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How to Talk to Your Gynecologist About Euthanasia

If I tell someone that I work with dogs, it’s guaranteed that that person will ask me for advice about their dogs. This happens no matter where I am.

If I’m getting a massage, I get asked about house training problems. If I’m at the dentist, my hygienist wants to know how she can convince her mother not to be terrified of her pit bull (who is lovely, thank you very much). And when I’m at the gynecologist, my doctor is asking me about her elderly dog’s end of life issues.

Let me say this from years of experience with a variety of gynecologists who have nothing in common with one another except that they all like to talk to me about their dogs while they root around in my lady bits:

After someone’s had their hand in your vagina, it’s pretty easy to talk about euthanasia.

 

So there I was at my new doctor’s office, having never met her before, and she’s telling me about the wonderful dog her family adopted a few years ago from the animal shelter where I used to work. The dog, let’s call him Paps (ladies, are you with me here?), was pretty old now and had a whole host of expensive medical conditions.

His meds were running about $500 a month. My doc said she didn’t mind paying, even though that meant her family wouldn’t be able to afford a vacation this summer. She was really just so worried about her dog.

Was he ok? Was he suffering? Why didn’t she know if it was the right time to let him go?

Everyone kept telling her she’d “just know” when it was time.

 

photo credit: glamour magazine

photo credit: glamour magazine

 

Around this point in the conversation I wrapped that weird plastic sheet around me and sat up. “That’s not true for a lot of us. We don’t just know. Some dogs don’t magically tell us and we can’t figure it out, even though we love them. It’s ok if you don’t know.”

Tears. Hers.

She was relieved to know she wasn’t failing Paps.  Because you know what “you’ll know when it’s time” implies? That if you don’t know, then you suck at loving them.

Doc thought that if she didn’t know the answer to this seriously important question, then that meant she didn’t really know her dog. How awful is that? On top of being torn up that your dog is old and sick, now you have to question whether or not you’re a good dog owner because you don’t “just know”?

I know we mean well when we say this (I know I’ve said it in the past) and it is true that sometimes we do “just know.” But this common advice winds up not only failing, but hurting, a lot of good people.

So, why wasn’t he just passing away quietly in his sleep? Would that happen, she wondered?

Maybe. But with the level of medical care she was giving her dog, Paps, like so many of our pets, was receiving life-extending treatment. It’s not like the old days – for pets or humans. Today we treat a lot of conditions we couldn’t years ago and that means that both pets and people may get to experience a long period of old age. And with it comes full on decrepitude and peeing in our beds (when we’re sober). Which means we need to actively make a choice on their behalf.

So when is it the right time?, she asked.

I told her what so many people have told me over the 15 years I’ve been caring for their pets:

Waiting too long, because we can’t bear to let them go, often results in a shit-storm of guilt later. If we let our pets suffer, because we’re not ready to lose them, then months and years later we’re stuck with a lot of guilt about the unnecessary pain we put them through. Often, it’s better to err on the slightly too soon side, then the slightly too late side of things.

Disclaimer: When I say “soon”, I don’t mean that the minute they have an accident or sneeze or fall over we should rush to put them to sleep (if that were the case I would have sent Birdie to meet her maker – Charles Schulz, I think – about 4 years ago). I really mean when things are already quite serious and the end is near.

But how will I know?

I told her about the Quality of Life scale which would help her measure the, uh, quality, of her dog’s life. She was so relieved to know this existed and that she would have something to help her measure this seemingly immeasurable thing. She thanked me profusely.

Tears again. Both of us this time. And a hug.

Then she stuck her hand back up my hoo-ha and talked to me about my cervix.

Later that night, when she opened my email that shared a link to the Quality of Life scale, Doc was sitting in her sons’ room waiting for her boys to fall asleep. Her boys wanted to know why she was crying. It was because, thanks to the scale, she now realized that old Pap had some life left to enjoy.

And when the time comes for her to make that inevitable and excruciating choice for her family member, now she knew that she didn’t have to hope that she’d “just know.” She’d have some help.

