Fall 2012 Magazine
Letter to PETrogplyhs Editor
(In the Summer 2012 issue of PETroglyphs there was an article entitled "Ethical Decisions and New Veterinary Treatments." We asked for comments about when you should try aggressive or new treatments for your animal and when you should let the animal go in the most humane, painless and timely manner possible. We received this response from Judy Paulsen of Greyhound Companions of New Mexico. We are printing it in its entirety. If you have any more thoughts on this topic, please let us hear from you. Ed.)
I read with interest your article, Ethical Decisions and New Veterinary Treatments. I recently had to make the decision to euthanize an Italian greyhound I rescued when he was 6 years old. He was just three months shy of 17 when I had him euthanized. He only had one bad day before I made the decision, but his health had been declining for several months. Always the chow hound, I knew he was about ready to go when he quit eating - then one morning he was unable to stand on his own and he was very confused. It was time. I held him close, kissing him on the head while they gave him the injection.
The issue I'd like to address is over-diagnosis and overtreatment of various ailments in our companion animals. Sometimes new veterinary treatments and methods of diagnosis are not good for the animals and won't necessarily prolong their life. Unfortunately, there is no way of knowing the outcome should you choose NOT to treat but the same is true if you take the more aggressive approach. You'll never know with certainty which choice will extend life with good quality (the key words here: good quality).
Veterinarians are in a bad position because the animal's guardian wants answers and of course so does the veterinarian, but I think sometimes we go too far in seeking answers rather than just trying to make life the best we can for our animals. Veterinarians and physicians are under tremendous pressure to diagnose and heal, but this can lead to over-diagnosis and considerable harm can come from that as well (excessive testing, invasive procedures, stress for the animal and guardian, and expense).
Too often various medications are prescribed which have severe side effects. The animal may have been seen for one ailment initially, but after various diagnostic tests which may reveal something "suspicious", the animal may end up on a slippery slope having to undergo more testing and being prescribed more medications or worse yet, surgeries to correct things that may not have created a problem had they never been detected.
This phenomenon is the subject of a book I am reading: Over-Diagnosed, Making People Sick in the Pursuit of Health. There are so many recommended screening tests for humans, many of which will find something and result in aggressive treatment or surgery. Even in the case of cancer - so many cancers are very slow growing and are unlikely to be the cause death. However, the treatment for cancer can cause many complications, including death. If the cancer is considered aggressive, it is likely to have metastasized to other organs, so in treating one cancer, another may be growing elsewhere and may end up being the cause of death. I'm not advocating NO treatment, I'm just making the point this book has already made: sometimes we make ourselves or our pets suffer more by being too aggressive for little or no benefit.
I prefer to take a very conservative approach to testing and/or treating my dogs. My main concern is to keep my animals as comfortable and safe as I can and to let them go when I know it's time. I lost one of my greyhounds following surgery to remove what was thought to have been a benign tumor on the spleen. The tumor was not benign and it ruptured during surgery. I felt great remorse in the following days as he lay there suffering from the huge incision. I had him euthanized later that week as his condition continued to decline. Necropsy revealed the cancer had metastasized to several organs.
Quality of life is more important to me than attempting to prolong it, especially in an older or extremely ill animal. I just wish we humans had the option of euthanasia when we feel it's time.
Judy K. Paulsen
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