal occasion. Lucky are you that finds your dog died in its sleep.

Now i try to make sure i tell anyone nearing this situation don't do it... Just bring the poor thing in to the vet. Or better yet find a vet that will come to you! Its scary, its frustrating, your in stress mode, your rushing, its not the way i'll ever let any animal go again. And its the memory i remember the most. Of course, i remember the wonderful memories of them, but those last memories are always present.

So never again!

i wrote a post remembering them not too long ago. They were such joys. and should never have died rushed like that. I would always recommend doing it before, making it a pleasant somber experience, not a rushed and painful one.

http://jojosfarmlife.blogspot.com/2009/09/for-love-of-dog.html

JOJO December 11th, 2009 12:35:51 PM

On November 6th I euthanized our beautiful fourteen year old sheltie.

I took her to our vet that morning and discovered that she was in renal failure.  As she aged, lost her hearing and her health obviously began to slip, we too hoped that she would die at home.  That day though, the writing was on the wall.

I realize that many others would have perhaps attempted to treat her illness and prolong her life, I felt that was selfish on my part - just delaying inevitable hurt for me. 

Our sweet girl had lived a long, wonderful life and like all dogs, had provided us with years of unconditional love.  In return for that love, I felt that I had the responsbility to provide her the gift of a pain free and peaceful death.

Nelson's Mama December 11th, 2009 12:39:30 PM

I believe it's better to euthanize a week too early than a day too late.

That one day of suffering and fear for the animal, or that late night ER rush is not worth putting the animals through just because we want them here with us as long as possible. I would rather 'deprive' my beloved pet of a week of status quo than risk the pain and personal guilt at having their last moments anything other than peaceful.

lindabcs December 11th, 2009 01:49:29 PM

Perhaps this doesn't directly corrolate, but I always thought this but have never stated my thoughts.  For all I know, this isn't the place to do it, but here it goes.

I do agree with all of the statements of maintaining quality of life, knowiing when a pet should be euthinized, etc.  I wish that we could get the same society that has the dignity to put a pet down when it's time to do teh same for a human in an identical situation.  I saw my Aunt go through hell the last month of her life with Leukemia.  I won't go into details except that I am positive she would have liked to enjoy the same type of death as our cancer riddened callico did, even if it was  a couple weeks and $300,000 sooner.

EAB December 11th, 2009 01:52:20 PM

Dr K, thanks for this post.  It's helped me gain perspective.

I have to admit that before reading this post I questioned my parents' decision to allow one of their dogs to die at home. She became quite frail at the end and spent most of her time sleeping on the rug. It seemed like they were just hanging on to her out of selfishness.  But, I have to admit she didn't appear to be suffering, just very weak. She was in her home, with her people.  It's easier to understand my parents' decision in light of the criteria outlined.

I just hope I can make the right choice when the day inevitably comes for each of my pets.

Posey December 11th, 2009 02:15:34 PM

"I believe it's better to euthanize a week too early than a day too late."

I fully agree, and so does my kid the vet. He's told me he thinks most people wait too long and included himself in that assessment with respect to his own two dogs.  I've seen more than enough bad deaths, I won't cause more if I can help it.

However, there's a good chance SmartCat and PrettyCat will outlive me. If there comes a time when my wife can't care for them my kid has agreed to find them a good home or euthanize them if he can't.  That's the best I can do without indulging in some insane grandiose preemption.

Will December 11th, 2009 02:31:16 PM

Thanks for this! Another great link for our Coping With Loss discussion forum. It is too bad more people can't follow the lead of their pets and face death with dignity. We all must make these decisions for them, and we owe it to our beloved dogs (and cats) to make the call – ensuring the time is right, and the process painless. Your tips are sure to help.

All too many times, we hear from those in a panic who have prolonged the deed to far, more for themselves than for their pups. We prefer to convey to all our members providing hospice care for their dogs that it is all about quality of life, not qantity.

tripawds.com December 11th, 2009 02:41:01 PM

My last cat death was much as you describe for your patient Dr. K.  It was indeed a good death, surrounded by his family and without the stress of an outsider.

I'm mostly inclined to preemptive euthanasia too but, if one is tuned in to one's pets, it's also an individual situation.  This last boy would not have done well at a vet's office nor even having one in.  Somehow, I think he made the decisions that would avoid that and chose to move on in his own way.  He passed in his sleep with me petting him.

This was also less distressing to the other dogs and cats in the household.  I think they wonder what happens when Fluffy goes off and doesn't come back, mom comes home distraught smelling of "vet office".

THANKS for this post.  I think it's incredibly important for people to think about and discuss the process of death.  All who are born will die so it deserves equal attention.

