Putting a pet down and end-of-life care decisions

Two things about this post before I go on:
1) It may be a bit heavy for the holidays, and
2) I promise that the two things in the title are related.

I have 15-year-old Siberian Husky that's had its fair share of health problems: diabetes, cataract surgery, liver cancer, debilitating arthritis...you get the point. She's old. My mom refuses to put her down. Like, we have made appointments with the vet and at the last minute she'll change her mind and not allow us to take the dog.

My dog in old, but better, years.

But the thing is, the dog needs to go and I say this in the most compassionate and sorrowful way I can convey over the internet. She can't stand for more than a minute. She has trouble standing up at all and makes it about 4 steps on average before falling over (not sitting down...I literally mean falling over, often onto her side). We have to hold her up so she can pee and often she soils herself before we can get her outside. In short, it's her time to go. And I wholeheartedly believe that we'd be doing the right thing by putting her down. Mom thinks the opposite and refuses to budge.

How does this relate to medicine and more importantly, human medicine? Well, it seems to me that the feelings toward extending someone's or something's life are reversed here as compared to how these decisions are regularly made.

I have been in healthcare for a while and I've seen relatives insist on keeping their elderly parent alive at all costs even when the patient's quality of life is non-existent. Usually these relatives are detached from direct care of the patient either due to distance or lack of relationship, and simply cannot bear the thought of losing the patient because they "want more time."

Usually this request to keep the patient alive is due to their guilt about not spending enough time with their loved ones in the years leading up to the illness, and thus they feel like they need to extend the parent's life as long as possible to squeeze in the time they've missed.

On the other hand, the caretakers and/or the family members who see the patient on a regular basis watch the suffering and decline of their loved one and thus are better able to come to terms with the end of their parent's life. In fact, in some cases death is seen as a relief and a thing that some people wish upon their loved one simply to end their suffering.

All of this is a gross oversimplification of an abundance of end-of-life issues and this scenario is not always the case, obviously. But if a trend can be attached to this stage of one's life, then this would be it.

However, it seems that the roles are reversed in my family. My mom, who does nearly all of the care-taking, insists on keeping my dog alive until she dies on her own (not happening any time soon, from what I can tell) even if that means she lives a miserable existence until then. On the other hand, my brother and I, who both live several states away and rarely see the dog these days, are completely okay with putting her down.

This does not mean we want to get rid of her by any means. I wish she could live forever, but unfortunately at this point in her life she has absolutely no quality of life, seems to suffer through her days, and gets no joy out of anything that happens around her. In the several weeks I've spent with her between October and today, I haven't seen her wag her tail once or show any interest in the delicious meaty dishes we cook up every day. She used to run/meander to the kitchen from the front yard as recently as June, so this is totally out of character and a good indication of the loss of her personality.

I know that putting a pet down does not compare to saying goodbye to a mother or a father, or any human member of one's family. But this dog situation and the family dynamics surrounding it have got me thinking about the human aspect of these issues.

I am a huge proponent of ceasing medical interventions at the request of the patient at a certain point in their care and letting them die with dignity and on their own terms when it becomes clear that they are terminally ill (which translates to putting a pet down in the animal world). This does not mean I advocate euthanasia but I definitely think hospice has a great role to play in patient care and it needs to be considered as an option more often than it is currently.

This situation has also started a discussion within my family about what we want others to do for us when we reach that point in our lives. That, and writing about it all helps take away some of the anger and helplessness I feel about watching my dog suffer unnecessarily.

Lastly, there are more complicated issues surrounding my mom's resistance to putting my dog down than what I have included here. I don't agree with them, but they exist. Regardless, I don't want this to become a discussion (between my three readers and me) about my mom's decisions or what we should do in this situation. We've discussed it ad nauseum and I really don't want to hear about it anymore.

Other than that, discuss away and happy holidays!

Dirty camping dog, at age 13.