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What Do You Believe About Pet Healthcare?

What are Your Core Values and Beliefs Regarding Pet Healthcare?

“It is a virtue to contemplate and face your fuzzy, grey, moral frontiers on a continual basis.  Sharpen your focus on the near concepts and ever-more dilemmas pop up on the horizon.  This is how we know ourselves.  This is how we know if we are being good pet parents.” –Doc Truli

Do you believe in chemotherapy for pets?

See if you agree or disagree with this comment: “I do not believe in chemotherapy for pets.”

Some people intuitively and vehemently believe that a cat or a dog should never undergo chemotherapy.  They have seen human loved ones suffer and do not think a creature who cannot tell you if it is suffering, and if it wants treatment, should not be asked to go through chemotherapy on our behalf.  Other people believe any chance for extension of life or a cure is worth the temporary setbacks.

Do you believe any surgery that medical science has approved is okay?

Full mouth tooth extractions

How do you feel about this statement: “I do not believe in extracting all of a cat’s teeth, even though the vet says it’s the only way to cure her mouth pain.”

As a veterinarian, I extract teeth in cats to cure feline stomatitis-gingivitis when medications and cleanings have not worked.  But I have been told by some people, “There has to be a different way.  I am morally opposed to that solution.”  I’ll tell you what: modern medicine knows of no other way at this time.  But I cannot argue with a person’s core moral beliefs.  I tried my best to educate this person and explain the situation, and she thoroughly understood the situation.  She just has a firm moral point of view on the subject.  Perhaps you do, too.

Amputation of a dog’s leg diagnosed with osteosarcoma

  • Does it make a difference to you if the dog is young or old?
  • Fat or thin?
  • Sick anyway with some other disease?
  • Does it make a difference how long the dog is expected to live?
    • one year?
    • three months?
  • Would you change your mind if you knew the osteosarcoma was incredibly painful and no amount of opioids or anything was going to take away the pain?
  • Would you change your mind if you thought the dog would suffer a pathologic fracture at the site of the cancer and bleed in front of young children?

What about “routine” surgeries?

  • spaying and castrating?
    • what if your dog gets pregnant and needs a c-section?
    • what if your dog makes unwanted puppies at a construction site down the street and they starve to death?
  • declawing cats
    • would you change your mind if the owner was 65, diabetic, lived because of the cat, and couldn’t risk a skin infection from inadvertent clawmarks?

Do you believe in euthanasia?

It’s okay to think about it.  Some people do not believe in it.  Most people express a wish that they could leave this world with dignity someday.  You may be having extra trouble making decisions for your older, or infirm pet because deep-down, you do not believe it is right to decide to euthanize anyone.  But we are also mindful of prolonging suffering in a little animal that depends on us for everything.

Hindsight is 20/20.  (We say that often at the animal hospital.)

The Center for Humans Interactions with Animals in Society

The first center at any major university to study and form a peer group to review research and hold conferences specifically devoted to the scientific study of the relationship of humans and animals together in society was founded by Dr. James Serpell at the University of Pennsylvania School of Veterinary Medicine.  If you enjoy contemplating and debating veterinary medical ethics, this is the premier starting point for your journey!

VirtuaVet Society

VirtuaVet is building on online home for interactive discussions and debate regarding issues of interactions of humans and animals in society and our moral and ethical obligations toward animals.

Doc Truli believes, “Committing our intellectual, emotional, and spiritual capital to the study of the moral imperatives inherent in our relationships with animals , as well as each other, actually is our first moral imperative.”

Please write VirtuaVet or leave a message on this page if you are interested in becoming a founding member of this community.  Original opinions, true argument, and first thoughts are especially respected and valued in this endeavor.

