View Full Version : When is it time to say goodbye? A guide to the hardest decision

8th January 2007, 03:43 AM
A kind vet has summarized this issue in a single sentence:

When an ill dog has more good days than bad days, then it is fine to give that dog some more time, as long as he or she is generally happy, but when an ill dog has more bad days than good days, it is time for the owner to be courageous and faithful to that dear friend, relieve their suffering, and let them go.

I would add to that: ...and please be at their side so that someone who loved them all through their life is a soothing presence for them at the profound moment when they slip gently away. Please do not let them go alone. It may seem daunting, but it is a special and moving and -- believe me -- even consoling moment especially later, to bear witness. Remember how many times they were there for you --- and don't forsake them. :flwr:

But for some, it maybe hard to decide whether their friend is having good days or bad days so I am cross posting an essay I think will be helpful to many who are facing this difficult decision.
How Do You Know When It's Time?

-- Hilary Brown, Owner, VetPet Partners veterinary e-list

I don't subscribe to the idea that dogs "will let us know when it's time", at least not in any conscious sense on their part.

For one thing, I've found in my years of counseling folks who have ill pets and often accompanying them through the euthanasia process, that this notion is often interpreted in a way that puts a lot of pressure on people when they're already stressed and grief-stricken. "What if I miss the signs? He looked miserable yesterday but not today. What if I act too soon or not soon enough? How could he ever let on that he wants it to end? But maybe I'm deluding myself that he feels better than he does."

Dogs are not people. We lovingly anthropomorphize our dogs during our time together and there's no harm in that, even quite a bit of reward for both them and us. But the bottom line is that they are not people and they don't think in the way people think. (Many of us would argue that that speaks to the superiority of dogs.) These amazing beings love us and trust us implicitly. It just isn't part of their awareness that they should need to telegraph anything to us in order for their needs to be met or their well-being ensured. They are quite sure that we operate only in their best interest at all times. Emotional selfishness is not a concept in dogdom and they don't know how hard we sometimes have to fight against it ourselves.

Dogs also have no mindset for emotional surrender or giving up. They have no awareness of the inevitability of death as we do and they have no fear of it. It is fear that so often influences and aggravates our perceptions when we are sick or dying and it becomes impossible to separate the fear out from the actual illness after a while. But that's not the case with dogs. Whatever we observe to be wrong with our sick dogs, it's all illness. And we don't even see the full impact of that until it's at a very advanced point, because it's a dog's nature to endure and to sustain the norm at all costs.

If that includes pain, then that's the way it is. Unlike us, they have never learned that letting pain show, or reporting on it, may generate relief or aid. So they endure, assuming in their deepest doggy subconscious that whatever we abide for them is what is to be abided. If there is a "look in the eye", or an indication of giving up, that we think we see from our beloved dogs, it isn't a conscious attitude on their part or a decision to communicate something to us. It's just an indication of how tired and depleted they are. But they don't know there's any option other than struggling on, so that's what they do.

We must assume that the discomfort we see is much less than the discomfort they really feel. And we do know of other options and it is entirely our obligation to always offer them the best option for that moment, be it further intervention, or none, or the gift of rest. From the moment we embrace these animals when they first grace our lives, every day is one day closer to the day they must abandon their very temporary and faulty bodies and return to the state of total perfection and rapture they have always deserved. We march along one day at a time, watching and weighing and continuing to embrace and respect each stage as it comes. Today is a good day. Perhaps tomorrow will be, too, and perhaps next week and the weeks or months after. But there will eventually be a winding down. And we must not let that part of the cycle become our enemy.

When I am faced with the ultimate decision about how I can best serve the animal I love so much, I try to set aside all the complications and rationales of what I may or may not understand medically and I try to clear my mind of any of the confusions and ups and downs that are so much a part of caring for a terminally ill pet. This is hard to do, because for months and often years we have been in this mode of weighing hard data, labs, food, how many ounces did he drink, should he have his rabies shot or not, etc.

But at some point it's time to put all of that in the academic folder and open the spiritual folder instead. At that point we are wise to ask ourselves the question: "Does he want to be here today, to experience this day in this way, as much as I want him to?" Remember, dogs are not afraid, they are not carrying anxiety and fear of the unknown. So for them it's only about whether this day holds enough companionship and ease and routine so that they would choose to have those things more than anything else and that they are able to focus on those things beyond any discomfort or pain or frustration they may feel. How great is his burden of illness this day, and does he want/need to live through this day with this burden of illness as much as I want/need him to?

If I honestly believe that his condition is such, his pleasures sufficient, that he would choose to persevere, then that's the answer and we press on. If, on the other hand, I can look honestly and bravely at the situation and admit that he, with none of the fear or sadness that cripples me, would choose instead to rest, then my obligation is clear. Because he needs to know in his giant heart, beyond any doubt, that I will have the courage to make the hard decisions on his behalf, that I will always put his peace before my own, and that I am able to love him as unselfishly as he has loved me.