End of life issues are so complicated. People shouldn’t have to hope that a dog walker with no filter and no shame comes into their office for a birth control refill just so they can get sound advice about when they should put their dog to sleep.

Instead let’s make a point to talk about the hard stuff. Leave out the judgement and shaming and let’s do everything we can to help our family, friends, and clients be better prepared, so that they can make choices that support real quality of life for both them and their pets.  And veterinarians, can you please do me a solid and make sure this Quality of Life scale (and hospice information) is easy to access? It’ll save me some weird moments next time I’m in stirrups at the doctor’s office. Many thanks.

 

weimaraner

 

Here are some resources about figuring out when it’s time, including the quality of life scale:

The “HHHHHMM” Quality of Life Scale by Dr. Alice Villalobos

Minimizing the stress of euthanasia by Dr. V of Pawcurious

How to say goodbye by Dr. Andy Roark (with other ways to measure quality of life)

 

And because I get asked about euthanasia for behavioral issues ALL the time, here are some wonderful, non-judgmental, realistic resources to help with that brutally painful and individual decision (really folks, we need to do a better job of openly talking about this too. I’ve had enough with the shaming and bullying around euthanasia. It’s not helping anyone when we go ALL CAPS about something as complex as this):

When is it time to put down a dog who is aggressive to people? by Patricia McConnell

When is it time to put a problem dog down? by Casey Lomonaco

Euthanizing Aggressive Dogs: Sometimes It’s the Best Choice by Phyllis DeGioia, editor Veterinary Partner and VetzInsight

The burden on euthanizing an aggressive dog by Mel of No Dog About It

Goodbye Huckleberry by Ana Poe – I read this years ago and it’s never left me. Such brave, compassionate, honest writing.

 

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36 Comments Post a comment
  1. Juli #

    You’re amazing. Paps, and her mom, are lucky that you needed your cervix checked/.

    November 24, 2015
    • My cervix was obnoxiously proud of itself for doing a good deed that day ; )

      November 25, 2015
  2. I did not think I could love your blog more, and then you write candidly about vaginal exams.

    November 24, 2015
    • Wait a sec, isn’t everyone writing about death and vaginas this Thanksgiving?! And, thank you Sara.

      November 25, 2015
  3. Victoria Olson #

    Where’s the “like” button?

    November 24, 2015
  4. Don’t know if I’d be so compassionate if my Urologist started talking about his dog during a prostate exam. 🙂 Seriously, good article and the links about euthanasia of aggressive dogs were especially timely for me – regarding shelter dogs, not my own.

    November 24, 2015
  5. ejhaskins #

    It is never easy, but to me the choice is made by the dog (or cat). When the animal is in distress and either there is no cure or the ‘cure’ will do nothing more than prolong the life then it is time. have neve found vets to me good at recommending the ‘right’ time — too often they have tried to stop me.
    They have offered MORE tests, surgery, or even ‘wait and see- with an animal at was obviously suffering 😦
    The first dog that I had euthanased was Topsy (GSD) – she had mammary cancers, and the vet kept assuring me that she was “In no pain”. Unfortunately I made myself believe him, and allowed her to live through months of distress. Forty years down the track, I STILL feel her pain 😦
    I will NEVER let another animal suffer like that. Too early is far far better than too late. The animals I’ve since had euthanased have all died very peacefully.

    November 24, 2015
  6. This is such an awesome post! I shared it!