25 Comments leave one →
  1. JenJen1973 permalink
    March 10, 2017 3:52 pm

    I’m at the point of pure nausea, heartburn, & honestly diarrhea trying to decide what to do w/my little Sissy Sue. She’s 15 w/progressive breast cancer. She’s gone from being always on the bed to now hiding under the bed. Her breast mass has now opened up & at times drips blood on the floor, & it’s a complete mess. I love her so much but if I take her into my vet at this point I’m afraid I’ll be judged for letting it get this bad. But when my vet stated that at her age the surgery could, 1. The anesthesia could kill her. 2. The surgery could cause her a great amount of pain, discomfort, & her quality of life could be greatly affected. 3. She may never “bounce back”. I just couldn’t put her through such an aggressive surgery & now I’m at a loss at what to do for her except to have her euthanized but I’m just afraid since she does purr at times that she’s ok. Actually that’s my husbands main defense for not taking her in.
    Her sister we had to have put down last year due to bone cancer in her jaw after treatment for six months which ended up coming back & she looked like walking death. She was obviously in misery. But now to have her sister also w/cancer & to have these sores opening up? I just don’t know what to do.

    • March 27, 2017 11:00 pm

      Dear Jen,
      Consult with a veterinarian trained in Traditional Chinese Veterinary Medicine. You can integrate herbal medicine, food therapy and acupuncture with Conventional medicine treatments. Or perhaps the veterinarian and you will decide Western medicine and surgery would be too much for her and you can try Chinese Medicine alone. The idea is: can we make her life better? Perhaps she cannot be cured. But we are all on our way out eventually, anyway. You do not live waiting to die, you want to live and enjoy yourself. And so does she. You can find a Chi Institute trained veterinarian at http://www.tcvm/com under their “references” page. It includes vets from around the world, not just the US.
      Doc Truli

  2. Susan permalink
    December 29, 2013 10:31 am

    Hi Doc,

    I wanted to share a service that was very helpful to Maybelline (kitty) when it was time to transition out of her body on 12/27/2013 due to Chronic Kidney Disease:

    Lap of Love is an in-home veterinary hospice and euthanasia service that allowed both of us (and the rest of the cats in the house) to have some time to get ready.

    It was a hard decision–especially when she “appeared” to still have a good quality of life, (running around, playing, etc.) but info you presented on the site about detecting pain helped me get my mind wrapped around the concept that she would be leaving sooner rather than later. I “caught” her doing the hunched up, fluffy thing when she thought I wasn’t looking!

    I also appreciate the person who mentioned Tanya’s site–it REALLY helped me with making her more comfortable:

    When the physical discomfort abruptly escalated, I asked Maybelline how much farther she wanted to go, and she answered…loud & clear. I was surprised by her answer, so consulted with a professional who confirmed she was ready–thank you Karen for chatting with us so quickly after I called!

    So then I made it my job to embrace and honor her wishes–Maybelline’s joy, relief (and impatience!) to be free of the worn out body was palpable while we spent our “Best Week Ever” together.

    The day of her appointment came, and Dr. Barry from Lap of Love helped her walk over The Rainbow Bridge.

    My personal views on pet healthcare and the ethics of “when to go” are these:

    I believe Free Will is the most powerful element in the Universe.

    Not having a human voice does not exclude from having a choice.

    Just because technology can extend another being’s time spent in a terminally ill body does not make it right to do so.

    I was ashamed (and later apologized to Maybelline) when I realized my “grieving” was 90% focused on me & my ego-based needs (what was “I” going to do without her there?). This powerful realization was her final gift to me–I am thankful for being able to lovingly focus on her and ease her transition.

    Truly a special friend!

    • December 29, 2013 6:45 pm

      I’ve recommended our local lap of live franchise vet when i’m already booked and my clients have been happy with their house call end of life care service.

      Thanks for the tips.

      -Doc Truli

  3. Barbara permalink
    January 12, 2012 3:48 pm

    Very much appreciate the conversation on this website. I can so identify with Molly’s comment from Nov. 3, 2010 as I am going through all this right now with my 14 year old cat, Leia. She has stopped eating since 11 days ago….have made 3 vet visits, done the assist feeding, getting ready to go to vet today to try some steroids and probably get some more subq fluids…..she now has a cough as well. Blood work is fine, she had very small fever so she was given convenia last Sunday. I can’t keep up with the force feeding and do not believe at this point in doing anything that distresses her too much, so, I’m in a quandary as to whether to even try the steroids. I think she is in some pain, and I just hate to drag this out for her. With all our medicine, human and veterinary these days……it is very hard to decide WHEN TO STOP.

