When Cure is Not an Option

There is compassionate help for pet owners facing end-of-life decisions for their pets.

Rocky, a 12-year old Labrador mix, enjoys extra hugs and lots of loving every morning, while his best friend, Michelle Jolley, mentally checks off the signs: Tail wagging–Yes! Eating–Yes! Running–Yes! Jolley relaxes because Rocky will live another day.

Michelle Jolley, DVM, adopted Rocky when he was a pup. Generally healthy his whole life, it came as a shock when her husband, Will, brought Rocky to the veterinary hospital where Jolley was working an overnight shift. Rocky had suddenly started vomiting and showing signs that he was in significant pain. An ultrasound and a biopsy later, Jolley faced the devastating news that Rocky had pancreatic adenocarcinoma, an incurable form of cancer. Devastated, Jolley planned to stabilize him in preparation for a peaceful, home euthanasia. Rocky had other ideas, and Jolley started down the path of palliative care.

Animal companions play varied and complex roles in our lives. Pets provide emotional support, make us feel needed and connected, reduce stress, decrease depression, and keep us more active. For many people, their pets truly become friends and family. No wonder preparing for the end of a pet’s life evokes such profound emotions.

The first step on this journey involves accepting the reality that cure is not an option. This harsh fact will likely bring on “anticipatory grief,” according to Lisa Frankel, Ph.D., MFT, and a provider for the Association of Pet Loss and Bereavement. People facing impending loss need support from someone who understands what they’re going through. Some individuals have those supports built into their lives, and some need to reach out for professional help, says Frankel.

Shortly after receiving the difficult news that loss is imminent, pet caretakers must shift into a hospice-care mindset. “It’s all about quality of life, and every person has to decide how to define that,” says Jolley, stepping out of her role as Rocky’s friend and metaphorically donning her white doctor’s coat. Modern veterinary medicine provides many options to help minimize discomfort and prolong life. Jolley encourages all pet owners to have frank conversations with their veterinarians to explore their options for palliative care.

Veterinarians commonly suggest a pain management protocol, subcutaneous fluids to maintain hydration, and anti-nausea medication. Orthopedic needs may require textured foot gear to prevent slipping, specific types of beds to take pressure off joints, slings for animals who need help standing while they relieve themselves, and even carts to hold up back legs for continued mobility.

Some veterinarians also recommend supplementing medical interventions with support from holistic practitioners. Swim therapy and underwater treadmills allow pets to exercise without putting weight on joints. Laser therapy and acupuncture provide pain and stress relief without side effects. Massage therapy soothes muscles and induces a calm state. The options now available for animals are similar to those provided to human patients.

Regardless of the decisions made during this final stage, grief inevitably accompanies the caretaker throughout the journey. And while grief is natural, it can cripple a person’s life if not processed properly. “You need to be aware of the signs of depression,” cautions Frankel.

If you’re experiencing prolonged withdrawal, fatigue, sleeplessness, or loss of appetite, you might need help sifting through your emotions and finding a way to move forward. Being haunted by questions like, “Did I prolong suffering by waiting too long to euthanize?” Or, “Did I euthanize too soon, robbing my pet of precious life?” is an indication that grief counseling might be helpful.

“You have to know when you’re stuck because that’s when it’s time to seek help,” adds Frankel.

Though sadness comes surely at the end of a loved one’s life, this period can also bring deep bonding and bittersweet satisfaction. “My husband said to me that there are two things we can give our pets,” says Jolley. “We can give them a good life and a dignified death. I share this with all my clients making end-of-life decisions.”

Recently, one of Rocky’s toes became swollen and sore from an infection, which has not responded to antibiotics. Once again Jolley faced the possibility that it might be time to say goodbye. After careful thought, she has decided to proceed with amputation to remove the pain because today that tail is wagging. Rocky hasn’t run out of hugs just yet.

Michelle Jolley, DVM works as an emergency veterinarian at Veterinary Specialty and Emergency Center of Thousand Oaks

Lisa Frankel, Ph.D., MFT, works as a psychotherapist in West Los Angeles. Her website is drlisafrankeltherapy.com.