I think people associate veterinary oncology with negativity because of a perceived increased proportion of patient-related deaths, but death is actually a rare event on our service. And often, when it is time to say good-bye to one of our patients, though absolutely heartbreaking, it is something owners know is the right thing for their pets. The emotional toll for me is tempered by knowing humane euthanasia is the kindest option for that animal.
I’m not saying it doesn’t hurt to lose a patient, because it does. But the pain related to relieving suffering from a cancer diagnosis stems mainly from the loss itself, and is mitigated by knowing that what I am doing is exactly what I am trained to do: relieve suffering and pain.
What I personally find far more emotionally impacting is finding a way to console owners, distraught over a recent diagnosis of cancer, who are only able to feel the urgency imparted by the diagnosis itself. We recognize the strain this causes and we will do everything we can to fit the pet in right away because we know it is not only important to help the animal, but, sometimes even more so, to help their owners cope with the diagnosis and to educate them about what would be the next recommended steps. We continually work and re-work our schedules to fit patients in on emergency bases.
Truth be told, there are few cancers so aggressive that waiting a day or two to schedule an appointment would truly make a difference in the pet’s outcome. And for cases of extremely sick pets with cancer, there are often very limited options for what can be done to help them, so that when we do fit those patients in on a last minute basis, I have nothing to offer. True oncological emergencies are rare indeed. But we are patient and understanding to the feelings and needs of our clients, sometimes to the detriment of our own.
The same is true for owners of pets currently undergoing treatment for their cancers. A single episode of vomiting or diarrhea, or a missed meal that typically would go virtually unnoticed now evokes a sense of urgency. I know it can be difficult for owners to discern what would be considered severe side effects from treatment versus "normal" mild adverse signs in their pets, and we make ourselves overly available to help with their questions and concerns. This means we are continuously busy with phone calls and e-mails from owners, including days where we are not in the office seeing appointments. We field inquiries as rapidly as we can in order to assuage fears and triage emotions to the best of our abilities, keeping in mind that on days we are seeing appointments, we are usually simultaneously dealing with new and equally distraught owners as mentioned above.
My standard of care is a proverbial double edged sword: I want my owners to feel as though their pet is the only pet I am concerned with at all times, yet simultaneously I want them to somehow understand and be cognizant of the fact that I treat dozens of patients a week who matter just as much to me as their own pet does. I can tell you from experience that it is virtually an impossible task to keep everyone happy all the time.
A diagnosis of cancer is emotionally provoking on so many different levels. It’s certainly easy to see how this is true for the pet owner, and as a veterinary oncologist, I know part of my role is to help people cope with their concerns while acting as an advocate for their animals throughout their treatment plans.
I would hope with the information provided above, I could offer some insight into the feelings encountered by the medical caretakers of pets with cancer. It’s hard for us, too, but we accept our responsibilities gratefully, even when it feels as though the appreciation for our role wears thin. The good days far outweigh the bad days, and the true emergencies are rare.
Please remember that we do care, often more than we are comfortable showing outwardly. And that a simple "Thank you" might just make our day.
Dr. Joanne Intile