Humane Euthanasia: The Gray Zone

One of my recent emergency shifts was what we in business reluctantly call"one of those shifts." This is a shift in which almost every patient that walks through the door is here for euthanasia, or PTS (put-to-sleep) for those in the jargon know. Nights like these, no matter how the end result may benefit the owner and/or the pet, take an emotional toll on the staff and myself. The term for this is empathy fatigue.

What tends to bother me the most is when it is a problem that goes undiagnosed, but the owner feels the patient is older and usually states, "while it's not the money, I just don't want to put him through testing when we don't know how much longer he has." While that makes sense to me emotionally, as a doctor, I want to find out more. I have a need to form a diagnosis in an attempt to treat and provide a prognosis.   I also feel that maybe we owe it to the pet to try some therapies, if the condition is treatable and the animal is not currently suffering, prior to ending a life. By offering diagnostics, I hope to give the client as much important information as possible to make an informed decision. The conflict arises because the amount of information needed is a personal choice and differs for everyone; and, ultimately the owner determines the right time for an animal to pass on.

If a client has a 13 year old dog and the dog started having some respiratory issues that clinically appear mild and a low grade heart murmur is detected, is that cause in itself for euthanasia without taking x-rays?  What about if, in addition to those signs, the owner may have to undergo a long distance move?

If we suspect strongly that a portosystemic shunt is the cause of persistent hypoglycemia that is difficult to manage, is it time to give up on that puppy prior to definitive diagnosis with an ultrasound?

Some clients worry about what they will find out and prefer to remember their pet in their best condition and accept the inevitable. So where do we draw the line between treating too aggressively and not treating enough? When is the right time to let our best friend go, and when is humane euthanasia an opt out card versus a means to end suffering? These are very real and permanent choices and questions we must face as part of being a responsible and caring pet owner.  There is, of course, no right or wrong answer. However, I know after nights of numerous euthanasias I start to wonder what my role should be in the decision process.

As a veterinarian, clients will ask you all the time, (especially with respect to humane euthanasia) what would you do if this was your pet? The truth is they usually already have a decision made and sometimes your job is to support them.  After all, it is their pet, their loved one, their choice...or should it always be?