Euthanasia: When there's no other way

As veterinarians, we've all been faced with the client who's contemplating euthanizing her old dog. Although the dog is in good overall health, he's been urinating in the house and hasn't responded to medical treatments. The client's frustrated. After talking with her, you complain to your technician, "I can't believe that Mrs. Johnson is going to euthanize her dog. He's perfectly healthy and he's so sweet. All this for just a few spots of urine on the floor!"

But do we ever stop to think that sometimes we're too quick to judge our clients? I know, because the client in that scenario was me. I've been on the other side of the exam room table.

An aging friend

Harry, my 13-year-old neutered Norwich terrier, had been with me since veterinary school and I adored him. But at age 13 he developed urge incontinence, which worsened despite negative urine cultures, a cystotomy by a boarded surgeon to remove several bladder stones, and trials of NSAIDs, amitriptyline, and phenylpropanolamine.

I considered my options. Should I find him a new home? No. I'd worry about his future owners mistreating him because of his urinary accidents. Could he be an outdoors-only dog? No. It gets cold in Salt Lake City in the winter and he has always been a heat-seeker. Should I try those doggy diapers? No. I've seen some terrible cases of urine scald from their use.

A tough decision

The final straw came one day when my 18-month-old daughter toddled over to a urine puddle on our tile floor before I had a chance to clean it up. She swiped her fingers through it and promptly stuck her fingers in her mouth. In desperation, I contemplated euthanizing Harry. I hated the idea, but I felt like I had no other options. Fortunately, a colleague suggested we try acupuncture as a last effort—and why not? It turns out that acupuncture markedly improved Harry's continence and comfort for nearly a year, until he died of unrelated causes.

Stop and think

Because of my experience with Harry, I've learned to think about the situation from the client's perspective. It's easy to berate a client's decision, especially a decision to euthanize or to stop treatment. But the next time you find yourself doing just that, think about what else might be going on in the client's life. Her decision may seem rash to you, but she has probably agonized over the choice and can't see any other options. Odds are, the client has given much more thought to the decision than you give her credit for.

Dr. Laura McLain is an associate at Central Valley Veterinary Hospital in Salt Lake City, Utah. Send comments to ve@advanstar.com or post your thoughts on our message boards at dvm360.com