Quality of Life

When it comes down to making medical decisions for a loved one, the veterinary field tends to lean towards having owners consider the Quality of Life a pet will have as opposed to the quantity of life.  This is due to a few factors. 

Firstly, we care about your pet, and you by default.  We want you to make an educated, ideal decision for your pet.  This is likely to be the most difficult transition you make in your life, and we cannot stress enough how we are here for you.

Second, we cannot ask the pet what s/he would like to do.  It's all in the movies that animals talk to their doctors.  You know your pet so much more than we do, and you know how s/he usually behaves.  You will know best when it is time.

i don't even want to know....

And third, we want to do everything we can to make your pet as happy in health as s/he can be.  If your pet is suffering, we need to know what we can do.  As a clinic and as medical staff, we CAN  do everything.  But it isn't always financially or humanely feasible.  We need to be able to reach a happy medium with your abilities and comfort level of treatments.

Technically the fourth reason is that we want to not be sad or helpless when it comes to the decision you've made. More than once, I have been sobbing uncontrollably because a human made an inhumane decision for their pet, and there was nothing I could do about it.

These are things to consider when looking at your pet's quality of life:
1. Activity
How active is your pet?  For older pets, it is understandable that they slow down.  We all do.  Whether it is due to pain, endurance, or desire is not usually crystal clear.  But if your pet chooses not to move around a lot, this is decreased quality of life.  Sometimes this can be fixed or assisted to improve quality of life with medication from the vet.  Does your pomeranian get winded just by barking at the cat? 

this pig can fly

2. Mobility
When your pet does move around, how easily does s/he do so?  Are the joints stiff and painful?  Is there a limp?  Does s/he stumble or miss a jump s/he has made thousands of times before?   Is your pet in need of pain medication, or is this truly a decreased overall quality of life?

d'awwwwwwwww

3. Appetite
Does your darling pet eat as much as before?  More?  Less?  Does s/he eat with the same vigor as in the past, or has it become more of a chore? If your pet can't get to the water or food dish, dehydration can occur and cause a rapid decline in health.

4. Pain Scale
The same pain scale you use can be used for your pet, but objectively instead of subjectively.  You've seen your pet pain free in the past - any pain above a 4 (on a 0-10 scale) is a poor quality of life in my book.  Fix the pain, or else your pet is suffering needlessly.

ouch

5. Attitude
Does your baby greet the day with the same enthusiasm as before?  Does s/he frolic alongside you, chew on or play with toys with spunk, or lie there listless?  Does s/he growl at people s/he would normally be affectionate with?  Does s/he appear to be going senile?

hygiene is important

6. Hygeine
 Decreased appetite or food intake can be due to dental issues.  Inability to get up and walk outside causes fecal balls, also known as dingleberries, to form.  Some fecal balls obstruct the anus and the pet can become impacted.  Does your pet have a funky smell?  All of these are contributors to a poor quality of life.  Urine dribbling can cause a scald on the skin, causing pain and infection.

7. Good Days vs Bad Days
 For elderly and terminal patients, this is the most heart-wrenching part of the Quality of Life story......because it means we are reaching the very end.  This is the point when I request that the owner start a journal.  Each day, before bed, write down your view of how the day went.  Good or bad, then elaborate.  Did s/he piddle in the house today?  How much did s/he eat?  And at the end of a single week, maybe two....see how many good days and bad days your little Puddin pop has had.  When bad days outweigh the good, it is time to make a decision.

8. (if surgery is an option) Recovery and Pre-op QOL
 The biggest thing to consider in a surgery is whether it is improving the pet's life or if it is prolonging the inevitable.  For a cat who has had a few urinary tract obstructions, surgery will be beneficial in the long run.  If you can afford it, surgery for a PU is an excellent plan.  However, the Saint Bernard with metastatic osteosarcoma getting two legs removed when the dog is already 11 years old is not ideal.  A 200lb dog that has massive arthritis shouldn't be put through a surgery and six week hospital stay knowing the dog will never walk again.  The same is true for the 12 year old Cavalier King Charles with congestive heart failure that needs a splenic mass removed.  The quality of life before the surgery is poor, and the surgery will do nothing but cause more suffering and cost you thousands.



Consider whether you are keeping your pet alive for THEIR benefit....or YOURS.  If it's for YOUR benefit.....try to love them enough to let them go.  Talk to your vet, your vet techs, your vet assistants.  Go on the internet.  Heck, you found this article.  You can find more. 

Patch Jackson.  Deaf as a post, but it didn't stop him.

This article is in memory of my favorite patient ever, Patch Jackson.  And a close second, Jax.  I hope y'all come see me at the Rainbow Bridge when I cross over.  Jax....please don't bite me, and I won't draw your blood.  Promise!