February 17, 2007

Euthanasia: Can you live with it?

Me Imperturbe

Walt Whitman (1819–1892). Leaves of Grass. 1900

ME imperturbe, standing at ease in Nature,
Master of all, or mistress of all—aplomb in the midst of irrational things,
Imbued as they—passive, receptive, silent as they,
Finding my occupation, poverty, notoriety, foibles, crimes, less important than I thought;
Me private, or public, or menial, or solitary—all these subordinate, (I am eternally equal with the best—I am not subordinate;)
Me toward the Mexican Sea, or in the Mannahatta, or the Tennessee, or far north, or inland,
A river man, or a man of the woods, or of any farm-life in These States, or of the coast, or the lakes, or Kanada,
Me, wherever my life is lived, O to be self-balanced for contingencies!
O to confront night, storms, hunger, ridicule, accidents, rebuffs, as the trees and animals do.


Along with its moral dilemma, euthanasia brings with it a number of practical considerations. Who will provide this service? Where will it be done? How much will it cost? How will the corpse be disposed? Will I be present? When is it time?

Since I'd gone through this once before, I wanted in-home euthanasia. It's private, less stressful for everyone and can be peaceful. Also, knowing how Aimee hated car travel, and how freaked out she became when going to the vet for a routine, I didn't want her last hour to be full of fear, panic and drama.

In preparation for her inevitable passing, I compiled a list of vets to call. I just procrastinated doing the legwork out of discomfort.

What questions do you ask? Is it crass to ask how much it costs? Am I going to get a lot of grief about my decision to let her disease progress without treatment? Ironically, I anticipated every possible question except, "is she current on shots?"(Actually only one vet asked this to provide an excuse to use the anesthesia box instead of an IV.)

So when the time came, there I was with this very sick cat, a moral dilemma, all that unresolved guilt and shame and I'm calling all over Kingdom Come for a mobile vet. When that proved impossible, I called for any vet I could get.

Because the ice storm shut so much down, I contacted the entire list. I asked about their availability for in-home euthanasia, the procedure, the costs and the methods as well as the options for handling the corpse.

What an eye-opening experience. Why is wanting the best for your cat a license to steal?

Mobile vets who answered their phones wanted from $180 to $240 for a routine procedure plus a trip charge and an additional fee for handling the remains. I understand the trip charge. Why would a mobile vet with far less overhead charge more for a routine procedure than a vet with a complete clinic?

And the costs and crapola around disposal of the remains ranks right up there with funeral home excesses exposed in "The American Way of Death" by Jessica Mitford 20 years ago.

There were lots of choices: 1) let the vet dispose of the corpse as medical waste: $25; 2) dispose of the corpse in a "mass cremation": $80; 3) private cremation and get the ashes back: $200; or 4) bury your pet in a cemetery; 5) bring your pet home and bury it yourself.

I was so disinterested in cemetery burial I didn't even inquire about the costs. Even cremation offered many choices of caskets, urns, headstones, memorials, etc., etc., etc. So one can "dignify the death of a pet, i.e, assuage one's guilt and/or grief to the maximum of Mastercard.

*Tsk*

First veterinarians soak you for unnecessary vaccinations, making your companion ill in the process. Then they play to your willingness to do anything to keep your pet alive for as long as possible, at any expense. And gouge you again at the end of life when your grief makes you most vulnerable.

Yes, I am guilty of not loving my cat enough to fight for her life. Some of the veterinarians I've encountered have no shame.

In the last 12 months, I have lost my respect for this profession. This makes the life or death decision about our beloved pets even more wrenching.

All I can say is prepare yourself; the information is out there.

It is perhaps easier to think through what you want, and assure that you get it, if you do the homework and legwork in advance. Clearly it would have been easier on me to have a working relationship with a vet who was compassionate, enlightened and flexible. That is not to say that things would have unfolded differently.

Who knew that Aimee would become deathly ill at the peak of an unprecedented ice storm?

I did my best with what the moment provided.

How did I "know it was time?" Some things were pretty obvious.

Aimee wasn't eating or drinking. She shifted from flooding the litter pan with urine to not peeing at all. Her last bowel movement was a viscous mass. She walked only a few steps, then rested, barely able to hold up her head. And she was vomiting this very foul-smelling fluid for two days. All signs to me of diabetic nephropathy - renal failure concomitant to unregulated diabetes.

The criteria for a pet's basic needs is universally recorded. These guidelines can be used as a benchmark in deciding your pet's well being. Even when health conditions do not meet some of these standards, euthanasia may not be appropriate. Each case for euthanasia should be judged on its own merits. Moreover, consulting a vet you trust beforehand is paramount to making a decision you can live with. As the guardian you also know your pet better than anyone.

  • Freedom from uncontrollable pain, distress and discomfort.

  • Ability to walk and balance.

  • Ability to eat and drink without pain and vomiting.

  • Freedom from painful, inoperable tumors.

  • Ability to breathe freely and without difficulty.

  • Ability to hold up head when at rest.

  • Ability to urinate and defecate without difficulty or incontinence.

  • Ability to see and hear.

  • Ability to enjoy food.

  • Responsive to owner and family.

  • Not suffering from repeated vomiting and/or convulsions.

By these criteria and my standards, it was time.

Before we left the house, I told Aimee what I was doing and why. I apologized for all the ways I may have caused her chronic illness - the vaccinations, the flea preventatives, the grain based food. I couldn't know what I didn't know. I told her she was dying and this measure would prevent her from going to worse pain than she already experienced. I would be with her until she went to sleep. It would not hurt. This was the best I could do given the circumstances.

She looked directly into my eyes and squenched her eyes in a cat kiss.

She did not resist the carrier or anything else. Also, I am extremely grateful for this, Aimee stayed calm and quiet for the entire ride - the one and only time to do so in her little life. (Which told me how sick she really was.)

After all was done, we decided to bring her home and bury her in a flower bed behind the house. I feel better about that than sending her away to a "communal cremation."

Because I had the unhappy accident of shopping for euthanasia services at the end of Aimee's life, I got a little more insight than the average "consumer."

The blue paper "shroud" one veterinarian offered as a benefit in her premium service is an ordinary part of in-office euthanasia services, nothing special about it. It's just one step above tossing carcasses out like used tissue. Private cremation for an animal under 35 pounds is available for as little as $35, though costs vary. You can arrange this direct with a service, or have your vet handle for you. But beware the vet markup; it can be steep.

Aimee's in-office euthansia at Caring Hands Animal Clinic cost $78; of this $28 went toward a painkiller that made her more alert rather than sleepy. She was looking around with avid interest, because she literally "felt no pain."

This is not how I wanted to let her go. When we buried her, no comforting breeze swept through me. And not being present for Aimee's last breath, I have this creepy feeling that I buried her alive. At least I was right about one thing. It didn't hurt.

I feel guilty and disappointed in myself. I made intellectual decisions without emotional integrity. I'll give more thought to how I will feel about my choices the next time.

On the other hand, if I want absolution, I can always consult with a pet psychic who will contact Aimee's spirit to assure me that she is happy and that she forgives me. There is a small fee, of course.

Further reading:

Feline diabetes mellitus: a retrospective mortality study of 55 cats (1982-1994).

Preparing for the Euthanasia Decision for Your Cat

In Home Euthanasia

Dialogues with the Departed

Pet Ghosts: Animal Encounters from Beyond the Grave

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