PJB December 11th, 2009 02:55:13 PM

I never seem to luck out with the dying peacefully at home thing.

I no longer wait until "there is no doubt". I know my animals well enough to know when they are no longer enjoying the signature things that always brought them happiness. At that point, if it's not treatable, I let them go.

I have never regretted moving on the decision, but I have sure as hell regretted waiting to do so.

Worst one in recent years was when our 185 pound pig suffered a massive stroke.  She'd been failing for a few months and we'd hemmed and hawed about when. But the stroke left no more room for speculation. And she was totally down. At night. On a Sunday.  No vets able to make it out before Monday morning, no way to move her that did not seem to cause her immense distress. I called a friend who lives about 30 minutes out and is a crack shot and who slaughters her own couple of project pigs yearly. In the mean time I gave her the painkillers the vet had prescribed, a very generous dose. She left the world quickly and humanely if not peacefully.

JenniferJ December 11th, 2009 03:20:43 PM

A friend of mine recently made a final appointment for her elderly, ailing Maine Coon. He'd been ill for a long time, but had recently shifted decisively to more bad days than good, and she didn't want to wait until there were only bad days. So she made the appointment for that Saturday, when she and their two close friends in her building could all be there.

And on Wednesday, he passed away, in his sleep, with her two other cats stretched out on either side of him, keeping him warm to the end. Decision made, decision pre-empted by the cat.

Every one of my pets, though, has been euthanized at the end, when it was clear that nothing I could do would restore them to a quality of life that was worth it to them. In one case, we were in the midst of diagnostics for what was in the end identified as liver cancer and bone cancer. The day before the results came back, she woke me up, in far more distress than she'd been in the night before, and it was absolutely crystal clear that she was telling me, "Mom, make it stop NOW!"

So I did. I called our vet, who cancelled her Sunday morning plans and came to the house. Otherwise, I'd have had to take her to the evet to do it.

All my other pets' ends have had their stress and grief, yes, no question. But not that whiplash change from "yes, this is clearly serious but there's a good chance it's treatable and she can have a good quality of life for a few more years" to "make it stop NOW!"

Lis December 11th, 2009 03:35:18 PM

This column and its comments are a keeper for me ... for me, when I'm tempted to subvert wisdom with wishes, and deprive any of my beloved pets as soft and gentle an exit as can be provided.

Sometime in the early hours of November 3, my 15 year, 3 month old Dal Lily adopted from a shelter almost 10 years ago, died in her sleep. She had no evident pain or discomfort right up till her last day. Lily ate that morning, but that night seemed "not present" when I gave her a treat. Because she was old and on the frial side, I'd been watchful for signals for months, and this seemed to be it. I called my vet to come in the morning for euthanasia. I knew I could change my mind and delay it if Lily rallied, because I'd done that with other dogs before and the vet was always understanding and patient.

Sometime between 2 and 7 AM, Lily passed away in her bed, downstairs from my bedroom. I didn't awaken to any sound she might have made, but when I did awaken, I knew instantly she was gone. The very sound of the air inside the house was different. Lily was in the same position she assumed when I kissed her goodnight just hours before.

That's rare; a blessing. Of the literally dozens of dogs I've taken in for more than 30 years (almost all are older shelter dogs, unlikely to be adopted), three have died this way. I'll never count on that, though, and vow to always maintain the will for, and rapid access to, euthanasia for all my animals.

oh holland December 11th, 2009 05:05:09 PM

Dr. Khuly, the biggest problem is how stoic so many pets are during the death process and that is what makes me utterly sad.

Many owners to NOT recognize the signs of distress and suffering. They think that shivering means "cold", or panting means "hot".

I have one very sad story of someone related to me that their very elderly cat went into seizures , they had just taken her to the vet less then 48 hours earlier and sent home. The owner was too frightened to go back for euthanasia and feels she died peacefully.

I can't tell you how sad that makes me. Yes, this person knows of my Pocket, who died a cruel and inhumane death. Yes, this person has known me long enough to know I am not "mentally ill" to have made up or imagined such a "tale".

Suffering? Hopefully not all veterinarians would call recumbancy in a cage unable to eat, nor lying in body wastes with a cone on her head, away from her family for an entire WEEK, without pain management (NONE) , not suffering. Hopefully NOT all veterinarians would think it acceptable to "drown an elderlydog in bolus of fluids" and still have an 18 phosphorus.

(Although, I did find one vet that suggested a 25 phosphorus had no meaning---numbers don't matter I guess, why do blood work?)

http://avetsguidetolife.blogspot.com/search?updated-min=2009-01-01T00%3A00%3A00-05%3A00&updated-max=2010-01-01T00%3A00%3A00-05%3A00&max-results=50

 Of course this topic makes me both sad and angry. Angry that it would even occur to a professional to behave this way.

