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Thursday, February 5, 2009

Euthanizing Because Of Cost?

Deciding to euthanaize a pet is rarely an easy thing. Which brings the following question from Scott.

Have you had clients resort to financial euthanasia? I read an article that said millions of dogs and cats are put down each year because their owners won't (or can't) pay for the treatment to save them. How do you fell when an owner makes that decision and you have to carry out the procedure?

I'm not sure that "financial euthanasia" is the best phrasing, but I understand what you're trying to say. This is not an uncommon situation, and in most cases I can't fault the owner. However, that's not to say that I like doing it. Always keep in mind that the veterinarian is the final decider about whether or not the euthanasia will be performed. Most of us try to respect an owner's wishes, but we have our own ethics and are under no moral or legal obligation to perform a service merely because a pet owner wants us to. So to me and most veterinarians, there has to be a justifiable reason for euthanizing a pet, and I take that on a case-by-case situation.

Case #1--An 11 year old cat begins to vomit frequently. The owner pays for lab tests, which show nothing abnormal. The vet repeats the exam a week later and notices a lump in the abdomen in the region of the stomach. X-rays don't reveal anything other than a mass, but it doesn't appear to be something the cat swallowed. The next step is exploratory surgery, which the owners cannot afford. The vet has a strong suspicion that the cat has a tumor, possibly in or on the stomach. The cat continues to vomit, and can't seem to keep food down. The owners don't want him to suffer, and ask the vet to perform euthanasia. In this situation, I would do it because the cat has a high likelihood of having a serious problem, and it isn't going to get better without extensive treatment. Rather than letting the pet suffer and die slowly, I would put it to sleep.

And know what? This happened with my own cat. However, I did the exploratory and discovered that most of his stomach was one big tumor. I knew that I couldn't afford chemotherapy, and it was large enough to be inoperable, so I ended up putting him to sleep. So this is a real situation that I modified slightly for the sake of discussion.

Case #2--Here's another real case. An owner has a 10 year old golden retriever that develops a large mass in the abdomen. Surgery is performed and it is discovered that there is a huge mass involving the spleen. The spleen is removed and the dog recovers well. About 6 months later, more masses are detected in the abdomen, which means that a return of the cancer is likely. The owner can't afford more treatment, and decides to put the dog to sleep when they become big enough to affect the quality of life. I would definitely do this euthanasia, as the owner has already done a lot, and further intervention would likely not help.

Case #3--A six year old cocker spaniel has a horrible ear infection, and has had frequent infections for the past five years. The owners aren't willing to do any further diagnostics or surgery to help, and are tired of the smell and appearance. The dog is otherwise happy and healthy, but will have life-long problems with the ears. The owners want the dog euthanized because of the chronic problems and impact on their lives. I would refuse to do this procedure because the dog's life is not at stake, and an inconvenience to the owner is not a justifiable reason to me.

Case #4--A five month old labrador puppy comes in with a broken front leg. The owners are young and cannot afford the needed surgery. Simply splinting or casting the leg would be questionable. This is a tougher case, as the dog's life will be significantly impacted, even if the injury isn't life-threatening. I would likely refuse euthanasia, but offer to help adopt the dog out to someone who could help.

As you can see, each case is different, and they aren't always clear-cut. The rule-of-thumb I tend to use is "what is the pet's life going to be like if we do nothing?" If the quality of life would be really bad or fatal, I will strongly consider euthanasia. If the quality of life won't be bad, just inconvienent or less than ideal, I likely won't do it.

So yes, Scott, people do have to make decisions for their pets' health based on finances. This is the reality of the world, and isn't something that I condemn people for. One of my equine professors in vet school taught me a very important lesson. She said that someone shouldn't have to go bankrupt simply to prove their love for an animal. I would agree with this, and have remembered it over 12 years later. I would prefer it if clients could always afford treatment, but that's not always the case. This is why I recommend having an emergency fund just for your pet's care. But in the cases where the owner can't pay for treatment, I try to put the pet's best interests first. Not always a pleasant task, but a necessary one.

9 comments:

  1. I had this come up today. Lady wanted to euthanize a 16 year old cat because she's allergic to it and moving to a new house or whatever. The tech told her that's not a reason we will euthanize for and so when she handed the phone to me the cat was suddenly "very ill and miserable." At 16 years old she very well may be but I insisted I needed to evaluate the cat first and get a good history and the owner declined.

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  2. There is certainly a very fine line here. I do have an emergency fund and would do anything within reason for my animals as long as they have a relatively good quality of life. I have had to make the decision to euthanize a couple of my pets, but the decision was not based on cost. (I have 2 hip-dysplastic older Labs, as well as my "foster-failures" --two amputee cats and a one-eyed cat). My criteria remains the "Choose your pet's five favorite things" theory--when the animal can no longer enjoy these, then it is time. As my very wise and trusted vet once told me "Better to make the decision one day too early than one hour too late".
    And then there are those who allow their pets to suffer and continue treatment much too long, in the misguided belief that they are doing the animal a favor by keeping it "alive". Last week at the shelter where I volunteer we did an owner-requested euthanasia (which we do as a public service at very low cost, but never for financial or frivolous reasons) on a 24-(!!!)-year-old cat. This unfortunate animal had been unable to eat for over a week, and unable to stand or move independently for over a month. She had pressure-sores on every bony prominence, and was covered in her own excrement. Her elderly owner had simply been unable or unwilling to let her go, but the cat would certainly have been better served to be humanely euthanized before she reached this pitiful state.