    November 24, 2015
  7. It was three months ago this morning (Aug. 24th) that I had to make the decision to let my beloved Callie, my canine soulmate, leave this earth. I had taken her back to the vet after a rough weekend; and upon examining her, he said “anything else we could do now would be for us, not her.” He wiped away a tear and said I could take all the time I needed to. After texting with a friend, and spending time just being with my girl, I called my husband and told him to bring our other two dogs to the vet so we could all say goodbye to our sweet girl. (I had wanted to say goodbye at home; but when I looked into her eyes at the vet’s office, I knew the ride home would be too much for her. The vet techs made up a comfy bed for her on the exam room floor and Callie and I waited for hubby, Shadow, and Ducky.) Callie’s brave, but short, battle with lymphoma was over less than an hour later. She was taken from us way too early; but I have never regretted the decision to end her suffering when we did. We will always miss our girl, but she’s at peace now and her sweet spirit is always with us.
    I did “just know” with Callie – and with my first dog – but I agree with you that not knowing should not add more stress to an already stressful, heart-wrenching time in our lives. Thank you for all the links you provided to help us when that time does come! I am going to make note of all of them.

    November 25, 2015
  8. This is an incredibly helpful post. I downloaded the Quality of Life chart and will be saving this post. Thank you and I hope your next OB-GYN appointment is a happier occasion! LOL!

    November 25, 2015
  9. Loved the candid way which you wrote about the whole situation. It sheds a positive light on a situation that is distressing at best!

    November 25, 2015
  10. Thank you for writing such a difficult but important post.

    November 25, 2015
  11. Reblogged this on Barking Up the Right Tree.

    November 25, 2015
  12. Karen DeBraal #

    Excellent post.

    November 25, 2015
  13. EmilyS #

    This is wonderful… no our pets won’t let us know. My compassionate vet told me “I’ve never had a client tell me she made the decision too soon, but I often hear from them that they waited too long”. Despite this advice, I DID wait too long and made my poor dog suffer. A humane death to relieve suffering is a gift we can give our animal friends …

    November 25, 2015
    • ejhaskins #

      We had one dog who DID tell us he wanted to go 😦 He had just been diagnosed with lung cancer and it was progressing alarmingly fast. Then one day, while my husband was standing working at his ‘workbench’. Genghis came up to him and persistently nudged the back of is knees — DO something!! DO something! So we delayed no longer.
      I suspect that his mother (Genghis’s mother that is) had also been asking us for a while. I am haunted by suffering face and pleading eyes to this day 😦 Yet the vet had assured me that she was ‘in no pain 😦

      November 25, 2015
  14. My sweet rescued girl is now 16, has serious doggie dementia..she gets stuck in new places DAILY in the same old house! But no bowel/potty issues indoors, yet. But I did the Quality scale. She eats, drinks, WANTS to walk daily, barks/chases at the new stray cat in a heartbeat but weight loss, failing energy, profound deafness and 15 hours asleep tell me it may not be long. I am thankful to have this scale to go by. I just CONSIOUSLY enjoy everyday I have left with her, and make her time with me as enjoyable as I can too.

    November 25, 2015
  15. Mel #

    Thank you!!! I have heard that phrase so often and it is rarely true. So many people wait for a sign and never see it and needlessly let their dog suffer, waiting “to know.”
    I will be sharing this post. (BTW-I am a former professional pet sitter and I STILL get questions. LOL.) 😊

    November 25, 2015
  16. ejhaskins #

    But I DID have a problem with the ‘quality of Life Scale’. I feel that it is far too “absolute”.
    My lovely Kelly started stumbling and moved vey slowly. One day I helped her into her caret and she never came out again. She was no longer interested in eating, but for a few days drank the water we brought her. Should we have had putdown? But she seemed content and peaceful. We ‘d check on her frequently and she’d open eyes to greet us. She died peacefully at home without the distress of a stranger hauling her out of her crate and the shaving her arm and for the injection. r being hauled out of her crate, bundled into a car and driven to the vets.
    I am left with od memories of the peacefulness of her passing (of simple old age).
    Her daughter Pearl thought was still mobile, with nothing (she was aware of) wrong other than the occasional stumble. She was eating and drinking, but was already beginning to show signs of knuckling over on her hind feet. I knew that she was getting frustrated with her decreased mobility. SHE had CDRM, and I knew that it was going to do nothing but progress — to the point that she WOULD be in distress. She also had some mammary cancers developing. So we called out the vet, she walked up to meet him, I told her everything was Ok, th vet was going to give her an injection to make her feel better and she relaxed, gave him her hand, and died peacefully at home.
    I have good memories of her passing, too. She seemed SO relaxed. Dear Pearl.

