Red finally succumbed to his disease(s). His owner, when faced finally with the inevitability of his impending death, decided it was time to let him go.

I should be thankful he didn’t elect to take him home—something he kept suggesting he might do. Somehow my pleas against this option were effective enough to keep him in hospital. My others, nudging gently towards euthanasia at every opportunity, were not.

Red stayed with us for three days. Three days of distress for him and for us, his ineffectual caretakers. I use this negative terminology to describe his care because there was nothing we could really do to alleviate his suffering while he was with us.

A variety of pain meds made him vomit—at the end, huge clots of blood were expelled. The antibiotics didn’t ever seem to help—he languished with a low-grade fever the whole time. We tortured him endlessly with peripheral IV catheters when the jugular catheters kinked. And all the while we knew it was for nothing.

I’m sure we made him feel somewhat better, but not enough to give us any solace. The ultrasound showed us the magnitude of his problem: tumors all over his liver, spleen, intestines and prostate. It looked like end-stage, metastatic cancer of the prostate. Yet we still had to watch for another day as the owner debated with himself over the right course to take—as if there was any other.

Euthanasia is a personal decision. While I always maintain a position of respect for a client’s decision, I have a hard time when it comes to cases like Red’s. Some vets refuse to treat cases where euthanasia seems mandatory—such as the terminally mangled puppy the client’s kids can’t bear to lose. For me, electing not to treat is not an option. Most would die slowly at home should I refuse—or go elsewhere, where I’d have no control over the delicate issue of pain relief nor the ability to slowly change a client’s mind over time.

This part of veterinary medicine never gets any easier.