Wednesday, November 28, 2012

Quality of Life Scale for Pets, or How Do You Know When It's Time?

Unfortunately, I recently had, for the 2nd time in a year, to make that horrible, gut-wrenching decision to send a beloved dog to the Rainbow Bridge. I will write about Boomer in another post, but I thought it might be helpful to point everyone to the quality of life scale that I used for both Emma and Boomer, when I had to make the decision for them.

If you have a pet in your life, you know that someday, you're probably going to have to decide when it's time for them to pass out of this life and into another. Sometimes, the pet is in pain, and perhaps the timing of the decision is not as difficult; other times, the pet is just old, and slowly losing the ability to do the things that he or she has enjoyed. Then the timing of the decision becomes very hard. Regardless of the situation, it is NEVER NEVER NEVER an easy decision to make. Having made it twice fairly recently, I can honestly tell you that I second-guessed my decision both times, although they were pretty different situations. And it's always painful. What a horrible responsibility - to have to decide when to end a pet's life. I personally would rather that my pets always die in their sleep, and therefore remove me from the equation. But it hasn't happened yet. If you own a pet, it's one of the many responsibilities you accept, but not one you often think about until too close to the end.

I have found a pet quality of life scale that is quite helpful in judging when it might be time. Of course, these things are completely subjective - each pet is different, and only you, the owner, can know how much joy your pet still gets out of the things he loves to do the most. If taking walks is really important to your dog, for example, the mobility question, in my opinion, becomes weighted more heavily than some of the other questions. If your pet loves to eat, then the hunger question is obviously an important one. So you have to answer these questions with your own pet in mind. I'll post it below. You can always search for it on Google with "pet quality of life scale for dogs."

The other rule of thumb I use is: is there any chance the pet will feel or get better? If the answer to that is no, then you have to decide if you want the pet to continue living as they are for more time. And if you think your pet isn't ready, I think it's only fair that you question if indeed your pet isn't ready, or if perhaps you're not ready. As much as we want to keep them alive, in the end, if they're suffering, that's selfish. You have to keep your pet's quality of life in mind, not yours. No one wants to lose a pet, but sometimes, it's the most loving thing you can do. You can send them off with dignity, and you can be there for them as they begin their journey.

The last thing I have done, when making this decision, is look into my dogs' eyes. With both Emma and Boomer, the light went out of their eyes a few days before I made the decision. They both seemed...tired. They were willing to do whatever I asked them - get up and go outside to potty, eat, and take their medecine dutifully. But neither of them seemed to have that spark that I see in Murphy's and Leeloo's eyes - you know, the "good morning, what are we doing today? I love you Momma" spark. Although both Emma and Boomer were still happy to see me, the tail wags were rare those last few days. I have pictures of Emma the day before we sent her to the Bridge, and she looks tired in those pictures, nothing like in any of her previous pictures. She looks like she was done with all of this silliness and was ready to go. I saw that in Boomer's eyes a few days before we made the decision.

Only you can know when the time is right, but just make sure you're keeping your pets' best interests at heart, not your own. It's the greatest gift we can give them, after having helped them live in this world, to send them to the next when they're ready to go. I have always heard of people who feel they've let their pet live too long when they should've said goodbye sooner. I've not yet heard of anyone who, looking back, thought they said goodbye too soon. I did a lot of soul-searching, especially with Emma, with that very question. Could I have done more? But in the end, I knew I made the right decision at the right time. She was ready, and so was Boomer.

I still tear up when I think of both Emma and (obviously, since I lost him only a few days ago) Boomer, and I probably always will. Each of our pets touches our hearts deeply and in so many different ways. I am blessed that I was able to share my life with them, and this was my way of expressing that gratitude.

The following quality of life scale has been really helpful for me. It is written by Dr. Alice Villalobos. You rank from a 1-10, with 1 being poor and 10 being great. Over 35, according to the scale, then your pet is probably still able to live a decent life. Less than 35, it might be time to start thinking of letting them go. Obviously, it's not cut and dried - if your dog ranks a 34, according to the scale, then their quality of life is compromised. But again, you have to take your own pet into account I think, and weigh the appropriate questions more or less heavily, depending on how important they are to YOUR pet. I hope you find it as helpful as I have, when the time comes.

Quality of Life Scale

By: Dr. Alice Villalobos


Quality of Life Scale1 The HHHHHMM Scale
Pet caregivers can use this Quality of Life Scale to determine the success of pawspice care. Score patients using a scale of 1 to 10.
Score
Criterion
H: 0 - 10 HURT - Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet's pain successfully managed? Is oxygen necessary?
H: 0 - 10HUNGER - Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?
H: 0 - 10HYDRATION - Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.
H: 0 - 10HYGIENE - The patient should be brushed and cleaned, particularly after elmination. Avoid pressure sores and keep all wounds clean.
H: 0 - 10HAPPINESS - Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet's bed be close to the family activities and not be isolated?
M: 0 - 10MOBILITY - Can the patient get up without assistance? Does the pet need human or mechanical help (e.g. a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)
M: 0 - 10MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.
*TOTAL=*A total >35 points is acceptable for a good pawspice

1.Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN,
09/2004,for Canine and Feline Geriatric Oncology Honoring the Human-Animal
Bond, by Blackwell Publishing, Table 10.1, released 2006.

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