I can not believe of the many posts on Doolittler for over TWO 1/2 years, the opposing attorneys pick ONE to quote me. I hope they are now regular followers, and quote me on this one.

My lawsuit is now filed :

"Pocket's Story from NH"

Barbara A. Albright/NH December 11th, 2009 06:22:49 PM

It's interesting how we feel that passing at home "naturally" may indeed not be the kindess, least painful way to die, for our pets, but yet it's not an accepted practice to euthanize humans. Humans who can usually clearly define pain and suffering.

what a convoluted world we live in.

LorriM December 11th, 2009 07:13:46 PM

I'm firmly in the camp of one week too early is better than two minutes too late. My mom's shihtzu, Kidd, was going down hill for a long time. Deaf, mostly blind, etc. Still ate fine, pottied fine, (just wherever he was) and slept a lot. He was almost 15. Last March 17, he went out the dog door to the back yard and somehow didn't find the way back in. No one was home. When my mom and I both got back at about the same time, he was seizuring in the backyard. I rushed him to the shower to see if it would stop as it seemed to be heatstroke (he felt as hot as dry grass under a Florida sun) and when that didn't work right quick, we took him to our non-regular vet that's right here on the street. We immediately opted for euthanasia when I saw he was already in DIC, and the vet was shocked I knew what it was. Two injections later, he was at the Bridge, and thankfully the ace worked quickly because there's no way the dr. could have hit a vein otherwise, and hopefully the ace alleviated some of the stress/pain. Either he had a seizure that left him out in the heat which caused heatstroke, or it was heatstroke because he could not find his way back in. No matter, because in the end that wonderful little boy did not deserve to go like that. We all knew his time was coming, and I just wish so much that something could be changed to have spared him that horrible prelude to death. He deserved so much better. I've known of cats too that owners took home to die, and maybe sometimes that works out, but the ones I know of were terrible. No cat/animal should have to lie there in their own waste as cancer eats them alive.

Euthanasia is our friend, and the hardest choices in life are so often the right ones.

Brooke December 11th, 2009 07:21:09 PM

I agree with Brooke here. My two childhood dogs both died of cancer... and after euthanizing the first who had osteosarcoma, my father didn't want to put down our lab who was diagbosed with lymphoma a year later. He said the dog would 'know when it was time to go'... the resulting misery and horrific decline I had to watch as a child before the vet could finally convince my parents to put him down, have set me firmly in the place where I would rather euthanize my dog too early rather than too late out of a misguided desire to prolong my time with them.

Pai December 11th, 2009 08:30:39 PM

LorriM: But aren't we forgettting that human's have hospice & many pain and anxiety drugs administered in their final time?

And haven't most states provided laws that even accidental overdose or increases in doses that may "hasten" death are not "prosecutable"?

I sure as heck have never been one to accept suffering in lieu of euthanasia, but anything would have been preferable to Pocket's death .

Dr. Khuly, wouldn't a post about the signs a veterinarian looks for to indicate suffering/pain/death be helpful for the readers?

Barbara A./NH December 11th, 2009 08:44:54 PM

"aren't we forgettting that human's have hospice & many pain and anxiety drugs administered in their final time? And haven't most states provided laws that even accidental overdose or increases in doses that may "hasten" death are not "prosecutable"?"

I know that wasn't directed to me but...  Generally, pain meds are grossly under administered to the dying and, in hospice, there's the added problem that drugs often "disappear" so the patient isn't the one who gets them.  There's always a push going on in some jurisdiction to prosecute anyone who hastens death, whether it's family or medical pro.  The result of that is to keep doctors and family members afraid of the possibility.  That increases the likelihood that insufficient pain relief will be provided at end of life unless someone has a very proactive advocate pushing for them and their needs.

I have no doubt these issues also contribute to less than optimal pain relief for large animals and to suffering or early euthanasia due to that unrelieved pain.

PJB December 11th, 2009 10:17:51 PM

What PJB said.  There's what the end of life is supposed to be for humans and what it actually is. They're not the same thing in all too many cases unless one's relatives are seriously tough-minded or one takes the off-ramp oneself.  The last is an option humans often (but not always) have but pets don't.

