Does A Bad Diagnosis Require Euthanasia Now? NO!

I wish I didn’t have to write this, but I feel it is an important topic to spend a few moments on. Ever since I changed my focus from general medicine to dealing with the older, elderly and end of life dogs and cats, I began to realize how easy it is for veterinarians to recommend and carry out euthanasia based on an ominous diagnosis or even on a speculative diagnosis that might be terminal. This is especially common when the diagnosis involves cancer or the possibility of cancer. Abdominal masses, when found on radiographs and/or abdominal ultrasounds, usually result in an immediate discussion recommending euthanasia, and not for a future consideration, but for the procedure to be accomplished then and there. I have no idea how many people accept this and have their pet euthanized. I only know about the people who call me regarding end of life for their animal when the veterinarian recommended euthanasia and the individual(s) did not consent. When someone calls me, I always determine why they called and what is going on with their pet. In almost every case involving another veterinarian, these people have been told it would be best to have their pet euthanized as soon as possible, even that same day. In my experience, less than 5% of the calls I receive require euthanasia at the time of the phone call. What this tells me is that euthanasia is not the last resort it should be, but a quick end for a life that may, with help, carry on for an undetermined period of time. My approach is to look at each individual animal, go through the medical record if available, and determine how the animal is actually doing. In a significant number of cases, the pet is doing remarkably well considering what they are dealing with. The pet caretaker is rarely doing as well as their pet is. Their animal is not concerned about what is going on. Instead the pet is approaching life as always, being in the moment and adapting to the malady. The human, on the other hand, has had their emotional life turned upside down. They have been put in a precarious situation involving a decision to determine if their beloved pet should live or die, and they are often told to decide NOW rather than having time to “wrap their brains around what is going on.” In my opinion, veterinarians should realize that the diagnosis alone will be difficult for the caretaker to comprehend, but to then put them in a position to immediately determine a living versus death choice is truly untenable for the people associated with the animal. 

Veterinarians have been taught to diagnose what is going on. That is their primary goal when dealing with a sick animal. The approach can almost seem “cookbook” like in its progression with blood tests and radiographs as the starting point. Once the veterinarian has the information he or she needs, they are then in a position to discuss what is going on, and how the problem can be dealt with from a treatment standpoint. If the diagnosis is a negative one, rather than softening the blow, they proceed with the ugly details, often without realizing what those details can mean to the people whose pet they are dealing with. Why this is? I truly am at a loss to determine the why and I am saddened by what I so often hear from the affected individual(s). Over half of the calls I receive in regard to end of life, start out with a hesitant discussion by a person who is crying. A significant number of voicemails I listen to are difficult to understand because the person leaving the message is sobbing and trying to ask for a call back because they have received devastating news about their beloved pet. The sadness is understandable. The way the reason that resulted in the sadness was delivered to the individual is not. 

What is the point of this discussion and why do I even bother to bring it up? Honestly, I want every pet person to understand that just because the diagnosis may be a ba