How do you know when “it’s time”?: Part 2 - When?

In Part 1, I discussed why euthanasia can be a good thing for our pets when they need it. Now, I want to use this opportunity to give some pointers on how to know when “it’s time” to help your pet by euthanasia. Each pet’s situation is unique, therefore, consult with your veterinarian when you think it’s time. When you see that the time is nearing, it is important to prepare your family for what’s ahead. Everyone needs time to say good-bye and to prepare. If everybody is in agreement when the time arrives, the process will be a lot smoother for everyone.

I’ll address a few common reasons for euthanasia and cover each situation individually. In any situation, though, the main priority is to do what’s best for the pet.



Long Term Illness



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Pets with long term illness usually slowly become sicker over time.  You’ll start to see things like:

• Lack of activity
• Lack of family interaction
• Vomiting, diarrhea, not eating (even their favorite treats)
• Reclusive behaviors

Cancer

This is in itself a “long term illness,” so you’re looking for a lot of the same symptoms. You also want to consider the situation where cancer treatment is not an option or is either already performed to its maximum. When you are out of cancer treatment options and they’re showing the symptoms above, consult your veterinarian.

Trauma/Sudden Debilitating Illness

In these cases, rely heavily on your veterinarian’s recommendation. It's easy for the stress of an emergency situation to cloud your judgement as an owner. Ask your vet about chances of survival and if a complete recovery can be expected. Don't be afraid to be straight forward and ask if euthanasia is necessary. Be sure to find agreement with the rest of the family if possible. 

Arthritis

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Arthritis can be very difficult to manage in your pet. There are many different options on how to treat arthritis, but when those options are exhausted, your pet will not be able to find complete relief. They may still interact with the family, eat well and appear happy. Rather, you'll see that you have to help them get up, help them up the stairs, they may be having accidents in their bed because they can't get up to go outside. I believe that choosing the "right time" for an arthritic patients is the hardest decision to make.  You usually have a pet that is mentally still with you, but yet very much in pain. The decision is usually made when we see how uncomfortable they are with their pain and we can't do anything about it but euthanasia.  

Financial Limitations

This is the toughest situation to be in. It leaves an opportunity for devastating guilt to set in on the owner. In an ideal world, we, as owners, would have unlimited funds to provide whatever care was needed for our pets. Also, in an ideal world, we as veterinarians could provide free care to whoever needed it for their pet. It's such a hard reality to face, but in the end, if the necessary treatments cannot be administered, we need to choose to relieve the pet of its suffering. For more information on how to deal with these financial limitations, see my next post, "How to Handle Your Pet's Emergency with Financial Limitations".

If you feel comfortable, please comment below and let others know how you knew it was the right time for your pet.

Sarasota Animal Hospital



How do you know when “it’s time”?: Part 1 - Why?

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Euthanasia. The most dreaded word in the life long relationship between a pet and its owners. We all hope that they will just drift off during their sleep when it’s their time. However, most of us are never that fortunate. There is usually a time for all of us when we have to make that decision for our beloved pet. We never want to make the decision and often struggle knowing just when it’s the appropriate time.

This blog is a three piece series discussing euthanasia and what to expect. The parts will include: 

general discussion on euthanasia and why we do it

guidelines on knowing when “it’s time” 

when it’s time to get a new pet

With sick patients, euthanasia provides an opportunity to prevent suffering when the end of life is imminent. Even though it’s such a tough decision to make, our responsibility is to assure that it’s made in the best interest of the pet. The veterinarian plays an integral part in helping owners to know when to make the decision. We know them medically and you know them personally. Together, combining both the medical and personal information, a decision can be made that’s best for your pet. We’re there to “hold your hand” during the process. We want what’s best for both you and your pet.

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Unfortunately, I’ve had a lot of euthanasias in the clinic over the past week. It’s been tough. A lot of them were long time clients where I have developed a relationship with not only the pet, but also the owner. It always breaks my heart a little with each one, but there is also this sense of knowing that I'm still doing what’s best for the pet. A lot of these euthanasias were cancer patients, others were patients with long term diseases that were taking their toll on the pet.

On a broad basis, euthanasia is supported when the quality of life of the patient is so poor that the pet appears to be suffering and there is no great chance for improvement in the quality of life. If the pet’s time span of suffering is considered to be limited with a good chance of improvement with treatment, then treatment is generally supported. In the next blog, Part 2, more specific and common scenarios are explained in detail with some different symptoms to watch for. Remember, consult with a veterinarian who knows your pet. They can make this process a lot easier for you.

I want to invite you to leave a comment below remembering your lost pet. Leave a fun memory, an experience that might help others, or just a name in remembrance of your pet.

