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Written by leading veterinarians to provide you with the information you need to care for your pets.

The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

The Decision to Euthanize a Pet: A Vet's Perspective

Making the decision to euthanize a beloved pet is the hardest thing an owner ever has to do. In my role as an in-home euthanasia provider, I see people struggling with this almost every day.

 

The most common question I hear from owners as they are reaching the end of their pet’s life is, "How will I know when it’s time?" My answer: "There is no 'right' time."

 

Quality of life is a roller coaster. You may make an appointment for euthanasia, only to have your cat rally and have a good morning. In response, you cancel the appointment and your cat’s condition declines overnight making you wish you hadn’t second guessed yourself.

 

Waiting until the suffering is nearly constant would make the decision to euthanize "easier," but this is certainly not best for the animal in question. All we can do is monitor quality of life, and when we see signs of significant decline with no reasonable expectation for meaningful improvement, euthanasia is warranted from that point on.

 

To help with this, I recommend that you write down a few concrete milestones. These are red flags. As quality of life deteriorates we get used to a new normal, and it can be hard to remember what a pet’s life used to be like. I tell people to monitor five categories: eating, drinking, peeing, pooping, and joy in life. Dr. Alice Villalobos has developed a more in depth quality of life scale that is worth taking a look at as well.

 

Without adequate nutrition, hydration, and elimination, suffering inevitably follows. Medications and/or medical procedures are available that can assist cats with their bodily functions and provide pain relief, but eventually they become inadequate to the job at hand.

 

Evaluating "joy in life" is more difficult. This is where the red flags are most useful. Has your cat always greeted you when you arrive home? If she no longer has the energy to walk to the front door, it is time to assess her situation. Has your cat always wanted to sit on your lap but is now seeking solitude behind the couch? While behavioral changes like these are more subtle than, for instance, an unwillingness to eat, they are just as important.

 

My clients frequently tell me how worried they are that they might step in too early. To this I reply, "Better a week too early than an hour too late." I have seen what the "hour too late" looks like and would do anything to spare pets and their owners this level of suffering. In my 12 years of veterinary practice, I have never had a single owner tell me that they wished they had waited longer to euthanize, but countless people have said that they wished they would have stepped in sooner.

 

If your pet is suffering and you cannot euthanize, you must provide hospice care. I often hear people claiming that they want their pet to die "naturally," but there is nothing natural about an animal enduring days, weeks, or even months of misery before death mercifully arrives. We bring this about by providing shelter from predators and the environment, and with nutritional support and medical care. We do this all out of love. But with the ability to prolong life comes the responsibility of saying "enough is enough" when we are no longer doing right by our beloved companions by keeping them alive.

 

 

Dr. Jennifer Coates

 

 

Image: Oscar: 1991-2007 by adamrice

 

Comments  9

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  • 07/31/2014 12:27am

    Over three years later, this reader agrees with your request, BarbaraA. I was almost set on having my 13 year-old cat put to sleep today in my home. It was not an easy decision to come to, and one I came to after witnessing his labored breathing for the past six days. Yesterday, I was ready to wait until his congestive heart failure worsened. Today, I decided to allow him to die while he was still in somewhat of a state of peace and not in excruciating pain. His breathing is labored from fluid buildup around his lungs, but he still eats a little, drinks, goes to the bathroom in the litter box, and can move around. But his discomfort is obvious from the way he moves, the fact that he goes back and forth from sleeping in one spot by the back door to his spot in the closet--not his usual behavior. He won't cuddle with me on the bed like he used to. He's responsive when I pet him, but not wholly affectionate the way he's always been. He won't take meds. And I just felt like today should be the day.

    But then two different vets talked me out of it. I brought him in to a nearby vet. They drained his lungs and had recommended a different form of medication for him, but that medication won't be available until tomorrow evening at the earliest. They don't know how long the medication will prolong his life, or improve the quality of his life. I'm not even sure he's take the meds because he never has before.

    I now have him home, he's in the same condition he was in before we left for the vet, if not in even less comfort and peace now. And tomorrow and Friday I'll be back at work and won't be able to keep an eye on him in case his condition worsens. I know the vets thought we ought to try everything before putting him down. I love him so much and coming to the decision to put him down today wasn't easy. Now I regret not having done so because in my heart, I feel like we're putting him through more than he needs to be put through, and without very much likelihood of prolonging his quality of life. If anything, I now feel like he's more at risk of suffering more than he already has.

    Ironically, 4 years ago one of the vets I talked to was quick to recommend putting him down when he was going through something else. In that situation, he looked even worse off, but at that time it was unknown what was wrong with him and what we could do. I rejected that idea of putting him to sleep right away. Within a few days he bounced back and has lived happily for the last four years. This time, he doesn't quite look as bad off as he did then, but somehow I feel like putting him down is the right thing to do sooner than later. I was expecting the vet to guide me to the right decision, but I feel as though I was guided in the opposite direction.

  • 08/08/2014 07:15pm

    Dr. Jennifer Coates made an excellent suggestion about euthanizing your next pet at home. If it can be done at home you will not have to drive and perhaps your physician can give you a low dose sedative like Valium to help keep you calm. Your physician will know what sedative is best for you.