  4. December 5, 2011 3:48 pm

    I am struggling with the decision to end my Buster’s life. He has bile duct cancer and has matasisized (?) to his liver and God only knows where else. He eats and goes to the bathroom just fine right now, but he is all bones. I sits with all four paws underneath him a lot of the time and lays in or around my closet in the my room. Yet, he is downstairs socializing with me and my other cat as well. He jumps on my bed every morning to wake me up (so far) and runs down stairs as soon as I take my first step down to get breakfast. He is a young 11 year old and way too young to have such a horrible disease. He went from 13.5 pounds to around 6 or 7 lbs now. He was on prednisone, but I stopped giving it to him this weekend. I had originally planned for the hospice to come over yesterday morning to put him to sleep, but cancelled about an hour before she was to arrive because he was having a good day…and I couldn’t go through with it. He spent the day laying on the patio and walking around outside (he’s always been an indoor cat so he loves the freedom and adventure this has brought him). I’m torn as to what to do…Today, he’s been in my room near the closet most of the day…and I wonder, is it time??? It’s like a roller coaster and I want him to tell me he is ready. Any advice would be appreciated. I read your blog on animals not “telling” their owners when it is time, but I sure do wish it was so because I hate have to make the decision.

    • December 5, 2011 3:53 pm

      Oh…and one more thing. His breathing is somewhat labored. His beats are vary between high 20’s to low 30’s per minute.

    • December 12, 2011 4:24 pm

      I am sorry you are facing this decision, it is absolutely heart wrenching to say the least. I just had to make the decision on November 28th with my Roo.

      Please allow me to share something with you that has helped me a few times now when I have been faced with the decision of when to put a friend to rest or if I should.

      Several years ago, I found a website online called ‘Tanya’s Comprehensive Guide to Chronic Renal Failure’ this is a fabulous site by the way, so informative but what I want to share with you is something she writes in a chapter called ‘The final Hours’
      She shares her thoughts about her own two cats, Tanya and Thomas who both lost their lives due to Chronic Renal Failure, So I will leave you with the following paragraph… her words make sense of so much…I hope it helps you like it helped me….

      “When Tanya was ill, I felt that I would never be able to bear having her put to sleep. The only way I was able to do it when the time came was when I finally accepted that neither Tanya nor Thomas was ever going to get any better than they were at that moment; that we had tried everything in our arsenal but our weapons were no longer working; and that waiting any longer would therefore ultimately be for my sake, not for theirs. How much more could I ask of them? Ultimately you cannot avoid death; but often it is possible to avoid suffering. Once I began to look at it from the perspective of what was right for them and what would spare them pain, it was still by no means an easy decision, but I did at least feel it was inevitable, because I simply could not stand by and watch them suffer when it was within my power to prevent that. By not acting, I would not be prolonging their lives, I would be prolonging their deaths”

      Written by Helen, Tanya and Thomas’ Mom
      “Tanya’s Comprehensive Guide to Chronic Renal Failure’