Will December 11th, 2009 10:49:37 PM

Our dog developed cancer which seemed to linger a long time. She was a cockapoo and very happy most of the time. Despite her cancer, she was playful, happy and loved to be around the kids.  Every now and again, she would slow down, and we would watch her, wondering if this was it.  And then she would bounce back to her usually puppy self.  This lasted for about 2 years.  Then we moved into a new house, and 2 weeks later, she started to get sick again.  Her breath was slow, and she had lost weight.  We knew it was time so we booked an appointment with our vet for the next morning. That night, we were in the living room with her (the whole family) because she couldn't go downstairs anymore.  The girls went to bed and said good night.  Then she got up and went to her blanket in our bedroom, where she died.  It was so sad, and I still cry to this day when I think of it.  Losing a pet is a hard thing, no matter how it happens. 

Lma December 11th, 2009 11:07:48 PM

PJB: I have little doubt that many humans have gone "under-medicated", but at least something was prescribed and administered for pain & anxiety. I have friends that witnessed at home hospice & use of morphine pump, etc. that was steadily increased.

This area has changed from 20-30 years ago, in a lot of places. And if we dare suggest that these drugs are misdirected , then we would seriously need to wonder what happens to all the "voiceless".

I believe that my Mom's medical directive included a sentence regarding administration of drugs "could" hasten death. I'll have to dig it out and read it again.

Hospice nurse associations, from my limited and friends (relayed) limited experience, really do know their work and are an incredibly compassionate group of professionals.

I also need to give credit to the doctor-hospitalist we encountered and to at least one long-time veterinarian I had, that both shared integrity, sheer honest communication, and the best interest of their dying patients at heart.

Barbara A./NH December 11th, 2009 11:49:59 PM

In theory euthanasia offers a peaceful end. But, in fact, many animals are terrified of the vet, the needle and the catheterization process--which can be a lengthy, painful and frightening process. Who would want their pet's last moments to be filled with terror? Euthanasia as it is currently practiced by veterinarians can be awful for the wrong reasons. Why won't veterinarians address this?

Chicago December 12th, 2009 04:04:00 AM

This is kind of like wanting to 'be there' when a loved one dies and wanting them to die at home.  Perhaps you could suggest a vet visit to do the deed at their home next time.  Don't know if you do this, but I believe this is a real comfort to pets and humans alike.

Dina December 12th, 2009 06:33:06 AM

"Euthanasia as it is currently practiced by veterinarians can be awful for the wrong reasons. Why won't veterinarians address this?"

I'm guessing that you have trouble with the idea of needles and a clinical atmosphere in general...and I don't blame you. We do try to improve on that by offering owners the choice of having the euthanasia performed at home, as Dina suggests. We also work hard to relieve the stress associated with the hospital environment by 1-not letting pets wait in the waiting room when it's time for euthanasia, 2-offering a sedating premedication to administer at home, 3-giving an injection of a strong sedative when they arrive, etc. We also try to make lots of concessions, including special euthanasia "suites" that are like little living rooms etc.

But it's true that it can be frustratingly difficult to have euthanasia happen beautifully, as it should, in every case. Some vets don't have a great bedside manner, some hospitals are not well run, sometimes protocols are adhered to too strictly and what's best for the individual animal fails to get considered. I could go on. We're not perfect (and some of us are downright unworthy of the profession) but most of us make a big deal out of euthanizing humanely, beautifully, every single time.

Dr. Patty Khuly December 12th, 2009 09:42:43 AM

Barbara,

trust me when I say that while your assumtion is good, it is not accurate. There is a great deal of suffering in hospitals and hospice alike and it is not a good, kind or nice thing.

overdosing people with drugs is great for TV, but rarely happens in real life and is prosecutable and that differs by hospital and location.

As far as people not suffering..that depends on their insurance and ability to pay...trust me..it can be really ugly out there.

LorriM December 12th, 2009 10:50:26 AM

My in-laws' 15-year-old, mixed breed dog was mostly blind and had developed bad vestibular disease. She was kept strictly outdoors in the fenced backyard with several other dogs and an in-ground swimming pool with no barriers to keep the dogs away from the pool. My in-laws were not equipped or willing to deal with her diseases of old age yet didn't want to euthanize her because all of their other dogs have died at home and they wanted the same thing for this dog. Well, one morning they went outside and discovered that, blind and with no sense of balance, she had fallen in the pool and drowned. Her horrible death still haunts me and I hope it haunts them too. No dog should die that way. The euthanasia of an old, ill pet when it is "time," and surrounded by family, can be a beautiful gift.

Anon December 12th, 2009 01:12:46 PM

Thank you for your kind response, Dr. Khuly. I was not aware that 2) and 3) were options. As the mom of FeLV+ children this is a subject of deep concern to me.

Chicago December 12th, 2009 01:22:13 PM

LorriM: I do believe you. But painting the entire country and every human medical facility with that broad brush, would be the same as "me" painting the entire pet-med profession as unethical and uncaring. It would be untrue.

