Today I had the honor of supporting some dear friends through the palliated, but not hastened, dying process of their cat. She was the ultimate “tough girl” – a barn cat turned beloved family member, a creature who resisted medical interventions at every turn, at one time requiring 3 people to do the typically 1 person job of subcutaneous fluid administration. An elderly lady who ultimately succumbed to severe kidney failure and concurrent liver compromise, she was appropriately given a grave prognosis. Her caregivers were given the options of referral to a 24-hour care facility, or euthanasia – appropriate recommendations, given her condition. But when they responded: “We don’t feel comfortable with either of those. What are our other options?” the traditional paradigm of veterinary end-of-life care was challenged.
The paradigm is a binary one; the system is overwhelmingly a “treat or euthanize” decision tree. The unfortunate reality is that most veterinarians are as uncomfortable with a third option as these folks were with the two that were offered. Through integration of hospice & palliative care into the veterinary curricula, I believe this can change. But currently, it is all too common that a communication breakdown ensues when these situations arise. Fortunately, in this case, a third option – hospice care – was well-known to this family because of their close personal relationship to me. But what if it hadn’t been? What if, as is the case for so many families, the binary system prevails and the “treat or euthanize” options are all that are offered? All too often, when this happens, it becomes a lose-lose situation for all involved: the veterinarian who is frustrated & feels s/he is unable to help the pet, the clients who are grief-stricken & feel alone and judged for rejecting the options that are presented, and the pet who is often taken home without any veterinary oversight or adequate symptom relief. Skilled hospice & palliative care can provide the missing link which is so important for filling in the gaps here. It is my belief that through community education, the “third option” will no longer be the anomaly, it will become standard of care. (See the previous blog entry for more on this.)
Today, a binary system was challenged, and a beloved cat transitioned peacefully into death overlooking Cayuga Lake, surrounded by people who loved her. I was honored to be a part of the journey. May we continue to empower ourselves and our communities with options that can help all involved – veterinarians, clients, and animals – feel as comfortable as possible with, & during, the dying process. It is, after all, as normal as birth for each and every one of us.