      You are in my thoughts and prayers

  5. December 1, 2011 3:01 am

    I had to put my Roo to rest two days ago but I can’t tell you exactly why because we don’t know. What I do know is that I rescued Roo 4 years ago, He was owned by an elderly lady who fell down one night while feeding Roo and she later died from her injuries. The daughter of the elderly lady blamed Roo for her moms death and kicked Roo out and never thought about him again. The neighborhood kept him alive for two years but barely. By the time I met Roo he had was severely malnourished, he had sever pharyngitis, an enlarged kidney, stomatitis and 4 teeth left in his mouth. Euthanasia was recommended at that time but I couldn’t give up on him so I found a vet that thought Roo was worth the effort too. We have had 4 years together and they have been good years despite a few problems now and again but nothing we couldn’t handle, his health exams every six months were all good but we knew at some point we would be pulling his remaining teeth if they troubled him anymore but they didn’t for a while. He was a happy, spoiled and was an adored member of this family.
    Two months ago I noticed that Roo’s right eye didn’t look right, the third lid was showing but worse, the pupil in just that eye was enlarged. I took him in immediately, his vet thought it was caused by an abscess from his teeth and it was decided to extract his remaining teeth and check for any fragments left behind from the other other teeth he had lost. She gave him a shot of Convenia and we made an appointment for surgery. We did a pre surgery blood screen and his blood work was perfect. The surgery went ok but she said he bled a lot. I brought him home, he was still bleeding but I kept a close eye on him. It was sad, he looked pathetic but I knew it was for the best so I just did what I do and I cared for him the best I could, he had pain meds and they helped a great deal. A couple of days later he began to move around more but he looked disoriented his eye was still dilated and the third lid was still showing and when he would walk he was running into things, I immediately took him back in to the vet, Roo was blind.
    Ok, I figured, a blind cat so what, we can handle blind, I already have two deaf cats that were born that way and now I would just have a blind one too. At this point his vet was a bit concerned, she put him on antibiotics in case of infection and also a steroid for inflammation. A week later he started sneezing and drooling badly, he was managing being blind and I was very proud of him, but he didn’t feel well, I took his temp and it was 106, so back to the vet. She said it looked like the calici virus which made sense I thought. She put him on a long term antibiotic, Clavamox, sent me home with three boxes and erythromycin for his eyes which were both showing the third lid by this time. Another week into this and Roo stopped eating, Roo never stopped eating before not even after the extraction he loved to eat but he stopped. No water either. So off to the store I go for baby food and I began feeding him with a syringe and water this way too. He looked so thin going from 11 1/2 pounds when this began to 8 pounds two days ago. I had been feeding him with a syringe for almost two weeks and each day he just looked worse. Roo, despite his horrible past was a loving animal, so affectionate, he had such a will to live, he never complained and he always seemed grateful just to be here, even when he didn’t feel well. But something had changed during these last days, at some point during his last week on this earth he lost his will to be here. Two days ago when I woke up that morning, Roo just looked defeated and it broke my heart, I tried to feed him and give him water but he didn’t want water or the food he just wanted it to stop. Up until that point he would eat the food I would put in his mouth but 2 days ago he wouldn’t even try and when it did go down his throat made a weird sound that I cannot really explain. Both of his eyes looked really sunken and I just couldn’t do it to him anymore despite the fact that I was making an appointment with an ophthalmologist for next week, I just couldn’t ask him for any more. I called his vet and told her this is it and she said to come in and she gave him a shot and he died in my arms.
    Maybe I should have waited to find out more I don’t know, his vet agreed with me that he looked ready to go but I am questioning my decision just as I have any time I have had to make this decision before. I miss him so much it is making my tummy hurt . I wish I would have known what was wrong with him but the fact is I don’t, all I know is that he had given up and I couldn’t ask him to endure anymore. I just wish my heart didn’t hurt so much.

    • December 1, 2011 7:40 am

      Jennifer – in your situation I would have done exactly what you had to do. You did the right thing for Roo. I wish I had words to ease your pain, but I know from bitter personal exerience there are none. Take care of yourself. Blessings and Love

      • December 2, 2011 4:17 am

        Thank you…really.
        I keep going over everything in my mind, everything I did, didn’t do, should have done, it’s crazy. Your reply helps a great deal, so thanks for taking the time.

    • December 2, 2011 1:37 pm

      Jennifer, your story about Roo is heartrending, as so many are, and I’ve been there more times than I care to count. I think it’s in our nature to question ourselves over and over and of course that’s the problem with euthanasia. It’s both a blessing and a curse to have the power to make that kind of decision for a loved one who can’t really speak for themselves. You loved him so much that you couldn’t allow him to suffer any longer and from what your wrote about your experience, I think it was very clear that he was ready. As sad as it was for you to let him go, it was the right thing to do.