I clearly miswrote if I misled you to believe that "overdosing" is common in hospice, that is not true either. My statement was to be that advanced directives, living wills, or whatever they are called in other localities contain a statement to be "initialed" that the drugs administered/prescribed "may hasten death".

No doubt if my dog Pocket was administered certain drugs, she may have simply "died" of respiratory/cardiac failure. Particularly since I asked for the fentanyl patch that was clearly printed atop of her hospital chart , yet checked "NO". Why?

Surely she must have had terrific pain, not too mention SEVERE anxiety just as any other dying human?

Lorrri, PJB: I count my lucky stars every day that my Mom happened upon a great hospital/staff/doctor/hospice--because clearly my Dad, the "named proxy" was not in good shape to fight any pressure had extraordinary measures been suggested.

I have a couple of other more distant family that did NOT fare as well. And that sure makes me sad too.

Barbara A./NH December 12th, 2009 05:20:39 PM

My grandmother recently passed away following a one-week stint on hospice during which I was responsible for much of her care. Her passing was neither peaceful nor quick, and it was a fairly unsettling experience for all involved... the hospice staff included. Despite being heavily medicated for pain and anxiety, the moments during which she was aware were terrifying for her. Since then, I've had to put up with a lot of well-intentioned commentary regarding the "beauty" of dying at home surrounded by loved ones. Maybe in some cases it is a beautiful experience. In her case, it wasn't. And those hefty amounts of morphine that are generally expected to hasten the patient's passing don't always work, even when administered properly. LorriM is right, it's not that simple. Our state has very stringent laws regarding the matter, and suspicions of intent to do anything more than relieve pain open staff and caregivers up to the possibility of felony charges.

But I digress. During the process, all I could think was how unfortunate it was that we did not have the option of allowing her to pass as quickly and humanely as our pets.

The experience cemented my belief that quality trumps quantity, that having the opportunity to spare terminally ill animals prolonged suffering at the end of their lives is nothing short of an absolute blessing, and that I would rather risk taking the boys a week to early than an hour too late... without question.

I know that end-of-life decisions are not a one-size-fits all affair. That said, in most (but not all) instances, I have a very hard time viewing bringing a dying animal home and allowing him to pass naturally as anything short of the infliction of needless suffering.

3 Fabulous Felines December 12th, 2009 05:50:01 PM

I am so sad that I want to cry.  On 12/15 it will be 1 year since my beloved 20 year old kitty Muffin died in my arms, what I think was a horrible death on my way to the vet to put her at rest.  I kept thinking she would get better.  My vet never stressed putting her to sleep so I kept going thinking she would get better.  Ithink he knew but he knew how much I loved her.  At at times she would rally.  That last afternoon when I came home, I found her and had finally realized it was (past) time.  I was on my way to the vet, I had no one to drive me, and she died in my lap, taking 2 last gasps for breath.  To this day I cannot forgive myself for letting it happen this way.  I should have known better and taken her in sooner.  I hate myself for what I did to her.  My intent was to have her put down at home when it was time.  She was always so afraid of car rides.  If by chance she can hear me at all, I ask for forgiveness every day from her.   And I ask again.  My beloved Muffin, please forgive me for putting you so much.  I love you now and always. 

Jan December 12th, 2009 06:14:52 PM

Have any of you read "Merle's Door" by Ted Kerasote?  I'm curious about how people felt about Merle's death.  I read the book a few months before my Belgian died (I knew she was mortally ill with cancer at the time), and Kerasote's experiences definitely colored the way I handled my girl's death.  I worked very hard to accept my dog's wishes and let her go naturally if that is what she wanted.  As her cancer progressed, and she began to be obviously uncomfortable, I added pain meds to her routine (this was about 2 weeks before she died).  Eventually (via a communicator) she indicated she was ready for euthanasia.

One of the hardest things I've ever done was set a time with the in-home euth. vet.  When she asked me what time I wanted her to come over, I felt like I had been kicked in the stomach.  I set a time for the following evening and proceeded to make as many loving memories as I could.  My girl glowed all day as we picked out flowers and did some final walks and meals together.  We had friends with us both physically and spiritually, and her death was very calm and peaceful.

I believe her co-owner probably would've put her down about the time I put her on pain meds if the dog had lived with the co-owner.  I don't regret those last 2 weeks.  We both did a great deal of growing and loving during that time.  Was she uncomfortable?  Yes, probably a good bit of the time.  Do I think I was cruel to wait?  No.  I did the right thing for both of us.

kabbage December 12th, 2009 08:13:36 PM

"I should have known better and taken her in sooner."

