Ethics of veterinary treatment Print E-mail
News - Rubrieke
Saturday, 11 December 2021 10:26
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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 was scrolling on my phone – a dangerous rabbit hole of wasted time – when I came across an article from the UK querying if the treatment of pets these days may be bordering on the unethical. Just because we can treat something doesn’t mean we should.

As pet owners we need to be clear that if we are treating, either aggressively or simply managing a chronic condition in our pets, whether it’s in the pet’s best interests or for reasons relating to our need to the pet’s continued presence in our lives.

As owners and veterinarians we also need to balance the risks and drawbacks of a procedure or treatment against the gains. Massive painful invasive surgery for a tumour, which is malignant or has already spread, is questionable. Weighing up a two to three month survival time against the pain and stress of surgery must be a factor, not just the affordability.

However, if the survival time after an invasive painful procedure is considered long term, then a case is easily made for putting the patient through some discomfort to achieve that goal. Certain tumours may be slow growing and managed with mild ongoing treatment for an extended period. In these cases people will often criticize pet owners as to why they are carrying on with treatment, yet the pet is happy and bouncing around, the medication may be daily or intermittent, but is not causing any significant side effects regardless if the survival time is two or 12 months .

Dogs and cats are also prone to chronic disease such as diabetes, heart disease, arthritis and kidney disease. Decisions to continue with treatment, besides an affordability consideration, must include the patient’s stability. As long as the patient has good quality of life and the treatment is not worse than the disease, then go ahead.

If you as owner are prepared to give the medication and take the dog for checkups, I don’t see the ethical problem. As disease progresses, patients will start to deteriorate and become resistant to treatment or treatment is inadequate to control the disease.

Owners often loathe acknowledging this. They desperately want to believe that things are still okay and will cling to any positive to promote continuation of treatment. I will be blunt and say that in cases like this, the pet has started the process of dying.

As soon as we are born, we are on our journey towards death, but it is often clear towards the end that the process of death has begun. Then owners really need to consider if they want to prolong this process rather than just allow their pet to slip away painlessly a few weeks to months earlier. It’s hard, I know, but it’s often the responsible and kindest thing to do.

However, everybody’s viewpoint will be different. A case in point is paralysed dogs in their little g-carts. These dogs are generally very adaptable and for them life is good. Generally owners prepared to go this far with treatment are also prepared to adjust the dog’s environment so that they have access and can get around.

This must be contrasted with those who cannot accept that their old dog is paralysed, won’t get “wheels” and also just leaves the dog on a blanket all day. This is definitely a quality of life (QOL) issue. QOL is a definite consideration and is part of the discussion in many situations between a vet and an owner.

I will often have a QOL talk with an owner and see that they are not interested in what I have to say. These situations stress vets because we feel that we are allowing a patient to suffer. If your vet has a QOL talk to you and you are not ready to hear this, maybe get a second opinion. If the answer is the same, then maybe you need to do some soul searching as to why you want to extend your pet’s life. Personal reasons can be very compelling and every step must be taken then to make the patient as comfortable as possible and manage the situation closely.

We sometimes have pets belonging to recently deceased spouses or children and these emotional bonds and links are much more complex than simple pet ownership and can be heartbreaking for all involved. However, if the personal reasons are just an unwillingness to let go or make a hard decision, then we as owners really need to make the decision that is correct for the pet.

 
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