Making the decision to let your pet pass can be one of the most difficult decisions that you face.
It is a decision that should be shared between yourself and your pet’s clinician. Your veterinarian is well placed to guide you and ease the burden. It should never feel like it is your responsibility ‘to know’ and yours alone.
To help you it can be useful to start considering your companion’s quality of life at this moment in time.
Your family unit needs to be considered too. Your quality of life and that of your family is equally important as you care for your ageing friend. Affordability, time available to dedicate to, physical ability of carers and their emotional reserves all need to be factored in. Caregiver burden can be immense.
We are seeing an increasing number of Quality of Life assessment tools becoming available to us. Some are still heavily biased towards your pet’s physical wellbeing with little attention paid to patient preference or weighting of parameters, an example being the widely used Dr. Alice Villalobos seven parameter HHHHHMM scale. GUVQuest, a 109 item questionnaire developed at the University of Glasgow, has proven far more statistically sound but its use in practice depends on the services of a proprietary vendor newmetrica.com/vetmetrica-hrql
But your pet can still have a good quality of life even with ongoing health issues, however hard this can sometimes be for owners to see as they struggle with the anticipatory grief of a bombshell diagnosis for their pet or worsening signs of chronic disease. Quality of life should not be purely focussed on the physical aspect but should also take in to account the pet’s emotional happiness and social health (the ‘balanced triangle’ or ‘pyramid’ approach). And sequential Quality of Life assessments (along with the use of pain scales) may yet have another role in assessing efficacy and clinical progress when treatments and palliation are implemented.
Below we have listed some useful resources that are considerate of the overall picture and that you may wish to use. Sometimes it can be as simple as marking good days and bad days on a calendar.
We have also included some articles by the very wonderful Drs. Cherie T. Buisson and Andy Roark-proving that what you are feeling is normal and even veterinary professionals are not immune.
And finally a poem, ‘If it should be’ that still says it all better than checklists and tick boxes ever could.
Ohio State University ‘How do I know when it’s time?’ vet.osu.edu/vmc/sites/default/files/import/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf
Lap of Love Pet’s Quality of Life scale and Family Concerns lapoflove.com/Pet_Quality_of_Life_Scale_DrMcVety.pdf
Lap of Love Pet Quality of Life Scale and Daily Diary lapoflove.com/Pet_Quality_of_Life_Scale.pdf
Lap of Love Grey Muzzle Quality of Life calendar app https://www.lapoflove.com/Quality-of-Life/Grey-Muzzle
Dr Cherie T. Buisson drandyroark.com/the-quality-of-life-question-we-all-should-be-asking
Dr Andy Roark vetstreet.com/our-pet-experts/how-to-say-goodbye?page=2
‘If it should be…’ thehousevet.files.wordpress.com/2020/11/f235a-ifitshouldbe.pdf