Assessing Quality of Life in Your Pet
So many times we hear “You’ll just know when it’s time” in reference to saying goodbye to your furry friend. Sometimes we do. Other times deciphering when it’s time to consider euthanasia can be a gut-wrenching and emotionally agonizing experience. Being told we are “supposed to know” only lays on the guilt when you are unsure if it is your pet’s time. I think a more realistic and beneficial way of looking at “knowing” is that when you feel that inkling that it’s time, you are probably right. For many of us, we don’t want to wait too long but we also want our pet to experience a good life for as long as possible. It is very uncommon to be unsure and confused if you should be considering euthanasia for your pet.
Tools to assess Quality of Life
There are several factors to take into consideration when considering an animal’s quality of life. A Quality of Life scale can be very beneficial for you and your veterinarian to convert subjective observations into objective numbers or data.
One of my personal favorites is Dr. Xie’s Quality of Life Assessment score. This system looks at the life activity of the pet as well as incorporating a pain score for an overall total quality of life score.
Another useful scale is the HHHHHMM scale. A value of 1 to 10 is given to the following categories: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad. A score of over 35 points on this scale is desirable.
Vetmetrica was developed by the University of Glasgow. It is an on-line assessment completed by pet owners, asking them 23 questions about the pet’s behavior. It is free for pet owners and it lets the pet owner know when to contact their veterinarian.
Assessing Pain in your Pet
An important part of assessing quality of life is considering a pet’s pain. This can be particularly hard for pet owners as humans are not particularly adept at reading, assessing, and interpreting pain in pets. Using a numerical scale like you would in a physician’s office is helpful in measuring and monitoring pane over time. There are many scales, ranging from 0 to 5, 1 to 10, and even 0 to 100. All of the scales are legitimate.
An easy-to-use pain scale can be found here for pet owners. In general, when assessing your pet for pain, you want to look for things like mobility changes such as struggling to jump on or off of things, climbing stairs, slower walking pace, spending more time laying down, taking longer to rise from a sitting position, etc. You may also see a decreased appetite, burping, vomiting or diarrhea associated with GI pain.
Assessing Quality of Life – Once size fits all?
We wish things in life were as easy as one size fits all. The truth is, in order to truly do justice to the animal, we must evaluate them as individuals. Some pets, and people choose pain. That’s right. Think of the big yellow lab, wagging his tail at the kids, shuffling along on his walks, happy to just be. This doesn’t mean we can’t do things to mitigate or control a pet’s pain as much as we can. But when this same pet stops eating, stops interacting with the family…maybe that’s how we know this particular pet’s quality of life has diminished to where he is ready to go.
What is Suffering?
Suffering is the state of consistently undergoing pain, distress, or hardship and is not beneficial to the organism. Suffering can occur without pain. Patients can suffer from severe anxiety disorders, inability to gain weight and paralysis. Suffering negatively affects quality of life and suffering can cause death. In a twist of fate, death also causes suffering because we are losing a loved one. Death can also bring relief.
The goal of hospice and palliative care is to relieve pain, provide comfort, and eliminate suffering from serious illness. If there is some quality of life and there is no suffering, it is appropriate to doubt that it is your pet’s time; that’s OK! If you find yourself in this situation, don’t go it alone. Engage your veterinarian or add a veterinarian that is trained and certified in Palliative and Hospice Care to join your pet’s medical care team.
The veterinary profession embraces providing a good death (euthanasia) when suffering is uncontrollable