What do you expect PDF Print E-mail
News - Rubrieke
Tuesday, 25 August 2015 08:38
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Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


Dr Liesel van der Merwe

I have been a vet for 23 years and it is interesting as you grow older, and hopefully wiser, how you realise that often your clients’ goal and your goal about a patient may be totally different.

I always want to do my best to fix any fixable animal as long as the benefits, such as quality of life, are plain to see. For some animals the best option is euthanasia, based on poor expected quality of life.
This is not necessarily what all clients want. Some want a dog, any dog, not necessarily this dog. And others want this dog, only this dog, for as long as they can possibly have it, sometimes to the detriment of the pet.

Different people see their animals as having different roles in their families or lives, and I have also seen different animals having varying levels of importance in families.

To some people a dog is a dog and not a part of the family. It lives in the yard, is played with intermittently and otherwise fed and watered. It is not exactly neglected, but not really loved and cared for. To others a dog is a companion, requiring food, water, shelter, exercise and love. To yet another group a dog (or cat) is part of the family and is seen as a surrogate child.

People caring a lot for their pets will often only be restricted by finances or quality of life issues when deciding which treatments to pursue. People who do not have a real bond with their animals will often not be prepared to spend a large sum of money, even if the outcome is guaranteed to be good.

Both situations can cause stress to vets. On the one hand we have to euthanize animals which we could fix, and on the other we are not allowed to euthanize animals we cannot fix. Even euthanizing a patient when you know it is the right time is stressful as often you have become attached to the animal or you are aware of the bond between the owner and the pet.

And there is really no right or wrong approach about when to treat and when to stop. It should all be about quality of life. Everyone’s decision on when quality deteriorates will be different. Also, don’t minimise the effect a pet’s terminal illness will have on the owner.

Then there is the financial aspect. If money is not available, it may be in the pet’s best interests to be euthanized, which can be heartbreaking.

When I was just starting out I couldn’t understand why some people would elect to euthanize their pets as soon as cancer is diagnosed, even though the animal would not be in pain for a few months yet.

After having my own dog diagnosed with cancer, I now understand that the spectre of death looms large every day. Every time you look at your pet you wonder, “How long do I have?” You look for lumps and bumps, enlarged glands, and check for tiredness.

Then there is the quality of life issue. When is it poor? When the animal cannot get around like he used to? When he stops eating? When he is fine most of the time? When he is still his old self some of the time?

In general, most medical procedures will cause discomfort or pain and stress, which can be controlled to varying degrees with pain killers and anaesthesias. What you as a client and the vet have to consider is the outcome.

Is the information gained going to impact the treatment and outcome significantly? What are you gaining? What is your pet gaining? A painful orthopaedic operation on a dog with a bone fracture is a good example. The post-operative period is painful and uncomfortable, but once the bone is healed everything is back to normal.

Compare this to a debilitating condition which we are managing in an older dog that is deteriorating and will eventually die from that condition. Once the medicine stops controlling symptoms, is it fair to continue?

These kinds of decisions and expectations need to be clearly discussed with your vet. Your vet can only act in you and your pet’s best interests if you are clear from the beginning.

And I hate to bring money back into it again, but when expectations are not met – this is when money often becomes an issue. Make sure you ask about and understand the implications of any test or procedure. Make sure you spend your money where it will do the most good for you and your pet.

 

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