      • December 2, 2011 10:14 pm

        I wish you knew how comforting your words are to me right now….

        I wanted so badly for Roo to get better but I guess it just wasn’t meant to be. I sure do miss his cuddles and his sweet little face, this is tough.

        I know at some point my grief will grow into acceptance and I will have many many memories to smile about, but right now…I am not smiling much, just missing my Roo.

        Thank you so much for your reply, it helps to know that others come to the same conclusion as I did. I wasn’t sure if people would think it was wrong since I didn’t even get to find out what was really wrong with him. That part has bothered me a little but not as much as seeing him so unhappy, so tired.

        It is such a difficult decision to make and it does at times feel like a curse but when you are watching someone you deeply love suffer, it makes you appreciate having that option available.

        Roo’s vet is a saint in my eyes because she made it all better for him, I will be forever grateful.

    • Andrea permalink
      February 6, 2012 11:40 am

      My Heart is with you. I know the pain you are feeling, you gave him so much love. I am watching my beautiful cupcake go through the ever increasing pain of squamous cell carcinoma of the jaw. I love him so much, I did not know that love can be this deep, as you feel for Roo.

      God Bless you and Roo. You did everything you could to make his life wonderful and you were there for him and he knew it. You were Best Friends. Nothing in this life is better than that relationship.

  6. November 7, 2010 1:19 am

    Doc Truli,

    Thank you for your thoughtful and insightful answer from both a medical as well as an emotional point of view. One of your statements brought up an interesting question in my mind. I do know that cats can be anxious, scared, and I’ve often thought on occasion that one of my cats was a little “down” for one reason or another. However do beings that live in the present experience emotional depression? In general, to be depressed, one has to be thinking about the past, the future, or how ones current circumstances are a result of the past or will affect the future. I agree that making sure your pet is in no pain is paramount, much as we do for our human family members. However, when a human patient is sent to hospice it essentially means that all support is removed with the exception of pain medication as needed. If the patient can’t or won’t drink or eat, these are not provided for them in the way of tubes, force-feeding and what have you. I do object to keeping an animal going with these measures and putting the family through this trauma unless there is better than a reasonable chance of recovery. I do understand the concept of unexpected recoveries or miracles, but with pets, unlike with people, we still have the freedom to say at what price? And by that I don’t mean purely monetarily. Is the family up to the possible on-going nursing care involved for a pet. Some are and do it gladly, but others are not, but do not know how to say I would rather help her cross the bridge. The guilt involved in this decision is overwhelming.

    The guilt involved in pet medical care actually begins much earlier than end of life issues. If you love your pet, you are urged to purchase wellness programs, pay for yearly fecal exams, blood screens, vaccines, dentals, etc. How much of this really IS essential to the ongoing health of your cat. How does the average person decide?

    • November 7, 2010 10:44 pm

      Good points!
      1. Depression- Can animals “suffer” in the Buddhist sense of the term? I don’t know. Depression, I say yes. Here’s how I know they don’t only “live in the moment” as you’ve described. First of all, they have memory. So that’s bringing other times on a timeline into the present. So I think reflection and memory and opinions about those experiences are there for our pets. I knew a family with 2 12-year-old Shih Tzus. One grew ill and passed away. The other one was quiet, did not play, lost weight from decreased eating, and stared at the wall part of every day for 2 months. Then she gradually shook herself out of it and acted normal. After 6 months, they visited their vacation home on the West coast of Florida. They had not been there as a family since before the companion Shih Tzu’s passing. Her friend perked up in the driveway, rushed through the front door, barking, and sniffing, and looking everywhere in that house, looking for her friend. Like she thought,”Oh! This is where my friend has been all this time!” Just like a person with wishful thinking. She was bummed, but not deeply changed after that day.

      I had a poodle patient that belonged to a clinical psychiatrist. Dog housemate passed away, poodle sat in coat closet facing wall day after day. We checked everything physical with laboratory tests, etc. Finally, mom said, “Could she be depressed?” So we tried a little elavil. Better in 3 days. Weaned off in 2 weeks. Hmmm….

