This is a topic that we, as veterinarians, face daily. I am often asked how will I know when it is time, should I be present for euthanasia, and what do I tell my children? I don’t know that there are any definitive answers to these questions. They certainly vary from family to family and on a case by case basis. I can only tell you what I believe and offer some advice for coping with this difficult situation.
How will I know when it is time?
This question is tricky because it really depends on the underlying process causing your pet to be ill. Certainly there are some clinical signs of progression of disease that apply to all pets. I generally tell owners that it is time to seriously consider euthanasia when the good days are outnumbered by the bad. This can be obvious in cases where pets have uncontrollable pain and/or vomiting, but it can be a little more challenging in cases where they simply are a little more lethargic or refuse to eat. I had a cat named Shadow who was diagnosed with Lymphoma back in 2006. I had it set in my mind that it would be time to euthanize him when he quit eating. As it turned out, Shadow ate ravenously every day up until the day I had to euthanize him. What made me decide it was time? I was holding him one afternoon and he urinated on me, something that he had never done before. It made me take a step back and really look at him. What I saw was shocking. He had become gaunt and he did not appear to really be seeing me even though he was looking at me. This is what I always think of when clients tell me that the light has gone out of their pet’s eyes or that their eyes have changed. I know that look and will never forget it. How had I had not noticed? I had set a single parameter in my mind… I will know when he stops eating. In hindsight, I realize that I had waited too long. In some chronic illnesses, the change can happen so gradually that it is hard to remember what “normal” behavior was. In those situations, I tell owners to keep a daily journal of their pet’s attitude, activity, appetite, and interactions with the other pets. This way, you will have something solid to review. If you look back and see that your pet spent most of last week in a crouched position on the window sill and was the last of the cats to come to eat, it might be time to consider euthanasia. Especially if you know from your journal that your pet use to sleep 12 hours on your head every night and then roam outside for most of the day.
Should I be present for euthanasia?
This varies from person to person and family to family. I will tell you that I do not ever judge anyone based on their willingness to be present for what can be the hardest decision they have ever made. If you are unable to be present, please take comfort in knowing that most of us became veterinarians due to our love of animals. This means that we will treat your pet as if they were our own and show them the love and respect that you would. We hold them, talk to them, pet them, and very often we cry. Tears are not something to be ashamed of and no one will think less of you for crying, so please do not ever let this keep you from being present for a loved one. If you opt to be present, we try to make this as comfortable as possible for both you and your pet. We tend to sit on the floor with our pets so that you are able to touch or hold them. The process itself is very fast and painless. Tux was the name of my first cat. He came to me in middle school and we shared 15 great years before he was diagnosed with metastatic cancer and I made the decision to euthanize him. This happened the first year of my residency. I remember seeing him decline at home, but being scared to bring him into work because deep down, I knew that once I found out what was wrong with him, I would be forced to make a decision. I waited 3 days before I had the courage to bring him in. Once I found the cancer and saw how extensive it was, I knew that euthanasia would be blessing for him. Even though I knew that in my mind, I could not make the decision right away and I took him home from the hospital. I felt a huge pressure in my chest whenever I would look at him and I could not eat. I was so distressed about making a decision that I delayed it for 48 hours. When I finally made the decision and moved forward with it, it was as if a great burden was lifted from my heart. I think this was because I was dreading losing him so much. The reality of his peaceful passing and knowledge that he was no longer suffering gave me immediate peace. I often hear people comment on how they feel great comfort after euthanasia. Making the decision to euthanize a loved one is a great burden to bear. Sadness is expected, but you should never feel guilty about having to make the decision to euthanize your pet. Often, it is the last gift we can give them to demonstrate our love and return the loyalty that they gave us.
What do I tell my children?
I believe that honesty is always best and that you should avoid using the phrase “putting him to sleep”. Children who are already having a hard time with the situation might misunderstand the permanence of euthanasia and it has the potential to make them afraid of bed/nap time. While it is incredibly hard to discuss death with a child, it is a natural part of life and the passing of life can often be a blessing. Children are very perceptive and they often share a special bond with our pets that is very different from ours. If your pet is painful, it is helpful to let your children know that we are helping them by relieving their discomfort. Based on your religious beliefs, you might feel it appropriate to discuss after-life. There are several children’s books available that can help with discussing euthanasia and the feelings your child might have.
Finally, if you or your child is having a difficult time making a decision or coping with the loss, I would suggest that you speak to someone. This someone can be a friend, family member, or grief counselor. The important part of this is to open up to someone. I do not believe that words will erase the pain, but I do know that time and a good support system are the greatest healers.