This month, a dog owner reflects on making the difficult decision to stop diagnostic investigations
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What can help your approach
Caring for a sick pet has been shown to generate a significant ‘caregiver burden’ for pet owners. This Vet Record article provides information to help veterinarians to better understand client distress and handle it more effectively https://veterinaryrecord.bmj.com/content/181/12/321.
This In Practice piece provides useful information to help you guide your client to reach an informed decision https://inpractice.bmj.com/content/26/4/223.
Addressing client questions and concerns without judgement, and with empathy, can reduce the stress associated with making difficult decisions.
Ernie, my three-year-old cane corso, has been trouble since the day he came home with me. He had boundless energy, indescribable separation anxiety, a taste for plaster and woodwork, was predisposed to crashing through doors, had the ability to consume entire toys within minutes, was a rampant banana thief and occasionally used all 50 kg of himself to drag me down the road at speed. But, I can’t deny that he has been the most loving, protective and hilarious friend I’ve had.
So, when what I’d hoped was a thorn in his pad turned into a medical mystery, I was distraught. Ernie’s intermittent limp escalated to constant severe pain, weight loss, coughing and increasing lethargy. Then, in the blink of an eye, the insurance money was used up, and I was faced with having to balance not only financial but also ethical and emotional considerations.
Ernie was seen by a multitude of specialists, all of whom couldn’t come up with a diagnosis. The vets were keen to continue diagnostic testing, but with Ernie continuing to deteriorate, not tolerating his hospital stays well, no insurance money left and no idea what we were looking for I had some decisions to make.
Ernie’s case was obviously a particularly challenging one. I genuinely believed he was in the best hands, and under the care of some of the best minds in the country. However, I sometimes felt left out of key discussions around the thought processes regarding possible diagnoses.
While not a vet, I am a scientist (and a keen pet parent) and would have liked to be privy to any thoughts or ideas regarding his condition. I am aware that liability is an issue, and expectations do need to be managed, but the more information vets are willing or able to give to owners (bad news or good) the better, as this will empower owners to make decisions.
My best friend was suffering, his care was in my hands and that was a huge burden
All of the vets I had the pleasure of seeing were really lovely. They worked hard to try and explain their thought processes to me so I could make well-informed choices. Nevertheless, I felt helpless. My best friend was suffering, his care was in my hands and that responsibility was a huge burden.
I was concerned that my choice to stop investigations would not be supported, and I would have benefitted from knowing that this fear was mistaken. I wanted to hear that my position was understood – that I wouldn’t be the ‘bad owner’ I was worried they’d think I was.
I knew Ernie couldn’t make these choices for himself, but it took a long time before I realised that no one could make these choices for me. Despite being surrounded by fantastic vets and supportive friends, I felt so alone. I was the one living with and caring for Ernie day in and day out, I was the one who really knew his little nuances and I was the one who would know when I had done all that was fair.
A good friend once said to me ‘just because something is physically possible doesn’t mean it is ethically responsible’, and those words guided me when I needed it most.
Making the choice to stop investigations, and let a best friend go when the time is right, is one of the hardest decisions any pet owner will have to make. The – albeit unjustified – worry that I’d be judged for making the wrong choice was so intense, but it wasn’t really an issue that was ever addressed by the vets.
I felt like the stress that this situation causes an owner was forgotten. Vets are animal lovers too, and it would be helpful for the empathy that I know is there to shine through so they can support owners making these difficult choices.
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