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  3. I still think that children should come before pets.... and as people will continue to get pets they can't really afford, by choice or acquiring strays, there will come a time when something major is needed and choices have to be made..
    I would rather see the children fed and cared for than the pet. Humane euthanasia may be an option if an animal cannot afford to be treated, or is not suitable to rehomed.. which can always be an option.
    Lets face it - it might be something vet clinic staff face in higher numbers while the there is a recession as people are reluctant to take on debt if things are tight.

    Mind you - some years ago, I treated a sick cat for many months - chronic renal failure, and one day it stopped coming. Some time later the owner appeared with their dog. I hesitantly asked after the cat, assuming it had died peacefully at home. He said that he fed it one day, and then hit it over the head with a spade; he could not face bringing it in to be put to sleep...

    Just occurs to me that if vets decline a client's request, there are other options they might resort to.... unfortunately. I guess that sometimes we have to suspend moral judgement.

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  4. As everyone can see, this is a difficult subject and one that vets and veterinary staff have to think about frequently.

    Just this afternoon we got a call from someone who wanted to euthanize their 7 year old cat. The cat had attacked the husband all of a sudden and for no apparent reason, to the point of the husband having to go to the hospital to be treated. We had never seen the cat before, and I found it strange that a cat would have such a drastic behavior change for no reason. I said that we could get the cat in tomorrow (this was about 30 minutes before closing) and evaluate if euthanasia was the best thing, but I wasn't going to rush into it tonight. The wife had been told by her husband that if the cat wasn't put to sleep when he got home, he was going to kill it. While I understand her difficult position, I couldn't bring myself to agree to such a fatal decision without more information. I have euthanized pets before because of extreme aggression, and feel this is in the best interests of the humans around the pet. But there are usually more signs. Some clients seem to have difficulty understanding that vets have their own morality and ethics, and aren't obligated to do something merely because the client asks us to.

    VetRN, I really like what you vet said, and completely agree. I have recommended and performed euthanasias when we knew the pet was terminal, and didn't want them to get to the point of suffering. Just like there are people that want to do it too soon, there are those who wait too long.

    Fi, I also agree about the human families coming first. I make those same statements to my own clients.

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  5. My predicament, we are trying to re-home our 13 yr old male Bengal. I have posted him on petfinder, kiiji and some site in the UK. A local shelter told us all her foster homes were full and that at our cat’s age he would most likely get sick and die in a shelter. She said our best bet is to euthanize him. I would rather him go to a good home, to cat people. I am not a cat person and I am in constant tears because I am NOT a cat person. I don’t hate the cat, I hate having a cat in my house. He is declawed, and not permitted outside. I feel his “quality of life” is below average because I do not pet him. I talk to him, feed him all the stuff you’re supposed to do. I took Kido in 3 yrs ago. I tried within the month to return him to his owner. The owner pretty much let me know he was NOT taking him back. Now that I am at my wits end he wants me to the leg work and find him a new home. I am truly devastated, I am crying all the time because I do not want to kill him, I want him to be sick and in pain so that the vet will tell me it is inhumane to keep him alive. I want to be with him for his last breath. I cannot stop crying, I am rambling because I am so torn. I want the best of both worlds and honestly do NOT have the time keep him here any longer.

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  6. Love For a lost soleMay 12, 2010 at 5:29 PM

    I had a great dog her name was Roxxanne (Roxxie, or Foxy Roxxie) for short. She woud of been 3yrs old on July 4,2010, but i was forced to put her down because i didn't have the money for treatment at the time of treatment. I beleve that if they would of taken the time to treat her she woud be hear playing and lighting up everyones day. She was a boxxer so those who know the breed know what a good dog she was.
    All i know is that when i cam home from night school she was having a sezier and i tried to get her to come out of it like i was trained to to at every kennle i worked at told me, and nothing worked so i made the desion to go to a after hours ER. for pets, and the min. i get their they had me a peice of paper that told me i could eather have $400 to $800 for treatment up frount or decline treatment, or for $100 talk the vet. So i talked to the vet told her i only had $100 till igetpayed she sead that they dont do payment plans and that she only had a 50/50 chance of living. I wanted to take that chance she had gotten up to a 108 temp., and she needed to stay a cuple days at that point i would of done anything, but sences all YOU VETS only care about your payment insted of the baby in your hand i will no longer se her face . I would of payed you back all of it. they would't even put her down untill i payed them the $100 office fee. Where is the love for our 4 leged friends.

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  7. What about when you need a few days to pay for the procedure the vet performed, and they euthanize the animal against your will?

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  8. Euthanizing a pet against your will is illegal in the US. At my practice we require a signed authorization form before we will do the procedure. If this was actually done against your will, you may have grounds for a lawsuit.

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  9. I have to say after reading the comments above it kinda helps me feel a little better that I'm gonna have to put my 11 yr old cat down. At first I kept thinking I was wrong to put her down considering I can't afford another surgery. August 21, 2013 my cat had to have surgery she had tiny lumps totally filled her entire bottom half of her. You could hardly feel them unless u pressed into her that's how i found out there was something wrong. Vet said it was aggressive so she prolly has 6-9 months. as it goes by I can actually see the tumurs now. It's so hard to think about putting any animal down but I totally get the reasons on why some people do....

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