Jan, I think you need to cut yourself some slack.  A 20 year old cat a few breaths from dying is not going to be worried about being in a car.  It's all well and good to say early better than later, it's quite another to know exactly when unless it's obvious.  You did your best, forgive yourself.

Will December 12th, 2009 08:35:24 PM

"Euthanasia as it is currently practiced by veterinarians can be awful for the wrong reasons. Why won't veterinarians address this?"

Euthanasia is always a very difficult decision and most of us veterinarians have been on your side of it. You wonder if you make the decision too early or too late, either way we all deal with feelings of guilt and betrayal. 

In our practice we try to schedule euthanasias early or late in the day and do our best to avoid you running into other animals or clients . If we know you and you ask us, we may come to your house.  

In the office the client may be present or leave, we offer sedation as needed or desired, even though in out part of the country dogs are pretty used to having blood drawn for heartworm tests and I often find myself with the slow i.v. Barbiturate injection only. Before we do anything we explain the whole procedure and what to expect. Again, we have had to make the same decision for animals we dearly loved and try to make the experience as peaceful and gentle as humanely possible.

DT December 12th, 2009 09:47:01 PM

Witness a vet botch a euthanasia and you may have a completely different mindset.

The same drugs used to euthanize pets are used to execute criminals. Read some about the controversy about their use -- including the drugs' effects -- and you may begin to think differently.

cb December 12th, 2009 11:52:52 PM

Jan, Time to forgive yourself.  I'm quite sure Muffin already has.  We don't know these hard things unless someone teaches us or we learn in this horrendously difficult way.  My Panther was 20 years old, underweight, dehydrating rapidly...  He was my first and I waited too long too.

PJB December 13th, 2009 03:22:54 AM

"The same drugs used to euthanize pets are used to execute criminals. Read some about the controversy about their use -- including the drugs' effects -- and you may begin to think differently."

cb - this is NOT true!  The execution of criminals uses drugs that vets do not use because they are considered cruel.  In fact, one state recently announced that it will update it's execution protocol, and use the same type of drug that vets use.  It is a peaceful death -the pet's systems slow down, and then the heart stops.   If you know a vet who is doing something different, it is time to get a different vet!

Sassy December 13th, 2009 11:26:46 AM

Jan, It is easy to tell you not to agonize over Muffin and hopefully in time you will forgive yourself. I think every pet-owner agonizes over their first pet's death or at least one of them. And it is very hard to discern the progression to when there will be no "rallys", unless you have seen it multiple times.

When my TCC Scottie was progressing towards the end, he would rally. Finally, the end of December, he would no longer bark. I brought him to his favorite obedience school---not a peep,  no interest in seeing the building.

I brought him to the vets and the newbie examined him, took blood & his results were edging to abnormal, but not critical. She told me he was ok, yet I told her I thought he was in pain.

I got home and received a call from his regular vet. She told me his time was very soon, VERY soon.

I knew that in my heart already, but it helped me to have her call me in agreement. His time was less than 2 weeks later, and we could at least feed him steak and everything he wanted, his last night. His groin lymph nodes were rock solid, he could not stand for but a few seconds

What's every pet-owners worst nightmare? I lived it in 2006, when a group of SOB's gang up on you in an utter time of stress and sadness, convincing you that you OWE something, and it does not benefit YOU or your beloved pet, and causes the most egregious and cruel harm that you would never have imagined. When a pet-owner goes over a week without rest, without food resulting in a 10lb weightlost in a week, hair turns gray & falls out---you have gone well beyond boundaries, an angel sat on my shoulder to keep me and others safe on the road.

I shared this multiple times and will warn others to do anything to prevent becoming this victim and having their pet DIE this way.

Pocket's Story from NH

http://walnut-hill.bravehost.com

Docket: 09-c-1063

Barbara A./NH December 13th, 2009 12:18:53 PM

Witness a vet botch a euthanasia and you may have a completely different mindset.

The same drugs used to euthanize pets are used to execute criminals. Read some about the controversy about their use -- including the drugs' effects -- and you may begin to think differently.

 Just what is that supposed to mean ???

Are you suggesting we just do away with euthanasia totally and let them all just suffer away until the bitter end ?

Sorry, your statement (if it can be called that) needed expanding upon.

cb December 12th, 2009 11:52:52 PM

Alison December 13th, 2009 01:00:30 PM

"Read some about the controversy about their use -- including the drugs' effects -"

cb, the "controversy" with respect to humans is over a hypothetical situation no one has shown has ever happened.  It's a ploy by the anti-death penalty people to stop executions.  IMO there are lots of practical and ethical reasons to not allow the state to put people to death but far-fetched scenarios about wakeful paralysis, agony, and so on aren't on my list of things to worry about.

