This is the most common question we receive when a pet starts to get older, or after they have been diagnosed with a terminal illness. The first thing we tell all pet parents is that there is no clear cut answer. It’s a difficult decision, no matter what the circumstances are.
The most important thing is to not wait too long. It is far better to make the decision ahead of time, when you are calm and collected, than to wait until an emergency situation where you are frantic, the pet is suffering, having difficulty breathing, or is about to collapse. That type of situation is traumatic not only for the pet, but for the pet parent as well.
If your pet has been diagnosed with a terminal illness, speak with your veterinarian about what to expect with progression of the disease. Discuss what might be a good indicator that it’s time. Depending on the type of illness, it may be when your pet starts having difficulty breathing, eating, urinating, or just difficulty getting comfortable or sleeping. By knowing what to expect, it will be easier for you to recognize that it is time when the time comes. The decision for end-of-life care needs to be made when medications or surgery can no longer improve your pet’s symptoms or quality of life, and before the pain and suffering becomes unbearable to them.
Mentation
- Disorientation—getting lost in a familiar setting like the home.
- Wandering through the home.
- Standing in a corner and staring at the wall.
- Unable to recognize family members.
Pain
- Difficulty getting up.
- Lameness.
- Stiffness when walking.
- No longer wanting to be petted, or exhibiting aggressive behavior when being petted.
- Panting.
- Pacing.
- Grinding teeth.
- Muscle trembling.
Appetite
- Decreased appetite or unwillingness to eat at all
- Weight loss due to inappetance or illness
- Although not all pets stop eating when it’s time, if they do stop eating, it is a serious sign.
Activity Level
- Decreased activity on a day to day basis.
- Laying in the same place all day.
- No longer interested in play.
- Hiding.
- Unwilling to be social with family members.
Mobility
- Extreme difficulty in getting around.
- Unable to get outside to use the bathroom.
- Falling frequently or slipping on slick, non-carpeted surfaces.
- Paws knuckling over while walking.
- Hind end incoordination, or legs crossing under while walking.
- Unable to get up at all.
Difficulty Breathing
- Labored breathing.
- Gums that are pale pink, blue, or even white.
- Only laying on the chest, refusing to lay on his/her side (certain positions allow better oxygen flow).
- Refusing to lay down at all.
- Open mouth breathing.
Perceived Enjoyment of Favorite Activities
- Think back to your pet’s earlier years what were his/her favorites activities? How many of those activities is he/she still able to enjoy?
- Does your pet respond with any happiness to family, food, toys, or other pets in the family?
- Does your pet still meaningfully interact with the family?
When evaluating all of the above factors, I often suggest that pet parents keep a diary of their pet’s day to day status. Often times, the days can start blending together. Some days they seem to rally, and other days they seem to struggle. It can make things really confusing. Sometimes you may get the impression that your pet is doing fairly well overall, when in reality they are starting to suffer.
By keeping a log of information, you can objectively assess the situation and more clearly see when your pet is starting to have more bad days than good days. Feel free to download copies of this Quality of Life score sheet to keep track of your pet’s overall condition.
Please keep in mind that animals instinctively hide their pain and suffering. They want to please their owners and keep them happy. This can make it very difficult for you to determine when it’s time. Some animals, despite their condition, will never stop eating. They may never appear to be in pain or suffering. So, using that end point to decide it’s time may mean that you never come to make that decision, or you may make that decision too late.
Please understand that the factors described above are just general guidelines and there are no clear cut answers.Try to look at the big picture, and only do those things that will help your pet toward better health and function but nothing that prolongs a hopeless struggle. This takes both courage and compassion, because it means you will have to make the brave but difficult decision to let go. Know that any time your decision is made in love, it is the right decision.