Pet Decisions

Last December was the first time either my wife or I was involved in the decision to end a pet's life, not counting some fish I had as a kid. We'd seen other people go through it, and the pattern always seemed to be: spend lots of money on vet care in the final days, for little effect. Different people had different feelings as to whether they regretted their decisions or not, but everyone agreed that you pay a lot to extend a pet's life by a matter of days or weeks. My father's favorite story here is that a vet wanted to run an expensive set of tests on their ailing eighteen year-old cat, to see if it had condition X. My father asked what would the treatment then be for condition X. Answer: none; it was a terminal condition. But at least they'd know. End result: they didn't go for the tests.

Before our cat died, my wife occasionally tried to talk about the lengths which we would go to keep her alive, and where are limits would be. How much we would spend; how much extra burden we would be willing to take on. We thought it would be useful to have a game plan ahead of time, before we were caught up in the emotional whirlwind of a critically sick cat, when it would be hard to make good decisions. Good idea, but those talks never got us anywhere. Too many unknowns. How old is the cat? How healthy do we think he or she would be after the procedures? What would their (and our) quality of life be?

Well, we've gone through the experience for real now. I can't say we did any better than to muddle through. But we did learn a few things from the process, hopefully, and I wanted to mark them down so I can remember them for the next time.

Don't rush your decisions - we gave ourselves a somewhat false sense of urgency. By the end, I was spending a few hours a day caring for and cleaning up after a very sick cat, which got old very fast. It was also very hard watching Autumn in her condition, unaware of things and aimlessly circling the house for hours on end. We also had a scheduled trip that was coming up soon, which added to the urgency of the situation. And, for better or for worse, all this was happening while I was on Christmas vacation. That gave us extra time to deal with everything, but that time was going to run out soon.

Looking back, though, the situation actually unfolded a lot faster than it seemed to at the time. Taking a few extra days and rescheduling the trip would not have hurt in the long run. On the other hand, I don't think it would have made a difference either, i.e. in keeping Autumn alive, but it should have been less of a factor in our decision-making.

High-level strategy. It seems like you can approach the question in vet care in one of two ways. If you can afford it, open your checkbook and pay for whatever treatment/diagnostics they suggest. This will cost you some thousands of dollars, but I'm guessing it makes the decision-making a lot easier and significantly reduces any future second-guessing. Alternatively, be an involved consumer and make decisions taking cost into account. It never really occurred to us to do the former, partly since we are cynical about vets, and partly because I'm coldly logical. We love our cats, and take great responsibility for them, but in the end, they aren't as important as our children or ourselves, and there's a limit to how much we will sacrifice for them. In the end, making the cost decisions was very hard -- and it never actually came down to the cold question of how much our cat was worth to us. The questions we had to answer were: how much was it worth funding tests that may or may not shed light on our cat's problems, which may or may not be treatable, and how long were we willing to care for the cat while we waited?

Make a choice that you can live with. If you read between the lines above, you get the idea that to some extent, I think the veterinarian industry might be playing grieving pet owners for suckers, extracting large amounts of money for meaningless operations on terminal pets. Much as the funeral industry capitalizes on grief to get families to pay out money for meaningless upgrades and accessories. I don't like being played for a sucker, but then again, in the end, I'd rather feel like a sucker than a heartless pet owner who killed his cat because he didn't want to shell out any money. Hard to find that balance, since you could be out an awful lot of money if you blindlessly search for medical solutions, but whatever you decide, the memories of that decision will be with you for a lifetime, so you need to be able to honestly justify that decision to yourself.

Be forceful with the vet, and don't be afraid to mention euthanasia if it is on your mind. My biggest failing. We talked to several different vets at different stages. The one we visited at the most critical time might have been the least helpful. He seemed to talk with the understanding that euthanasia was not an option, and that our options were to run tests of varying expense. My wife and I, after carefully watching our cat for days, thought there was a good chance that her condition was terminal, and only wanted to spent out real money if we thought it would make a difference. Not only that -- time was not on our side, or on Autumn's, and we tried but didn't get that across somehow.

Basically, I wanted some sort of sense for what the odds attached to each of our options was. Run this test; what's the likelihood that it will find something, and then what is the prognosis for whatever the tests find. I wasn't expecting something super-quantitative, and I realize that every case is different. I just figured that he's seen thousands of cats, gone over however many case studies in vet school ... he should have had at least some qualitative feel for what the probabilities were. And I just couldn't get anything out of him beyond an anecdotal case or two, which was worthless to us. We walked out of his office profoundly disappointed. I didn't feel like he really got it, that he gave us information that really helped us make a good decision.

I'm struggling to find the right words here, but maybe one way to summarize my point here is that you shouldn't trust the veterinary profession to give you good ethical guidance.

Get a second opinion. Another mistake on our part. After the unfortunate encounter with the vet above, we should have tried somewhere else. But at that point, we felt the time pressure of our upcoming trip, and a depressing sense that another visit wasn't going to matter, and that we would be throwing our money away, and delaying the inevitable.

You are your pet's best advocate. I'm saving this topic for a later post.

I'll try and keep that all in mind for the next time, which I'm completely dreading, and I hope won't be for a long, long time.