How Do I Know When It’s Time?

Assessing Quality of Life and End-of-Life Questions

It’s something we get asked often. “How will I know when it’s time?” Unfortunately, the answer can be very subjective, and it’s our job to help guide you through this process. When used appropriately, euthanasia is a last kindness you can give to your pet that prevents further physical suffering for them and emotional suffering for your family.

Quality of Life

The term “quality of life” is one you will hear often when discussing end-of-life decisions with your veterinarian. Assessing your pet’s quality of life can be highly subjective and dependent on the progression of disease, your pet’s personality, and your personal beliefs. Like humans, as your pet ages, they will become more prone to disease progression in the body, and each pet will react to this progression differently. Certain diseases may progress slowly and be maintained by medication management. Other diseases may progress very rapidly, requiring surgery, and costly treatments, and your pet may experience difficult side effects. Understanding the progression of disease in your pet will involve consistent observations in body, mind, and behavior, as well as discussions with the veterinarian to contribute to your understanding of their quality of life.

Pain and Anxiety

Pain is often at the forefront when discussing veterinary hospice care, and can be one of the most misunderstood symptoms by pet owners. Our pets often do not show pain as we humans are used to expressing our own pain, and so it is easily missed or misunderstood. Shaking, panting, lowered posture, flattened ears, grumpiness, reluctance to eat or play, and stiffness after resting are a few signs of pain and discomfort.

Anxiety can also be a large factor in your pet’s comfort, and will often be shown more in their behavior than pain. Panting, pacing, whining, crying, hiding, and agitation are all associated with anxiety and should be monitored and treated.

Natural Death

We all hope that our pet’s can pass naturally in their sleep, but, just as in humans, such things can be rare. Some owners fear their pet passing alone, while, for the animal, they may seek out such a natural scenario for themselves. Being with your pet as they pass naturally can also be difficult to watch, especially for non-medically oriented people, as the animal’s mind and body can go through different stages during this process. Should you wish for your pet to pass naturally, you should have an in-depth conversation with the veterinarian to prepare, including how long the process can take, what it will look like, what you and your pet may experience, etc.

Waiting Too Long

While decisions about euthanasia are incredibly subjective and personal, there is an interesting phenomenon that should be noted. When experiencing the decline or terminal illness of a pet for the first time, owners are more likely to wait until the very last minute to make a decision on euthanasia. They fear euthanizing too soon, giving up without giving a good fight, or wish to wait to see if their pet will pass naturally. Afterward, however, many owners come to regret their decision to wait so long. When reflecting back, they can feel great guilt for the days, weeks, or months spent with their pet enduring complicated or invasive medical procedures, pain, and degeneration. Families that have experienced the loss of a pet previously are much more likely to recognize the decline of their pet and tend to make decisions at the beginning of their pet’s decline instead of at the end.

The following are some questions and tools to consider when considering euthanasia and your pet’s quality of life:

What is most important when considering my pet’s end-of-life treatment?
Is my pet in unmanageable pain?
Are they able to urinate or defecate independently?
Do they have a medical condition that will only worsen over time?
Are they still eating and drinking?
Create a family calendar to mark good days and bad days. Some may go even further to distinguish between nighttime and daytime as there can be significant
Write a list of three to five things that your pet enjoys doing. When your pet is unable or unwilling to do these things, it may be time to discuss euthanasia with the veterinarian.

Assessing Quality of Life Chart

While this chart can be helpful, it is mainly a visual tool to help guide you in assessing your pet’s current situation. This chart can be especially useful when used over time, as symptoms may progress slowly and it can be difficult to notice minute changes in your pet physically or behaviorally.

Date: Weight:

Is My Pet…	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Not wanting to play
Not responding to my presence normally
Not enjoying their favorite activities
Hiding
Had a change in personality
Having more good days than bad days
Sleeping more than usual
Dull or depressed
In Pain
Painting (even while resting)
Pacing/Restless
Shaking or Trembling
Vomiting/Nauseous
Not eating well or losing interest in food
Not drinking well
Losing weight
Uncontrollably urinating
Uncontrollably defecating
Having diarrhea
Able to move without assistance

The more your observations lean towards “Strongly Agree” or “Agree” would indicate a poorer quality of life for your pet. This would indicate you may need to have a conversation with the veterinarian about euthanasia and your pet’s prognosis.

Bartonville Veterinary Center does offer phone consultations for established clients if you would like to speak with the veterinarian about specific questions pertaining to your pet and their quality of life or euthanasia. Please call (940)241-2023 to inquire about pricing or scheduling a phone consultation.

Walking You Through the End of Life Appointment

We know that making the decision for euthanasia can be one of the most difficult you will face. We strive to make the appointment process as smooth and comfortable for you as possible. Below is an outline of what you can expect as you enter your appointment.

When you enter the clinic you will be immediately directed to an empty room that has been prepared for your appointment. A blanket or bed will be provided for your pet’s comfort. If you require assistance bringing your pet into the building, please let us know upon your arrival.
Once inside your room, a technician will give you a brief overview of the process and what to expect during your They will also ask about your preferences for aftercare services. Your technician will then take your pet into treatment to place an intravenous catheter for medication administration.
While your pet is having their catheter placed, a receptionist will come and speak with you about aftercare options, review charges for your visit, and take payment inside the room. Bartonville Veterinary can assist with several aftercare options as outlined below:
- Private burial – If you wish to bury your pet on your own property, or if you have a pet cemetery you wish to use, we will provide a secure vessel for you to transport your pet.
- Communal Cremation – This service does not provide any ashes back and disposes of cremated remains for you. Prices can be provided upon your request. Clay paw prints are available with this service for an additional
- Private Cremation – This service provides a private cremation where ashes will be returned in a carved rosewood Prices can be provided upon your request. Clay paw prints are available with the service for an additional fee.
Once reception has completed all the necessary paperwork and the technician has brought your pet back into the exam room, you are welcome to spend some time alone with them. When you feel you are ready, the technician and veterinarian will return to complete the procedure.
Whether you wish to stay in the room while the procedure is being completed, or not, is at your discretion. Depending on which aftercare option you choose, you may leave at your convenience or will be directed by reception on the next steps.

End of Life Questions