If Only Our Pet Could Talk

September 4, 2010 by  
Filed under Ethics In Action


boo-vet-blog-picture

I think for most pet owners, there are days when we wish we could know what our pet was thinking. This is especially true when it comes to medical decision making. We adopt our pets when they are young and healthy and it doesn’t cross our mind that someday, they might get sick or die. The same thing is true for humans. We want to pretend that we will all live forever.

In my work as a clinical bioethicist, I help families who are struggling to make the right medical and end-of-life decisions for their seriously ill loved ones. I never imagined that I would be having these conversations about my beloved kitty, BooBoo. BooBoo had been living with chronic renal failure for over 9 years. She had outlived every expectation and broken all the records for survival at the vet clinic. This sense of my cat being unstoppable and able to overcome every challenge blinded me to the reality that even a cat, who was a medical miracle, could die.

As her health began to change, certain decisions had to be made. I was lucky because I know how to use one of the tools from my work called the Best Interest Standard. Here is how it works.

Step 1. Ask plenty of questions regarding your pet’s medical condition, treatment options including the option of doing nothing, and the risks and benefits of the different options.

Step 2. Ask quality-of-life questions to understand how your decision will be experienced by your pet.

Step 3. After the decision is made, keep checking in to see how your choice is working. If the decision is not working out, then re-evaluate the situation and make a new decision.

The second step is the step that is often missed. When we ask quality-of-life questions, we are asking what it will feel like for our pet. If your beloved pet has to have surgery, what kind of pain will she be in after the surgery? How long will your pet be in pain? What can be done to make the process easier on your pet?

Here is an example of how I made sure I kept BooBoo’s experience in mind.

The vet said that he could run a special thyroid test to see if she was deficient. It was a simple blood test but before I agreed, I asked, “If she does have a problem with her thyroid, what will you do about it?” The doctor said, “I won’t be able to do anything about it because the medicine that would help her thyroid would harm her kidneys.” So I asked him, “Why put her through the needle stick if it won’t help.” He replied, “Some people just want to know.”

Here is where I had to remind myself that what I might want may not be what is best for my kitty. Sure I would like to know, but I didn’t want to put her through the stress of one more blood test when there was no benefit. When we ask about the risks and benefits we are asking, “What are the good things that could happen from the treatment and what are the bad things that could happen?” This doesn’t mean that we shouldn’t choose the treatment, we just have to be responsible pet owners and to understand there can be bad outcomes.

BooBoo got to a point where she had to have daily sub-cutaneous injections, I had to pill her 5 times a day and her quality of life had deteriorated. The doctor told me that he could put in a feeding tube and I could put all of her fluids and medications down the tube so she her quality of life would improve. No more shoving pills down her mouth or sticking her with a needle. It sounded like a perfect solution. Even though I knew it might not make her live any longer, it would sure improve the quality of her remaining days. So I agreed. Unfortunately, BooBoo had a stroke after the procedure and died a few days later.

Did I make the right decision?

I think I did. I asked lots of questions, thought through my choices and did the best I could. Even though it didn’t turn out right, I have peace of mind knowing I gave her the best quality of life possible. Even when I knew she was dying, instead of leaving her at the vets, I brought her home for the last two days of her life so she could have quality time with me. These were precious moments for both of us. When the end was very near, I returned to the vet so she could have a peaceful end. In life and in death, I did right by her by thinking about her needs first.

For a list of questions you can use when making medical decisions for your pets or your humans, go to the resource page on TheCaregiversPath.com

Have a kind and respectful day.

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