      Depressed from illness? I think of it as a physical and mental fog, a physiologic depression. I do not know if a cat is regretting life or sad about the end — I doubt it — cats don;t seem very regretful. But depressed in a sluggish, dull, non focussed, not interacting with you or the environment, yes. And that can be treated, or addressed, with physical and pharmacological intervention (sunshine, walks, massages, etc.)

      2. Regarding the pawspice care nursing. Some people do certainly believe it is unethical to syringe or tube feed an animal that has a terminal diagnosis and does not relish the treatment. At the University of Pennsylvania School of Veterinary Medicine Ryan Teaching Hospital, it is part of the nurses’ contract that they may refuse to “force feed” a patient with no adverse effect to their career. It’s a personal decision. Perhaps with a better cultural understanding and less fear or sadness about death, we could know how to treat our cats to a good death, and not stumble around so much wondering if what we are doing is right or not.

      3. Guilt? I don’t think it’s guilt. Uncertainty. Just not knowing what is right…Go with your gut. Or you could say, do what spirit tells you. Or, if you pray, follow the advice that you hear in response to your prayers. Whatever way you connect, the guilt enters if you listen to humans and society and go against your instinct, your personal belief, your spiritual knowledge. Do you feel what I’m saying?

      4. The pet medical care guilt. Do you mean, wanting to do everything the doctors say is right and good, but either financially saying no, or your cat says no by refusing treatment? Your veterinarian should answer your questions about the pros and cons of each recommendation. The potential benefits, and the detriments of not checking things. With enough questions and answers and medical coaching, the course of action that is perfect for you merges like a glowing path in your mind. Doubt falls away with open communication. Find a veterinarian you can see and talk to in this way. Even a super educated and empathetic nurse can coach you through these decisions so you feel no guilt or remorse. (Yes, it can be that pleasant to go to the vet’s!)

      I hope VirtuaVet continues to help you. I’m going to ponder your discussion more, because, as you know, everybody has these worries and concerns and I write these stories to help alleviate the layer of guilt and uncertainty.

      Doc Truli

      • November 7, 2010 11:22 pm

        Yes! I have heard many stories of pets missing an animal or human companion. That certainly would be depression. VirtuaVet is fabulous for addressing these issues. I’ve been reading some or your resources listed with a great deal of interest – i.e. pet law, and The Center for Human Interactions …

      • November 9, 2010 12:49 pm

        I had planned to drop this discussion as it is such an emotional one. Also I felt (feel) that I may be coming from an entirely different background and point of view having grown up in a farming community in the early 50’s. Still I’ve come a long way in the evolution of my thinking in regards to my beloved pets. But I could not get this one statement out of my mind from your last post: “At the University of Pennsylvania School of Veterinary Medicine Ryan Teaching Hospital, it is part of the nurses’ contract that they may refuse to “force feed” a patient with no adverse effect to their career.” Pawspice is a totally new concept to me. In fact the first time I heard the term was on your blog recently. The fact that a Veterinary school is treating terminally ill animal patients with ‘fore feed” methods indicates to me a horrendously wrong turn in the direction we are taking in medical care for our pets. I’m relieved to read on second review or your post that that I’m not the only one who finds this unethical.

        I think this adds a little more clarity to my statement concerning the “guilt” I mentioned and that you rightfully questioned. Yes, I did mean that the pet owner finds it difficult to go against the veterinarian’s recommendations in regards to these matters and feels a lot of pressure and guilt as a result. It’s also easy to get caught up in the machinations of the veterinarian’s attempt to ‘help’ the animal and in hindsight realize that you’ve subjected the poor animal to needless torture it is incapable of understanding. I’ve been there a number of times — wanting relief for my pet and in essence ending up with excessive and unnecessary testing and life saving measures.

        I SO envy you the perfect action that merges like a glowing path in your mind. In 60+ years it has never merged for me and I don’t expect that it ever will. I know that there is no easy solution to these weighty ethical and emotional issues. If we haven’t solved them for ourselves, how can we expect to solve them for our pets? However, I do hope that the veterinary medical community will take stock of the trends and try not to bring our pets into the same cloudy miasma that we find ourselves.