    November 25, 2015
  17. Mel #

    I totally missed the credit back to my blog post on euthanizing an aggressive dog. That is such a difficult decision for people.

    November 25, 2015
  18. SarahA #

    This is great, thanks, I will share it!
    I waited too long to make the decision the first time it was up to me. My vet told me the dog wasn’t in pain, but I don’t know about that. He certainly wasn’t happy. (kidney failure) With my next dog, I feel very at peace with my decision. And no, I didn’t “just know”. When she lost interest in all the things she used to love most, I knew it was time. She was not in pain, but she was lost to herself.

    November 25, 2015
  19. Caron #

    Thank you for the links regarding aggressive dogs. It’s been many years since I had to euthanize a beautiful Dutch shepherd rescue. She was a year old, beautiful, smart, and we bonded tight within hours. She was the product of a puppy mill. For a year, through two obedience classes, flyball training, etc, her aggression towards dogs and people continued to escalate. The day she went through a chain link fence to attack with intent to kill my old dog, I knew it was time. I was blessed to get a vet who was supportive and told me that sometimes the kindest thing we could do is release them from their demons. Nearly twenty years later I still wonder if I did everything I could. I wish I could have read the above links years ago.

    November 26, 2015
  20. Geri Duke #

    Such an important topic!
    Thank you SO much.

    November 26, 2015
  21. Don #

    My Border Collie, Charlie, contracted bone cancer in late 2011. The vet talked about options but ultimately said the removal of the leg probably would not do much since the cancer was so close to the hip so, we decided to keep him comfortable until the end. The vet told me them same thing, I would know when it was time. We made it through his birthday, the holidays and into the new year. Jan 18, 2012, I got his meds ready and tried to give them to him. He refused. Then, he did the most amazing thing, he gently laid his paw on my arm and looked me in the eye as if to say, “I’ve had enough, time to let me go”. I eventually got him to take his meds and I called the vet. Later that day we said good-bye to my friend. I know we did the right thing at the right time for him. When we left the house, he fell a little going down the stairs off the back porch. I lifted him into the car for the short trip. I don’t mind telling you, this still affects me greatly and it is difficult typing this through my tears. I miss him every day but that moment when he put his paw on my arm let me know we did have a wonderful connection. RIP Charlie, you were a great companion.

    November 28, 2015
  22. We face this question frequently in Rescue. I wrote a letter to the rescued dog that must be euthanized: http://secondchancepoms.org/Euthanasia_and_Rescue.html

    December 4, 2015
  23. It’s always amazing what happens when we drop the platitudes at the door. Thank you for being present for her and ‘Paps’.

