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Monday, September 26, 2011

Ask the Vet with Dr. Mark:
The Toughest Decision

by Carrie Boyko, CEB

© courtesy of amcdaniel83 via Flickr
Hi Dr. Mark,

I have an 11 year old pom that is currently experiencing very advanced heart disease, very enlarged heart, a severe murmur and lung disease. We are on 4 different medicines twice daily and her condition only seems to be getting worse. She coughs more often than not, with some spells lasting up to 10 minutes straight and VERY frequent. All night sometimes with breaks where you can still hear her struggle to breathe. 

She has been seeing our vet frequently, adding new medications and finding new problems with every visit. She was treated for pneumonia with an antibiotic. The vet will not recommend euthanization, but I can't help but think it is the way to go. 

She has slowed down so much, often not wanting to walk outside to use the bathroom. Her appetite is barely existent, hardly eating, she does not get excited and want to play anymore. The constant coughing has to be hurting her, but when I raise this question to my vet, I get the response of taking her to a cardiologist 2 1/2 hours away from my home to make her more comfortable. I was told by the same vet that I would be lucky to have her around another year. I feel as if they are more interested in money than the actual quality of life of my pom. Would this be your same recommendation or would you suggest the option of euthanization?

A. A.
Dear A.:

Euthanasia is always a delicate and somber subject. The passing of a family member is a difficult issue in general, but couple that with the fact that we are the ones that are left with the decision and you are left with a gut wrenching situation. The dreaded decision of when it is time can be a difficult one to make. Many people hinge it on whether or not their pet is eating, but appetite is not the only factor to consider. I have seen plenty of dogs and cats that are eating, but have a miserable quality of life. Quality of life is the most important factor to consider. Consider the following when trying to make this difficult decision:
·        Can your dog be a dog or your cat be a cat? 
·        Can they still go for walks (dogs)? 
·        Do they still enjoy games that they always have? 
·        Are they able to stand on their own and "do their business?" 
·        Do they spend the majority of the day in one spot unless coaxed to move around? 
·        Is there a dramatic weight loss that cannot be reversed despite a good appetite? 
·        Are they hiding and avoiding interaction with other family members? 
·        Are they panting excessively for seemingly no reason (dogs, panting is never normal in cats)?
·        Do they have a known painful condition that is no longer well controlled despite treatment? 
·        Do you think they look miserable compared to how they normally behave, and is there an end to this in sight? 

These are the questions we should be considering at this most difficult of times, along with appetite. We should also be considering what is in the best interest of our beloved family members. I know how difficult it can be to let go. Even when we know in ours hearts that we are making the right decision, it doesn't make it any easier. Our pets trust us with their lives and general wellbeing. I look at euthanasia as a way to end suffering, not as taking a life. Sometimes it is the only option that remains.

Dr. Mark

© courtesy M.N.

Dr. Nunez is a practicing veterinarian while also assisting patients through The Balanced Canine blog and his own online veterinary pharmacyHave a question for Dr. Mark? Send it to You can also follow Mark on Twitter.

Dr. Mark's virtual advice is not a substitute for an actual examination with a veterinarian.


Elizabeth said...

What a tough subject but I think Dr. Mark answered it wonderfully. Prayers for A's little Pom!

Peggy Frezon said...

That is the best response to that question I've ever heard. I've had to make this difficult decision before, too, and it's never ever easy. I, too will pray for that special little dog and family.

Michelle Spayde said...

Fabulous response, Dr. Mark!

This post broke my heart....

Having had made this decision last year with my 14 year old Pomeranian, Symba, my heart goes out to this Pom and the family that loves her.

Sometimes when you're very emotional and not getting the information that you (personally) are needing from your regular Vet, a second opinion can help to bring clarity, as well as peace to whatever decision you make.

Maybe jump online and find some canine cardiac support groups? There are also many Pomeranian health groups out there as well. Sharing information with other loving pet parents may help guide you both with your little Pom's condition, and any Vets or Specialists that you may be considering. Also, if a Vet is in it for the money, you'll most likely (easily) find something online about it.

To me, what's most important is to find peace and acceptance. That's my prayer for this little Pommie girl and her loving people.

I wish you all the very best... Just please know that you are not alone...

Dawn said...

I'm sorry to hear about your baby. That is a very tough decision and only one that you can answer. Listen to your vet's advice but don't ever let the vet be the only deciding factor.

DawgBlogger said...

For us it boils down to one question: quality of life.

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