I have recently begun a new and exciting chapter in my veterinary career after almost 11 years of being a veterinarian. The area of my field that I have decided to pursue is a small but growing segment of veterinary medicine, end of life care and euthanasia. I have chosen to focus on providing an intimate in-home euthanasia rather than in a typical hospital or clinic setting which is what most of us are familiar with.
Many of my friends and colleagues have asked me why I have made a choice to pursue this small portion of what veterinary medicine is. After all, my job as a veterinarian is to keep animals healthy, right? The Hippocratic Oath states that we are to do no harm to our patients and we do take this seriously. In veterinary school we spend almost the entire four years of our study meticulously learning organ systems, anatomy, pathophysiology of disease, medication/pharmacology, progression and treatment of diseases, surgery, anesthesia, etc. In other words, we learn how to SAVE animals and after all, that is why many of us became veterinarians.
Where does euthanasia fit into that picture? I actually can’t specifically remember being taught how to euthanize an animal during veterinary school (most of this is picked up by your first job and mentoring of other doctors) or issues surrounding euthanasia other than that it is sometimes inevitable.
As a veterinarian we often start to consider a patient that we lose as a personal loss, a failure. Maybe if we had treated sooner or more aggressively we could have gotten more time for that pet or maybe we could have cured their disease? Maybe if we had been better at communicating treatment options to the owner they would have allowed us to treat sooner or provide the care that was needed? Maybe if we had referred to a specialist they would have been able to come up with a magic cure? These are the types of questions that often plague veterinarians when they have to euthanize a patient. Euthanasias can also be emotionally and psychologically draining to veterinarians and indeed may be part of the reason that those in our profession are prone to depression and burnout.
So, the question is valid. Why would I subject myself to one of the most emotionally draining and difficult parts of my profession? The answer is...because I believe we can provide a better euthanasia, a better death for our beloved pets, our faithful friends.
About 6 years ago I went through a life-changing event. This was the loss of my father. He was very ill for several months and eventually died in hospice care at home. In the course of his illness we dealt with dozens of physicians in the emergency rooms and hospitals. Even though his prognosis was pretty clearly terminal it was difficult to find a doctor who was able to freely discuss that he was dying and to help deal with the care he needed for the end of his life. I feel that veterinarians, and (likely) physicians, as well, are not taught how to help people deal with death very well.
Once I had recovered from my initial grief at the loss of my Dad I realized that looking back on his final days had taught me something really important about dying. There are many ways to help improve the quality of the end of life as well as the quality of the death. I know this sounds strange. Quality of life is a topic most people are familiar with and makes sense. We understand that things like pain, inability to eat, difficulty breathing, difficulty moving around can contribute to a poor quality of life. However, what is a poor quality of death? I feel that a death that is prolonged to allow more suffering (without adequate treatment to control those symptoms) or that allows for more stress at the time of death would be a poor quality death.
There has been a movement of increased awareness of palliative and hospice care within human medicine and now the trend is continuing in veterinary medicine. It is not new but is small and growing. Currently there is the International Association for Animal Hospice and Palliative Care (IAAHPC) that provides information to veterinarians and owners. They also have conferences yearly to discuss current ongoing changes and protocols for end-of-life care.
The American Veterinary Medical Association (AVMA) has also published specific guidelines for veterinary hospice care. I am excited about this trend. I think it represents an opening to allow us as veterinarians to discuss end-of-life care more openly with owners and to help us think differently about death with our patients.
End of life and ultimately euthanasia of a pet can afford a valuable opportunity to a veterinarian to provide a passing that is peaceful, non-stressful, and comfortable. As a veterinarian this is the type of passing I would want for my own beloved pets. I think that our obligation to our patients to do no harm should include allowing them to die without pain, Ideally surrounded by their family in their home. This should not ever be considered a failure.
So, after months of planning and research… I am proud to announce that Faithful Friend is now officially open. Please check out our website and facebook page. If you want to e-mail Dr. Sarah click below ...
- Dr. Sarah Whitley, DVM