  • 08/08/2014 08:01pm

    I too viewed the author's comment as "better a fews days or a week early than an hour too late." I made the decision to euthanize my beloved senior cat, Allie yesterday when after spending two days at the Vet. While there it was discovered she had a tumor on her lung causing fluid build up which nothing could be done for. She was also found to have a temperature below normal. The night before she had an episode where she was lying on the floor just struggling to breath. I still feel guilty about making the decision to euthanize her but she could no longer eat, void, or defacate. She could drink little bits of water but that is all. Her breathing had become labored. I noticed her labored breathing the same night she went into severe respiratory distress. She was diagnosed with hyperthyroidism and hypertension late last year and was being treated for those conditions. But, once a beloved pet stops eating it is just a matter of time. Despite this, I still feel guilty about being the one to decide to euthanize her although pets cannot tell you how they feel or what they want or need. I've heard it said that euthanasia is the last best gift we can give our pets. But, it does not feel that way to me right now. All I feel is grief and sadness.

  • 08/11/2014 01:40am

    I am so sorry for your loss. Please take care of yourself during this difficult time.

  • 08/12/2014 04:26pm

    Dr. Coates, May I ask you, is it common for cats to fight so hard when the time to euthanize comes? I ask myself, how can a cat so ill put up such a big fight? I am struggling with this.

  • 08/13/2014 01:41am

    It can be. I tell owners that even though a cat is desperately ill, he or she is still a cat. What I mean by this is that some cats will react in unexpected ways to restraint and injections. They do this when they are feeling well, so I'm not too surprised that some will do so when they are feeling awful.

  • 04/17/2014 03:30pm

    On March 9th 2014 I showed up at the emergency pet hospital with my dog who had collapsed earlier in the day. I knew something awful was coming when his blood test came back abnormal about a month earlier. He was able to make it to through the vet's door before he collapsed again in the lab area. He suffered severe anemia. My beloved dog was 15 years and 8 months and was my boon companion for 14 1/2 years. I was in a state of shock, and was crying (a 61 year old man, not so tough after all). The vet came into the room and the first words out of her mouth were "dogs live more in the moment than people do". So with that comment she was setting the stage for euthanasia. Now, a month later, I have regrets that she started out our discussion with those words. In retrospect she biased my feelings. Vets have a lot of authority due to their training and experience and they need to understand this much better. Now I am stuck not knowing whether I made the right decision, and I miss my dog profoundly. The grief and sorrow have been more than I have experienced at any other time in my life.

  • 04/18/2014 01:16am

    I am so sorry for your loss. Second guessing the decisions we make around end of life care and euthanasia is very normal, but if you find yourself "stuck" in your grieving process, don't hesitate to reach out for help. Petpartners.org has a wonderful list of resources - http://www.petpartners.org/page.aspx?pid=307

  • REGRET EUTHANASIA
    11/28/2016 12:00am

    I am one of those who regret having my cat's life ended prematurely.
    My treating vet and I were in agreement that I'm Here Max could have his usual quality of life with the administration of pain medication for a month due to an inoperable cancer which had spread to his jaw.
    He was never a playful cat during his estimated thirteen years, nor much of a lap cat.He liked to warm himself by the heater and meowed only in the morning when he wanted his wet food. He used the cat litter without urging and his weight had stabilized when medication for hyperthyroidism was started. In short, other than being in the house most of the time rather than being mostly outside as before, and sleeping more due to the pain medication his life was much the same as before cancer of the jaw progressed.
    I didn't find it a problem to wipe the occasional drool but he started to bleed on the left side of his gumline. I was concerned about this but had planned to take I'm Here Max to consult with a vet who also practiced holistic medicine for pets so I went ahead with the appointment and asked if anything could be done about his bleeding from his jaw by removing the three teeth which had become loose. The vet told me that he would loose his teeth on his own but that she wouldn't remove his teeth but had good results with jaw removal.
    I had stated from the beginning that I didn't want jaw removal, radiation or chemo so I'm not sure why the subject was brought up although IF I remember right she did state that this wasn't an option at this point.
    The reason for my visit was to have herbal medication added to his current treatment was pushed aside and replaced by what I thought the vet was getting at was that, even with hospice as an option,a more effective pain killer,later on, the correct thing for me to do was to have him euthanized.
    To be honest, at the time I relied on what I perceived was the better judgment of the vet and a friend to euthanize him (ie: have him killed).
    That much as I would miss him and he required no more care really than a well cat I bought into the guilt trip that I was being selfish to keep him alive when he had a terminal cancer.
    That day I was initially relieved that I'm Here Max would be safe from any future suffering due to my "selfish desire" to keep him alive for an estimated 1 to 2 months more.
    It was less than two hours later that I realized that I had made a decision that was neither good for my cat, I'm Here Max, or for me.
    I had pain medication on hand and an 24 hour Emergency Clinic
    within a half hour drive with an indoor cat who NEVER meows so I feel confident he would let me know, if I missed other signs that the time had come. In addition I had him under the care of a vet who supported hospice as a good option for I'm Here Max and me.
    While others may not have the same support I had, I also had to contend with the ideas that "You're being selfish to keep your cat alive in pain" and "You can't tell when your cat is in pain". In short the implication is that I are doing the wrong thing to let the cat live because the cat has a terminal illness and he was in pain which I didn't realize.
    Don't let this guilt trip influence what is best for your pet.
    While sick cats find hiding places healthy cats do too.
    Cats aren't silent in pain.They want YOU to do something,
    Euthanasia can NEVER be undone.









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