I saw a patient last month that came in after she collapsed on her walk. Her mom had to carry her into the hospital and was in a panic because she thought she was dying. Let me back up and let you know why she thought this. You see, my patient was diagnosed with a bone tumor in her pelvis a couple of months ago. She was doing well and we were managing the pain with medications. But there were not a lot of great options to treat this tumor due to the location. So when she collapsed on her walk, of course, her mom thought she was dying. And here is why always performing a thorough physical exam is necessary for all patients. Because it would have also been easy for me to believe that since she has bone cancer, it probably metastasized to the lungs and that is why she collapsed. However, after the physical exam, I found that she had a heart arrhythmia and was in heart failure. This is where the tough decisions come in and we have to listen to our pets to try to understand what is best for them. I thought I could help her by getting the fluid out of her lungs and putting her on medication to get her heart back into rhythm. I had to put her on 3 medications which are expensive every month and don’t forget, she still has that tumor in her pelvis. So her parents had to decide. Euthanize her that day or start treatment, all the while knowing that her tumor will become a big problem for her sooner than later. So I asked them, ‘Before she collapsed, was she a happy dog? Were her day to day activities relatively normal? Did she still have a will to live?’ Her mom and dad looked at each other and with tears in their eyes, they said yes. She overall was doing okay and even though things were changing due to her bone tumor, she was still a happy dog. She wasn’t letting that tumor get her down. She wanted to live. So we decided to treat the heart condition.
One week later, this dog bounded into the hospital for her recheck EKG and was doing great. Her mom again had tears in her eyes when she thanked me for helping her dog and said that if they only had her for another few months, she was so happy to get those months with her.
This interaction made me think about two personal stories of my own. My grandmother collapsed when she was 90 years old and we found out she had a heart arrhythmia and needed a pacemaker. She was otherwise very healthy for her age, still lived on her own, and was taking minimal medications. However, it was difficult to find a doctor to perform this procedure strictly because my grandmother was old. We eventually got her a pacemaker and she went on to live another 11 years. She was able to see another 5 great-grandchildren be born! You see, you shouldn’t not do a test or not do a procedure on your pet just because of age. You have to look at all the other factors affecting your pet’s quality of life. And you have to listen to them! Do they still have a will to live?
I also had to personally make a very hard decision for my own dog Tyler. She was diagnosed with a brain tumor at age 11. Surgery was an option to try and remove the tumor but putting your dog through brain surgery is no easy decision! Plus she had mildly elevated liver values and arthritis in her hip. I agonized over this decision and since finances were not the deciding factor, I had to base my decision on what I thought was best for her. And after weeks of thinking of all the options and really listening to my dog, I decided to go through with the surgery. She ended up living another 18 months and that time with her was invaluable. People told me I was crazy that I was having my old dog undergo brain surgery, but I knew she was not ready to die.
Even us veterinarians agonize over what is best for our own pets. Medical knowledge does not make our decisions to run tests or perform procedures on our elderly pets any easier. It can be very hard to care for aging animals and even harder to know how much to put them through or when to let them go. So ask your pet what they want. I promise you, if you really listen, they will answer you.
Dr. Carrie Uehlein