    December 7, 2015
  24. Ruth #

    I currently lie in bed with 5 rescue dogs of all sizes, ages and breeds. These are not the first dogs of my life, but they are the ones I have grown closest to….almost. When I got married in Aug 29 years ago, during our Honeymoon I told my husband, I either want a baby or a puppy. Didn’t put in that ultimatum until after the vows. 24 days later my husband walked in with the most precious 6 wk old puppy,yellow lab, he had gone to the Humane Assoc and adopted. I cried with tears of joy. (in Dec we were crying for joy because I was pregnant). I had lived on a farm and owned LOTS of pets, but on 2,000 acres life is much different than that of life in a city living in an apt with a pet. Jim and I had a lot to learn. Being that all of my pets up to that time had lived with total freedom I was against crate training. By the time my sofa cushions from my India cotton sofa were gone, the wall paper in the bathroom and kitchen was pulled up, our 1st Christmas tree as a married couple covered in a series of one of a kind wooden ornaments I had collected over the years and the tree was down with all of the ornaments chewed up, ever single corner of the base boards were chewed to shreds and the carpet in the dining room corner was pulled up, all I could see that the $ for having this child was going to end up in the rental agents pocket for all of the damage. For Christmas we purchased a crate. We never put her in for punishment and in the beginning it was hard, but she grew to understand this was her place and hers alone. I admit surprise that in no time she loved it. The guilt of leaving her in it when we left the house melted away as we 3 began to love and enjoy each other without all of the stress of puppy antics. At least she knew when we got home instead of anger and tension in the house we could go have fun. I tell this story of my first real, very close pet because it was the first time I had to make the dreaded decision as to ‘when’ to let her go. And I will be the first to admit, we selfishly waited too long. We had gotten another dog when she turned 8. I knew she should live longer but she no longer wanted to play and just wasn’t the same dog. Our vet agreed we probably added 5 yrs to her life. She had someone with her during the day and it was wonderful to see her happy. I also now know that although I am retired and home all day, I will NEVER have just one dog. They need companionship of their own kind and as much as they love us, they need each other. I have felt guilt since her time. She was suffering and we could see in her eyes there was no longer a spark of any kind. She was just tired and done. We had to let go. It took 2 yrs to be able to bring in another companion for Tuck. But all of a sudden ;06, ’07 and ’08 we quickly grew to a family of 5; taking in puppies who needed a forever home. ALL of our dogs were born in Jan and we got all of them in March. To me it was a sign. When it came time for out next dog, we were much better prepared. He was the soulmate for me and as much as I love these guys here on my bed, there will never be another Tuck. And my love for him is the reason I was able to know and let go without questioning myself about the decision. We now are coming up on our 3rd decision. The dog adopted 2 yrs after losing our very first dog. She is 13 and still in great shape, but becoming fragile. Our Vet and a visiting vet both told us as a Border Collie mix she had to be in the best shape of any they had ever seen. Skin healthy, weight perfect. appetite still great. Last night, we do not know why or what kind of pain she was in, she spent the entire night crying, moaning and screaming. I have never heard such sounds from a dog. Today, she is fine. It is a signal to begin preparing ourselves tho and prepare we are. It may be a year or more, but there are 18 steps leading up to our home. The home is roughed in for an elevator and if at some point in the near future we can afford to have it put in, it will extend her life, but yes, you do know. When u love so deeply u can read the signs. They may not tell u but u can tell. Don’t let them suffer out of selfishness. U will be able to think of that pet more fondly after they are gone if ur not feeling the guilt.

    December 13, 2015
  25. Hi Jessica, I never thought I would find myself laughing out loud and then crying sympathetic tears a few sentences later when I started searching for fellow dog walker blogs to follow. This is my new favourite blog by a country mile, so refreshing and also informative. Thanks also for the links, I’m sure they will come in useful the next time I’m asked the same thing. subscribed and looking forward to your next article!

    January 6, 2016
  26. Thank you for this. Its something I’m struggling with with my cat. I have serious emotional issues tied up with her and I’m very afraid I’m going to hold on too long. Now I have something concrete I can use to keep my balance and make a decision for her sake and not mine.

    January 16, 2016
  27. Reading this made me want to both laugh and cry. Beautifully written.

    February 20, 2016
  28. Janet Nygard #

    My 9 year old Dane Caesar has degenerative nerve disease. He had bowel incontinence on a regular basis. We deal with it everyday. He still loves to eat, go for a short walk as he can’t do much more. we limit his food to the morning hoping he will not poop at night in his sleep , but it has become an almost nightly event. He is sleeping a lot and doesn’t like to play with toys like he use to and while asleep he has involuntary leg spasms . I don’t know if it’s time we are having difficulties coming to that decision. He has been with us since 8 weeks old. The scale didn’t help that much. Still not sure what to do. I guess only time will tell.

    January 3, 2017

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  1. How to Talk to Your Gynecologist About Euthanasia | Hello Yiddy's Blog
  2. Top 15 Blog Posts of 2015 | No Dog About It Blog
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