Sarasota Animal Hospital



An Ounce of Prevention is Worth a Pound of Cure

We’ve all heard the familiar saying, “an ounce of prevention is worth a pound of cure,” yet, how many of us apply this philosophy to our own health care. How many of us go to the doctor on a regular basis just to “make sure things are ok”? I don’t! I don’t like going to the doctors. However, there is one doctor that most people see about twice a year, their dentist.

Our dentists have drilled it into us that we need to have our teeth cleaned twice a year to maintain healthy teeth and gums. We believe them. We know it’s true. And, we should apply this preventative thinking to the rest of our body’s health! Don’t wait until you’re a diabetic to start exercising. Don’t wait until your cholesterol is so high that you have a heart attack causing permanent heart damage to think about eating healthy. Make changes early when it’s easier and more rewarding. We, as veterinarians, apply these same principals to your pets’ health.

In recent years, our profession has been shifting our focus from just giving vaccines and treating sick pets to focusing on the importance your pets’ overall health. Applying preventative medicine is the best way of doing this. The following is a summary of common measures implemented in preventative medicine:

• Bloodwork screening:  Bloodwork isn’t just used to identify diseases, let’s confirm that your pet is as healthy on the inside as it looks on the outside. It is recommended every 12 months for pets less than 7 years of age and every 6 months for pets 7 and older.
• Balanced diet:  A balanced diet will provide the best opportunity for your pet to have a long and healthy life. Some foods are even designed specifically for health concerns such as healthy teeth, urinary stone prevention or skin sensitivities.
• Heartworm prevention:  Heartworm prevention is one of the most vital preventative measures that you can implement for your pets’ health, whether DOG or CAT. Heartworm disease is a potentially deadly disease that is easily prevented in dogs and cats.
• Flea and tick prevention:  Here, prevention is a lot cheaper and easier than treatment. Flea treatment involves not only treating every pet in the household, but also the house itself. Tick treatment, wow! You don’t want to have to ever go through that! It can take up to a few months to get ticks out of your home once your dog brings them in!
• Intestinal parasite prevention:  If your pet is on heartworm prevention, this is included as an additional benefit to the use of the preventative. Some intestinal parasites are transmissible to people (especially children and the immune suppressed) and are easily prevented.
• Yearly and bi-yearly physical exams:  Pets under 7 years of age should have a full physical exam every 12 months to assure the health of your pet. Pets over 7 years of age are considered senior pets. Senior pets, just like senior adults, tend to change quicker than younger pets. For this reason, it is recommended that they have a full physical exam performed every 6 months.
• Vaccines for dogs or cats:  Although they are not the center focus of veterinary medicine anymore, they are still very important. They are given on a schedule to most benefit your pets’ health. That means:  Vaccines will only be administered as often as necessary. And, only the vaccines of benefit to that specific pet will be given.

Sarasota Animal Hospital



How Victoria Became Victor

Our clinic, Sarasota Animal Hospital, has a sister clinic in Lakeland, FL named My Pets Animal Hospital. I had the pleasure of working there is weekend for the first time. They are a small animal clinic as well, serving mostly dogs and cats. They have a wonderful staff who made my work easy and enjoyable! Their clients also made me feel welcome to be serving them. One appointment I saw there on Friday really stands out in my memory. It was a cat that was dropped off at the clinic in the morning as a spayed female cat named Victoria, and left that afternoon as a neutered male named Victor. Oops!

Trying to determine the sex of a cat can often be difficult and sometimes it isn't accurately determined until it is first seen by a veterinarian. It's pretty common to have a 12 week old kitten come to the vet for the first time and discover that it is really a girl and not a boy as the owner's had assumed. However, Victoria's story is a little more unique and brought a lot more shock to the owner when she came to pick "her" up. You see, Victoria is an adult cat and had even already had a surgery to be spayed!

Victoria came to her new home as an older kitten and the details of her previous life were unknown. Her owners had taken her to a facility (NOT My Pets) to get spayed. Somehow, that facility prepared Victoria for surgery as though she were a female and attempted to spay her. After searching and not finding any ovaries or uterus, they finished the surgery and declared her to have already been spayed. Again, it's not uncommon to attempt to spay a cat with an unknown background to find that she had already been spayed. The owner took Victoria home from the surgery and lived life as normal with her newly acquired "girl" kitty.

Well, during "her" physical exam, I noted an "appendage" that any female should not have! I could also feel a scar on the abdomen from an attempted spay. Fortunately for Victoria, "she" did not have any testicles, for "he" had already been neutered! Now, Victoria's name has been changed to "Victor" and he can final live the life appropriate for him! Do you realize that this could have a very significant implication to his health? Male cats are prone to different issues than female cats and because of that, need to be observed differently and possibly even fed a special food. His owners were completely shocked! I'm sure it will take a while before they get used to the fact that their "Victoria" is a boy! Could you imagine?
 

