Ending a pet's life by deciding to put them down through euthanasia is a difficult and emotional decision none of us want to make for our beloved pets. However, it may be a selfless decision when a pet is suffering from a serious illness, in extreme pain or injury that cannot be effectively treated or managed. Putting a pet to sleep is also a very personal decision, and only you can decide what is right for your pet.
Quality of Life for Your Pet
When contemplating this difficult decision, people often start by considering the pet's quality of life. This is subjective and highly dependent on your dog or cat's disease progress, their personality, and your personal beliefs. Quality of Life (QoL) scales try to make it as objective as possible by providing a tool to help pet owners and veterinarians assess the well-being of a pet. They evaluate various aspects of your pet's life, such as their physical health, pain, behavior, and emotional state. Most find QoL scales make the process easier, providing a clearer structure for evaluating your pet's comfort and well-being.
QoL scales typically consist of questions or statements that measure different aspects of a pet's life, such as appetite, mobility, energy level, and enjoyment of life. They are meant to be used over defined intervals (e.g., daily or weekly), based on how sick your pet is, to monitor changes in your pet's quality of life, and make informed decisions about the pet's care and treatment.
There are a variety of QoL scales for pets. One of the most well-known was developed by veterinary oncologist Dr. Alice Villalobos, called the HHHHHMM or H5M2 scale. Each letter stands for a category that can be used for QoL assessment. Each category is given points on a 0 to 10 scale, with 1 being poor and 10 being best. A score above 5 in each category, or an overall score greater than 35, suggests that the pet's quality of life is acceptable. If the total is less than 35, it may mean that your pet's quality of life is suffering.
HHHHHMM includes:
- Hurt. Does your pet have adequate pain control? Can they breathe easily without distress?
- Hunger. Is your pet able to take in adequate nutrition? Does hand feeding help? Does your pet require a feeding tube?
- Hydration. Is your pet drinking enough water on their own or with help from subcutaneous fluids to maintain their hydration?
- Hygiene. Can your pet be brushed, combed, and kept clean? Can the pet move away from stool or urine if they have an accident? Can your pet be kept clean without getting sores from lying in one place too long?
- Happiness. Does your pet express joy or interest? Is your pet responsive, engaging with people and toys that they have enjoyed in the past, or do they seem withdrawn?
- Mobility. Is your pet able to get up and move about freely on their own, or do they need assistance? When walking on their own, are they at risk of stumbling or hurting themselves?
- More good days than bad. Does your pet have more overall good days than bad? Using a calendar or diary can help with answering this question.
Lap of Love is a nationwide network of veterinarians dedicated to end-of-life care. Their website has several resources that can assist you in determining the quality of life of your pet:
QoL scales are often used for pets with chronic illnesses or those nearing the end of their lives, but they can also be used to evaluate a pet's overall well-being at any stage of life.
When using and thinking about the QoL scales, it is important to involve your veterinarian. Your veterinarian can help you complete the assessment, discuss the results, and monitor the changes in your pet.
Other Considerations with Your Pet’s Quality of Life
Quality of life is a major consideration when contemplating euthanasia, providing a painless way of ending the suffering of your beloved pet. However, there are others:
- Terminal illness. If your pet has a terminal illness with a poor prognosis and limited treatment options, it may be kinder to let them go rather than prolong their suffering.
- Aggressive behavior. If your pet is showing aggressive behavior that cannot be safely managed, it may be necessary to consider euthanasia for the safety of yourself, your family, and others.
- Chronic pain. If your pet is in chronic pain that is not being managed well, it may be humane to euthanize your pet.
- Financial considerations. While it's not the most important factor, it is worth considering the financial burden of continuing treatment or care for your pet.
What About a Natural Death for Your Pet?
We all hope that our pets would peacefully pass away in their sleep, but unfortunately that rarely happens.
A natural death can be difficult to watch, especially for people who do not have a medical background, and pets can experience pain and anxiety during a natural death. It can manifest in different ways depending on the animal species and the underlying medical conditions. Some common signs are loss of appetite and thirst, decreased energy and activity, labored breathing, loss of control over bodily functions, withdrawal and isolation, and changes in behavior.
If you suspect that your pet is nearing the end of their life, consult with your veterinarian to ensure that your pet is comfortable and pain-free in their final days. There are more and more veterinarians that are offering hospice services that can help your pet have an anxiety and pain free end of life. If you want to consider hospice care, please look for veterinarians in the area that practice hospice care. They can provide guidance and support and help you make the best decision for your pet's health and well-being.
You may get a lot of advice from many people. But remember, it is your decision to make. It is important to honor your personal beliefs and feelings to make the best decision for your pet and your family.
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