      • November 9, 2010 9:48 pm

        Hi Molly,
        Thank you so much for your contributions. Most likely, you have already helped someone who is reading and not ready to comment.
        If I was unclear about the term “force feeding,” I meant syringe-feeding or tube-feeding, where a red rubber feeding tube is inserted down the patent’s throat. It takes about 3 seconds, and while scary, it is fast. Some people consider a pet that does not want to eat, and has an imminently terminal illness, to be “telling us” something. Other people wish to keep doing whatever they can to keep the animal going.

        We can use our sense of compassion, and realize the cat or dog that is terminal, in pain, and beyond recovery, may not wish to be disturbed by eating!

        Anyone reading this should distinguish terminal illness from other illnesses. Cats and dogs can live happy, full lives with low-profile feeding tubes installed through their sides straight into the stomach! The tubes do not get infected, they do not hurt, and a pet who cannot eat enough maybe saved with this procedure. For instance, my friend’s dog developed an esophageal stricture after vomiting a lot from eating shoe leather. The stricture is a band of scar tissue that only lets liquid down her throat. Other than regurgitating all food, she’s happy! The solution when the stricture repair did not work (after 5 tries?), a low-profile “PEG” feeding system. It’s been two years, and she’s a wonderful, sweet, happy little dog. Anyone who sees her falls in love with her.

        So, by force feeding, I do not mean fois gras-style stuffing. If someone has reached the end of their life, food is not necessarily the most basic love and care that they need!

        (BTW–I grew up across from a dairy farm in rural Northeast PA in the 70’s. My parents never took the pets to the vet–they still don’t. I think my upbringing gives me perspective lacking in textbooks.)

        Molly, I wish you well. Thank yo so much for your input in this interesting and challenging discussion.

        -Doc Truli

  7. November 3, 2010 1:14 pm

    I couldn’t find a date on this invitation, but it’s a subject that I’m intensely interested in. How far DO we want to go in medical care for our pets? Do we want to carry it as far as we have for humans? Personally I don’t. Case history: 17 year old female Himalayan who had been relatively healthy throughout her life except for intestinal lymphoma at the age of 11 for which she had surgery and complete recovery. Blood test apprx. 3 months prior to the time in question showed that she was borderline kidney failure. She subsequently began to exhibit signs — excessive drinking, frequent urination, etc. At that time she also developed a corneal ulcer in her left eye which did not respond to treatment and we were hustled to a specialist who said the eye needed grafting or removing. He recommended grafting. When asked if he would do this on his own cat, considering age and compromised kidneys he responded “yes.” He also discovered an ulcer developing in the right eye. She underwent surgery, and we began treatment for both eyes. On first followup exam, surgery went well, and right eye had improved. Second follow up exam – surgery still good, but ulcer was back in right eye and he said we might have to consider surgery on it as well. At that point I decided that one more follow up visit was all she would get so that I could get the medications she needed for both eyes and the stitches removed from the graft. I didn’t want to subject her to the 45 minute drive each way and I certainly wasn’t going so subject her to another surgery…. that’s another $3000 in my area plus follow office visits and meds at about$300 each time. I have the money set aside for this, and though expense is always an issue it was not THE issue in this case. I planned to transfer any subsequent care to my local vet, knowing that they would not be happy with this decision. You might ask why some of us wait so long to bring in a cat? Pain in any of my cats worries me greatly, and yet I am in terror of bringing in a cat that needs relief and being thrown into the medical blender of testing and aggressive procedures. Let’s step back and take a moment. Just ONE moment, to ask if it’s warranted. Fifteen years ago, or even ten, the vet would have explained to me all that this might involve for my elderly kitty. I’m relatively well versed in feline health and I still managed to be sucked into this maelstrom of medical care. As loving pet owners we feel such guilt at not giving our pet every opportunity to live one more day, but at what expense in pain and suffering to the pet as well as ourselves. I cringe when I hear of anyone schlepping a failing older animal back and forth to the vet for continuing medical intervention. I know everyone is different as is every pet and every vet, but in my case I would be thinking each time: “please Mr./Ms. Vet help me decide to let this poor old soul go. Josephine was my Himalayan’s name and I had her euthanized about this time last year after eye surgery, 2 months of vet visits and me torturing the poor old thing with my nursing. Her eyes were actually holding their own for the time being, but she had become incontinent, stopped eating, and was clearly miserable. I had to make the decision on may own which is as it should be, I suppose, but I miss the days when the vets felt more inclined to help in this difficult time.