And to be perfectly blunt about it, even a "botched" job of euthanasia is better than having a pet in bad pain for some days or even hours more.  What's your point?

Will December 13th, 2009 01:19:27 PM

Wow, this thread has gotten lots of interesting responses...as far as euthanasia going badly, I've been lucky. I've had vets prepare me to medicate a FeLV+ cat with bad veins before hand so they could use the jugular vein, etc. One vet I worked for, when my hamster had liver cancer and it was time, wanted to just do a heart stick on her and I refused. We put Little in a dog mask with the iso on so that she wouldn't feel the needle, because no one was sticking a needle in my animal's heart with her able to feel it. A month ago today, I took a friend of mine and his cat for the cat's euthanasia, to a vet I'd never seen before, and nor had my friend. This was my friend's first time, and he was all kinds of mixed up emotions and afraid he was being a bad dad. As it turned out the kitty was likely diabetic, hypothyroid, something else I forget, and 19 years old. The vet did a wonderful job and Mr. Kitty went quickly and peacefully, after my friend realized this was the right thing for him and his family and most importantly the cat. I always advise folks that when it's time they need to ask ahead if the vet does one injection or two, or if pre-administered meds may be in order. Even so I have to agree with Will, even a euthansia that goes even terribly awry, is often better than your animal suffering for a length of time.

Brooke December 13th, 2009 03:42:16 PM

Will: there was a "botched job" of execution in 2005? I believe the sod. pento wore off as the 2nd & 3rd drugs were administered & caused a conscious perceived death, although the person was "paralyzed" from the paralytic drug and then excruitiating pain from the 3rd & final injection of potassium chloride to stop the heart. A lot of states then reviewed protocol, including my own state of NH to eliminate the 2nd & 3rd chemicals but provide continuous drip of sod. pento until death albeit it may take up to a half hour (as in the most recent publicized execution)but clearly not painful nor inhumane. Brooke: In theory I would agree, dependant on method used.

Barb A./NH December 13th, 2009 05:07:07 PM

Barbara,

There appear to be a fair number where veins couldn't be found and some drug reactions but I don't see any where the Pentothal wore off before the other drugs worked.  I don't think there's much of a time lag.

http://www.deathpenaltyinfo.org/some-examples-post-furman-botched-executions

In any event, if there's going to be executions then I don't see that the witnesses can't wait a bit until the overdose of the single drug takes full effect.  The three drug cocktail wasn't necessary in the first place.  It's not as if there's a line forming up for the gurney even in Texas.

All of which is far afield from a "good death" for pets.  No matter how good the intentions and no matter how well trained people are,  sometimes things go wrong. That doesn't invalidate the concept, as cb seems to think it does if I'm reading that post correctly.

This is all too depressing.  I'm going to pet the cats.

Will December 13th, 2009 07:19:21 PM

Barb, Human executions get botched all the time and there's always a controversy over just exactly what happened.  The big difference between human executions and animal euthanasia is who is participating (and why and a bunch of other stuff...).  The AMA "Code of Medical Ethics prohibits involvement of physicians in executions" and suicide and euthanasia, as I understand those rules.  When you've got primarily lay people trying to figure out and do stuff the pros who would have the best understanding of are afraid to even discuss, there's going to be a whole lot of bungling.  And, obviously, killing animals and humans isn't going to get as much scientific evaluation as many other areas because it would require killing to do the research.  Even using results from questionable sources that did raises ethical concerns.

On the other hand, this is the reason we don't really always know the best ways to help either humans or animals cross the final threshold of life with dignity and peace.

And now I'm going to join Will and pet some furry friends in the here and now :)

PJB December 13th, 2009 11:11:45 PM

I'm still waiting to hear if cb was tring to suggest that we do away with euthanasia altogether or not....

Far better to let a being drag on indefinately than risk the (miniscule) chance of a 'botched' euthanasia ?

Alison December 14th, 2009 01:31:56 AM

Is it common veterinary practice to use opiates or sedatives toward the end? I would think that that would be an ok solution to keeping pets at home.

And I'm so lucky to have had both times my pets die in their sleep, I can't even imagine what everyone here has gone through.

sara December 14th, 2009 10:07:03 AM

"Witness a vet botch a euthanasia and you may have a completely different mindset.

The same drugs used to euthanize pets are used to execute criminals. Read some about the controversy about their use -- including the drugs' effects -- and you may begin to think differently."

 No, the same drugs are NOT used!