After many years, and so very many loved ones now living on joyously in their forever home in my heart, this is the view I take. As my veterinarian, who is a good and loving friend, injects my precious one with that freedom elixir, I always place my hand on top of his hand that holds the syringe. He has chosen a life of healing animals and I know how terribly hard it is for him to give up on one. So I want to shoulder that burden with him so he's not alone. The law of my state says the veterinarian is the one licensed to administer the shot, not me. But a much higher law says this is my ultimate gift to my dog and the responsibility that I undertook on the day I welcomed that dog into my life forever.

Something to think about when the time comes; the final item of the list of '10 things a dog asks of its person':

Go with me on difficult journeys.

Never say "I can't bear to watch" or "Let it happen in my absence."
Everything is easier for me if you are there.

Author unknown

This may seem too difficult for some, but imagine how you might feel if at the end, your family left you alone with the doctor... :(... Try to have courage and be there just as your dog was there for you in your times of grief and sadness. From personal experience, I can say it is very consoling to be there and bear witness to your loved companion's rich life with you and final gentle loving farewell, and brings a proper sense of a completed life. With a kind vet, the final moments for your pet are simply a gentle passing from a soft sleep -- they will already be sedated -- to a peaceful passing as they are sent into a deeper sleep then released. It is an honour to say goodbye, with the same love that you once welcomed them into your life. Please try not to leave them to this alone. Vets are understanding about grief and supportive, too. IMPORTANT: Be sure to discuss in advance with your vet to make sure they use the Humane Euthanasia Protocol (explained towards end of this helpful article (http://www.naturescornermagazine.com/help_companions.html)).

UC Davis Vet School's information (http://www.avma.org/communications/brochures/euthanasia/pet/pet_euth_brochure.asp) on knowing when it is time, and bereavement.

Also, thanks to Trisha for this link on how to assess the quality of life (http://www.naturescornermagazine.com/help_companions.html) your companion has, in making this difficult decision, and how to ease the whole process. Also notes the importance of making sure your vets use the Humane Euthanasia Protocol.

Here is an excellent publication (http://www.vet.ohio-state.edu/assets/pdf/hospital/companionAnimals/HonoringtheBond/DifficultDecisionsFactSheet.pdf) from Ohio State University on weighing up this difficult decision and different ways of thinking about it. And this one (http://www.vet.ohio-state.edu/assets/pdf/hospital/companionAnimals/HonoringtheBond/CopingWithLossFactSheet.pdf)is on coping with grief and loss.

And here's a thoughtful perspective on how to decide (http://www.naturalholistic.com/download/Dr_Bernstein_Holistic_Care_Saying_Goodbye.pdf), from a vet.

9th June 2009, 07:13 PM
I think this is a *wonderful* tool to help you gauge how your dog is doing and sets a scale for certain behaviors and keeps a lot of the emotional trauma out of it. If you have a dog that is in pain, or elderly, check this out. This is never an easy decision and I feel for anyone who is facing it.


Love my Cavaliers
9th June 2009, 08:24 PM
You're right Trisha - it is never an easy decision, even when it's obvious that it's the right decision. I can still remember the uncertainty about putting our German Shepherd to sleep 7 years ago. She had a seizure disorder and was starting to detriorate. I had made an appointment to PTS on Monday so that we could have one last weekend with her. Well, on Sunday she started going up the stairs for the first time in weeks and seemed more lively. Called on Monday to cancel the appt, but by Wednesday afternoon, she hadn't moved in 24 hours. I took her out to pee and bolstered her up because she couldn't stand on her own. At that point I knew it was time. My daughter and I went with her and held her while she passed away so peacefully on her own bed which we brought to the vet. We are both so happy to have had that last moment with her and I'm sure we would regret it if we had said goodbye without being with her to the end.

9th June 2009, 11:26 PM
I just want to thank Karlin for providing these links. I recently visited my neighbor and her 16 year old cocker spaniel. It was clear to me that the dog was in a lot of pain and really failing. I talked with my neighbor about her dog and she expressed sadness and confusion over knowing how to deal with the issue of PTS. I asked if I could give her a couple articles (these listed here) and she gladly took them.

She called me last week and asked if I would mind helping her facilitate the process with her dog. She said the articles had really helped her realize that her dog needed to be "set free." We share a vet, so I arranged for the vet to come to her home. This happened a couple days ago and my neighbor, while very sad, is so glad she was able to provide her companion with a peaceful and dignified death.

Thank you again Karlin.

14th June 2009, 03:13 PM
You're welcome, it is always such a hard time for every companion animal owner.

I've consolidated all my posts and links into a single post now, and added the one from Trisha; thanks for that. :)

I've also added some personal thoughts about being there with your loved companion at the end, which I think is the greatest gift we can give back to these amazing creatures after all they do for us during their too-short time in our lives. Please stand by them, and bear personal witness if you can.