    • November 4, 2010 10:11 am

      Dear Molly,
      Please accept my condolences on Josephine’s passing. She must have been a light in your life, as my HImalayan Buster (VirtuaCat) is for me.

      The invitation is timeless. You raise essential points about what makes up life and our role in it as the guardians of our cats and the gatekeepers to the car and the animal hospital.

      An essential ability and sense is the perception and evaluation of the “will to live,” or the “spunk” or the essential energy of our animal companions. Many people have lost the ability and the personal confidence to “know” when the life force is gone or almost gone. It must be separated from the detection of pain (which is often temporary), or the haze of emotional depression (rarely even talked about in our pets.) If we felt we could perceive the vital force left, through the vigor of response, the shine and directness of the gaze, the interest and reaching out for life, we would better know what course of treatments and hospice care were fair and reasonable, and what constitute futile cat wrangling and compromise for no good reason.

      Depression and pain can make our cat turn inward, not seek company, not look around. Dehydration makes the body feel light and brittle, like a dried tree branch.

      I propose, doctors address dehydration, pain, and depression. Give it a reasonable amount of time, maybe a week. Maybe two. If the dull, lackluster, dim look and feel remains, the vital energy is almost done. It is time. I’ll bet Josephine was just not responding to the kidney treatments. And the corneal ulcers were another sign of the lack of basic integrity left in her bodily systems; they were trying to fall apart before your eyes.

      So, it should not be a question of age. I’ve done massive surgery on several 20 year-old-cats that went on to good quality life for 3 years more! It should not be a question of modern medicine, which deals with the probabilities and statistical normals for research data from groups of cats.

      Really, isn’t the “chance,” “unusual,” “miracle” what we all hope for our own families? And yet our allopathic medical system gives us group data and historical odds. So we’re hoping we’re the exception and our decision-making is supposed to be based upon the 95% confidence interval; of a standard deviation mathematical calculation applied to incomplete historical medical records and single-variable closed-system restricted medical research studies.

      I believe life is non-linear, and the chances of miracles and far-fetched pleasant surprises far, far higher than any science predicts. Heck, that’s a big reason I started writing these stories, to counter the flood of “data” that tells us to stop hoping and praying and believing in ourselves and our families, especially our animal friends.

      Perhaps old-time docs still felt confident in their ability to detect the strength and will of the cat and let us, the emotional, bereft pet parents know what they felt in a semi-objective way. As a doctor, I try to give my clients this perspective on their loved ones. Admittedly, it had little to do with science and medicine, but everything to do with healing.

      What do you think?
      -Doc Truli

      • November 30, 2011 6:07 am

        What you have said here is absolutely correct and spot on – and since the dental drama with my cat (details in that section of your blog), I am more adamant than ever that you do not throw in the towel on an animal because they have exceeded their normal lifespan and have some health issues.
        As an aside, absolutely no to chemo, yes to extractions and amputations, declawing I disapprove of except perhaps in the example you mention, absolutely spay and neuter your pet.
        A sick, suffering animal who has lost the will to live – yes to euthanasia – but if that animal, regardless of age, still has some of that life force, you have to fight for and with them. My preference would be for them to pass naturally – so long as they are not in real suffering.
        When my pets finally go, as they must, I want to know in my bones I have done everything I possibly could while they were alive.

    • Judith permalink
      May 17, 2016 3:37 pm

      Molly, your words are such wisdom for me, as I face the end-of-life decisions with my kitty.


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