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Permission to euthanize

October 5, 2006
Karen Wheeler, DVM

Sometimes it's OK to give clients permission to euthanize. And making this choice doesn't make them bad people -- or you a bad doctor.

I scanned the check-in sheet for the next appointment. "Urinating around the house. Owner might want to euthanize." When I was a young veterinarian, I would have walked into that exam room with a plan, and euthanasia was not any part of it. Examine the cat. Urinalysis. Radiographs. Special diet. Pheromones. Access restriction. Try this. Cover that. Move this. Spray that.

I went to conferences. I read the journals. I never wavered from the plan. This cat would use its litter box if only I'd get smarter. If the owner would try harder. Euthanasia equaled failure and, if it eventually came to that, I held myself and the owner equally accountable.

I got married. I had kids. I sprinted from afternoon appointments to soccer games to piano lessons, and most days I didn't know if I was coming or going.

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Our cat began urinating in the bedrooms, so I initiated the plan. I covered this. Sprayed that. Tried this. I hung "KEEP CLOSED!" on every bedroom door upstairs. The kids ran past the signs and opened the doors. On warm summer nights, I tossed and turned to the stench of ammonia. The cat, presumably also bothered by the smell, started peeing by the piano.

My first few years as a veterinarian, I focused almost entirely on the pet and minimally on the owner. My compassion and understanding didn't necessarily include the human part of the pet equation. If owners couldn't afford treatment, shame on them. If they couldn't clean the litter box daily, bring their pet in for retesting, or travel to see the oncologist, shame on them.

Life, however, has a way of teaching us lessons—even those we don't necessarily wish to be taught. Health issues. Unemployment. Strained marriages. Aging parents. For better or worse, we learn the most from circumstances that bring us to our knees.

As time passed, I began to see things from a different angle. I recognized a client's "deer in the headlights" look because I had worn it. I began to temper my treatments with reality. I stopped saying, "This is what you must do!" and started asking, "Is it possible for you to do this?"

"Can you give your diabetic cat its shots twice a day?" "Can you afford chemotherapy with your husband unemployed?" "Do you think you can hang in there and see if this next step will help the behavior problem?" I began to understand that all of us—you and I included—do the best we can juggling the problems and issues tossed at us at that specific time in our lives. Tomorrow may find us more or less able to cope with a situation than today.

A veterinarian's compassionate and healing hand needs to be extended over the entire animal kingdom, including the humans that we work with. Yes, perhaps the owner could have tried more things or run more tests. It's possible that if I were the owner, I wouldn't yet have arrived at this decision. But the client on the other side of the exam table might be at a totally different point in his or her life than I am, whether physically, emotionally, or financially.

This very afternoon you might work with a client trying to deal with a pet's chronic or severe medical or behavioral problem. That client might be desperately waiting to hear you say, "Hey, it's OK to be considering humane euthanasia. That doesn't make you a bad person." And saying it doesn't make us bad veterinarians, either.

Dr. Karen Wheeler is a writer and an associate practitioner at Companion Animal Hospital in Eagan, Minn. Please send questions or comments to ve@advanstar.com.

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