Wednesday, March 21, 2012


A few days ago, I had the opportunity to ease the passing of a long-time patient of mine. I'd been seeing this dog for >10 years in my practice, and we got along pretty well. In the past six months or so he'd been in a decline, and for multiple reasons his owner chose this past weekend to end it.

These occasions always make me think.

I think about death. What does it mean to die? Is it really true that sometimes, dying is better than living? I think so, but can I really be sure? It just about kills me (no pun intended) that I can't be sure. No one can show me the evidence. I have to take it on faith. I am not a person for whom that comes easily. I don't really believe in faith.

I think about my part in the process. Do I have "the right" to end anyone's life? Is there any person, group of people, or supernatural power that can grant me that right, or am I allowed to grant it to myself? Regardless, I feel a responsibility to end suffering when possible. Sometimes any continued life will mean continued suffering. So.

I think about the impact my patient's death will have on the people in his or her life. The owner. The extended family. Me. My staff. Sometimes it is very very hard. Other times, not so much. I'll come out and say it: given the opportunity to euthanize a particularly nasty-tempered animal, I have sometimes felt pretty good about never having to see that animal alive again. I believe the phrase "don't let the freezer door hit your ass on the way in" may have been uttered, in jest, even. More often it's sad, though. Sometimes devastatingly so, as when octagenarian or even nonagenarian pet owners have to say goodbye to their companions, and feel it would be unethical or inhumane of them to get a new pet, if they have no trusted friend or family who agrees to take it in should they, the owner, predecease the new pet. Those people always seem so terribly lonely - sometimes, we call them every few weeks just to say hi... sometimes, they just slip away and are never heard from again.

Anyway, all of this is just an aside. This past weekend, my patient was accompanied by his owner, a man of about 35 or 40 years old. The patient was quite large and we elected not to put him on a table, but to spread a blanket on the floor and let him lie down comfortably before I injected the euthanasia solution. Afterwards, the man laid down next to him and hugged him and cried, in a way that generally men of this age in this society do not do in public, unless experiencing overwhelming tragedy. I put the tissue box near them both, told him how very sorry I was, and left them to have a private goodbye.

The man ended up leaving the building while I was occupied in the other exam room, before I could come back in and say anything else. Not that I had any great prepared words of wisdom, but usually I'll offer a final "I'm so sorry," a handshake or hand on the shoulder, a "please let me know if there's anything else we can do for you," that kind of thing. For a long-time client like this, we'll follow up by sending flowers or a charitable donation or something in memory of the pet, depending on what we think would be best appreciated. I flagged the patient's chart to make sure the staff would have me personally sign whatever card might be sent. I'm not always around when they are preparing those to go out.

My very next patient was an adorable so-cute-it-hurt puppy. On the one hand - yay, puppy! Cycle of life, to everything there is a season, yada yada yada. On the other hand - pet store puppy. Fake/made-up pseudo-designer "breed." Entropion. Luxating patellae. HUGE inguinal hernia. No vaccine history. No deworming history. Serious case of craniorectal inversion in the owners! So, essentially, no heartwarming take-home message here. Just another day at the office.


  1. It is so very sad when a beloved pet dies. I am currently struggling to decide if it is time for my 10.5 y/o chin. He is still alert & engaged but struggling mightily with end-stage CHF & a god awful cough that doesn't respond to anything.
    To have a vet that cares & understands is truly a blessing. I am so thankful that my vet is like this.

  2. In January, we moved to a new town, and only 2 weeks later our cat went into renal failure that neither our new vets (what an introduction, right?), nor the emergency vets, could pull her out of after a week of emergency care. It was the hardest decision I have ever had to make, and I still cry about on a regular basis (like, right now). But it was the compassion of our new vets that made it less soul-crushingly awful. I echo the comment above - to have a caring vet is a blessing.

  3. I have been near death a couple times from some health problems I have (now well managed, thankfully). Both times it was a relief to lose consciousness, because it gave me a huge break from the enormous pain I was in (physical pain). Having surgery can be a relief for me, because of the nice drugs you get to put you under and there's a brief bit of time after you get them and before you go out that is very nice indeed. I imagine euthanasia feels like that, given what is in the injection. This is why I feel that euthanizing pets is a really peaceful and painless way for them to go.

  4. I recently lost my old guy to oral cancer. It all happened so fast. Only the month prior he had been in for an appointment, vaccinations and an exam. No tumors evident in the mouth. Ultra careful of my dogs' teeth as one had dental decay a year ago and had to be put under to clean well.

    Bless my Vet's assistant who got me in within half hour of me finding the lump in his upper lip. Indeed the swelling was inflating his nose. Was only during a haircut did I notice his resistance to letting me touch that side of his face.

    Kind vet we have gone to forever ago examined him. After diagnosing the cancer gave me 5 days worth of pain meds and antibiotics. Told me on the 5th day to come in to talk about what the next step would be.

    I so appreciated how he laid out the facts so gently but left it up to me. And gave me a time line to process and think about what I wanted to do.

    I know he would have done all he could to do what I had wanted to prolong my dogs life but it would have only been a matter of time and I in no way wanted my Buddy to suffer. He respected and seemed to appreciate my decision as hard as it (damned well) was. I made the decision to euthanize him, then changed my mind, again and again and again. I feel I did the right thing. I hope. Just could not bear to think of him in pain and not being able to tell me.

    Very interesting to read this post and understand it from the vet's perspective. When my guy passed it was after he was lavished with love and praised by me, my husband, the Vet and his assistant. I will never forget hearing the Vet tell my dog that "I will miss seeing you in here, you were always such a good boy". Warmed my heart and still makes me tear up.

    How kind you are to send flowers, and /or cards to those who have lost their Buddy. Means the world to us bereaved pet owners to recognize our very great loss. Thank you.

  5. Craniorectal inversion?? Too awesome...I may have to use that phrase, possibly during this afternoon's appointments...

  6. When people exclaim how hard that part of my job must be, I tell them that actually I feel it is the most important thing I do and a great privilege to help owners through that most difficult of decisions.

  7. I think as an owner it's the most selfless decision we can make for our pets. We know when they are no longer able to enjoy the things they love & it's a part of our commitment to them to make that difficult decision if necessary. I have been on both sides of the counter, as a grieving pet owner & as an employee at a vet clinic. Having a vet & staff that truly care can really help with the grieving process. And we do truly care for our patients & miss seeing them and "their people" when we lose them.

  8. Wow, just another day at the office, huh? Dunno if you like hugs, but I am sending you one. This career is so much harder than I ever imagined, but so much better than I ever imagined too. I could not do anything else, but I am glad I did not know about days like the one you just described before I started. *sigh*