Sarasota Animal Hospital

When the Vet Becomes the Client

I recently was forced to diagnose and treat my own Pomeranian, Joey. The panic of the owner within my heart battled the sensible veterinarian in my mind. My big tough Italian husband, Guy, loved his little fluff-ball to pieces! I couldn't stand to break his heart with any bad news. I spent twice as much money on tests trying to convince myself that my dog wasn't sick, instead of just accepting the facts. I then went on to spend just as much money trying to identify the cause of the illness, when just like a lot of clients, no specific cause could be found. It was frustrating and scary. I was annoyed that my dog, the veterinarian's dog, was seriously ill.

Guy and Joey on his 1st birthday!

Joey was diagnosed with a potentially fatal condition called "immune mediated thrombocytopenia." This is where his body destroys his own platelets, the components in blood that prevent and stop bleeding. They are the main components in blood clots and scabs. Without enough platelets, a dog can bleed to death. He was only two years old at the time. I performed pre-anesthetic bloodwork to have his teeth cleaned. The platelets came back low, very low. I ran three more platelets tests with even lower numbers before I decided that the numbers were real. He didn't act sick!! He still chased the cat, had a great appetite, loved to go on walks; everything was completely normal!

The good news is, Joey has responded wonderfully to treatment and his platelet counts soared back up to normal before any complications arose. The bad news is, his medications have side effects, very noticeable side effects. For those of you with dogs with allergies or immune diseases, you've likely already had the unfortunate pleasure of meeting prednisone. I know the side effects, but I also know the benefits. It saved my dog's life! I always weigh the risks versus the benefits before prescribing or taking medications. In this case, the benefit hugely outweighed any risk or any side effect.

I have had owners tell me over and over again about how their dog is drinking more and urinating more, they won't stop panting and he seems so hungry while on prednisone! Well, yeah, those are the most common side effects of prednisone. They are pretty benign side effects medically speaking but can be very disturbing to the owner taking care of the pet. I experienced first hand what some of my clients had already shared with me. Joey was on a very high dose of prednisone. Because of that, he would wake me up 3-4 times a night to go outside. He would try to snag food out of my hands he was so hungry. He didn't want to go for walks and he didn't want to play with his cat anymore. Even though I saw him appear more sick on the medication than I saw him before the diagnosis, I had evidence in the bloodwork that the medicine was actually helping and not hurting. It was saving his life! That was worth a little interruption in my sleep and a pup that was a little less active. Medicines serve a purpose. And as long as we use them carefully within the boundaries, it's a good thing.

Granted, I have lots of patients who never experience these side effects on the low doses that are prescribed with the common allergy or inflammatory situation. But, because of Joey, I have been more emotionally conscience of the side effects of common medications rather than just medically conscience.

Joey is doing well. He's on a lower dose of prednisone for maintenance purposes. He's back to playing with is kitty, taking long walks and never asks to go out in the middle of the night anymore.  He will be on prednisone for 2 more months before I can try to take him off. Even at that, if his blood levels drop again, I'll just have to put him back on the medicine. It's a battle that we'll be fighting for a long time, but in the end, we will be victorious.


Sarasota Animal Hospital

Getting Started

So, I've been thinking lately. Every time I travel, I see more people traveling with their dogs; usually small and fluffy but sometimes a little larger. I'm seeing more pet toys and items in the stores sold to pet owners. Even Publix has a sign outside of its store promoting its new pet specific website. People are LOVING their pets lately and that love seems to keep growing.  Now, that's a great thing for me as a veterinarian. It usually translates into owners providing higher quality care for their "loved-ones." So, with this movement of increasing human-pet bond, I decided to jump on the wave and share my insider experiences.

During my daily routine as a small animal (predominately cats and dogs) veterinarian, I get to experience some pretty cool stuff.  I get to see some pretty awesome medical cases, which isn't always best for the patient, but that can be educational for other pet owners. I get to bond with pet owners and become a part of their lives. And I get to be creative and learn something new almost every day. There are fun times and sad times, but I think that many pet lovers will find these experiences enlightening and interesting. I hear a lot, "I always wanted to be a vet, but I just never did it." Well, join me in my adventure and enjoy the ride with me along the way.


*** Disclaimer:  Even though I may share cases or experiences from my work, I will never disclose the true identities of my patients or clients.  I  will change any aspect as necessary to maintain anonymity for my patients and clients. However, this will NOT take way from the excitement of the story or the power in the educational lesson. ***