The only similarity is the use of a barbiturate, a more concentrated version of what some of us use for induction before tubing and prepping an animal for surgery. For animal euthanasia we keep slowly injecting more and more until the animal's breathing and heartbeat stop. The animal falls deeply unconscious after less than half of the drug is administered and, even if unsedated, feels only the needle prick.

The executions I have read about use a barbiturate to induce unconsciousness, followed by a paralyzing agent with absolutely no effect on consciousness, followed by potassium chloride to stop the heart. Frankly, apart from my mixed feelings towards the death penalty, I have no idea why anybody would want to use this combination.

"Is it common veterinary practice to use opiates or sedatives toward the end? I would think that that would be an ok solution to keeping pets at home."

No, it is not common where I work, because of the human abuse potential and complex paperwork involved. However, we often prescribe maximum doses of other pain relievers as needed. Sedatives would just make the animal sleepy and a bit less anxious and we rarely use them in my practice.

We, just like the owner want to keep the pet comfortable with decent quality of life as long as possible. No vet I have ever met actually enjoys euthanizing animals. It is just something I feel I have to do if the animal is miserable, in pain or a danger to humans (no convenience euthanasias!)

DT December 14th, 2009 04:10:51 PM

Great post!

We have a Great Dane with cancer. He was diagnosed over a year ago and we are fortunate that he is still doing SO well.

We decided at the time of his diagnosis to do what was best for HIM. To not be swayed by our needs to keep him.

The time is not near, Ike is happy and in no pain. But, we are prepared for this to change. Well, as prepared as we can be... it does hurt to even think about it.

We want Ike to "go" at home. We want this for him and for our other dane Joey. This IS an option for us because our vet (whom Ike ADORES) has already commit to come to us, when it's time. If this weren't an option for us, the decision would be easy. For various reason we want this to happen at home but, Ike's comfort is priority. We owe him nothing less!

I suppose that. in some ways, we are fortunate, we KNOW its coming. And we know that when it happens, it will happen fast.  We made a huge comittment to our boys when we adopted them...

It breaks my heart to even write about all of this.

Making the decision to let your beloved companion go is devastating. I dread the day. With all of Ike's medical issues, his comfort and his well-being were the deciding factors. This dog didn't commit to us, we committed to him.

M in Texas December 16th, 2009 01:18:39 PM

 My beautiful rescue dalmation, Disney, was a credit to his breed.WE had never had a dog, nor a rescue dog, nor a supposdly difficult breed. I never saw the end coming which was the hardest thing, he had some surgery and found a geart condition, but  6 months later his hips went and with a bleeding ulcer, we decided to euthanise him qt 12yrs .  It was the most painless gift i could give him in the world...i held his head in my lap and he was gone.I believe that death is a dignified process not one that should be dragged out because we fear the pain that comes with it.

i have had many months to grieve his death and as christmas comes closer , i still believe that it was the loving thing to do for him.He would have suffered more and we would have had difficulty putting him in the car, howling in pain.  Disney  licked my tears, sat on my lap for a final car ride and walked into the office, layed on a soft rug and with those who cared for him relieved him of his earthly burden.

There is no easy escape for us in the making the decision but the greatest gift that i could give him was that he would never be abandoned again or be in unloved or die alone.With God''s help, I kept my promise.

Love Disney, God's newest angel and his saddest  family friend Debbieand frank

debbie December 23rd, 2009 03:40:58 PM

My kitty Pegasus, passed away a few months ago. She came into my life, the same same way she left.......quietly. I had gone for my coffee in the kitchen, Pegasus was in her usual spot, laying on her side in her usual way. Nothing told me something was wrong, I went back to the kitchen and thought "that's odd she hasn't come to me this AM". She had a heart-attack in her sleep, she was only 10 years old. Hard as it was to see she had passed, she passed away,at the place she loved the most....at home. She enjoyed going out into the fenced yard w/2 Poms, to sun, to play, to poop, what-ever suited her, til she was ready to come in. She never meowed til later in life, she had been abused, and was adopted from the shelter. She was a Calico-Persian, a gorgeous tri colored coat, so soft. I know not every pet can go to RAINBOW BRIDGE the same way, but I wished it could be that way....quietly, at home, in their own surrounding w/their pets friends the have loved for the years they have been in our lives. The vet was caIled, and we had gone over and sat in the cat area, so upset.......I handed over my box with Pegasus so neatly wrapped up, Sheri saying to me she'll be ok. A week later she was home with me where she sits on my desk w/her picture next to the colorful box. She is the first pet of many to have passed quietly, but have know many other where this has happened, sad as it is, I would prefer this over a vet. If it to be, it will be, only us as human and knowing what is quality and what is not can make the best decision for our pet.t Laurie

Laurie December 24th, 2009 08:32:20 AM