Thursday, January 17, 2013

Natural Dying in Companion Animals By Mary Gardner, DVM

sunset over lake
Photo by Holly Russo

 Faced with a terminal illness or a geriatric pet in a declining state, pet owners have to eventually come to terms with their pet’s passing and make the decision between a ‘natural death’ and humane euthanasia. I imagine just about everyone would like their pet to comfortably crawl into their bed one night, drift off to sleep and pass away peacefully while sleeping. I hope that I personally pass that way as well and I believe this is what many people think ‘natural death’ is. However, more often than not, this is not how a pet dies naturally; and a ‘natural’ death does not necessarily mean that it’s a peaceful death.

To begin with, one has to understand how an animal actually dies. Honestly, this is not fully understood in many cases as it’s dependent on the disease or issue the pet is suffering from. Many “end stage” diseases can be extremely painful or full of anxiety for the pet. Below is a review of the more common ones.

Congestive heart failure is a common cause of death in companion animals and as the heart condition worsens, fluid starts to build up in the lungs. In end stage heart failure, a pet actually drowns in their own lung fluid. Unfortunately for the animal, this associated with an enormous amount of pain and anxiety. Just ask any asthmatic how painful not being able to breath is.

Kidney or liver failure is another very common ailment. The main function of these organs is to filter out toxins and as these toxins build up to poisonous levels in the bloodstream, a pet will become very sick, lose their appetite and slowly die from starvation, dehydration and complications from the toxin build up.

Arthritis or mobility is the most common ailment of larger dogs that I treat. As their joints begin to increasingly hurt, they move less, find it more difficult to get up from a prone position and their leg muscles atrophy making it even more difficult to move. Eventually they will lose mobility all together and not be able to get up. This however will not end the pet’s life. The pet owner will still bring them food or water, so one has to think, ‘How will my pet die from lack of mobility?’ It is usually from secondary complications like bed sores and infection.

When I consult with clients who desire a ‘natural passing’ for their pet – I explain what their pet may experience during that process depending on their ailment. I also ask why they want a natural passing for their pet. More often than not, I receive two answers:

  1. They do not want to make the decision (or make the decision too early) which I totally understand. However, death will occur eventually but it is up to us to help relieve pain, anxiety and suffering for our furry family members by electing humane euthanasia which is the gentlest, most caring thing you can do for your ailing pet.
  2. The second most common answer I hear is that they think euthanasia hurts and entails giving a poison to their pet or giving them a heart attack. 
None of which are true.

With that being said, I think it’s very important that people are educated on what veterinary euthanasia actually is. First, a pet is given a small sedative to help them relax and get comfortable while their family says their goodbyes. If you have ever had surgery, they usually give you a small injectable sedative or pain reliever before the anesthesia. Basically it just makes you feel good and relax! The final medication is an over dose of a barbiturate given in the blood supply – this is an anesthetic. This overdose of an anesthetic makes the pet fall asleep and then stops brain function, which is followed by the heart and lungs stopping. This anesthetic does not hurt at all and it’s just like when humans go under anesthesia for surgery. The pet is totally unconscious when they pass.

On rare occasions some pets may vocalize, however this is a natural reflex when inhibitions are lowered with certain drugs. But this does not mean they are in any pain. Some dogs or cats also may be startled by the feeling of the liquid going thru their vein – again, very similar to humans feeling an odd sensation when we receive IV fluids and the fluid is not the same temperature as our blood. It is still - not painful.

Another thing to keep in mind with a so-called ‘natural’ passing is that it doesn’t always happen at night while they are in bed. It can happen when you run to the store, when you’re at work, when they are outside going to the bathroom etc. More often than not, death doesn’t occur while they are asleep. They eventually do fall unconscious which people then perceive as having occurred while they were asleep. I personally lost my own dog when I was at work. I returned to the sight of him lying in his own feces, in a horrible position and certainly NOT the passing I wanted for my best friend.

A natural passing doesn’t always happen very quickly either. I have had many frantic phone calls from people wanting me to rush to their home because they wanted a natural passing for their pet but the process is taking too long or not very peaceful. The pet might start having a seizure, they may start to choke or they may have difficulty breathing. This is not easy to watch or let your pet go through and people need to be prepared for this. What happens if your pet is alone during this traumatic time? I wouldn’t want to be alone during my final moments, so families with pets that are near the end should have someone with them at all times to make sure they are not suffering.

A family should know that it is never too late to call a veterinarian if the natural route is not going as they had planned. The owner should give themselves permission to choose humane euthanasia if their plan for natural death is not what they had envisioned for their pet's end of life experience.

Many families are amazed after I euthanize their pet at how peaceful and respectful the process actually can be. Many even comment that they wish they could pass that way or they wish it was that peaceful for a family member who passed.

Many elderly people that have a painful or anxiety driven condition are afforded the benefit of a constant infusion of medications like morphine or other sedatives so that they do not feel the effects of body organ shut down and death. Although sad, this is the humane thing to do, but our pets are not normally given this type of care (however, it can be) Understandably, most wouldn't want their pets fully sedated for weeks at a time. That is not quality of life in my eyes and why I believe euthanasia is a better alternative in certain instances.

There is really no down-side to humane euthanasia, aside from the cost to the owner which varies by location and veterinarian but is typically not cost prohibitive. During euthanasia, owners can, if they wish, communicate with their pet's spirit and incorporate personal rituals into the process. There is no shame to providing a pet with a peaceful passing. Personally, I find it satisfying knowing that the pet's final minutes were ones where they felt no pain (due to the effect of sedation and pain relief) versus their final minutes being ones of experiencing some degree of suffering, confusion and anxiety. I think that we, as veterinarians and co-animal lovers, need to give owners "permission" to choose a pain free, peaceful, death for their pets. It can be their last gesture of love.

In conclusion, with euthanasia we are doing exactly what the family originally wanted. For their pet to fall asleep peacefully and pass in their sleep with no pain or anxiety. The only way one can guarantee that will happen is with humane euthanasia.

Posted by Dr. Mary Gardner, DVM

1 comment:

  1. Thank you. This is comforting. Our beloved Tanner was able to leave us peacefully knowing how much we all loved him and how much joy he gave us.


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