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Thursday, February 5, 2009

Euthanizing Because Of Cost?

Deciding to euthanaize a pet is rarely an easy thing. Which brings the following question from Scott.

Have you had clients resort to financial euthanasia? I read an article that said millions of dogs and cats are put down each year because their owners won't (or can't) pay for the treatment to save them. How do you fell when an owner makes that decision and you have to carry out the procedure?

I'm not sure that "financial euthanasia" is the best phrasing, but I understand what you're trying to say. This is not an uncommon situation, and in most cases I can't fault the owner. However, that's not to say that I like doing it. Always keep in mind that the veterinarian is the final decider about whether or not the euthanasia will be performed. Most of us try to respect an owner's wishes, but we have our own ethics and are under no moral or legal obligation to perform a service merely because a pet owner wants us to. So to me and most veterinarians, there has to be a justifiable reason for euthanizing a pet, and I take that on a case-by-case situation.

Case #1--An 11 year old cat begins to vomit frequently. The owner pays for lab tests, which show nothing abnormal. The vet repeats the exam a week later and notices a lump in the abdomen in the region of the stomach. X-rays don't reveal anything other than a mass, but it doesn't appear to be something the cat swallowed. The next step is exploratory surgery, which the owners cannot afford. The vet has a strong suspicion that the cat has a tumor, possibly in or on the stomach. The cat continues to vomit, and can't seem to keep food down. The owners don't want him to suffer, and ask the vet to perform euthanasia. In this situation, I would do it because the cat has a high likelihood of having a serious problem, and it isn't going to get better without extensive treatment. Rather than letting the pet suffer and die slowly, I would put it to sleep.

And know what? This happened with my own cat. However, I did the exploratory and discovered that most of his stomach was one big tumor. I knew that I couldn't afford chemotherapy, and it was large enough to be inoperable, so I ended up putting him to sleep. So this is a real situation that I modified slightly for the sake of discussion.

Case #2--Here's another real case. An owner has a 10 year old golden retriever that develops a large mass in the abdomen. Surgery is performed and it is discovered that there is a huge mass involving the spleen. The spleen is removed and the dog recovers well. About 6 months later, more masses are detected in the abdomen, which means that a return of the cancer is likely. The owner can't afford more treatment, and decides to put the dog to sleep when they become big enough to affect the quality of life. I would definitely do this euthanasia, as the owner has already done a lot, and further intervention would likely not help.

Case #3--A six year old cocker spaniel has a horrible ear infection, and has had frequent infections for the past five years. The owners aren't willing to do any further diagnostics or surgery to help, and are tired of the smell and appearance. The dog is otherwise happy and healthy, but will have life-long problems with the ears. The owners want the dog euthanized because of the chronic problems and impact on their lives. I would refuse to do this procedure because the dog's life is not at stake, and an inconvenience to the owner is not a justifiable reason to me.

Case #4--A five month old labrador puppy comes in with a broken front leg. The owners are young and cannot afford the needed surgery. Simply splinting or casting the leg would be questionable. This is a tougher case, as the dog's life will be significantly impacted, even if the injury isn't life-threatening. I would likely refuse euthanasia, but offer to help adopt the dog out to someone who could help.

As you can see, each case is different, and they aren't always clear-cut. The rule-of-thumb I tend to use is "what is the pet's life going to be like if we do nothing?" If the quality of life would be really bad or fatal, I will strongly consider euthanasia. If the quality of life won't be bad, just inconvienent or less than ideal, I likely won't do it.

So yes, Scott, people do have to make decisions for their pets' health based on finances. This is the reality of the world, and isn't something that I condemn people for. One of my equine professors in vet school taught me a very important lesson. She said that someone shouldn't have to go bankrupt simply to prove their love for an animal. I would agree with this, and have remembered it over 12 years later. I would prefer it if clients could always afford treatment, but that's not always the case. This is why I recommend having an emergency fund just for your pet's care. But in the cases where the owner can't pay for treatment, I try to put the pet's best interests first. Not always a pleasant task, but a necessary one.